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UCSM-OBSTETRICS > Ch5-Implantation And Placental Development > Flashcards

Ch5-Implantation And Placental Development Flashcards

1
Q

average ovarian-endometrial cycle duration

A

28 days (25-32days)

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2
Q

OVARIAN CYCLE Phases

A

Follicular Phase 1-14 days

Luteal Phase 14-21 days

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3
Q

Corpus luteam produces these hormonal steroids which prepare endometrium for implantation

A

Estrogen and progesterone

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4
Q

Ovarian follicles are depleted until what age?

A

35 y.o.

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5
Q

Ovarian Cycle

A

Development of follicle

Ovulation

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6
Q

Uterine Cycle

A

Functional endometrium thickens and sheds

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7
Q

Ovulation

A

Release of OOCYTE from ovary

Occurs 14 days before the 1st day of menstruation or 14 days before the next cycle begins

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8
Q

Follicular phase (preovulatory phase)

A

Menstrual and proliferative phase

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9
Q

Luteal phase (postovulatory)

A

Secretory phase

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10
Q

After puberty, GnRH is released in..

A

PULSES

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11
Q

A follicle consists of

A
  1. Primary oocyte
  2. Granulosa cells
  3. Theca cells
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12
Q

Theca cells + LH

A

Androstenedione

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13
Q

Granulosa cell + FSH

A

Aromatase

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14
Q

Androstenedione is converted to Estrogen (17B Estradiol)

A

Aromatase

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15
Q

Group of antral follicles

A

Cohort

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16
Q

Androstenedione (______) –> Estrogen

A

Aromatase

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17
Q

After ovulation, the corpus luteum forms

A

Both theca and granulosa cells respond to LH

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18
Q

Granulosa cell + LH

A

Progesterone

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19
Q

important source of cholesterol for steroidogenesis

A

LDL

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20
Q

Follicle releases

A

Estrogen

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21
Q

Dominant follicles

A

Follicles with MOST FSH RECEPTORS

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22
Q

Estrogen (folicular phase)

A

Negative feedbak

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23
Q

Progesterone and Estrogen⭐️ (luteal phase)

A

Positive feedback

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24
Q

FSH and LH Surge

A

1) 1-2 days before ovulation
2) rupture of ovarian follicle
3) release of oocyte

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25
Q

Effects of ⬆️ Estrogen Levels in the Proliferative Phase of the Uterine(endometrial cycle)

A

1) thickening of endometrium
2) Growth of endometrial glands
3) Emergence of SPIRAL Arteries
4) change consistency of cervical mucus (for sperm)➡️ optimize chance of fertilization (Day 11-Day 15)

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26
Q

During the early folliclar phase, this can feedback of the pituitary to inhibit FSH release

A

Inhibin B

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27
Q

This drop in FSH levels is responsible for the failure of other follicles to reach preovulatory satus

A

The Graafian follicle stage

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28
Q

Selection of a dominant follicle

A

Graafian follicle stage

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29
Q

LH secretion peakes

A

10-12 hours before ovulation

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30
Q

How many hours does ovulation occurs before the ovum is released from the follice?

A

34-36 hours

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31
Q

During synthesis of matric, cumulus cells lose cntact with one another and move outward from the oocyte along the hyaluronan polymer

A

Expansion

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32
Q

Graafian follicle ➡️ Corpus luteum

A

Luteinization

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33
Q

Primary luteotropic factor responsible for corpus luteum maintenance

A

LH

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34
Q

can extend corpus luteum life span in normal women by 2 weeks

A

LH injections

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35
Q

Regression of the corpus luteum

A

Luteolysis

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36
Q

Corpus luteum will regress in the absence of pregnancy

A

9-11 days

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37
Q

Most important factor in endometria recovery following menstruation

A

Folliculr phase estradiol production

38
Q

Important to cessation of endometrial bleeding

A

Reepithelalization (epidermal growth factor and TGFa) and angiogenesis

39
Q

Uterine vessel ➡️ arcuate ➡️ myometrial ➡️ radial ➡️ basal ➡️ spiral A

A

Highlight of the secretory phase

40
Q

Secretory phase Day 17

A

Glycogen accumulates in the basal portion of glandular epithelium, creating subnuclear vacuolesand pseudostratification.

41
Q

Sceretory phase Day 18

A

Vacoules move to the apical portion of the secretory nonciliated cells

42
Q

Secretory phase Day 19

A

Sceretory nonciliated clls begin to secrete glycoprotein and mucopolysaccharide content into the gland lumen.

43
Q

Sceratory phase Day 21-24

A

Stroma becomes edematous

44
Q

Secretory phase Day 22-25

A

Stromal cells currounding the spiral arterioles begin to enlarge and stromal mitosis becomes apparent.

45
Q

Secretory phase Day 23-28

A

Predicidual cells surroud spiral arterioles

46
Q

window of implantation

A

Day 20-24

47
Q

Secretory phase Day 22 and 25

A

Secretory phase endometrium undergoes striking changes associated with predecidual transfomation of the upper two thirds of the functionalis layer.

48
Q

Ovarian progesterone production peaks during the midluteal phase

A

25-50 mg/d

49
Q

Secretory phase Day 19

A

Glandular cell mitosis ceases with secretory activity due to rising progesterone levelswhich antagonize the mitotic effects of estrogen.

50
Q

Key to both endometrial extraellular matric breakdown and repair of the functionalis layr

A

Leukocyte infiltration

51
Q

Ability of macrophages to assume phenotypes that vary from proinflammatory and phagocytic to immunosuppressive and reparative

A

Inflammatory tightrope

52
Q

Endometrial stromal and epithelial cells produce:

A

IL8, MCP-1, chemotactic activating factor for neutrophils

53
Q

Prostaglandins play a key role in the events leading to menstruation that include:

A

1) vasoconstriction
2) myometrial contractions
3) upregulation of proinflammatory responses

54
Q

Painful menstruation is caused by

A

Myometrial contractions and uterine ischemia

55
Q

Myometrial contractions and uterine ischemia

A

PGF2a induced spiral vasoconstriction

56
Q

COX2

A

Prostaglandin synthase 2

57
Q

COX2

A

Synthesize prostaglandins

58
Q

PGDH

A

15hydroxyprostaglandin dehydrogenase

59
Q

PGDH

A

Degrades prostaglandin after progesterone withdrawal

60
Q

Hemorchial placentation

A

Maternal blood contacts trophoblasts

61
Q

Transformation of proliferating endometrial stromal cells into specialized secretory cells

A

Decidualization

62
Q

Decidualization is dependent on

A

Estrogen, progesterone, androgens, and factors secreted by the implanting blastocyst.

63
Q

Decidua basalis

A

Decidua directly beneath blastocyst implantation is modified by triohoblast invasion

64
Q

Decidua capsularis

A

Overlies the enlarging blastocust and intially separates the conceptus form the rest of the uterine cavity.

65
Q

Most prominent during the secodmonth of pregnancy and consists of stromal decidual cells overed by a single layer of flattened epithelial cells

A

Decidua capsularis

66
Q

Avascular, extraembryonic fetal membrane

A

Chorion laeve

67
Q

Remainder of the uterus

A

Decidua parietalis

68
Q

The gestational sac also called the chorionic cavity is the

A

Extraembryonic coelom

69
Q

The expanding sac has enlarged to completely fill the uterine cavity

A

14-16 weeks AOG

70
Q

Resulting aposition of decidua capsularis and parietalis

A

Decidua vera

71
Q

Decidua parietalis and basalis are composedof three layers:

A

Zona compacta
Zona spongiosa
Zona basalis

72
Q

Zona compacta

A

Surface or compact zone

73
Q

Zona spongiosa

A

Middle portion or spongy zone

74
Q

Zona spongiosa

A

Remnant of glands and numerous blood vessels

75
Q

Zona basalis

A

Basal layer - remains fter delivery and gives rise to new endometrium.

76
Q

Smooth muscle wall

A

Respons to vasoactive agents

77
Q

Zone of fibrinoid degeneration in which invading trophoblasts meet the decidua basalis

A

Nitabuch layer

78
Q

Decidua basalis

A

Maternal portion of the placenta

79
Q

Decidua capsularis

A

Decidua that grows over the blastpcyst after implantation appearing as a cap like structure

80
Q

Decidua parietalis

A

Decidua lining the uterus elsewhere than at the site of implantation

81
Q

Zona functionalis

A

Zona compacta and spongiosa

82
Q

More superficial but inconsistent deposition of fibrin at the bottom of the intervillous space and surrounding the anchoring villi

A

Rohr stria

83
Q

Normal phenomenon in the first and second trimesters

A

Decidual necrosis

84
Q

Present in enormous amounts in amniotic fluid

A

Prolactin

85
Q

Source of prolactin

A

Decidua

86
Q

Produced only by synccytiotrophoblast

A

Placental lactogen (hPL)

87
Q

Prolactin levels in ammnionic fluid

A

10,000 ng/mL at 20-24 weeks AOG

88
Q

Fetal serum levels

A

350 ng/mL

89
Q

Maternal serum levels

A

150-200 ng/mL

90
Q

Decidual prolactin

A

Classic example of paracrin function between maternal and fetal tissues

UCSM-OBSTETRICS (4 decks)

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