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Semester 4 > deck_17174947 > Flashcards

deck_17174947 Flashcards

1
Q

WHAT ARE THE TWO CYCLE within the female reproductive cycle

A

1) OVARIAN CYCLE

2) UTERINE CYCLE (menstrual cycle)

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2
Q

1) Ovarian cycle =

A

Events that occur during & after OOCYTE MATURATION

Focused on the changes in the follicle
—> Follicular phase and luteal phase

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3
Q

what are the phases in the OVARIAN CYCLE

A

a) follicular phase

b) ovulation

c) luteal phase

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4
Q

2) UTERINE CYCLE (menstrual cycle) =

A

Changes in endometrium in preparation of fertilized ovum

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5
Q

Regulation of the ovarian AND Uterine cycles

how regulated?

A

controlled by cyclical changes in hormones

All coordinated by GnRH from the hypothalamus

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6
Q

are two cycles (ovarian and uterine) interdependent?

A

YES

The two cycles must operate synchronously for proper reproductive function

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7
Q

The regulation of the ovarian (AND UTERINE) cycle(s) begins with …

A

1) Begins with the release of gonadotropin-releasing hormone (GnRH)

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8
Q

where is GnRH released from?

A

From hypothalamus

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9
Q

what does GnRH cause?

A

Causes production and secretion of FSH

Causes production (not secretion) of LH

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10
Q

Cyclical rise in GnRH creates (OVARIAN) cycle

A

DAY 0 of ovarian cycle
= GnRH levels begin to rise

DAY 0 to DAY 14 (FOLLICULAR PHASE)
= GnRH levels rise steadily until just before day 14
—> GnRH causes LH/FSH levels to rise SUDDENLY (as opposed to gradual rise of GnRH)

after DAY 14, till DAY 28 (LUTEAL PHASE)
= GnRH levels gradually begin to decrease to levels at day 0
= LH & FSH sharp DECLINE shortly after sharp rise.
—-> LH/FSH back to previous decreased levels shortly after day 14

LH levels
in FOLLICULAR PHASE (day 0-14)
—-> LH levels are slightly above base level
—-> they gradually reduce (as tertiary follicles develop, FSH levels decline as a result of negative feedback effects of INHIBIN)

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11
Q

2) Follicular phase of the ovarian cycle

A

TERTIARY FOLLICLES are formed via FSH stimulation

(Follicular phase begins when FSH stimulates some follicles to become TERTIARY FOLLICLES)

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12
Q

how do FSH levels decline? (around day 14)

A

As (TERTIARY) follicles develop, FSH levels decline

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13
Q

What causes FSH to decline?

A

INHIBIN

(as a result of negative feedback effects of INHIBIN)

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14
Q

what do developing follicles secrete?

A

ESTROGENS

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15
Q

How is LH secretion regulated?

A

LOW LEVELS of estrogens INHIBIT LH SECRETION

Inhibition DECREASES as estrogen levels climb (released by developing follicles)

I.e.
ESTROGENS INCREASE LH SECRETION
(whereas GnRH is responsible for LH PRODUCTION)

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16
Q

estrogen and basal body temperature

A

Estrogen decreases basal body temperature about 0.3ºC (0.5ºF) lower than during the LUTEAL PHASE

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17
Q

in which phase does FSH (follicle stimulating hormone) stimulate follicles to become TERTIARY follicles?

A

FOLLICULAR PHASE

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18
Q

3) OVULATION (OVULATORY PHASE)

A

GnRH and elevated estrogen levels stimulate LH secretion

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19
Q

Massive surge in LH on or around day 14 triggers:

A

Completion of meiosis I by the primary oocyte

Forceful rupture of the follicular wall

Ovulation (~9 hours after LH peak)

Formation of CORPUS LUTEUM

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20
Q

when does luteal phase begin?

A

Luteal phase begins after ovulation
—> AROUND day 14

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21
Q

Mittelschmerz

A

pain from follicular swelling, ovarian wall rupture, small amount of blood leaking into pelvic cavity surrounding ovulation

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22
Q

4) Luteal phase of ovarian cycle

A

..

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23
Q

the CORPUS LUTEUM secretes …

A

PROGESTERONE

Corpus Luteum secretes PROGESTERONE

—> “Stimulates and sustains endometrial development”

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24
Q

as progesterone levels INCREASE, estrogen levels ____, which causes ____.

A

FALL

—> Suppresses GnRH

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25
Q

What happens if pregnancy does not occur at this stage?

A

corpus luteum lasts 2 weeks

stops secreting hormones & degenerates into CORPUS ALBICANS

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26
Q

What happens if pregnancy does occur at this stage?

A

Early cells of the placenta produces hCG (human chorionic gonadotropin)

it rescues corpus luteum to keep it alive & it continues secretory functions

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27
Q

RECAP of events during OVARIAN (& uterine) cycle

A

1) Release of GnRH
—> leads to production/secretion of FSH @ anterior pituitary
—> leads to PRODUCTION (not secretion) of LH @ anterior pituitary

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28
Q

FSH @ ovary causes

A

a) ovarian follicle development (tertiary follicle)

b) inhibin secretion (which causes FSH to decline = NEG FEEDBACK)

c) Estrogens secreted (causes LH secretion)

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29
Q

secreted LH causes ____ in ovary

A

a) Meiosis 1 completion

b) Ovulation

c) Corpus Luteum formation —> which secretes PROGESTERONE (which stimulates ENDOMETRIAL development)

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30
Q

high progesterone —> low estrogen

A

—> supresses GnRH

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31
Q

NOTE FOLLICLE STAGES DURING OVARIAN CYCLE

A

recall that FOLLICULAR phase begins when FSH stimulates some follicles to become TERTIARY FOLLICLES

FOLLICULAR PHASE = tertiary follicle development

@ day 14
= OVULATION
(Ovum released)

after day 14 (LUTEAL PHASE)
= corpus luteum formation
—> to mature corpus luteum
—> CORPUS ALBICANS forms if pregnancy DOES NOT occur

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32
Q

IF PREGNANCY DOES* OCCUR, which hormone is formed by which structure

A

EARLY CELLS OF PLACENTA PRODUCES hCG (human chorionic gonadotropin)

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33
Q

ovarian hormone levels during the ovarian cycle

A

at day 0
= estrogen > inhibin > progesterone
= all three levels low

towards day 14
= estrogen rises above the other 2
= inhibin also has slight rise (later, just before day 14)

RECALL:
FSH causes estrogen and inhibin to rise
—> inhibin the causes FSH to decline
—> estrogens decline occurs with Progesterone RISE

AFTER DAY 14:
= estrogen levels begin to DECLINE
= progesterone levels RISE with estrogen DECLINE

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34
Q

basal body temperature during ovarian cycle

A

slightly lower during FOLLICULAR PHASE of Ovarian cycle

small dip @ day 14

then rise slightly high during LUTEAL PHASE

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35
Q

ENDOMETRIAL CHANGES DURING UTERINE CYCLE

A

.. (will outline after slides on review of hormones)

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36
Q

Follicle Stimulating Hormone (FSH)

Source

A

ANTERIOR PITUITARY

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37
Q

FSH

Stimulation

A

GnRH stimulates FSH production/secretion

GnRH released from HYPOTHALAMUS

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38
Q

FSH

Inhibition

A

inhibin from granulosa cells and corpus luteum, estrogen

—> FSH stimulates INHIBIN, which inhibits FSH

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39
Q

FSH

function

A

initiates follicle growth

stimulates ovarian follicles to release ESTROGENS and INHIBIN

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40
Q

Luteinizing hormone (LH) is from

A

source: from Anterior Pituitary

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41
Q

LUTEINIZING hormone promotes formation of corpus LUTEUM

A

..

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42
Q

LH production is via ____ and secretion is via ____

A

stimulation: production by GnRH, secretion by ESTROGEN and GnRH

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43
Q

LH inhibition is via

A

inhibition: INHIBIN from granulosa cells and CORPUS LUTEUM

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44
Q

LH functions

A

functions:
—> triggers ovulation
—> promotes formation of corpus luteum
—> stimulates corpus luteum to produce ESTROGENS, PROGESTERONE, RELAXIN & INHIBIN

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45
Q

Estrogen is made from ____

A

cholesterol

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46
Q

estrogen, THREE types

A

estradiol, estrone, estriol

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47
Q

estrogen, source

A

granulosa cells, theca cells, then corpus luteum

48
Q

granulosa cells

A

“Granulosa cells are a type of cell in your ovaries that produce hormones including estrogen and progesterone. Hormones released from the base of your brain (anterior pituitary) control the numbers and function of granulosa cells.”

49
Q

theca cells

A

“Theca cells are the endocrine cells associated with ovarian follicles that play an essential role in fertility by producing the androgen substrate required for ovarian estrogen biosynthesis.”

50
Q

granulosa cells vs theca cells

A

“Granulosa lutein cells are closest to the central connective tissue core of the corpus luteum and produce progesterone. Theca lutein cells are smaller cells than the former with dark-staining nuclei.”

“These cells produce estrogen and are located peripherally between the folds of the granulosa lutein cells.”

51
Q

how are granulosa cells / theca cells related to CORPUS LUTEUM

A

“The surge also causes the luteinization of thecal and granulosa cells, forming the corpus luteum,”

—> somewhat related structures – the same? or in very close proximity?

52
Q

Estrogen, Stimulation? (what stimulates its release?)

A

via FSH/LH

53
Q

Estrogen function

A

Triggers SECRETION of LH (LH surge)

develop & maintain secondary sex characteristics
—> adipose deposit: breasts, hips, mons pubis
—> broad pelvis
—> hair growth on head, pubic, axillae

Increases PROTEIN ANABOLISM (?)

DECREASES osteoclast activity

54
Q

PROGESTERONE – made from?

A

Made from cholesterol

55
Q

progesterone – SOURCE

A

corpus luteum

56
Q

PROGESTERONE, stimulated via

A

VIA LH

57
Q

Progesterone – functions

A

prepares endometrium for implantation

prepares MAMMARY GLANDS for milk secretion

58
Q

INHIBIN Source

A

granulosa cells then corpus luteum (similar structures?)

59
Q

INHIBIN, stimulation

A

Stimulation: FSH and LH

60
Q

Inhibin, Functions

A

inhibits FSH & LH secretion

61
Q

Inhibin and estrogen from same source, but opposite effects ????

A

(granulosa cells / corpus luteum)

inhibin decrease LH secretion
estrogen increases LH secretion

62
Q

Relaxin – SOURCE

A

corpus luteum then placenta (if implantation occurs)

63
Q

Relaxin – STIMULATION is via

A

LH

64
Q

Relaxin function

A

RELAXES myometrium

RELAXES pubic symphysis (during pregnancy)

DILATES cervix (during pregnancy)

65
Q

Uterine cycle (menstrual cycle)

A

the uterine cycle is the changes in endometrium in preparation of fertilized ovum

66
Q

THREE phases of the uterine cycle

A

1) Menstruation (menses / “period”)

2) Proliferative phase

3) Secretory phase

67
Q

1) Menstruation (menses / “period”)

A

Day 1-7 (day 1 is the first day of bleeding)

68
Q

Uterine Changes during menstruation

A

DECREASE in prog. & estrogen = spiral arteries constrict & cells die

entire STRATUM FUNCTIONALIS sloughs off

2-5 mm of stratum basalis is left

69
Q

endometrium stratum functionalis

A

Endometrium: consists of a
—> thin base layer (stratum basalis)
—> and a thicker functional layer (stratum functionalis).

The stratum functionalis is a highly vascularized mucosal layer that undergoes monthly cyclical changes and is lost during menstruation.

70
Q

what happens in OVARIES during menstruation

A

FSH influences primordial follicles to develop into primary, then secondary follicles

can take several months, so a follicle that starts development at the beginning of a cycle, may not be mature until many months later

71
Q

2) Proliferative phase of uterine cycle

A

day 7-14, but variable

72
Q

uterine changes during proliferative phase of uterine cycle

A

estrogens from growing follicles build endometrium

—> stratum basalis undergoes mitosis to produce stratum functionalis

—> endometrial glands & arterioles grow & develop

73
Q

What happens in OVARIES during PROLIFERATIVE phase of uterine cycle?

A

secondary follicles in ovaries begin secreting estrogens & inhibin

usually dominant follicle becomes the mature follicle and enlarges until ready for ovulation
—> increases estrogen production

74
Q

3) SECRETORY PHASE of uterine cycle

A

day 15-28, but variable

75
Q

uterine changes during secretory phase of uterine cycle?

A

progesterone & estrogens from corpus luteum cause:
—> endometrial glands to grow & secrete glycogen
—> endometrium to vascularize (increase in spiral artery size) & thicken
—> uterus is ready for a fertilized ovum to arrive

76
Q

Secretory phase of uterine cycle if NO FERTILIZATION (pregnancy)

A

corpus luteum degenerates & progesterone & estrogen production declines and begins the menstrual phase

77
Q

what is happening in the OVARIES during the uterine cycle

A

LH promotes formation of CORPUS LUTEUM
—> stim by LH, corpus luteum secretes estrogens, progesterone, relaxin & inhibin

78
Q

if pregnancy does NOT occur?

A

corpus luteum lasts 2 weeks

stops secreting hormones & degenerates into CORPUS ALBICANS

79
Q

If pregnancy DOES occur?

A

Early cells of the placenta produces hCG

it rescues corpus luteum to keep it alive & it continues secretory functions

80
Q

Pregnancy and labour

A

…

81
Q

CLEAVAGE

A

Rapid division of cells to create multiple cells

Happens on the journey to the uterus

82
Q

cell cleavage ends with …

A

Ends with a BLASTOCYST

83
Q

Implantation of fertilized egg – starts @

A

Starts around day 7

Begins with the attachment of the blastocyst to the uterine endometrium

Blastocyst erodes endometrial lining and becomes enclosed within the endometrium by DAY 10

84
Q

how is PLACENTAL MEMBRANE formed?

A

Trophoblast cells invade (invade the blastocyst?) and become syncytiotrophoblasts

Eventually forms the placental membrane

85
Q

syncytiotrophoblast — etymology

A

syncytiotrophoblast (from the Greek ‘syn’- “together”; ‘cytio’- “of cells”; ‘tropho’- “nutrition”; ‘blast’- “bud”)

86
Q

how does embryo form?

A

Inner cell mass becomes embryo

“The syncytiotrophoblast is the epithelial covering of the highly vascular embryonic placental villi, which invades the wall of the uterus to establish nutrient circulation between the embryo and the mother.”

87
Q

implantation day 9

A

Around day 9, AMNIOTIC CAVITY forms

Filled with amniotic fluid
—> Protects and supports embryo

AMNIOCENTESIS is usually carried outbetween the 15th and 20th weeks of pregnancy

88
Q

around day 10

A

Around day 10, implantation finishes and the YOLK SAC forms

—> Site of early hematopoiesis from stem cells
(Week 3 – 8)

Gives nutrients to developing fetus prior to placental formation

89
Q

The PLACENTA

A

Fully formed and functional around week 12

Site of exchange between maternal blood and fetal blood

90
Q

placenta BLOOD SUPPLY

A

A) Umbilical arteries

B) Chorionic villi

C) Umbilical vein

91
Q

Umbilical arteries

A

—> Carry blood from the developing fetus to the placenta
—> Blood is deoxygenated and full of waste products

92
Q

Chorionic villi

A

Provide surface area for exchange of gases, nutrients, and wastes between fetal and maternal bloodstreams

93
Q

Umbilical Vein

A

—> Carries blood from the placenta to the fetus
—> Blood contains nutrients and oxygen

94
Q

Hormone production from PLACENTA

A

Human chorionic gonadotropin (hCG)
—> Maintains corpus luteum until about week 12

Human placental lactogen (hPL)
—> Helps prepare mammary glands for milk production

Relaxin
—> relaxes myometrium
—> relaxes pubic symphysis & dilates cervix during pregnancy

Estrogen and progesterone
—> Takes over progesterone production from corpus luteum at week 12 (Maintains uterine lining)
—> During third trimester, rising estrogen plays a role in stimulating labour and delivery

95
Q

how long does corpus luteum last during pregnancy?

A

“If you’re pregnant, your corpus luteum usually goes away around week 12, when the placenta starts making enough progesterone to keep the fetus healthy. If the egg doesn’t get fertilized, your corpus luteum usually goes away 10 days after the egg left your ovary.”

96
Q

MULTIPLE BIRTHS

A

Dizygotic (“fraternal”) twins

Monozygotic (“identical” or “maternal) twins

97
Q

Dizygotic (“fraternal”) twins

A

Develop when two separate oocytes are ovulated and fertilized

70 percent of twins are dizygotic

98
Q

Monozygotic (“identical” or “maternal) twins

A

Result from separation of blastomeres early in cleavage

Can also result when inner cell mass splits before gastrulation

Genetic makeup of twins is identical (both formed from the same set of gametes)

99
Q

Changes during pregnancy

A

Uterus ascends to the abdominal cavity

The abdominal contents displaced in response to the increased size of the uterus

100
Q

what GI issues are common?

A

GERD and increased urination are possible results

101
Q

pregnancy and cervix & mucus

(CERVICAL MUCUS PLUG)

A

enlarged mucus glands of the cervix duringpregnancy secrete a mucus, which forms a plug

—> acts as a seal for the uterus and protects it from ascending infection

102
Q

cervical mucus plug

A

A cervical mucus plug (operculum) is a plug that fills and seals the cervical canal during pregnancy.

It is formed by a small amount of cervical mucus that condenses to form a cervical mucus plug during pregnancy.

103
Q

operculum (cervical mucus plug) etymology

A

operire – to cover

operculum = lid, covering

104
Q

pregnancy and fluid retention

A

Fluid retention can compress nerves passing through narrow canals, such as the carpal tunnel, causing pain, numbness and weakness in the hand

105
Q

pregnancy and cardiac output

A

Cardiac output increases to meet increased demand

—> Up to 30-50% of baselinewhat does

106
Q

what does estrogen do to mediate rise in CO

A

estrogen mediates this rise in cardiac output by increasing the PRE-LOAD and STROKE VOLUME, mainly via a higher overall blood volume

107
Q

recall PRELOAD – heart

A

“Preload, also known as the left ventricular end-diastolic pressure (LVEDP), is the amount of ventricular stretch at the end of diastole”

108
Q

how much higher blood volume?

A

Up 40-50%

109
Q

heart rate during pregnancy?

A

The heart rate increases, but generally not above 100 beats/ minute

110
Q

pregnancy and diaphragm / thorax

A

Thediaphragmis elevated by about 4cm due to the enlarged uterus

Ligaments connecting ribs to sternum become lax during pregnancy
—> Leads to increased tidal volume (30-50%)

111
Q

recall tidal volume

A

Tidal volume is the amount of air that moves in or out of the lungs with each respiratory cycle.

112
Q

pregnancy and respiratory rate

A

respiratory rate more than normal

113
Q

note pregnancy and permanent increase in size of thorax

A

structural changes?

decreases elasticity and higher position of ribs?

increased size of costal cartilages?

both?

114
Q

pigmentation during pregnancy

A

Pigmentation changes occur during pregnancy include darkening of:

areola on the breasts
linea nigra
increased facial pigmentation

115
Q

pregnancy and striae

A

Stretch marks (striae gravidarum) occur on the abdomen, breasts, thighs and buttocks to varying degrees.

116
Q

pregnancy and breasts

A

enlargement under the influence of relaxin, progesterone and estrogen, prolactin, and hPL

—> Breast tenderness is common in the early stages of pregnancy

Montgomery’s tubercles developing from enlarging sebaceous glands around the areolar
—> Protect nipple from cracking

Semester 4 (30 decks)

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