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Physiology II > E2- Summary > Flashcards

E2- Summary Flashcards

1
Q

What is a “trophic” hormone

A

Hormone that regulates hormone secretion by another gland

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2
Q

What type of hormone regulates processes in neighboring cells?

A

Paracrine

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3
Q

What type of hormone regulates processes within the cell of origin without being secreted?

A

Intracrine

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4
Q

What type of hormone “acts back” to regulate processes within the cell of origin?

A

Autocrine

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5
Q

What type of hormone originates in the neuron, and after axonal transport, is carried distally either by a blood vessel or synaptic transmission?

A

Neurocrine

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6
Q

What type of hormones are derived from amino acids and account for the majority of hormones?

A

Peptide hormones

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7
Q

What type of hormones are derived from tyrosine and come from the adrenal medullae and thyroid gland?

A

Amine hormones

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8
Q

What type of hormones are derived from cholesterol and have a cyclopentanoperhydrophenanthrene ring?

A

Steroid hormones

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9
Q 
Follicle stimulating hormone
Thyroid stimulating hormone 
Luteinizing hormone (LH)
Human chorionic gonadotropin (hCG)
Are apart of what class of hormones?
A

Glycoproteins (peptide family)

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10
Q 
Aldosterone
Cortisol
Estradiol
Progesterone 
Estrogen
Testosterone
DHEA
Vitamin D
Are apart of what class of hormones?
A

Steroids

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11
Q 
Epinephrine
Norepinephrine
Dopamine
Thyroxine (T4)
Triiodothyronine (T3)
Are apart of what class of hormones?
A

Amines

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12
Q

What classes of hormones are hydrophilic and are transported dissolved in the blood stream?

A

Peptides and catecholamines

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13
Q

What classes of hormones are hydrophobic and are transported bound to binding proteins?

A

Thyroid and steroids

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14
Q

What is the precursor for peptide hormones?

A

Specific genes that direct mRNA

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15
Q

Are peptide hormones stored?

A

Yes, in granules

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16
Q

What is the precursor for catecholamines?

A

Tyrosine

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17
Q

Are catecholamines stored?

A

Yes, in granules

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18
Q

What is the precursor for thyroid hormones?

A

Tyrosine and iodine

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19
Q

Are thyroid hormones stores?

A

Yes, in follicular cells

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20
Q

What is the precursor of steroids?

A

Cholesterol

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21
Q

Are steroid hormones stored?

A

No

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22
Q

Synthesis of peptide hormones

The gene for a hormone is transcribed into a mRNA in what part of the cell?

A

Nucleus

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23
Q

Synthesis of peptide hormones

The mRNA binds amino acids into a peptide chain called a preprohormone in what part of the cell?

A

Endoplasmic reticulum

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24
Q

Synthesis of peptide hormones

The preprohormone is cleaved into a prohormone in what part of the cell?

A

Endoplasmic reticulum

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25
Q

Synthesis of peptide hormones

The prohormone is cleaved to become the hormone is what part of the cell?

A

Golgi apparatus

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26
Q

What type of hormones may undergo peripheral tissue conversion to increase their biologic activity or to change their class?

A

Steroids and amines

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27
Q

In the skin, the prohormone vitamin D3 is converted to what?

A

1,25-dihydroxyvitamin D3

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28
Q

In the testes, the prohormone testosterone is converted into what?

A

Dihydrotestosterone (DTH) or estradiol

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29
Q

In the thyroid, the prohormone thyroxine (T4) is converted into what?

A

Triiodothyronine (T3)

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30
Q

What type of hormone secretion mechanism is activated by blood born substrates above or below the set-point?

A

Humoral

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31
Q

What type of hormone secretion mechanism is an extension of the CNS that signals to the gland to secrete the hormone?

A

Neural

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32
Q

What type of hormone secretion mechanism relies on hypothalamic factors to stimulate the pituitary gland to secrete TSH, which then stimulates the endocrine gland to secrete thyroid hormone?

A

Hormonal

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33
Q

What are to hormones that have positive feedback regulation?

A

Estrogen and Oxytocin

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34
Q

What type of hormones bind to receptors/channels located on the outer cell membrane of the target cell?

A

Hydrophilic hormones

Peptides and catecholamines

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35
Q

What type of hormones diffuse through the lipid bilayer and bind to a nuclear receptor in the target cell?

A

Hydrophobic hormones

Steroids and thyroids

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36
Q

What can occur when hormone levels are too high to reduce the physiologic response of hormones?

A

Decrease in maximal response (increasing the hormone does not increase the max response)
Decrease in sensitivity (more hormone is requires to produce 50% of the max response)

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37
Q

Where are magnocellular neurons of the hypothalamus primarily located?

A

Paraventricular (PVN) and Supraoptic nuclei (SON)

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38
Q

Where do magnocellular neurons terminate? What hormones do they release?

A

Posterior pituitary

Oxytocin, ADH/AVP, neurophysin

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39
Q

What acts as the neruovascular link between the hypothalamus and the anterior pituitary?

A

Parvicellular neurons

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40
Q

Where do parvicellular neurons terminate? What hormones do they release?

A

Median eminence

CRH, TRH, GnRH, GHRH, SS, DA

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41
Q

Once parvicellular neurons release their hormones in the median eminence, the hormones flow down the pituitary stalk in the _______ to the ______ lobe of the pituitary.

A

Hypothalmo-hypophyseal portal vessels

Anterior

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42
Q

Hormones from the parivicellular neurons regulate the secretion of what hormones from the anterior pituitary?

A

ACTH, GH, TSH, prolactin, LH, FSH

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43
Q

Somatostatin decreases the synthesis of what hormones?

A

GH and TSH

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44
Q

Thyroid releasing hormone (TRH) stimulates the release of what hormone from the pituitary?
What effect does this hormone have in mammary glands?

A

Prolactin
Breast development
Milk production

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45
Q

Gonadotropin releasing hormone (GnRH) stimulates the release of what hormones from the pituitary?

A

LH

FSH

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46
Q

What effect does LH have in gonads?

A

Females: ovulation and synthesis of estrogen
Males: secretion of testosterone from leydig cells

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47
Q

What effect does FSH have in gonads?

A

Females: development of follicle

Males; initiates spermatogenesis

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48
Q

Corticotropin releasing hormone (CRH) stimulates the release of what hormone from the pituitary?
What effect does this hormone have in adrenal glands?

A

ACTH

Growth of the adrenal gland and synthesis of corticosteroids

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49
Q

Prolactin releasing factor (PRF) stimulates the release of what hormone from the pituitary?
What effect does this hormone have in mammary glands?

A

Prolactin
Breast development
Milk production

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50
Q

Prepro-oxyphysin is cleaved into ____ in the hypothalamus.

A

Pro-oxyphysin

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51
Q

Pro-oxyphysin is cleaved into ____ and ____ in the axon.

A

Oxytocin and Neurophysin I

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52
Q

Neurophysin I arranges into tetramers that bind ____ preventing it from diffusing out of the axon in the posterior pituitary.

A

Oxytocin

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53
Q

Prepro-pressophysin is cleaved into ____ in the hypothalamus.

A

Pro-pressophysin

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54
Q

Pro-pressophysin is cleaved into ____ and ____ in the axon.

A

ADH/AVP and Neurophysin II

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55
Q

Neurophysin II arranges into tetramers that bind ____ preventing it from diffusing out of the axon in the posterior pituitary.

A

ADH/AVP

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56
Q

AVP/ADH is released following an increase in what?

A 
Plasma osmolarity (dehydration) 
Osmoreceptors have direct contact with systemic circulation
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57
Q

Does release of AVP/ADH or thirst occur first?

A

Release of AVP/ADH

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58
Q

Does the osmoreceptor for magnocellular neurons have high or low sensitivity?

A

High

1% increase increase in osmolarity above the threshold produces an increase in ADP/AVP release

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59
Q

What are the overall homeostatic adjustments to dehydration?

A

AVP/ADH secretion
Water reabsorption (distal tubule, collecting duct)
Decreased urine output
Simulation of thirst

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60
Q

AVP/ADH is released following a decrease in what?

A

Blood volume or pressure

Decrease in BP decreases the stretch of baroreceptors and decreases their rate of firing

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61
Q

How does a decrease in the stretch of baroreceptors affect ADH/AVP?

A

Removes inhibition of AHD/AVP release, leading to an increase in ADH/AVP from magnocellular neurons
Baroreceptors also stimulate thirst centers
Decrease in BP is also perceived by the macula densa –> renin release

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62
Q

Does the stretch baroreceptor mechanism for magnocellular neurons have high or low sensitivity?

A

Lower sensitivity than the ADH/AVP system for osmolarity

8-10% decrease in blood volume/pressure below the threshold produces an increase in ADH/AVP release

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63
Q

Distention of the cervix, contraction of the uterus during parturition, or suckling of the nipple of the lactating breast transmit signals to the ___ and ___ where they provide ____ feedback for ____ release.

A

PVN and SON
Positive
Oxytocin

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64
Q

In addition to milk synthesis, suckling on a lactating breast, causes oxytocin to promote what?

A

Uterine regression

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65
Q

In a pregnant uterus, oxytocin causes what?

A

Rhythmic smooth muscle contractions to induce labor

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66
Q

The effects of oxytocin in the uterus are amplified by what?

A

An increase in receptors in uterine muscle

Increased gap junction formation between smooth muscle cells

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67
Q

The increase in oxytocin receptors in the uterus is mediated by what 2 hormones?

A

Oxytocin and progesterone

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68
Q

In the heart, oxytocin causes _____ release from ____.

A

ANP/BNP

Cardiomyocytes

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69
Q

Activation of peripheral aortic baroreceptors in response to stimuli (blood volume expansion, HTN) and integration within the nucleus tractus solitarius (NST) results in activation of what?

A

Oxytocin neurons (OTn)

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70
Q

What enhances the effect of oxytocin induced NO-dependent vasodilation?

A

Estrogen

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71
Q

What is the effect of oxytocin in the brain?

A

Decrease CRF (decreased cortisiol)

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72
Q

What is the effect of oxytocin in the heart?

A

Stimulates ANP release, which stimulates NO release from vascular endothelium to cause vasodilation to decrease BP

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73
Q

What is the effect of oxytocin in the kidney?

A

Increase urine output (increase diuresis)

Decrease aldosterone and renin production to cause vasodilation to decrease BP

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74
Q

In pre-diabetes, studies show that oxytocin increases peripheral glucose uptake via what?

A

GLUT4

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75
Q

What cell types are in the seminiferous tubules in the testes?

A

Germ cells

Sertoli cells

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76
Q

What cell types are in the connective tissue in the testes?

A

Leydig cells

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77
Q

What is the function of germ cells and sertoli cells in the seminiferous tubules in the testes?

A

Spermatogenesis

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78
Q

What is the function of leydig cells in the connective tissue in the testes?

A

Secrete testosterone

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79
Q

At puberty, some spermatogonia undergo ___ division to become _____.

A

Mitotic

primary spermatocytes

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80
Q

Each primary spermatocyte enters the _____ to become 2 secondary spermatocytes.

A

1st meiotic division

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81
Q

Each secondary spermatocyte enters the 2nd meiotic division to become what?

A

Spermatids

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82
Q

Developing sperm cells do not complete ____ during meiosis, therefore the 4 daughter cells form a _____.

A

Cytokinesis

Synctium

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83
Q

What ensures that haploid cells that contain either an X or Y chromosome, have access to all the gene products available in a complete diploid genome?

A

Synctium

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84
Q

Further maturation of the spermatids in the seminiferous tubule lumen creates what?

A

Spermatozoa

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85
Q

Which is the correct order of spermatogenesis?

  1. Spermatogonium –> Spermatogonia –> Primary spermatocyte –> Secondary spermatocyte –> Spermatids –> Spermatozoa
  2. Spermatozoa –> Spermatogonium –> Primary spermatocyte –> Secondary spermatocyte –> Spermatids –> Spermatogonia
A
  1. Spermatogonium –> Spermatogonia –> Primary spermatocyte –> Secondary spermatocyte –> Spermatids –> Spermatozoa
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86
Q

What establishes a blood-testes barrier, prevents immune cells from accessing genetically variant spermatoza and is needed for fertility?

A

Tight junctions between sertoli cells

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87
Q

What allows Y-sperm to transport necessary gene products to X-sperm?

A

Cytoplasmic bridges

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88
Q

What is the process by which spermatids are packaged and mature into spermatozoa?

A

Spermiogenesis

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89
Q

What is the process by which mature sperm are extruded from sertoli cells into the lumen of the seminiferous tubules?

A

Spermiation

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90
Q

Sperm pass through the ____ before entering the ______, the site for maturation

A

Rete testes

Epididymis

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91
Q

Pulsatile release of GnRH from the anterior pituitary stimulates the release of what two hormones?

A

FSH and LH

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92
Q

FSH stimulation in the testes causes the release of what?

A

Androgen-binding protein and inhibin release from sertoli cells

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93
Q

What is the function of inhibin in regards to hormone control of spermatogensis?

A

Negative feedback to FSH

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94
Q

What is the function of LH in the testes?

A

Promotes testosterone release from leydig cells

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95
Q

What is the function of testosterone in regards to hormone control of spermatogensis?

A

Negative feedback to FSH and LH

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96
Q

Testosterone can be converted to dihydrotestosterone (DTH) via what enzyme?

A

5a-reductase

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97
Q

Testosterone can be converted to estradiol via what enzyme?

A

Aromatase

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98
Q

Testosterone can be concentrated in the seminiferous tubules by binding to what?
Testosterone travels through the circulation bound to what?

A

Testosterone can be concentrated in the seminiferous tubules by binding to ABP
Testosterone travels through the circulation bound to sex-hormone binding globulin (SHBG)

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99
Q

Optimal spermatogenesis requires the action of ____ and ____ and the presence of adequate _____ cells.

A

Testosterone and FSH

sertoli cells

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100
Q 
Differentiation of epididymis, vas deferens, and seminal vesicles
Increased muscle mass
Pubertal growth spurt
Growth of penis seminal vesicles
Deepening of voice
Negative feedback on anterior pituitary
Libio 
Are affects of what hormone?
A

Testosterone

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101
Q 
Differentiation of penis, scrotum, and prostate
Male hair pattern
Sebaceous gland activity
Growth of prostate
Are affects of what hormone?
A

Dihydrotestosterone

*DTH is twice as potent as testosterone

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102
Q

What determines the rate of the spermatogenic cycle?

A

Rate is constant
Retinoic acid signaling within sertoli cells
(NOT accelerated by testosterone)

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103
Q

What determines the ultimate spermatogenic potential of the testes?

A

The number of sertoli cells that occur in development (sertoli cells cease proliferation at the end of puberty)

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104
Q

What is smaller than normal testicle size that results in low sperm counts?

A

Hypogonadism

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105
Q

What are some environmental factors that can cause oligozoospermia (< 15 million sperm/ml)?

A

Pollution
X-rays
Tobacco, alcohol, steroid use
Stress

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106
Q

What is the most widespread environmental factor producing oligozoospermia?

A

Interference with the ability of the scrotum to cool testes

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107
Q

What is undescended testes that are unable to produce viable sperm?

A

Cryptorchidism

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108
Q

What affect does marijuana have on sperm count?

A

Endocannabinoid receptors are present in the sperm and in the HPG axis
Decrease sperm count, alters morphology, and reduces activity
Suppressive effect of male sex hormones

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109
Q

What are 3 endocrine consequences to testosterone replacement therapy?

A

Reductions in LH and FSH through negative feedback
Reduced sperm production
Increase in free estrogen

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110
Q

What stimulates pubic and axial hair growth in men?

A

Dehydroepiandrosterone (DHEA)

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111
Q

Hair follicle miniaturation occurs with 5a-reductase conversion of testosterone to what?
What can be used to treat this?

A

DHT
Propecia (5a-reductase antagonist)
Can cause ED, loss of libido, reduced ejaculate

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112
Q

What produces 60% of the ejaculate while also adding fructose to nourish the sperm, prostaglandins to stimulate contractions in the reproductive tract, and clotting factors?

A

Seminal vesicles

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113
Q

What produces 20% of the ejaculate while also secreting alkaline fluid to counter the acidic vaginal environment and activate clotting factors?

A

Prostate

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114
Q

What produces 10% of the ejaculate while also adding lubrication fluid?

A

Bulburethral glands

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115
Q

What 2 physiologic responses allow for an erection?

A

Relaxation of the helicine arteries byEm NO to allow blood flow into cavernous spaces
Compression of the subtunical venules to decrease the venous return from the cavernous space

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116
Q

Upon sexual stimulation, the penis arterioles dilate by parasympathetic release of what?

A

NO

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117
Q

In the process of achieving an erection, the parasympathetic release of NO leads to the production of ___, thus lowering the intracellular Ca which promotes ___.

A

cGMP

Relaxation (allowing for increased blood flow)

118
Q

What is the integration site for the CNS control of erections?

A

Medial Preoptic Area (MPOA)

119
Q

The MPOA receives sensory input from the amygdala and sends impulses to where?

A

Paraventricular nuclei

Periaqueductal gray matter in the sacral spinal cord

120
Q

Tonic ____ stimulation results in a flaccid penis

A

Sympathetic

121
Q

In the flaccid state, blood flow into the penile tissue is limited by the contraction of what?

A

Helicine arteries and trabecular smooth muscle

122
Q

Ejaculatory emission occurs from SNS impulses from ___ and ___

A

L1 and L2

123
Q

What is the pathway of semen expulsion?

A

Seminiferous tubules —> Retes testes —> Epididymis—> Vas deferens –> ampulla –> urethra

124
Q

What occurs as a result of failure of the urethral sphincter, allowing the semen into the bladder?

A

Retrograde ejaculation

125
Q

What can be used to treat ED? How do they work?

What is a SE?

A

Phosphodiesterase inhibitors (PDE5)
“-afils”
Prevent cGMP degradation, leading to sustained NO levels
Activates PDE6 in the retina leading to vision changes

126
Q

How does a vasectomy work?

A

Vas deferens are cut
Sperm can no longer move through the ejaculatory tract
Sperm removed through phagocytosis

127
Q

Oogonia (2N) divide via ___into ___.

When does this occur?

A

Primary oocytes (2N)
Mitosis
Birth

128
Q

Primary oocytes are arrested in what phase?

Until when?

A

Arrested in prophase I of meiosis until just before ovulation

129
Q

In the follicular phase, ____ cells secrete a gel like substance that covers the oocyte called the _____.

A

Granulosa

Zona pellucida

130
Q

In the follicular phase, cuboidal ____ cells proliferate from ___ stimulation and outer most layers become stratified. The surrounding ovarian tissue differentiates into ____ cells.

A 
Granulosa 
FSH
Thecal cells
Inner cells = granulosa
Outer cells = theca cells
131
Q

In the follicular phase, ___ stimulation causes thecal cells to convert cholesterol to ___ via cholesterol desmolase

A

LH

Androstenedione (androgens)

132
Q

In the follicular phase, LH stimulation causes ___ cells to convert ___ to androstenedione (androgens) via ___

A

Thecal
Cholesterol
Cholesterol desmolase

133
Q

In the follicular phase, the androgens produced in the thecal cells diffuse into the ___ cells where upon ___ stimulation, they are converted to estradiol/estrogen via aromatase.

A

Granulosa

FSH

134
Q

In the follicular phase, the androgens produced in the thecal cells diffuse into the granulosa cells where upon FSH stimulation, they are converted to ___ via ___.

A

Estradiol/estrogen via aromatase.

135
Q

In the follicular phase, some of the estrogen produced by the granulosa cells is secreted into the blood and binds to proteins, but some remains in the follicle to contribute to what?

A

Antral formation

136
Q

In the follicular phase, one follicle usually grows more rapidly and matures about 14 days after onset of follicular development and is called what?
This follicle contain a ___ oocyte which has completed ____.

A

Graafian follicle
Secondary oocyte (N)
Meiosis I
(this occurs just before ovulation)

137
Q

The Graafian follicle ruptures by enzymatic digestion to release the oocyte, what is this event called?

A

Ovulation

138
Q

The released oocyte enters the ___ where it may or may not be fertilized.

A

Oviduct

139
Q

In the luteal phase, old follicular cells undergo structural transformation to form what?

A

Corpus luteum

140
Q

In the luteal phase, luteal cells enlarge and become ___ hormone producing tissues.
What is a nickname of the corpus luteum?

A

Cholesterol

“yellow body” due to storage of cholesterol

141
Q

In the luteal phase, if released oocyte is not fertilized and does not implant, corpus luteum degenerates within about 14 days and becomes what?
What is nick name of this structure?

A

Corpus albicans

“white body” due to fibrous tissue

142
Q

In the luteal phase, if fertilization and implantation do occur, the corpus luteum continues to grow and produce ___ and ___ and becomes the corpus luteum of pregnancy.. Sperm entry triggers what?

A

Estrogen and progesterone

Meiosis II

143
Q

In the luteal phase, theca and granulosa cells only secrete ___ after being converted into luteal cells

A

Progesterone

144
Q

GnRH is released in a pulsatile manner.
What gonadotrope is stimulated by a low pulse frequency of GnRH?
What gonadotrope is stimulated by a high pulse frequency of GnRH?

A 
Low = FSH
High = LH
145
Q

What are the 3 main functions of FSH in the follicular phase?

A

Stimulate proliferation of cuboidal granulosa cells
Stimulate granulosa cells to convert androgens to estrogen via aromatase
Induce inhibin release from ganulosa cells for negative feedback of FSH

146
Q

In the follicular phase what hormone has negative feedback on gonadotropes in general (FSH/LH)?

A

Estrogen

147
Q

Th high amounts of estrogen from FSH signaling in the follicular phase causes what?

A

Estrogen to have positive feedback

148
Q

What does estrogen positive feedback cause?

A 
LH surge 
(FSH does not rise as much due to inhibin)
149
Q

What are the effects of the LH surge? (5)

A
  1. Conversion of antral follicle to Graafian follicle
  2. Meiosis is resumed
  3. Production of proteolytic enzymes in follicle (digest follicle for ovulatory rupture)
  4. Increase prostaglandins
  5. Differentiates follicle cells into corpus luteum
150
Q

In the luteal phase, what hormone has negative feedback on the hypothalamus and pituitary, which suppresses the positive feedback of estrogen, therefore suppressing a second LH surge?

A

Progesterone

151
Q

What phase of the endometrial cycle occurs on days 0-4 and

discharges blood and endometrial debris from vagina?

A

Menstral phase

152
Q

Menses occurs __ days after ovulation, regardless of cycle length.
Therefore, cycles longer than 28 days have a longer ___ phase.

A

14

Proliferative (follicular)

153
Q

The menstrual phase of the endometrial cycle coincides with what phase of the ovarian cycle?

A

The end of ovarian luteal phase and onset of follicular phase

154
Q

The release of what hormone causes vasoconstriction of endometrial vessels which disrupts blood supply and results in the death of the endometrium?

A

Prostaglandins

155
Q

The release of what hormone stimulates mild rhythmic contractions of uterine myometrium which helps expel blood and endometrial debris from the uterine cavity to the vagina?

A

Prostaglandins

156
Q

What phase of the endometrial cycle occurs on days 5-14?

A

Proliferative phase

157
Q

The proliferative phase of the endometrial cycle begins concurrently with what part of the ovarian cycle?

A

Last portion of the ovarian follicular phase

158
Q

In the proliferative phase of the endometrial cycle, the endometrium starts to repair itself and proliferates under the influence of ____ from newly growing follicles.

A

Estrogen

159
Q

What phase of the endometrial cycle lasts from the end of menstruation to ovulation?

A

Estrogen-dominant proliferative phase

160
Q

What phase of the endometrial cycle occurs on days 15-28?

A

Secretory phase

161
Q

What phase of the endometrial cycle does the uterus enter after ovulation when the corpus luteum is formed?

A

Secretory phase

162
Q

Secretory phase of the endometrial cycle, progesterone from the corpus luteum converts the endometrium into what?

A

A highly vascularized, glycogen-filled tissue

163
Q

What hormone is responsible for the growth and development of the vagina, uterus, and oviducts?

A

Estrogen

164
Q

What is the effect of estrogen in the fallopian tubes?

A

Increases the number of cilia and their rate of beating, drawing the ovum into the tube

165
Q

What is the effect of estrogen in the myometrium of the uterus?

A

Increases oxytocin receptors and contractions

166
Q

What is the effect of estrogen in the endometrium of the uterus?

A

Thickens, increases permeability, and blood supply

*Synthesizes receptors for progesterone on uterine cells

167
Q

What is the effect of estrogen in the cervix?

A

Makes mucous thin, watery, and alkaline

Increases distensibility, making birth easier

168
Q

What is the effect of estrogen in the vagina?

A

Proliferation of epithelial layer

Increases vaginal secretions

169
Q

What is the effect of estrogen in the mammary glands?

A

Increases ductal growth and growth of the breast

Increases nipple size and pigmentation

170
Q

What is the effect of estrogen in the body?

A

Increased deposit of subcutaneous fat (hips/breasts)

171
Q

What is the effect of estrogen in the skeletal system/Ca metabolism?

A

Epiphyseal closure

Calcium uptake into bone

172
Q

What is the effect of estrogen in the skin?

A

Inhibits body and facial hair growth (except pubic and axillary)
Promotes pubic and axially hair growth

173
Q

What is the effect of estrogen in the kidney?

A

Increases absorption of Na, Cl, and H2O

Contributes to bloating during menstrual cycle

174
Q

What is the effect of estrogen in the heart?

A

Maintains low blood cholesterol
Arterial vasodilator
Decreases atherosclerosis

175
Q

What hormone is responsible for implantation of the zygote and the maintenance of the pregnant state?

A

Progesterone

176
Q

What is the effect of progesterone in the uterus?

A

*Needs estrogen prior to stimulation
Converts uterus into an actively secreting tissue
Induces decidua formation (placenta)
Decreases contractility

177
Q

What is the effect of progesterone in the cervix?

A

Decreases distensibility

Makes mucous thick and acidic

178
Q

What is the effect of progesterone in the vagina?

A

Decreases proliferation of epithelium layer

179
Q

What is the effect of progesterone in the mammary glands?

A

Increases branching of the ductal system

Stimulates development of lobules and alveoli

180
Q

What is the effect of progesterone in the body?

A

Increases temperature following ovulation (indication that ovulation has occurred)
Increases appetite

181
Q

What is the effect of progesterone in the kidney?

A

Decreases Na reabsorption by competing with aldosterone

182
Q

What causes menstrual cramps?

What is severe pain combined with nausea, vomiting, and diarrhea called?

A

Contraction of the uterus caused by increased prostaglandins

Dysmenorrhea

183
Q

What phase of the ovarian cycle is PMS associated with?

A

Luteal phase

184
Q

What is defined by a decline in fertility associated with a decline in ovarian function, FSH > 30 mlU/mL and no menses for 12 mo in women of typical age range?

A

Menopause

185
Q

In the first step of menopause, there is a decrease in the follicle pool which leads to what?

A

Decreased Inhibin –> Increased FSH –> Acceleration of follicular maturation –> Shorter cycle

186
Q

In the second step of menopause there is a further decrease in the follicular pool which leads to what?

A

Decreased estrogen –> Delayed positive feedback –> Longer cycle
Insufficient estrogen –> No positive feedback –> Anovulatory

187
Q

In the third step of menopause there is a lack of estrogen which leads to what?

A

Increased LH and FSH

Cycle arrest

188
Q 
Hot flashes
Urogenital atrophy
Cognitive function 
Increased risk of Alzheimer’s disease
Osteoporosis
Cardiovascular disease
Are all what?
A

Clinical concerns of menopause

189
Q

How does a tubectomy work?

A

Fallopian tubes are cut

Prevents eggs from reaching the uterus for fertilization

190
Q

What is the MOA of hormonal contraceptives?

A

Prevents ovulation by negative feedback on the anterior pituitary, preventing LH surge

191
Q

The combination of sex chromosomes at the time of conception determined what?

A

Genetic sex

192
Q

Whether testes or ovaries develop and the presence or absence of a Y chromosome determines what?

A

Gonadal sex

193
Q

The presence or absence of masculinizing hormones and the apparent anatomic sex determines what?

A

Phenotypic sex

194
Q

The sex-determining region of the Y chromosome (SRY) codes for the production of what?

A

Testis-determining factor (TDF)

195
Q

Testis-determining factor (TDF) directs the differentiation of gonads into what?

A

Testes

196
Q

Testes secrete ___ from leydig cells and ___ from sertoli cells.

A

Testosterone from leydig cells

Mullerian-inhibiting factor from sertoli cells

197
Q

Mullerian-inhibiting factor causes secreted from the sertoli cells, causes what?

A

Degeneration of Mullerian ducts

198
Q

Testosterone secreted from leydig cells is converted to dihydrotestosterone (DTH) via what?

A

5-a reductase

199
Q

DTH promotes the development of undifferentiated external genitalia into what?

A

Male external genitalia (penis, scrotum)

200
Q

The absence of what causes the development of female external genitalia?

A

DTH

201
Q

Testosterone secreted from leydig cells transforms what into male reproductive tract (epididymis, ductus deferens, ejaculatory duct, seminal vesicles)?

A

Wolffian ducts

202
Q

What is required what ovarian development?

A

Two functional X chromosomes

203
Q

After an embryo has been made with 2 functional XX chromosomes, what is the next step in sexual differentiation?

A

There is no Y chromosome present, so there is no SRY gene to code for TDF
With no TDF, undifferentiated gonads develop into ovaries
(hormone independent process)

204
Q

In the process of female sex differentiation, there is no development of testes and therefore no secretion of what?

A

Testosterone (from Leydig cells)

Mullerian-inhibiting factor (from Sertoli cells)

205
Q

In the process of female sex differentiation, the absence of testosterone leads to what?

A

Degeneration of Wolffian ducts
Development of female external genitalia (clitoris, labia)
(hormone independent process)

206
Q

In the process of female sex differentiation, the absence of Mullerian-inhibiting factor leads to what?

A

Development of Mullerian ducts into female reproductive tract (oviducts, uterus)
(hormone independent process)

207
Q 
15 yr old girls presents with standard breast development, an appropriately timed growth spurt, and amenorrhea. She has female external genitalia with a shortened vagina that ends in a blind pouch w/o a cervix. There are bilateral inguinal masses.  
Testosterone: high
DTH: normal
FSH and inhibin: normal
LH: high
AMH: high
Chromosome: 46 XY
Biopsy:  absence of binding affinity of testosterone to androgen receptors 
What is her dx?
A

Complete Androgen Insensitivity Syndrome

XY
Presence of testes
Secretion of AMH and testosterone
AMH causes degeneration of mullerian ducts
Loss of function of testosterone receptors cause the degeneration of the wolffian duct and the development of female external genitalia

208
Q

What are the 3 testes cell types?

A 
Germ cells (spermatogonia)
Sertoli cells (produce antimullerian hormone)
Leydig cells (produce testosterone)
209
Q

What are the 3 ovary cell types?

A 
Germ cells (oogonia)
Granulosa cells (produce estradiol)
Theca cells (produce androgens and progesterone)
210
Q

XY Individuals lacking SRY gene are defined by what?

A

No gonads

Develop as female

211
Q

XX individuals with SRY translocation are defined by what?

A

Testes

Develop as male

212
Q

XY individuals with defective antimullerian hormone production or action are defined by what?

A

Testes
Both male and female internal reproductive tracts develop
Male external genitalia

213
Q

Individuals with a 5-a reductase deficiency are defined by what?

A 
Testes
Male internal reproductive tract
Female external genitalia
Male pseudohemaphrotidism 
Large clitoris at birth that develops into a penis at puberty due to the increase in testosterone
214
Q

When does puberty begin for boys?

When does puberty begin for girls?

A

8-13 for girls

9-14 for boys

215
Q

What is characterized by maturation of the hypothalamic-pituitary-gonadal axis, appearance of secondary sex characteristics, acceleration of growth, and capacity for fertilization?

A

Puberty

216
Q

There are transient peaks in gonadotropins (LH, FSH) during gestation and early infancy and then ___ levels in childhood

A

Low

217
Q

After puberty, women develop monthly cyclic bursts, with __ concentrations exceeding __ concentrations.

A

LH>FSH

218
Q

Both genders show increased gonadotropin production after 50 years of age, with __ exceeding __ levels.

A

FSH>LH

219
Q

What marks the start of puberty in boys?

A

Increase in testicular size (gonadarche)

220
Q

`At what age is sperm production and ejaculatory capability developed?

A

13.5-13.7 years old

221
Q

What marks the start of puberty in girls?

A

Thelarche (breast development)

222
Q

At what age does menarche usually occur? What is unique about the first few cycles?

A

By age 13

No ovulation for the first few cycles because there is no positive feedback by estrogen

223
Q

What hormone promotes epiphyseal fusion in both genders?

A

Estrogen

Longer time to reach puberty accounts for most of the difference in stature

224
Q

What hypothesis suggest that puberty timing is based on the reduction in intrinsic suppression of GnRH, leading to reactivation of gonadotropin synthesis and secretion?

A

Hypothalamic Maturation hypothesis

225
Q

What hypothesis suggest that puberty timing is based on decreased sensitivity to the negative feedback of estrogen (females) or testosterone (males), leading to reactivation of gonadotropin synthesis and secretion?

A

Gonadostat hypothesis

226
Q

One factor that influences pubertal timing is the increase in pulsatile release of ___ leading to an increased ratio of___ that correlates with the onset of puberty

A

GnRH
LH/FSH
First occurs in sleep

227
Q

What is leptin theory for pubertal timing?

A

A metabolic signal from adipose tissue may control onset of sexual maturation
Leptin (product of obese gene)

228
Q

What is the melatonin theory for pubertal timing?

A

Melatonin inhibits GnRH release
Melanin is secreted from the pineal gland, so puberty may be initiated by a reduction in melatonin secretion with the removal of the pineal gland that precipitates puberty

229
Q

What is defined as the development of secondary sexual characteristics before age 8 in boys or age 9 in girls?

A

Precocious puberty

230
Q

What is seen with Gonadotropin-dependent precocious puberty?

A

Increased gonadotropins (LH, FSH)
Increased gonadal hormones (estrogen, testosterone)
CNS tumors

231
Q

What is seen with Gonadotropin-independent precocious puberty?

A 
Normal gonadotropins (LH, FSH)
Increased gonadal hormones (estrogen, testosterone)
232
Q

What is defined as the lack of physical maturation 2 SD beyond the mean onset?

A

Delayed puberty

233
Q

17 year old boy with no physical signs of puberty presents with deficiency of pulsatile release of gonadotropins from pituitary that results in low levels of gonadal hormones. He has no signs of anosmia and does not respond to a GnRH injection
What do you suspect?

A

Idiopathic Hypogonadotropic Hypogonadism

low gonadotropins (LH, FSH) result in low gonadal hormones

234
Q

17 year old boy with no physical signs of puberty presents with deficiency of pulsatile release of gonadotropins from pituitary that results in low levels of gonadal hormones. He has signs of anosmia and responds to a GnRH injection
What do you suspect?

A

Kallman’s Syndrome

235
Q

17 yr old girl presents with no signs of physical puberty and amenorrhea. PE shows female genital tract, but no functional gonads. What do you suspect?

A

Turner’s syndrome (XO)

Primary gonadal failure

236
Q

What is the most common cause of primary testicular failure?

A

Klinefelter’s Syndrome (47, XXY)

237
Q

What are 2 types of Hypergonadotropic Hypogonadism?

A

Turner’s Syndrome (XO)

Klinefelter’s Syndrome (47, XXY)

238
Q

What are 2 types of Hypogonadotropic Hypogonadism?

A

Idiopathic Hypogonadotropic Hypogonadism

Kallman’s Syndrome

239
Q

17 year old male patients presents with feminization and testicular failure due to lack of negative feedback. What do you suspect?

A

Klinefelter’s Syndrome (47, XXY)

low gonadal hormones (estrogen, testosterone) result in high gonadotropins (estrogen, testosterone

240
Q

What are complications of Klinefelter’s Syndrome?

A

Germ cell tumors, breast cancer, osteoporosis

241
Q

Where is the site of fertilization

A

Upper third of oviduct (ampulla)

242
Q

What is released by mature eggs and acts a chemoattractant for sperm to reach egg in ampulla of oviduct?

A

Allurin

243
Q

Sperm transport is assisted myometrial contractions, which are stimulated by what?

A

Prostaglandins in the ejaculate

244
Q

Upon sperm passage through female reproductive tract, what occurs?

A

Capacitation (activation) occurs

245
Q

What process gives the sperm the ability to fertilize eggs?

A

Capacitation

246
Q

What three things occur in the process of Capacitation?

A

Cholesterol is withdrawn
Surface proteins are redistributed
Calcium influx
(Increases motility –>whiplashing)

247
Q

Capacitated sperm penetrate the corona radiata and bind to ___ proteins on the ____.

A

ZP3 proteins

Zona pellucida

248
Q

The binding of the sperm to the ZP3 proteins on the zona pellucida triggers what?

A

The acrosomal reaction

249
Q

During the acrosomal reaction, ___ is released from the acrosome and digests the ___, creating a pathway to the plasma membrane of the ovum.

A

Acrosin (hydrolytic enzyme)

Zona pellucida

250
Q

When the sperm reaches the ovum, the ___ of the 2 cells fuse.

A

Plasma membrane

251
Q

The fusion of the sperm and ovum plasma membrane is mediated by what?

A

The binding of fertilin on the sperm head to an integrin receptor on the ovum’s membrane

252
Q

The sperm stimulates release of enzymes stored in the ___ in the ovum, which in turn inactives ___ proteins and ___ the zona pellica.
What does this prevent?

A

ZP3 proteins
Cortical granules
Hardens
Polyspermy

253
Q

What occurs after the completion of the zona reaction?

A

Signals ovum to complete the 2nd meiotic division

254
Q

The fertilized ovum divides by ___. Within a week it grows into a ___ capable of implantation.

A

Mitosis

blastocyst

255
Q

The blastocyst adheres to the endometrial lining and ___ cells penetrate the endothelium to accomplish implantation.

A

Cords of trophoblastic

256
Q

Because of what hormone are days 20-24 of a regular 28 cycle are the optimal period for implantation?

A

Progesterone

257
Q

hCG in maternal serum is only detectable after ___ is complete (8-11 days after conception)

A

Implantation

258
Q

Placental hcG rescues what?

A

The corpus leuteum

259
Q

What is responsible for:
Exchange between maternal and fetal blood
Performs the functions of the digestive system, the respiratory system, and they kidneys for the fetus
Prevents immunologic rejection
Acts as transient endocrine organ that secretes essential pregnancy hormones?

A

Placenta (operational 5 weeks after implantation)

260
Q

What hormones the placenta secrete?

A

hCG
Estrogen
Progesterone

261
Q

What maintains the corpus luteum until the placenta take over the last 2 trimesters?

A

hCG

When the placenta begins to secrete estrogen and progesterone, the hCG levels decline and the corpus luteum regresses

262
Q

Does estrogen or progesterone synthesis require both the fetus and the placenta for synthesis?

A

Estrogen

263
Q

In the synthesis of estrogen by the placenta, cholesterol (placenta) is converted to _____ (placenta), which then enters the fetus.

A

Pregnenolonen

264
Q

In the synthesis of estrogen by the placenta, Pregnenolonen (fetus), is converted into ____ (fetus), via the fetal adrenal gland.

A

DHEA-sulfate

265
Q

In the synthesis of estrogen by the placenta, DHEA-sulfate (fetus), is converted into ____ (fetus), via the fetal liver; which then enters the placenta.

A

16-OH DHEA-sulfate

266
Q

In the synthesis of estrogen by the placenta, 16-OH DHEA-sulfate (mother), is converted to ____ (mother) via aromatase or sulfatase.

A

Estriol

267
Q

What is the sequence of synthesis of estrogen by the placenta?

A

Cholesterol –> pregnenolone –>DHEA-sulfate –> 16-OH DHEA-sulfate –> Estriol

268
Q

In the synthesis of progesterone by the placenta, cholesterol (mother), is converted to ____(mother).

A

Pregneolone

269
Q

In the synthesis of progesterone by the placenta, pregneolone (mother), is converted to ____(mother).

A

Progesterone

270
Q

What pregnancy hormone inhibits myometrial contractions and prostaglandin synthesis?

A

Progesterone

271
Q

In the first 2 trimesters, the uterus is quiet due to progesterone.
In the last trimester, the uterus becomes progressively more excitable. What are these early contractions called?

A

Braxton-Hicks contractions`

272
Q

What hormone produced by corpus luteum and the placenta, relaxes the pelvic ligaments and softens the cervix by loosening the connective tissue between pelvic bones?

A

Relaxin

273
Q

What are the 3 roles of high estrogen levels in labor induction?

A
  1. Synthesis of connexons for gap junctions –> coordinated contraction
  2. Increase concentration of myometrial receptors for oxytocin –> increase responsiveness to oxytocin
  3. Increase production of prostaglandins –> cervical ripening and increase response to oxytocin
274
Q

What causes the uterine responsiveness to oxytocin to be greater at term than in nonpregnant women?

A

Even though circulating blood levels of oxytocin remains constant, there is a profound effect of oxytocin at term due to the increased concentration of myometrial oxytocin receptors

275
Q

What initiates labor?

A

Labor is initiated when the oxytocin receptor concentration reaches a critical threshold that permits the onset of strong, coordinated contractions

276
Q

What is the role of Corticotrophin-releasing hormone (CRH) in labor induction?

A
  1. Fetal portion of placental secretes CRH into the fetal circulation, which results in increased fetal ACTH
  2. ACTH stimulates the fetal adrenal cortex to make DHEA and fetal cortisol
  3. DHEA –> estrogen
  4. Cortisol –> fetal lung maturation
277
Q

What hormone acts as a placental clock for timing parturition?

A

Corticotrophin-releasing hormone (CRH)
High: premature delivery
Low: late delivery

278
Q

Uterine stretching (especially with multiple pregnancies), increased production of macrophages from pulmonary surfactant, bacterial infection, and allergic reactions activates what in the uterus?

A

NF-kB (nuclear factor)

279
Q

NF-kB (nuclear factor) stimulates the production of ___ and ___, which promote cervical softening.

A

Cytokines (IL-8) and prostaglandins

280
Q

What positive-feedback cycle progressively increases until cervical dilation and delivery are complete?

A

Baby’s head stretches the cervix –> excites fundic contraction –> pushes baby down –> stretches the cervix

281
Q

What is a pharmacologic synthetic form of oxytocin that can be used to induce labor?

A

Pitocin

282
Q

Why does lactation not occur during pregnancy?

A

Inhibition from estrogen and progesterone
After parturition, estrogen and progesterone decrease, so lactation can occur
(they promote development of during gestation; Estrogen-ductal grown, Progesterone-lobules and alveoli)

283
Q

What is the nervous pathway of the sucking reflex?

A

Posterior pituitary –> increase oxytocin –> contraction of myoepithelial cells surrounding alveoli –> milk ejection

(can be stimulated by infants cry/smell or inhibited by stress)

284
Q

What is the prolactin pathway of the sucking reflex?

A

Anterior pituitary –> increase prolactin –> secretion by alveolar epithelial cells –> milk secretion/production

285
Q

What 2 hormones control the release of prolactin?

A

Thyrotropin-relasing hormone (stimulatory)

Dopamine (inhibitory)

286
Q

What hormone acts as a natural contraceptive during regular breast feeding? How?

A

Prolactin

Inhibits GnRh release preventing ovulation

287
Q

28 year old female patient prevents with pelvic pain, heavy menses, and pain during intercourse. PE shows evidence of ovarian cysts and infertility. What do you suspect?

A

Endometriosis

288
Q

28 year old female patient prevents with irregular heavy menses, dark coarse hair on her face and chest, persistence acne, and difficulty becoming pregnant.
US shows ovarian enlargement with 20 follicles.
Blood test shows elevated LH/FSH ratio and testosterone. What do you suspect?

A

Polycystic ovarian syndrome
(Stein-Leventhal Syndrome)
Irreggular/anovulation

Genetic predisposition to excess androgen secretion
Affected by dietary factors

289
Q

Newborn girl presents with an enlarged clitoris.
PE: vagina and labial folds, no inguinal masses
US: ovaries and uterus, no testes
Blood tests: Elevated ACTH, 17-ketosteroid, and testosterone
Karyotype: 46XX
What do you suspect?

A

Congenital Adrenal Hyperplasia
21-hydroxylase deficiency (Virilized XX)

Most common cause of genital ambiguity and can lead to life-threating adrenal insufficiency within the first weeks of life

290
Q

What is the pathophysiology behind Congenital Adrenal Hyperplasia/21-hydroxylase deficiency?

A

Reduced cortisol –> Increased ACTH –> adrenal hyperplasia –> increased progesterone precursors are converted to testosterone

291
Q

Why would high testosterone decrease male fertility?

A

Testosterone inhibits the release of gonadotropins

Physiology II (3 decks)

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