ER 14+15

Question 1

role of the proper ovarian ligament?

Answer 1

attach the ovary to the uterus

Question 2

suspensory ligament?

broad ligament?

Answer 2

suspended in the pelvic cavity by this ligament

contains the ovarian vasculature and nerves

attached to the broad ligament by the mesovarium

Question 3

where in the uterine tube does fertilization take place

Answer 3

the ampulla

Question 4

uterine position?

alternative positions on fertility?

Answer 4

anteflexed (bent forward) and anteverted (turned forward)

other positions may negatively impact fertility

Question 5

role of the ligaments of the cervix?

Answer 5

anterior- pubocervical
lateral - transverse cervical
posterior - uterosacral

they support the uterus by acting as a stabilizer

Question 6

uterine prolapse?

Answer 6

due to loss of support by the ligaments and the levator ani

symptoms: 
sensation of fullness or pressure 
discomfort 
back or pelvic pain 
urinary or defecation symptoms

Question 7

Oogenesis

Answer 7

oogonia forms primary oocyte

primary oocyte is in prophase I of meiosis until puberty

after menarche primary oocytes mature every month

just before ovulation meiosis I is complete and secondary oocyte is in metaphase II at ovulation

meiosis is complete at fertilization

Question 8

follicular phase of ovary

Answer 8

under influence of FSH and LH

development of follicles

FSH = granulosa and theca cells

estrogen is the principle hormone

late follicular phase: 
increased progesterone 
LH surge 
small FSH increase 
ovulation

Question 9

primoridal follicle

Answer 9

most numerous and located just deep to the tunica albuginea

oocyte:
primary and in prophase I of meiosis
large nucleus

follicular cells:
single layer of squamous cells
surround oocyte

Question 10

Early primary follicle

Answer 10

oocyte enlarges
secretes an glycoprotein layer

zona pellucida:
made up of glycoproteins

follicular cells:
become cuboidal

Question 11

Late primary follicle

Answer 11

Zona pellucida:
becomes well defined
contains processes of granulosa cells and microvilli of oocyte

follicular cells:
multi-layered (stratum granulosum)
receptor for FSH
secrete aromatase and distinct BL

Theca folliculi:
theca interna- close to BM
receptor for LH
produce androgens

theca externa - less defined (SM and CT)

Question 12

secondary or antral follicle

Answer 12

oocyte:
no further growth
no longer centered

stratum granulosum:
6-12 layers of granulsa cells
appearance of antral spaces that contain liquor folliculi

theca layers are more defined

granulosa cells secrete:
hyaluronan and hormones
oocyte maturation inhibitor

Question 13

tertiary or mature or graafian follicle

Answer 13

oocyte:
becomes secondary oocyte

stratum granulosum:
single large crescent shaped antrum
have cumulus oophorus, corona radiata

theca layers are thick and defined

Question 14

role of theca and granulosa cells in the tertiary follicle

Answer 14

theca has LH receptors and stimulates androgen production

granulosa cells have FSH receptors and stimulates aromatase activity (androgens to estrogen)

Question 15

what occurs 24hr before ovulation?

Answer 15

surge in LH

smaller FSH increase

Question 16

ovulation?

Answer 16

desensitization of LH receptors
decreased estrogen production

secondary oocyte and surrounding granulosa cells are released from the ovary

failure of fertilization leads to oocyte degeneration

Question 17

luteal phase of ovary

Answer 17

begins after ovulation
formation of corpus luteum

progesterone is the principle hormone

LH maintains corpus luteum

corpus luteum will degenerate if not fertilized

Question 18

Corpus hemorrhagicum

Answer 18

after ovulation the follicle wall collapses

the follicle fills with blood from thecal A.

Question 19

CL of menstration vs CL of pregnancy

what hormones does the Cl release?

Answer 19

Cl of M = declines after 10 days

Cl of P = first weeks of pregnancy and then declines as placenta develops

inhibit LH and FSH to prevent development and ovulation of other follicles

prepares the uterus for implantation

Question 20

cells of the corpus luteum?

Answer 20

granulosa lutein cells:  
secrete progesterone, inhibin, and estrogen 
large cells 
theca lutein cells: 
secrete progesterone and androgens 
small cells

Question 21

corpus albicans

Answer 21

the corpus luteum degenerates and is replaced by fibrotic tissue or the corpus albicans

cells undergo apoptosis and are removed by macrophages

Question 22

Atretic follicle

Answer 22

follicle that degenerated by apoptosis

oocyte degenerates
zona pellucida is distorted

Question 23

cells of the uterine tubes

Answer 23

most cells are ciliated columnar epithelium

number of ciliated cells increases by estrogen

peg cells:
non-ciliated cells between the ciliated cells
these cells are increased by progesterone
secretes nutrients for the ovum

Question 24

cells of the uterus (endometrium) and layers?

Answer 24

simple columnar epithelium
simple tubular glands
high vascular

two layers:
stratum functionale: changes dramatically during menses
shed if pregnancy does not occur

stratum basale:
retained during menses
stem cells

Question 25

menstrual cycle

phases

Answer 25

proliferative phase:
under the influence of estrogen
stratum functionale thickens

secretory phase:
glands are under the influence of progesterone

menstrual phase:
glands degenerate
functional layer sheds
decrease in progesterone (10 days after)