Female Phys review Flashcards
what ages does FSH and LH spike?
2nd trimester of fetal development around 4-5 months of age small rise at puberty cyclically until menopause rises with menopause dt loss of neg feedback by E
Pituitary-ovary x-talk
- corpus luteum dies and E and P fall
- pit responds to loss of neg feedback -> increased FSH
- FSH recruits cohort of large antral follicles which secrete E and inhibin
- E and inhibin inhibit FSH secretion
- loss of FSH causes all but dominant follicle to die which then produces lots of E
- E switches to pos feedback get LH (and some FSH) surge
- LH surge induces metabolic maturation, ovulation, and luteinization and produces high P, E and inhibin
- high P, E, and inhibin inhibit LH and FSH
- corpus luteum become less sensitive to LH and dies unless there is an hCG rescue
stages of follicular development
primordial follicle -> primary follicle -> secondary preantral follicle -> small antral follicle -> large recruitable antral follicle -> dominant follicle
mural granulose cells
highly steriodogenic and differentiate into corpus luteum
cumulus cells
released with oocyte upon ovulation and faciliatate oocyte capture by oviduct
stages of gamete
oogonium -> primary oocyte arrested at prophase 1 -> shortly before ovulation oocyte completes meiosis I -> secondary oocyte arrested at metaphase II -> completes meiosis at fertilization
thecal cells
produce angrogen androstenedione
have low levels of 17beta hydroxysteroid dehydrogenase so produce very little T
follicular phase
FSH induces expression of LHR on mural granulosa cells
luteal phase
mural granulosa cells experience
- transient inhibition of CYP19 expression and E prodution turning off pos feedback
- vascularization of granulosa cells making cholesterol available for steroidogenesis
- expression of StAR proteins, CYPIIA1 and 3beta HSD -> Progesterone secretion
E effects on oviduct
increases endosalpinx epi size increases blood flow increases oviduct specific glycoproteins increases ciliogenesis increases mucus and muscular tone
P effects on oviduct
decrease epi size
deciliation
decrease mucus
relaxes mm tone
aa supply
uterine a -> arcuate a -> radial br -> splits into straight and spiral aa in basal zone -> spiral anatamous with venous lakes in functional zone
late menstrual phase is what days?
3-5
late proliferative phase is what days
10-13
early secretory is what days
15-18
late secretory is what days
22-25
which endometrial phases coincide with the ovarian follicular phase?
proliferative
days 0-14 when ovulation occurs
which endometrial phases coincide with ovarian luteal phase?
secretory (begins at ovulation) and menstrual
days 14-28
structure and fnx of cervix
- highly elastic lamina propria
- gateway to upper female tract
- during luteal phase passage of sperm is impeded d/t changes in endocervical canal
hormonal regulation of cervical mucus
E-> stimulates production of thin watery slightly alkaline mucus
P-> stimulates production of scant, viscous, slightly acidic mucus
P transport
bound to cortisol binding protein and albumin
fertilization is how may days after ovulation
1
blastocyst enters uterine cavity is how may days after ovulation
4
implantation is how may days after ovulation
5
trophoblast forms and attaches to endometrium is how may days after ovulation
6
trophoblast begins to secrete hCG is how may days after ovulation
8
HCG resuces corpus luteum is how may days after ovulation
10
limitations of placenta
cannot make adequate cholesterol
lacks enzymes for estrone and estradiol
lacks enzyme for etriol
what does the mother contribute for hormone synthesis
LDL cholesterol
what does the placenta contribute for hormone synthesis
3beta HSD
aromatase (P-450)
what does the fetus contribute for hormone synthesis
17alpha hydroxylase (for E1 and E2)
17,20 desmolase (E1 and E2)
16 alpha hydroxylase (E3)
P synthesis
mom give cholesterol to placenta which creates P for both mom and baby
E3 synthesis
mom gives chol to placenta which makes pregnolone -> converted to DHEA by fetus -> placenta converts to E3 for mom
hPL
human placental lactogen
aka hCS
structurally similar to GH and PRL
dectectable in moms blood at 3 weeks and continues to increase
fnx of hPL
antagonistic to insulin -> diabetogenic effect
increases glucose for fetus
stimuluates mammary growth and development
pituitary changes in pregnancy
2x increased size
ADH set point lowered
adrenal changes in pregnancy
cortisol and aldosterone levels rise
E stimulates activity RAAS
thyroid changes in pregnanacy
total T4 and T3 increase, but free T4 normal
TSH levels decrease in first trimester
CV changes in pregnancy
increased vascular volume decreased peripheral resistance increased SV increased HR increased contractility increased CO
respiratory changes in pregnancy
increased minute volume increased tidal volume decreased PCO2 decreased FRC decreased IRV respiratory alkalosis
renal changes in pregnancy
increased ADH and RAAS
increased GFR
stages of labor
strong uterine contractions
delivery of fetus
delivery of placenta
initiation of parturition
placental CRH E Oxy prostaglandins uterine size
endocrine changes after parturition
E and P falls close to 0, bc inhibited by prolactin
prolactin remains cyclical if mom breast feeds
