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female physiology Flashcards

1
Q

female hormones

A
  1. estrogen

2. progesterone

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2
Q

estrogen - source

A
  1. ovary (17β-estradiol)
  2. placenta (estriol)
  3. adipose tissue (estrone via aromatization)
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3
Q

adipose produce … (estrogen) via …

A

estrone via aromatization

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4
Q

estrogen hormones - potency (from most potent to least)

A
  1. estradiol
  2. estrone
  3. estriol
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5
Q

estrogen hormones - function

A
  1. development of genitalia and breast
  2. female fat distribution
  3. growth of follicle
  4. increase myometrial excitability
  5. increase transport proteins, SHBG
  6. increase HDL
  7. decrease LDL
  8. effects on other hormones
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6
Q

estrogen hormones - effects on other hormones

A
  1. uperegulation of estrogen, LH, progesterone receptors
  2. feedback inhibition of FSH and LH
  3. LH surge
  4. stimulation of prolactin secretion
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7
Q

estrogen - concentrations in pregnancy

A
  1. 50-fold increase in estradiol and estrone

2. 1000-fold increase in estriol (indicatior of fetal well being)

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8
Q

estrogen - indicator of a fetal well-being

A

1000-fold increase in estriol

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9
Q

estrogen receptors mechanism

A

expressed in cytoplasm –> trasnlocate to nucleus when bound by estrogen

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10
Q

estrogen production - control

A

pulsatile GnRH –> LH and FSH

  • LH –> desmolase (cholesterol to antogens) in theca interna cell
  • FSH –> aromatase (Androgens –> estrogens) in granulosa cells
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11
Q

FSH vs LH location action according ot estrogen production

A

LH –> theca internal cells

FSH –> granulosa cells

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12
Q
  1. theca internal cells
  2. granulosa cells
    homolog in mlaes
A
  1. Leyding cells (endocrine cells)

2. Sertoli (non gem)

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13
Q

progesterone source

A
  1. corpus lateum
  2. placenta
  3. adrenal cortex
  4. testes
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14
Q

increased progesterone is indicator of

A

ovaluation

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15
Q

progesterone function

A
  1. stimulation of endometrial grandular secretions and spiral artery development
  2. Maintenance of pregnancy
  3. decreases myometrial excitability
  4. production of thick cervical mucus (inhibits sperm entry into uterus)
  5. increases body temperature
  6. uterine smooth muscle relaxation (preventing contraction)
  7. prevents endometrial hyperplasia
  8. effects on other hormones
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16
Q

progesterone effects on other hormones

A
  1. inhibition of gonadotropins (LH, FSH)
  2. decrease estrogen receptor expression
  3. fall in progesterone after pregnancy disinhibits prolactin –> lactation
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17
Q

progesterone - production of thick cervical mucus –> …

A

inhibits sperm entry into uterus

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18
Q

gametes - types/definition/origin

A

types: 1. Oocytes 2. Spermatozoa
they are descendants of primordial germ cells that originate in the wall of yolk sac of the embryo –> migrate into the gonadal cells (6th week)

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19
Q

gametes originate in the

A

yolk sac of the embryo

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20
Q

meiosis occurs during

A

the production of gametes (only)

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21
Q

oogenesis - all the process

A

primordial cells from yolk sac to embryo and becomes oogonia (6th week) –> Oogonia (2N, 2C) undergo DNA replication to form 1ry oocytes (2N, 4C) and undergro begin meiosis during fetal life (5 mth) –> arresterd in prophase I complete meiosis I just prior to ovulation (1 1ry oocyte per ovaluation) –> 2ry oocyte (1N, 2C) + polar body –> Meiosis II is arrested in metaphase until fertilization –> if fertilization, ovume (1N, 1C), if not fertilization within 1 day, the 2ry oocytes degenerates

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22
Q

fate of polar body after meiosis I

A

can degenerate or give rise to 2 polar body (meiosis 2)

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23
Q

oogenesis - DNA status of cells

A

n=chromosomes
C=1 DNA
oogonioum –> Diploid (2n) and 2C
1ry oocyte –> diploid (2n) and 4C (46 doubled chromosomes, sister chromatides)
2r oocyte –> haploid (1n) and 2C (23 doubled chromosomes)
ovum –> haploid –> (1n) and 1c

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24
Q

1ry oocytes –> 2ry oocyte

A

1ry oocytes begin meiosis during fetal life (5 mth) –> arresterd in prophase I complete meiosis I just prior to ovulation –> 2ry oocyte (1N, 2C) + polar body
(1 1ry oocyte per ovaluation)

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25
Q

1ry oocytes are arrested in

A

prophase I

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26
Q

2ry oocytes are arrested in

A

metaphase of meiosis 2

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27
Q

hormone status during evaluation

A
  1. increased estrogen
  2. increased GnRH receptor on anterior pituitary
  3. estrogen surge tehn stimulates LH release –> ovulation (rupture of follicle)
  4. increased temperature (progensterone induced)
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28
Q

ovulation occurs as a result of

A

estrogen-induced LH surge

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29
Q

Mittelschmerz - definition/mechanism

A

transiet mid-cycle ovulatory pain –> classically associated with peritoneal irratation (eg. follicular swelling/rupture, fallopian tube contraction)

30
Q

Menstrual cycle - periods (and time)

A
  1. funicular phase (vary in length - 0-14 in normal cycle)
  2. ovulation (14 days before menses, regardless the cycle length
  3. Luteal phase (after ovaluation for 14 days)
  4. mesnes (0-4 days)
31
Q

Menstrual cycle - periods (and time)

A
  1. funicular phase (vary in length - 0-14 in normal cycle)
  2. ovulation (14 days before menses, regardless the cycle length
  3. Luteal phase (after ovaluation of 14 days)
  4. mesnes (0-4 days)
32
Q

Folicular phase - events

A
  1. primordial follicle develops (with atresia of neighboring follicles) - growth fastest during 2nd week
  2. LH and FSH receptors are upregulated in Theca and and granulosa cells (on follicles) –> estradiol levels –> decreases FSH/LH levels
  3. at the end –> a burst of estradiol –> + feedback on LH/FSH secretion (LH surge) –> ovaluation
33
Q

Folicular phase - progesterone levels

A

low

34
Q

LH, FSH, estradiol levels during follicular phase

A

LH/FSH decrease, estrogen increase

at the end of the phase burst of estradiol –> + feedback on LH/FSH secretion (LH surge)

35
Q

estrogen effects on uterus follicular phase

A
  1. growth of follicle
  2. endometrial proliferation
  3. increased myometrial excitability
36
Q

developing follicle is developed by

A
  1. FSH
  2. LH
  3. estrogen
37
Q

ovaluation day + …(number) days = menstruation

A

14

38
Q

ovulation occurs as a result of

A

estrogen-induced LH surge

39
Q

follicle after ovulation

A

corpus lateum

40
Q

Luteal phase - events (generally)

A

corpus lateum produce estrogen + progesteron

41
Q

Luteal phase - progesterone –>

A
  1. stimulation of endometrial grandular secretions and spiral artery development
  2. decreases myometrial excitability
  3. production of thick cervical mucus (inhibits sperm entry into uterus)
  4. increases body temperature
  5. uterine smooth muscle relaxation (preventing contraction)
  6. prevents endometrial hyperplasia
  7. inhibition of gonadotropins (LH, FSH)
  8. decrease estrogen receptor expression
42
Q

progesterone - pregnancy

A

Progesterone maintains endometrium to support implantation

43
Q

estrogen vs progesterone according to myometrial excitability

A

progesterone –> decrease

estrogen –> increase

44
Q

Dysmenorrhea?

A

pain with menses

45
Q

dysmenorrhea is often associated with

A

endometriosis

46
Q

oligomenorrhea?

A

more than 35 days cycle

47
Q

polymenorrhea?

A

less than 21 day cycle

48
Q

Metrorrhagia?

A

frequent or irregular mestriation

49
Q

Menorrhagia?

A

Heavy menstrual bleedin

more than 80ml loss or more than 7 days

50
Q

Menometrorrhagia

A

heavy, irregular menstruation

51
Q

Fertilization - location and time

A 
MC in upper end of fallopian tube (the ampulla) 
day 0 (within 1 day of ovulation)
52
Q

implantation within the wall of the uterus occurs (when)

A

6 days after fertilization (6-10)

53
Q

gestational vs embryonic age according to calculation

A

gestational –> from date of last menstrual period

embryonic –> from date of conception (gestational minus 2 weeks)

54
Q

Physiologic adaptions in pregnancy (namely)

A
  1. increased cardiac ouput
  2. anemia
  3. hypercoagulability
  4. hyperventilation
55
Q

Physiologic adaptions in pregnancy - increased cardiac ouput - explain

A

increased preload, decreased afteload, increased HR

–> increased placental and renal perfusion

56
Q

Physiologic adaptions in pregnancy - anemia - explain

A

increased plasma and RBCs (but plasma more) –> decreased hematocrit –> decreased viscosity

57
Q

Physiologic adaptions in pregnancy - hyperventilation - explain

A

to eliminate fetal CO2

58
Q

Physiologic adaptions in pregnancy - hypercoagulability - explain

A

low blood loss at delivery

59
Q

hcG - source/secretion begins/peak

A

syncitiotrophoblast of placenta

around the time of implantation of blastocyst (within 1 week). peak: 8-10 weeks

60
Q

hcG - function

A

maintains corpus luteum (and thus progesterone) for first 8-10 weeks of pregnancy by acting like LH –> After 8-10 weeks, placenta syntehsizes its own estriol and progesterone and corpus lateum degenerates

61
Q

fate of corpus lateum in pregnancy

A

hcG maintains it (and thus progesterone) for 8-10 weeks –> then degenerates

62
Q

hcG - structure

A

α subunit –> as LH, FSH, TSH

β subunit –> unique (detected by pregnancy test)

63
Q

hcG - thyroid function

A

α subunit is similar to TSH –> states of increased hcG can cause hyperthyroidism

64
Q

increased hCG - ddx

A
  1. multiple gestation
  2. hydatidiform moles
  3. choriocarcinomas
  4. Down syndrome
  5. testicular cancer
  6. Large cell Ca of lung
65
Q

low hcG - ddx

A
  1. ectopic/failing pregnancy (spontaneous abortion)
  2. Edward syndrome
  3. Patau syndrome
66
Q

estorgne and progesteron in pregnancy

A

increasing levels –> maintain endometrium for the fetus, suppress ovarian follicular function (by inhibiting FSH/LH secretion) and stimulates the development of the breast

67
Q

action of estorgne and progesteron in pregnancy

A
  1. maintain endometrium for the fetus
  2. suppress ovarian follicular function (by inhibiting FSH/LH secretion)
  3. stimulates the development of the breast
68
Q

estrogen and progesteron production during pregnancy

A

until 7-8 weeks from corpus luteum, then a transition state, and then from placenta

69
Q

levels of hormones in pregnancy (generally)

A

placental hormone secretion generally increases over the course of pregnancy (estrogens, progesteron, human placental lactogen), but hCg peaks ta 8-10 weeks

70
Q

human placental lactogen levels

A

increasing during pregnancy –> a peak/platue at the end of pregnancy and after birth

Reproductive (20 decks)

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