Female Repro phys Flashcards by Amir Bhuiyan

what part of the ovary do naurovascular elements run into?

The medulla

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What part of the ovary is the functional part,Cortex or medulla?

Cortex

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What group of cells surrounds the primary oocyte?

follicle cells.

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The granulosa cells remain intimately attached to the oocyte throughout its development. What is the role of granulosa cells?

They provides nutrients such as amino acids, nucleic acids, and pyruvate to support oocyte maturation.

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When does the first primordial follicle appear and when does the production of final set of primordial follicles end?

Starts at about 6 weeks intrauterine life and is complete by month 6 after birth.

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What restricts the development of too many primordial follicles?

Release of anti-mullerian hormone (AMH)

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At what point in maturation does the follicle secrete paracrine factors that induce nearby stormal cells to differentiate into epitheloid thecal cells?

Secondary follicle

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when and what releases angiogenic factors that induce the development of 1 or 2 arterioles which generate vascular wearth around the follicle?

Follicle releases the factor when the follicle becomes secondary follicle.

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when does the zona pellucida begin to form and what initiates it’s production?

It starts to produce during the preantral phase. The oocyte secretes extracellular matrix glycoproteins (ZP1, ZP2, and ZP3) that form the zona pellucida.

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On what layer of the oocyte are binding sites for sperm located?

On the zona pellucida

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At the preantral follicular stage, granulaos cells express receptors for what hormone and are hormones produced at this stage?

Granulosa cells express receptors for FSH, but do not produce ovarian hormones at this stage

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What is the female analog of the testicular Leydig cells?

Thecal cells

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what is the major steroid hormone produced by the thecal cells?

Androsetenedione. (thecal cells do not express high levels of 17beta hyddroxysteroid dehydrogenase.

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When does antrum begin to form?

Once the granulosa epithelium increases to 6 to 7 layers, fluid-filled spaces appear between cells and come together to form the antrum.

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During the antral stage, the granulosa cell divides into what 2 discrete population?

mural granulosa cell (stratum granulosum)

2. cumulus cells (cumulus oophorus or corona radiata)

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The antral follicles are dependent on what hormone for it’s growth and sustained viability?

FSH

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Which layer of the granulosa cells is close to the outlying thecal layers and becomes highly steroidogenic and remain in the ovary after voluation to differentiate into the corpus leuteum.

Mural granulosa cell layer.

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What role does the cumulus cells play?

Surrounds the oocyte
innermost layer of cumulus cells maintains gap and adhesion junction with the oocyte
During ovulation, cumulus cells are released from the ovary with the oocyte (cumulus-oocyte complex)
Crucial for the ability of the fimbriated end of the oviduct grab and move the oocyte along the length of the oviduct to the site of fertilization

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the oocyte becomes competent and completes meiosis 1 at ovulation during which stage of follicular devleopment?

At the antral stage.

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what second messenger is responsible for maintaining the arrest of oocyte at meiosis 1 before ovulation?

Elevated levels of cAMP

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the Thecal cell of large antral follicle produces mainly what hormones?

Androstenedione and testosterone to a lesser extend.

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Which cell is responsible for the conversion of androgens to estradiol 17beta?

Mural granulosa cells.

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What hormone is responsible for the proliferation of granulosa cells and induces the expression of CYP19-aromatase?

FSH

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Increasing amount of inhibin (Inhibin B) is produced during the early follicular phase by what cell type?

mural granulosa cells of the large antral follicles.

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Low levels of _ and _ exert a negative feedback effect on FSH secretion, thereby contributing to the selection of the follicle with the most FSH-responsive cells.

estrogen and inhibin

How and when does the dominant follicle arise?

By midcycle, towards the end of follicular phase, the largest follicle with the most FSH receptors of the recruited crop becomes the dominant follicle.

The steroidogenic function of the _ and _ cells (aka lueteinization) culminates in the formation of corpus luteum.

Theca and mural granuloca cells.

What structural changes does the LH surge induce?

- Rupture and ovulation of the cumulus-oocyte complex, | - biogenesis corpus leuteum from the remaining thecal cells and mural granulosa cells

Explain what happens during the periovulatory period, mechanism by which the oocyte is freed.

- Before ovulation, follicle presses against wall of ovary to form a bulge called stigma - The LH surge induces release of inflammatory cytokines and hydrolytic enzymes from the theca and granulosa cells. - Those secreted components lead to the breakdown of the follicle wall, tunica albuginea, and surface epithelium in the vicinity of the stigma - Cumulus cells detach from granulosa cells and oocyte is freed within the antral cavity - the oocyte releases TGF-b related factors, GDR9 which stimulates the cumulus cells to secrete hyaluronic acid and other extracellular matrix components which causes expansion of the oocyte complex making it easier for capture by the oviduct.

During the luteal phase what is the major product of the corpus luetum?

Progestins, but estradiol synthesis still continues.

What is the corpus hemorrhagicum?

After ovulation, the antral cavity fills with blood from the ruptured vessels and this is what forms the corpus hemorrhagican.

During the 2nd half of the luteal phase progesterone and estrogen levels will decline unless there is an increase in circulating _ which compensates fro the decreased sensitivity to LH.

hCG.

During fetal and infancy periods, which gonadotropins secretion is higher, LH or FSH?

FSH.

True or False, Unlike in the male, FSH and LH levels remain low during puberty in female.

True

True or Flase, After penopause, FSH and LH levels remain at an elevated level.

True

The follicular phase of the ovarian cycle coincides with which phase of the endometrial cycle?

proliferative phase

The luteal phase of the ovarian cycle coincides with which phase of the endometrial cycle?

secretory phase

What are the three phases of the endometrial cycle?

menses; proliferative; secretory

which ovarian cycle starts at the onset of menses?

Follicular phase

Which hormone produced by the granulosa cells of the follicles is responsible for stimulating the endometrium to undergo rapid and continuous growth and maturation?

estrogen estradiol

inhibin production is stimulated by what hormone acting on what cell?

FSH acting on granulosa cells. Just before ovulation when the granulosa cells acquire LH receptors, LH also stimulates the production of inhibin by granulosa cells.

The higher levels of estrogen present during follicular phase is associated with increased or decreased basal body temperature?

decreased. It is increased right after ovulation and then goes back down after ovulation.

Once a theal layer forms, the follicle is referred to as a mature _ follicle

preantral

How long does it normally take for a primary follicle to each the mature preantral stage?

several months

At the end of ovulation, how is the positive feedback of LH turned off?

Rapid decline in estrogen

Explain how The LH surge induces the shift in steroidogenic activity of the mural granulosa cells to increase hormone production

During the periovulatory period the LH surge induces shifts int he steroidogenic activity of the mural granulosa cells. This causes the vascularization of granulosa cells to make cholesterol available for steroid synthesis and increase expression of LDL and HLDL receptors which is able to accumulate cholesterol for hormone synthesis.

During the follicular phase, the major product of the follicle is what hormone?

estradiol

During the luteal phase, the major product of the corpus luteum are _.

progestins, although estradiol synthesis is still substantial.

During the luteal phase, granulosa lutein cells secrete _ which, along with progesterone and estrogen further suppresses FSH.

inhibin A. progesterone and estrogen inhibits both FSH and LH. Inhibin only suppress FSH

What is Menarche?

beginning of the menstrual cycles

what is thelarche?

breast development

What is adrenenarche?

increase in adrenal androgen secretion

The follicular phase of the ovarian cycle begins with the onset of _1_ and ends n day of _2_.

1. menses | 2. LH surge

Increased estrogen estradiol production by the _ cells of the follicles stimulates the endometirum to undergo rapid and continuous growth and maturation

granulosa.

The sensitivity of GnRH changes throughout the follicular cycle. explain how.

- Early in the follicular phase of the cycle, when the gonadotrophs are not every GnRH sensitive, each burst of GnRh elicits only a small rise in LH. - Later in the follicular phase, when the gonadotrophs in the anterior pituitary become much more sensitive to the GnRH in the portal blood, each burst of GnRH triggers a much larger release of LH

Theca cells of the follicle have _ 1_receptors whereas the granulosa cells have receptors for both _2_ and _3_.

1. LH 2. LH 3. FSH

After ovulation, the LH acts on _ instead of the theca cells.

corpus luteum

In the ovary, inhibin is produced by what cells?

granulosa cells of the follicle

What hormone stimulates the granulosa cells to produce inhibin?

FSH

LH can also stimulate granulosa cells to produce inhibin after_

granulosa cell acquire LH receptors just before ovulation

Inhibits acts to inhibit _1_ whereas activin stimulates _

FSH production by gonadtotrpohs and 2. stimulates FSH release from pituitary cells.

As the luteal phase begins, circulating levels of LH and FSH rapidly _

decrease

During the luteal phase, the rise in concentration of estradiol, progesterone, and inhibin causes - in typical negative feedback fashion - the continued __ of gonadotropin levels midway through the luteal phase.

Decrease

During the late luteal phase, due to gradual demise of the corpus luteum leads to decrease of _, _ and _

progesterone, estradiol and inhibin

what makes ovarian cells that synthesizes estrogen different from that of other parts of the body?

Cells in the ovaries have an aromatase that can converet adrostenedione to estrone and testosterone to estradiol.

what enzyme can convert estrone into the more powerful estrogen estradiol and vice versa?

17b-HSD

The liver can convert both estradiol and estrone into _ (stronger or weaker) estrogen estriol

weaker

Estradiol synthesis requires the contribution of 2 distinct cell types in both the follicle and in the corpus leuteum. what are the cell types?

Theca and granulosa cells in the follicle and theca-lutein and graulosa-lutein cells in the corpus luteum

What causes the rise in basal body temperature after ovulation?

Higher levels of progesterone released by the corpus luteum

After menstruation, the endometrium is resstored by about what day of the cycle?

5th day

The proliferation and differentation of the endometrium are stimulated by estrogen secreted by _.

developing follicles

which hormone (estrogen or progesteron) is responsible for the stromal components of the endometrial development

Estrogen

Progesterone can oppose the action of estrogen on _ and function as an antiestrogen. In doing so, it inhibits these cells to promote prolliferation of the endometrial stroma.

epithelail cells of the endometrium

Progesterone can stimulate _ and _ to convert estradiol to weaker compounds

17b-HSD and sulfotransferase

During the secretory phase of the endometrial cycle, progesterone promotes the differentiation of the stromal cells into _1_ which must be prepared to form the _2_ of pregnancy or to orchestrate menstration in the absence of pregnancy

1. predecidualcels | 2. Decidua

What is the schedule for oral contraceptive pill (OCP)?

Take OCP for 21 days out of 28 day cycle; She can take a placebo, iron pill or no pills on days 22-28

Explain how OCP work.

Contraceptive steroids feed back both at the level of the hypothalamus and at the level of pituitary to suppress FSH and LH release. without FSH follicle cant develop and without LH ovulation cant take place.

what effect does progestin have as a OCP?

Causes the cervical mucus to thicken and become sticky and insuffient

What is menorrhagia

loss of > 80 mL of blood

what is dysmenorrhea

painful period

what is oligomenorrhea

existence of few, irregular periods

what is amenorrhea?

absence of periods

Oligomenorrhea and amenorrhea are often due to dysfunction or cessation of the _ as opposed to local pelvic pathophysiology.

hypothalamus-pituitary ovarian axis

what some clinical presentation of endometriosis?

- Chronic pelvic pain linked to menses - dysmenorrhea - dyspareunia - rectal pain and constipation - infertility

A young obese woman presents with hirsute females of reproductive age; oligomenorrhea or secondary amenorrhea; infertiity. Her Ovarian dysfunction was characterize by abnormal ovarian steroidogenesis and folliculogenesis that are manifested clinically by androgen excess or anovulation is consequnces of what disease?

polycystic ovarian syndrome

in polycystic ovarian syndrome the enlarged polycistic ovaries are known to be associated with increase in _

androgen levels (DHEA)

During menopause, due to reduction in estrogen, low levels of inhibin, there is no negative feedback of _1_ and _2_ and thus these levels remain _3_ (high or low)

1. LH 2. FSH 3. high

Signs and symptoms of menopause include:

- irregular periods - vaginal dryness - hot flashes - night sweats - sleep problems - mood changes - weight gain and slowed metabolism - thinner hair and dry skin - loss of breast fullness