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COM - Repro > Female Repro Physio - 2/23 Lopez > Flashcards

Female Repro Physio - 2/23 Lopez Flashcards

1
Q

What part of the ovary do neurovascular elements run?

A

Medulla

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2
Q

What is the cortex of the ovary composed of?

A

Dense cellular stroma

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3
Q

What resides inside the cellular stroma?

A

Ovarian follicle

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4
Q

Primary oocytes are arrested in what phase of meiosis?

A

Diplotene stage of prophase I

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5
Q

How do follicle cells stimulate oocyte growth?

What does it bind?

A

Release of c-kit ligand (stem cell factor)

c-KIT receptor

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6
Q

The appearance of what signals a primary follicle?

A

Cuboidal granulosa cells

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7
Q

Pre-antral follicles fail to complete meiosis and the oocyte begins to grow. What does it secrete?

What is the fx of the secretion?

A

ZP1, 2, 3

Species-specific binding site for sperm during fertilization

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8
Q

How do Granulosa cells and oocyte maintain contacts?

A

Gap junctions

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9
Q

Thecal cells are analogous to what?

Major product?

A

Leydig cells

Androstenedione

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10
Q

Early natural follicles are depended upon what for normal growth?

A

FSH

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11
Q

What do mural Granulosa cells form?

Where are they located?

What happens to them?

A

Outer wall of follicle

Close to thecal layers

Become highly steroidogenic and remain in ovary after ovulation to differentiate into the CL

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12
Q

The innermost layer relative to the oocyte of cumulus cells maintains contact how?

A

Gap junctions and adherens junction

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13
Q

Larger antral follicles have meiotic competence but are still arrested until when?

Via what mechanism?

A

Mid cycle LH surge

elevated cAMP levels in mature oocyte

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14
Q

What converts androgens to estradiol-17B?

A

Mural Granulosa cells

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15
Q

What stimulates proliferation of Granulosa cells?

What else does it induce?

A

FSH

Expression of CYP19-aromatase

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16
Q

Mural Granulosa cells of large antral follicles producing increasing amounts of what?
When?

A

Inhibin B

Early follicular phase

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17
Q

When does the process of follicle selection occur?

A

Early follicular phase

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18
Q

What converts androstenedione to estrone?

A

Aromatase (CYP19)

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19
Q

Aromatase converts testosterone to what?

A

Estradiol-17B

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20
Q

What receptors do thecal cells express?

What do they produce?

A

LH

Androgens

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21
Q

What receptors do Granulosa cells express?

What is present in granulosa cells And what does it do?

A

FSH AND LH receptors

Aromatase which converts androgens to estrogens

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22
Q

What is the periovulatory period?

Lasts how long?

A

Onset of LH surge to ovulation

32-36 hours

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23
Q

The CL is made how and of what?

A

Biogenesis from remaining thecal and mural Granulosa cells

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24
Q

Main product of CL?

Secondary product?

A

Progesterone

Estrogen

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25
Before ovulation, the follicle presses against the wall of the ovary forming what?
Bulge called the stigma
26
LH surge induces release of what?
Inflammatory cytokines and hydrolytic enzymes from Theca and Granulosa cells
27
As an indirect response to LH surge what does the oocyte release? What does this do? What do these products do?
GDF9 Hyaluronic acid and other extracellular matrix components Expansion of the oocyte complex, making it easier for sperm to locate
28
What are some angiotensin factors the Granulosa cells produce to increase blood supply to the new CL?
VEGF, angiopoietin-2, bFGF
29
What converts androstenedione to testosterone?
17B-HSD Major thing that does this
30
What happens during lute ionization of the Granulosa cells?
Inhibits Aromatase and estrogen formation Causes vascularization of Granulosa cells increasing LDL receptor expression
31
CL lives how long? Saved by what?
14 days hCG from implanted embryo
32
When does progesterone production increase? | When does it peak?
After onset of LH surge Peaks midluteal phase
33
What does estrogen do after LH surge?
Decreases but then peaks at midluteal phase
34
What happens to FSH and LH levels during the Luteal phase? Why?
DEC Negative feedback from progesterone and estrogen
35
What do Granulosa lutein cells secrete? What does this do?
Inhibin A Suppress FSH
36
What is thelarche?
Breast development
37
What does the follicular phase coincide with? Luteal phase?
Proliferative Secretory These are endometrial phases
38
Granulosa cells increase production of what to stimulate endometrial growth and maturation?
Estrogen estradiol
39
What 2nd messenger does GnRH work through?
Gq -> PLC -> PKC, DAG, IP3
40
How is GnRH released? High levels of what, typical of the late follicular phase sensitize gonadotrophs to GnRH?
Rhythmic pulses Estradiol
41
What do activins stimulate? Made from where?
FSH release Granulosa cells
42
What are inhibins composed of? Activins?
Alpha beta heterodimers Beta A and B Heterodimers
43
When do estrogens exert negative feedback control? Progestins?
High and low [ ]'s ONLY high [ ]'s
44
Where are estrogens derived from in the female?
Ovary Adrenal gland Peripheral conversion in adipose
45
How does estrogen affect basal body temperature? When?
Lowers it Pre-ovulation
46
How do high levels of progesterone affect basal body temperature? When?
Raise it After ovulation
47
When is the endometrium restored after menstruation? What proliferates?
Day 5 Basal stromal cells Epithelial cells from uterus
48
How does progesterone act in accordance with estrogen? What does it inhibit/stimulate?
Opposes its action on endometrium and functions as anti estrogen Inhibits epithelial cells proliferation but promotes proliferation of endometrial stroma Stimulates 17B-HSD and sulfotransferase
49
What promotes the differentiation from of stromal cells into predicdual cells?
Progesterone
50
What do oral contraceptive pills suppress?
FSH and LH
51
How do progestin-only OCP work?
Cause the cervical mucus to thicken and become sticky and insufficient
52
What are oligomenorrhea and amenorrhea due to?
Dysfunction or cessation of the HPA ovarian axis
53
What is menorrhagia?
Loss of greater than 80mL of blood
54
What is endometriosis? What tissue is most commonly involved? Clinical presentation?
Tissue that normally grows inside the uterus grows outside it Ovaries, bowel or tissue lining the pelvis Pelvic pain, dysmenorrhea, dyspareunia, constipation, infertility
55
What is most common infertility in women? Caused by what?
PCOS Hyperandrogenism, anovulation, polycystic ovary
56
Enlarged polycystic ovaries are associated with what? Presentation?
DHEA Young, obese, infertility, oligomenorrhea, insure females
57
Describe the following levels in PCOS: LH FSH Testosterone
Elevated Low Elevated
58
Turner syndrome due to what? What are the external and internal genitalia like? Clinical presentation?
Congenital hypogonadism Female Webbed neck, short, low-set ears, shout 4th metacarpals, sexual infantilism
59
Menopausal women have what kind of levels of FSH and LH? Why?
High Low levels of estrogen and Inhibin -> no (-) feedback
60
What are some signs of peri menopause?
``` Irregular periods Hot flashes Vaginal dryness Night sweats Mood problems Etc ```
61
What is considered part of the female reproductive system?
Ovaries, breasts, reproductive tract

COM - Repro (15 decks)

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