Female Reproductive Flashcards
What are the internal and external genitalia?
- Internal genitalia
– Ovaries, uterine tubes,
uterus, and vagina - External genitalia
– Clitoris, labia minora,
and labia majora
What are the primary and secondary sex organs?
Primary sex organs
– Ovaries
* Secondary sex organs
– Other internal and
external genitalia
What are the layers of the ovary?
– Tunica albuginea capsule, like on testes
– Outer cortex where germ cells develop
– Inner medulla occupied by major arteries and veins
– Each egg develops in its own fluid-filled follicle
What are the ligaments of the ovary?
– Attached to uterus by ovarian ligament
– Attached to pelvic wall by suspensory ligament
* Contains ovarian artery, vein, and nerves
What is the fallopian tube lined with?
ciliated cells
What are the portions of the fallopian tube?
– Infundibulum: flared,
trumpet-shaped distal
(ovarian) end
– Fimbriae: feathery
projections on
infundibulum
– Ampulla: middle and
longest part
– Isthmus: narrower end
toward uterus
What is the mesosalpinx?
superior
portion of broad ligament
that enfolds uterine tube
What are the portions of the uterus?
- Fundus—broad superior curvature
- Body (corpus)—middle portion
- Cervix—cylindrical inferior end
What direction does the uterus tilt?
Over bladder
What is the uterus in a nonpregnant person?
potential space
What are the parts of the cervical canal?
- Internal os—superior opening of canal into body of uterus
- External os—inferior opening of canal into vagina
What are the 3 parts of the uterine wall?
perimetrium, myometrium, endometrium
What is the myometrium composed of?
smooth muscle
What are the 2 layers of the endometrium? Which one doesn’t change?
functional layer & basal layer, basal layer
What are the features of the vagina?
– Allows for discharge of menstrual fluid, receipt of penis
and semen, and birth of baby
– Outer adventitia, middle muscularis, and inner mucosa
– Tilted posteriorly between rectum and urethra
– Vagina has no glands
– Fornices: blind-ended spaces at top of vagina that extend
slightly beyond the cervix
– Transverse friction ridges (vaginal rugae) at lower end
What are the components of the vulva?
– Mons pubis: mound of fat over pubic symphysis bearing
most of the pubic hair
– Labia majora: pair of thick folds of skin and adipose
tissue inferior to the mons
* Pudendal cleft—fissure between labia majora
– Labia minora: thin, hairless folds medial to labia majora
* Space between forms vestibule which contains urethral
and vaginal openings
* Anterior margins of labia minora join to form hood-like
prepuce over clitoris
What are the regions of the breast?
– Body: conical to pendulous, with nipple at its apex
– Axillary tail: extension toward armpit
* Lymphatics in axillary tail are important as a route for
breast cancer metastasis
What happens at the onset of puberty? What age?
8-10, * Triggered by rising levels of GnRH which
stimulates anterior pituitary to secrete FSH and
LH
* FSH stimulates ovarian follicles and they begin to
secrete estrogen, progesterone, inhibin, and a
small amount of androgen
* Estrogens are feminizing hormones with
widespread effects on the body
– Estradiol (most abundant), estriol, and estrone
What are the 3 stages of puberty?
Thelarche (breast development), Pubarche (pubic hair development), and Menarche (onset of period)
What are the first few menstrual cycles?
anovulatory
What are the effects of estrogen and progesterone in puberty?
- Estradiol stimulates many changes in puberty
– Stimulates vaginal metaplasia
– Stimulates growth of ovaries and secondary sex organs
– Stimulates growth hormone secretion - Increase in height and widening of pelvis
– Stimulates fat deposition (breast, hips, etc…)
– Thickens skin - But girls’ skin is still thinner, softer, and warmer than boys
- Progesterone
– Primarily acts on the uterus preparing it for possible
pregnancy in the second half of the menstrual cycle
What does inhibin do?
selectively suppress FSH
What is climacteric?
midlife change in hormone secretion
What are the signs of menopause?
– Follicles less responsive to gonadotropins – secrete less
estrogen and progesterone
– Uterus, vagina, and breast atrophy
– Intercourse may become uncomfortable
– Vaginal infections more common
– Skin becomes thinner
– Cholesterol levels rise, increasing risk of cardiovascular
disease
– Bone mass declines, increasing risk of osteoporosis
– Blood vessels constrict and dilate in response to shifting
hormone balances
* Dilations may produce hot flashes: spreading sense of
heat from abdomen to thorax, neck, and face
What is menopause and when does it happen?
- Menopause—cessation of menstrual cycles
– Usually occurs between ages of 45 and 55
– Age of menopause has increased in last century
– Menopouse considered complete when there has been
no menstruation for a year
What are the 2 parts of the sexual cycle?
- Ovarian cycle—events in ovaries
- Menstrual cycle—parallel changes in uterus
What is oogenesis?
- Oogenesis—egg production
– Produces haploid gametes by means of meiosis
– Distinctly cyclic event that normally releases one egg
each month
– Accompanied by cyclic changes in hormone secretion
– Cyclic changes in histological structure of the ovaries and
uterus - Uterine changes result in monthly menstrual flow
What is folliculogenesis?
development of the follicles
around the egg that undergoes oogenesis
What are the different stages of folliculogenesis?
– Primordial follicles
* Consists of a primary oocyte in early meiosis
* Surrounded by a single layer of squamous follicular cells
* Follicular cells connected to the oocyte by fine cytoplasmic
processes for passage of nutrients and chemical signals
* Concentrated in the cortex of the ovary
– Primary follicles
* Contain larger, secondary oocytes and a surrounding layer of
cuboidal follicular cells
– Secondary follicles
* Oocytes are even larger and follicular cells now in two or
more layers (granulosa cells)
* Zona pellucida—layer of glycoprotein gel secreted by
granulosa cells around the oocyte
* Theca folliculi—connective tissue around the granulosa
cells condenses to form a fibrous husk that differentiates into
two layers
– Theca externa: outer fibrous capsule rich in blood vessels
– Theca interna: inner cellular, hormone-secreting layer
producing androgens (androstenedione and testosterone), and
granulosa cells convert them to estradiol
– Tertiary follicles
* As pools enlarge, they merge, forming a single antrum
* Cumulus oophorus—a mound of granulosa cells on one
side of the antrum that covers the oocyte and secures it to
the follicular wall
* Corona radiata—innermost layer of cells in the cumulus
surrounding zona pellucida and oocyte
– Forms a protective barrier around egg with function similar to
blood–testis barrier
– Mature follicles
* About 20 days before ovulation, one follicle becomes
dominant (the one destined to ovulate)
– Remainder degenerate
* It captures and holds FSH
* At about 5 days before ovulation it is large enough to be
considered a preovulatory (graafian) follicle
How long is the sexual cycle? What are the stages?
28 days, follicular, ovulation, luteal
What is the hierarchy of hormonal control?
hypothalamus - pituitary - ovaries - uterus
What is the follicular phase?
extends from beginning of
menstruation until ovulation (Days 1-14)
– Includes preovulatory phase: from end of menstruation
until ovulation
– Most variable part of cycle; seldom possible to predict date
of ovulation
– FSH stimulates follicles to grow and secrete estradiol
– Dominant follicle becomes increasingly sensitive to FSH,
LH, and estradiol
What is the ovulation phase?
rupture of the mature follicle and
release of its egg and attendant cells
– Typically around day 14
* Estradiol stimulates a surge of LH and a lesser
spike of FSH by anterior pituitary
– LH induces several events
* Primary oocyte completes meiosis I (producing secondary
oocyte and first polar body)
* Follicular fluid builds rapidly and follicle swells (resembles
blister on ovary)
* Macrophages and leukocytes secrete enzymes that weaken
follicle wall
* Nipple-like stigma appears on surface
– Ovulation takes only 2 to 3 minutes
* Stigma seeps follicular fluid for 1 to 2 minutes
* Follicle bursts and remaining fluid oozes out carrying the
secondary oocyte and cumulus oophorus
* Normally swept up by ciliary current and taken into
uterine tube
What happens in the luteal phase?
day 15 to day 28,
from just after ovulation to onset of menstruation
* If pregnancy does not occur, events happen as
follows:
– When follicle ruptures it collapses and bleeds into antrum
– Clotted blood is slowly absorbed
– Granulosa and theca interna cells multiply and fill antrum
– Dense bed of capillaries grows amid them
– Ovulated follicle has now become the corpus luteum
* Named for yellow lipid that accumulates in theca interna
cells, now called lutein cells
– Transformation from ruptured follicle to corpus
luteum is regulated by LH
* LH stimulates corpus luteum to grow and secrete rising
levels of estradiol and progesterone
* 10-fold increase in progesterone is most important aspect
of luteal phase
– Progesterone has a crucial role in preparing the uterus
for possibility of pregnancy
– LH and FSH secretion declines over the rest of the cycle
– High levels of estradiol and progesterone, along with
inhibin from the corpus luteum, have a negative feedback
effect on the pituitary
– Corpus luteum begins process of involution (shrinkage)
* Beginning about day 22 (8 days after ovulation)
* By day 26 involution is complete and what was corpus
luteum becomes corpus albicans—small scar
* With diminishing ovarian steroid secretion, FSH levels rise,
ripening a new cohort of follicles
– Ovulation occurs in one ovary per cycle with the two
ovaries usually alternating from month to month`
What are the phases of the menstrual cycle?
proliferative phase,
secretory phase, premenstrual phase, and menstrual
phase
What is the proliferative phase?
rebuilding of functional layer
of endometrium that was lost in last menstruation
– At day 5 of menstruation, the endometrium is about 0.5
mm thick and consists only of basal layer
– As new cohort of follicles develops, they secrete more
estrogen
– Estrogen stimulates mitosis in basal layer and regrowth of
blood vessels to regenerate the functional layer
– By day 14, endometrium is 2 to 3 mm thick
– Estrogen also stimulates endometrial cells to produce
progesterone receptors
What is the secretory phase?
endometrium thickens more in
response to progesterone from corpus luteum
– Day 15 to day 26
– Thickening due to secretion and fluid accumulation
rather than mitosis
– Endometrial glands secrete glycogen
– Glands grow wider, longer, and more coiled
– Endometrium 5 to 6 mm thick
– Soft, wet, nutritious bed available for embryonic
development
What is the premenstrual phase?
period of endometrial
degeneration
– Last 2 days of the cycle
– Corpus luteum atrophies and progesterone levels fall
– Triggers spasmodic contractions of spiral arteries
– Causes endometrial ischemia (interrupted blood flow)
– Brings about tissue necrosis and menstrual cramps
– Pools of blood accumulate in the functional layer
– Necrotic endometrium mixes with blood and serous fluid:
menstrual fluid
What is the menstrual phase?
discharge of
menstrual fluid from the vagina
* First day of discharge is day 1 of the new cycle
* Average woman expels about 40 mL of blood and
35 mL of serous fluid over a 5-day period
* Contains fibrinolysin so it does not clot
