Female Reproductive Flashcards
what is the broad ligament consist of?
double layer of peritoneum (smooth muscle)
what are the 3 subdivisions of the broad ligament?
mesometrium: surroudns the uterus
Mesovarium: projects from posterior surface and attaches to ovary (does not cover surface of ovary itself)
mesosalpinx: superior to mesovarium, encloses the fallopian tubes
what are the ligaments associated with the ovary and their functions? (2)
ovarian ligament: attached inferiorly, connects ovary to side of uterus
Suspensory ligament of ovary: extends outward from ovary to lateral abdominal wall. Connects ovarian vessels and nerves
what ligaments supports the superior aspect of the uterus? (uterine ligaments)
broad ligament and round ligaments
what ligaments support the middle aspect of uterus? (cervical ligaments)
cardinal, pubocervial, uterosacaral
note: inferior aspect is supported by the pelvic floor
The ovarian ligament connects the ovary to the ______?
lateral surface of the uterus
what section of the broad ligament encloses the fallopian tubes?
the mesosalpinx
what ligament contains the ovarian vessels and nerves?
the suspensory ligament of the ovary
what is the function of the round ligament of the uterus?
attaches to the ovarian ligament and extends antero-inferiorly to the mons pubis and labia majora
passively pulls the uterus forward, helping to maintain the uterus anterverted
what is the function of the cardinal (transverse cervical) ligament?
it attaches from the cervix and superior vagina -> lateral wall of pelvis
passively (no muscular contraction) holds the uterus in place
what does the broad ligament connect to?
the lateral walls and floor of pelvis
what is the normal position of the uterus?
anteverted (lies over the bladder) and anteflexed (angle at the cervix)
this position is maintained by the cardinal and uterosacral ligaments
what is the vasculature of the ovary
ovarian artery from abdominal aorta which runs within the suspensory ligament of the ovary
venous drainage from pampiniform plexus into left renal vein
lymphatic drainage of the ovary
internal iliac and/or the para-aortic lymph nodes. some drainage into inguninal lymph nodes
what is the infundibulum?
funnel-shaped peripheral opening of fallopian tube
lined with fimbriae to draw ovulated oocytes into the infundibulum
what region where fertilization usually occurs in the fallopian tube?
ampulla
what is the region called where fallopian tube attaches to and opens into the lumen of the uterus
isthmus
what is the vasculature of the uterus?
ovarian and uterine arteries (internal iliac artery), venous drainage into the uterine plexus -> internal iliac veins
lymphatic drainage of the uterus?
aortic lymph nodes, internal and external iliac
what layer of the uterus mucosa is shed?
functional layer is shed during menses
the basal layer is not
what are lacunae in the uterus?
“little lakes” of blood that drain into the veins
spiral arteries what androgen are they sensitive to?
progesterone, bc withdrawal at the end of cycle -> constriction and ischemia of the functional layer of the endometrium
what is the transformation zone in the cervix?
squamocolumnar junction (goes from columnar to stratified squamous)
around the opening of the cervix
what contributes to the selection of the dominant follicle at ovulation
growth factors
the antral follicles develop into graafian follicles just before ovulation and these are enriched with growth factors
note: the dominant follicle also has a lot of FSH receptors making it very sensitive to FSH
what does the dominant follicle release?
large stores of estradiol which trigger the midcycle LH surge
How is the LH surge stimulated and what does the LH surge do?
it is stimulated by + feedback on GnRH during late follicular stage.
leads to maturation of primary oocyte into secondary oocyte and ovulation
the LH surge promotes release of histamine, prostaglandins and bradykinins, which cause _____?
vasodilation -> follicle swells
note: histamine can cause dilation or constriction but here its dilation.
when does the basement membrane begin to disintegrate allowing for LDL can enter granulosa cell and make progesterone?
ovulation, the rupture of the mature follicle breaches the basement membrane
why do we see a rise in progesterone after ovulation?
after ovulation, the follicle ruptures and basement membrane rupture, granulosa cells now have access to vasculature and LDL to make hormones.
what does the aromatase enzyme do?
it converts testosterone to estradiol in the granulosa cells
what cells are responsible for making estrogen from androgens during the proliferative phase?
granulosa cells
What maintains thickness of the endometrial lining during the secretory phase?
progesterone
what nuclei in the hypothalamus is GnRH released from?
arcuate and preoptic
How does GnRH promote synthesis and release of LH and FSH? Role of GnRH agnoists medications?
pulsiltile
slow = FSH
rapid = LH
GnRH agonist is a steady stream, shut down menstrual cycle.
When does the menstrual cycle estradiol have a negative feeback loop to regulate FSH
most of the cycle. FSH promotes follicular growth in the ovary, leading to estradiol production by the granulosa cells.
when does the menstrual cycle (28 days) switch to positive feedback? How is this accomplished?
late follicular phase to ovulation
as estradiol promotes GnRH release resulting the LH surge.
prolonged periods of elevated estradiol
When does the menstrual cycle switch back to negative feedback?
at ovulation
Estradiol negative feed drives down FSH.
how is the dominant follicle selected?
on day 5-7 based on size and steroidogenic activity (needs more resources)
when does estradiol peak? what day and stage of menstrual cycle?
late follicular phase
peaks at day 12 for 24 to 36 hours and initials the LH surge
what secretes progesterone and when?
the corpus luteum! while FSH and LH production declines
what type of epithelium in in the endometrium?
secretory columnar
how does the endometrium get nutrients to grow during the proliferative phase?
spiral arteries
when is peak thickness of the endometrium achieved?
secretory phase about 6-8 days post ovulation
what hormones decreases the spontaneous myomeetrial contraction in preparation for implantation?
progesterone
what surge needs to happen in order for the LH surge to happen? (rapid pulse of GnRH?)
estradiol increases as follicular phase progresses! this increases pulse frequency and thus LH. So we need estrogen in order for ovulation to occur.
what causes an ovarian cyst ?
follicular cyst: when the follicle fails to rupture during ovulation in the
luteal cyst: corpus luteum fails to dissolve/fibrosis instead = cyst
where are most of the follicles found in the ovary?
cortex
what is the medulla of the ovary
where loose CT and larger blood vessels are
