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Y3 repro > female reproductive physiology > Flashcards

female reproductive physiology Flashcards

1
Q

main female reproductive organs

A 
ovaries containing ovarian follicles
fallopian tube 
uterus - body
cervix - opening of the uterus into the vagina
vagina
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2
Q

structure of ovaries

A

surface

cortex and medulla

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3
Q

describe the surface structure of the ovary

A

connective tissue capsule covered with layer of simple cuboidal epithelium

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4
Q

describe the cortex of the ovary

A

peripheral part

connective tissue containing ovarian follicles

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5
Q

what is an ovarian follicle

A

one oocyte surrounded by single layer of cells

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6
Q

describe the medulla of the ovary

A

central part

connective tissue with blood vessels supplying the ovary

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7
Q

what are the 2 main functions of the ovary

A

oocyte production

steroid hormone production

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8
Q

oocyte production in the ovaries

A

one mature egg per menstrual cycle
~400 ovulated during entire reproductive lifespan
majority of eggs perish during the cycle
finite number, decreases with increasing age - starts at ~30y/o

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9
Q

steroid hormone production in the ovaries

A

oestrogen develops and maintains female 2y sexual characteristics
progesterone prepares endometrium for implantation
50% of testosterone produced by ovaries before menopause

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10
Q

when does primordial germ cell mitosis occur

A

fetal life only

primordial follicles arrested in the stage of 1st meiotic division until puberty

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11
Q

meiotic division of germ cells

A

1st meiotic division complete and 2nd division starts after puberty and leads to release of 1 2y oocyte in a menstrual cycle which is capable of fertilisation

2nd meiotic division completes after fertilisation of oocyte with sperm

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12
Q

describe the process of oogenesis

A

mitosis before birth
FSH, LH secretion at sexual maturity
early 1y follicle –> 1y follicle –> 2y follicle
1st meiotic division now completed
2y meiotic division starts 2y follicle –> graafian follicle containing 2y oocyte
corpus luteum
if no fertilisation –> corpus albicans

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13
Q

follicular development stages

A

primordial follicles
primary follicle
2y follicle
3y/graddian follicle

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14
Q

what is a primordial follicle

A

1y oocyte arrested in 1st meiotic division surrounded by 1 layer of squamous pre granulosa cells

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15
Q

what is a 1y follicle

A

oocyte surrounded by zona and cuboidal granulosa cells

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16
Q

what is a 2y follicle

A

increased oocyte diameter and multiple layer of granulosa cells
resumption of 1st meiotic division

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17
Q

what is a 3y/graffian follicle

A

follicular fluid between the cells which coalesce to form antrum (fluid filled space)
completion of first meiotic division to form 2y oocyte and start of 2nd meiotic division

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18
Q

chromosomal division during oogenesis

A

oogonium - 2n (46)
mitosis
primary oocyte - 2n

PUBERTY 
meiosis continues
2y oocyte - 1n larger (arrests in metaphase 2), 1n polar body smaller (no use)
ovulation, sperm entry - 1n 
meiosis, fertilisation
fertilised egg - 2n
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19
Q

endocrine control of female reproductive axis

A

hypothalamic-pituitary-ovarian axis

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20
Q

hypothalamic-pituitary-ovarian axis

A

hypothalamus releases GnRH
GnRH acts of anterior pituitary which releases FSH and LH
FSH and LH act on the ovary
ovary releases oestrogen and progesterone which both act on the uterus to coordinate the menstrual cycle

21
Q

positive and negative feedback in the hypothalamic-pituitary-ovarian axis

A

oestrogen released by the ovary has +ve feedback on anterior pituitary and hypothalamus during day 12-14 to increase GnRH and FSH+LH release

oestrogen and progesterone have -ve feedback on hypothalamus and anterior pituitary for most of the cycle to reduce GnRH and FSH+LH release

22
Q

what is the purpose of the +ve feedback in the hypothalamic-pituitary-ovarian axis

A

aids with mid-cycle ovulation

23
Q

the ovarian cycle

A

first 1/2 (follicular stage) - FSH and LH released and levels increased
follicular development starts - 2y follicle to antral follicle stage
FSH levels stays relatively static, small peak mid cycle
during the 1st 1/2 oestrogen is produced which causes follicular development

+ve feedback of oestrogen as it reaches its peak results in LH surge mid cycle –> ovulation

luteal phase (2nd 1/2)
if a pregnancy doesn’t occur the follicle –> corpus luteum
rise in progesterone to prepare the lining for pregnancy after ovulation and oestrogen drops
w/o pregnancy the corpus luteum dies, oestrogen and progesteone drop and the lining is shed

24
Q

follicular phase of the ovarian cycle

A

FSH causes follicle to mature and produce oestrogen - inhibits development of other follicles

25
Q

ovulation phase of ovarian cycle

A

LH surge causes ovulation

follicle ruptures and releases 2y oocyte

26
Q

luteal phase of ovarian cycle

A

ruptured follicle forms a corpus luteum and secretes progesterone and some oestrogen

27
Q

menstruation phase of the ovarian cycle

A

if a pregnancy hasn’t resulted the corpus luteum degenerates and forms a corpus albicans
new ovarian cycle can begin

28
Q

menstrual cycle - endometrial development

A

day 1 - thin endometrium due to bleeding
cycle progresses with increasing oestrogen, endometrium starts to thicken
reaches a certain thickness mid cycle
progesterone secretion causes changes in the blood vessels
day 28 - max thickness, if no pregnancy, lining is shed

29
Q

what does oestrogen cause in relation to the endometrial lining

A

thickening of the lining

30
Q

what does progesterone cause in relation to the endometrial lining

A

changes in the vasculature

also adds to the thickness

31
Q

what is the name given to the changes in the endometrial lining caused by oestrogen and progesterone

A

decidualisation - changes to the endometrium in preparation for pregnancy

32
Q

ovarian and menstrual cycle together

A
  1. pituitary releases LH and FSH causes ovarian cycle - divided into follicular and luteal phase
  2. ovary produces oestrogen and progesterone - oestrogen dominant in first 1/2 for the follicular phase and progesterone dominant in the luteal phase
  3. these cause resulting changes to the endometrium during the menstrual cycle
  4. at the end if there is no pregnancy, the endometrium is shed and a new cycle begins
33
Q

which part of the pituitary releases LH and FSH

A

ANTERIOR

34
Q

define amenorrhoea

A

no periods
1y or 2y
2y is where they have started then stopped for 6mths or more

35
Q

reasons for amenorrhoea

A

problem with regulating hormones - low FSH/LH, high prolactin (hypogonadotropic hypogonadism)
problem with ovarian function
problem with uterus or outflow tract

36
Q

causes for problems with regulating hormones

A 
functional 
chronic medical conditions
intracranial space occupying lesion
infection or trauma
drugs 
genetic
37
Q

functional causes for problems with regulating hormones

A

XS weight loss/gain
over exercising
stress

38
Q

chronic medical conditions - causes for problems with regulating hormones

A

DM
sarcoidosis
renal disease
TB

39
Q

intrancranial space occupying lesions - causes for problems with regulating hormones

A

prolactinoma
tumours
cysts

40
Q

infection/trauma causes for problems with regulating hormones

A

meningitis
intracranial bleed
Sheehan’s

41
Q

drug causes for problems with regulating hormones

A

glucocorticoids
anabolic steroids
opioids

42
Q

genetic causes for problems with regulating hormones

A

Kallmann’s syndrome

43
Q

causes for problems with ovarian function

A

hypergonadic hypogonadism - high/normal FSH/LH

genetic 
ageing 
POI/POF
chronic illness - AI
radio/chemotherapy
infection - TB, mumps oophoritis
44
Q

genetic causes for problems with ovarian function

A

Turner’s syndrome

46X, fragile X

45
Q

ageing causes for problems with ovarian function

A

steep decline in ovarian function past 35y/o

46
Q

problems with uterus or outflow tract

A

congenital

iatrogenic

47
Q

congenital causes for problems with uterus or outflow tract

A

absent uterus, vagina - lack of mullerian duct development (MRKH syndrome)
transverse vaginal septum or imperforate hymen - Mullerian duct fail to canalise
androgen insensitivity syndrome

48
Q

iatrogenic causes for problems with uterus or outflow tract

A

uterine adhesions or synechiae (Asherman syndrome)

Radiotherapy - pelvic/cervical

49
Q

management of amenorrhoea

A

life style changes
optimise control of medical illness
stop drugs or switch to alternatives
prolactinoma - medical treatment
intracranial SOL - surgical treatment
vaginal anomalies (septum/hymen) - surgical treatment
uterine adhesions - surgical division hysteroscopic
fertility preservation before radio/chemotherapy
fertility treatment - IVF w/ own or donor eggs

Y3 repro (47 decks)

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