Female Reproductive Physiology Flashcards

1
Q

What is included in the female reproductive organs?

A

Uterus, ovary, fallopian tube, cervix and vagina

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2
Q

Describe the surface of the ovaries

A

Connective tissue capsule covered with layer of simple cuboidal epithelium

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3
Q

Describe the cortex of the ovaries

A

Peripheral part
Connective tissue containing ovarian follicles

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4
Q

Describe the medulla of the ovaries

A

Central part
Connective tissue with blood vessels

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5
Q

What is a ovarian follicle?

A

One oocyte surrounded by single layer of cells

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6
Q

What are the functions of the ovaries?

A

Oocyte production
Steroid hormone production

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7
Q

Describe oocyte production

A

One mature egg per menstrual cycle, 400 ovulated over entire reproductive lifespan
Majority of eggs perish during cycle
Finite number which declines with age

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8
Q

Describe steroid production by the ovaries

A

Oestrogen develops female secondary sexual characters
Progesterone prepares endometrium for pregnancy
50% of testosterone produced by ovaries before menopause

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9
Q

Describe oogenesis at birth

A

Primordial germ cell mitosis in foetal life
The primordial follicles are arrested in stage of first meiotic division at birth so no further development until sexual maturity

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10
Q

Describe oogenesis at puberty

A

First meiotic division is complete and second division starts after puberty which leads to release of one secondary oocyte in menstrual cycle

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11
Q

When is second meiotic division completed?

A

After fertilisation of oocyte with sperm

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12
Q

What are primordial follicles?

A

Primary oocyte arrested in first meiotic division surrounded by one layer of squamous pre granulosa cells

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13
Q

What is a primary follicle?

A

Oocyte surrounded by zona and cuboidal granulosa cells
Activated by puberty

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14
Q

What is a secondary follicle?

A

Increased oocyte diameter and multiple layer of granulosa cells
Resumption of first meiotic division

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15
Q

Wat is a tertiary/ Graffian follicle?

A

Follicular fluid between cells which coalesce to form antrum, completion of first meiotic division to form secondary oocyte and start second meiotic division

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16
Q

What are the 2 phases of follicular development stages?

A

Preantral phase - oogonia to secondary follicle
Antral phase - tertiary to preovulatory follicle

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17
Q

Describe a summary of oogenesis

A

Before birth - oogonium undergoes mitosis to primary oocyte
After puberty meiosis continues to secondary oocyte
Then ovulation and sperm entry causes meiosis to be completed and fertilisation

18
Q

What does the hypothalamus secrete in the hypothalamic-pituitary-ovarian axis?

A

GnRH

19
Q

What does the pituitary secrete in the hypothalamic-pituitary-ovarian axis?

A

FSH and LH

20
Q

What does the ovaries secrete in the hypothalamic-pituitary-ovarian axis?

A

Oestrogen and progesterone

21
Q

Where does oestrogen and progesterone work on?

A

Uterus

22
Q

When are negative feedbacks in the hypothalamic-pituitary-ovarian axis seen?

A

Can happen most of the cycle
When hormone levels are too high

23
Q

When are positive feedbacks in the hypothalamic-pituitary-ovarian axis seen?

A

Day 12-14
Cause the surge responsible for ovulation

24
Q

Describe GnRH and LH secretion and events in the ovary during the ovarian cycle

A

LH has a surge due to positive feedback loop from oestrogen - results in ovulation
Rise in the hormones leads from egg to developing follicle to ovulation then corpus luteum if not fertilised

25
Q

What is the result of increased oestrogen?

A

Surge in LH leading to ovulation

26
Q

What is the follicular stage of the ovarian cycle?

A

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

27
Q

What is the ovulation phase of the ovarian cycle?

A

LH surges causes ovulation so follicle ruptures and releases secondary oocyte

28
Q

What is the luteal phase of the ovarian cycle?

A

Ruptured follicle forms a corpus luteum and secretes progesterone

29
Q

What is the menstruation phase of the ovarian cycle?

A

From day 28 when corpus luteum degenerates and a new ovarian cycle can begin

30
Q

Describe the follicular stage of the menstrual cycle

A

LH and FSH increase - follicle matures - oestrogen and progesterone increase
Spike in the LH and FSH as oestrogen is increased - ovulation

31
Q

What hormone is most important in the follicular stage of the menstrual cycle?

A

Oestrogen

32
Q

What hormone is most important in the luteal phase of the menstrual cycle?

A

Progesterone

33
Q

What is the role of progesterone in the menstrual cycle?

A

Changes in the blood vessels within the lining of the womb and adds thickness

34
Q

What happens when there is no fertilisation of the egg in the menstrual cycle?

A

Hormone levels drop which starts the bleeding and new menstrual cycle

35
Q

What are the types of amenorrhoea?

A

Primary - never had a period
Secondary - had a period after going through puberty but stopped bleeding for 6 or more months

36
Q

What are causes of amenorrhoea?

A

Problem with regulating hormones
Problem with ovarian function
Problem with uterus or outflow tract

37
Q

What are causes of hypothalamic or pituitary cause - hypogonadotropic hypogonadism (low FSH, LH and high prolactin)?

A

Functional - weight loss/ gain, over exercising and stress
Chronic - diabetes, sarcoidosis, TB and renal
Intracranial space occupying lesion
Infection or trauma
Drugs - glucocorticoids, anabolic steroids and opiates
Genetic - Kallmann’s syndrome

38
Q

What are causes of hypergonadotropic hypogonadism - high or normal FSH or LH?

A

Genetic - Turner’s, fragile X
Ageing
POI or POF
Autoimmune diseases
RT or chemo
Infection - TB, mumps

39
Q

What are congenital causes for problems in the uterus?

A

Absent uterus or vagina (MRKH syndrome)
Transverse vaginal septum or imperforate hymen-Mullerian duct fail
Androgen insensitivity syndrome

40
Q

What are iatrogenic causes for problems in the uterus?

A

Uterine adhesions or synechiae
RT - pelvic or cervical

41
Q

What are the managements for amenorrhoea?

A

Life style, optimise control of medical illness, stop drugs, prolactinoma - medical treatment, surgery, surgical division hysteroscopic and fertility treatment