Female Reproductive Physiology Flashcards

1
Q

luteal phase

A

elevated progesterone and low estrogen

secretory endometrium forms

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2
Q

follicular phase

A

FSH elevated
-proliferation of granulosa cells

increased estrogen secretion in follicles

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3
Q

theca cells

A

LH stimulation

form androgens

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4
Q

granulosa cells

A

FSH stimulation

increased aromatase - androgen to estrogen

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5
Q

estrogen

A

acts locally on granulosa cells - increased proliferation and sensitivity to FSH

rising level of estrogens - follicular phase

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6
Q

inhibin B

A

from granulosa cells

inhibits secretion of FSH by pituitary

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7
Q

estrogen effect

A

endometrial cell - increased rate of mitotic divions

cervical mucus thin and watery

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8
Q

very high estrogen

A

no longer inhibit LH and FSH

start positive feedback - LH surge and very high FSH

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9
Q

LH surge

A

induction of ovulation

removed restraint upon meiosis
prophase 1 to metaphase 2
first polar body lost

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10
Q

production of progesterone

A

decreased activity of aromatase and decreased estrogen production

from luteal cells -that were formerly granulosa and theca cells

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11
Q

progesterone effect

A

endometrial to become secretory

thickens cervical mucus

thermogenic - increased body temp

negative feedback on LH

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12
Q

menstruation

A

due to lack of gonadal sex steroids

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13
Q

to monitor menstrual cycle

A

look at sex steroids in urine

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14
Q

early follicular phase

A

low progesterone

low but slowly rising estrogen

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15
Q

follicular phase

A

low progestone and rapidly rising estrogens

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16
Q

luteal phase and pregnancy

A

elevated progesterone

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17
Q

potency estrogens

A

estradiol > estrone > estriol

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18
Q

amenorrhea

A

lack of menstrual bleeding

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19
Q

length of follicular phase

A

more variable

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20
Q

increased DHEA

A

PCOS

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21
Q

hirsutism caused by ovarian source of adrenal source

A

measure DHEA

dexamethasone suppression test

22
Q

most common cause of ovarian androgen excess

A

PCOS

23
Q

ectopic pregancy

A

failure of pick up of ovum by fimbrae

24
Q

fertilization

A

upper end of oviduct

25
Q

first step in infertility evaluation

A

semen analysis

26
Q

implantation

A

5-7 days after fertilization

at blastocyst stage

27
Q

hCG

A

from trophoblast cells of fetus

has LH activity

test for pregnancy

rescues corpus luteum

28
Q

peak of hCG

A

first three months of pregnancy

29
Q

marker of corpus luteum function

A

17-hydroxyprogesterone

secreted by CL and not placenta

30
Q

relaxin

A

from CL

31
Q

third month

A

placenta secretes enough progesterone and estrogen to maintain uterus

not controlled by hCG anymore

32
Q

placental progesterone secretion limited by

A

cholesterol delivered by LDL to placenta

33
Q

index of placental function and fetal well being

A

estriol levels

34
Q

estrogen secretion during pregnancy

A

involves transfer of steroids from fetal adrenal cortex and fetal liver to placenta
-then to maternal circulation

fetal adrenal cortex - secrete DHEA and DHEAS

fetal liver and placenta - convert these to estrogens - enter maternal circulation

35
Q

hPL

A

from placenta
-aka hCS

during latter half of pregnancy

actions similar to GH

maternal energy more available to fetus

36
Q

second trimester

A

pregnancy becomes hyperinsulinemic state with peripheral resistance to metabolic effects of insulin

reserves glucose for fetal needs

mother - FA for energy

modest fasting - ketosis

37
Q

maternal compensation to pregnancy

A

CV/renal
-CO increases with peripheral resistance decrease

no HTN

BP decline first trimester - then rises

GFR increase and renal threshold decrease

glucose in urine

38
Q

endocrine maternal changes during pregnancy

A

anterior pituitary enlarges

39
Q

postpartum pituitary necrosis

A

sheehan
-preced by obstetric hemorrhage

failure to lactate

40
Q

relaxin

A

from ovary

pubic symphysis, cervix, vagina increased distensibility

41
Q

induce contractions

A

oxytocin

but normal pregnancy - oxytocin not elevated until fetus enters birth canal

so does not initiate rhythmic uterine contractions characteristic of onset of labor

does cause uterus to contract immediately after fetus expelled - to limit blood flow and loss

42
Q

prostaglandins

A

act locally on myometrium - contraction

increased with oxytocin

43
Q

dead fetus

A

increased prostaglandins - initiates contractions - miscarriage

44
Q

induce abortion

A

prostaglandins

45
Q

mammary tissue grwoth

A

stimulated by estrogen and progesterone

also need PRL, GH, and cortisol

46
Q

milk synthesis

A

occurs with high PRL

at birth - estrogen drops - withdraws block on milk synthesis

47
Q

to maintain lactation

A

suckling necessary

afferent to magnocellular nucleus of hypothalamus
-synthesize oxytocin

oxytocin to post pituitary

  • causes contraction of myoepithelial cells
  • milk ejection

anterior pituitary - PRL - milk synthesis

48
Q

dopamine

A

prolactin inhibiting factor

this is inhibited by suckling - allowing PRL secretion to increase

49
Q

suckling

A

inhibits GnRH, FSH, and LH release

follicular growth, estrogen secretion, and menses stop

50
Q

women who doesn’t want to breastfeed

A

high dose

inhibits lactation

51
Q

contraceptive effect

A

breast feeding