Female Reproductive System Flashcards
________
• The female gonads or sex glands
• They develop and expel an _____each month
• A woman is born with approximately ______immature eggs called follicles
• In a lifetime: about _______fully matured eggs for fertilization
Ovaries
ovum/egg cell
2-4 million
400 to 500
Ovaries
• The follicles in the ovaries produce the female sex hormones,(2)
• Maturation of follicles is blocked until______(oocyte maturation inhibiting factor)
• These hormones prepare the uterus for implantation of the fertilized egg
progesterone and estrogen
puberty
Oogenesis / Ovulation / Ovarian cycle
Follicular phase
Ovulation phase
Luteal Phase
Monthly Ovarian Cycle
W/ corresponding days
• FOLLICULAR PHASE (Day 1-14)
• Ovulation (Day 14-15)
• Luteal Phase (Day 15-28)
Monthly Ovarian Cycle
• FOLLICULAR PHASE (Day 1-14)
• Birth of female child:______ (ovum + granulosa cells)
•_______ provide nourishment for ovum and secrete oocyte maturation inhibiting factor
PRIMORDIAL FOLLICLE
Granulosa cells
•______: increased FSH and LH (follicular development and release of estrogen)
• Moderate enlargement of ovum + additional layer of granulosa cells
(_______)
• Growth of_______ primary follicles each month
Puberty
PRIMARY FOLLICLE
6-12
What phase???
• Puberty: increased FSH and LH (follicular development and release of estrogen)
• Moderate enlargement of ovum + additional layer of granulosa cells
(PRIMARY FOLLICLE)
• Growth of 6-12 primary follicles each month
Follicular
What phase???
• SECONDARY FOLLICLE
• Mass of______ and formation of______
• Production of follicular fluid packets from granulosa cells
Follicular phase
granulosa cells; theca cells
• Mass of granulosa cells and formation of theca cells
• Production of follicular fluid packets from granulosa cells
SECONDARY FOLLICLE
What phase???
• TERTIARY OR GRAAFIAN FOLLICLE
• Follicular fluid packets coalesce to form______, a fluid rich in hyaluronic acid
• Formation of______(granulosa cells directly wrapping the oocyte)
antrum
corona radiata
• Follicular fluid packets coalesce to form antrum, a fluid rich in hyaluronic acid
• Formation of corona radiata (granulosa cells directly wrapping the oocyte)
TERTIARY OR GRAAFIAN FOLLICLE
• Note: Only 1 follicle will undergo ovulation, the rest will undergo_____.
atresia
Ovulation (Day 14-15)
• NOTE: WITHOUT_____ SURGE, OVULATION WILL NOT TAKE PLACE
• From the positive feedback of estrogen to the hypothalamus and anterior pituitary
LH
• NOTE: WITHOUT LH SURGE, OVULATION WILL NOT TAKE PLACE
• From the positive feedback of estrogen to the hypothalamus and anterior pituitary
Ovulation (Day 14-15)
• Plasma transudation into the follicle leading to swelling and follicle rupture and release of ovum
• Swelling of the outer wall of the follicle, rupture, and the viscous fluid carries the ovum surrounded by corona radiata
Ovulation
Luteal Phase (Day 15-28)
• The remaining cells enlarge and filled with lipid inclusions (luteinization) and become the_______ that produces (2)
• If fertilization occurs, the developing embryo will secrete_____ and the CL will continue to produce______
• If no fertilization occurs, the CL will degenerate into_______ and won’t continue producing______
CORPUS LUTEUM; progesterone and estrogen
HCG; progesterone
CORPUS ALBICANS; progesterone
Uterine Wall
• Composed of three layers
Perimetrium
Myometrium
Endometrium
•
• outermost serous layer; the visceral peritoneum
•
• middle layer; interlacing layers of smooth muscle
•
• mucosal lining of the uterine cavity
Perimetrium
Myometrium
Endometrium
Two zones of endometrium
• Functional zone
• Basal zone
- layer closest to the cavity
- thicker portion
- undergoes changes with monthly cycle
- contains spiral arteries
Endometrium
Functional zone
- layer adjacent to myometrium
- attaches functional layer to myometrium
- remains constant
Endometrium
• Basal zone
Days 1-5
Menses/Menstruation Phase
• Initiated by a lack of signal from a fertilized egg
• Vasospasm of the spiral blood vessels in SF (dependent on progesterone)
• Weakening and rupture of the blood vessels leading to ischemia and necrosis
• Decreased nutrients to endometrium
• Loss of hormonal stimulation
• Necrosis and desquamation of endometrial layers
Menses/Menstruation Phase
Day 6-14
• Proliferative phase (stimulated by estrogen)
• Proliferative phase (stimulated by_____)
estrogen
• Regeneration of stratum functionalis and the blood vessels
• Re-epithelialization within 4-7 days after menses
• Thickening of endometrium and increased blood supply
• Endometrial glands secrete mucus that align along the cervical canal to guide sperm cells
Proliferative phase (stimulated by estrogen)
Day 15-28
Secretory phase (estrogen and progesterone)
Secretory phase (hormones???)
estrogen and progesterone
• Increased secretory substances
• Increased lipid and glycogen deposits
• Increased blood supply
• Goal: presence of large amounts of stored nutrients in case of implantation of fertilized ovum
Day 15-28
• Secretory phase (estrogen and progesterone)
Fertilization
• If the egg is fertilized, the embryo produces_______
• HCG signals the_____ to continue supplying_____ to maintain the uterine lining
• The cervical mucus thickens to protect the developing embryo
• Continuous levels of progesterone prevent the release of____ and ovulation ceases
human chorionic gonadotropin (HCG)
corpus luteum; progesterone
FSH
• Carbon-18 compounds
Estrogen
• Principal estrogen -
• Primary metabolites
_________ (___; menopause) and
_________(____; pregnancy)
ESTRADIOL (E2)
Estrone; E1
estriol
E3
Promote breast, uterine and vaginal development
• Change vaginal epithelium from cuboidal to stratified for more resistance to trauma and infection
Estrogen
• Affects vascular smooth muscle - VASODILATION
• Estriol during pregnancy - uteroplacental blood flow
Estrogen
• Inhibits osteoclastic activity
Estrogen
• Surge in estrogen level induces the release of______, which then triggers______ by releasing the egg from the Graafian follicle in the ovary
luteinizing hormone
ovulation
• Cardioprotective Properties
• Increase HDL level
• Decrease LDL
• Decreased platelet adhesion
Estrogen
• Fluid balance
• Salt (sodium) and water retention
Estrogen
• Carbon 21 compound
Progesterone
• Produced by the corpus luteum
• Secretory phase
Prgesterone
• Reduction of uterine contractions
• Increased cervical mucus (allows sperm to survive)
• Reconstruction and maintenance of endometrium
Progesterone
• Thermogenic effects
Progesterone
Pregnancy
• characterized by steadily increasing levels of (2), which maintain the endometrium for the fetus, suppress ovarian follicular function, and stimulate development of the breasts
estrogen and progesterone
Fertilization
• If fertilization occurs, the_____ is rescued from regression by______, which is produced by the_____.
corpus luteum
human chorionic gonadotropin (HCG)
placenta
• First trimester
• The corpus luteum (stimulated by HCG) is responsible for the production of (2).
Peak levels of HCG occur at gestational week__ and then decline.
estradiol and progesterone
9
Pregnancy
• Second and third trimesters
• Progesterone is produced by the_____.
• Estrogens are produced by the interplay of the fetal adrenal gland and the placenta.
The _______synthesizes dehydroepiandrosterone sulfate (DHEA-S), which is then hydroxylated in the fetal liver.
These intermediates are transterred to the placenta, where enzymes remove sulfate and aromatize to estrogens.
The major placental estrogen is_____.
placenta
fetal adrenal gland
estriol
Menstruation
•_______ - absence of menses in a woman of reproductive age
•_______ - infrequent or irregular menstrual bleeding with cycle lengths in excess of 35-40 days
•_______ - uterine bleeding in excess of 80 ml per period
Amenorrhea
Oligomenorrhea
Menorrhagia
Hypothalamic or pituitary disorder
• Low FSH/LH, low estrogen/progesterone
• Hypopituitarism, prolactinoma, anorexia, strenuous exercise
Ovarian disorder
• Decreased estrogen/progesterone, high FSH/LH
• Surgical removal of ovaries
End-organ defect
• Normal FSH, LH, estrogen, and progesterone
• Prevents the normal egress of blood in menses
Amenorrhea
• Permanent cessation of menses for 12 months without pathologic cause
• Average age: 51 years old (earlier in smokers and nulliparous women)
Menopause
• Lab findings
• Increased serum FSH: best marker
• Increased serum LH, low estrogen and progesterone
Menopause
• Painful menses with crampy, midline pain (lower abdomen)
• Occurs in approximately 50% of women (10% of women are incapacitated for 1 to 3 days)
• Caused by increased prostaglandin F 2a (PGF 2a)
Dysmenorrhea
Dysmenorrhea
Caused by increased______
• causes uterine contractions leading to increased uterine pressure which develops into uterine ischemia: the net effect is pain caused by the accumulation of anaerobic metabolites
prostaglandin F 2a (PGF 2a)
• Presence of incompletely developed ovarian follicles in ovaries caused by anovulation and increased androgens
• Increased secretion of LH (LH:FSH ratio is > 3)
• Hyperplasia of theca cells
• Increased production of testosterone and androstenedione
• Pituitary secretion of FSH is decreased
• Low granulosa cell aromatization of androgens to estrogens
• Follicular arrest
Polycystic Ovarian Syndrome
• weight loss: ANOREXIA NERVOSA
• disruption of normal GnRH secretion
• intense physical exercise: RUNNER’S
AMENORRHEA
• low energy availability
• pituitary tumor
• prolactinoma
Hypogonadotropic Hypogonadism
Hypogonadotropic Hypogonadism
• weight loss: ANOREXIA NERVOSA
• disruption of normal GnRH secretion
• intense physical exercise: RUNNER’S
AMENORRHEA
• low energy availability
• pituitary tumor
• prolactinoma
• Menopause: 45-55 years old
• Premature ovarian failure/Turner syndrome
• normal ovarian development
• egg cells die prematurely
• occurs when your ovaries which store and release eggs stop working before age 40
Hypergonadotropic Hypogonadism
• normal ovarian development
• egg cells die prematurely
• occurs when your ovaries which store and release eggs stop working before age 40
Premature ovarian failure/Turner syndrome
Hypergonadotropic
Hypogonadism
• Menopause: 45-55 years old
Hypergonadotropic Hypogonadism
• irregular periods, increased androgen, polycystic ovaries (underdeveloped follicles, unable to release egg)
Polycystic ovary syndrome (PCOS)
Hypergonadotropic Hypogonadism
