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Physiology Block 3- Endocrine Physiology > Female Reproductive System > Flashcards

Female Reproductive System Flashcards

1
Q

What are the functions of the ovaries?

A

Storage and release of the ovum and production and estrogen and progesterone

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2
Q

From what structure are the uterus, fallopian tubes, and vagina derived?

A

Mullerian ducts

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3
Q

To what cells does LH bind in females?

A

Theca cells of the ovary;

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4
Q

To what cells does FSH bind in females?

A

Granulosa cells of the ovary;

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5
Q

What is the function of specifically FSH in females? Specifically LH? Both LH and FSH?

A

FSH- follicular recruitment and development; LH-Ovulation; FSH and LH- estrogen and progesterone release

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6
Q

What are the two phases of the ovarian cycle? What occurs during each and which hormones stimulate them?

A

Follicular phase- follicular recruitment and growth and estrogen synthesis- mostly FSH stimulation; and luteal phase- progesterone and estrogen synthesis from the corpus luteum- mostly LH stimulation

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7
Q

What phase if the endometrium in when estrogen is the predominant hormone in the blood?

A

Proliferative phase

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8
Q

What are the endometrial phases?

A

Proliferative phase–> secretory phase–> menstruation–>

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9
Q

In what stage are oogonia at birth?

A

Primary oocytes

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10
Q

What is ovulation?

A

Rupture of the follicular surface and release of oocyte and corona radiata

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11
Q

At what point in the female reproductive cycle is LH present in highest concentrations? What stimulates this high release?

A

12-24 hours pre-ovulation; Feed forward stimulation by estrogen

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12
Q

What structure develops from the ruptured follicle following ovulation? What is its function?

A

Corpus luteum; Produces progeterone and estradiol to maintain early gestation

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13
Q

What is necessary for survival of the corpus luteum?

A

Fertilization and the initial steps in placental formation resulting in hCG release

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14
Q

What occurs during the proliferative phase of the uterus? What is the primary hormone that regulates it?

A

Proliferation, increase expression of estradiol and progesterone receptor; Estrogen

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15
Q

What occurs during the secretory phase of the uterus? What is the primary hormone that regulates it?

A

Differentiation of epithelial cells to secretory cells; Progesterone

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16
Q

How is estrogen produced within the ovary?

A

Theca cells convert cholesterol to androdstenedione and Granulosa cells convert the androgens to estradiol

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17
Q

True or False: The synthesis of androgen parallels estrogen throughout the menstrual cycle

A

True

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18
Q

What circulating hormone gives an indication of corpus luteum function?

A

Inhibin A

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19
Q

What circulating hormone is an index of granulosa cell function

A

Inhibin B

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20
Q

What is the effect of activin?

A

Increased granulosa cell proliferation, increased FSHr expression, increased steroidogenesis, and stimulates FSH and LH release

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21
Q

True or False: the conversion of androgens to estrogens is freely reversible

A

False- irreversible

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22
Q

What causes the difference in sex hormone levels in males vs females?

A

How much androgen is made and what percentage of it is converted to estrogen (females have more aromatase expression)

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23
Q

How can estrogen and progesterone be metabolized?

A

Estrogen can undergo conversion to estrone, estriol, and 2-methoxyestrone; Progesterone can be converted to pregnenolone and then pregnandiol

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24
Q

To what receptors does estrogen bind? Progesterone? In what tissues are they expressed? What etrogen type is predominant in reproductive tissues?

A

Estrogen alpha and beta receptors and progesterone A and B expressed in uterus, ovary, breast, bone, brain, cardiovascular– mostly alpha in reproductive tissues

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25
Q

How does estrogen affect progesterone receptors?

A

Upregulates their expression

26
Q

True or False: Estrogen can mediate non-genomic effects.

A

True

27
Q

How does estrogen affect the uterus?

A

Stimulates proliferation of the endometrium and sensitizes it to oxytocin by increasing oxytocin receptors and contractile proteins, increases cervical mucus production

28
Q

How does estrogen affect the ovary?

A

Mitotic effects on granulosa cells and increases the FSH-mediated differentiation process

29
Q

How does estrogen affect the breast?

A

Increased ductal epithial growth and differentiation, and increased mammary progesterone receptor expression

30
Q

What are the non-reproductive effects of estrogen? (Liver, brain, bone)

A

Increases lipoproteion receptor expression, increases HDL and decreases total cholesterol and LDL, decreases fibrinogen antithrombin III and PAI-1, increases thyroid and cortisol binding globulin; neuroprotection; increased bone maturation, epihpyseal plate closure, decreased bone turnover and decreased osteoclast activity

31
Q

What are the effects of progesterone on the ovary?

A

Decreased follicular atresia, promotes oocyte maturation

32
Q

What are the effects of progesterone on the uterus? During pregnancy?

A

Increases growth, differentiation and glandular secretions; during pregnancy it decreases contractility, decreases alpha adrenergic receptor expression, decreases prostaglandin synthesis, and increases relaxin and distensibility

33
Q

How does progesterone affect breast tissue?

A

Prepares the breast for lactation by increasing lobular-alveolar development, decreased prolactin effects

34
Q

How does progesterone affect the brain?

A

Modulates sexual behavior and increases body temperature

35
Q

What is the function of anti-mullerian hormone in females?

A

Inhibition of primordial follicle recruitment- maintain the right tempo of folliculogenesis

36
Q

What hormone can be used as a biomarker of ovarian reserve?

A

anti-Mullerian hormone

37
Q

What changes occur during capacitation?

A

Changes in the sperm plasma membrane, increased affinity of the sperm for the zona pellucida, synthesis of enzymes for the acrosome reaction

38
Q

What is the problem with low birthweight?

A

Associated with an increased risk for mortality, neurologic dysfunction, and adult onset disease

39
Q

What are the functions of the placenta?

A

Support (embryo implantation and nutrients for fetal growth), prevent maternal immunologic rejection of fetus, endocrine function to promote fetal growth and survival

40
Q

True or False: human chorionic gonadotropin can only be found in fetal circulation

A

False

41
Q

What tissue produces human chorionic gonadotropin? When does its production peak?

A

Placenta; Peaks at end of 1st trimester

42
Q

What is the effect of human chorionic gonadotropin?

A

Prevents regression of corpus luteum, stimulates CL hormone synthesis

43
Q

At what point can human placental lactogen be found in maternal and fetal circulation?

A

6 weeks

44
Q

What is the effect/function of placental lactogen?

A

Increases IGF production, regulates insulin, adrenocortical hormone, and pulmonary surfactant production

45
Q

What is the role of human growth hormone-V?

A

Plays a role in intermediary metabolism, increases fetal glucose and amino acids, replaces maternal pituitary GH, ensures adequate supply of nutrients from mother to fetus

46
Q

What is the role of placental progesterone?

A

Uterine quiescence, decreases prostaglandin synthesis, and immunomodulation

47
Q

What is the role of placental estrogen?

A

Increased uterine growth, prostaglandin synthesis, thickening of vaginal wall, sensitization to oxytocin, growth and development of mammary epithelium, inhibition of milk production

48
Q

True or False: During pregnancy the placenta increasingly secretes CRH?

A

True

49
Q

How does the fetoplacental unit work together to synthesize and metabolize sex steroids?

A

The mother’s liver converts acetate to cholesterol which is transferred to the placenta where it is converted to pregnenolone. Pregnenolone can be converted to progesterone or be transported to the fetal adrenal cortex to be converted into DHEA which can reenter the placenta to be converted to estriol which can be conjugated in the maternal liver and excreted by the kidney

50
Q

What is secreting estrogen and progesterone in the third trimester?

A

Just the placenta

51
Q

What are the phases of uterine activity in parturition?

A

0- Quiescent; 1- Activation, 2- Active uterine contraction, 3- postpartum uterine involution

52
Q

What are the steps of breast development, what are the hormones involved in each step, and when does each process occur?

A

Ductal elongation (Puberty; Estrogen, GH, IGF-1, EGF), Ductal branching and budding (Sexual maturation and pregnancy; Progesterone, estrogen, cortisol, prolactin, T3/T4), and Expansion and differntiation (Pregnancy and Post-partum lactation; Prolactin, IGF-1, hPL, cortisol, insulin, oxytocin

53
Q

What is the first change associated with puberty in females?

A

Increased nocturnal LH and FSH pulses

54
Q

What changes occur with female puberty?

A

Skeletal maturation (epiphyseal fusion and increased bone mass), breast development, ovarian and follicular growth, pubic and axillary hair, onset of menses

55
Q

What is required for the initial pulsitility of estrogen and GH in female puberty?

A

Adipose-derived leptin

56
Q

What are the initial stages of menopause characterized by? What causes this?

A

Increased release of GnRH due to the decreased ability of ovary to make hormones, decreasing negative feedback inhibition from inhibin and estrogen

57
Q

What happens to the ratio of androgens/ estrogens in menopause?

A

Increases because the adrenals have not lost the ability to make androgens but ovaries have lost ability too make estrogens

58
Q

What are the risk factors for developing osteoporosis?

A

Decreased sex hormones, chronically elevated glucocorticoids and thyroid hormone, prolonged immobilization, GI disorders, malignancy, alcoholism, cigarette smoking

59
Q

What does DEXA measure?

A

Bone density

60
Q

What is FRAX?

A

A fracture risk prediction tool proposed by the WHO that incoporates DEXA and clinical risk factors

Physiology Block 3- Endocrine Physiology (10 decks)

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