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3rd Block > Female Reproductive System > Flashcards

Female Reproductive System Flashcards

1
Q

What is the function of mammary glands?

A

Synthesize, secrete and eject milk to nourish the new born

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2
Q

What is the function of the vagina?

A

Receives the penis during sexual intercourse and is a passageway for childbirth

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3
Q

What are the functions of the uterus?

A
  • site of Implantation of fertilized ovum
  • site for development of the fetus during pregnancy and labor
  • inner lining sheds during menstruation
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4
Q

What are the function of the ovaries?

A

Produce secondary oocytes and hormones including progesterone, estrogen, inhibin and relaxin

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5
Q

What is the function of the uterine tubes?

A

Transports a secondary oocyte to the uterus and is usually the site of fertilllization

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6
Q

What ligaments hold the ovaries to the peritoneal cavity?

A

Broad ligament - part of the parietal peritoneum

Ovarian ligament- anchors ovaries to uterus

Suspensory ligament- attaches ovaries to pelvic wall

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7
Q

What are produced by ovaries?

A

Hormones- progesterone, estrogen, inhibin and relaxin

Secondary oocytes which develop into a mature ova(eggs)

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8
Q

Ovaries are paired female glands ___________. To the testes

A

Homologous

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9
Q

What is the surface of the ovary covered by?

A

Germinal epithelium

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10
Q

What does the medulla of the ovaries contain?

A

Blood vessels, lymphatic and nerves

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11
Q

What is the ovarian cortex made of?

A

Connective tissue and ovarian follicle at different stages

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12
Q

What is the tunica albugenia?

A

A thick connective tissue layer between germinal epithelium and ovarian cortex

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13
Q

Where do the ovarian arteries branched from?

A

Abdominal aorta

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14
Q

Where do the ovarian veins end?

A

Left ovarian vein ends in the left renal vein

Right ovarian vein ends in inferior vena cava

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15
Q

Ovarian vessels travel in ___________ _________

A

Suspensory ligament

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16
Q

Where does ovarian lymphatic drainage end?

A

In the lateral aortic lymph nodes

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17
Q

What are risk factors for ovarian cancer?

A

Age(usually over 50)

Race(highest in whites)

Family history of ovarian cancer

More grant 40 years of ovulation

Nulliparty or first pregnancy after age 30

High fat, low fiber, vitamin A deficient diet

Prolonged exposure to talc or asbestos

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18
Q

What is ovarian cancer?

A

Sixth most common cancer in females but the leading cause of deaths from gynecological cancers except for breast cancer

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19
Q

Why is ovarian cancer a leading cause of cancer in females?

A

Because it is difficult to detect before metastases(spread to different sites)

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20
Q

Describe the asymptomatic stages/early stages of ovarian cancer

A

Usually in the early stages or patient may have mild symptoms like abdominal discomfort, heartburn, nausea, loss of appetite, bloating and flatulence

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21
Q

What are the symptoms of ovarian cancer when it is symptomatic/later stages?

A

Enlarged abdomen, abdominal and pelvic pain, persistent gastrointestinal disturbances, urinary complications, menstrual irregularities and heavy menstrual bleeding

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22
Q

What is the Fallopian tube?

A

Pair of fibromuscular tubes- no direct connection to ovary

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23
Q

What is the purpose of the Fallopian tube?

A

Conducts ova expelled from ovary to the uterus

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24
Q

What is an ectopic pregnancy?

A

When egg implants outside of the uterus. This can be intra-abdominal, tubal

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25
Q

What are the parts of the Fallopian tube?

A

Ampulla, infundibulum and isthmus

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26
Q

What is the uterus?

A

A muscular organ that provides a protective and nutritive environment for developing fetus

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27
Q

Where is the uterus located?

A

Behind the bladder and in front of the rectum

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28
Q

Where is the rectouterine pouch (of Douglas)?

A

Between uterus and rectum

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29
Q

Describe the 3 parts of the uterus

A

Fundus- dome-shaped and superior to the termination of the uterine tubes

Body- tapering central portion

Cervix is the inferior narrow portion

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30
Q

What are the 3 layers of the uterine wall?

A
  1. Outer peritoneum- lined by serosa or adventitia
  2. Middle thick layer- myometrium
  3. Innneer endometrium
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31
Q

Name the 2 parts of the endometrium

A
  1. Stratum functionalis

2. Stratum basalis

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32
Q

What is the function of the stratum functionalis?

A

It changes drastically during each cycle, being lost monthly if pregnancy does not occur

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33
Q

What is the function of the stratum basalis?

A

Close to Myometrium, maintained during menstruation and provides stem cells for stratum functionalis

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34
Q

What is the normal anatomical position of the uterus?

A

Anteverted and anteflexed

The body of the uterus is bent forwards over the cervix- anteflexion

Long axis of the cervix is bent forward over the long axis of the vagina- anteverted

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35
Q

What structures provide support for the uterus?

A

Pelvic floor muscles

Perineal body

Transverse cervical ligaments

Uterosacral ligaments

Round ligaments of the uterus

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36
Q

What is a uterine prolapse?

A

The loss of support by the cardinal and/or uterosacral ligaments and by the pelvic floor muscles (lavatory ani and coccygeus)

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37
Q

What are treatments for a uterine prolapse?

A

Exercises

Lifestyle changes

Surgery

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38
Q

What is the consequence of a uterine prolapse?

A

Support structures can no longer counteract typical intra-abdominal pressures

Various degrees of prolapse May occur

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39
Q

What is an episiotomy?

A

A cut/incision in the Perineum between the vagina and the anus made with surgical sciccors to widen the birth canal for the baby to pass through.

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40
Q

What are the complications due to an episiotomy?

A

Pain

Increased risk of fecal incontinence

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41
Q

What are some indications that an episiotomy?

A

Very large fetus

Breech presentation(buttocks or lower limbs coming first)

Abnormal fetal heart rate(fetal distress)

Forceps delivery

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42
Q

What is the arterial supply of the uterus?

A

Uterine arteries-branches of the internal iliac arteries

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43
Q

Describe veinous drainage of the uterus

A

Uterine and vaginal veins which drain to the ovarian and internal iliac veins

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44
Q

What is a hysterectomy?

A

The surgical removal of the uterus and is the most common gynecological operation

Surgical incision is made through the abdominnal wall or the vagina

Can be complete, partial, radical or subtotal

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45
Q

What are some indications a hysterectomy maybe needed?

A

Uterine fibroids(abnormal growths)

Pelvic inflammatory disease( remember public health)

Endometriosis

Excessive uterine bleeding

Cancer of the cervix, uterus or ovaries

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46
Q

In most cases, cervical cancer can be detected in its earliest stages by a _______ ________

A

Pap smear

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47
Q

How are most cases of cervical cancer caused?

A

By several types of HPV( human papilloma virus), most commonly implicated are 16 and 18

48
Q

Is HPV sexually transmitted?

A

Yes

49
Q

What are risk factors for cervical cancer?

A

HPV

Smoking

Immunosuppression

Long term oral contraceptive use

Being overweight

50
Q

What are the main symptoms of cervical cancer?

A

Abnormal vaginal bleeding

51
Q

Describe the development of cervical cancer

A

Begins as a precancerous stage called cervical dysplasia where there is a change in number, shape and growth of cervical cells

Abnormal cells can either revert back to normal or progress slowly to cancer

52
Q

Describe the impact of carvical cancer

A

Affects about 12,000 females a year in the US with a mortality of 4,000 annually

53
Q

How can cervical cancer be prevented?

A

Two vaccines are available to protect against cervical cancer

Gardasil and Cervarix

54
Q

How can cervical cancer be treated?

A

Radiation therapy

Cryotherapy

Surgery

Laser therapy

Chemotherapy

55
Q

Describe the 3 layers of the vagina

A

(Outer most layer)Mucousa- comprised of non-keratinized stratified epithelium and lamina propia

Middle layer- muscularis- 2 layers of smooth muscle= inner circular and outer longitudinal layer

Inner layer, adventitia- loose connective tissue that anchors the vagina to the surroundings

56
Q

Histology of mammary glands varies with _________ and the __________ ________ of the individual

A

Age

Physiological state

57
Q

Hormones that affect mammary glands come from,,,,

A

The ovary, placenta and pituitary

58
Q

Describe the mammary glands

A

Modified sweat glands, 15-25 lobes tuboalveolar glands

59
Q

Describe the glandular elements/ arrangement of mammary glands

A

Arranged in radical fashion around the nipple into which ducts from secretory units empty

60
Q

Who does fibrocystic change of ducts affect? Why?

A

Affects women between 30-50 years and usually due to hormonal stimulation of the breast tissue(glands and fibrous stroma)

61
Q

What are the consequences and symptoms of fibrocystic change of the breast?

A

Dilated fluid filled acini and stroma abundance

Small cyst and nodules are formed leading to painful and lumpy breast

This is not a cancer

Symptoms- follow a periodic trend tied closely related to the menstrual cycle

62
Q

What is the second leading cause of cancer death in women?

A

Breast cancer

63
Q

What are treatments for breast cancer?

A

Breast conservation surgery

Radiation therapy

Modified radical mastectomy

Chemotherapy

64
Q

What is the most common type of breast cancer?

A

Ductal carcinoma

65
Q

What are the risk factors of breast cancer?

A

Female sex(it’s rare in men)

Advancing age

Positive family history

Increased exposure to endogenous estrogen (Early menarche and late menopause)

Delayed childbirth

Prolonged use of hormone replacement therapy

Alcohol consumption

Nulliparty

66
Q

What is the screening recommendations for testing for breast cancer by the American Cancer society in women over 20?

A

Monthly breast self examination

67
Q

What is the screening recommendation for breast cancer by the American Cancer society for women between 20-40 years?

A

Clinical breast examination every 3 years

68
Q

What is the screening recommendation for breast cancer in women over 40 years or older?

A

Annual mammography and annual clinical breast examination

69
Q

What is the typical duration of the menstrual cycle?

A

24-35 ( average 28 days)

70
Q

Name the 4 phases of the menstrual cycle and the days in which they occur

A

Menstrual phase = 1-5 days

Preovulatory phase= 6-13 days

Ovulation= day 14

Postovulatory phase= days 15-28

71
Q

What is the purpose of Gonadotropin in female reproductive cycles?

A

Secreted by hypothalamus controls ovarian and uterine cycle

Stimulates release of follicle-stimulating hormone(FSH) and lutenizing hormone (LH) from anterior pituitary

72
Q

How does GnRH lead to follicular development?

A

Stimulates release of LH and FSH

Each month from puberty to menopause LH and FSH stimulate many primordial follicles to develop until one reaches ovulation

This is caused by a surge of LH as well as formation of the corpus luteum

FSH and LH Stimulate follicles to secrete estrogen

Corpus Luteum secretes progesterone, estrogen, relaxin and inhibin until it degenerate into corpus albicans

73
Q

Explain the development of the follicle

A

Primordial follicles develop into primary follicles in the cortex of the ovaries

With about 200,000 to 2,000,000 primordial follicles at birth 40,000 remain at puberty and 400 will mature during a lifetime

Primary follicle completes first meiosis division to form a secondary follicle and first polar body

Secondary follicle enters second meiosis division and becomes a mature (Graafian) follicle

During ovulation, the Graafian follicle ruptures and releases a secondary oocyte and surrounding granulosa cells

Corpus luteum- remnant of mature follicle after ovulation

74
Q

What is the purpose of estrogens secreted by ovarian follicles in hormonal regulation?

A
  • Promote development and maintenance of female reproductive structures and secondary sex characteristics
  • increases protein anabolism including building strong bones
  • lowers blood cholesterol
  • inhibit release of GnRH, LH and FSH via negative feedback
75
Q

What is the purpose of progesterone in hormonal regulation?

A
  • Secreted mainly by corpus luteum
  • works with estrogens to prepare and maintain endometrium for implantation and mammary glands for milk production
  • inhibits secretion of GnRH and LH( negative feedback)
76
Q

What is the purpose of relaxin in hormonal regulation?

A

Produced by the corpus luteum

Relaxes uterus by inhibiting contraction of the myometrium

At the end of pregnancy, increases flexibility of pubic symphysis and dilates the uterine cervix

77
Q

What is the purpose of inhibin in hormonal regulation?

A
  • Secreted by granulosa cells of growing follicles and by corpus luteum
  • inhibits secretion of FSH and LH
78
Q

Describe the menstrual phase of the uterine cycle

A

First 5 days of a new cycle

FSH stimulates several primordial follicles to primary follicles and then secondary follicles- this takes several months and a follicle that begins developing in one cycle may not mature until several cycles later

Declining levels estrogens and progesterone stimulate release of prostaglandins causing uterine spiral arterioles in stratum functionalis to constrict

This deprived cells in stratum functionalis to become oxygen deprived and die, discharging as menstruak discharge

Only stratum basalis remains

79
Q

Describe the preovulatory phase in the uterine cycle

A

Days 6-13

Some of the secondary follicles begin to secrete estrogens and inhibin

The dominant follicle secretes estrogens and inhibin to inhibit FSH to prevent other follicles from growing

Estrogens stimulate repair of the endometrium

Cells of stratum basalis undergo mitosis to form new stratum functionalis

Thickness of endometrium doubles

In the uterine cycle, preovulatory phase is the proliferative because the endometrium is proliferating

80
Q

How are fraternal/non identical twins produced ?

A

Normally one dominant follicle becomes the mature follicle

But 2 or 3 secondary follicles can become codominant and are ovulated and fertilized at the same time

81
Q

What are the preovulatory and menstrual phases called in the ovarian cycle?

A

The follicular phase because follicles are growing

82
Q

Describe ovulation

A

-Rupture of Graafian/mature follicle and release of secondary oocyte

Day 14 of 28 day cycle

-a high levels of estrogens exert a positive feedback effect on cells secreting LH and GnRH

83
Q

Describe the postovulatory phase

A

Duration most constant of phases

Last 14 days of 28 days

After ovulation, mature follicle collapses to form Corpus luteum under the influence of LH

  • Secretes progesterone, estrogen, relaxin and inhibin
  • in the ovarian cycle, this is the literal ohase
84
Q

Describe the fate of the Corpus Luteum if oocyte is not fertilized.

A

Corpus lasts 2 weeks and degenerates into the Corpus albicans

-As levels of estrogen, progesterone and inhibin decrease, release of GnRH, FSH and LH increase due to loss of negative feedback

Follicular growth begins as a new cycle begins

85
Q

Describe the fate of the corpus luteum if the oocyte is fertilized

A

Corpus luteum lasts more than 2 weeks

Human chorionic gonadotropin(hCG) produced by chorion of embryo about 8 days after fertilization stimulates corpus luteum

86
Q

Describe the secretory phase of the uterine cycle

A

Progesterone and estrogens produced by corpus let emu stimulate growth of endometrium with changes peaking about 1 week after ovulation when a fertilized ovum might arrive in the uterus

87
Q

Differentiate the uterine and ovarian supply

A

Uterine arterial supply- branches of the internal iliac arteries

Ovarian arterial supply- from aorta

88
Q

From what cells are inhibin secreted?

A

Granulosa cells on growing follicles

Corpus luteum

89
Q

What is chlamydia?

A

A commonly transmitted STD caused by infection with Chlamydia Trachomatis

90
Q

What are the symptoms of chlamydia?

A

Usually asymptomatic

Can cause cervix is in women as well as other serious complications:

  • Pelvic inflammatory Disease(PID)
  • Tubal factor infertility
  • Ectopic pregnancy
  • Chronic pelvic pain
91
Q

What is the treatment for Chlamydia?

A

Antibiotics

Drug of choice is Azithromycin or Doxycycline

92
Q

What is gonorrhea?

A

STD caused by infection by bacterium Neisseria gonorrhoeae within the:

  • Cervix and uterus and uterine tubes in women
  • Urethra in men and women
  • an also infect mucous me,brands of mouth, throat, eyes and anus
93
Q

What are the symptoms and complications of Gonorrhea?

A

Women infected with gonorrhea are usually asymptomatic

Women are at risk of developing serious complications from infection, even in the absence of symptoms.

Complications are similar to those of chlamydia

94
Q

What are the treatments for gonorrhea?

A

Antibiotic

Drug of choice is ceftriaxone(intramuscular)

95
Q

What causes genital herpes?

A

Caused by 2 types of viruses:

Herpes simplex type. 1 and herpes simplex type 2

96
Q

Describe the symptoms of herpes

A

Most people who have genital herpes have no or very mild symptoms

When symptomatic the typical manifestation is a cluster of blisters appearing on or around genitalia, rectum or mouth resembling cold sores

Blisters break and leave painful sores that may take weeks to heal

97
Q

What is treatment for Genital herpes?

A

Cannot be cured

Antiviral(acyclovir) help reduce pain and number of lesions

98
Q

What is Syphilis?

A

An STD caused by the bacterium Treponema pallidum

May also be transferred from mother to fetus resulting in Congenital syphilis

99
Q

What are 4 stages of syphilis?

A

Primary syphilis, secondary syphilis, latent syphilis and late stage

100
Q

What are the symptoms of primary syphilis?

A

Classicallly presents with a single firm, painless and non-itchy ulcer on the genitalia known as chancre

101
Q

What are the symptoms of Secondary Syphilis?

A

Presents with diffuse rash which frequently involves palms and soles

102
Q

What are the symptoms for latent syphilis?

A

Shows no symptoms

103
Q

What are the symptoms of the late stages of syphilis?

A
  • May damage the internal organs and patients may show symptoms difficulty coordinating muscle movements
  • paralysis
  • numbness
  • gradual blindness
  • dementia
104
Q

How can Syphilis be treated?

A
  • Drug of choice is Benzathine penicillin G (intramuscular)

- if allergic to penicillin: Doxycycline or Tetracyclin

105
Q

What are Genital warts?

A

Highly contagious warts or condylomata acuminata

106
Q

What causes Genital Warts?

A

HPV types 6 and 11

107
Q

How can Genital warts be prevented?

A

Gardasil HPV vaccine

108
Q

What is the use of Gardasil?

A

Protects against HPV types 16, 18, 6 and 11

Cervical cancer and genital warts

109
Q

What are the treatments for Genital Warts?

A

There is no cure for genital warts through topical gels like trichloroacetic acid or podophyllotoxin are often useful

110
Q

What is an abortion?

A

The premature expulsion of the products from the uterus usually before the twentieth week of pregnancy

Can be spontaneous(naturally occurring/miscarriage) or induced(intentional)

111
Q

What are the types of induced abortion?

A

Mifepristone

Vacuum aspiration

Dilation and evacuation

Late-stage abortion

112
Q

What are the methods of sterilization of each sex?

A

Male- vasectomy

Female- tubal ligation

113
Q

What is coitus interruptus? Why is it ineffective?

A

Withdrawal of penis before ejaculation

Problem: pre-ejaculatory fluid

114
Q

List 2 methods of periodic abstinence

A

Rhythm method

Symptoms-thermal method

115
Q

What birth control method is 10p% effective?

A

Abstinence

3rd Block (5 decks)

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