Hacker and Moore Part 1

Question 1

Name the five important uterine ligaments and provide one functional detail about each one.

Answer 1

1) Round ligament - keeps uterus anteverted
2) Uterosacral ligament - sympathetic and parasympathetic innervation to the uterus
3) Cardinal ligament - important in support, prevent uterine prolapse
4) Infundibulopelvic ligament/ Ovarian ligament - carries vessels and nerves to the ovary
5) Pubocervical ligaments - attach to pubic symphysis

Question 2

Where is the most common place for an ectopic pregnancy to occur?

Answer 2

Ampullary portion of the fallopian tubes

Question 3

Name the hormones of the anterior pituitary gland (6) and posterior pituitary gland (2).

Answer 3

Anterior: FSH, LH, TSH, prolactin, GH, ACTH
Posterior: oxytocin and vasopressin (ADH)

Question 4

Describe the serum levels of FSH, LH, Estradiol, and Progesterone in the early and late follicular phase

Answer 4

Early: all levels low
Late: LH surge, high FSH, high estradiol, low progesterone

Question 5

Describe the serum levels of FSH, LH, Estradiol, and Progesterone in the early and late luteal phase

Answer 5

Early: LH surge, FSH high, Estradiol high, Progesterone low
Late: LH and FSH low, progesterone and estradiol falling from high in mid-luteal cycle.

Question 6

Provide the five hormones secreted by the hypothalamus

Answer 6

1) GnRH
2) TRH - thyrotropin-releasing hormone
3) Somatostatin
4) CRF - corticotropin-releasing factor
5) PIF - prolactin release-inhibting factor

Question 7

What are the action of GnRH on the anterior pituitary (2)

Answer 7

1) stimulate synthesis of LH and FSH

2) stimulates release of LH and FSH into circulation

Question 8

What affect would a continuous infusion of a GnRH agonist have on the LH and FSH levels? What medical conditions could this be used to treat (4)?

Answer 8

1) Decreases gonatroph synthesis and release through down-regulation
2) endometriosis, leiomyomas, hirsutism, precocious puberty

Question 9

What impact does dopamine have on prolactin release?

Answer 9

Inhibitory

Question 10

During which point in the menstrual cycle are estrogens highest (2)?

Answer 10

1) Biphasic response. Highest 1 day prior to ovulation (LH surge)
2) 5-6 days following ovulation in the luteal phase

Question 11

When in the menstrual cycle does progesterone peak?

Answer 11

5-7 days after ovulation, due to production by the corpus luteum

Question 12

What cells are stimulated by LH, what is their output? What cells are stimulated by FSH, what is their output?

Answer 12

1) LH - theca cells - produce androgens

2) FSH - granulosa cells - convert androgens into estrogens through aromatization.

Question 13

A follicle destined for ovulation is likely to have increased quantities of what (2)?

Answer 13

1) FSH receptors
2) Granulosa cells
Both increase local estrogen concentration

Question 14

When does the first meiotic division take place in an oocyte? What is the oocyte called after this division?

Answer 14

1) A few hours preceding ovulation

2) This forms the secondary oocyte and the first polar body

Question 15

What layer of the endometrium is shed during menses? What are the vessels within this layer called?

Answer 15

1) outer portion - functionalis

2) Spiral arteries

Question 16

Describe the pertinent points of the three phases of endometrial changes during the menstrual cycle: menstrual phase, proliferative phase, estrogenic phase.

Answer 16

1) Menstrual - glands and stroma disintegrate, leukocyte infiltration, RBC extravasation
2) Proliferative - endometrial growth secondary to estrogen stimulation
3) Secretory - follows ovulation, corpus luteum secreting progesterone, progesterone stimulates glandular cells to secrete glycogen and mucus

Question 17

What is the typical volume of ejaculate? How many sperm are present? And what percentage are motile?

Answer 17

1) 2-5ml
2) 40-300 million
3) 50-90 percent

Question 18

How long does the fertilized ovum typically take to reach the uterine cavity? How long until it implants?

Answer 18

1) 3 days

2) 2-3 days after arrival

Question 19

What are the 3 decidual layers of the uterus that form after implantation? When do two of the layers fuse?

Answer 19

1) Basalis (site of implantation), Capsularis (covers ovum), Vera (lines uterine cavity)
2) Capsularis and vera fuse at 4 months

Question 20

At what day of pregnancy is the placenta functional?

Answer 20

17th