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Semester 5 April > Histology - Female Genital Tract and Pregnancy > Flashcards

Histology - Female Genital Tract and Pregnancy Flashcards

0
Q

Example of autocrine signaling in female gen tract

A

Activin from granulosa cells up regulates FSH receptors on their surface

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1
Q

Example of paracrine signaling in female gen tract

A

Inhibin from granulosa cells act on theca interna (assists LH in androstenedione synthesis)

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2
Q

What is cortex of ovary lined by

A

Simple cuboidal/ squamous epithelium (tunica albuginea)

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3
Q

Epithelium of endocervical canal

A

Mucus secreting simple columnar epithelium

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4
Q

Epithelium of ectocervix

A

Stratified squamous epithelium

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5
Q

Development of transformation zone

A

Estradiol causes eversion of endocervical canal and columnar epi exposed to acidic pH. Squamous metaplasia (epidermalisation)

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6
Q

Risks associated with transformation zone

A
  1. Infection (early puberty)
  2. Nabothian cyst
  3. Dysplasia
  4. Carcinoma
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7
Q

Epithelium of vagina

A

Stratified squamous epithelium (produces glycogen under influence of estriol)

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8
Q

Role of glycogen in vaginal

A

Lactobacilli convert glycogen to lactic acid creating an acidic pH

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9
Q

Vaginal lubricated by

A

(Vaginal lacks glands)
Uterine glands
Endocervical glands
Glands of Bartholin (vestibules)

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10
Q

Epithelium of uterine tubes

A

Simple columnar epi.
Ciliated - larger in follicular phase, estrogen increases motility.
Secretory (peg) cells - increase secretion w estrogen

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11
Q

Fx of secretions in uterine tubes

A

Capacitation of sperm

Nutrients for ovum, sperm, morula

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12
Q

Features of atretic follicles

A

Delamination of granulosa cells (pyknotic nuclei, apoptotic bodies)
Collapse
Fibrous body -> corpus albicans

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13
Q

Five stages of follicular development

A 
Primordial follicle
Primary follicle - unilayered
Primary follicle - multilayered 
Secondary follicle
Graafian follicle
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14
Q

Three regions of granulosa cells in Graafian follicle

A

Mural granulosa cells
Cumulus oophorous
Corona radiata

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15
Q

When is dominant follicle determined

A

Day 7

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16
Q

How is steroid produced in follicle

A

Granulosa cells lack enzymes to generate steroid. Therefore, theca interna cells produce androstenedione which is taken up by the GCs and converted to estradiol by aromatase

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17
Q

Role of follicle hormones in estradiol synthesis

A

Activin - released by GCs up regulates FSH receptors on GCs (autocrine)

FSH - increases aromatase activity in GCs. Increases the expression of inhibin in GCs

Inhibin - acts on theca interna (paracrine) assisting LH in androstenedione synthesis

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18
Q

What does LH surge do

A
  1. Halts estrogen production
  2. Initiates 2nd meiotic division (block oocyte maturation-inhibitory substance of GCs)
  3. Increase local prostaglandin production (vascular changes = follicle swelling, proteolytic enzyme action on ovary stroma)
  4. Differentiate follicular cells to form granulosa lutein cells (take up cholesterol)
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19
Q

Formation of corpus luteum

A

BM breaks down. Invasion of blood vessels into theca lutein. LH causes cholesterol uptake. Theca lutein produces progesterone and androstenedione.
FSH still needed for aromatase

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20
Q

Changes seen in uterine cycle from proliferators phase -> secretory phase

A

Endometrium thin -> thick
Glands straight/tortuous -> saw toothed, many secretions
Cells low/tall -> basal/apical glycogen
Stroma Mitotic figures -> large decidual-like/ oedema and lymphocytes

21
Q

What happens in ischemic phase of uterine cycle

A

Release of prostaglandins = spiral artery spasm. Hypoxia = stroma flooded w blood. Functional layer shed. Basal layer remains intact (straight arteries)

22
Q

Eversion of endocervical canal forms

A

Ectropion

23
Q

Process of female sexual arousal

A

Parasympathetic activation - engorgements of clitoris.
Increased vaginal excretions.
Engorged blood vessels.
Orgasm - peristaltic contractions of vaginal/uterus.
Pudendal nerve = rhythmic contraction (bulbosongiosus/ ischiocavernosus)

24
Q

Effect of contraceptive pill

A
  1. HP axis - inhibits synthesis/secretion of FSH. Therefore, no follicle maturation/ LH surge/ ovulation.
  2. Cervix - cubical mucus thicker, more hostile. Prevents sperm entry.
  3. Endometrium - lining thins, alters tubes (ovum can’t travel easily)
25
Q

Mechanism of morning after pill

A

Synthetic progesterone prevents implantation

26
Q

Mechanism of estrogen-progesterone-glucocorticoid receptor antagonist

A

Non supportive endometrium

27
Q

Mechanism of prostaglandin E2 contraceptive

A

Uterine contractions

28
Q

Role of estrogens in the female

A

Many genital tract changes
Bone deposition
Cardiac protection (cholesterol metabolism, antioxidant, vasodilation, regulates arterial muscle proliferation after injury)
Modulates E and NE actions

29
Q

Fx of syncytiotrophoblasts

A
  1. Release proteases - erode maternal tissue
  2. Secrete hCG - maintain corpus luteum
  3. No MHC
  4. Line inter villus space
  5. Microvilli brush border increases SA for exchange
30
Q

Fx of cytotrophoblasts

A
  1. Syncytiotrophoblast precursor
  2. Secretes FAS ligand - kills T cells
  3. Anchors villus stem to decidua by secreting fibrinogen substance
  4. Invasion of spiral arteries to form maternal sinusoids and regulate blood flow (poor invasion = abortion, eclampsia, growth retardation)
31
Q

Immune protection mechanisms in placenta

A

Decidua - prostaglandins inhibit NK cells. Infiltration leukocytes secrete IL 2
Inter villus space - IgGs
Chorionic villi - syncytiotrophoblasts have no MHC. Cytotrophoblasts secrete FAS ligand
Hofbauer cells in early pregnancy = phagocytosis

32
Q

Describe process of blastocyst attachment

A
  1. Blastocyst hatches from zona pellucida
  2. Trophoectoderm binds uterine surface
  3. Primary decidual zone formed (cells proliferate, ECM proteins laid down, various proteins released)
  4. Vasculature becomes permeable at implantation site.
33
Q

Describe process of blastocyst implantation

A
  1. Trophoectoderm invades uterine luminal cells which undergo apoptosis.
  2. Reduced desmosomes helps embryo penetration.
  3. Secondary decidual zone replaces primary zone.
34
Q

What makes secondary villus different to primary

A

Extraembryonic mesodermal core

35
Q

Role of decidua cells

A

Luteal phase - secrete decidual prolactin -> GF for corpus luteum
After implantation - modulate trophoblast implantation, provide nutrients for embryo, prostaglandins inhibit NKs, secrete relaxin, secretes IGF binding protein preventing endometrial gland proliferation, prostaglandins regulate blood flow.

36
Q

How is estrogen produced in pregnancy

A

Fetoplacental unit.
Cholesterol -> pregnenalone -> progesterone in placenta
Progesterone -> DHEA in fetal adrenals
DHEA -> estrogen in placenta

37
Q

What is the placental luteal shift

A

Chorionic gonadotropin used instead of LH to maintain the corpus luteum

38
Q

Why may glucose and insulin be high in preg woman

A

Human chorionic somatomammotropin (placental lactogen) increases liver resistance to insulin. [ structure similar to GH and prolactin ]

39
Q

Role of human chorionic somatomammotropin

A

Fetal growth

Mammary gland development

40
Q

Pregnancy’s effect on maternal physiology

A 
Alveolar respiration (>progesterone)
Tidal volume
Maternal blood volume
Nutrient requirements
GFR
Uterus size
Mammary gland growth + development
41
Q

Role of cortisol in parturition

A

Fetal lungs exposed to more pulmonary surfactant = maturation
Surfactant protein in amniotic fluid = macrophages causing increase prostaglandin production.

42
Q

Role of estrogen in triggering parturition

A

Increase number of gap junctions = synsytium
Increase oxytocin receptors in myometrium = increased responsiveness to low levels of oxy
Increase prostaglandin production = cervical softening

43
Q

Describe process responsible for progression of parturition

A

Oxytocin causes uterus to contract. Fetus pushed against cervix -> ferguson reflex causes more oxytocin release increasing prostaglandin production and causing more contraction (positive feedback cycle)

44
Q

Structure where all mammary glands meet

A

Lactiferous sinus

45
Q

What inhibits lactation

A

High levels of estrogen

Dopamine

46
Q

Constituents of colostrum

A

Proteins (merocrine)
Lipids (apocrine)
Lactose -> draw water into milk by creating osmotic gradient

47
Q

What initiates lactation

A

Increase cortisol -> milk synthesis enzymes induced

Rapid fall in estrogen overrides dopamine’s inhibitory effect

48
Q

How is prolactin secretion controlled

A

Dopamine inhibits prolactin. Suckling inhibits dopamine release allowing increase in prolactin stimulating galactopoeisis. Suckling also stimulates oxytocin release causing contraction of myoepithelial cells.
NB prolactin inhibits GnRH therefore no menses

49
Q

Other functions of oxytocin

A

Pair bonding with sexual partner

Maternal behavior

50
Q

Cells seen on Pap smear (normal)

A

Large squamous epithelial cells with pyknotic nuclei = surface epithelium. Can be acidopholic (Pre) or basophilic (post) ovulation.
Columnar cells of endocervix indicates that the TZ and squamocolumnar junction cells are present

Semester 5 April (17 decks)

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