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Endo Exam 2 > Histology/Physiology of the Female Reproductive Tract > Flashcards

Histology/Physiology of the Female Reproductive Tract Flashcards

1
Q

FSH and LH levels in women over lifespan

A

reproductive years - cyclical increases

1,2,3 trimesters - increased
also increased at birth to 6 months
childgood low, puberty increase

menopause high but arent cyclical

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2
Q

FSH and LH in female during menopause

A

high levels that plateaus

  • because no negative feedback
  • lose function of ovaries
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3
Q

hypothalamic amenorrhea

A

decreased LH and FSH during reproductive years

amenorrhea or oligomenorrhea

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4
Q

LH and FSH feedback

A

pulse of GnRH determines LH or FSH

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5
Q

thecal cells

A

LH receptors

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6
Q

granulosa cells

A

FSH

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7
Q

estrogen and progestin

A

both positive and negative feedback on hypothalamus and pituitary

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8
Q

inhibins

A

by granulosa cells

negative feedback

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9
Q

activins

A

by granulosa cells

positive feedback

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10
Q

day menstrual starts

A

corpus luteum degenerates - no more progesterone and estrogen
-levels decrease

usually determined by onset of menses

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11
Q

pituitary ovary cross talk

A

1 corpus luteum dies - E and P fall

2 pituitary increases FSH (no E and P - feedback)

3 FSH recruits numerous antral follicles - that secrete low E and inhibin

4 E and inhibin negative feedback on FSH

5 low FSH causes 1 follicle to be chosen - produces high E and inhibin

6 high E - positive feedback on LH and FSH surges

7 LH surge induces metabolic maturation, ovulation, luteinization - corpus luteum produces high P, E and inhibin

8 high P, E, and inhibin negative feedback on FSH

9 corpus luteum becomes less sensitive to basal LH - dies if no hCG (LH like hormone)

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12
Q

fast pulse GnRH

A

LH

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13
Q

slow pulse GnRH

A

FSH

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14
Q

capsule of ovary

A

tunica albuginea

  • simple cuboidal epithelium
  • underneath is dense irregular CT
  • eroded at time of ovulation

loose in medulla
compact at cortex

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15
Q

hilus of ovary

A

main structures in medulla

  • vessels
  • lymphatics
  • nerves
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16
Q

first 14 days ovarian cycle

A

follicular cycle

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17
Q

last 14 days ovarian cycle

A

luteal phase

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18
Q

during follicular phase?

A

menses and proliferative phase of endometrial cycle

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19
Q

during luteal phase?

A

secretory phase of endometrial cycle

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20
Q

follicular phase hormones

A

first small increase in FSH

-follicles mature

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21
Q

ovulation

A

LH surge

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22
Q

corpus luteum

A

formation begins luteal phase

from ovarian follicle

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23
Q

during follicular phase

A

FSH increase stimulates cohort of follicles to mature

  • follicles produce estradiol
  • levels peak prior to ovulation
  • mid-cycle LH surge due to estradiol + feedback
  • necessary to stimulate ovulation
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24
Q

aromatase

A

converts androgens to estrogens

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25
granulosa cells
contains aromatase | -can produce estrogens
26
stages of follicular development
``` primordial follicle - present at birth primary follicle secondary preantral follicle small antral follicle large, recruitable antral follicle dominant follicle at ovulation ```
27
gonadotropin independent growth phase
follicular growth not regulated by pituitary paracrine factors between oocytes and follicle cells primordial to secondary preantral follicles
28
basal growth phase
dependent on gonadotropins low sensitivity and not influenced by fluctuations associated with menstrual cycle secondary preantral follicle to large antral follicle
29
rapid growth phase
follicles extremely sensitive to FSH -need FSH to avoid atresia large antral follicle to dominant follicle at ovulation
30
graafian follicle
becomes estrogenic
31
primordial follicle
has primary oocyte 46 chromosomes diploid 4N arrested in prophase 1 of meiosis - stay here squamous follicular cell surround primary oocyte - joined by desmosomes - separated from stroma by BM
32
cell layer in primary follicle
squamous follicular cell surrounding primary oocyte
33
unilaminar primary follicle
oocyte grows - follicular cells become cuboidal - zona pellucida begins to form
34
zona pellucida
glycoprotein coat separates oocyte from follicular cells | -forms in unilaminar primary follicle
35
multilaminar primary follicle
follicular cells - now granulosa - become multilayered -pass small precursor molecules to nurture oocyte zona pellucida continues to develop theca interna begins to become visible differentiate from stroma around follicle
36
secondary follicle
antrum appears** granulosa cells proliferate - synthesize estrogens aka antral follicle
37
theca cells
interna - cuboidal - steroid producing cell synthesize - testosterone and androstenedione - response to LH - converted to estradiol and estrone (aromatase) externa - visible CT arrayed around theca interna
38
theca interna
produce estrogens
39
theca externa
CT cells that support
40
graafian follicle
mature follicle - near ovulation, antrum enlarges and distends capsule - antrum fills with follicular fluid plasma contains steroids, GAGs, inhibins
41
inhibins
acts on hypothalamus - decreased FSH
42
corona radiata
in graafian follicle - granulosa around oocyte in antrum - exposed to antrum stays with oocyte at ovulation** -must be penetrated by sperm
43
cumulus oophorus
in graafian follicle - granulosa around oocyte where its connected to wall - not exposed to antrum
44
follicles develop
in response to FSH cause increase in estrogen late in follicular - switch to positive feedback causes LH surge (ovulation)
45
graafian follicle hormones
granulosa cells develop receptors for LH begin to synthesize and secrete progesterone immediately prior to ovulation -progesterone stimulated by gonadotropins binding releases oocyte from prophase 1 -enables ovum to mature
46
thecal cells follicular phase
LH receptors -produce pregnenolone > androgens no aromatase
47
granulosa cells follicular phase
androgens from thecal to granulosa granulosa has aromatase -produces estrogen also produce inhibin estrogen is negative feedback on FSH and LH
48
dominant follicle
most FSH receptors
49
switch to positive feedback
end of follicular phase -high estrogen now positive on thecal and granulosa cells cause LH and FSH surge -induces ovulation
50
ovulation
LH surge -switch of gonadotroph feedback estrogens achieve critical levels for 36 hours some release of blood at this time - fills remaining follicular antrum - corpora hemorrhagicum
51
as follicle matures
theca cells and granulosa cells increase causes sharp increase in estrogens
52
at ovulation
primary oocyte completes 1st meiotic division produces secondary oocyte and polar body
53
secondary oocyte
23 chromosomes, 2N | -also gets most of cytoplasm
54
after ovulation - oocyte to where?
then picked up by fimbrae - enters infundibulum - peristalsis (primary force) - ciliary action move it along
55
primary force of oocyte moving ?
peristalsis
56
secondary oocyte next?
enters 2nd meiotic division - suspended in metaphase II - until fertilization
57
until fertilization?
2nd meiotic division into metaphase II
58
fertilization
secondary oocyte divides - another polar body - ovum - haploid 1N
59
ovum
23 chromosomes | 1N
60
ovulation vs. atresia
ovulation - usually single oocyte - atresia occurs with rest of oocyte - oocyte dies and antrum collapses - some theca interna cells persist (androgens)
61
older elderly women
theca interna - androgens -secondary male sex characteristics interstitial glands - androgens through out lifetime
62
neonatal ovary
PGCs (oogonia) proliferate in genital ridges follicle mature - because of moms hormones
63
menarche
establishment of menstrual function - puberty - pituitary gonadotropin release - leads to cyclic maturation of follicles atresia occurs during childhood (losing follicles before puberty)
64
menopause
cessation of menstrual cycling -only 400-500 oocytes ovulated during fertile years menopause - follicles all gone
65
menopausal ovary
theca cells still there no granulosa to convert androgens to estrogens get male sex characteristics
66
corpus luteum
after ovulation - follicle becomes corpus luteum - under effects of LH - persistence of corpus luteum depends on LH granulosa cells hypertrophy - granulosa lutein cells still steroid secreting - estrogens estradiol feeds back on pituitary - inhibition of LH secretion - decreased LH cannot support corpus luteum - menstruation follows
67
luteal phase hormone production
theca cells - still LH receptive -produce androgens and progesterone granulosa cells FSH and LH** sensitive -aromatase to convert androgen to estrogen see increased progesterone enzymes
68
FSH receptors
to synthesize aromatase in granulosa cells
69
LH receptors on granulosa cells?
allows increased progesterone
70
corpus luteum
thecal cells and granulosa -producing progesterone and some estrogen positive feedback from LH
71
multiple corpus luteum at once
possible
72
corpus albicans
regressed form of corpus luteum - scar left after involution - partially or complete involute with time
73
corpus luteum expansion
maintained under hCG -for around 6 months as other placental hormones take over -corpus luteum than regresses later in pregnancy - CL secretes relaxin -increases pliability of pelvic CT
74
relaxin
late stage corpus luteum secretion - increased pliability of pelvic CT - facilitates parturition
75
estrogen effects puberty
stimulate growth of uterus and breast - puberty
76
menstrual cycle estrogen effects
proliferation of endometrium production of clear mucous by cervical glands maturation of vaginal epithelium
77
menstrual cycle progesterone effects
trophic effect on uterine glands | stimulate thick cervical mucous secretion
78
puberty progesterone effects
main affect - maturation of secretory cells
79
pregnancy progesterone effects
growth mammary gland alveoli impedes ovarian cycle by feedback maybe homing signal to sperm
80
pregnancy estrogen effects
growth of mammary gland duct system myometrial hypertrophy increase in uterine blood flow also causes production of progesterone receptors
81
oviduct
uterine tube or fallopian tube where fertilization occurs - commonly in ampulla conveys oocyte to uterus implantation should occur in uterus
82
most common site of fertilization
ampulla of uterine tube
83
intramural zone of uterine tube
where its entering uterus
84
segments of oviduct
``` fimbria infundibulum ampulla isthmus intramural zone ```
85
progesterone on uterine tube
decreases epithelial size deciliation decreased mucus relaxes muscle tone
86
estrogen on uterine tube
increases epithelial size increased blood flow increased ciliogenesis increased mucus and muscle tone of isthmus
87
wall of oviduct
mucous membrane muscular coat serosa mucous membrane - folds few folds in isthmus extensive and complex folding in ampulla/infundibulum
88
oviduct epithelium
ciliated - all directions | peg cells - secretory, columnar, tallest in midcycle and shortest premenstrual
89
major motion of occyte
muscular peristalsis of oviduct
90
lamina propria of oviduct
very extensive
91
oviduct muscle
inner circular outer longitudinal primary force of ovum movement - muscular
92
uterus histo
serosa or adventitia myometrium - muscular, thick endometrium - mucous membrane
93
myometrium
bundles of smooth m. separated by CT outer, middle, inner zones outermost and inner very thin -longitudinal and oblique middle layer thick under influence of hormones
94
endometrium
simple columnar epithelium ciliated and secretory cells simple tubular glands -produces proteins, glycoproteins, mucous lamina propria CT rich in blood vessels, fibroblasts, reticular fibers store glycogen soon after ovulation -diagnostic for post-ovulatory period
95
pars functionalis
part of endometrium sloughed
96
pars basalis
part of endometrium retained during menstruation - germinal tissue - renew pars functionalis
97
uterine blood supply
arcuate arteries in myometrium -give off branches - straight arteries straight arteries supply pars basalis -eventually become coiled arteries
98
coiled arteries
in pars functionalis -influenced by progesterone and estrogen as they coil - becomes ischemic - menstruation
99
endometrial cycle
``` menstrual phase resurfacing phase proliferative phase secretory phase ischemic phase ```
100
luteal phase
estrogen AND progesterone
101
proliferative phase
estrogen drives proliferation | induced expression of progesterone receptors
102
secretory phase
inhibits endometrium growth | oppose proliferation of estrogen
103
menstrual phase
upregulates MMPs and COX-2
104
stimulation of endometrium proliferation
estrogen progesterone inhibits this during secretory phase (during luteal phase - corpus luteum - progesterone)
105
menstrual phase
day 1-5 slough functionalis WBCs and M0s invade coiled arteries compact day 1 of menses - functional layer necrosis coiled arteries compact - stop bleeding
106
cramps
prostaglandins secreted during menses -myometrial contractions vasodilators - water retention
107
resurfacing cells
day 5-6 epithelial cells from base of glands proliferate resurface endometrium angiogenesis begins
108
proliferative phase
day 7-15 basalis grows and renews functionalis -influence of estrogen endometrium thickens, glycogen accumulates in basal portion, coiled arteries grow toward surface, glands straight with small lumen
109
secretory phase
``` day 15-26 functionalis thickens glandular tall fills with secretory products coiled arteries extent to upper endometrium under influence of progesterone - glands coil glycogen to apical region ragged appearance to surface fluid in interstitium ```
110
ischemic phase
``` day 27-28 estradiol and progesterone fall -cannot support functionalis -glands very coiled and tortuous -interruption of blood supply endometrium shrinks and functionalis degenerates ``` prepares for onset of menstrual phase
111
more than 4-6mm endometrium growth
excessive
112
higher estrogen
increased tissue and blood loss for each menstrual cycle
113
cervix
differs from rest of uterus - little smooth muscle - dense CT - simple columnar epithelium - mucosa - no coiled arteries - not shed** - external os - stratified squamous
114
collagenolysis
CT degradation in cervix prior to partuition | -leads to cervical dilations
115
external os
stratified non-ketatinized squamous
116
mucous secreting cells
in cervix mucosa
117
cervical glands
branched mucous secreting glands - produce thin, watery mucous - allow sperm to access ovum - after ovulation - mucous thick - inhibits foreign object entry under influence of estrogen -thin, watery, alkaline mucus influence of progesterone -scant, viscous, acidic mucus
118
estrogen on cervical glands
alkaline, thin watery
119
progesterone on cervical glands
scant, viscous, acidic
120
vagina
``` fibromuscular tube stratified squamous wet epithelium transverse folds - rugae thickness regulated by estrogen thickest - mid cycle langerhans cells - APCs ``` NO GLANDS in vagina -mucous from cervical glands**
121
glands in vagina
NO | mucous from cervical glands
122
vagina surface
midcycle - glycogen -cells desquamate and release glycogen at menstruation acidic pH - native bacteria -prevents infection mid cycle - fall in estrogen - less glycogen - alkaline vaginal pH - favorable for sperm - however more susceptible to infection
123
lamina propria of vagina
wide band of dense fibrous CT -elastic fibers no sensory receptors diffuse lymphocytes outer region very vascular
124
muscle of vagina
2 interlaced smooth m layers inner circular outer longitundinal skeletal m around vaginal introitus -muscles of pelvis - UG diaphragm adventitia - typical of abdominal organs
125
labia majora
scrotum homolog
126
clitoris
homolog of penis
127
vestibule
mucous glands present -glands of bertholin homolog - bulbourethral in male
128
labia minora
stratified non-keratinized epithelium vascular lamina propria sebaceous glands - no hair follicles
129
estrogen on cervix
alkaline, thin, watery mucus
130
progesterone on cervix
scant, viscous acidic mucus
131
estrogen on bone
promotes closure plates | -anabolic and calcitropic hormone
132
estrogens in liver
``` increased LDL receptor HDL levels increase cortisol binding protein increase thyroid hormone binding protein increase sex hormone binding protein increase ```
133
estrogens and cardiovascular
vasodilation (NO synthesis)
134
CNS and estrogen
neuroprotectuve
135
progesterone and CNS
thermoregulation

Endo Exam 2 (17 decks)

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