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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
Q

granulosa cells

A

contains aromatase

-can produce estrogens

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26
Q

stages of follicular development

A 
primordial follicle - present at birth
primary follicle
secondary preantral follicle
small antral follicle
large, recruitable antral follicle
dominant follicle at ovulation
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27
Q

gonadotropin independent growth phase

A

follicular growth not regulated by pituitary

paracrine factors between oocytes and follicle cells

primordial to secondary preantral follicles

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28
Q

basal growth phase

A

dependent on gonadotropins

low sensitivity and not influenced by fluctuations associated with menstrual cycle

secondary preantral follicle to large antral follicle

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29
Q

rapid growth phase

A

follicles extremely sensitive to FSH
-need FSH to avoid atresia

large antral follicle to dominant follicle at ovulation

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30
Q

graafian follicle

A

becomes estrogenic

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31
Q

primordial follicle

A

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
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32
Q

cell layer in primary follicle

A

squamous follicular cell surrounding primary oocyte

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33
Q

unilaminar primary follicle

A

oocyte grows

  • follicular cells become cuboidal
  • zona pellucida begins to form
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34
Q

zona pellucida

A

glycoprotein coat separates oocyte from follicular cells

-forms in unilaminar primary follicle

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35
Q

multilaminar primary follicle

A

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

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36
Q

secondary follicle

A

antrum appears**
granulosa cells proliferate - synthesize estrogens

aka antral follicle

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37
Q

theca cells

A

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

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38
Q

theca interna

A

produce estrogens

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39
Q

theca externa

A

CT cells that support

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40
Q

graafian follicle

A

mature follicle

  • near ovulation, antrum enlarges and distends capsule
  • antrum fills with follicular fluid

plasma contains steroids, GAGs, inhibins

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41
Q

inhibins

A

acts on hypothalamus - decreased FSH

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42
Q

corona radiata

A

in graafian follicle

  • granulosa around oocyte in antrum
  • exposed to antrum

stays with oocyte at ovulation**
-must be penetrated by sperm

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43
Q

cumulus oophorus

A

in graafian follicle

  • granulosa around oocyte where its connected to wall
  • not exposed to antrum
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44
Q

follicles develop

A

in response to FSH
cause increase in estrogen

late in follicular - switch to positive feedback
causes LH surge (ovulation)

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45
Q

graafian follicle hormones

A

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

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46
Q

thecal cells follicular phase

A

LH receptors
-produce pregnenolone > androgens

no aromatase

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47
Q

granulosa cells follicular phase

A

androgens from thecal to granulosa

granulosa has aromatase
-produces estrogen

also produce inhibin

estrogen is negative feedback on FSH and LH

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48
Q

dominant follicle

A

most FSH receptors

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49
Q

switch to positive feedback

A

end of follicular phase
-high estrogen now positive on thecal and granulosa cells

cause LH and FSH surge
-induces ovulation

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50
Q

ovulation

A

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
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51
Q

as follicle matures

A

theca cells and granulosa cells increase

causes sharp increase in estrogens

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52
Q

at ovulation

A

primary oocyte completes 1st meiotic division

produces secondary oocyte and polar body

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53
Q

secondary oocyte

A

23 chromosomes, 2N

-also gets most of cytoplasm

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54
Q

after ovulation - oocyte to where?

A

then picked up by fimbrae

  • enters infundibulum
  • peristalsis (primary force)
  • ciliary action

move it along

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55
Q

primary force of oocyte moving ?

A

peristalsis

56
Q

secondary oocyte next?

A

enters 2nd meiotic division

  • suspended in metaphase II
  • until fertilization
57
Q

until fertilization?

A

2nd meiotic division into metaphase II

58
Q

fertilization

A

secondary oocyte divides

  • another polar body
  • ovum - haploid 1N
59
Q

ovum

A

23 chromosomes

1N

60
Q

ovulation vs. atresia

A

ovulation - usually single oocyte

  • atresia occurs with rest of oocyte
  • oocyte dies and antrum collapses
  • some theca interna cells persist (androgens)
61
Q

older elderly women

A

theca interna - androgens
-secondary male sex characteristics

interstitial glands - androgens through out lifetime

62
Q

neonatal ovary

A

PGCs (oogonia) proliferate in genital ridges

follicle mature - because of moms hormones

63
Q

menarche

A

establishment of menstrual function

  • puberty - pituitary gonadotropin release
  • leads to cyclic maturation of follicles

atresia occurs during childhood (losing follicles before puberty)

64
Q

menopause

A

cessation of menstrual cycling
-only 400-500 oocytes ovulated during fertile years

menopause - follicles all gone

65
Q

menopausal ovary

A

theca cells still there
no granulosa to convert androgens to estrogens

get male sex characteristics

66
Q

corpus luteum

A

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
Q

luteal phase hormone production

A

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
Q

FSH receptors

A

to synthesize aromatase in granulosa cells

69
Q

LH receptors on granulosa cells?

A

allows increased progesterone

70
Q

corpus luteum

A

thecal cells and granulosa
-producing progesterone and some estrogen

positive feedback from LH

71
Q

multiple corpus luteum at once

A

possible

72
Q

corpus albicans

A

regressed form of corpus luteum

  • scar left after involution
  • partially or complete involute with time
73
Q

corpus luteum expansion

A

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
Q

relaxin

A

late stage corpus luteum secretion

  • increased pliability of pelvic CT
  • facilitates parturition
75
Q

estrogen effects puberty

A

stimulate growth of uterus and breast - puberty

76
Q

menstrual cycle estrogen effects

A

proliferation of endometrium
production of clear mucous by cervical glands
maturation of vaginal epithelium

77
Q

menstrual cycle progesterone effects

A

trophic effect on uterine glands

stimulate thick cervical mucous secretion

78
Q

puberty progesterone effects

A

main affect - maturation of secretory cells

79
Q

pregnancy progesterone effects

A

growth mammary gland alveoli
impedes ovarian cycle by feedback

maybe homing signal to sperm

80
Q

pregnancy estrogen effects

A

growth of mammary gland duct system
myometrial hypertrophy
increase in uterine blood flow

also causes production of progesterone receptors

81
Q

oviduct

A

uterine tube or fallopian tube

where fertilization occurs - commonly in ampulla
conveys oocyte to uterus

implantation should occur in uterus

82
Q

most common site of fertilization

A

ampulla of uterine tube

83
Q

intramural zone of uterine tube

A

where its entering uterus

84
Q

segments of oviduct

A 
fimbria
infundibulum
ampulla
isthmus
intramural zone
85
Q

progesterone on uterine tube

A

decreases epithelial size
deciliation
decreased mucus
relaxes muscle tone

86
Q

estrogen on uterine tube

A

increases epithelial size
increased blood flow
increased ciliogenesis
increased mucus and muscle tone of isthmus

87
Q

wall of oviduct

A

mucous membrane
muscular coat
serosa

mucous membrane - folds

few folds in isthmus
extensive and complex folding in ampulla/infundibulum

88
Q

oviduct epithelium

A

ciliated - all directions

peg cells - secretory, columnar, tallest in midcycle and shortest premenstrual

89
Q

major motion of occyte

A

muscular peristalsis of oviduct

90
Q

lamina propria of oviduct

A

very extensive

91
Q

oviduct muscle

A

inner circular
outer longitudinal

primary force of ovum movement - muscular

92
Q

uterus histo

A

serosa or adventitia
myometrium - muscular, thick
endometrium - mucous membrane

93
Q

myometrium

A

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
Q

endometrium

A

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
Q

pars functionalis

A

part of endometrium sloughed

96
Q

pars basalis

A

part of endometrium retained during menstruation

  • germinal tissue
  • renew pars functionalis
97
Q

uterine blood supply

A

arcuate arteries in myometrium
-give off branches - straight arteries

straight arteries supply pars basalis
-eventually become coiled arteries

98
Q

coiled arteries

A

in pars functionalis
-influenced by progesterone and estrogen

as they coil - becomes ischemic - menstruation

99
Q

endometrial cycle

A 
menstrual phase
resurfacing phase
proliferative phase
secretory phase
ischemic phase
100
Q

luteal phase

A

estrogen AND progesterone

101
Q

proliferative phase

A

estrogen drives proliferation

induced expression of progesterone receptors

102
Q

secretory phase

A

inhibits endometrium growth

oppose proliferation of estrogen

103
Q

menstrual phase

A

upregulates MMPs and COX-2

104
Q

stimulation of endometrium proliferation

A

estrogen

progesterone inhibits this during secretory phase (during luteal phase - corpus luteum - progesterone)

105
Q

menstrual phase

A

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
Q

cramps

A

prostaglandins secreted during menses
-myometrial contractions

vasodilators - water retention

107
Q

resurfacing cells

A

day 5-6
epithelial cells from base of glands proliferate
resurface endometrium
angiogenesis begins

108
Q

proliferative phase

A

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
Q

secretory phase

A 
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
Q

ischemic phase

A 
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
Q

more than 4-6mm endometrium growth

A

excessive

112
Q

higher estrogen

A

increased tissue and blood loss for each menstrual cycle

113
Q

cervix

A

differs from rest of uterus

  • little smooth muscle
  • dense CT
  • simple columnar epithelium
  • mucosa - no coiled arteries
  • not shed**
  • external os - stratified squamous
114
Q

collagenolysis

A

CT degradation in cervix prior to partuition

-leads to cervical dilations

115
Q

external os

A

stratified non-ketatinized squamous

116
Q

mucous secreting cells

A

in cervix mucosa

117
Q

cervical glands

A

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
Q

estrogen on cervical glands

A

alkaline, thin watery

119
Q

progesterone on cervical glands

A

scant, viscous, acidic

120
Q

vagina

A 
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
Q

glands in vagina

A

NO

mucous from cervical glands

122
Q

vagina surface

A

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
Q

lamina propria of vagina

A

wide band of dense fibrous CT
-elastic fibers

no sensory receptors

diffuse lymphocytes

outer region very vascular

124
Q

muscle of vagina

A

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
Q

labia majora

A

scrotum homolog

126
Q

clitoris

A

homolog of penis

127
Q

vestibule

A

mucous glands present
-glands of bertholin
homolog - bulbourethral in male

128
Q

labia minora

A

stratified non-keratinized epithelium
vascular lamina propria
sebaceous glands - no hair follicles

129
Q

estrogen on cervix

A

alkaline, thin, watery mucus

130
Q

progesterone on cervix

A

scant, viscous acidic mucus

131
Q

estrogen on bone

A

promotes closure plates

-anabolic and calcitropic hormone

132
Q

estrogens in liver

A 
increased LDL receptor
HDL levels increase
cortisol binding protein increase
thyroid hormone binding protein increase
sex hormone binding protein increase
133
Q

estrogens and cardiovascular

A

vasodilation (NO synthesis)

134
Q

CNS and estrogen

A

neuroprotectuve

135
Q

progesterone and CNS

A

thermoregulation

Endo Exam 2 (17 decks)

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