Histophys of female repro Flashcards
1
Q
Why do levels of LH and FSH rise after menopause
A
loss of negative feedback
2
Q
Where are the Receptors for LH
A
Theca cells
3
Q
Where are the R for FSH
A
Granulosa cells
4
Q
What do the granulosa cells secrete
A
inhibins, activins which act on anterior pituitary
progestins and estrogens which can + or - affect hypothalamus and CNS
5
Q
What do theca cells secrete
A
androgens and progestins
6
Q
What happens when progesterone and estrogen levels fall
A
negative feedback inhibition decreases, so increas in FSH and LH
7
Q
When in the cycle does progesterone and estrogen levels fall
A
when corpus luteum is degrading
8
Q
After FSH is increased (after corpus luteum degrades) what happens
A
recruitment of many follicles entering rapid growth phase, secreting low amounts of estrogen
9
Q
What is the effect of estrogen on FSH and affect on growing follicles
A
negative feedback, causes selection of one dominant follicle(producing high levels E)
10
Q
What is the effect of high E on gonadotropes
A
LH and some FSH surges
11
Q
What does the LH surge cause
A
metabolic maturation, ovulation, and luteinization. corpus luteum starts producing high P and some E and inhibin
12
Q
What is the effect of high P, E and inhibit on gonadotropes
A
negative feedback to inhibit LH and FSH returing them to basal levels
13
Q
What initiates the death of corpus luteum
A
low LH activity (basal level)
14
Q
What is constidered external genitalia of female repro organ
A
clitoris, labia minora, labia majora, bartholin gland
15
Q
What is a follicle
A
oocyte in center with surrounding cells that develop to become hormone secreting and hormone responsiveness
16
Q
Describe stroma of ovary
A
tunica albuginia
simple cuboidal epithelium
subtended by dense irregular CT
eroded at time of ovulation
17
Q
Why is the capsule of the ovary called germinal epithelium
A
because the cells grow and differentiate to respond to hormones for folicular growth
18
Q
The deeper you go into ovary how does CT change
A
the looser CT it becomes in medulla, more compact andcellular at cortex
19
Q
What are the main structures that enter hilus of ovary to reach medulla
A
blood, lymph, nerves
20
Q
What phase is usually responsible for shorter or longer duration cycles
A
follicular phase (first 14 days usually)
21
Q
What is the positive feedback loop in the menstrual cycle
A
around day 14 when high levels of E + cause LH secretion increase
22
Q
The luteal phase of ovarian cycle overlaps what phase of endometrial cycle
A
secretory
23
Q
What is the length of the luteal phase
A
+/- 14 days, lifespan corpus luteum
24
Q
What happens during follicular phase
A
FSH stimulates cohort of follicles to mature, follicles produce estradiol
levels peaks just prior to ovulation
mid cycle surge of LH reinforces ovulation (Trigger)
25
What is necessary to stimulate ovulation
estradiol-mediated mechanism
26
What is the strongest estrogen
estradiol
27
What converts testosterone and androstenedione to estradiol and estrone
aromatase
28
What type of follicle is present at birth in a female
primordial follicle
29
What is the Independent growth phase of follicles
growth of primordial follicles to secondary preantral, not dependent on pituitary
30
What is the basal growth phase
growth from secondary preantral follicle to large ant ran follicle
dependent on gonadotropins-> low sensitivity
31
What is the rapid growth phase for follicles
large antral follicle to dominant (ovulation)
| extremely sensitive to FSH
32
What is the histo term for secondary follicle
primary follicle multi laminar
33
What is the histo term for tertiary follicle
secondary follicle
34
What does the standard primordial follicle have inside
primary oocyte, arrested in prophase of 1st meiotic division
| hase 4N DNA
35
What does the primordial follicle look like histologically
surrounded by squamous follicular cells joined by desmosomes with a BM to separate from stroma
36
When do primordial follicles start to differentiate
puberty
37
What does the primary follicle look like histologically
unilaminar
oocyte grows
follicular cells become cuboidal
zona pellucida begins but not visible
38
What is the main component of zone pellucida
glycoprotein coat separates oocyte from follicular cells
39
Describe multilaminar primary follicles histologically
follicular (granulosa) cells become multilayered
pass small precursor molecules to nurture oocyte
zona pellucida continues to develop
theca interna begins to be visible and differentiates from stroma around follicle
40
Describe general histo of secondary or (antral) follicle
antrum appears, granulosa cells continue to proliferate and start to make and secrete estrogens(estradiol and estrone)
41
Describe histo of theca cells in secondary, antral follicle
theca interna develops more and becomes cuboidal and steroid producing
separated from granulosa cells by BM
42
What do the theca cells produce under influence of LH
testosterone and androstenedione which is converted to estradiol and estrone by granulosa cells
43
What do theca externa look like
CT elements, fibroblastic because supporting structurally
44
What is the name for a mature follicle
graafian
45
What happens to general features in graafian follicle
antrum enlarges and distends capsule, fills with follicular fluid
46
What is within the follicular fluid of antrum of graafian follicle
steroid hormones, steroid binding proteins GAGs, inhibin
47
What is the role of inhibin
feedback to hypothalamus and inhibits FSH
48
Describe layers of ovarian follicle (graafian)
```
zona pellucida
cumulus oophorus (hillock of cells supporting)
corona radiata (granulosa cells around oocyte)
```
49
What is the purpose of corona radiata
needed to transport ova into oviduct.
| must be penetrated by sperm
50
What type of cells form the cumulus oophorus and corona radiata
granulosa cells, same thing just in different areas
51
Describe granulosa cell development in graafian follicle
develop R for LH
| synthesize and secrete progesterone right before ovulation
52
What stimulates release of oocyte from prophase I
binding of LH to graafian follicle
53
What stimulates progesterone production in the granulosa cells
gonadotropins
54
Granulosa cells have alot of what enzyme to convert androgens to estradiol
aromatase
55
What follicle has high amount of FSH Receptors
granulosa
56
The mid cycle LH surge causes what shift in feedback
switch form neg to positive
57
What is the name for the follicle rupture
stigma
58
what it corpora hemorrhagicum
when the follicle ruptures blood fill remaining follicular antrum
59
At ovulation what phase does the oocyte move into
completes 1st meiotic division, produce secondary oocyte and polar body
60
What is within the secondary oocyte
nearly all cytoplasm
half of chromosomes
has 23 chromosomes with sister chromatid
2N DNA
61
How does the oocyte enter uterine tube
fimbriae
62
How is the oocyte moved to uterus
peristalsis, ciliary action
63
Once in the uterus what phase is the oocyte in
frozen in metaphase II of 2nd meiotic division
64
What completes division of secondary oocyte
fertilization
65
What time period does the dominant follicle emerge
1 week before ovulation
66
What occurs in follicular atresia
oocyte dies, antrum collapses
granulosa cells stop dividing, detach from basal lamina
during atresia some theca interna cells persist (androgen secreting)
67
where do the primordial germ cells proliferate
in genital ridges
68
What phase in fetal development do all the oogonia arrest in prophase I of meiosis
7th month of fetal life
69
why do fetal/neonatal ovaries show features of maturity and menarche
late term fetus sees increased placental hormones which mimic pituitary
70
what induces puberty
gonadotropin release is increased
71
high LH causes the follicle to change into what
corpus luteum
72
What do the granulosa cells look like in the corpus luteum
hypertrophy and still characteristic steroid secreting cells
73
What happens to thecal cells in corpus luteum
surround granulosa lutein cells and called theca lutein cells
these secrete E and P
74
Increased estradiol levels from thecal lutein cells cause what
neg feedback to inhibit LH from pituitary so that corpus luteum degrades because levels so low cannot support steroidgenesis
75
How can progesterone levels increase so much in luteal phase
theca cells have LH R so produce progesterone but also granulosa cells upregulate LH R and also produce progesterone
76
how is the corpus luteum maintained during pregnancy for atleast first 6 months
human chorionic gonadotropin
| then taken over by other hormones
77
What does the corpus luteum secrete in latter stages of pregnancy
polypeptide hormone relaxin
increases pliability of pelvic CT
facilitates parturition
78
what is the corpus albicans
scar left after involution of corpus luteum
79
```
What are the effects of estrogens in:
puberty
menstrual cycle
pregnancy
cell effects
```
puberty: growth of uterus and breasts, develop female somatic profile
menstrual: proliferation of endometrium
production of clear mucous by cervical glands
maturation of vaginal epithelium
pregnancy: growth of mammary gland system
myometrial hypertrophy
increase in uterine blood flow
cell--> production of progesterone R
80
What are the effects of progesterone in:
puberty
menstrual cycle
pregnancy
puberty: maturation of secretory cells maybe
menstrual cycle: trophic effects on uterine glands
stimulate thick cervical mucous secretion
pregnancy: growth of mammary gland alveoli
impedes ovarian cycle by feedback to pituitary
produced by ovum, homing signal to sperm?
81
Where does fertilization usually occur
in the ampulla of oviduct,( uterine or fallopian tube)
82
What are the 4 anatomical regions of the oviduct, or uterine tube
infundibulum (fimbriae)
ampulla
isthmus
intramural zone
83
What are the effects of estrogen on oviduct
Increase: endosalpinx epithelial size, blood blow to lamina propria, oviduct specific glycoproteins, ciliogenesis, mucus, muscular tone of isthmus
84
What are the effects of progesterone on oviduct
decrease: epithelial size, mucus, relaxes muscle tone
| increase deciliation
85
What is the wall of the oviduct made up of
mucous membrane, muscular coat, serosa
86
Where is most of the folding of oviduct
ampulla and infundibulum
| less folds in isthmus
87
What is the epithelium of the oviduct
simple columnar epithelium of 2 varieties
ciliated (most beat in direction of uterus)
have peg cells (secretory non ciliated) that are columnar
88
What is the primary movement of the ovum
muscular
89
How do the peg cells of the oviduct epithelium change during the cycle
tallest in midcycle
| shortest in premenstrual period
90
By day 4 of fertilization where should the follicle be
in the uterus
91
Describe lamina propria of oviduct
typical CT components
92
DEscribe the musculature of oviduct
inner circular tight layer
| outer longitudinal elongate spiral layer
93
What are the layers of the uterus histologically
serosa or adventitia
myometrium- thick external layer
endometrium
94
describe the myometrium layer of uterus
fibro-muscular
bundles of smooth m separated by CT
outermost and innermost layers are very thin, longitudinal and oblique
middle layer is much thicker , circumferentially arranged and the smooth muscles are long
95
What happens to uterine myometrium during pregnancy
estrogen causes extensive growth
hyperplasia and hypertrophy
gap junctions develop to coordinate contractions
96
what are the histological layers of the uterine endometrium
mucosa and lamina propria
97
describe mucosa layer of uterus histologically
simple columnar epithelium
mixed ciliated and secretory cells
form simple tubular glands
produce complex mixture of proteins, glycoproteins and mucous
98
Describe the lamina propria of the uterine endometrium
CT rich in blood vessels, fibroblasts and reticular fibers
99
What is a diagnostic tool to measure post-ovulatory period
cells store glycogen soon after ovulation
100
What are the 2 distinct layers of endometrium and function
pars functionalis- sloughed during menstruation
| oars basalis- retained during menstruation, forms germinal tissue and renews the pars functionalis
101
Describe uterine blood supply
```
arcuate a (myometrium)
straight aa (pars basalis)
coiled aa(off of straight) and supply pars functionalis
```
102
What induces growth of the coiled aa in endometrium
E and P
103
What are the phases ot the uterine cycle
menstrual, resurfacing, proliferative, secretory and ischemic
104
What are the two separate cycles that together make up uterine cycle
endometrial and follicular
105
What happens hormonally during proliferative phase of cycle
reepithelialization of basal layer
estrogen drives proliferation of cells
induce expression of P Receptors
106
what happens hormonally during secretory phase of cycle
inhibition of enometrial growth
stimulation uterine glands
changes to adhesivity of surface epithelium
opposes proliferative effect of estrogen
107
What happens hormonally during menstrual phase of cycle
coincides with early follicular phase
upregulate MMPs
Upregulate COX-2 from the increase in PGF2alpha
108
How many days is the menstrual cycle
1-5
109
What occurs to functional is during menstrual cycle
sloughing of functionalis occurs at onset of regression (end of ischemic phase)
WBCs and macrophages invade stroma of functionalis
the coilded aa become compact
110
Day 1 of menstrual cycle explain histo changes
functional layer necroses, damaged arterioles
blood accumulates in the stroma which ruptures epithelium and then the functionalis detaches
arterioles then bleed directly onto surface until coiled aa constrict to stop hemorrhage
111
Does sloughing off functionalis affect basalis
no because basalis receives blood from straight aa
112
What does the mesntrual flow consist of
unfertilized secondary oocyte, non-clotting venous and arterial blood, disintegrated epithelial and stromal cells
glandular secretions
113
what substance is secreted in menses
PGs to affect uterine smooth m
result in cramps, myometrial contractions
also potent vaso dilators shad to water retention
114
What days is the resurfacing phase of uterine cycle
5-6
115
What occurs in resurfacing phase
epithelial cells from base of glands proliferate to migrate to the top
angiongenesis begins and vascular channels rebuild
116
What days is the proliferative phase of uterine cycle
7-15
117
what happens in proliferative phase
basalis begins to grow and renew functionalis layer under estrogen
endometrium will thicken, glands are straight with small lumen
glycogen accumulates in basal portion of epithelium
coiled aa grow toward surface
118
what days is the secretory phase of uterine cycle
15-26
119
What happens in secretory phase
functionalis thickens more, and glandular epithelium grows tall and fills with secretory product
coild aa extend to upper surface
glands coil under progesterone
glycogen moves to apical region giving ragged appearance
fluid accumulates in interstitium
120
What days is the ischemic phase of uterine cycle
27-28
121
What happens during ischemic cycle
estradiol and progesterone fail
levels become insufficient to support functionalis
glands become more coiled and tortuous causing intermittent obstruction in blood flow
endometrium shrinks and functionalis degenerates
122
Describe histo of cervix
little smooth muscle, very dense CT
| surface is lined with simple columnar with mucus cells and no coiled aa
123
How does cervix histo change prior to parturition
```
CT degrades (collagenolysis)
leads to cervical dilation
```
124
what is the histo of the external uterine os
stratified squamous (non-keratinized)
125
What type of gland are the cervical glands
branched mucus secreting glands that produce thin watery mucus, allowing sperm to access ovum
126
What happens to the mucus from cervical glands after ovulation
becomes thick to inhibit foreign material from entering uterus
127
how does E and P affect cervical gland secretions
estrogen causes thin, watery and slightly alkaline mucus
| P causes scant, viscous and slightly acidic mucus
128
Describe mucosa of vagina
stratified squamous wet epithelium thrown into transverse folds (rugae)
129
What regulates thickness of mucosa layer of vagina
estrogen, thickest at mid cycle
130
What type of cells are present in mucosal layer of vagina
Langerhans, no glands
131
Describe surface layers of cells of vagina during cycle
flattened and begin to accumulate glycogen at mid cycle, cells desquamate and release glycogen to act as substrate for acid forming bacteria (acidic pH)
decrease in estrogen resduce glycogen stores and vagina becomes more alkaline (favorable to sperm, but susceptible to infections)
132
Describe the lamina propria of vaginal mucosa
```
wide band of dense fibrous CT
some elastic fibers
deepr-- CT becomes looser
outer region highly vascularized
some lymph nodules and WBC
no general sensory R, mainly nociceptors
```
133
Is there a muscularis mucsae in the vaginal lamina propria
no
134
describe the muscularis layer of vagina
inner sm muscle, circular
outer longitudinal smooth muscle
skel m surrounds vaginal introitus (mm of pelvic UG diaphragm)
135
Does the vagina have adventitia
yes
136
Describe labia majora
skin, hair and thin layer smooth m
| adipose tissue
137
describe labia minora
stratified non-keratinized epithelium
lamina propria highly vascularized with papillae
sebaceous glands but no hair follicles
melanocytes present, highly pigmented epithelium
138
describe clitoris
erectile body which is homolog of penis
139
describe vestibule
similar to vagina, except mucus glands are present
| major mucus glands include the glands of bartholin (vestibular)
140
What glands in the vagina are homolog to the bulbourethral glands in the male
the glans of bartholin
141
Where do hormones come from that act on cervix
epithelial glands in endocervical canal
142
what are the effects of E and P on cervix
E stimulates production of thin, water and alkaline mucus
| P stimulates production of scant viscous acidic mucus
143
What are the effects of P and E on the vagina
E stimulates proliferation of epithelium and increases glycogen
P increases desquamation of epithelium
144
What are the effects of glycogen on vagina
metabolized to lactic acid by commensal lactobacilli
| maintain the acidic environment and prevent infections
145
What are the effects of estrogens on bone
promote closure of epiphyseal plates
| anabolic and calciotropic
146
What are the effects of estrogens on liver
```
increase LDL R
increase HDL levels
cortisol binding protein
thyroid hormone binding protein
sex hormone binding protein
```
147
What are the effects of estrogen on CV
cause vasodilation thru NO synthesis
148
What are the effects of E and P on CNS
E appear to be neuroprotective
| P regulate set point for thermoregulation
