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ENDO I exam 2 > Histophys of female repro > Flashcards

Histophys of female repro Flashcards

1
Q

Why do levels of LH and FSH rise after menopause

A

loss of negative feedback

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2
Q

Where are the Receptors for LH

A

Theca cells

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3
Q

Where are the R for FSH

A

Granulosa cells

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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

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5
Q

What do theca cells secrete

A

androgens and progestins

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6
Q

What happens when progesterone and estrogen levels fall

A

negative feedback inhibition decreases, so increas in FSH and LH

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7
Q

When in the cycle does progesterone and estrogen levels fall

A

when corpus luteum is degrading

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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

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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)

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10
Q

What is the effect of high E on gonadotropes

A

LH and some FSH surges

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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

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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

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13
Q

What initiates the death of corpus luteum

A

low LH activity (basal level)

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14
Q

What is constidered external genitalia of female repro organ

A

clitoris, labia minora, labia majora, bartholin gland

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15
Q

What is a follicle

A

oocyte in center with surrounding cells that develop to become hormone secreting and hormone responsiveness

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16
Q

Describe stroma of ovary

A

tunica albuginia
simple cuboidal epithelium
subtended by dense irregular CT
eroded at time of ovulation

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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

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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

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19
Q

What are the main structures that enter hilus of ovary to reach medulla

A

blood, lymph, nerves

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20
Q

What phase is usually responsible for shorter or longer duration cycles

A

follicular phase (first 14 days usually)

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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

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22
Q

The luteal phase of ovarian cycle overlaps what phase of endometrial cycle

A

secretory

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23
Q

What is the length of the luteal phase

A

+/- 14 days, lifespan corpus luteum

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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)

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25
Q

What is necessary to stimulate ovulation

A

estradiol-mediated mechanism

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26
Q

What is the strongest estrogen

A

estradiol

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27
Q

What converts testosterone and androstenedione to estradiol and estrone

A

aromatase

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28
Q

What type of follicle is present at birth in a female

A

primordial follicle

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29
Q

What is the Independent growth phase of follicles

A

growth of primordial follicles to secondary preantral, not dependent on pituitary

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30
Q

What is the basal growth phase

A

growth from secondary preantral follicle to large ant ran follicle
dependent on gonadotropins-> low sensitivity

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31
Q

What is the rapid growth phase for follicles

A

large antral follicle to dominant (ovulation)

extremely sensitive to FSH

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32
Q

What is the histo term for secondary follicle

A

primary follicle multi laminar

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33
Q

What is the histo term for tertiary follicle

A

secondary follicle

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34
Q

What does the standard primordial follicle have inside

A

primary oocyte, arrested in prophase of 1st meiotic division

hase 4N DNA

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35
Q

What does the primordial follicle look like histologically

A

surrounded by squamous follicular cells joined by desmosomes with a BM to separate from stroma

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36
Q

When do primordial follicles start to differentiate

A

puberty

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37
Q

What does the primary follicle look like histologically

A

unilaminar
oocyte grows
follicular cells become cuboidal
zona pellucida begins but not visible

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38
Q

What is the main component of zone pellucida

A

glycoprotein coat separates oocyte from follicular cells

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39
Q

Describe multilaminar primary follicles histologically

A

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

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40
Q

Describe general histo of secondary or (antral) follicle

A

antrum appears, granulosa cells continue to proliferate and start to make and secrete estrogens(estradiol and estrone)

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41
Q

Describe histo of theca cells in secondary, antral follicle

A

theca interna develops more and becomes cuboidal and steroid producing
separated from granulosa cells by BM

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42
Q

What do the theca cells produce under influence of LH

A

testosterone and androstenedione which is converted to estradiol and estrone by granulosa cells

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43
Q

What do theca externa look like

A

CT elements, fibroblastic because supporting structurally

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44
Q

What is the name for a mature follicle

A

graafian

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45
Q

What happens to general features in graafian follicle

A

antrum enlarges and distends capsule, fills with follicular fluid

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46
Q

What is within the follicular fluid of antrum of graafian follicle

A

steroid hormones, steroid binding proteins GAGs, inhibin

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47
Q

What is the role of inhibin

A

feedback to hypothalamus and inhibits FSH

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48
Q

Describe layers of ovarian follicle (graafian)

A 
zona pellucida
cumulus oophorus (hillock of cells supporting)
corona radiata (granulosa cells around oocyte)
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49
Q

What is the purpose of corona radiata

A

needed to transport ova into oviduct.

must be penetrated by sperm

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50
Q

What type of cells form the cumulus oophorus and corona radiata

A

granulosa cells, same thing just in different areas

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51
Q

Describe granulosa cell development in graafian follicle

A

develop R for LH

synthesize and secrete progesterone right before ovulation

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52
Q

What stimulates release of oocyte from prophase I

A

binding of LH to graafian follicle

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53
Q

What stimulates progesterone production in the granulosa cells

A

gonadotropins

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54
Q

Granulosa cells have alot of what enzyme to convert androgens to estradiol

A

aromatase

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55
Q

What follicle has high amount of FSH Receptors

A

granulosa

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56
Q

The mid cycle LH surge causes what shift in feedback

A

switch form neg to positive

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57
Q

What is the name for the follicle rupture

A

stigma

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58
Q

what it corpora hemorrhagicum

A

when the follicle ruptures blood fill remaining follicular antrum

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59
Q

At ovulation what phase does the oocyte move into

A

completes 1st meiotic division, produce secondary oocyte and polar body

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60
Q

What is within the secondary oocyte

A

nearly all cytoplasm
half of chromosomes
has 23 chromosomes with sister chromatid
2N DNA

61
Q

How does the oocyte enter uterine tube

A

fimbriae

62
Q

How is the oocyte moved to uterus

A

peristalsis, ciliary action

63
Q

Once in the uterus what phase is the oocyte in

A

frozen in metaphase II of 2nd meiotic division

64
Q

What completes division of secondary oocyte

A

fertilization

65
Q

What time period does the dominant follicle emerge

A

1 week before ovulation

66
Q

What occurs in follicular atresia

A

oocyte dies, antrum collapses
granulosa cells stop dividing, detach from basal lamina
during atresia some theca interna cells persist (androgen secreting)

67
Q

where do the primordial germ cells proliferate

A

in genital ridges

68
Q

What phase in fetal development do all the oogonia arrest in prophase I of meiosis

A

7th month of fetal life

69
Q

why do fetal/neonatal ovaries show features of maturity and menarche

A

late term fetus sees increased placental hormones which mimic pituitary

70
Q

what induces puberty

A

gonadotropin release is increased

71
Q

high LH causes the follicle to change into what

A

corpus luteum

72
Q

What do the granulosa cells look like in the corpus luteum

A

hypertrophy and still characteristic steroid secreting cells

73
Q

What happens to thecal cells in corpus luteum

A

surround granulosa lutein cells and called theca lutein cells
these secrete E and P

74
Q

Increased estradiol levels from thecal lutein cells cause what

A

neg feedback to inhibit LH from pituitary so that corpus luteum degrades because levels so low cannot support steroidgenesis

75
Q

How can progesterone levels increase so much in luteal phase

A

theca cells have LH R so produce progesterone but also granulosa cells upregulate LH R and also produce progesterone

76
Q

how is the corpus luteum maintained during pregnancy for atleast first 6 months

A

human chorionic gonadotropin

then taken over by other hormones

77
Q

What does the corpus luteum secrete in latter stages of pregnancy

A

polypeptide hormone relaxin
increases pliability of pelvic CT
facilitates parturition

78
Q

what is the corpus albicans

A

scar left after involution of corpus luteum

79
Q 
What are the effects of estrogens in:
puberty
menstrual cycle
pregnancy
cell effects
A

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
Q

What are the effects of progesterone in:
puberty
menstrual cycle
pregnancy

A

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
Q

Where does fertilization usually occur

A

in the ampulla of oviduct,( uterine or fallopian tube)

82
Q

What are the 4 anatomical regions of the oviduct, or uterine tube

A

infundibulum (fimbriae)
ampulla
isthmus
intramural zone

83
Q

What are the effects of estrogen on oviduct

A

Increase: endosalpinx epithelial size, blood blow to lamina propria, oviduct specific glycoproteins, ciliogenesis, mucus, muscular tone of isthmus

84
Q

What are the effects of progesterone on oviduct

A

decrease: epithelial size, mucus, relaxes muscle tone

increase deciliation

85
Q

What is the wall of the oviduct made up of

A

mucous membrane, muscular coat, serosa

86
Q

Where is most of the folding of oviduct

A

ampulla and infundibulum

less folds in isthmus

87
Q

What is the epithelium of the oviduct

A

simple columnar epithelium of 2 varieties
ciliated (most beat in direction of uterus)
have peg cells (secretory non ciliated) that are columnar

88
Q

What is the primary movement of the ovum

A

muscular

89
Q

How do the peg cells of the oviduct epithelium change during the cycle

A

tallest in midcycle

shortest in premenstrual period

90
Q

By day 4 of fertilization where should the follicle be

A

in the uterus

91
Q

Describe lamina propria of oviduct

A

typical CT components

92
Q

DEscribe the musculature of oviduct

A

inner circular tight layer

outer longitudinal elongate spiral layer

93
Q

What are the layers of the uterus histologically

A

serosa or adventitia
myometrium- thick external layer
endometrium

94
Q

describe the myometrium layer of uterus

A

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
Q

What happens to uterine myometrium during pregnancy

A

estrogen causes extensive growth
hyperplasia and hypertrophy
gap junctions develop to coordinate contractions

96
Q

what are the histological layers of the uterine endometrium

A

mucosa and lamina propria

97
Q

describe mucosa layer of uterus histologically

A

simple columnar epithelium
mixed ciliated and secretory cells
form simple tubular glands
produce complex mixture of proteins, glycoproteins and mucous

98
Q

Describe the lamina propria of the uterine endometrium

A

CT rich in blood vessels, fibroblasts and reticular fibers

99
Q

What is a diagnostic tool to measure post-ovulatory period

A

cells store glycogen soon after ovulation

100
Q

What are the 2 distinct layers of endometrium and function

A

pars functionalis- sloughed during menstruation

oars basalis- retained during menstruation, forms germinal tissue and renews the pars functionalis

101
Q

Describe uterine blood supply

A 
arcuate a (myometrium)
straight aa (pars basalis)
coiled aa(off of straight) and supply pars functionalis
102
Q

What induces growth of the coiled aa in endometrium

A

E and P

103
Q

What are the phases ot the uterine cycle

A

menstrual, resurfacing, proliferative, secretory and ischemic

104
Q

What are the two separate cycles that together make up uterine cycle

A

endometrial and follicular

105
Q

What happens hormonally during proliferative phase of cycle

A

reepithelialization of basal layer
estrogen drives proliferation of cells
induce expression of P Receptors

106
Q

what happens hormonally during secretory phase of cycle

A

inhibition of enometrial growth
stimulation uterine glands
changes to adhesivity of surface epithelium
opposes proliferative effect of estrogen

107
Q

What happens hormonally during menstrual phase of cycle

A

coincides with early follicular phase
upregulate MMPs
Upregulate COX-2 from the increase in PGF2alpha

108
Q

How many days is the menstrual cycle

A

1-5

109
Q

What occurs to functional is during menstrual cycle

A

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
Q

Day 1 of menstrual cycle explain histo changes

A

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
Q

Does sloughing off functionalis affect basalis

A

no because basalis receives blood from straight aa

112
Q

What does the mesntrual flow consist of

A

unfertilized secondary oocyte, non-clotting venous and arterial blood, disintegrated epithelial and stromal cells
glandular secretions

113
Q

what substance is secreted in menses

A

PGs to affect uterine smooth m
result in cramps, myometrial contractions
also potent vaso dilators shad to water retention

114
Q

What days is the resurfacing phase of uterine cycle

A

5-6

115
Q

What occurs in resurfacing phase

A

epithelial cells from base of glands proliferate to migrate to the top
angiongenesis begins and vascular channels rebuild

116
Q

What days is the proliferative phase of uterine cycle

A

7-15

117
Q

what happens in proliferative phase

A

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
Q

what days is the secretory phase of uterine cycle

A

15-26

119
Q

What happens in secretory phase

A

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
Q

What days is the ischemic phase of uterine cycle

A

27-28

121
Q

What happens during ischemic cycle

A

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
Q

Describe histo of cervix

A

little smooth muscle, very dense CT

surface is lined with simple columnar with mucus cells and no coiled aa

123
Q

How does cervix histo change prior to parturition

A 
CT degrades (collagenolysis)
leads to cervical dilation
124
Q

what is the histo of the external uterine os

A

stratified squamous (non-keratinized)

125
Q

What type of gland are the cervical glands

A

branched mucus secreting glands that produce thin watery mucus, allowing sperm to access ovum

126
Q

What happens to the mucus from cervical glands after ovulation

A

becomes thick to inhibit foreign material from entering uterus

127
Q

how does E and P affect cervical gland secretions

A

estrogen causes thin, watery and slightly alkaline mucus

P causes scant, viscous and slightly acidic mucus

128
Q

Describe mucosa of vagina

A

stratified squamous wet epithelium thrown into transverse folds (rugae)

129
Q

What regulates thickness of mucosa layer of vagina

A

estrogen, thickest at mid cycle

130
Q

What type of cells are present in mucosal layer of vagina

A

Langerhans, no glands

131
Q

Describe surface layers of cells of vagina during cycle

A

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
Q

Describe the lamina propria of vaginal mucosa

A 
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
Q

Is there a muscularis mucsae in the vaginal lamina propria

A

no

134
Q

describe the muscularis layer of vagina

A

inner sm muscle, circular
outer longitudinal smooth muscle

skel m surrounds vaginal introitus (mm of pelvic UG diaphragm)

135
Q

Does the vagina have adventitia

A

yes

136
Q

Describe labia majora

A

skin, hair and thin layer smooth m

adipose tissue

137
Q

describe labia minora

A

stratified non-keratinized epithelium
lamina propria highly vascularized with papillae
sebaceous glands but no hair follicles
melanocytes present, highly pigmented epithelium

138
Q

describe clitoris

A

erectile body which is homolog of penis

139
Q

describe vestibule

A

similar to vagina, except mucus glands are present

major mucus glands include the glands of bartholin (vestibular)

140
Q

What glands in the vagina are homolog to the bulbourethral glands in the male

A

the glans of bartholin

141
Q

Where do hormones come from that act on cervix

A

epithelial glands in endocervical canal

142
Q

what are the effects of E and P on cervix

A

E stimulates production of thin, water and alkaline mucus

P stimulates production of scant viscous acidic mucus

143
Q

What are the effects of P and E on the vagina

A

E stimulates proliferation of epithelium and increases glycogen
P increases desquamation of epithelium

144
Q

What are the effects of glycogen on vagina

A

metabolized to lactic acid by commensal lactobacilli

maintain the acidic environment and prevent infections

145
Q

What are the effects of estrogens on bone

A

promote closure of epiphyseal plates

anabolic and calciotropic

146
Q

What are the effects of estrogens on liver

A 
increase LDL R
increase HDL levels
cortisol binding protein
thyroid hormone binding protein
sex hormone binding protein
147
Q

What are the effects of estrogen on CV

A

cause vasodilation thru NO synthesis

148
Q

What are the effects of E and P on CNS

A

E appear to be neuroprotective

P regulate set point for thermoregulation

ENDO I exam 2 (11 decks)

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