Intro and Menstrual Cycle Flashcards

1
Q

What is the purpose of the menstrual cycle?

A
  • Generate oocyte
  • Facilitate fertilisation
  • Optimise endometrium for implantation
  • Protect developing embryo
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2
Q

What is the endocrine control of the menstrual cycle?

A

Hypothalamus, anterior pituitary and ovaries work together

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3
Q

What is the name of the first menstrual cycle?

A

Menarche

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4
Q

What does the hypothalamus release during menstrual cycle?

A

GnRH

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5
Q

How does GnRH act?

A

Exerts effect on anterior pituitary –> stimulates release of FSH and LH

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6
Q

What does LH stand for?

A

Luteinising hormone

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7
Q

What does FSH stand for?

A

Follicular stimulating hormone

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8
Q

What does FSH and LH act on?

A

Ovary to release oestrogens (this feeds back to hypothalamus and anterior pituitary)

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9
Q

What part of the hypothalamus is GnRH secreted by?

A

Mid basal hypothalamic neurons

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10
Q

How is GnRH transported to the pituitary?

A

Via hypophyseal portal blood system

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11
Q

What is GnRH secretion affected by?

A
bereavement
anxiety
time zone
day/night duty
exercise
weight loss/gain
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12
Q

What cells of the anterior pituitary secrete FSH and LH?

A

Basophils

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13
Q

What type of molecules are FSH and LH?

A

Glycoproteins

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14
Q

What does FSH stimulate?

A

Stimulates follicular activity, thus promoting estradiol production from granulosa cells

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15
Q

What does LH stimulate?

A

Triggers release of egg from dominant follicle

Promotes development of the corpus luteum and the production of progesterone

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16
Q

What is the predominant gonadotropin during the 1st half oF the cycle?

A

FSH

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17
Q

GnRH, LH and FSH production is inhibited by rising E2 levels.

When is there an exception to this?

A

Near midcycle when high levels of E2 lead to a surge in LH release which triggers ovulation

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18
Q

What E2?

A

Oestradiol –> Major female sex hormone (strongest of the 3 naturally produced oestrogens)

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19
Q

What are the first class of follicles formed in ovaries?

A

Primordial follicles

  • In fetus at 6 months: 2,000,000
  • At birth: 750,000
  • At puberty 400,000

Approx 450 follicles develop and produce an egg; remainder degenerate

No new follicles produced

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20
Q

Describe the sequence in which the egg is produced before ovulation

A
  1. Primordial follicle
  2. Primary/preantral follicle
  3. Secondary/antral follicle
  4. Preovulatory follicle
  5. Ovulation
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21
Q

What are the phases of the ovarian cycle?

A
  1. Follicular phase
  2. Ovulation
  3. Luteal phase
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22
Q

What is the follicular phase?

A

Marks the beginning of a new cycle as follicles (oocytes surrounded by stromal cells) begin to mature and prepare to release an oocyte.

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23
Q

What are follicular cells also known as?

A

Granulosa cells

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24
Q

Where do granulosa cells lie?

A

Directly around the oocyte zone pellucida and are released with the oocyte at ovulation

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25
Q

Describe a primordial follicle

A

Cconsist of an oocyte surrounded by a single layer of flattened granulosa cells

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26
Q

Describe the follicular development

A
  1. Proliferation of granulosa cells: antrum develops (fluid)
  2. Gap junctions and cytoplasmic processes between oocyte and granulosa cells allows communication and passage of low mol wt materials (e.g.nutrients)
  3. Proliferation of theca cells
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27
Q

What are theca cells?

A

The endocrine cells associated with ovarian follicles that play an essential role in fertility by producing the androgen substrate required for oestrogen biosynthesis.

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28
Q

Describe the theca interna cells

A

Glandular and highly vascularised.

Express receptors for luteinising hormone (LH).

Secrete androgens.

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29
Q

Describe the theca externa

A

Fibrous capsule

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30
Q

After the follicle ruptures, what do the theca interna cells differentiate into?

A

The theca lutein cells of the corpus luteum.

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31
Q

What are the androgens secreted by the theca interna cells converted to? Where?

A

Converted to oestradiol in granulosa cells

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32
Q

Describe the ovarian hormone production at the beginning of the cycle (menses)

A

There is little ovarian hormone production and the follicle begins to develop independently of gonadotropins or ovarian steroids.

33
Q

What do the low steroid and inhibin levels at the beginning of the cycle cause? Why?

A

There is little negative feedback at the HPG axis resulting in an increase in FSH and LH levels. These stimulate follicle growth and oestrogen production.

34
Q

What do almost mature follicles release? What does this then stimulate?

A

High levels of oestrogens

Stimulates release of more GnRH and LH

GnRH then promotes release of FSH and even more LH

35
Q

How many follicles can continue to maturity? What do the other follicles form?

A

Only one

Polar bodies

36
Q

As follicular oestrogen eventually becomes high enough to initiate at the HPG axis, what happens?

A

Causes increasing levels of GnRH and gonadotropins.

However, the effect is only reflected in LH levels (the LH surge).

37
Q

What is the LH surge due to?

A

Due to the increased follicular inhibin, selectively inhibiting FSH production at the anterior pituitary.

Granulosa cells become luteinised and express receptors for LH.

38
Q

What is the HPG axis?

A

Connection between the hypothalamus, pituitary gland, and gonads.

39
Q

Describe the production of inhibin

A

FSH stimulates the secretion of inhibin from the granulosa cells of the ovarian follicles in the ovaries. In turn, inhibin suppresses FSH

40
Q

What does the LH surge bring about?

A

Ovulation

41
Q

What happens to the follicle in response to the LH surge?

A

It ruptures and the mature oocyte is assisted to the fallopian tube by fimbria.

Here it remains viable for fertilisation for around 24 hours.

42
Q

Following ovulation, what does the follicle secrete?

A

Secreting oestrogen and now also progesterone

43
Q

What is the effect of the secretion of oesotrogen and progesterone by the follicle? What is purpose of this?

A

-ve feedback on HPG axis

This, together with inhibin (inhibits FSH) stalls the cycle in anticipation of fertilisation.

44
Q

What is the corpus luteum? What does it produce?

A

The tissue in the ovary that forms at the site of a ruptured follicle following ovulation.

It produces oestrogens, progesterone and inhibin to maintain conditions for fertilisation and implantation.

45
Q

If no fertilisation occurs, what happens to the corpus luteum?

A

Degenerate/fibroses to become corpus albicans

46
Q

As the corpus luteum regresses, what happens to the hormone levels?

A

Fall significantly, relieving negative feedback, resetting the HPG axis ready to begin the cycle again.

47
Q

What is the endometrium?

A

The lining layer of the uterus

48
Q

What are the phases of the uterine cycle?

A
  1. Proliferative phase (runs alongside follicular phase)
  2. Secretory phase (runs alongside luteal phase)
  3. Menses
49
Q

What does menses mark?

A

Beginning of new menstrual cycle

50
Q

Describe the endometrium during the proliferative phase?

A

Effects of oestradiol:

  • Endometrium thickens
  • Increased stromal cels
  • Increased glands, blood vessels

By ovulation, endometrium is 2-3mm thick

51
Q

What else does oestradiol initiate during proliferative phase?

A

Fallopian tube formation, thickening of the endometrium, increased growth and motility of the myometrium and production of a thin alkaline cervical mucus (to facilitate sperm transport).

52
Q

What else does oestradiol initiate during proliferative phase?

A

Fallopian tube formation, thickening of the endometrium, increased growth and motility of the myometrium and production of a thin alkaline cervical mucus (to facilitate sperm transport).

53
Q

What is the predominant hormone during the 2nd half of the cycle?

A

Progesterone

54
Q

Describe the secretory phase

A

Progesterone stimulates further thickening of endometrium

Increased secretion
Increased lipids and glycogen
Increased blood supply

55
Q

Describe the endometrium at the end of the secretory phase

A

Optimal conditions for implantation of fertilised egg: stable, vascular, nutrient-rich

56
Q

What happens during menstruation?

A

Corpus luteum has broken down and the internal lining of the uterus is shed

57
Q

How does the uterus lining shed?

A

Necrotic outer layers of endometrium separate from uterus

Separated tissue and blood initiate uterine contractions –> expel contents

58
Q

What is produced by the cervix?

A

Mucus production from columnar glands

59
Q

Describe the mucus produced by the cervix midcycle? What is purpose of this?

A

Stringy and runny midcycle

Facilitates sperm access at ovulation

60
Q

Describe the mucus produced by the cervix in the luteal phase? What is purpose of this?

A

Tenacious and inelastic in luteal phase

  • Prevents microbial ingress protects developing embryo
  • Critical to pregnancy (mucus ‘plug’)
61
Q

What does the combined oral contraceptive contain?

A

Oestradiol and a progestagen

62
Q

What is progestagen?

A

A synthetic progesterone

63
Q

What does the combined oral contraceptive do?

A

Inhibits GnRH/FSH/LH to prevent ovulation.

Thin endometrium.

Tenacious and inelastic mucus.

64
Q

Describe the effects of FSH in the menstrual cycle

A

Binds to granulosa cells to stimulate follicle growth, permit the conversion of androgens (from theca cells) to oestrogens and stimulate inhibin secretion

65
Q

Describe the effects of LH in the menstrual cycle

A

LH acts on theca cells to stimulate production and secretion of androgens

66
Q

What are the effects of moderate oesotrogen levels on the HPG axis?

A

Negative feedback

67
Q

What are the effects of high oesotrogen levels on the HPG axis (in the absence of progesterone)?

A

Positively feedback on the HPG axis

68
Q

What are the effects of oesotrogen on the HPG axis in the presence of progesterone?

A

Negative feedback on the HPG axis

69
Q

What are the effects of inhibin?

A

Selectively inhibits FSH at the anterior pituitary

70
Q

What is only hormone with positive feedback effect on HPG axis?

A

Oestrogen (LH surge)

71
Q

What day is ovulation?

A

Around day 14

72
Q

What is the Tanner Scale?

A

Scale of physical development in children, adolescents and adults (puberty scale)

73
Q

How many stages are there in the Tanner Scale?

A

5

74
Q

Describe stage 1 in Tanner Scale

A

Preadolescent, no sexual hair

No boobs for females

75
Q

Describe stage 2 in Tanner Scale

A

Sparse, pigmented, long straight hair along labia and at base of penis

Breast budding (areola and papilla)

76
Q

Describe stage 3 in Tanner Scale

A

Darker, coarser, curlier hair

Continued enlargement of breats

77
Q

Describe stage 4 in Tanner Scale

A

Adult but decreased distribution (hair)

Areola and papilla form secondary mound

78
Q

Describe stage 5 in Tanner Scale

A

Adult in quantity and type with spread to medial thighs

Mature female breast