Lecture 11: Female Reproductive System Flashcards

1
Q

Majority of female reproductive system is…

A

Duct system

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2
Q

The ovaries are homologous to the…

A

testes

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3
Q

In an adult female, ovaries are the size and shape of…

A

almonds

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4
Q

How much does each ovary weight?

A

3 grams each

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5
Q

Ovaries are posterior to the

A

uterus

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6
Q

It’s important that ovaries are kept in position relevant to fallopian tubes. Fallopian tubes don’t touch ovaries. If ovaries move around, what happens?

A

We increase likelihood that eggs that are being ovulated don’t make it into fallopian tube.

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7
Q

What are the structures that keep them in place?

A
  • Ovarian ligament
  • Mesovarian ligament
  • Suspensory ligament
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8
Q

What does the Ovarian ligament do?

A

Connects ovary to uterus. Helps to keep it in place

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9
Q

What does the Mesovarian ligament do?

A

helps keep the ovary in the right place

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10
Q

Last is the Suspensory ligament ?

A

the retractor doesn’t keep the ovary in the right place
(3:14)

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11
Q

The Mesovarian is carrying…

A

blood vessels, lymphatics, and nerves.

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12
Q

The vaginal canal is open…

A

to the outside world.

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13
Q

The cervix is open to the…

A

vaginal canal

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14
Q

The uterus is open to the …

A

cervix

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15
Q

The fallopian tubes are open to the

A

uterus

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16
Q

There’s open space in the abdominal pelvic cavity, between the fallopian tube and the ovary. This can present a problem bc…

A

if a woman gets a vaginal infection and it’s not treated, it can progress up into the uterus, into fallopian tubes and ultimately into the abdominal pelvic cavity.

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17
Q

The other reason that there’s an issue here that we need to pay attention is even with all these ligaments, helping to hold the ovaries in the right position, relative to the fallopian tube, …

A

it is still possible that an egg can be ovulated and not go into the fallopian tube. And bc is open, sperm can also go out into the fallopian tube

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18
Q

If that egg that’s not in the fallopian tube meets up with sperm that’s not in the fallopian tube, …

A

you can’t have fertilization outside the reproductive system and that fertilized egg can plant in the wall of the abdomen and plant in all sorts of places it shouldn’t be.

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19
Q

This is called

A

ectopic pregnancy

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20
Q

Ectopic pregnancy is never going to reach term because…

A

there is no way for a placenta to develop.

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21
Q

But depending on where that egg implants, it can be

A

life threatening

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22
Q

Males can make more spermatogonia as they go through mitosis and meisosis. Females can’t make more stem cells. In females, their stem cells are called…

A

Oogonia.

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23
Q

What that means is, while a man can continue to make sperm, for the vas majority of their adult life, women…

A

are born with all the eggs they’re gonna have.

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24
Q

Medically, this makes a big difference. Ex: You have a male patient who has to go thru chemotherapy. That might affect their fertility level for a while but they will resume making sperm at the level of a healthy male once the effects of the chemotherapy has past. Women who go thru chemotherapy, …

A

harvest eggs if they’re at child bearing years.

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25
Q

B4 they go thru chemotherapy bc they’re not able to make more oogonia, …

A

if those cells get killed off by chemotherapy, we now have a woman who can now not have children.

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26
Q

So, we start with an oogonium and gonna watch this now. Just like we had in a male, we have mitosis and we’re gonna go into meiosis 1. So, first division looks just like …

A

mitosis

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27
Q

What we’re gonna get is one large cell and one small cell. The small cell is called

A

a polar body

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28
Q

It gets just enough membrane and cytoplasm to hold the DNA that we’re not gonna use. The large cell, secondary oocyte, …

A

most of the cytoplasm & organelles are in the secondary oocyte.

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29
Q

As we go thru meiosis to make an egg, what we’re gonna wind up with at the end is …

A

one functional egg and 2 or 3 polar bodies.

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30
Q

The reason is the egg is gonna supply the organelles, nutrition, energy is

A

to keep a newly formed embryo alive until you can get implantation

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31
Q

So, we don’t evenly divide the resources. Meiosis 1 gets us

A

our first polar body and secondary oocyte.

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32
Q

Meiosis 2, might divide, might not. Our secondary oocyte is going to…

A

divide and give us a mature egg and a second polar body.

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33
Q

If everything divides, we wind up with…

A

one mature oocyte and 3 polar bodies.

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34
Q

The second division in meiosis for an egg is triggered by …

A

fertilization.

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35
Q

Meiosis 1 starts in utero. Then, it gets suspended until puberty. At puberty, what’s gonna start happening is…

A

you’re gonna have groups of these oocytes start to complete meiosis and start to develop as follicles.

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36
Q

The idea is that ultimately, the one developing most quickly, is going to be…

A

the egg that’s going to be released in ovulation.

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37
Q

The rest of them will be delayed. While there’s a chance that the ovulated egg can get fertilized, we’re gonna…

A

stop meiosis

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38
Q

What you need to remember about the female reproductive system is that…

A

it’s built to save all the resources for pregnancy.

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39
Q

So, in a few days leading up to ovulation till we know it’s not possible for the woman to be pregnant, we …

A

turn down everything else and focus on those actions of hormones, follicles, etc that would support pregnancy.

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40
Q

Ovaries have 2 layers. We have the outer portion called…

A

cortex

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41
Q

The portion is in the middle is the…

A

medulla.

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42
Q

Outside here, we have a an outermost layer called…

A

germinal epithelium

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43
Q

The germinal epithelium is…

A

part of a capsule that surrounds the ovary.

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44
Q

Deep to that, we have a layer called…

A

tunica albuginea.

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45
Q

Throughout the coretx of the ovary, we have eggs and follicles that are in different levels of development. So, in the smaller structure, these are oogonia that haven’t started dividing and allowing cells to develop. What happens here is…

A

that we’re gonna have our egg.

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46
Q

As development starts, we’re gonna put a single layer of cells around this. These cells are…

A

called granulosa cells.

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47
Q

The layer of granulosa cells that’s touching the egg, is…

A

going to leave with the egg when it gets ovulated.

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48
Q

Once the egg gets ovulated, we’re gonna change the name of these particular cells. Now, we only have a single layer of granulosa cells, this is…

A

a primary follicle

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49
Q

As development continues, we add layers of granulosa cells . When we get enough layers of granulosa cells, some of the outer layers are going to change and we’re gonna get …

A

a layer or two of theca interna cells.

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50
Q

Outside that, we’re gonna get a layer of theca externa cells. The theca externa cells…

A

make up fibrous capsule around this particular follicle.

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51
Q

The theca interna cells make…

A

testosterone.

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52
Q

That testosterone is taken up by…

A

granulosa cells.

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53
Q

That granulosa cells converts…

A

testosterone into estrogen.

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54
Q

For the female reproductive system, the main role of testosterone is…

A

to be a precursor for estrogen.

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55
Q

As the follicle continues to develop, we get a space called the…

A

antrum

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56
Q

The antrum is filled with…

A

fluid, primarily, estrogen-riched fluid.

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57
Q

That first layer of granulosa cells that is touching the egg and travels with the egg when it’s ovulated, once the egg is ovulated, those cells are called…

A

cumulus cells.

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58
Q

Those cumulus cells secrete a substance that helps surround the egg, protect it, and keep it from dehydrating. This is called the…

A

zona pellucida.

59
Q

The zona pellucida is…

A

a barrier against fertilization. It’s enough of a barrier to slow things down and make it less likely that more than one sperm can fertilize an egg.

60
Q

The theca interna is very vascular. What has to happen for this particular egg to get ovulated?

A

The follicle has to be turned

61
Q

When you do that, you tear the blood vessels in the theca interna. If we tear the follicle, …

A

the egg is released.

62
Q

The blood vessels in the theca interna that were torn, they’re gonna bleed in the remnant of the follicle and…

A

form the body of the corpus hemorrhagium.

63
Q

The blood being close to the theca interna cells is going to…

A

make the theca interna cells proliferate and produce something called corpus luteum.

64
Q

Corpus luteum means yellow body. Corpus luteum is a…

A

temporary endocrine organ lives for about 2 weeks.

65
Q

In the process, it makes hormones. It makes…

A

lots of progesterone, small amounts of estrogen, makes inhibin, relaxin, and makes WIF (Wolffian Inhibiting Factor).

66
Q

What does WIF do?

A

It blocks development of the male reproductive tract.

67
Q

The corpus luteum takes about 7 days to reach it’s full maturation and then it starts to decrease in function. After 2 weeks, …

A

it’s not functioning anymore and becomes corpus albicans.

68
Q

Corpus albican is …

A

a piece of white scar tissue.

69
Q

Now we have a problem. We have an organ the size of an almond who has a job that rips open it’s surface once a month and release an egg. If we start accumulating scar tissue at the surface,

A

it gets harder and harder to ovulate.

70
Q

Through mechanism we don’t understand, the corpus albicans gets moved into…

A

the medulla of the ovary and broken down. This is so we don’t end up with an accumulation of scar tissue.

71
Q

Progesterone is the…

A

main hormone that supports pregnancy.

72
Q

Inhibin, like in males,

A

blocks the release of FSH.

73
Q

Relaxin has a function relating to…

A

maintaining pregnancy. It quiets down uterine smooth muscle and makes it contract less.

74
Q

Remember after fertilization, that embryo needs to implant. If the uterine smooth muscle is very active, …

A

it’s hard to implant or stay implanted.

75
Q

So, higher Relaxin levels, …

A

make it easier for a newly fertilized embryo to implant.

76
Q

Near end of pregnancy, Relaxin…

A

looses up the pubic symphysis to make it so that the pelvis can expand a little bit more.

77
Q

What’s different here hormonally, in the male system is controlled by GnRH. The female system is controlled by…

A

estrogen and progesterone levels.

78
Q

Functions of ovaries:

A
  • oogenesis ( making reproductive cells)
  • it’s an endocrine organ (produces estrogen & progesterone)
79
Q

Remember all hormones made by corpus luteum is also made by the placenta. If I ask you to tell me all places in the female body where estrogen is made, it’s made by…

A

granulosa cells, corpus leteum, and placenta.

80
Q

Fallopian tubes are about…

A

10 cm long.

81
Q

They come off of…

A

upper angles of the uterus and wrap around and end up posterior to the uterus as well. They have to bc ovaries are posterior to the uterus.

82
Q

They have 3 layers. They have a mucosal layer, moist epithelium. They have a smooth muscle layer and have a serous layer on the outside.

A
  • a mucosal layer (moist epithelium)
  • a smooth muscle layer
  • a serous layer on the outside.
83
Q

There are 3 regions of the fallopian tube. The area where the fallopian tubes connect to the uterus is called…

A

the Isthmus.

84
Q

We get closer to the ovary and it broadens into the ampulla. Then we have the…

A

infundibulum.

85
Q

The last portion is called…

A

fimbriae.

86
Q

Fimbriae looks like…

A

fingers. It’s the fimbriae that’s close to the ovary.

87
Q

We have cells in the mucosal part of the fallopian tube that secrete mucus. Then, we have another population of cells that have cilia. The mucus…

A

helps to keep inside of the tube moist.

88
Q

The cilia is important to…

A

make sure an ovulated egg makes its way into the fallopian tube.

89
Q

The cilia and lining of fallopian tubes…

A

beat towards the uterus.

90
Q

There is a small amount of fluid in the abdominalpelvic cavity and having those cilia beat…

A

creates a current that pulls fluid into the fallopian tube and eggs will get stuck in that current and get pulled into the fallopian tube.

91
Q

The other thing that’s gonna help bring the egg into the fallopian tube are the fimbriae. The fimbriae…

A

can kind of reach out and guide that egg into the opening on the infundibulum.

92
Q

What’s the job of the fallopian tube? If the fallopian tube is blocked, you can’t get an egg or an embryo into the uterus. Fallopian tubes are the common site of fertilization. This is where egg meets sperm most often (not in the uterus).

A

Brings the egg to the uterus.

93
Q

If the fallopian tube is blocked, …

A

you can’t get an egg or an embryo into the uterus.

94
Q

What is the common site of fertilization?

A

Fallopian tubes.
This is where egg meets sperm most often (not in the uterus).

95
Q

The uterus sits…

A

anterior to the rectum, posterior to the urinary bladder.

96
Q

There is a lot of smooth muscle in the wall of the uterus. The position and size of the uterus change with age. In menopause, the uterus involutes. This means…

A

That thick muscular wall is going to get thinner and uterus is going to drop lower in the pelvic cavity.

97
Q

The uterus in a woman who has never been pregnant is pear shaped. With the base of pear facing…

A

up and the part closer to the stem facing downward.

98
Q

We have 2 main parts…

A

The body and narrow region that sticks into vaginal canal called the cervix. The cervix is part of the uterus.

99
Q

The bulging portion at the top of the uterus is called…

A

the fundus.

100
Q

In pregnant women, they locate the fundus and fundal position is…

A

one way to guesstimate how far a long a woman is in pregnancy.

101
Q

Where we enter the cervical canal from the uterine cavity is called…

A

internal os

102
Q

Where we exit the cervical canal into the vagina is called…

A

external os

103
Q

Bc uterus has a purpose for providing a place for development of a growing fetus, blood supply to uterus is very important. We have uterine arteries that…

A

supply blood to the walls of the uterus.

104
Q

We also have internal iliac arteries providing blood supply. If you look along the fallopian tube, uterus, and even vagina, all these blood vessels are anastomosing. What is the benefit of it?

A

Having anastomosis, would mean if we have a blockage here, pressure will cause blood to enter in another vessel.

105
Q

All these anastamoses are defending blood supply to the uterus which is defending…

A

O2 and nutrient delivery to the fetus.

106
Q

The wall of the uterus has 3 layers. Innermost layer is…

A

endometrium

107
Q

The thickest layer is smooth muscle called…

A

myometrium.

108
Q

The outermost layer is…

A

perimetrium. This is part of the peritoneum.

109
Q

Only the anterior surface of the uterus has peritoneum on it bc…

A

the uterus has retroperitoneal. So it’s covered in the front but not in the back.

110
Q

The endometrium, the lining of the uterus, has 3 sections to it. Those sections are…

A

stratum compactum, stratum spongiosum, and stratum basale.

111
Q

The stratum compactum is the layer…

A

closest to the uterine cavity. It’s partially ciliated. T

112
Q

The stratum compactum is one of the layers in the uterine wall that…

A

will be shed during menstruation.

113
Q

The layer just deep to that is the stratum spongiosum. The stratum spongiosum is…

A

a layer of loose connective tissue.

114
Q

Remember stratum compactum is…

A

an epithelium and doesn’t have a blood supply. stratum spongiosum provides the blood supply.

115
Q

The stratum spongiosum is…

A

also gonna be shed during menstruation.

116
Q

The functional zone refers to…

A

the 2 layers that are shed during menstration (stratum compactum + stratum spongiosum).

117
Q

The deepest layer of the endometrium is stratum basale. This is the layer that…

A

connects the endometrium to myometrium and is going to give us the cells to rebuild the stratum compactum and stratum spongiosum after menstruation.

118
Q

The thickness of the endometrium changes depending where you are in the menstrual cycle. Right after menstruation, ….

A

the endometrium is half a mm thick. Bc all you have left there is stratum basale.

119
Q

Just before menstruation, …

A

the endometrium is 5 mm thick.

120
Q

Spiral arteries are arterioles. We care about spiral arteries. One reason we care about them is that…

A

they’re hormone sensitive.

121
Q

Their vasoconstriction or vasodilation depends on the…

A

presence of progesterone.

122
Q

When we have high progesterone in higher concentration, those spiral arteries…

A

will grow and be dilated which gives us a blood supply to keep the stratum compactum and stratum spongiosum alive.

123
Q

When progesterone levels drop, spiral arteries…

A

spasm so tightly that the blood can’t get to the stratum spongiosum and nutrients and O2 can’t get to the stratum compactum.

124
Q

That causes…

A

those two layers to die and that’s what causes menstruation.

125
Q

Every time a woman menstruates, she has to rebuild spiral arteries because…

A

they’re in the stratum spongiosum and it’s gonna get shut.

126
Q

There’s also glands in the stratum compactum. Those glands or ducts are gonna have to be rebuilt. They’re very important because…

A

b4 a fertilized egg can implant, the secretions from the uterine glands can be used to let the embryo make energy.

127
Q

The cervix is part of the uterus which means…

A

there is endometrium in the cervix as well.

128
Q

The mucus glands in the cervix are also sensitive to hormones. In the first half of a woman’s menstrual cycle, from onset of menstruation to right before ovulation, …

A

cervical mucus is thick, sticky, and it’s job at that point is to be a barrier to sperm.

129
Q

The second half from ovulation to the onset of the first period of menstruation, the changes in the hormones, cause the

A

same mucus glands to produce the mucus that is thinner, more slippery and actually helps sperm make their way into the uterus.

130
Q

Our next layer in the wall of the uterus is by far the thickest is the…

A

myometrium

131
Q

The myometrium has 3 layers of smooth muscle…

A

A circular layer, longitudinal layer, and oblique layer.

132
Q

3 layers of smooth muscle in the myometrium gives strength to the wall and contraction in all directions. That’s gonna make…

A

labor and delivery happen.

133
Q

Myometrium is thinnest at the cervix. Why?

A

Make it easier there to be a definitive exit for the uterus.

134
Q

If you have a thicker muscle at the fundus and thinner muscle at the cervix, then…

A

that movement is going to be down towards and into the cervix.

135
Q

Another thing that happens when we get to labor is that …

A

while the uterus is contracting, the cervix is going to be dilating.

136
Q

The first half of the menstrual cycle (from onset of menstruation to ovulation), …

A

we have a lot of contraction of uterine smooth muscle.

137
Q

That is going to…

A

break down the endometrium that’s supposed to be shed and help move it out of the uterus and out of the cervix.

138
Q

The second half (ovulation to onset of the next menstrual period), we want the…

A

myometrium to be quiet. Contractions decrease bc it makes it easier for a fertilized embryo to implant and stay implanted.

139
Q

Perimetrium covers anterior part of uterus. There’s one thing clinically that is significant about this. Bc uterus is retroperitoneal, if a woman needs uterine surgery, they…

A

can go in behind peritoneum and it can decrease the likelihood of infection spreading into the peritoneum cavity.

140
Q

Endometrial cycle and menstrual cycle are the same thing. There’s different names. These different names tell you..

A

what’s going on at the ovary, uterus, w/hormonal situation is.

141
Q

Menstruation is…

A

the shedding of endometrium (stratum compactum and stratum spongiosum).

142
Q

Blood loss

A

between 30-100 ml, there’s much individual variability.

143
Q

There is generally no clotting. Menstruation is the first phase in the menstrual cycle. After menstruation, the…

A

endometrium starts to thicken and next phase is the proliferative phase.