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OB GYN > M1: Physiology of Female Repro > Flashcards

M1: Physiology of Female Repro Flashcards

0
Q

Each primary oocyte is packaged in an epithelial vesicle called

A

Follicle

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1
Q

Ovulation divides the menstrual cycle in two phases

A

Follicular & Luteal Phases

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2
Q

It is within follicle that ___________ takes place to create _______ oocyte.

A

Second meiotic division. Secondary.

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3
Q

Four stages Follicular structure

A

Primordial(primary) Follicle, Graafian(vesicular ovarian) Follicle, Corpus Luteum & Corpus Albicans

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4
Q

Secretes estrogen & progesterone

A

Corpus luteum

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5
Q

Maturation of the Follicle

A

Folliculogenesis

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6
Q

Folliculogenesis: 1. FSH stimulates _________(oocyte arrested in the diplotene stage of the ____________ surrounded by a single layer of __________)

A

Primordial follicle. 1st meiotic division. Granulosa cells.

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7
Q

Folliculogenesis: 2. _______ follicle (oocyte surround by a single layer of ________ cells basement membrane and ______ cells)

A

Primary. Granulosa. Theca.

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8
Q

Folliculogenesis: 3. _________ follicle (oocyte surrounded by _________, several layers of granulosa cells & theca cells)

A

Secondary. Zona pellucida.

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9
Q

Folliculogenesis: 4. Tertiary or ________ follicle. Secondary follicle accumulates fluid in a cavity. Oocyte is eccentric position. Surrounded by granulosa cells.

A

Antral

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10
Q

Secondary follicle accumulates fluid in a cavity

A

Antrum

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11
Q

Surrounded by granulosa cells

A

Cumulous oophorus

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12
Q

Primary site for fertilization

A

Ampulla of the Fallopian tube

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13
Q

Begins with menses in dat 1 of the menstrual cycle and ends with ovulation

A

Follicular Phase

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14
Q

FSH causes maturation of a cohort of ovarian follicles. However, only one reaches maturity.

A

Recruitement

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15
Q

Selection of the dominant follicle occurs day _____.

A

5-7

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16
Q

As the follicle matures, increase _________ & decrease _______. Negative feedback on the pituitary, the follicle with the highest number of ___________ will continue to thrive. Follicular _______.

A

Estrogen. FSH. FSH receptor. Atresia.

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17
Q

For recruitement. Has mitogenic effect. Increase in number of granulosa cells & FSH receptor. Stimulates ______ activity for the conversion of androgens(androstenedione) to estrogen or ________. LH receptors.

A

FSH. Aromatase. Estradiol.

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18
Q

Acts synergistically with FSH to induce LH receptors, FSH receptors in granulosa & theca cells. LH acts on theca cells for the uptake of _____ & _______ to androstenedione & testosterone.

A

Estrogen. Cholesterol & LDL.

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19
Q

Hormonal Regulation in Nonpregnant state

A

Uterine cycle

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20
Q

Uterine cycle: 1. _______ stimulates the anterior pituitary to release FSH & LH.

A

Hypothalamus releases GnRH

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21
Q

Uterine cycle: 2. _____ stimulates maturation of primary oocyte in an immature follicle.

A

FSH

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22
Q

Uterine cycle: 3. Follicle produces _______. This builds the uterine wall (endometrium) and inhibits secretion of FSH.

A

Estrogen

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23
Q

Uterine cycle: 4. High levels of Estrogen further stimulate secretion of ____ by anterior pituitary. With ____ also causes ovulation of the secondary oocyte, corpus luteum.

A

LH. FSH.

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24
Q

What happens to patients if estrogen secretion is uncontrolled by progesterone

A

Irregular menses

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25
Q

Local peptide in the follicular fluid. Negative feedback on pituitary FSH secretion. Locally enhances LH induced androstenedione production.

A

Inhibin

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26
Q

Found in follicular fluid. Stimulates FSH induced estrogen production. Gonadotropin receptors. Decrease androgen.

A

Activin

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27
Q

Increase estradiol (reaching a threshold concentration) leads to positive feedback on the pituitary (facilitated by low levels of progesterone) LH surge then secretion of progesterone. Operates after puberty. Positive feedback on pituitary equals ___ FSH.

A

Positive feedback. Increase.

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28
Q

Increase estradiol and inhibin which leads to decrease FSH.

A

Negative feedback

29
Q

Accompanied by rapid fall of estradiol level. Triggers the resumption of meiosis. Lasts for ____ hours. Ovulation occurs after ___ hours. Affects follicular wall causing follicular rupture. Granulosa cells undergo luteinization which leads to ________ synthesis.

A

LH surge. 48. 36. Progesterone.

30
Q

Release of secondary oocyte from a mature follicle. Occurs in response to high concentrations of FSH & LH. Secondary oocyte is rejected from the ovary directly through a mass of ovarian wall. ______ directs oocyte into fallopian tube.

A

Ovulation. Fimbria.

31
Q

Changes in the composition of the antral fluid. Increase in colloid osmotic pressure.

A

Increase Follicular pressure

32
Q

Enzymatic rupture of the follicular wall: LH & FSH stimulates granulosa cells then production of ________ activator. Increase plasmin leads to increase ________ activity which will eventually result to breakdown of follicular wall.

A

Plasminogen. Fibrinolytic.

33
Q

Enzymatic rupture of the follicular wall: LH will increase _________ then increase plasminogen activator then increase ________ which will result to increase lysosomes under follicular wall.

A

Prostaglandin E. PG F2a.

34
Q

Formation of the corpus luteum. Marked increase in progesterone.

A

Luteal Phase

35
Q

Luteal Phase lasts _______ days.

A

12-14 days

36
Q

Formation of Corpus Luteum: after ______ the point of rupture in the follicular wall seals.

A

Ovulation

37
Q

Formation of Corpus Luteum: Vascular capillaries cross the basement membrane & grow into the ________. Increase availability of ____ cholesterol.

A

Granulosa cells. LDL.

38
Q

Formation of Corpus Luteum: increases LDL binding to receptors. Inc 3a OH steroid dehydrogenase activity w/c will increase progesterone.

A

LH

39
Q

Suppresses the follicular maturation on the ipsilateral ovary. Thermogenic activity, inc basal body temp. For endometrial maturation.

A

Progesterone

40
Q

Progesterone peak _______ after ovulation (day22

A

8 days

41
Q

Is sustained by LH. It loses its sensitivity to gonadotropins leads to luteolysis then dec estrogen & progesterone level the. Desquamation of the endometrium.

A

Corpus Luteum

42
Q

Decrease estrogen & progesterone will increase _________ during luteal phase.

A

FSH & LH

43
Q

The new cycle starts with the beginning of

A

Menses

44
Q

If pregnancy occurs, ____ secretion maintain the corpus luteum.

A

hCG

45
Q

Secretes estrogen & progesterone. This maintains the endometrium for _______ days and inhibits LH.

A

Corpus Luteum. 15-16.

46
Q

If oocyte is not fertilized and implanted on the uterine wall, corpus degenerates and stops producing estrogen & progesterone.

A

Corpus Albicans

47
Q

Without progesterone & estrogen, endometrium breaks down. ______ occurs.

A

Menstruation

48
Q

Decrease in progesterone & LH. Low ____ causes secretion of FSH by pituitary again. The cycle repeats.

A

LH

49
Q

Aside from the ovaries, where can estrogen be synthesized.

A

Adipocytes & Placenta

50
Q

Adjacent to the myometrium. Unresponsive to hormonal stimulation. Remains intact throughout the menstrual cycle. Does not sloughs off during menstruation.

A

Basal layer

51
Q

Sloughs of during menstruation

A

Functional layer

52
Q

Functional layer is composed of two layers

A

Zona compacta(superficial) & Spongiosum layers

53
Q

Phase wherein estrogen induces mitotic activity in the glands & stroma which will increase endometrial thickness from 2-8mm.

A

Proliferative phase

54
Q

Progesterone induces a severe restriction in the mitotic activity. Endometrial glands (basal glandular epithelium) produce then secrete glycogen leads to vacuoles (D17)

A

Secretory phase

55
Q

First sign of ovulation. Accompanied by stromal edema & enlargement of cells. Spiral arterioles develop, lengthen & recoil.

A

Subnuclear vacuoles & Pseuodstratification

56
Q

Two phases of Endometrial cycle

A

Proliferative & Secretory

57
Q

Hormone responsible for Proliferative phase

A

Estrogen

58
Q

Hormone responsible for Secretory phase

A

Progesterone

59
Q

Periodic desquamation of the endometrium. The external hallmark of menstrual cycle.

A

Menstruation

60
Q

Just before menses the endometrium is infiltrated with

A

Leukocytes

61
Q

Are maximal in the endometrium just before menses. Constriction of the spiral arterioles then ischemia and desquamation. Followed by arteriolar relaxation, bleeding & tissue breakdown.

A

Prostaglandins (PGF2a)

62
Q

Secretes GnRH in a pulsatile fashion

A

Hypothalamus

63
Q

GnRH activity is first evident at

A

Puberty

64
Q

Follicular phase GnRH pulses occur

A

Hourly

65
Q

Luteal phase GnRH occur every

A

90mins (pulsatile)

66
Q

Leads to down regulation of pituitary receptors. Decrease secretion of gonadotropins.

A

Loss of pulsatility

67
Q

Release of GnRH is modulated by negative feedback by

A

Steroids & Gonadotropins

68
Q

Aside from pain relief, what is another reason for giving NSAIDs to women suffering from heavy menstrual bleeding

A

Reduce bleeding

69
Q

Fertile period: Longest cycle

A

11

70
Q

Fertile period: shortest cycle

A

18

OB GYN (5 decks)

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