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OB/Gyn > Menstrual Cycle > Flashcards

Menstrual Cycle Flashcards

0
Q

Around what age does the menstrual cycle typically end?

A

around age 50

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1
Q

Around what age does the menstrual cycle begin?

A

around age 11-13

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2
Q

How long does a menstrual cycle last?

A

Typically 28 days from first day of bleeding

varies from patient to patient

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3
Q

What regulates the menstrual cycle?

A

the hypothalamus

dependent upon cyclic release of estrogen and progesterone from ovaries

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4
Q

What is Premenarch?

A

prepuberty - prior to the onset of menses

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5
Q

What is Menarch?

A

after reaching puberty

menses occurs normally every 28 days (1st menses to menopause)

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6
Q

What is menopause?

A

the cessation of menses

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7
Q

What are the menstrual statuses?

A

Premenarch

Menarch

Menopause (no period for one solid year)

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8
Q

What are the gonadotropins?

A

Hormonal substance which stimulates the function of the testes and ovaries

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9
Q

What hormones do the gonadotropins release?

A

FSH (follicle stimulating hormone)

LH (luteninizing hormone)

LTH (luteotropic hormone)

Estrogen

Progesterone

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10
Q

What is Estrogen?

A

Steroid

Released by theca interna and granulose cells of ovarian follicle

promotes growth of endometrium durning menstrual cycle

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11
Q

What is ovulation?

A

explosive release of ovum from ruptured graafian follicle

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12
Q

what is an oocyte?

A

primordial or incompletely developed ovum

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13
Q

who regulates ovulation?

A

the hypothalalmus

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14
Q

What does the Anterior Pituitary gland do?

A

secretes varying levels of gonadotropins (FSH, LH, LTH)

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15
Q

What is the first half of the menstrual cycle called?

A

proliferative, follicular or estrogenic phase

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16
Q

When is the first half of the menstrual cycle?

A

usually days 1-14 may vary in length accounts for shortere or longer menstrual cycle

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17
Q

What happens on day 1 of the first half of the menstrual cycle?

A

first day of bleeding ( menstrual flow)

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18
Q

What happens day 1 through day 4-5?

A

estrogen levels decreases

FSH releases/stimulates follicular growth and maturity

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19
Q

What happens day 4-5 of the first half of the menstrual cycle?

A

menstrual flow complete

endo lining ready for new growth (proliferation)

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20
Q

What happens day 5-14 of the first half of the menstrual cycle?

A

follicles grow

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21
Q

what is a mature follicle called?

A

a graafian follicle

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22
Q

What does estrogen trigger?

A

new growth of endometrial lining (proliferation)

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23
Q

When does ovulation occur?

A

approx day 14

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24
Q

What is the lutenizing surge?

A

LH surge peaks 10-12 hours prior to ovulation - used for ovulation prediction for conception

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25
Q

What released the egg, who catches it?

A

Released by: Graafian follicle

directed by fimbria into the infundibulum of the Fallopian tube.

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26
Q

Where would you find fluid after the follicular rupture?

A

usually associated with release of fluid into posterior cul-de-sac

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27
Q

What is Mittleschmerz (middle pain)

A

fluid causes irritation to membranes (fluid from released ovum during ovulation…this is normal)

causes pain during ovulation

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28
Q

What is the second half of the menstrual cycle called?

A

pro-gestational, luteal or secretory phase

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29
Q

What is the measurement for a follicle?

A

2-2.5 cm

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30
Q

what is the measurement for an ovarian cyst?

A

2.5cm or bigger

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31
Q

When does the second half of the menstrual cycle begin?

A

begins with ovulation

lasts approx 14 days

does not vary in length

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32
Q

What happens during the second half of the menstrual cycle?

A

follicle ruptured - corpus luteum

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33
Q

what does corpus luteum mean?

A

Yellow body

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34
Q

how is the endometrium affected by the ovulatory cycle?

A

affected by varying levels of progesterone and estrogen

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35
Q

what are the three phases of the menstrual cycle that affect the endometrium?

A

the menstrual phase

proliferative phase

secretory phase

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36
Q

what is the menstrual phase?

A

decreasing progesterone levels

spiral arterioles constrict

zona functionalis ischemia - shedding

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37
Q

what is the proliferative phase?

A

days 6-14

lasts until ovulation

lasts until luteinization of Graafian follicle - ovulation

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38
Q

what happens to the superficial layer of the endometrium during the proliferative phase?

A

it regenerates and grows

follicles regrow with FSH stimulation (estrogen rises)

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39
Q

what is the periovulatory phase or late proliferative?

A

days 10-14

endometrium triple layer appearance

slide 25 finish

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40
Q

When is the secretory phase?

A

15-28 days or the on set of menses

when the person starts to bleed

41
Q

what happens during the secretory phase?

A

the thickest point of the endometrium*

progesterone secreted by ovary

spiral arteries and endometrial glands enlarge

finalizes endometrial lining for implantation if fertilization occurs

42
Q

What is an anovulatory patient?

A

birth control users or post menopausal or prepubescent

endometrium is thin and has an echogenic line

birth control will be <5mm

43
Q

What does a postmenopausal endometrium NOT on hormone replacement therapy measure?

A

endometrial thickness <5mm

a thickened endometrium with no HRT and bleeding can be cancer so know this!!

44
Q

what is menorrhagia?

A

abnormally heavy or long periods

associated with fibroids, IUd, hormonal imbalance

can lead to anemia

45
Q

What is oligomenorhea?

A

abnormally short or light periods

associated with polycystic ovary syndrome (POS)

emotional/physical stress, chronic illness, tumors secreting estrogen, poor nutrition, eating disorders, heavy exercise

46
Q

what is polymenorrhea?

A

cycle occurs at intervals of <21 days

47
Q

what is dysmenorrhea?

A

painful periods (severe pain)

associated with endometriosis (the endometrium outside the uterus goes through the same changes as the stuff inside)

48
Q

what is Amenorrhea - primary?

A

absence of menstruation

delayed beyond 18 yr old

due to:

ovarian dysfunction

pituitary disease

other endocrine disturbances

49
Q

what is amenorrhea - secondary?

A

cessation of menstruation in women who previously menstruated

due to:

congenital vaginal or cervical stenosis

infection

trauma

pituitary disease

other endocrine distrubances

50
Q

What is progesterone?

A

Produced by corpus luteum

prepares and maintains endometrium for arrival and implantation of embryo

51
Q

What does FSH do?

A

Causes follicle to develop during first half of menstrual cycle

estrogen level rises with follicle maturation

52
Q

what does LH do?

A

triggers ovulation

53
Q

what does LTH do?

A

maintains corpus luteum

54
Q

what is a steriod?

A

chemical which stimulates growth or maturation

55
Q

What two steroids are produced in the female body for menstruation?

A

Estrogen

progesterone

56
Q

What is Progesterone?

A

Steroid

produced by corpus luteum

Prepares and maintains endometrium for arrival and implantation of embryo

57
Q

During ovulation how often in an ovum released?

A

Monthly

58
Q

when does ovulation occur in the month?

A

occurs midcycle

day 14 of a 28 day cycle

59
Q

When is the ovum released from each left or right ovary?

A

ovulation alternates monthly between the two ovaries

60
Q

At what stage of life does a female begin developing ova?

A

development begins during embryonic life

61
Q

How many oocytes will a female have at the time of birth?

A

approx 200,000

62
Q

How does the hypothalamus regulate ovulation?

A

releases gonadotropin releasing hormones (GnRHs)

63
Q

During ovulation what gland does the hypothalamus stimulate?

A

the anterior pituitary gland

64
Q

What does FSH (follicle stimulating hormone) do during ovulation?

A

causes follicle to develop during first half of menstrual cycle

65
Q

what happens to the estrogen level during follicle maturation?

A

it rises

66
Q

What does LH (lutenizing hormone) do during ovulation?

A

triggers ovulation

67
Q

What does LTH (Luteotropic hormone) do during ovulation?

A

maintains the corpus luteum

68
Q

What happens to estrogen production during the first half of the menstrual cycle?

A

decreased - no pregnancy

69
Q

What does the anterior pituitary gland do during the first half of the menstrual cycle?

A

secrets FSH

70
Q

What does FSH do during the first half of the menstrual cycle?

A

stimulates ovarian follicles to grow and mature

71
Q

What happens on day 5-8 of the first half of the menstrual cycle?

A

follicles begin to develop

72
Q

What does a follicle do when it develops in the first half of the menstrual cycle

A

days 5-8

the follicles fill with fluid

secrete increasing amounts of estrogen

73
Q

What happens to FSH levels during day 5-8 of the first half of the menstrual cycle?

A

FSH level decreases

74
Q

In the first half of the menstrual cycle what is the follicle called that reaches maturity around day 14?

A

a Graafian follicle

75
Q

Describe the Graafian follicle on day 14 of the first half of the menstrual cycle…

A

usually only 1 follicle reaches maturity

approx 2 cm in diameter

76
Q

What does estrogen do during the 5-14 days of the first half of the menstrual cycle?

A

triggers new growth of endometrial lining (proliferation)

77
Q

What does the corpus luteum release during the second half of the menstrual cycle?

A

progesterone

78
Q

What happens to the basal body temperature during the second half of the menstrual cycle?

A

body temp increases

79
Q

Is LTH released in the first or second half of the menstrual cycle?

A

LTH is released in the second half of the menstrual cycle

80
Q

What happens in the second half of the menstrual cycle if the ovum is released?

A

hCG is released

81
Q

What happens in the second half of the menstrual cycle if the ovum is NOT fertilized?

A

Menses will occur

82
Q

What happens to the corpus luteum if the ovum is not fertiziled?

A

it gradually decreases after 9 days

83
Q

What happens on day 25-26 of the second half of menstrual cycle if fertilization has taken place?

A

9-11 days after ovulation

hCG (human chorionic gonadotropin) produced by zygote

corpus luteum persists (maintained by LTH) and secrets progesterone for three months until placenta takes over. corpus luteum gradually dissolves

84
Q

What happens on day 25-26 of the second half of menstrual cycle if no fertilization occurs?

A

9-11 days after ovulation…
If no fertilization occurs:

LTH subsides

corpus luteum degenerates

progesterone levels drop

menstruation begins

85
Q

What happens to the spiral arteries on day 25-26 of the second half of the menstrual cycle?

A

spiral arteries contract due to decreased progesterone and estrogen

blood supply to inner 2/3 of endometrium is cut off which creates endometrium necrosis and then it sloughs off

86
Q

what happens on approx day 28 of the second half of the menstrual cycle

A

decreased estrogen

increased FSH

process starts again

87
Q

What correlates with the ovulatory cycle of the ovary?

A

Endometrial changes….which also correlates with patients menstrual status

88
Q

What ovarian cycle phase coincides with the menstrual phase?

A

the follicular phase of the ovarian cycle

89
Q

How long does the menstrual phase last?

A

Lasts approx 1-5 days

90
Q

What does the endometrium look like during the menstrual phase?

A

thin line…late in the menstrual phase

91
Q

What does the proliferative phase prepare the endometrium for?

A

the endometrium is prepared for implantation

92
Q

During the proliferative phase, how does the endometrium look?

A

the endometrium is in it’s 3 line phase

average measurement is 4-8mm

made of the zona basalis A &P and the uterine cavity creates the central line

93
Q

In the proliferative phase, what is the thickened three line?

A

The endometrium thickens and three lines are able to be seen

occurs late in the phase - ovulation

average measurement is 6-10mm

appears isoechoic to myometrium

94
Q

The secretory phase corresponds to which ovarian phase?

A

the luteal phase of the ovary

95
Q

What happens to the endometrial lining during ovulation?

A

It continues to grow because of the stimulation of increasing estrogen levels

96
Q

What does an increased level of estrogen trigger during ovulation?

A

release of LH from the anterior pituitary gland

97
Q

What does LH do during ovulation?

A

rapidly increases over a 24-36 hour time period

triggers ovulation

98
Q

What is the measurement for a postmenopausal endometrium for a patient taking HRT or tamoxifen (ta MOX a phen)?

A

endometrium up to 8mm

99
Q

What are the measurements of the endometrium during the secretory phase?

A

average 7-14 mm

thick endometrium with posterior acoustic enhancement

becomes echogenic

OB/Gyn (14 decks)

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