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Maternal Newborn-MJ > Menstrual Cycle Worksheet > Flashcards

Menstrual Cycle Worksheet Flashcards

1
Q

What are the 4 phases of endometrial cycle?

A

Proliferation
Secretory
Ischemic
Menstrual

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2
Q

What is the endometrial cycle influenced by?

A

Hypothalamic-pituitary-ovarian axis feedback mechanism

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3
Q

Explain the hypothalamic-pituitary-ovarian axis feedback mechanism.

A

When the hypothalamic-pit-ovarian axis feedback mechanism functions properly, other tissues undergo predictable responses.

EX: Before ovulation, BBT is less than 37C; after ovulation (with increasing progesterone levels) BBT rises

EX2: Changes in cervix and cervical mucos follow a predictable pattern..Preovu and postov mucus is viscous so that sperm penetration is discouraged–at time of ovulation, the mucus is clear and thin [it looks, feels, and stretches like egg white–the stretchable quality is called spinnbarkeit]

EX3: Some women have localized lower abdominal pain called mittelschmerz that coincides with ovulation

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4
Q

What are main hormones associated with endometrial cycle?

A

Estrogen and progesterone

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5
Q

Endometrial Cycle: Proliferation phase

What happens here?

A

A significant rich layer of myometrium and blood vessels develops to cover the endometrial cavity

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6
Q

Endometrial Cycle: Proliferation phase

What does this phase correlate with? What does it depend on? Can this phase support an implanted ovum?

A

Correlates with: Follicular phase of OVARIAN cycle

Depends on the dominance of ESTROGEN stimulation from the ovarian follicles

This phase DOES NOT adequately support and implanted ovum

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7
Q

Endometrial Cycle: Secretory phase

What is this phase characterized by?

A

Deepening and maturing of the succulent layer of endometrium implantation

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8
Q

Endometrial Cycle: Secretory phase

This phase is characterized by deepening and maturing of the succulent layer of endometrium implantation.

  1. What does this layer do?
  2. What is going on with progesterone at this point?
  3. What if pregnancy does not occur?
A
  1. This layer WILL SUPPORT the developing zygote
  2. Progesterone continues to be produced by the corpus lute
  3. If pregnancy does not occur, the corpus luteum REGRESSES, ischemia of endometrium develops, and cyclic menstrual bleeding begins
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9
Q

First day of the menstrual cycle is ___. What phase is this in?

A

Day 1; ischemic phase

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10
Q

What happens in the ischemic phase of the endometrial cycle?

A

Shedding of functional 2/3 of endometrium

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11
Q

What are the 3 phases of the ovarian cycle?

A

Follicular phase (pre-ovulatory)
Ovulation
Luteal (post-ov)

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12
Q

T/F: Blood levels of the ovarian hormones (estrogen and progesterone) increase toward the end of the normal menstrual cycle.

A

FALSE–They decline!!!

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13
Q

The low blood levels of hormones at the end of a normal menstrual cycles triggers the _____ to begin a new ovarian cycle by secreting _____

A

Hypothalamus to begin a new ovarian cycle by secreting gonadotropin-releasing hormone (GnRH)

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14
Q

GnRH stimulates the _______ to secrete _______ and _____. What is the target organ of these hormones?

A

GnRH stimulates the ANTERIOR PITUITARY to secrete follicle stimulating hormone (FSH) and luteinizing hormone (LH)

The target organ of these hormones is the OVARY

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15
Q

What is dominant in the follicular phase: FSH or LH? Why?

A

FSH…it stimulates the development of ovarian griffin follicles

One of these follicles will develop into a mature ova and a surge of LH causes the mature ova to be released from the ovary

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16
Q

What does a surge of LH cause?

A

The mature ova to be released from the ovary

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17
Q

The developing follicles produce ____ and ____ in large amounts. What do these hormones prepare?

A

Estrogen and progesterone

These hormones prepare the endometrial lining of the uterus for implantation of a zygote!

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18
Q

When does ovulation occur? What happens when these hormones peak?

A

After a marked surge of LH and a smaller peak of estrogen 14 days (+/- 2 days) before the next menstrual flow

When the hormones LH and estrogen peak, ovulation occurs within 24-36 hours

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19
Q

Clinical signs of ovulation: What happens in the body basal temp (BBT)?

A

Sharp increase in body temp

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20
Q

Clinical signs of ovulation: What happens to the vaginal mucus?

A

It becomes thin and stretchable (spinnbarkeit)

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21
Q

Clinical signs of ovulation: Why is spinnbarkeit important?

A

This characteristic of the mucus is hospitable to sperm, allowing sperm to survive and propel though the reproductive tract

22
Q

Clinical signs of ovulation: How does cervical mucus pH change and why?

A

Changes from acidic to more alkaline. Semen is alkaline. When the mucus is more alkaline, it allows survival of the sperm.

23
Q

Clinical signs of ovulation: A subjective feeling of slight abdominal discomfort

A

Mittelschmerz

24
Q

Clinical signs of ovulation: How does progesterone plasma level changes?

A

Increase to about 3 mg/mL (about 3 days post-ov)

25
Q

Luteal phase of the ovarian cycle: What is the follicle crater on the surface of the ovary called?

A

Corpus luteum

26
Q

What does the corpus luteum do?

A

Secretes copious amounts of estrogen and progesterone (with progesterone dominant)

27
Q

Luteal phase of the ovarian cycle: The hormones estrogen and progesterone peak at approx. ____ after ovulation, about the time a fertilized ovum would be implanted in the endometrium if pregnancy occurred. If no implantation occurs, what happens?

A

8-10 days

If no implantation occurs, corpus luteum regresses, blood levels of hormones decline and menstruation occurs

28
Q

Average menstrual cycle is _____

A

28 days

29
Q

How long is flow of menstrual cycle?

A

4-7 days

30
Q

“Cramps” and tenderness of breasts; fatigue may occur

A

Dysmenorrhea

31
Q

What is dysmenorrhea?

A

Abdominal and lower back pain during menstruation

32
Q

What are examples of therapeutic management to help with dysmenorrhea?

A
  • Heating pad, hot bath
  • Massaging lower back
  • Soft, rhymthic rubbing of the abdomen
  • TENS
  • Hatha yoga, accupuncture, and meditation
  • 8 weeks of yoga
  • Exercise (one specific exercise nurses can suggest= Pelvic Rocking)
33
Q

What are some foods to help with therapeutic management of dysmenorrhea?

A
  • Decreased salt and sugar 7-10 days before menses
  • Asparagus, cran juice, peaches, parsley, or watermelon (natural diuretics to help reduce edema)
  • Low fat vegetarian diet
34
Q

NSAIDS can be given for dysmenorrhea. If one NSAID is ineffective, a different one may often be effective. If the second one is unsuccessful after a 6 month trial, combine ______ may be used.

A

Combined oral contraceptive pills (OCPs)

35
Q

____ are effective in reliving symptoms of primary dysmenorrhea in approx. 90% of women

A

OCPs

36
Q

Variations in menstrual cycle flow due to oral contraceptives: flow may ___

A

Decrease

37
Q

Variations in menstrual cycle flow due to IUD: flow may ____

A

Increase

38
Q

A collection of symptoms preceding menstruation

A

PMS

39
Q

PMS is a collection of symptoms preceding menstruation characterized by what 6 things?

A
  • HA
  • Bloating (heaviness in lower abdomen and legs)
  • Tenderness and swelling of breasts
  • Food cravings
  • Depression
  • Irritability
40
Q

Cessation of menstruation; early sign of pregnancy; symptoms of menopause, or pathology

A

Primary amenorrhea

41
Q

Cessation of ovarian and menstrual cycles. How is it diagnosed?

A

Menopause; diagnosed one year after last menstrual period

42
Q

Transition period during which ovarian function and hormone production decline

A

Climacteric

43
Q

Hypogonadotropic amenorrhea: Generally reflects a problem in the __________ so that hormone production is inadequate. May also be related to ____ or ___________

A

Generally reflects a problem in the CENTRAL HYPOTHALAMIC PITUITARY AXIS so that hormone production is inadequate. May also be related to STRESS or INAPPROPRIATE BODY FATE to LEAN ration

44
Q

Any form of uterine bleeding that is irregular in amount, duration, or timing

A

Dysfunctional uterine bleeding

45
Q

What is another way dysfunctional uterine bleeding is referred?

A

Abnormal uterine bleeding

46
Q

First line treatment for heavy menstrual bleeding (HMB) is nonsurgical. The most effective nonsurgical treatments, in order of efficacy, are: (4)

A
  1. LNR-IUS (an IUD)
  2. Danazol
  3. Antifibrinolytic
  4. Non-steroid anti-inflammatories
47
Q

What are some possible causes of abnormal uterine bleeding (AUB)? (8)

A
  • Preg related condition
  • Lower reproductive tract infections
  • Benign anatomic abnormalities
  • Neoplasms
  • Malignant lesions
  • Trauma
  • Systemic conditions
  • Iatrogenic conditions
48
Q

What is Danazol?

A

Synthetic testosterone–an “anti estrogen”

49
Q

What does Danazol do?

A

Suppresses FSH and LH secretion, thus producing involution and hypogonadotropism—this results in decreased secretion of estrogen and progesterone and regression of endometrial tissue

50
Q

Characterized by the presence and growth of endometrial glands and stroma outside of the uterus

A

Endometriosis

That was book definition

51
Q

Tissue resembling endometrial tissues, but located outside the endometrium in the pelvis

A

Endometriosis (worksheet definition)

Maternal Newborn-MJ (29 decks)

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