module 3- conception and implantation Flashcards

1
Q

what is the best way to describe the human sexual response

A

the 4 phase model of sexual response cycle

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2
Q

what does the 4 phase model of sexual response cycle focus on

A

the physiological aspects of the sexual response

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3
Q

who formulated the 4 phase sexaul response cycle

A
  • william H masters and virgina E johnson 1966
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4
Q

what is the 4 used to describe

A

the common physiological changes that occur when engaging in intercourse or sexually stimulating activities

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5
Q

phase 1: 4 phase model

A

excitement
- increase in arousal that results as a response to sexual stimuli

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6
Q

signs of phase 1

A
  • increased heart rate
  • increased blood pressure
  • accelerated breathing
  • increased muscle tension
  • increase blow flow to genitals
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7
Q

phase 2: 4 phase model

A

plateau
- continuation or intensification of the responses observed in phase 1

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8
Q

phase 3: 4 phase model

A

orgasm
- conclusion of the plateau phase and the shortest phase, lasting only a few seconds

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9
Q

signs of phase 3

A
  • involuntary muscle contractions
  • peak in heart rate
  • blood pressure
  • breathing
  • release of muscle tension
    (vaginal contractions) (ejaculation males)
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10
Q

phase 4: of 4 phase model

A

resolution
- body slowly returns to its normal state
- swelled/erect body parts go back to normal
- general sense of well-being, enhanced intimacy, and fatigue

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11
Q

what is the sexual response mediated by for male and females

A
  • autonomic nervous system
  • somatic innervation
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12
Q

autonomic nervous system

A
  • involuntary control
  • divided into sympathetic and parasympathetic
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13
Q

somatic innervation

A
  • nerves responsible for sensation and associated with voluntary control of muscles
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14
Q

what are all sexual stimuli mental or physcial integrated by

A
  • autonomic nervous system via the spinal cord
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15
Q

what is the process of integration a key to

A

coodinate the subsequent responses and reflexes that characterize the sexual response

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16
Q

what does the sexual response involve

A

complex interplay between somatic, parasympathetic and symtpathic input

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17
Q

where does all the innervation for the reproduction organs originate from

A
  • sacral (parasympathetic) and lumbar nerve roots (sympathetic) in the spine
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18
Q

what are the shared reflexes

A
  • vascular dilation
  • stimulation of secretions
  • smooth muscle contractions
  • contractions of the somatic pelvic muscles
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19
Q

vascular dilation

A

causes swelling of the genital organs

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20
Q

stimulation of secretions

A

either prostatic or vaginal secretions

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21
Q

smooth muscle contractions

A

of the vas deferns during ejaculation in males or rhythmic vaginal contraction during orgasm in femals

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22
Q

contractions of the somatic pelvic muscles

A

that accompany orgasm in both sexes

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23
Q

what is the first sexual stimuli for males in phase 1: excitement

A

erectile reflex

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24
Q

sexual stimuli males phase 1, how

A
  • integrated by the central NS to stimulate the parasympathetic nerves that supply the arterioles of the penis, initiating the erection reflex
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25
Q

what does the parasympathetic nerve fibers release in the phase 1, males + what does that do

A
  • neurotransmitters
  • induce relaxation of the smooth muscles of the arteries of the corpora cavernosa allowing blood flow into the sinusoids of the corpora cavernosa
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26
Q

what does high pressure in the sinusoids cause

A

push against the hard sruface of the tunica albuginea and causes ballooning of the tissue
- also causes occlusion of the veins between the tunica albuginea and the peripheral sinusoids (reducing venous outflow)
- overall hardening and elongating the penis

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27
Q

what is the role of nitric oxide for males

A

responsible for inducing the relaxation of smooth muscles of the penile arteries
- NO is released from parasymtpathetic and local endothelial cells during sexual arousal

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28
Q

what does NO activate

A

guanylyl cylase within smooth muscle cells, increasing the cellular concentration of cGMP

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29
Q

what does cGMP activate

A

additional secondary messenger molecules that cause a reduction in the intracellular calcium ion concentration, leading to smooth-muscle relaxation

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30
Q

what enxyme can revers the effect of NO

A

PDE-5 by rapidly metalizing cGMP to GMP

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31
Q

plateu phase for males

A

erection reflex continues and additional changes occur

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32
Q

what are the additional change that occur in the plateu phase for males

A
  • urethral sphincter contracts to prevent retrograde ejaculation
  • bulbourethral glands produce mucus to aid lubrication
  • scrotum may become tightened, causing the testicles to rise to the body, necessary for full ejaculation
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33
Q

orgasm phase 3 males what does it lead to

A

sudden release of semen through the penis (ejaculation)

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34
Q

how does ejaculation occur

A
  • when the sexual stimuli becomes very intense, the reflex centers of the spinal cord begin to emit sympathetic impulses that lead to ejaculation (semen out the urethra via rhythmic contractions)
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35
Q

first phase of the orgasm phase

A
  • emission
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36
Q

emission

A

the bladder neck closes to prevent retrograde ejaculations’

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37
Q

emission contrinued

A
  • sperm mixes with prostatic fluid as they are ejacted into the prostatic section of the urethra followed by seminal vesicle fluid, and cowpers gland fluid
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38
Q

what is the second phase of the orgasm phase

A

expulsion

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39
Q

expulsion

A

rhythmic contractions are generated by the bulbospongiosus and ischiocavernosus muscles
- and seme is propelled outward

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40
Q

resolution phase of males what happens

A
  • the ability to have an erection or rejactulation is inhibited temporarily (known as the refractory period)
  • length of this period varies
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41
Q

what is the hormones responsible for the male refractory period

A

oxytocin
- key in ejaculation and the post ejaculatory detumescence of the penis

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42
Q

detumscence of the penis

A

the process of subsiding from a state of tension, swelling or sexual arousal

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43
Q

what are the 2 main categories of erectile disorders

A

ischemic priapism and erectile dysfunction

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44
Q

ischemic pripism

A
  • penis remains erect for hours due to inadequate draining of the blood from the penis
  • occurs when promblems in the resolution phase of males
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45
Q

erectile dysfunction

A
  • ability to get or maintain erection is impaired
  • serve causes ranging from psychogenic, neurogenic, endocrinoligic, or arteriogenic
    (low arteriole pressure or high levels of vasoconstricion may suffer)
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46
Q

physiological changes during excitement phase for females

A
  • swelling of external genitalia
  • elevation of the uterus
  • increased vaginal lubrication
  • swelling of the breasts
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47
Q

swelling of external genitalia

A
  • the clitoris, surrounding labia, and the vagina become engorded with blood
  • innervated by parasympathetic
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48
Q

what does the clitoris become in the excitment phase

A

tumescent as its composed of vascular eretile tissue

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49
Q

tumescent

A

swollen

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50
Q

increased vaginal lubrication

A

vasocngestion of the pelvic organs results in the production of vaginal lubrication, which composed of transudate
- bartholins glands also contribute to lubrication by secreting mucus

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51
Q

elevation of the uterus

A

the uterues goes upward known as uterine tenting, causing the internal enlargement of the vaginal canal

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52
Q

swelling of the breasts

A

increased blood pressure of the excitement phase causes the swelling of the external genitalia and swelling and enlargement of the breasts

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53
Q

what happens to the female in the plateau phase

A

more pronouced:
- swelling of clit
- labia minora
- vagina increases
- uterus elevates further
- increased lubrication
- swellong of external genitalia and breasts

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54
Q

what happens near the moment of orgasm for women

A
  • pubococcygeus muscle tightens
  • reducing the diameter of vaginal opening
  • tissues near the opening swell significantly forming orgasmic platform
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55
Q

what happens in a orasgma of women

A
  • involuntary, rhythmic contractions of the uterus and vaginal muscles, particularly at the orgasmic platform, followed by release of muscle tension
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56
Q

what are the involuntary contractions of the uterus aiding in for females

A
  • transporting the sperm as they jouney up the female reproductive tract to reach the oviducts
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57
Q

what happens in the resolution pahse for females

A

refractory phase (not as pronouced as males)
- females can experience multiple orgasms before or after entering the refractory period

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58
Q

persistent genital arousal disorder

A
  • women become sexually aroused without any sexual activity or stimulation
  • spontaneous, persistent, unwanted and uncontrollable genital arousal can be painful and distrupful to persons life
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59
Q

how human genitalia have coevolved

A
  • penis largest of all primates possibly evolved to adapt to the female vagina
  • as humans became bipedial the relative positions of the pelvis shifted towards down
  • we grew larger heads which required wider pelvis and vaginal canal for babies
  • likely that in order to stimulate both partners towards successful intercourse, the male penis also had to grow bigger
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60
Q

what is internal fertilization process

A
  • occurs within the female body
  • female gamete is non-motile and the male gametes motility is designed to ensure it reaches the female gamete
  • howerver both gametes do need to travel a certain distance for fertilization
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61
Q

what is the site of fertilization

A

ampulla of the fallopian tube

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62
Q

what is egg transport

A

refers to the movement of the oocyte from the moment of expulsion from the ovarian follicle to its entry into the distal segment of the fallopian tube

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63
Q

what is the cumulus-oocyte complex (COC)

A

upon ovulation the oocyte is released within a thick layer of surrounding cumulus cells

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64
Q

what do the cumulus cells do

A

closely surround the occyte to produce large amounts of hyaluronan, along with other components form an expanded extracellular matrix

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65
Q

hyaluronan

A

this molecule is polysaccharide which consitiutes a large portion of the extracellular matrix

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66
Q

what are the functions of the cumulus layer

A
  • aiding the pickup of the oocyte by the oviduct
  • release of sperm-attracting molecules to increase the chances of an encounter with one of the few sperm that will reach the ampulla tube
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67
Q

what happens to the cumulus layer once sperm reaches egg

A

it is the first barrier that it will need to penetrate to reach the egg

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68
Q

stigma

A

the area of the ovarian surface where the follicle will burst through during ovulation and release the ovum

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69
Q

what is the cumulus cell layer composed of

A

the same granulose cells that surround the occyte inside the preovulatory or antral follicle, before the egg is released

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70
Q

what happens after release oocyte

A
  • it does not immediately land insdie the fallopian tube, it must find its way
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71
Q

peridoic sweeping of ovarian surface by the fimbriae

A

allows the egg to attach and gain entry into the fallopian tube

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72
Q

how does peridoic sweeping work

A
  • the beating of the ciliated cells of the oviductual epithelium, and peristalitc movements of the oviduct help transport the oocyte to the ampulla
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73
Q

what is the final step of transport of ova

A

activation of the oocyte
- only occurs at fertilization

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74
Q

activation of oocyte

A

upon sperm entry the oocyte completes meiosis II and completes its fusion with the sperm

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75
Q

how does a sperm achieve the long-pre fertilization jounrye

A
  • sperm must finsih their maturation and become “activated” within the female reproductive tract via a carefully regulated multistep process that involves lots of signals from male and female
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76
Q

first of sperm transport and maturation

A

spermatozoa undergo maturational changes within the male reproductive tract

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77
Q

changes to the spermatozoa within the male repro tract

A

acquiring motility changing their membrane fluidity during their transit through the epididymis, and being coated with decapitation factors

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78
Q

what does the female repro tract due to contribute to maturation of sperm

A
  • careful regulation of the rate at which spermatozoa achieve maturity so that they are delivered to the surface of the oocyte in a fully primated state, ready for fertilization
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79
Q

what are the major sets sperm must undergo to become activated and fertilizated

A
  1. capacitation
  2. acrosome reaction
    activated sperm
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80
Q

what is a capacitated sperm

A

has acrosomal cap regions and equatorial region

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81
Q

what is sperm capacitation

A

is the process by which sperm acquire the capacity to fertilize

82
Q

how does sperm capacitiation occur

A
  • begins as sperm come in contact with the cervical mucus, whose acidic pH, compared to the alkalinity of semen, causes the modification of sperm surface molecules
83
Q

what happens to increase sperm chances of reaching the oocyte in their optimal state

A

seminal fluids coat spermatozoa with inhibitory factors, collectivity termed decapacitations factors

84
Q

example of decapacitation factors

A

cholesterol
- serves to stabilize the plasma membrane of the spermatozoa during transit in the male reproductive tract and prevent the intermolecular interactions responsible for achieving a capacitate state

85
Q

what increases the chances of sperm coming across the oocyte in their optimal state

A

maturation in a staggered sequence

86
Q

what happens to removal of the cholsesterol from the sperm plasma membrane

A

may be initiating event for capcitation

87
Q

what does albumin from female secretion to

A

binds cholesterol, causing the outer acrosomal membrane (of sperm) to have increased permeability and fluidity as a result of these changes

88
Q

why does permeable sperm allow

A

for the influx of calcium and bicarbonate,

89
Q

what does the influx of calcium and bicarbonate result in

A

activation of second messengers and inhibition of signaling events that will later facilitate the acrosome reaction

90
Q

what does capactitation also involve

A

hyperactivation

91
Q

what is the hyperactivation of sperm

A
  • flagellar wave pattern of the sperm changes to asymmetrical and faster thrashing of the sperm tail (help propel sperm forward)
92
Q

how does a sperm get hypermotility

A
  • cumulus cells (of oocyte) release progesterone
  • that binds to Ca ions channel (catsper) on the surface of flagella
  • this binding acitvations the Ca channel and stimulates hypermotility of the tail towards occyte
93
Q

what does progesterone also do to the sperm

A

acts as a chemoattractant molecule that helps guide the sperm towards the oocyte

94
Q

what is the acrosome reaction

A

is an exocytotic process occurring in the sperm head that is essential for penetration of the zona pellucida and fertilization of the oocyte.

95
Q

the induction of acrosomal exocytosis

A

occurs when spermatozoa approach the oocyte in response to soluble factors in the vicinity of the cumulus-oocyte complex such as progesterone

96
Q

exocytosis

A

process in which the cells transport molecules out of the cell

97
Q

what does the acrosome reaction begin

A

begins after the sperm traverses the cumulus layer and reaches the zona pellucida

98
Q

is the female tract welcoming to sperm

A

no.
- most spermatozoa released during ejaculation are elminated from the female tract through the same mechansism deisgned to defend female tract from pathogens

99
Q

does the female tract have mechanisms to facilitate transfer of sperm

A

yes around ovulation

100
Q

what are mechanisms to faciliate the transfer of sperm

A
  • cervical mucus and muscle contraction
  • oviductal fluid
101
Q

cervical mucus and muscle contraction

A
  • around time of ovulation, the ceervix opens up to facilate sperm entry
  • the mucus becomes thinner due to the high levels of estrogen, which helps the sperm swim towards the oocyte
  • the muscle contraction also help transport sperm
102
Q

oviductal fluid how is it produced

A

by the oviductal epithelium

103
Q

how does the oviductal fluid help transport sperm

A

the epithelium that produces it alwasy flows in the direction of the uterus because of the beasting of the oviductal cilia
- the egg and chemoattractant molecules that indicate the position of the egg are pushed toward the incoming sperm

104
Q

after fertilization and oviductal fluid

A

the flow will help transport the zygote towards the uterus

105
Q

what is the timing of fertilization

A
  • an oocyte is viable for approx. 24-48h (small window after ovulation during which fert can occur)
106
Q

how long can sperm survive in female tract

A

3-5 days, meaning they cane be present a few days before ovulation and manage to fertilize an oocyte once its released
(most common for fert to occur this way)

107
Q

where is the site of fert

A

in the oviduct, specifically the ampulla of the fallopian tube

108
Q

how many steps in fertilization

A

4
1. binding and penetration of cumulus matrix
2. adhesion and penetration of zona pellucida
3. plasma membrane fusion
4. oocyte activation and nuclear fusion

109
Q

step 1: of fert

A
  • sperm cells make contact with the outer layer cumulus cells (penetration requires mechical and chemical forces)
110
Q

what makes contact with the cumulus layer

A

hyperactivated sperms

111
Q

what comes into contact with the hyaluronan molecule in the extracellular matrix of the cumulus

A

hyalurondiase protein in the sperm head

112
Q

what does the hyaluronidase protein in sperm head coming into contact with the hyaluronan molecule created

A

degrading the molecules allowing sperm to transverse the cumulus layer and reach the zona pelluica

113
Q

what is the penetration of the zona pellcuida a key step for

A

allowing sperm to gain access to the oocyte
- however before penetration occurs the sperm must first bind to the zona pellucida

114
Q

how does sperm interact with the zona pellucida

A

zona binding
acrosome recreation

115
Q

what is the zona binding

A
  • after crossing the cumulus layer, spermatozoa reach the zona pellucida
116
Q

zona binding: after crossing the cumulus layer

A

the plasma membrane of the sperm head then binds tightly to this membrane, in a step known as zona binding

116
Q

what is the zona pellucide

A

is an extracellular matrix composed of 3 glycoproteins: ZP1, ZP2, ZP3

116
Q

what do the receptors on the sperm plasma membrane attach to

A

ZP3, which triggers the sperm head to undergo the acrosome reaction

117
Q

what does the acrosome reaction involve

A

the fusion of the plasma membrane with the outer arcosomal membrane of the sperm

118
Q

what does the acrosome reaction cause the release of

A

enxymes (including neuroaminidsae and acrosin) from the acrosomal space of the sperm to break down the zona pellucida

119
Q

neuraminidase

A

an enzyme, present in many pathogenic or symbiotic microorganisms, that catalyzes the breakdown of glycosides containing neuraminic acid

120
Q

acrosin

A

a proteolyic enzyme found in the acrosomes of spermatozoa, that enables penetration of the egg

121
Q

what does the enxymes help with in the acrosome reactions

A

breaking down the zona pellucide allowing the sperm to reach the vitelline membrane of the oocyte

122
Q

what does the acrsome reaction expose

A

the inner acrosomal membrane with its receptors for another zona pellucida gylcoprotein, ZP2

123
Q

step 3: of fertilization ,

A

plasma membrane fusion

124
Q

what happens after zona binding and acrosome reaction

A

sperm penetrate the zona and enter the perivitelline space

125
Q

perivitelline space

A

the extracellular region between the zona pelluida and the oocyte plasma membrane where the final adhesion in the fertilizaition process occurs

126
Q

plasma membrane fusion: the inner acrosomal membrane

A

binds to the oocyte membrane via the ZP2 receptors ,which mediates fusion of the plasma membrane of the sperm to that of the ovum

127
Q

what happens to the sperm when it fuses with the ovum

A

the sperm head loses the tail and only the sperm head is incporated into the ovum

128
Q

what does the oocyte deply upon fusion

A

deploys 2 mechanisms to prevent polyspermy, which is penetration by more than one sperm

129
Q

what are 2 mechanisms used to prevent polyspermy

A

fast block
cortical reaction (slow block)

130
Q

what does fast block involve

A

a near instantaneous change in sodium ion permeability up on binding of the first sperm, depolaring the oocyte plasma membrane and preventing the fusion of additional sperm cells.

131
Q

when does the fast block occur and more how long

A
  • sets in almost immediately and last for about a minute, during which time an influx of calcium ions following sperm penetration triggers the second mechanism, the slow block
132
Q

what is cortical reaction

A

referred to as the process cortical reaction, cortical granules sitting immediately below the oocyte plasma membrane fuse with the membrane and release zonal inhibiting proteins and glycosaminoglycans in the periviteliine space

133
Q

what does the release of zonal inhibiting protein and glycosaminoglycans cause

A

cause the release of any other attached sperm and destroying the oocyes glycoportieints (located on the zona pellucida), thus preventing any more sperm binding to these receptors

134
Q

step 4 of fertilization: occyte activation and nuclear fusion what does it involve

A

oocyte activation, in which the egg resumes and completes meiosis II and the pronuclei of the oocyte and sperm now fuse, creating a zygote

135
Q

what nutrient is involved in egg activation

136
Q

what does zinc do in egg activation

A

it is required in high levels for meiotic progession of the egg

137
Q

what must zinc do after after fert

A

decrease for cell cycle resumption so there is coordinated release of zinc into the extracellular space in a prominent ‘zinc spark’

138
Q

after fertilization what happens with the gametes

A

undergo a transition step invovling massive modification to the parental cell structure

139
Q

what do the partental genomes do after fert

A

fuse and the genome is reprogrammed to switch from a highly speciliazed cell to a totipotent cell

140
Q

totipotent cell

A

capable of giving rise to any other cell type in the body

141
Q

what is also altered after fert with the parental genomes

A

cell cycle machinery is reprogrammed to switch from meitoic to mitotic division, thus transiting from gamate to zygote and initing the process of embyro development

142
Q

what happens after release of ovum

A

transported to the ampullary-isthmic junction where fertilization takes place

143
Q

what happens after fertilization/ wehre does embyro go

A

needs to travel from the oviduct to the uterus and succeed in implanting itself onto the uterine surface

144
Q

what is the preimplantation period

A

the period of time between ferilization and the moment of embryo attachment
- take 8-10 days

145
Q

what is cleavage and when does it occur

A

between day 0 and day 8
- are rapid cell divisions that will lead to tissue differentiation, but with no significant growth

146
Q

what does cleavage division result in?

A

cell cluster that are the same sizes as the orginal zygote

147
Q

what are the resulting cells from cleavage called?

A

blastomeres

148
Q

day 1 of cell divisions of the preimplantation period

A

first cleavage

149
Q

what happens in first cell cleavage

A

the number of cells doubles with each cell division, starting with the zygote dividing into 2 cells

150
Q

what is the 2-cell stage of the embryo

A

the zygote dividing into 2 cells
- the embryo has 2 evenly sized blastomeres each containing 1 nucleus

151
Q

day 2-4 of cell divisons of the preimplanatation pe4riod

A

further cleavages

152
Q

what happens in day 2-4 preimplanataion perid

A

the number of blastomeres will double with each division, causing the 2-cell embryo to dividion into 4 cells, 8cell and then 16 cells

153
Q

what happens at the 16 cells stage

A

the embryo is also known as the morula

154
Q

day 4 of the preimplanatation period and cell divison

A

compaction

155
Q

what happens in compaction

A

in the morula, the cells begin to exert pressure against each other, mainly because they are still encased within the zona pellucida layer
- bc the pressure inside the embryo increases the cells undergo compaction, becoming deformed and flattened

156
Q

day 5 of preimplanation period

A

blastulation

157
Q

what happens in blasutlation

A

the process of compaction provides cells with signals that induce them to differentiate into inner and outer cells

158
Q

what does differentiate into inner and outer cells induce

A

the formation of the blastocyst from a morula, which is the process of basculation

159
Q

inner cell : blastocyst

A

it will later form the trilaminar germ disc, undergo gastrulation and then form the fetus so the inner cell mass is also known as the embryoblast

160
Q

outer layer: blastocyst

A

will go on to form the trophectoderm layer, composed of trophoblast cells that are in charge of latching onto the uterine wall and will go on to form the surrounding fetal membranes

161
Q

day 6-7 of preimplantation period

A

zona hatching

162
Q

what is zona hatching

A

within 72 hours after reaching the uterine cavity, the blastocyst breaks out of the zona pellucisa

163
Q

what does zona hatching allow

A

the trophoblast to come in direct contact with the uterine epithelium to begin the process of implantation

164
Q

day 7-10 of preimplanation period

A

implantation

165
Q

what happens during implantation

A

after the hatching the blastocyst will begin the process of implantation and attach itself to the uterine cavity

166
Q

what is implantation

A

is the process by which the embryo attaches itself to the uterine wall

167
Q

what are the three main stages of implantation

A
  1. apposition
  2. adhesion
  3. invasion
168
Q

what is implantation: apposition

A

first connection between the blastocyst and the endometrium of the uterine wall is formed

169
Q

weak contact- apposition

A

weak contact with the uterus occurs, wehre mircovilli on the surface of the trophoblast cells interdigitate with microprotruisons from the uterine epithelium (pinopodes)

170
Q

pinopodes

A

cellular membrane protrusions that form on the surface of epithelial endometrial cells

171
Q

appositions- pinopodes

A

are clear marker of endometrial receptivity as they are only present during the implantation window

172
Q

apposition- inner cell mass

A

rotates inside the trophectodern in order to align with the endometrium

173
Q

how does the embryo mange to attach in the correct position everytime

A

the occurrence of the rotation

174
Q

implantation: adhesion when does it occur

A

around day 6 or 7 post fert

175
Q

what is implantation: adhesion

A

a combination of inhibitory signals (mucins) and adhesive signals (cytokines and adhesion molecules) from the endometrial surface help the embryo avoid areas with poor chances of implantation and adhere to an appropriate spot in the endometrium

176
Q

implanatation: invasion

A
  • trophoblast cells begin to penetrate adn effectively invade the endometrium, anchoring the blastocyst in place
177
Q

implanatation : invasion 9th or 10th day after conception

A

the blastocyst is completely embedded in the stromal tissue of the uterus, and the uterine epithelium has grown to cover the site of implanation

178
Q

implanation: invasion

A

the trophoblast cells will then differentiate into an outer and inner layer each with specific functions

179
Q

what does the differentation into outer and inner layer estbalish

A

the vascular link between the mother and fetus, ensuring access to nutrients for its growth

180
Q

ectopic impanatation

A

ectopic pregnancy
- abnormal implantation of the blastocyst
- blastocyst implants at a number of sites outside the uterine body, with the most common site being within the fallopian tube

181
Q

what are some spots of ectopic implantation

A
  • ovary
  • cervix
  • fallopian tube
  • abdominal cavity
182
Q

window of implantation- role of preogestrone

A

progesterone secreted by the corpus luteum prepares the endometrium for implantation and is vital for a pregnancy to remain successful

183
Q

successful implantation what does it depend on

A

synchronized interaction of a mature blastocyst and a hormonally primed uterus

184
Q

window of implanation- endometrial receptivity

A

endometrium is typically not receptive to embyro implantation, excepting during WOI

185
Q

when does the window occur

A

around days 6-10 post ovulation (day 20-24)

186
Q

factors that influence endometrial receptivity

A
  • acquires adhesion ligands
  • loses inhibitory components
187
Q

endometrial receptivity- acquires adhesion ligands

A
  • under hormones factors such as adhesion molecules (integrins, selectins, cadherins and immunoglobulins) cytokines, growth factors, lipids
  • mediate this early maternal-fetal interaction
188
Q

what will cytokines do in the adhesion ligands factor

A

will attract the blastocyst to the optimal implanation spot

189
Q

what do adhesion molecules fo

A

firmly attach the blastocyst to the endometrial pinopodes to ensure successful implantation

190
Q

endometrial receptivity- loses inhibitory components

A
  • near the WOI, there is a decrease in the synthesis of antiadhesive glycoprotein molecules which prevent receptor interactions between the blastocyst and endometrium, and thus act as barriers for invading embryo
191
Q

loses inhibitory components- mucin-1 (MUC-1)

A

repels blastocyst and prevents adhesion to endometrial areas with poor chances of implantation

192
Q

what will an receptive endometrium have

A

increased vascularization and enhanced secretary activity of the uterine glands

193
Q

what is the decidulizatoin of the uterine lining

A
  • when progesterone from the corpus luteum reaches the uterus and causes uterine glands to increase in size and stromal cells turn into large swollen cells containing extra quantities of glycogen, protein and lipids
194
Q

what is the transformation of the uterine lining considered

A

a distinct tissue.

195
Q

inner lining of uterus is called

A

decidua (throughout pregnancy) and is the tissue baby will interact with

196
Q

what is histotrophic nutrition (from celld)

A
  • until the embryo is able to connect to the maternal circulation, the nutrients provided by the decidua are the only source of nutrients it can receive
197
Q

when can embryo get hemotrophic nutrition (from blood)

A

after around the 16th day of fertilization, the embryo will have access to the maternal blood

198
Q

what are causes of pregnancy loss

A
  • inadequate uterine receptivity
  • problems with the embryo itself
199
Q

recurrent implantation failure

A

is a cause of female infertility
- no gold standard marker that can accurately indicate or measure endometrial receptivity