Normal Female Physiology Flashcards
The uterine and vaginal arteries branch off of the _
The uterine and vaginal arteries branch off of the internal iliac artery
The ovarian artery branches off of the _
The ovarian artery branches off of the abdominal aorta (directly)
The ovaries drain into the _ lymph nodes
The ovaries drain into the para-aortic lymph nodes
The labia majora and minora drain into the _ lymph nodes
The labia majora and minora drain into the superficial inguinal nodes lymph nodes
The uterus and cervix drain into the _ lymph nodes
The uterus and cervix drain into the external iliac nodes
_ is the primary sensory innervation to the genitalia
Pudendal nerve is the primary sensory innervation to the genitalia
The _ is the ligament that contains the ovarian vessels
The suspensory ligament is the ligament that contains the ovarian vessels
There is a risk of damaging the ureter during hysterectomy when operating around the _ ligament
There is a risk of damaging the ureter during hysterectomy when operating around the suspensory or cardinal ligament
The normal menstrual cycle is around _ days with menses lasting _ days
The normal menstrual cycle is around 28 days with menses lasting 3-7 days
Two phases of the ovarian cycle include _ and _
Two phases of the ovarian cycle include follicular phase and luteal phase
Days 1-14 are the (follicular/luteal) phase of the ovarian cycle
Days 1-14 are the follicular phase of the ovarian cycle
Days 15-28 are the (follicular/luteal) phase of the ovarian cycle
Days 15-28 are the luteal phase of the ovarian cycle
In the beginning of the follicular phase, _ is the rising hormone that is responsible for ovarian follicle development
In the beginning of the follicular phase, FSH is the rising hormone that is responsible for ovarian follicle development
As the ovarian follicle is developing, _ cells are producing more and more estrogen
As the ovarian follicle is developing, granulosa cells are producing more and more estrogen
* (This is in the follicular phase)
During the follicular phase, what happens to FSH levels?
During follicular phase:
* FSH is originally rising (to develop the follicles)
* Then it starts to fall because estrogen sends negative feedback
* At ovulation, estrogen causes positive feedback to increase FSH again
Ovulation involves a surge of _ and the rupture of a tertiary follicle
Ovulation involves a surge of LH and the rupture of a tertiary follicle
The tertiary follicle remnant becomes the _ structure
The tertiary follicle remnant becomes the corpus luteum
The corpus luteum normally only lasts for around 14 days unless in the case of _
The corpus luteum normally only lasts for around 14 days unless in the case of pregnancy, which prolongs it for 10 weeks
When fertilization occurs, we have devlopment of _ cells which make beta-hCG
When fertilization occurs, we have devlopment of trophoblast cells which make beta-hCG
The corpus luteum is maintained during pregnancy by _
The corpus luteum is maintained during pregnancy by beta-hCG
* This is our source of progesterone for the first 10 weeks of pregnancy before the placenta takes over
At the end of luteal phase, if there is no fertilized egg, then _ and _ levels drop and we get _
At the end of luteal phase, if there is no fertilized egg, then estrogen and progesterone levels drop and we get menses
_ hormone is responsible for producing our spiral arteries and secretory endothelium
Progesterone is responsible for producing our spiral arteries and secretory endothelium
The three phases of the uterine cycle include _ , _ , _
The three phases of the uterine cycle include menstrual cycle , proliferative phase , secretory phase
Days 1-7 of the uterine cycle make up the _ phase
Days 1-7 of the uterine cycle make up the menstrual phase
* The corpus luteum regresses
* Causes progesterone to drop –> vasospasm of spiral arteries –> bleeding
Days 7-14 of the uterine cycle make up the _ phase
Days 7-14 of the uterine cycle make up the proliferative phase
The proliferative phase of the uterine cycle is mediated by _ hormone
The proliferative phase of the uterine cycle is mediated by estrogen
* “Estrogen establishes” aka causes endometrium growth
* The follicle is producing the estrogen which is stimulating endometrium
Days 14-28 of the uterine cycle make up the _ phase
Days 14-28 of the uterine cycle make up the secretory phase
The secretory phase is mediated by _
The secretory phase is mediated by progesterone
What is the purpose of the secretory phase?
The purpose of the secretory phase is to prepare the endometrium for possible pregnancy
* Corpus luteum is making progesterone (pro-gestation hormone)
* Spiral arteries are extending the full length of the endometrium
* The endometrial glands get more tortuous (twisty)
The external, squamous epithelial layer of the follicle are the _ cells
The external, squamous epithelial layer of the follicle are the theca cells
The cuboidal cells in the ovarian follicle are called _ cells
The cuboidal cells in the ovarian follicle are called granulosa cells
The primordial follicle begins with a simple squamous epithelium; it must gain _ receptors to reach maturity
The primordial follicle begins with a simple squamous epithelium; it must gain FSH receptors to reach maturity
Another name for the tertiary follicle is _
Another name for the tertiary follicle is the graafian follicle
What are the functions of estrogen?
- Development/maintainance of female reproductive tract
- Female secondary sex characteristics
- Induces progesterone receptors
- Prepares for/maintains pregnancy
- Increases HDL and decreases LDL
- Increases bone mass
Women are at risk of atherosclerosis and osteoporosis after menopause due to estrogen’s important roles of:
Women are at risk of atherosclerosis and osteoporosis after menopause due to estrogen’s important roles of:
* Increasing HLD and decreasing LDL
* Increasing bone mass
Cholesterol diffuses across the (theca/granulosa) cell membrane
Cholesterol diffuses across the theca cell membrane
Cholesterol is converted to _ in the theca cell before moving into the granulosa cell
Cholesterol is converted to androstenedione in the theca cell before moving into the granulosa cell
Once androstenedione diffuses into the granulosa cell, it is converted to _ via _
Once androstenedione diffuses into the granulosa cell, it is converted to estrone via aromatase
* Estrone can then –> estrogen
(Theca/Granulosa) cells contain aromatase
Granulosa cells contain aromatase
Explain the pathway of estrogen synthesis starting from the hypothalamus
Hypothalamus- GnRH
Anterior pituitary- FSH, LH
Ovary (theca cell)- androstenedione
Ovary (granulosa cell)- estrogen
Theca cells have (LH/FSH) receptors while
Granulosa cells have (LH/FSH) receptors
Theca cells have LH receptors while
Granulosa cells have FSH receptors
Androstenedione is converted to estrogen via _
Androstenedione is converted to estrogen via aromatase
Aromatase can create extragonadal estrogen in low levels in the following tissues:
Aromatase can create extragonadal estrogen in low levels in the following tissues:
* Adipose tissue
* Liver
* Pancreas
* Bone
* Adrenal glands
* Skin
* Brain
* Breast
Name the three forms of estrogen
Estradiol (E2) > estrone (E1) > estriol (E3)
(listed by potency)
17-B estradiol is made by the _
17-B estradiol is made by the ovary
* Also called E2
Estriol is made by the _
Estriol is made by the placenta
* Also called E3
Estrone is made by the _
Estrone is made by the adipose tissue (via aromatization)
* Also called E1
Name the functions of progesterone:
Name the functions of progesterone:
* Prepares the uterus for pregnancy
* Prepares the breast for lactation
* Allows for secretory endometrium that is needed for implantation
* Maintains uterine endometrium during pregnancy
* Developing breast
* Increases body temperature
After ovulation, the theca interna cells differentiate into _ cells which make androgens and progesterone
After ovulation, the theca interna cells differentiate into theca leukin cells which make androgens and progesterone
(True/False) The theca leukin (cells of the corpus luteum) make small amounts of estrogen
True; The theca leukin (cells of the corpus luteum) make small amounts of estrogen
* Progesterone can get converted back into androstenedione
Explain the steps of progesterone synthesis
Cholesterol –>
Pregnenolone –>
Progesterone –>
Androstenedione –> estrone –> estradiol
Androstenedione –> testosterone –> estradiol
Only (estrogen/progesterone) can provide negative feedback at the level of the hypothalamus
Only estrogen can provide negative feedback at the level of the hypothalamus
* Progesterone provides negative feedback to the anterior pituitary
Positive feedback of estrogen that allows for a high sustained estrogen level is responsible for _
Positive feedback of estrogen that allows for a high sustained estrogen level is responsible for ovulation
* Prolonged estrogen causes massive LH release
* LH surge causes ovulation of oocyte
_ is the hormone that “rescues the corpus luteum” if implantation of an embryo occurs
Beta-hCG is the hormone that “rescues the corpus luteum” if implantation of an embryo occurs
After about 7-10 weeks of pregnancy, the _ begins to take over production of progesterone
After about 7-10 weeks of pregnancy, the placenta begins to take over production of progesterone
Estrogen and progesterone bind (intracellular/extracellular) receptors and cause changes in _
Estrogen and progesterone bind intracellular receptors and cause changes in transcription and translation
Explain the ovulatory and menstrual cycles
LH/FSH act on the testes to produce _
LH/FSH act on the ovaries to produce _
LH/FSH act on the testes to produce testosterone, inhibin
LH/FSH act on the ovaries to produce estradiol, progesterone, inhibin
Inhibin is a hormone released by the gonads with the purpose of _
Inhibin is a hormone released by the gonads with the purpose of inhibiting LH/FSH release aka providing negative feedback
Estrogen has _ effect on the uterus
Estrogen causes proliferation of functional layer of columnar epithelial cells + formation of tubular glands
* Estrogen also induces progesterone receptors on endometrial cells
The dominant follicle produces increasing amounts of estrogen; granulosa cells express more _ receptors making the cells highly sensitive
The dominant follicle produces increasing amounts of estrogen; granulosa cells express more LH/FSH receptors making the cells highly sensitive
The LH surge causes _
The LH surge causes ovulation of oocyte
* The LH binding causes secretion of enzymes that break down the follicle wall
Progesterone causes _ growth and _ secretions in the uterus
Progesterone causes decreased growth and increased secretions in the uterus
Progesterone causes glands to become _ shaped and secrete _
Progesterone causes glands to become coiled (tortuous) and secrete glycoprotein
If pregnancy does not occur, the lack of _ leads to degeneration of the corpus luteum and thus decline in hormone levels that leads to menses
If pregnancy does not occur, the lack of LH leads to degeneration of the corpus luteum and thus decline in hormone levels that leads to menses
If pregnancy does occur we have _ of the corpus luteum
If pregnancy does occur we have rescuing of the corpus luteum by hCG
* hCG binds LH receptors
_ acts on the theca cells to induce androgen production
LH acts on the theca cells to induce androgen production
_ stimulates the granulosa cells to convert androgen –> estradiol (driving the proliferative phase)
FSH stimulates the granulosa cells to convert androgen –> estradiol (driving the proliferative phase)
_ mediates the pain experienced with uterine contractions and menstrual cramping during menstruation
Prostaglandin E2 mediates the pain experienced with uterine contractions and menstrual cramping. Most of the production and release of prostaglandins occurs during the first 48 hours of menstrual flow
* Ibuprofen is first line treatment to block prostaglandins
A fall in _ (hormone) levels after baby delivery disinhibits prolactin to allow lactation
A fall in progesterone levels after baby delivery disinhibits prolactin to allow lactation
_ is a transient mid-cycle ovulatory pain; it is classically associated with pertitoneal irritation
Mittelschmerz is a transient mid-cycle ovulatory pain; it is classically associated with pertitoneal irritation
Follicular growth is fastest during week _ of the follicular phase
Follicular growth is fastest during week 2 of the follicular phase
Fertilization of an egg occurs within _ days of ovulation; implantation within the utuerus occurs _ days after fertilization
Fertilization of an egg occurs within 1 day of ovulation; implantation within the utuerus occurs 6 days after fertilization
Blood and urine pregnancy tests detect hCG secreted by _
Blood and urine pregnancy tests detect hCG secreted by syncytiotrophoblasts
* Blood test after 1 week of conception
* Urine test after 2 weeks of conception
Beta hCG has an alpha subunit that closely resembles _ , _ , _
Beta hCG has an alpha subunit that closely resembles LH , FSH , TSH
* Allows it to act on LH receptors
* Also means high hCG can cause hyperthyroidism
