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Repro > Normal Female Physiology > Flashcards

Normal Female Physiology Flashcards

1
Q

The uterine and vaginal arteries branch off of the _

A

The uterine and vaginal arteries branch off of the internal iliac artery

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2
Q

The ovarian artery branches off of the _

A

The ovarian artery branches off of the abdominal aorta (directly)

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3
Q

The ovaries drain into the _ lymph nodes

A

The ovaries drain into the para-aortic lymph nodes

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4
Q

The labia majora and minora drain into the _ lymph nodes

A

The labia majora and minora drain into the superficial inguinal nodes lymph nodes

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5
Q

The uterus and cervix drain into the _ lymph nodes

A

The uterus and cervix drain into the external iliac nodes

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6
Q

_ is the primary sensory innervation to the genitalia

A

Pudendal nerve is the primary sensory innervation to the genitalia

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7
Q

The _ is the ligament that contains the ovarian vessels

A

The suspensory ligament is the ligament that contains the ovarian vessels

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8
Q

There is a risk of damaging the ureter during hysterectomy when operating around the _ ligament

A

There is a risk of damaging the ureter during hysterectomy when operating around the suspensory or cardinal ligament

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9
Q

The normal menstrual cycle is around _ days with menses lasting _ days

A

The normal menstrual cycle is around 28 days with menses lasting 3-7 days

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10
Q

Two phases of the ovarian cycle include _ and _

A

Two phases of the ovarian cycle include follicular phase and luteal phase

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11
Q

Days 1-14 are the (follicular/luteal) phase of the ovarian cycle

A

Days 1-14 are the follicular phase of the ovarian cycle

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12
Q

Days 15-28 are the (follicular/luteal) phase of the ovarian cycle

A

Days 15-28 are the luteal phase of the ovarian cycle

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13
Q

In the beginning of the follicular phase, _ is the rising hormone that is responsible for ovarian follicle development

A

In the beginning of the follicular phase, FSH is the rising hormone that is responsible for ovarian follicle development

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14
Q

As the ovarian follicle is developing, _ cells are producing more and more estrogen

A

As the ovarian follicle is developing, granulosa cells are producing more and more estrogen
* (This is in the follicular phase)

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15
Q

During the follicular phase, what happens to FSH levels?

A

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

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16
Q

Ovulation involves a surge of _ and the rupture of a tertiary follicle

A

Ovulation involves a surge of LH and the rupture of a tertiary follicle

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17
Q

The tertiary follicle remnant becomes the _ structure

A

The tertiary follicle remnant becomes the corpus luteum

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18
Q

The corpus luteum normally only lasts for around 14 days unless in the case of _

A

The corpus luteum normally only lasts for around 14 days unless in the case of pregnancy, which prolongs it for 10 weeks

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19
Q

When fertilization occurs, we have devlopment of _ cells which make beta-hCG

A

When fertilization occurs, we have devlopment of trophoblast cells which make beta-hCG

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20
Q

The corpus luteum is maintained during pregnancy by _

A

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

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21
Q

At the end of luteal phase, if there is no fertilized egg, then _ and _ levels drop and we get _

A

At the end of luteal phase, if there is no fertilized egg, then estrogen and progesterone levels drop and we get menses

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22
Q

_ hormone is responsible for producing our spiral arteries and secretory endothelium

A

Progesterone is responsible for producing our spiral arteries and secretory endothelium

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23
Q

The three phases of the uterine cycle include _ , _ , _

A

The three phases of the uterine cycle include menstrual cycle , proliferative phase , secretory phase

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24
Q

Days 1-7 of the uterine cycle make up the _ phase

A

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

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25
Q

Days 7-14 of the uterine cycle make up the _ phase

A

Days 7-14 of the uterine cycle make up the proliferative phase

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26
Q

The proliferative phase of the uterine cycle is mediated by _ hormone

A

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

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27
Q

Days 14-28 of the uterine cycle make up the _ phase

A

Days 14-28 of the uterine cycle make up the secretory phase

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28
Q

The secretory phase is mediated by _

A

The secretory phase is mediated by progesterone

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29
Q

What is the purpose of the secretory phase?

A

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)

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30
Q

The external, squamous epithelial layer of the follicle are the _ cells

A

The external, squamous epithelial layer of the follicle are the theca cells

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31
Q

The cuboidal cells in the ovarian follicle are called _ cells

A

The cuboidal cells in the ovarian follicle are called granulosa cells

32
Q

The primordial follicle begins with a simple squamous epithelium; it must gain _ receptors to reach maturity

A

The primordial follicle begins with a simple squamous epithelium; it must gain FSH receptors to reach maturity

33
Q

Another name for the tertiary follicle is _

A

Another name for the tertiary follicle is the graafian follicle

34
Q

What are the functions of estrogen?

A
  1. Development/maintainance of female reproductive tract
  2. Female secondary sex characteristics
  3. Induces progesterone receptors
  4. Prepares for/maintains pregnancy
  5. Increases HDL and decreases LDL
  6. Increases bone mass
35
Q

Women are at risk of atherosclerosis and osteoporosis after menopause due to estrogen’s important roles of:

A

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

36
Q

Cholesterol diffuses across the (theca/granulosa) cell membrane

A

Cholesterol diffuses across the theca cell membrane

37
Q

Cholesterol is converted to _ in the theca cell before moving into the granulosa cell

A

Cholesterol is converted to androstenedione in the theca cell before moving into the granulosa cell

38
Q

Once androstenedione diffuses into the granulosa cell, it is converted to _ via _

A

Once androstenedione diffuses into the granulosa cell, it is converted to estrone via aromatase
* Estrone can then –> estrogen

39
Q

(Theca/Granulosa) cells contain aromatase

A

Granulosa cells contain aromatase

40
Q

Explain the pathway of estrogen synthesis starting from the hypothalamus

A

Hypothalamus- GnRH
Anterior pituitary- FSH, LH
Ovary (theca cell)- androstenedione
Ovary (granulosa cell)- estrogen

41
Q

Theca cells have (LH/FSH) receptors while
Granulosa cells have (LH/FSH) receptors

A

Theca cells have LH receptors while
Granulosa cells have FSH receptors

42
Q

Androstenedione is converted to estrogen via _

A

Androstenedione is converted to estrogen via aromatase

43
Q

Aromatase can create extragonadal estrogen in low levels in the following tissues:

A

Aromatase can create extragonadal estrogen in low levels in the following tissues:
* Adipose tissue
* Liver
* Pancreas
* Bone
* Adrenal glands
* Skin
* Brain
* Breast

44
Q

Name the three forms of estrogen

A

Estradiol (E2) > estrone (E1) > estriol (E3)
(listed by potency)

45
Q

17-B estradiol is made by the _

A

17-B estradiol is made by the ovary
* Also called E2

46
Q

Estriol is made by the _

A

Estriol is made by the placenta
* Also called E3

47
Q

Estrone is made by the _

A

Estrone is made by the adipose tissue (via aromatization)
* Also called E1

48
Q

Name the functions of progesterone:

A

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

49
Q

After ovulation, the theca interna cells differentiate into _ cells which make androgens and progesterone

A

After ovulation, the theca interna cells differentiate into theca leukin cells which make androgens and progesterone

50
Q

(True/False) The theca leukin (cells of the corpus luteum) make small amounts of estrogen

A

True; The theca leukin (cells of the corpus luteum) make small amounts of estrogen
* Progesterone can get converted back into androstenedione

51
Q

Explain the steps of progesterone synthesis

A

Cholesterol –>
Pregnenolone –>
Progesterone –>
Androstenedione –> estrone –> estradiol
Androstenedione –> testosterone –> estradiol

52
Q

Only (estrogen/progesterone) can provide negative feedback at the level of the hypothalamus

A

Only estrogen can provide negative feedback at the level of the hypothalamus
* Progesterone provides negative feedback to the anterior pituitary

53
Q

Positive feedback of estrogen that allows for a high sustained estrogen level is responsible for _

A

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

54
Q

_ is the hormone that “rescues the corpus luteum” if implantation of an embryo occurs

A

Beta-hCG is the hormone that “rescues the corpus luteum” if implantation of an embryo occurs

55
Q

After about 7-10 weeks of pregnancy, the _ begins to take over production of progesterone

A

After about 7-10 weeks of pregnancy, the placenta begins to take over production of progesterone

56
Q

Estrogen and progesterone bind (intracellular/extracellular) receptors and cause changes in _

A

Estrogen and progesterone bind intracellular receptors and cause changes in transcription and translation

57
Q

Explain the ovulatory and menstrual cycles

A
58
Q

LH/FSH act on the testes to produce _
LH/FSH act on the ovaries to produce _

A

LH/FSH act on the testes to produce testosterone, inhibin
LH/FSH act on the ovaries to produce estradiol, progesterone, inhibin

59
Q

Inhibin is a hormone released by the gonads with the purpose of _

A

Inhibin is a hormone released by the gonads with the purpose of inhibiting LH/FSH release aka providing negative feedback

60
Q

Estrogen has _ effect on the uterus

A

Estrogen causes proliferation of functional layer of columnar epithelial cells + formation of tubular glands
* Estrogen also induces progesterone receptors on endometrial cells

61
Q

The dominant follicle produces increasing amounts of estrogen; granulosa cells express more _ receptors making the cells highly sensitive

A

The dominant follicle produces increasing amounts of estrogen; granulosa cells express more LH/FSH receptors making the cells highly sensitive

62
Q

The LH surge causes _

A

The LH surge causes ovulation of oocyte
* The LH binding causes secretion of enzymes that break down the follicle wall

63
Q

Progesterone causes _ growth and _ secretions in the uterus

A

Progesterone causes decreased growth and increased secretions in the uterus

64
Q

Progesterone causes glands to become _ shaped and secrete _

A

Progesterone causes glands to become coiled (tortuous) and secrete glycoprotein

65
Q

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

A

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

66
Q

If pregnancy does occur we have _ of the corpus luteum

A

If pregnancy does occur we have rescuing of the corpus luteum by hCG
* hCG binds LH receptors

67
Q

_ acts on the theca cells to induce androgen production

A

LH acts on the theca cells to induce androgen production

68
Q

_ stimulates the granulosa cells to convert androgen –> estradiol (driving the proliferative phase)

A

FSH stimulates the granulosa cells to convert androgen –> estradiol (driving the proliferative phase)

69
Q

_ mediates the pain experienced with uterine contractions and menstrual cramping during menstruation

A

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

70
Q

A fall in _ (hormone) levels after baby delivery disinhibits prolactin to allow lactation

A

A fall in progesterone levels after baby delivery disinhibits prolactin to allow lactation

71
Q

_ is a transient mid-cycle ovulatory pain; it is classically associated with pertitoneal irritation

A

Mittelschmerz is a transient mid-cycle ovulatory pain; it is classically associated with pertitoneal irritation

72
Q

Follicular growth is fastest during week _ of the follicular phase

A

Follicular growth is fastest during week 2 of the follicular phase

73
Q

Fertilization of an egg occurs within _ days of ovulation; implantation within the utuerus occurs _ days after fertilization

A

Fertilization of an egg occurs within 1 day of ovulation; implantation within the utuerus occurs 6 days after fertilization

74
Q

Blood and urine pregnancy tests detect hCG secreted by _

A

Blood and urine pregnancy tests detect hCG secreted by syncytiotrophoblasts
* Blood test after 1 week of conception
* Urine test after 2 weeks of conception

75
Q

Beta hCG has an alpha subunit that closely resembles _ , _ , _

A

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

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