OB Correlates Flashcards
Left Ovarian vein and testicular veins drain to
Left renal vein
Right ovarian and right testicular vein drains to
IVC
Surgical abdomen
Board like rigidity
From hypercoagulability in pregnancy
Ovarian vein thrombosis
Most common blood vessel in pelvic thrombophlebitis
Left Ovarian veins emptying into left renal vein
Which anticoagulant can be given in pregnancy
Heparin
APAS (hypercoagulable state) give
heparin
Antidote for heparin toxicity
Protamine sulfate
Most varicoceles are found on the
Left side bec of 90 degree drainage of left testicular vein to left renal vein
Assoc with left renal tumor
Bridge over troubled water during hysterectomy
Iliac artery over ureter
Pudendal canal aka
Transmits
Alcocks canal
Internal pudendal artery, vein and nerves pass
Alcock’s canal is derived from the fascia of the muscle
obturator internus
Syndrome presenting with congenital absence of uterus and vagina
Mullerian dysgenesis
Mayer Hauser Rokitansky Kuster syndrome
Hypogonadism
Anosmia
Kallman syndrome
Dec in levels activate puberty
GABA
Causes decrease in circulating LH and prolactin
Dopamine
Dec AMPLITUDE of GnRH
Estrogen
Dec FREQUENCY of GnRH
Progesterone
Stimulatory pulsatile/inhibitory continuous
Neuropeptide Y in stressful situations
GnRH is secreted in
pulsatile manner
Reproductive process begins in the
brain
Low GnRH pulse frequency
FSH synthesis
Progesterone
High GnRH frequency
LH synthesis
Progesterone
Constant release of GnRH leads to
Drastic reduction of gonadotropic response
Desensitization
Downregulation
Rx: GnRH agonist (FSH)
We test for B HCH bec the different subunit in hormones are
Beta !!
Acts on granulosa cells
FSH
Acts on theca cells
LH
Plays a role in follicle growth and maturation
FSH
Plays a role in ovulation
LH
Goals of ovarian cycle
Produce a mature follicle
Steroidogenesis of estrogen, progesterone
On the follicular and midcycle the steroid produced is
estrogen
On the lutesl cycle the steroid produced is
progesterone (inhibitory to GnRH)
Causes completion of Meiosis I and becoming secondsry oocyte prior ovulation
LH surge
Arrest of oocyte development happens in
Metaphase
Non growing oocyte arresting prophase of meiosis
Envelopes by single layer of spindle granulosa cells
Primordial follicle
Unilaminar or multilaminar
Primary preantral follicle
Change of pregranulosa layer to single layer of cuboidal cell
First change of follicle development
Unilaminar preantral follicle
Surrounding by zona pellucida
Complete granulosa prolif
Dependent on hormone:
And correlated with inc:
Multilaminar preantral follicle
FSH
ESTROGEN
Critical feature in rescuing cohort of follicles from atresia
Allows dominant follicle to emerge and pursue ovulation
Initiates steroidogeneis: estrogen production
FSH rise
Androgen substrate is converted into estrogen via aromatization by
FSH!
Gonad ind recruitment of primordial follicle from resring pool and their growth to antral stage
Regulare grabulosa cell prolif
Growth differentiation factor 9
Bone Morphogenetic protein 15
Transforming growth factor B superfamily
Secretory product of granulosa cells in preantral and small antral folllicle
Inhibits premature follicle growth
Anti Mullerian Hormone
Take anytime of the cycle
Inc in production of follicular fluid in intracellular space eventually forming cavity
Antral follicle
Granulosa cell sureounding oocyte
Cumulus oophorus
Fluid rich in hormones, gf, cytokines
Excessive inc in estrogen initiates this feedback on hypo
Positive
If enough, negative feedback
Recruitment of a cohort
Selection of dominant follicle
Growth of selected dominant follicle
Follicular phase
Goal of two cell system
Accelerate estrogen production with help of theca cells responding to LH to produce ANDROGEN
Inhibits FSH
Inhibin
What hormone gonadotropin peaks before ovulation
LH
Peak at 10-12h prior ovulation
Stimulates resumption of meiosis metaphsse II in 2nd meiotic division