Pathophysiology of Female Reproduction

Question 1

What happens in the ovaries?

Answer 1

Site of ovum/egg production and release

Question 2

What happens in the uterine or Fallopian tubes?

Answer 2

Transport and site of fertilization for ovum

Question 3

What happens in the uterus?

Answer 3

Site of implantation and growth of developing embryo

Fundus, body and cervix

Question 4

What happen in the vagina?

Answer 4

Site of delivery of sperm

Question 5

Puberty in Females

Answer 5

8: hypothalamus releases GnRH which leads to production of LH and FSH which causes growth of ovaries and follicles and induces the first menarche
Ovaries also start secreting estrogen and progesterone

Question 6

Estrogen is responsible for?

Answer 6

secondary sex characteristics (enlargement of breast, fat and skin changes)

Question 7

Follicular Phase

Answer 7

Increased FSH and LH leading to maturation of follicles (ultimately just one)
Granulosa and theca cells cause a high concentration of estrogen

Question 8

Positive Feedback Effect

Answer 8

Estrogen increases the amount of LH and LH increases the amount of estrogen

Question 9

Surge of LH leads to?

Answer 9

Ovulation

Question 10

Ovarian Cycle

Answer 10

Mid-cycle surge of LH stimulates follicular rupture and ovulation
Ovum is picked up by the fimbriae at the end of the uterine tubes and carried to the fallopian tubes

Question 11

Why does the follicule rupture?

Answer 11

Because the LH and FSH cause rapid swelling due to increased fluid accumulation

Question 12

Luteal phase if pregnant

Answer 12

Corpus luteum forms via lutenization (needs LH) which secretes progesterone
hCG maintains the corpus luteum and keeps the progesterone secretion

Question 13

Luteal phase in the absence of pregnancy

Answer 13

The LH levels drop and the corpus luteum cannot survive

It becomes scar tissue and leads to NO estrogen or progesterone leading to menstruation

Question 14

Estrogen and progesterone do what when secreted by the corpus luteum?

Answer 14

Feedback inhibit AP and decrease FSH and LH secretion

Question 15

Another hormone released by the corpus luteum?

Answer 15

Inhibin

Question 16

What does Inhibin do?

Answer 16

Further decreases FSH

Question 17

Low levels of FSH and LH leads to?

Answer 17

Involution of the corpus luteum

Question 18

So what happens when there is no more estrogen, progesterone, and corpus luteum?

Answer 18

Feedback inhibition disappears and FSH and LH will begin and the initiate of the growth of new follicles

Question 19

What is the most potent estrogen?

Answer 19

Beta estradiol from testosterone/androstenedione

Question 20

What enzyme helps form estrogens?

Answer 20

Aromatase

FSH and LH increase the activity and import of cholesterol

Question 21

Estrogen function

Answer 21

PROLIFERATION
Increase the size of the ovaries, fallopian tubes, uterus, and vagina
Growth of the breast and milk-apparatus
Early uniting of opiphyses

Question 22

What is a function of estrogen that causes problems in menopausal women?

Answer 22

It inhibits osteoclast and stimulate bone growth and since menopausal women have decreased or no estrogen this doesn’t occur

Question 23

Progesterone functions

Answer 23

SECRETION
Promotes changes in secretion in the uterus and decrease uterine contractions
Promotes increased secretion in the fallopian tubes
Causes alveolar cells of the breast to become secretory

Question 24

Monthly Cycle Phases

Answer 24

Proliferative phase
Secretory phase
Menses

Question 25

Proliferative phase is otherwise known as?

Answer 25

Estrogen phase or Follicular phase & occurs BEFORE ovulation | PROLIFERATION

Question 26

Secretory phase otherwise known as?

Answer 26

Progestational phase or Luteal phase & occurs AFTER ovulation SECRETORY

Question 27

Menstruation

Answer 27

Not fertilized --> involution of CL --> decreased E and P --> menstration Vasospasms of spiral arteries --> decreased nutrient supply --> necrosis of endothelium and blood vessels --> hemorrhage and desquammation Uterine contractions help get it all out

Question 28

GnRH, LH, FSH receptors

Answer 28

Cell surface receptors or G protein coupled receptors which act via 2nd messengers

Question 29

E & P receptors

Answer 29

Hormone receptors lead to transcription of certain genes

Question 30

Estrogen + Fallopian tubes?

Answer 30

Ciliation --> facilitates transport of ovum

Question 31

Progesterone + Fallopian tubes?

Answer 31

Nutritional secretions

Question 32

Menopause

Answer 32

Cessation of menses | Ovaries don't respond to LH and FSH so no production of E & P --> no feedback inhibition of LH and FSH