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Women's Health > Phys and Pathophys - part 1 - Exam 1 > Flashcards

Phys and Pathophys - part 1 - Exam 1 Flashcards

1
Q

What are the 4 main functions of the HPO axis?

A
  1. development of sex characteristics (puberty)
  2. coordinating regular periodic body changes (ovarial and uterine cycle)
  3. cervix, vagina and breast function
  4. maintains pregnancy
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2
Q

Describe the general flow of the HPO axis

A

hypothalamus makes GnRH ->

then travels to anterior pituitary through the blood stream ->

once at the AP, GnRH binds to receptors then LH and FSH are release ->

FSH and LH travel through bloodstream to the ovary, bind to receptors and Estrogen and Progesterone are released (Activin, Follistatin, Inhibin and Relaxin are also released)

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3
Q

What two things do gondotrope cells synthesize and release? What happens next?

A

Gonadotrope cells - synthesize and release

Follicle Stimulating Hormone (FSH)
Luteinizing Hormone (LH)

FSH and LH then travel to the ovary

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4
Q

Where is GnRH made? How is it released? Where does it head next?

A

GnRH in hypothalamus

GnRH is released in PULSES that correlate with their intended action

GnRH then goes to the Anterior pituitary

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5
Q

Once FSH and LH arrive at the ______. What happens next?

A

ovary

binds to theca and granulosa cells

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6
Q

What are theca cells? Granulosa cells?

A

theca cells are the outer shell around the oocyte

ganulosa cells are the inner circle of the oocyte

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7
Q

______ is more responsible for the growth and maturity of the theca and granulosa cells in the oocyte

A

FSH more than LH

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8
Q

What is folliculogenesis?

A

the growth and maturity process that a primordial follicle takes on the way to becoming a mature/Graafian follicle

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9
Q

Besides stimulating the growth and development of a follicle, name 3 additional roles of FSH and LH?

A

FSH and LH also stimulate ovarian production of:

steroid hormones: estrogens, progesterone, androgens

gonadal peptides: activins, inhibins, follistatins

growth factors

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10
Q

What are the 6 roles of estrogens?

A
  1. Assist with libido
  2. Promotes vaginal wall thickness and lubrication
  3. Maintains health of GU mucosa

other:
reduces acne formation
reduces cholesterol and atherosclerosis

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11
Q

What are the 3 secondary sex characteristics that happen has a result of estrogen?

A

breast enlargement and areolar pigmentation

mature female body shape: wider hips and narrow waist

increased scalp hair, less body hair

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12
Q

What are the 3 roles of progesterone? What is the most important one to remember?

A

Major player in maintenance of pregnancy

Decreases uterine contractility: allows it to stretch for a baby

Promotes breast maturation and differentiation

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13
Q

(increase/decrease) progesterone levels trigger ______. (increase/decrease) progesterone levels after pregnancy signal _____

A

decrease progesterone levels trigger menses

decrease progesterone levels after pregnancy signal lactation

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14
Q

_________ stimulate FSH secretion and are
involved in WBC production, embryo development

A

activins

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15
Q

______ inhibit FSH secretion. ____ and _____ are considered counterpoints to each other

A

Inhibins

Activins and Inhibins

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16
Q

______ help regulate gonadotropin secretion and binds to and inhibits activins → less FSH

A

Follistatins

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17
Q

______ inhibits uterine contractions and relaxes pubic symphysis

A

relaxin

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18
Q

sudden high level spikes of estrogen result in what? in terms of LH and FSH

A

increased GnRH and LH and then ovulation happens

decreases FSH

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19
Q

sudden slow gradual increase in estrogen, what happens next? in terms of LH and FSH

A

decrease in LH

decrease in FSH

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20
Q

What are the 2 hormones that use a positive feedback mechanism?

A

Estrogen and Activin (estrogen is an outlier and can also use a negative feedback mechanisms)

everything else uses a negative feedback mechanisms (Progesterone, inhibin, follistatin, lactation and estrogen)

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21
Q

______ inhibits GnRH and LH

A

progesterone

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22
Q

______ and ______ inhibit FSH secretion

A

Inhibin and follistatin

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23
Q

during lactation, ______ causes increased ______ and altered release of ______

A

hyperprolactinemia causes increased dopamine and altered release of GnRH

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24
Q

What are the 5 pathologic reasons that can affect the HPO axis feedback?

A
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25
What is the general age of puberty for female? male? What are the 3 factors that can influence the onset of puberty?
females: 8-13 males: 9-14 Weight and nutritional status Genetic factors Abnormal hormone levels
26
What is adrenarche? Is there any evidence to the naked eye? When does it typically start?
increase in secretion of adrenal androgens, DHEA NO! can only tell with labs starts PRIOR to or at ONSET of puberty
27
in females, what is the first event of puberty? what effect does estrogen have on breasts? progesterone?
thelarche (breast developlement) estrogen is responsible for enlargement of the breasts (think size) progesterone: responsible for MATURATION of the lobule and alveoli growth
28
What is the second event in puberty for females? What is the 3rd event?
2nd: pubarche: developement of pubic and axillary hair 3rd: menarche
29
typically, how long does a pt NOT OVULATE once they start menarche?
Typically anovulatory for first 12-18 months
30
How long does the average menstrual cycle last? +/- ____ days
roughly every 28 days +/- 7 days
31
**Draw the chart that has the hormone levels depending on the day of the menstrual cycle. Be sure to include what phase is included for the coorelating day
32
a pt has a menstrual cycle that is typically 35 days, what phase is typically longer than average to account for this change
follicular phase is the one that can changes in length ovulation and luteal phase duration are normally fixed
33
How long is the typically follicular phase? What is it called?
varying length (roughly 14 days) Preovulatory phase
34
early in the follicular phase, what are FSH and LH doing? _____ begins to enlarge
rise in FSH > rise in LH SEVERAL follicles begin to enlarge
35
early in the follicular phase, ____ causes production of inhibin B. What is the result?
FSH causes production of inhibin B inhibin B decreases release of FSH later in follicular phase
36
What day is considered midfollicular phase? Why is this significant?
about day 6 1 follicle grows very rapidly, becoming DOMINANT follicle and all other follicles regress to become atretic follicles
37
When is the FSH level higher than the LH level?
at the VERY beginning of the follicular phase, think day 1
38
What happens to the follicle as it starts to mature during the follicular phase?
develops LH receptors and releases estrogens
39
What happens as a result of the rising estrogen levels as the follicle matures?
Rising estrogen levels → increased GnRH pulses → LH surge → ovulation
40
**______ hormone is responsible for ovulation
huge spike in LH
41
What day in the menstrual cycle does ovulation typically occur?
approx day 14
42
What is a Corpus hemorrhagicum?
a ruptured follicle that fills with blood
43
What is Mittelschmerz? How would a pt describe it?
blood that is leaking from the rupture follicle irritates the peritoneal lining a "stinging" pain
44
Describe the terminology flow of a follicle through a menstruation cycle
Dominate follicle, ovulation, corpus hemorrhagicum, corpus luteum, corpus albicans
45
the corpus luteum reacts to _____ by making _____ and ______
corpus luteum reacts to LH by making progesterone and estrogen
46
in the luteal phase, rising levels of estrogen and progesterone result in ????
Rising levels of estrogen and progesterone → negative feedback → decline in FSH and LH -> which leads to atrophy of corpus luteum 3-4 days before menses
47
What is corpus albicans?
the atrophic corpus luteum
48
What does a declining level of progesterone lead to?
shedding of endometrial lining (menses)
49
What are the 3 phases of the uterine cycle? What phase can differ in length?
menstrual phase proliferative phase** can change in duration secretory phase
50
during menses, _____ layer of the endometrium does NOT slough off. What is the technical term for it? What is the outer 2/3rd of the uterine lining called?
deep stratum basale stratum functionale
51
What day does the proliferative phase typically begin? **_____ is a growth factor for uterine endometrium
usually around day 5-16 **estrogen
52
how does progesterone effect the uterine endometrium? How does it effect your period?
tells the endometrium to mature, NOT GROW progesterone only birth control usually results in lighter periods because endometrium is THINNER
53
When does progesterone typically peak?
day 21
54
What is happening in the secretory phase of the uterine cycle as a result of the estrogen and progesterone from corpus luteum?
endometrium becomes more vascularized, edematous Glands become coiled, tortuous and secrete clear fluid
55
during the secretory phase, once the corpus luteum regresses, estrogen and progesterone ______. Then what happens?
decline vascular spasms → endometrial ischemia Breakdown of extracellular matrix of strata functionalis and necrosis of endometrium and supplying arterial walls which causes hemorrhage which coalesces into menstrual flow
56
Draw all chart that shows both the ovarian and uterine cycle on the same page. Consider looking at this again, if needed
57
How does estrogen affect the cervical mucous? progesterone?
Estrogen: mucus is thinner and more alkaline which enhances survival and transport of sperm progesterone: mucus is more thick, tenacious and cellular
58
______ influenced cervical mucus: Dries in a fern-like pattern when spread on a slide
estrogen
59
______ influenced cervical mucus: NO fern pattern, goop, no discernible pattern
progesterone
60
As estrogen levels rise in puberty, cervical os opens exposing endocervical _____ epithelium. ______ gradually replaces in 20s-30s due to ______ of vagina
columnar (when it first gets exposed, gradually shifts to squamous) Squamous metaplasia (normal healthy adult) acidic environment
61
62
How does progesterone and estrogen affect the fallopian tubes?
Progesterone - reduces ciliary beat frequency (CBF) Estrogen - increases ciliary beat frequency (CBF)
63
How does progesterone and estrogen affect muscle?
Progesterone - reduces spasms, relaxes smooth muscle, and antagonizes effects of insulin on glucose metabolism Estrogen - improves skeletal muscle contractility Both estrogen and progesterone may regulate protein metabolism
64
Which ovarian hormone is the mediator of fat gain in pregnancy?
progesterone
65
in sodium/water balance, ______ is responsible for sodium and water retention. _____ is responsible for sodium and water excretion.
estrogen: retention progesterone: excretion
66
__________ mediates the first half of the menstrual cycle and ____ mediates the second half
estrogen: first progesterone: second
67
If the Y chromosome is not functional, what gender will a human embryo develop by “default” (male, female, or intersex)?
female
68
longitudinal septum
69
Tetany of the uterine wall during pregnancy can result in what pathologic outcome?
fetal hypoxia
70
What hormone causes diminished release of FSH in the latter portion of the follicular phase?
Inhibin B
71
What hormone causes endometrial glands to become more convoluted and secrete fluid?
progesterone
72

Women's Health (16 decks)

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