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MEDI 202 - Genes To Community > Physiological Changes of Puberty > Flashcards

Physiological Changes of Puberty Flashcards

1
Q

What is puberty defined as?

A

Endocrine and gametogenic functions of the gonads develop

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2
Q

When does puberty start for boys / girls?

A

Girls: 8 to 13 years
Boys: 9 to 14

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3
Q

What is the “timing” of puberty?

A

How mature a child is relative to his/her peers at the same age and gender.

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4
Q

What is the “tempo” of puberty?

A

How quickly or slowly a child progresses throughout the stages of puberty to the complete development

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5
Q

How many stages of puberty are there?

A

5 stages

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6
Q

What are the factors controlling the onset of puberty?

A

Genetic factors
Environmental factors

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7
Q

What are the categories under environmental factors?

A

Nutritional
Geographical location
Exposure to light

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8
Q

When does adrenarche begin and what is its function?

A

Girls: 8 to 10 years
Boys: 10 to 12 years

To produce androgens

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9
Q

What causes thelarche and menarche?

A

The production of ovary hormones (oestrogen and progesterone)

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10
Q

What initiates puberty?

A

Maturation and reactivation of the HPG axis

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11
Q

What is the cycle of HPG axis?

A

Well-developed at birth
Remains suppressed during childhood
Reactivated at the onset of puberty

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12
Q

How does CNS control puberty?

A

Hypothalamus releases GnRH
Pituitary releases LH and FSH
Ovaries and testes which release testosterone, oestrogen and progesterone

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13
Q

First half of pregnancy HPG axis:

A

The surge in FSH and LH secretion is hypothalamus independent, gonadotropins release those hormones on their own.

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14
Q

When does FSH and LH secretion become hypothalamus dependent? Why?

A

2nd half of pregnancy
Inhibited by placenta hormones

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15
Q

FSH and LH levels during infancy?

A

They peak due to loss of negative feedback by placental hormones

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16
Q

Why is there a low level of GnRH during prepubertal years?

A

High sensitivity of the hypothalamic-pituitary system to negative feedback inhibition by low levels of gonadal steroids +/- CNS inhibitory mechanism

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17
Q

What is testosterone surge induced by in fetal age?

A

hCG

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18
Q

At the what age stage is testosterone induced by FSH and LH?

A

Infancy

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19
Q

What induces testosterone surge during puberty?

A

Pulsatile LH and FSH

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20
Q

What may cause the onset of puberty?

A

Diminished brain inhibition or neural stimulation of the hypothalamic “gonadostat”

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21
Q

What does the increase in GnRH secretion stimulate?

A

Pituitary gonadotropin secretion and gonadal sex steroid production.

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22
Q

What factors are included in the maturation process that triggers onset of puberty?

A

Kisspeptin and Gamma-aminobutyric acid.

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23
Q

What is kisspeptin and what is its function?

A

It is a peptide hormone that is secreted by the hypothalamic neurone and potently stimulates the release of GnRH

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24
Q

What is GABA and what is its function?

A

A neurotransmitter that appears to play an important role in the inhibition of GnRH. A decrease in GABA could play a role in the onset of puberty.

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25
Q

What is leptin?

A

A satiety-producing hormone secreted by adipocytes

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26
Q

How does a decrease in hypothalamic NPY happen?

A

Increase in leptin

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27
Q

What kind of signal does leptin provide the hypothalamus with?

A

Signal that informs there are sufficient energy stores to support reproduction.

28
Q

Why do young women with anorexia stop menstruating?

A

There is insufficient fat and decrease in leptin so not sufficient energy stores to support reproduction

29
Q

What is Tanner’s staging in girls?

A

5 stages of breast development and pubic hair growth

30
Q

What is the first sign of puberty for girls?

A

Thelarche

31
Q

What is the first stage of tanner’s staging in girls?

A

Prepubertal: childhood no glandular breast tissue, elevation of breast papilla, no pubic hair.

32
Q

What happens during the second stage of Tanner’s staging in girls?

A

Breast budding with elevation of breast and papilla (thelarche) Downy soft pubic hair.

33
Q

What occurs between the second and third stages of Tanner’s staging for girls?

A

Growth spurt

34
Q

When is there an enlargement of the breast and areola? What else occurs during that stage?

A

Stage 3, darker, coarser and curled hair develops

35
Q

What happens during the fourth stage of Tanner’s staging for girls?

A

Projection of areola and papilla to form the double mound. More dense hair fills the pubic triangle and external genitalia.

36
Q

What is the difference in hair growth between stages 4 and 5 according to Tanner’s for girls?

A

Pubic hair is only limited to external genitalia and pubic triangle in stage 4 while in stage 5 it spreads to inner thigh too

37
Q

When does menarche occur?

A

Between stages 4 and 5

38
Q

What happens in the final stage of Tanner’s staging for girls?

A

Matter breast, loss of double mound, dense air that extends beyond the inguinal area onto inner thigh.

39
Q

Why is there a loss of the double mound of the breast during stage 5?

A

Due to the projection of the papilla only and the recession of the areola to the level of the breast.

40
Q

What is a limitation of Tanner’s staging when it comes to boy’s pubertal development?

A

Does not include testicular volume which is the sign of initiate of puberty for boys.

41
Q

What is the testicular volume required for puberty to start?

A

Greater than 3ml

42
Q

What is the instrument used to measure volume and size of testes?

A

Prader orchidometer

43
Q

What is stage 1 of Tanner’s staging for boys and what does it include?

A

Prepubertal: Childhood
Testicular volume <3ml and no pubic hair.

44
Q

What is the second stage of Tanner’s staging for boys and what is its significance?

A

Enlargement of testicular volume, little or no change in penile size, downy soft pubic hair.

Initiation of puberty

45
Q

What is the testicular volume in stage 1?

A

Between 3 to 6 ml

46
Q
A
47
Q
A
47
Q
A
48
Q

When is the testicular volume between 8 and 12ml?

A

Stage 3

49
Q

What occurs in stage 3 of tanner’s staging for boys?

A

Testicular volume increases more, penile lengthening, darker, coarser and curled hair is developed.

50
Q

When does growth spurt occur according to Tanner’s staging for boys?

A

Between stages 3 and 4

51
Q

What occurs during stage 4 of Tanner’s staging for boys?

A

Testicular volume increases to 12 to 15, penile lengthening and broadening. Hair fills the pubic triangle and external genitalia.

52
Q

What occurs during the fifth and final stage of Tanner’s staging for boys?

A

Testicular volume is over 15ml, adult genitalia, pubic hair extends beyond inguinal area onto inner thigh.

53
Q

Why does growth stop eventually?

A

Growth plates of bones close, closure of epiphyseal plate

54
Q

What causes the closure of epiphyseal plates?

A

Influence of oestrogen for girls and testosterone for boys

55
Q

What happens to growth if puberty starts earlier than expected?

A

The height development will decrease because growth plates will close earlier

56
Q

What happens if oestrogen and testosterone are absent but LH and FSH are present?

A

Development of secondary sexual characteristics but no gametogenesis.

57
Q

What are the two types of precocious puberty?

A

True precocious puberty and pseudo-precocious puberty.

58
Q

What is true precocious puberty?

A

Premature activation of the HPG axis, early gametogenesis and appearance of secondary sexual characteristics.

59
Q

What is pseudo-precocious puberty?

A

Premature sex steroid secretion, primary disorder of the gonads or adrenal gland independent of hypothalamic-pituitary control

60
Q

What occurs during pseudo-precocious puberty?

A

Early development of secondary sexual characteristics without gametogenesis.

61
Q

What is considered a delay in puberty for boys?

A

Testicular volume < 3ml by the age of 14

62
Q

What is considered a delay in puberty for girls?

A

Lack of thelarche by 13, or menarche by 15.

63
Q

What are the two types of delayed puberty?

A

Pubertal delay, pubertal failure

64
Q

What is the diagnosis for pubertal failure?

A

Turner’s syndrome

65
Q

Why do boys often develop gynecomastia during the first stages of pubertal development?

A

Imbalance between oestrogen and testosterone, abnormal sensitivity of the mammary glands to oestrogen, exaggerated conversion of testosterone to oestrogen.

66
Q

When is gynecomastia considered normal and when not?

A

If it during stages 2, 3, or 4 of pubertal development then it is normal and resolves within 6 months to 2 years. If it stage 5, it is always pathologic

MEDI 202 - Genes To Community (23 decks)

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