Physiology of the Femal Pelvis Flashcards
Length of menstrual cycle ranges between
21 + 35 w
Rupture of a graffian follicle occurs during what ut cycle
Menstrual Cycle
Estradiol Levels
Follicular: 30-100 pg/ml
Ovulatory: 200-400 pg/ml
Luteal: 50-140 pg/ml
Estradiol reflects the activity of
ovaries
During pregnancy, estradiol levels
will steadily rise
Small amounts of Estradiol is present in
adrenal cortex and arterial walls
Estrogen Levels
5 - 100 ug/24h
Estrogen
female sex hormone
produced by follicles and placenta
Stimulates the production of estrogen in ovaries
FSH + LH
follicle-stimulating hormones and lutenizing hormone
Produce small amounts of estrogen
breast, liver, and adrenal gland
Estrogen Functions
formation of female secondary sex characteristics
accelerate growth in height and metabolism
reduce muscle mass
stimulate endo growth and proliferation
increase uterine growth
Follicle- Stimulating Hormones (FSH)
Premenopause: 4-25 mU/mL
Postmenopause: 4-30 mU/mL
FSH
initiates follicular growth and stimulates the maturation of graafian follicles
FSH secreted by
Anterior Pituitary Gland
FSH decline in _____ phase and increase @ ________ phase
later follicular
end luteal
FSH produced by
hypothalamus
Stimulates PSH production
low-levels of estrogen
Lutenizing Hormone Levels
Follicular: 2-10 u/L
Midcycle peak: 15-65 u/L
Luteal: 10-12 u/L
Postmenopause: 1.3-2.1 mg/mL
LH is essential
in both men and women for reproduction
LH is secreted by
Anterior Pituitary Gland
Stimulates LH production
increase estrogen levels
Corpus Luteum produces
progestrone to prepare the endo for implantation
LH surge lasts
only 48 hours
LH surge triggers
ovulation and initiates the conversion of residual follicle into corpus luteum
LH produced by
hypthalamus
Progestrone is produced in
adrenal gland, corpus luteum, brain, and placenta
Progestrone Function
prepare endo for implantation or starting next cycle
Progestrone Levels
Follicular: .1-15 ng/mL
Luteal: 2.5-28 ng/mL
Progestrone levels increase during
pregnancy and after ovulation
progestrone levels decrease during
childhood
Progestrone levels remain the same during
luteal phase
Endo Thickness
shouldnt exceed 14 mm
Fluid w/in endo should or shouldnt be measuring w/in endo measurement
shouldnt
Thickness of postmenopausal endo w/o hormone replacement should not exceed
8 mm
considered benign if 5 mm or less
Premanarche
- time before onset of menses
- follicular cyst may be present
- cervix to corpus 2:1
Menstrual Phase of Endo
occurs days 1-5
Menstrual Phase of Endo
Functional Layer undergoes
necrosis from a decrease in estrogen and progestrone
Early Menstrual Phase of Endo
hypoechoic, 4-8 mm
Late Menstrual Phase of Endo
thin, discrete, hyperechoic, 2-3mm
Proliferative Phase of Endo
day 6-14
overlaps postmenopausal
Proliferative Phase of Endo
increase estrogen
regenerates functional layer
Proliferative Phase of Endo
coincides w/
folliclar phase of the ovaries
Early Proliferative Phase of Endo
days 6-9, thin, echogneic, 4-6mm
Late Proliferative Phase of Endo
days 10-14, triple line, 6-10 mm, thick hypoechoic functional layer and hyperechoic basal layer
Secretory Phase of Endo
day 15-28, 7-14 mm
Secretory Phase of Endo
functional layer
thickens
Secretory Phase of Endo
progestrone increase
stimulates changes
Secretory Phase of Endo
Functional and Basal Layer
Functional Layer is hyperechoic
Basal Layer is hypoechoic
How many follicles are in an ovary at birth?
200,000
Secretion of _______ stimulates folliclar development
FSH
Ovulation is regualted by
hypothalamus
LH reaches its peak
10-12 hours before ovulation
Triggers ovulation
surge in LH and small FSH surge
Follicular Phase of the Ov
begins at start of menstruation
ends at ovulation
14 days
estrogen levels increase
Follicular Phase of Ov
What happens between 5 + 7
dominant secondary follicle is determined
Follicular Phase of Ov
FSH stimulates the growth of
primary follicle
Dominant follicle will grow ____ mm/day during what phase?
2-3
follicular
Early Follicular Phase of Ov
- multiple small anechoic functional cyst
- 5-11 small follicles begin to develop
Late Follicular Phase of Ov
- graafian follicle reaches 2-2.4 cm in diameter before ovulation
- visualization of cumulos oophorus increase probability ovulatoin will occur w.in the next 46 hours
Ovulatory Phase of the Ov
- occurs at the rupture of the graafian follicle
- day 14
- irregular shaped cystic structure
- small amount of fluid in caul-de-sac
Mittelscherz
pelvic pain increase over ovulatory ov
Luteal Phase of Ov
- begins post-ovulation
- day 15-28
- 14 day span
During Luteal Phase of Ov, corpus luteum
- grows for 7-8 days
- secretes some estrogen and an increasing amount of progestrone
Luteal Phase of Ov
If ovum is fertilized
corpus luteum will secrete progestrone
Luteal Phase of Ov
If fertilization doesn’t occur
corpus luteum regresses after approx. 9 days and progestrone levels decrease
Postmenopausal
- cessation of menstruation for 12 months
- 15% of cases will have simple ov cyst
- less than 5 cm benign
Postmenopausal w/ hormone replacement therapy
- includes estrogen and progesterone
- endo thickness varies, should measure
Postmenopausal w/o hormone replacement therapy
- UT decreases in length and width
- endo thickness shouldnt exceed 8 mm in asymptomatic or 5 mm with vag bleeding
- ov atrophy
- decrease in estrogen shorten vag and decrease cervical muscous
Corpus luteum cyst etiology
formed by ruptured graafian follicle
Corpus luteal cyst clinical findings
- asymptomatic
- pelvic pain