Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Endo/Repro Final > Physiology Of The Mestrual Cycle > Flashcards

Physiology Of The Mestrual Cycle Flashcards

1
Q

What is puberty?

What are the four steps occurring during puberty?

A

Period of change when the anterior pituitary gland begins to secrete progressively more FSH and LH leading to normal monthly menstrual cycles

  1. Thelarche: breast development
  2. Adrenarche: increased adrenal androgens secretion
  3. Growth spurt
  4. Menarche: first period age 12.5yrs
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Amenorrhea

Primary amenorrhea

Secondary amenorrhea

Oligomenorrhea

Polymenorrhea

Dysmenorrhea

Metrorrhagia

Menorrhagia

Menometrorrhagia

A

Absences of menses

Absence of menarche by age 15, with secondary sexual development

No menses for 3 months or more

> 35 day cycle

< 21 day cycle

Painful menses

Frequent of irregular menstruation

Heavy menstrual bleeding

Heavy irregular bleeding

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is the menstrual cycle and what two organs are involved?

A

Rhythmical secretion of hormones leading to physical changes in the ovaries and uterus, including release of an ovum and preparation of the endometrium for implantation (28 days)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Explain the hypothalamic-pituitary axis regulation in females

A

Hypothalamus: neurons synthesize, store and releases pulsatile GnRH

Anterior pituitary: LH (acts on theca and granulosa cells); FSH (acts on granulosa cells)

Ovarian theca cell: androgens, progestins

Ovarian granulosa cell: estrogen, inhibin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What are the simultaneous cycles occurring in the ovary and the endometrium?

A

Ovarian cycle: follicular phase; luteal phase

Endometrial cycle: menses -> proliferative phase; secretory phase

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Ovarian cycle before puberty:

How many ova are females born with and what stage are the ova in until puberty?

What are the ova called?

What do granulosa cells do?

A

1-2 million; prophase 1

Primordial follicles

Nourish the primordial follicles and produce oocyte maturation inhibiting factor

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Ovarian cycle after puberty:

When do the ovarian follicles develop?

What do these cells stay arrested in until fertilized?

A

When FSH and LH are secreted from the anterior pituitary

Metaphase II

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

When does the follicular phase of the ovarian cycle begin?

What occurs during the follicular phase?

When is it completed?

A

Onset of menses

FSH stimulates follicular development

Granulosa cells produce estradiol -> endometrial growth and maturation and LH surge

Complete day of LH surge (day 14)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Follicular phase of ovarian cycle:

What happens after the break down of the corpus luteum from the previous cycle?

When does FSH increase?

What does FSH do?

A

There is a release of negative feedback on hypothalamus and pituitary -> increase production of FSH

Two days prior to menstruation

FSH recruits several follicles -> follicles produce low concentrations of estrogen and inhibin B (negative feedback on FSH)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Follicular phase of ovarian cycle:

What effect does a decrease in FSH have on the ovaries?

A

Decrease FSH -> decrease progesterone and estrogen -> increase frequency of GnRH pulsation -> increase LH and LH/FSH ratio

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Follicular phase of ovarian cycle:

After increase in LH/FSH ratio, FSH is decreased leading to ____ producing one _____ follicle.

This follicle has what?

What effect does FSH have on this one follicle?

A

Follicular atresia; dominant follicle

The most FSH receptors and greatest angiogenesis/blood supply

FSH causes the dominant follicle to secrete estradiol-17 beta and inhibin B

FSH also induces expression of LH receptors in the mural granulosa cells of the dominant follicle

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

When does the luteal phase of the ovarian cycle begin?

What happens to the follicle?

What do luteal cells secrete and what is their fx?

When does the luteal phase end?

A

Day of LH surge (day 14)

Follicle becomes corpus luteum

Luteal cells secrete progesterone and estrogen -> further endometrial growth and development

Onset of menses

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What causes the LH surge in the ovarian cycle?

A

FSH causes the follicle to secrete estrogen -> when circulating estrogen exceeds 200pg/mL for 50 hours, estrogen begins to have a positive feedback on the anterior pituitary -> LH surge

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What does the LH surge in the ovarian cycle cause?

A

Primary oocyte to complete meiosis and become arrested in metaphase II

Wall of the follicle and ovary at the stigma are broken down to release ovum

Mural granulosa cells and theca cells are restructured to become the corpus luteum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Luteal phase of the ovarian cycle:

Corpus luteum produces ____ and ____ that cause a negative feedback on the anterior pituitary.

What does progesterone inhibit?

What is required for corpus luteum function without pregnancy and during pregnancy?

A

Estrogen and inhibin A

The positive feedback of estrogen, therefore FSH and LH are under negative feedback and return to basal levels

LH; hCG from the implanted embryo maintains the corpus luteum during pregnancy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Luteal phase of the ovarian cycle:

No LH or hCG causes what to happen to the corpus luteum?

The corpus luteum becomes ____ leading to a decrease in ____.

This ultimately causes ___.

A

Corpus luteum regresses in 14days -> menstruation

Corpus albicans

Decrease in progesterone, estrogen, inhibin A; all releasing a negative feedback on the hypothalamus and anterior pituitary

Menses

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What is the most common cause of vaginal bleeding in a young child?

A

Foreign body

18
Q

What inhibits the hypothalamic pituitary axis during the follicular phase of the ovarian cycle?

What inhibits the axis during the luteal phase?

A

Estradiol secreted from the ovary

Progesterone secreted from the ovary

19
Q

What cells aid in the biosynthesis of steroids in ovaries?

A

Theca cells

Granulosa cells

20
Q

What do theca cells contain and produce?

What do granulosa cells contain and produce?

What do both cells do?

How are estrogen and progesterone transported?

A

LH receptors
No aromatase
Produce androgens; primarily androstenedione

LH and FSH receptors
Contain aromatase to convert androgens to estrogens
Produce inhibins

*both cells contain LDL receptors to make cholesterol; need both cells to make estrogen

Transported loosely bound to plasma proteins in circulation

21
Q

How is cholesterol synthesized in the follicular phase of the ovarian cycle?

How is cholesterol synthesized in the luteal phase of the ovarian cycle?

What stimulates aromatase?

A

Follicle secretes estradiol
LH primes theca cells to convert cholesterol to androstenedione; theca cells lack aromatase; androstenedione diffuses into granulosa cells

Follicle secretes progestins
Androstenedione from theca cells is converted to estradiol by aromatase

FSH stimulates aromatase in granulosa cells

22
Q

What is the fx of estrogen on female genitalia?

Vaginal epithelium?

Uterine tubes?

Puberty?

A

Maturation and maintenance of the uterine tubes, uterus, cervix, and vagina

Vaginal epithelium: goes from cuboidal -> stratified squamous

Uterine tubes: glandular tissue proliferation, enhanced cilia activity

Development of female secondary sex characteristics at puberty

23
Q

What are the different types of estrogen from most potent to lease potent?

What effect do they have on the hypothalamus and pituitary?

Where is estrogen metabolized?

Excreted?

A

Beta-estradiol > estrone > estriol

Negative feedback on hypothalamus and pituitary at high and low concentrations

Liver: decreased liver fx -> increase activity of estrogen

Urine

24
Q

What are the effects of estrogen on pregnancy?

What other hormone does estrogen stimulate?

What effect does estrogen have on breast tissue?

A

Maintains pregnancy

Pregnancy lowers uterine threshold to contractile stimuli

Stimulates prolactin secretion

Stromal tissue development, growth of ductile system, deposition of fat

25
Q

What are the effects of progesterone on the uterus?

Breasts?

Pregnancy?

A

Maintains secretory activity of uterus during luteal phase (prepares uterus for implantation)

Develops internal breast structures: lobules and alveoli to ensure secretory capabilities if stimulated by prolactin

Maintains pregnancy: raises uterine threshold to contractile stimuli during pregnancy

26
Q

Where is progesterone metabolized?

Where is it excreted?

When is it at its highest concentration?

A

Liver

Urine: rate of progesterone formation can be estimated from uterine excretion rate

Between ovulation and beginning of menstruation

27
Q

What hormone regulates the basal body temperature (BBT)?

How?

What does an increase in body temperature mean?

What does a decrease of body temperature mean?

A

Progesterone

Acts on the hypothalamus to increase the set point for thermoregulation; increases body temperature by 0.5 degrees

Sign of the LH surge and start of ovulation

Disintegration of corpus luteum -> drop in BBT -> menstruation

28
Q

What cells produce inhibins? When?

What do inhibins inhibit?

A

Granulosa cells of the follicle when stimulated by FSH; LH produced prior to ovulation also stimulate production

Inhibit FSH production by gonadotropes (negative feedback)

No effect on LH

Decrease intraovarian production of androgens (estrogens)

29
Q

What cells produce activins?

What do they activins activate?

A

Produced by granulosa cells

Stimulate production of FSH by gonadotropes

Increase intraovarian production of estrogens

No effect on LH

30
Q

How many days are between ovulation and the start of menses?

A

14 days

31
Q

What occurs during the menses phase of the endometrial cycle?

What do MMP do?

What do prostaglandins do?

A

Day 1 of menstrual cycle; lasts 3-5 days; 25-35mL blood loss

Decreased estradiol and progesterone -> indicate corpus luteum regression and withdrawal of hormonal support from the endometrium

Matrix metalloproteases (MMP) break down stratum functionalis

Prostaglandins lead to hypoxia necrosis of spiral arteries

Shedding of the functional layer of the endometrium

32
Q

What occurs during the proliferative phase of the endometrial cycle?

What happens to the endometrium?
Uterine glands?

What is the fx of progesterone receptors?

A

Day 5

In the ovarian cycle, antral follicles being to produce estradiol

Endometrium proliferates

Uterine glands become straight or coiled with narrow lumina

Induce expression of progesterone receptors that allow endometrium to respond to progesterone during the luteal phase

33
Q

What occurs during the secretory phase of the endometrial cycle?

How does progesterone inhibit endometrial growth?

What are the fx of progesterone during this phase?

A

Progesterone is secreted

Inhibits endometrial growth by down-regulating estrogen receptors (activates enzymes that inactivate estrogen and convert estradiol to estrone)

Induces differentiation of epithelial and stromal cells

Induces production of nutrient rich secretion from uterine glands

Alters adhesivity of surface epithelium

34
Q

What is Turner Syndrome?

Characteristics?

A

Most common cause of congenital/primary hypogonadism

Due to loss of part or all of X chromosome

Internal and external genitalia is female

Ovarian failure; increase FSH because trying to stimulate ovary that is not present; ovaries appear as CT filled streak (streak ovaries)

Short, shield chest, bicuspid aortic valve, coarctation of aorta, low ears, short 4th metacarpal, lymphatic defects, sexual infantilism, amenorrhea

35
Q

How do you diagnose polycystic ovarian syndrome (PCOS)?

A

Diagnosis requires 2/3 symptoms:

Amenorrhea

Evident of excessive androgen secretion (acne, hirsutism)

Polycystic ovaries on US (string of pearls)

36
Q

What causes polycystic ovarian syndrome?

A

Continuous secretion of LH leading to ovarian enlargement

Increase LH -> increase androgen production (theca cells)

Elevated levels of androgens -> aromatase in adipose converts androgens to estrone -> high estrone inhibits FSH secretion -> decreased FSH inhibits follicular maturation -> no ovulation/no menstrual cycle

37
Q

What are the symptoms of polycystic ovarian syndrome?

A

Menstrual dysfunction (amenorrhea)

Hyperandrogenism (acne, hirsutism, male pattern hair loss in women)

Polycystic ovaries

Metabolic issues/cardiovascular risks (obesity, insulin resistance, type 2 DM)

Infertility

38
Q

What is endometriosis?

Where are the most common locations?

What causes this?

A

Endometrial glands implant outside of the endometrial cavity; can form cysts filled with chocolate like fluid

Ovary, pelvis, peritoneum

Retrograde flow, metaplastic transformation of multipotent cells, lymphatic transport of endometrial tissue

39
Q

What are signs and symptoms of endometriosis (based on location and size of implants)?

How do you treat this?

A

Cyclic abdominopelvic pain, dysmenorrhea, dyspareunia, dyschezia, heavy menstrual bleeding, tenderness on vaginal examination, infertility

NSAIDS, OCPs, progestins (levels hormone; prevents LH surge), laparoscopic removal, GnRH agonist (no pulsatile release; no LH release)

40
Q

What is menopause?

What is decreased?

What becomes the primary source of estrogen?

What causes menopause?

A

12 consecutive months without menstruation; cycles become irregular then cease; 51.4 years

Decrease estrogen -> increase LH and FSH because lack of negative feedback

Estrone; synthesized from circulating androgens

Natural, premature ovarian failure, surgical, chemotherapy

41
Q

What are the signs and symptoms of menopause?

How do you treat menopause? Why do you not treat with estrogen in a menopausal woman with a uterus?

A

Irregular menstruation, vaginal dryness, hot flashes, night sweats, sleep problems, mood changes, decreased metabolism, weight gain, thinning hair, dry skin, loss of breast fullness

Relief of signs and symptoms, estrogen therapy -> have to manage because estrogen increases the uterine lining and can lead to uterine cancer

Endo/Repro Final (20 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions