Puberty, Disorders of Development, and Menstrual Disorders (Moulton) Flashcards
Menstrual cycle occurs with the maturation of the ____ axis.
Hypothalamic-pituitary-ovarian
__1__ from the hypothalamus stimulates __2__ and __2__ from the anterior pituitary, which stimulates __3__ and __3__ from the ovarian follicle.
1) Gonadotropin-releasing hormone (GnRH)
2) Follicle-stimulating hormones (FSH) and Luteinizing hormone (LH)
3) Estrogen and progesterone
Damage to the sella turcica can cause damage to what structure?
Pituitary gland
What are the six hormones that the anterior pituitary lobe can produce?
What are the two hormones that the posterior lobe produces?
1) FSH, LH, TSH, prolactin, growth hormone, and ACTH
2) Vasopressin and oxytocin
FSH and LH are synthesized and stored in cells called?
Gonadotrophs
The normal ovarian cycle can be divided into the __1__ phase and __2__ phase.
1) Follicular
2) Luteal
The follicular phase begins with the onset of __1__ and culminates in the preovulatory surge of __2__.
1) Menstruation
2) LH
The luteal phase begins with the onset of the preovulatory __1__ surge and ends with the first day of __2__.
1) LH
2) Menses
Decreasing levels of __1__ and __1__ from the regressing corpus luteum of the preceding cycle initiates an increase in __2__ by a negative feedback mechanism, which stimulates follicular growth and__3__ secretion.
1) Estradiol and progesterone
2) FSH
3) Estradiol
LH stimulates the __1__ cells to produce __2__.
FSH stimulates the __3__ cells to convert these __2__ into __4__.
1) Theca
2) Androgens (androstenedione and testosterone)
3) Granulosa
4) Estrogens (estrone and estradiol)
In the luteal phase, __1__ and __1__ are significantly suppressed through the negative feedback effect of the elevated circulating __2__ and __2__ levels.
If conception does not occur __2__ and __2__ levels decline near the end of the luteal phase as a result of __3__ regression.
__4__ will then rise which initiates new follicular growth for the next cycle.
1) LH and FSH
2) Estradiol and progesterone
3) Corpus luteal
4) FSH
GnRH is a decapeptide synthesized in the arcuate nucleus that is responsible for the synthesis and release of __1__ and __1__ into the circulation.
__2__ appears to enhance the hypothalamic release of GnRH and induce the midcycle __3__ surge.
__4__ have an inhibitory effect on GnRH release
1) FSH and LH
2) Estradiol
3) LH
4) Gonadotropins
During early follicular development estradiol levels are __1__.
Approximately __2__ before ovulation, estradiol levels begin to increase.
Estrogen levels generally reach a maximum 1 day before the __3__.
After the peak and before ovulation there is a marked __4__ in estradiol levels.
During the __5__ phase, estradiol rises to a maximum 5 to 7 days after ovulation and returns to baseline before menstruation.
1) Low
2) 1 week
3) Midcycle LH peak
4) Fall
5) Luteal
During follicular development the ovary secretes a __1__ amount of progesterone.
The bulk of the progesterone comes from the peripheral conversion of the adrenal __2__ and __2__.
Prior to ovulation the unruptured __3__ follicle begins to produce increasing amounts of progesterone.
Secretion of progesterone by the __4__ reaches a maximum 5-7 days after ovulation and returns to baseline before menstruation.
1) Small
2) Pregnenolone and pregnenolone sulfate
3) Luteinizing graafian
4) Corpus luteum
Primordial follicles undergo sequential development, differentiation, and maturation until a mature __1__ follicle is produced.
The follicle then rupture, releasing an __2__.
Subsequent luteinization of the ruptured follicle produces the __3__.
At about 8 to 10 weeks of fetal development, oocytes become surrounded by precursor __4__ cells.
This oocyte __4__ cell complex is called a primordial follicle.
1) Graafian
2) Ovum
3) Corpus luteum
4) Granulosa
In the adult ovary, a graafian follicle forms. The innermost three to four layers of multiplying granulosa cells become __1__ and adherent to the ovum this is known as the __2__.
A fluid filled __3__ forms among the granulosa cells which enlarges and the centrally located primary oocyte migrates to the wall of the follicle.
The innermost layer of the granulosa cells of the cumulus become elongated and form the __4__, which is released with the oocyte at ovulation.
1) Cuboidal
2) Cumulus oophorus
3) Antrum
4) Corona radiata
The LH surge initiates a sequence of biochemical and structural changes that result in __1__.
Cells on the follicular wall surface degenerate and a stigma forms, the follicular __2__ bulges through the stigma.
When this ruptures the oocyte is expelled into the __3__ cavity and ovulation has occurred.
1) Ovulation
2) Basement membrane
3) Peritoneal
After ovulation the granulosa cells of the ruptured follicle undergo luteinization. The luteinized granulosa cells, theca cells, capillaries and connective tissue form the ____.
Corpus luteum
The corpus luteum produces copious amounts of __1__ and some __2__.
Normal functional lifespan of corpus luteum is __3__ days.
If pregnancy does not occur, menses ensues and the corpus luteum is gradually replaced by an avascular scar called __4__.
1) Progesterone
2) Estradiol
3) 9-10
4) Corpus albicans
The endometrium is divided into two zones, the __1__ layer undergoes cyclic changes in morphology during the menstrual cycle and is sloughed off at menstruation. This layer contains __2__ arteries.
The __3__ layer remains relatively unchanged during each cycle and after menstruation provides stem cells for the renewal of the functionalis. This layer contains __4__ arteries.
1) Outer portion or functionalis
2) Spiral
3) Inner portion or basalis
4) Basal
During the menstrual phase there is disruption and disintegration of the __1__ glands and stroma, leukocyte infiltration, and red blood cell extravasation.
This leads to sloughing of the __2__ layer and compression of the __2__ layer.
1) Endometrial
2) Functionalis
3) Basalis
The proliferative phase is characterized by endometrial growth secondary to __1__ stimulation.
Increase in the length of the __2__ arteries and numerous mitoses can be seen in these tissues.
1) Estrogenic
2) Spiral
During the secretory phase following ovulation, __1__ secretion by the corpus luteum stimulate the glandular cells to secrete mucous, glycogen, and other substances.
__2__ arteries continue to extend into superficial layer of the endometrium and become convoluted.
1) Progesterone
2) Spiral
If conception does not occur by day 23 the __1__ begins to regress, secretion of __2__ and __2__ declines, and the __3__ undergoes involution.
1) Corpus luteum
2) Progesterone and estradiol
3) Endometrium
Medications such as ____, ____, and ____ can impair the coagulation system and be associated with heavy bleeding.
Warfarin, Aspirin, and Clopidogrel
The mediage age of menarche is 12.43 years which occurs within 2-3 years after __1__ at Tanner stage IV.
__2__ is diagnosed if there is no menstruation by 13 y/o without secondary sexual development or by the age of 15 y/o with secondary sexual characteristics.
1) Thelarche (breast development)
2) Primary amenorrhea
While the mean blood loss per menstrual period is 30cc, greater than 80cc has been associated with?
Anemia
