Quiz 3 Flashcards
What accumulates in 11b-Hydroxylase deficiency?
11-Deoxycorticosterone
11-Deoxycortisol
What lowers body temperature during the pre-ovulatory follicular phase of the menstrual cycle?
High estrogen levels
What are the two Galactopoietic hormones?
Prolactin
Cortisol
What three things do the granulosa cells eventually segregate into?
Cumulus Oophorous
Mural Granulosa Cells
Corona Radiata
What does Glyburide do?
Increases insulin sensitivity in peripheral tissues
What is a Galactopoietic hormone?
maintains milk production once established
What does the thinned capsularis fuse with to obliterate the uterine cavity?
Decidua Parietalis
What type of cells surround the seminiferous tubules?
Peritubular Myoid Cells
Leydig Cells in between tubules
What causes the Oocyte to undergo ovulation and enter the oviduct?
LH surge
When would you see elevated levels of cAMP in the menstrual cycle?
Prophase I arresrt
What brings large antra follicles out of their Prophase I arrest?
LH surge
What does LH stimulate Theca Lutein Cells to produce?
Androstenedione
Progesterone
What Syncytiotrophoblast protein is expressed in the conversion of pregnenolone to progesterone?
3b-HSD
What cells would you find in the mucosal layer of the oviduct wall?
Ciliated Cells
Secretory Peg cells
Where does the oxygenated blood from the umbilical vein enter the fetus in order to bypass the liver?
Ductus Venosus that leads right to the IVC
what defines tertiary villi?
Mesenchymal cells forming fetal blood vessels
What supplies sympathetics two the pelvic viscera?
Hypogastric Plexuses via Visceral Afferents (not ANS)
What type of epithelium surrounds the primordial follicles?
Simple Squamous layer of follicular/pregranulosa cells
How do you decide which follicle becomes the dominant follicle?
The one with the most FSH receptors
What does the stratum vasculare supply?
Myometrium
What does the anmiochorionic membrane do?
Fuse with Capsularis
Adhere to Parietalis
What artery becomes the Femoral?
Eternal Iliac
Which layer of the endometrium is lost during menstruation?
Functional layer (basal stays intact)
What divides the chorion into cotyledons?
Placental Septa
What three regions give Internal Iliac Lymph Nodes their lymph?
Inferior Pelvic Viscera
Deep Perineum
Glutei
What three things dont cross the placenta?
Protein Hormones
Bacteria
Amino Acid Structured Drugs
What are the three main sites of prenatal hematopoiesis?
Yolk Sac
Liver
Bone Marrow
What indicates a change from a primordial follicle to a primary follicle?
The surrounding granulosa cells go from simple squamous to simple cuboidal
What raises body temperature during the luteal phase of the menstrual cycle?
High Progesterone
What causes a primary oocyte to become secondary?
LH surge
What causes the effects of preeclampsia on the placenta?
Limited blood supply to the uterine arteries
How do steroids activating the mineralocorticoid receptor lead to hypertension?
They increase Na retention
What is the corpus lutem producing when its out of the luteal phase?
Progestins (but some estradiol)
What do the fetal organs of the MPF unit supply?
DHEAS and 16a-OH-DHEAS (weak androgens)
When would you see elevated levels of MAPK in the menstrual cycle, and when does it degrade?
Elevated in Metaphase II arrest, degrade with fertilization
What are sex-cord stromal cells derived from?
Stromal component of the ovary (granulosa and thecae cells, fibrocytes)
What type of cells do gestational choriocarcinoma come from?
Trophoblast cells
What is the Barker Hypothesis?
Obesity during pregnancy changes metabolic programming in utero
What conditions favor negative feedback for estrogens vs progestins?
Estrogens do negative feedback all the time
Progestins only do it at high concentrations
What synthesizes 1,25-Dihydroxycholecalciferol in the liver?
1-a Hydroxylase
Why does the secondary follicle secrete paracrine factors?
So local stroll cells can differentiate into thecal cells
What do sperm use their hyaluronidase to digest?
Hyaluronic acid in the Cumulus
What maintains the Right to Left shunt that is the Ductus Arteriosus?
PGE2 dilating the smooth muscle
What anchors the chorionic sac to the decidua basalis?
the Cytotrophoblastic shell, with vasculature passing through its gaps
What is the major product of the follicle in the follicular phase, and the luteum in the luteal phase?
Estradiol
What do the CT components of the endometrium come from?
Basal Stromal cells proliferating into the Zona Basalis
What is the difference in menstrual period length in a young patient vs an adult?
Adults’ are shorter, 21-35 days rather than 45
What is the Tunica Albuginea?
Dense CT Capsule of the Ovary, Testicle, or corpora cavernosa
What are the three components of the chorionic sac?
Cytotrophoblasts
Syncytiotrophoblasts
Extra-embryonic somatic Mesoderm
What is the result of the Ferguson reflex?
This refers to cervical distention, which stimulates oxytocin’s release of PGF2a in increasingly frequent bursts
Which menstrual phase is estrogen-dependent?
Proliferative Phase
What facilitates hatching of the embryo from the zona pellucid?
Trophoblasts secreting ZP-digesting Proteases
What stimulates fetal leydig cells to produce testosterone?
hCG (small amount from placenta0
What kind of epithelium is the ductus deferens?
Pseudostratified columnar wit sparse stereocilia
Where does the superior rectal vein send its tributaries?
Inferior Mesenteric V
What two things use passive exchange to transfer solutes between mother and fetus?
Nitrogen Waste (urea, creatine) Lipid Soluble Hormones
What two things does gCG serve as a growth factor for?
Trophoblasts and Placenta
Where is the decidua basalis relative to the decidua capsularis?
Basalis is deep to the conceptus, whereas the capsularis is superficial to the conceptus
How does estrogen oppose the action of progesterone on the myometrium?
Increases oxytocin receptors on it
Which type of villi actually do have vasculature?
Tertiary only
What keeps the mucosal layer of the vagina moist, since it doesn’t have any of its own glands?
Uterine / endocervical glands
Glands of Bartholin (vestibule)
What is the hallmark of Sertoli cells?
Cyclops Nucleus
Which part of the sperm contains mitochondria
Middle Piece of the Tail
What is the major product of thecal cells?
Androstenedione
What anchors granulosa cells to the Zona Pellucida?
Corona Radiata
What extra-embryonic tissue surrounds the umbilical vesicle?
Splanchnic Mesoderm
What two types of cells make up the seminiferous tubules?
Sertoli and Spermatogenic cells
Where do incapacitated sperm bind?
Oviduct Isthmus epithelium
The transformation zone is the abrupt transition between the endo- and ectocervix. What is the histological composition?
Simple Columnar (endo) to Non-keratinized Stratified Squamous (etco)
What Zona Pellucida receptors do sperm have, and what are they for?
ZP3 - trigger the acrosome reaction
What is the significance of the Cortical Reaction?
Prevents Polyspermy
What does CRH act on?
The anterior pituitary, which releases ACTH onto the adrenals
What does Glyburide bind?
beta cell ATP/K receptors
Where do Common Iliac LN drain?
Lumbar nodes
What does the fetal part of the placenta project into?
Intervillous space
What are the glycoprotein and Ca-rich concentrations found in the prostate?
Corpora Amylacea
How does metformin act on the liver?
Inhibits Gluconeogenesis and Glucose Absorption
What anchors the primary oocyte to the follicle?
Cumulus Oophorous
What is the function of the theca internal vs externa?
Interna produces Androstenedione (to Estradiol)
Externa has Fibroblasts and Smooth Muscle
What does the Mediastinum Testis come from?
Thickened posterior portion of Tunica Albuginea surrounding the nut.
In twins, what stage of cleavage would have to occur to have Diamniotic and Monochorionic membranes?
Blastocyst (4 - 8 days)
What other molecule can bind LH receptors for Progesterone production?
hCG
What causes Ciliated cells and Secretory Peg cells to increase in size?
Estrogen Signaling
What must the Pelvic Nerve sub-Plexus penetrate through in order to provide parasympathetics for an erection?
Pelvic Diaphragm
Appearance of what marks the first stage of placental development?
Primary chorionic villi
Where does a stigma protrude from?
Pre-ovulatory follicle surface
What type of cells are found within the pseudo stratified columnar epithelium of the epididymis?
Principle cells and their stem cells
What are the two Galactokinetic hormones?
Oxytocin
Vasopressin
Why would you want to inhibit DA when suckling?
So that lactotrophs are no longer inhibited and can release prolactin for milk production
How is LH positive feedback temporarily reduced during Ovulation / Leutinization?
LH surge inhibits aromatase
What do you get with two sperm fertilizing a normal ovum?
A partial Hydatidiform Mole
Triploid or Tetraploid karyotype
Fetal tissue commonly found
What does the liver-specific vitamin D enzyme do?
25-Hydroxylase: converts D3 to 25-Hydroxycholecalciferol
What is the fate of post-ovulation mural granulosa cells?
Becomes part of the corpus luteum as Granulosa Lutein Cells
How do Nabothian Cysts form?
Occlusion and dilation of cervical crypts
What can rescue the corpus luteum from becoming the corpus albicans?
hCG
Where do inhibins act?
AP gonadotrophs
What does the endocervix canal allow communication with?
Cervix to the uterine cavity and vagina
What layer of the endometrium contains the spiral arteries?
the outer, Functionalis layer
Where do the External Iliac Lymph nodes get their lymph form?
Inguinal Nodes
Upper middle to anterior Pelvic Organs
What are Mullerian epithelial cells from?
The outer epithelial lining of the ovary
When is the period of rapid renal function maturation?
3rd trimester
What do amnioblasts need to separate from so they can enclose the developing amniotic cavity/
Epiblast
What secretes glycoproteins ZP1 - ZP4?
Primary Follicle
What stimulates completion of Meiosis II of the egg?
Ca++ release breaking down MAPK proteins, also releasing the second polar body
Where do Sacral LN drain?
Internal or Common Iliac Nodes
What is the significance of estrogen up regulating oxytocin receptors in the decidual tissue?
this stimulates prostaglandin PGF2a synthesis which favors delivery
What component of the developing embryo is pluripotent and which is totipotent?
Blastomeres: Totipotent
Inner Cell Mass: Pluripotent
What supplies parasympathetics to the pelvic viscera and GI tract starting at the descending colon?
Pelvic Splanchnic Ns
What segment of the arcuate arteries supples the Basal layer of the Endometrium?
Straight Segment
When is functional development of the renal system complete?
1 month of age
What does preventing Corpus Luteum involution lead to?
Prevention of menstruation
Increased Progesterone and Estrogen
What effect does suckling-stimulated oxytocin have?
Allows myoepithelial cells to let milk down
How long does a newborn rely on maternal Abs for immunity?
6 months, with a return to normal on its own in 12-20 months
What is the most common site of an ectopic pregnancy?
Oviduct (ampulla and isthmus)
What does LH and FSH affect before and after ovulation for the production of estrogens and progestins?
Before: Theca and Granulosa Cells
After: Corpus Luteum
What kind of epithelium is the mucosal layer of the vagina?
Nonkeratinized stratified squamous
Pelvic sub-plexuses are always associated with the lateral rectum and inferolateral urinary bladder. What do they supply exclusively to males and females though?
Males: Prostate, Seminal Vesicles, Erectile Tissues
Females: Cervix and Lateral Fornices
Where is the Izumo protein and receptor?
Sperm protein binding to Oocyte receptor for entrance into oocyte
Where do Sacral Lymph Nodes get their Lymph?
Posterior Inferior Pelvic Viscera
What does the trophoblast give rise to?
Extra-embryonic tissue
What is the Theca Externa continuous with?
Ovarian Stroma
Where does 1-a Hydroxylase act to convert 25-D to the active 1,25-D?
Kidney
What class of Pregestational Diabetes is associated with Nephropathy?
F
How do ovarian cysts manifest clinically?
High Testosterone and LH
Low FSH
What menstrual phase do glands have a “saw-tooth” appearance?
Secretory Phase
What is the effect of CRH stimulating fetoplacental estrogen release (via ACTH)?
It further increases myometrial contractility
What is the functional unit of the placenta?
Chorionic Villi
What are the two parts of the placenta from?
Fetal part is from the chorionic sac (outermost part)
Maternal part is from the endometrium
What does Estradiol induce?
GnRH, leading to more FSH and the LH surge
How does glucose transfer between fetus and mother?
Facilitated diffusion
What phase of cell division are primary oocytes arrested in?
Meiosis I Prophase I
Where do the Superior Gluteal Veins send their Tributaries?
Internal Iliac V (the largest ones, at least)
What defines secondary villi?
Mesenchyme cells from extra-embryonic mesoderm invading villi / chorionic membrane
What two hormones are made by the posterior pituitary?
Oxytocin
ADH / Vasopressin
What does the mother supply in the Maternal Placental Fetal Unit of endocrine function?
Cholesterol
How do the Lateral Sacral Veins make sure that they reach the IVC or SVC?
Anastamose with the Internal Vertebral Plexus
What type of spermatogonia enter meiotic prophase as Primary Spermatocytes?
Type B
What promotes myometrial relaxation vs contractility in pregnancy?
Progesterone is relaxing
Estrogen increases contractility
What receptor does aldosterone (and many other steroids) bind?
Mineralocorticoid Receptor
What parts of the antral follicle are responsive to what hormones?
Theca Interna - LH
Granulosa - FSH and LH
What is the role of the Decidual reaction in the endometrium during pregnancy?
Immune protection for the embryo
Moderation of syncytiotrophoblast invasion
How does PGF2a potentiate oxytocin-induced contractions?
Formation of gap junctions
Which part of the placenta contains maternal blood?
Fetal part
What kind of spermatids are in Sertoli cell niches vs apical crypts?
Round (Early) Spermatids: Niches
Elongated (Late) Spermatids: Apical Crypts
What do lutein cells secrete to suppress FSH?
Inhibin A
What are the 4 extra-embryonic structures?
Amnion
Umbilical Vesicle
Connecting Stalk
Chorionic Sac
What regulates P450scc / Desmolase?
ACTH
What happens to syncitiotrophoblasts and cytotrophoblasts to cause Placentation?
They proliferate to lacunae (primary villi)
What does the hypothalamus use to affect Anterior Pituitary Gonadotrophs in the HPO axis?
GnRH
What explains the High levels of LH and FSH after menopause?
Low estrogen means low inhibin - so it cant provide negative feedback on LH and FSH
What two things does hCG do?
Prevents involution of the corpus luteum
Autocrine growth factor
Where are mucosal folds most prominent and where are they absent?
Most prominent in the Ampulla
Absent in the Uterine part
What signified the beginning of embryonic development?
Fusion of pronuclei, which initiates the first embryonic cleavage
What three structures are supplied by the coccygeal plexus?
Coccygeus m.
Part of Levator Ani m.
Sacrococcygeal joint
What is the result of 17,20-Lyase activity on both 17a-Hydroxyprogesterone and -Pregenenolone?
-Progesterone is converted to Androstenedione directly
-Pregenolone is first converted to DEAH
Both result in more Testosterone in the ZR
What stimulates endometrial growth?
Estrogen
What does Estrogen do to syncytiotrophoblasts?
Increases LDL receptor expression
What effect does the sudden drop of temperature have on the newly delivered baby?
Stimulates breathing
What class of Pregestational Diabetes is associated with Arteriosclerotic Heart Disease?
H
In twins, what stage of cleavage would have to occur to have Diamniotic and Dichorionic membranes?
2 - 8 cell stage
What does the Anterior Internal Iliac a. use to supply the bladder with blood?
Umbilical A
What function of the HPO axis promotes the LH surge?
Switching to positive feedback regulation toward the end of the follicular phase
What is the core and covering made from in a primary villus?
Cytotrophoblast core
covered with syncytiotrophoblasts
What are the chromosomes of Turners Syndrome?
One X
What does the syncytiotrophoblast secrete to increase invasion?
Metalloproteinases
Angiogenic Factors
Why is fetal blood shunted to the left via the foramen ovale?
to supply the carotid artery and brain
What does the Coiled Segment of the Arcuate a. Supply?
Functional layer of the Endometrium
What three layers must the sperm penetrate to reach fertilization?
Cumulus
Zona PEllucida
Oocyte PM
In twins, what stage of cleavage would have to occur to have Monoamniotic and Monochorionic membranes?
Implanted (9 - 12 days)
What produces ACTH for P450scc regulation?
Adrenal Glands
What structures are lost for mature spermatids to be released in spermiation?
Residual Bodies
What three major nutritional needs are met with breastmilk?
Vitamin C
iron
Ca / Vit D
What triggers deciduation?
Maternal Stromal Cells responding to Invasion and Progesterone
Where would you have estrogen up regulate oxytocin receptors for smooth muscle contraction?
Uterine myometrium
What separates the primary oocyte from granulosa cells?
Zona Pellucida
Where does the ampulla of the ductus deferens lead?
Directly into the prostate
What condition leads to the formation of the Corpus Albicans?
Lack of fertilization and Involution of the Corpus Luteum
What four nerves of the sacral plexus pass through the greater sciatic foramen?
Sciatic (obvs)
Pudendal
Superior and Inferior Gluteal Ns
What type of epithelium is found in seminal vesicles?
Pseudostratified Columnar
How does FSH use the ovaries to regulate itself?
Stimulates the ovaries to produce inhibins (or activins)
What is the fate of the amnion?
Obliterates chorionic cavity
forms epithelial covering of umbilical cord
What type of epithelium is ovarian surface epi?
Simple Cuboidal
What stimulates Granulosa Lutein cells to secrete Progesterone and Estrogen?
FSH and LH
What two things secrete hCG?
Trophoblasts
Syncytiotrophoblasts
What is the function of the Zona Pellucida developing on the secondary follicle?
Provides binding sites for sperm
What is the difference between Class A1 and Class A2 Gestational Diabetes?
A2 is controlled with diet like A1, but also includes Glyburide or Insulin
What causes the closure of the ductus arteriosus?
Aortic BP overtaking pulmonary BP:
Oxygenated blood and falling PG levels cause vasoconstriction
What three things use active transport as an exchange mechanism between mother and fetus?
Amino Acids
Vitamins
Minerals
What characterizes the placenta of a woman with preeclampsia?
Poor trophoblastic invasion
What does the embryoblast become following implantation?
Bilaminar Embryonic Disc
What does PTH do in vitamin D synthesis?
Directs the conversion of 25-D to 1,25-D
What examples of Large molecules would use Receptor Mediated Endocytosis for exchange between fetus and mother?
Hormones like insulin
LDL
Abs
What part of the ovary houses the follicles?
Cortex / cortical stroma
What is the role of the trophectoderm in the blastocyst?
Increases Na transport and osmosis to form a blastocele
What happens to body temperature if pregnancy does not occur?
It drops with the onset of the next menstruation
What is the result of the amniotic sac growing faster than the chorionic sac?
They fuse to become the amniochorionic membrane
What structure doe the Testicular Veins pass through to get to the nuts?
Deep Inguinal Ring
What does progesterone do in the secretory part of the uterine cycle?
Differentiates stroll cells into predecidual cells
What defines the apposition stage of implantation?
Contact between endometrium and trophoblasts
How can 11B-hydroxylase deficiency give you hypertension, even though it decreases cortisol?
11-Deoxycorticosterone that builds up has a high affinity for MR too
What does the Theca Interna use to create Androstenedione?
Acetate and Cholesterol
What two structures does the Middle Rectal A. supply, besides the obvious?
Seminal Vesicles
Prostate
What is released from the hypothalamus in response to low cortisol levels?
Cortocotropin-Releasing Hormone (CRH)
What is the trophoblast and amnion lined with?
Extra-embryonic Somatic Mesoderm
What do the distal ends of the ductus deferens form?
Ejaculatory ducts
What is the significance of decidualization in the attachment phase of fertilization?
It makes the endometrium ready for embryo implatation
When is polar body 2 extruded?
At fertilization, when Meiosis II resumes
What structure reaches through the basement membrane and into the endometrial stroma in the invasion phase of fertilization?
Syncytiotrophoblast
What phase of cell division are Secondary Oocytes arrested in?
Meiosis II metaphase II
What maintains meiotic arrest until the LH surge?
Elevated cAMP
What is the hallmark of the vaginal wall?
Lacks glands
What villi form the villous chorion?
Decidua basalis
What does hPL convert glucose to in the mother?
Fatty acids and ketones
What does the placenta use to slow down blood flow and allow for greater nutrient exchange?
Discharge of blood into the intervillous space
What do you get with fertilization of two sperm on a blighted ovum, and duplication of a single sperm?
Complete Hydatidiform Mole
What serum levels are elevated in Turner Syndrome because of ovarian failure?
FSH
What do decidual cells do?
Orchestrate menstruation in the absence of pregnancy
What three fetal organs does the placenta function as?
Gut (nutrients)
Lung
kidney
What two precursors can you make vitamin D3 from?
Dietary D2
Skin 7-Dehydrocholesterol (UV)
Why is a partial or complete absence of the decidua a problem in Placenta Accrete?
Causes the villus chorion to adhere directly to the myometrium, meaning no placental separation at birth
What joins the ductus deferens in penetration of the prostate to form the ejaculatory ducts?
Seminal Vesicles
What would you expect PGF2a and PGE2 to do with a pregnancy?
These are prostaglandins: induce labor
What inhibits GnRH?
Gonadotropins
What type of mole has elevated blood hCG?
Invasive
What accumulates in 21-Hydroxylase deficiency?
Progesterone
17-HydroxyProgesterone
What gene encodes the enzyme with both 17a-Hydroxylase and 17,20-Lyase activity?
CYP17A1 (aka 17,20-Lyase)
What is the hallmark of the primary follicle development into a secondary follicle?
Vascularization
What is the maternal part of the placenta made from?
Decidua Baslis (endometrium deep to conceptus)
What type of epithelium lines the bulbourethral glands?
Simple Columnar
What kind of epithelium lines the ectocervix?
Stratified squamous
How does CRH directly promote myometrial contractions?
By sensitizing the uterus to Prostaglandins and Oxytocin
What is the relationship between the egg activation and sperm DNA?
Activates as sperm DNA condenses
Why inhibit GnRH production when suckling?
Decreasing downstream LH and FSH will inhibit the ovarian cycle
How does CRH from the placenta up regulate itself?
By stimulating fetal ACTH, the cortisol it produces stimulates more CRH release
What do the ovarian products of the HPO axis affect?
Positive and Negative on both Hypothalamus and Anterior Pituitary
What type of epithelium is in the epididymis?
Pseudostratified Columnar
What Syncytiotrophoblast protein is expressed in the conversion of cholesterol to pregnenolone?
CYP11A1
What disease is associated with excess aldosterone secretion from the adrenal cortex?
Conn Syndrome
What does estrogen induce that causes strong myometrial contractions?
Prostaglandins
What fetal organs contribute to the MPF unit?
Adrenal Glands
Liver
What class of Pregestational Diabetes is associated with Retinopathy?
R
What are the three branches of the Posterior Internal Iliac A?
Iliolumbar
Lateral Sacral As
Superior Gluteal a.
What do Mural Granulosa Cells secrete?
Estrogen and Follicular Fluid
What two distinct cell types are required for estradiol production?
Follicle: Theca and Granulosa cells
Corpus Luteum: Theca-Lutein and Granulosa-Lutein
When and where would you see a Glassy Membrane?
Surrounding a follicle undergoing apoptosis / atresia
What is the fate of Theca Interna Cells following ovulation?
They become Theca Lutein Cells (part of corpus luteum)
What would you expect a prostaglandin antagonist to do with a pregnancy?
Induce labor at any time
What kind of epithelium is in cervical crypts?
Simple Columnar
