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ELM3 - reproduction, development & aging > reproduction > Flashcards

reproduction Flashcards

1
Q

What is the function of the glycoprotein shell that covers ovulated oocytes?

A

Protects oocyte from polyspermy (fertilisation by more than one sperm) and prevents early implantation in the fallopian tube

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2
Q

What are the parts of the female reproductive tract that sperm must pass through to reach the ovum?

A

Vagina, cervic, isthmus, ampulla, infundibulum

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3
Q

What 2 key physiological changes occur to sperm to allow them to successfully fertilise the ovum?

A
  1. Capacitiation - glyocprotein coat around sperm is removed by vaginal secretions, signalling sperm hyperactivity.
  2. Acrosome reaction - sperm release hydrolytic enzymes that break down the zona pellucida so that sperm can penetrate
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4
Q

What is the cortical reaction in fertilisation?

A

Filaments in the zona pellucida of the ovum become tightly packed and block subsequent sperm from entering to prevent polyspermy.

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5
Q

What are the steps in the process of fertilisation?

A
  1. sperm contacts the zona pellucida of the sperm, releasing acrosomal enzymes to digest this layer.
  2. the sperm reach the oocyte cytoplasm, which triggers the oocyte to finish meiosis II, forming a polar body and a mature ovum.
  3. The sperm nucleus and ovum nucleus fuse to combine their genetic material forming a diploid zygote.
  4. the zygote begins mitosis, as it moves down the fallopian tube towards the uterus for implantation
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6
Q

What is zygote hatching?

A

7-9 days post-ovulation, the blastocyst hatches out of the zona pellucida to prepare form implantation.

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7
Q

What is the process of blastocyst implantation?

A
  1. the blastocyst adheres to the endometrium, via the outer layer (trophoblast) which interacts with the receptive endometrial lining via adhesion molecules
  2. the trophoblast differentiates unto the inner cytotrophoblast and out syncitiotrophoblast.
  3. the syncyitiotrophoblast secretes enzymes that allow for burrowing of the embyro into the endometrium.
  4. the decidual reaction occurs, which increases vascularity around the embryo to nourish it for development
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8
Q

What hormone does the trophoblast release after implantation?

A

hCG (human chorionic gonadotrophin hormone)

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9
Q

What is the function of hCG?

A

Prevents lysis of the corpus luteum, to maintain oestrogen and progesterone production

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10
Q

What is the decidual reaction?

A

A process triggered by implantation, where there are changes to the endometrium to facilitate embryo growth and prevent invasion of the trophoblast further into the myometrium

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11
Q

What are changes that occur in the endometrium during the decidual reaction?

A

endometrial vascularisation to improve embryonic blood flow, glycogen/fat collection to provide nutrients, immunolgical inactivity to protect embryo from maternal T cell attack.

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12
Q

What part of the embryo will form the placenta?

A

The trophoblast (outer later of blastocyst) which will differentiate into the cytotrophoblast and syncytiotrophopblast whcih form different parts of the placenta/

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13
Q

What are the steps in chorionic villi formation

A
  1. syncytiotrophoblast cells penetrate the uterine lining, breaking down maternal blood vessels to form intervillous spaces that fill with maternal blood
  2. cytrotrophoblast sends out projections into the the syncitiotrophobast to fporm primary chorionic villi.
  3. over time, the villi develop a core of mesodermal tissue becoming secondary chorionic villi
  4. the mesodermic core form blood vessels making them tertiary chorionic villi
  5. these vessels connect to embryonic blood vessels
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14
Q

What are the 3 main functions of the placenta?

A
  1. exchange of oxygen, CO2, nutrients and wastes between mother and foetus
  2. hormone production to maintain pregnancy
  3. immunological barrier to protect foetus from microbes
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15
Q

What is the nature of blood in the umbilical arteries?

A

De-oxygenated, nutrient poor, Co2 rich

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16
Q

What is the nature of blood in the umbilical vein?

A

Oxygenated, nutrient rich

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17
Q

What is the amnion?

A

A membranous sac that contains amniotic fluid, and later forms the amniotic sac

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18
Q

What are the functions of the amniotic fluid?

A

allows foetal movements with low resistance, absorbs shock, prevents adhesion of the foetus to membranes

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19
Q

What are the physiological adaptations of the uterus to pregnancy?

A

There is increased uterine vascularity and overall size. The myometrium hypertrophies, and elastic and fibrous tissues increase to aid in contractions during labour. There is increased sensitivity of the uterus to prostaglandins and oxytocin to increase responsiveness during labour.

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20
Q

What are the physiological adaptations of the cardiovascular system to pregnancy?

A

Heart rate, stroke volume and cardiac output increase, while total peripheral resistance decreases. Blood volume increases overall due to raised oestrogen levels which trigger renin to cause sodium/water retention. Organ blood flow is increased. There is a hypercoagulable state

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21
Q

What are the physiological adaptations of the skin to pregnancy?

A

Peripheral vasodilation occurs increasing blood flow to the skin, and causing spider naevi and palmar erythema. Increased melanin levels may cause linea nigra. Striae may be caused by elastin and collagen breakdown

22
Q

What are the physiological adaptations of the metabolism to pregnancy?

A

Insulin levels rise, but insulin sensitivity decreases, which raises glucose supply to the foetus. Leptin resistance occurs to increase appetite

23
Q

What are the physiological adaptations of the cervix to pregnancy?

A

Cervix becomes hypertrophied, mucous plug obstructs cervical canal, in later pregnancy is softens via the relaxin hormone

24
Q

What are some causes of infertility?

A

STIs, medical conditions (thyroid, diabetes, pituitary issues), radiation, smoking, alcohol, obesity/underweight, drug/solvent exposure, anatomical abnormalities (male/female)

25
Q

What are the causes of age-related infertility?

A
  1. oocyte depletion
  2. increased risk of genetic mutation
  3. hormone changes
  4. erratic ovarian function
  5. uterine fibrosis/scarring
26
Q

What is the process of IVF?

A
  1. hyper-stimulation of the pituitary with GnRH agonist increase levels of FSH
  2. progesterone therapy and egg pick up
  3. oocyte insemination and fertilisation
  4. development of embryos for 7 days in a dish, then viable embryos selected
  5. one embryo is transferred to the uterus and the rest may be frozen
27
Q

What are the key forms of contraception available?

A

Combined oral contraceptives, injections, implants, IUDs, sterilisation (hysterectomy, vasectomy), barrier methods

28
Q

How do combined oral contraceptives work?

A

They thicken cervical mucus, thin the endometrium and suppress ovulation

29
Q

What are the non-contraceptive benefits of COCs?

A

reduced rate of gynaecological disorders (endometriosis, dysmenorrhoea, ovarian cysts, etc.), reduced risk of ovarian/endometrial cancer

30
Q

What are risks of taking COCs?

A

Increased risk of liver/cervical/breast cancer (though rare). Increased risk of DVT/PE due to oestrogen, hypertension

31
Q

How do progesterone only pills work as contraceptives?

A

Thicken cervical mucous and sometimes prohibits ovulation

32
Q

What are the benefits of progesterone only pills over COCs?

A

They do not increase risk of cardiovascular disease, VTE or cancer, there may be less oestrogen related side effects

33
Q

What are the downsides of progestogen only pills?

A

Periods may be irregular. You must take them at the same time everyday, and you cannot miss any pills

34
Q

What is the injectable contraceptive used in NZ?

A

Depo Provera - a progesterone intramuscular injection given every 90 days

35
Q

How do contraceptive implants, such as Jadelle, work?

A

They slowly release progesterone which thickens cervical mucus and inhibits ovulatiom

36
Q

How do hormonal IUCs work?

A

They release progesterone into the uterus, causing thickened cervical mucus, and endometrial thinning

37
Q

How do copper IUCs work?

A

They release copper which acts as a spermicide and also prevent implantation

38
Q

What are the risks/side effects of IUC contraceptives?

A

Copper may cause heavy periods, there is a small risk of infection after insertion and cannot be used with STIs/PID

39
Q

What methods can be used for emergency contraception?

A

Emergency Contraceptive Pill, Post-coital copper IUD insertion

40
Q

What is the mechanism of action of the Emergency Contraceptive pill?

A

Contains a high dose of progesterone which delays ovulation, and creates a uterine environment that is hostile to sperm.

41
Q

What are the benefits of using the barrier method for contraception?

A

Condoms are cheap (on prescription), readily available and protect against STIs

42
Q

What is parturition?

A

The process of childbirth/labour

43
Q

What occurs during the 3 phases of labour?

A

Phase 1 - dilation of the cervix up to 10cm and uterine contractions
Phase 2 - Delivery of the infant
Phase 3 - Delivery of the placenta

44
Q

What are the movements/positions the baby undergoes during labour (normally)?

A

engagement, descent, flexion, internal rotation, extension, head external rotation, expulsion

45
Q

What are the possible foetal presentations?

A

cephalic (head/face), breech (buttocks or feet), shoulder

46
Q

What is foetal presentation?

A

The part of the foetus closest to the pelvic inlet of the birth canal during labour

47
Q

What changes occur in the infant after delivery?

A

Ductos arteriosum closes to form the ligamentum arteriosis, the foramen ovale in the heart closes, ductos venosum closes to form ligamentum venosum, infant passes meconium

48
Q

What causes respiratory distress in premature infants?

A

There is an increased work of breathing because the lungs have not developed the ability to produce surfactant.

49
Q

What is female Sexual Arousal Disorder (FASD)?

A

Inability to attain or maintain sexual arosal, leading to recurrent sexual and relationship problems

50
Q

What is erectile dysfunction?

A

Inability to develop or maintain an erection during sexual activity

51
Q

What are the risk factors for erectile dysfunction?

A

Smoking, hypertension, diabetes, obesity, aging, psychological issues

52
Q

What are the steps of the PLISSIT model for discussing sexual health issues with patients?

A

P=permission
LI=limited information
SS=specific suggestions
IT=intensive therapy

ELM3 - reproduction, development & aging (6 decks)

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