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Physiology > Reproduction 2 > Flashcards

Reproduction 2 Flashcards

1
Q

primary amenorrhea

A

absence of menses in phenotypic female by age 17

- e.g. Turner syndrome (XO), androgen resistance

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2
Q

secondary amenorrhea

A

cessation of menstruation for longer than 6 months

- e.g. pregnancy, lactation, menopause

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3
Q

oligomenorrhea

A 
infrequent periods (cycle length >35 days)
- e.g. stress, illness, changes in body fat, intense exercise
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4
Q

dysmenorrhea (& what promotes prostaglandins)

A

painful menses related to uterine contraction, nausea, vomiting, diarrhea
- E2 and progesterone promote prostaglandins which cause uterine contractions

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5
Q

causes and consequences of PCOS

A

insulin resistance and obesity

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6
Q

how does high insulin impact ovaries? what do you treat with?

A

stimulates androgen production, causing impaired follicle development and no ovulation; follicles degrade into cysts and ovaries double in size
- treat with metformin

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7
Q

when is the window of opportunity for fertilization?

A

24 hours post-ovulation for the ovum and 48-72 hours post-coitus for the sperm

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8
Q

where does fertilization occur?

A

in the fallopian tubes

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9
Q

two exocytotic events during the fertilization process

A

1) Exocytosis of spermatozoan internal membrane contents- allows sperm to attach to zona pellucida
2) Exocytosis of oocyte’s internal vesicles- harden the rest of the zona pellucida (Ca2+ mediated- also triggers second meiotic division after metaphase II)

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10
Q

what primes female tract to aid sperm transport to the oviduct; what facilitates and what enhances sperm motility

A
  • primes: estrogen
  • facilitates: decreased acidity and viscosity of mucus
  • enhances: ciliary movement, peristaltic movement, fluid flow
    cGMP enhances velocity and direction
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11
Q

what three processes is embryo implantation made up of?

A

adhesion, penetration, invasion

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12
Q

what happens during adhesion?

A
  • zona pellucida dissolves
  • Il-1 increases integrins in endometrial cells
  • osteopontin (bridging molecules) binds integrins together
  • trophopblasts develop
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13
Q

what happens during penetration?

A
  • stromal cells of endometrium enlarge to form the decidua (progesterone-promoted) and secrete nutrients (source until placenta)
  • cells preform some endocrine functions (e.g. prolactin)
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14
Q

what happens during invasion?

A
  • find balance between decidual cells and trophoblast migration
  • trophoblasts differentiate into syncytiotrophoblasts (like pituitary- most endocrine functions, makes hCG/hCL) and cytotrophoblasts (like hypothalamus- CRH, TRH, somatostatins)
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15
Q

functions of the placenta

A

1) gut- supplies nutrients
2) lungs- gas exchange (high pCO2)
3) kidneys- regulating fluid volume and waste disposal (urea, creatinine)
4) endocrine gland

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16
Q

what is hCG produced by/what is it under the control of?

A

produced by syncytiotrophoblasts, under control of GnRH from cytotrophoblasts

17
Q

what does high hCG signal?

A
  • negative feedback on maternal pituitary to prevent LH/FSH secretion (which would normally stimulate next cohort of follicles to develop)
  • rescues corpus luteum, stimulates progesterone and estradiol
18
Q

what is hPL?

A

HCS aka human placental lactogen (HPL)

  • similar to growth hormone
  • stimulates lipolysis and has anti-insulin effects on maternal metabolism
  • leads to increase in plasma glucose and FFA for fetus
  • cause of gestational diabetes
19
Q

T/F Gestational age is two weeks less than fetal age

A

FALSE- “Fetal age” is about 2 weeks less than gestational age.

20
Q

T/F 100 or less sperm arrive at distal end of the fallopian tube

A

FALSE- 50 or less

21
Q

what is relaxin produced by and what does it do?

A
  • produced by: corpus luteum and placenta
    1) inhibits myometrial (uterine) contractions
    2) relaxes pelvic bones
    3) softens cervix
22
Q

T/F Prolactin comes from the placenta

A

FALSE- from maternal pituitary

23
Q

what is lactation inhibited by?

A

estrogen and progesterone

24
Q

what is the major estrogen of pregnancy

A
  • estriol
25
Q

how is estriol produced?

A

mom’s cholesterol (LDL)- pregnenolone in placenta- converted by fetal adrenal to DHEA-S- converted by fetal liver to oh-DHEA-S- sulfer removed by placenta- placenta makes estriol

26
Q

what does the conjugation of sulfur do?

A

makes it more water soluble, less bioactive

27
Q

effects of progesterone during pregnancy

A

establishment/sustenance of the fetus including:

  • inhibiting uterine contractions/prostaglandins
  • decreasing sensitivity to OXT
  • inhibits maternal immune response
  • mammogenesis- alveolar pouches, capacity to secrete milk
28
Q

effects of estrogens during pregnancy

A
  • mammogenesis- growth of ducts

* growth of myometrium, softens pelvis, enlargement of genitalia

29
Q

describe the estrogen:progesterone ratio

A

estrogen progesterone- birth

30
Q

what are the actions of progesterone and estrogen in birth control?

A

progesterone- prevents LH secretion

estrogen- inhibits FSH

31
Q

cardiovascular changes in pregnancy

A 
increased CO- HR and SV
reversible cardiomegaly 
50% increase in blood volume
MAP decreases
TPR decreases 
venous pressure increases 
uterus gets 30% of CO
skin blood flow increases (increased metabolism)
blood flow to kidneys increases
32
Q

respiratory changes during pregnancy

A

increase in tidal volume

no change in frequency

33
Q

GI changes with pregnancy

A

decreased motility, greater nutrition assimilation

LES tone decreased

34
Q

metabolic changes with pregnancy

A

first 1/2- mom in anabolic state, increases fat and glycogen stores
second 1/2- catabolic state with insulin resistance mediated by HPL

35
Q

cortisol’s relationship to parturition

A
  • CRH peaks at labor (no surge though)
  • potentiates contracture response to PGEs/OXT
  • CRH from placenta/fetus increases E2
36
Q

how does myometrial cell contracture change with parturition?

A
  • decrease in P:E2 ratio
  • increases local prostaglandins
  • increased cell Ca++
  • more forceful contractions
37
Q

T/F Maternal oxytocin initiates labor

A

FALSE- released in bursts once labor beings, has positive feedback loop, stimulating prostaglandin release
- stimulus is distention of the cervix: Ferguson reflex

38
Q

catecholamine actions during parturition

A

alpha-adrenergics- stimulates contraction
beta-adrenergics- inhibits contraction

E2& prostaglandins increase alphas
stress can precipitate labor

39
Q

how does lactating reduce fertility?

A

neural inputs from spinal cord have inhibitory action on arcuate nucleus and pre-optic nuclei causing a decrease in GnRH

Physiology (22 decks)

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