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Introduction to Physiology and Parmacology > Reproduction and Pregnancy > Flashcards

Reproduction and Pregnancy Flashcards

1
Q

What is the general structure of a Fallopian tube ?

A

Infundibulum with fimbriae
Ampulla and isthmus
Longitudinal and circular smooth muscle in walls - peristalsis
Highly folded mucosa – ciliated and secretory cells

Transports egg from ovary to uterus

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2
Q

What are the ovaries

A

Female gonads

Development and maturation of ova

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3
Q

What is the structure of the Ovaries ?

A

Cortex – outer zone with germinal epithelial layer containing oocytes
Inner medulla, – blood vessels and lymph
Oocytes enclosed within follicle
Follicular cells secrete steroid hormones:
Granulosa - 17β-oestradiol
Theca - progesterone

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4
Q

What is the uterine wall made of ?

A 
Perimetrium
Myometrium 
Endometrium
Endometrium:
thick inner layer
Highly branched
Simple columnar epithelial cells
Compound tubular glands
Spiral arteries
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5
Q

What is the Cervix and what does it do ?

A

Connect uterus to vagina

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6
Q

How does the cervix prevent a moist and warm environment so good breeding ground for microbes ?

A

Cervical glands secrete mucus.

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7
Q

What is the thin, distensible wall of the vagina made from ?

A

Adventia
Muscularis
Mucosa

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8
Q

What type of epithelia is found in the vagina ?

A

Stratified squamous epithelium rich in glycogen
fermented by bacteria to lactic acid producing pH 3.5-4 inhibits pathogens
antigen-presenting dendritic cells

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9
Q

What are the 2 female cycles ?

A

Ovarian

Endometrial

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10
Q

How does the Hypothalamic-pituitary-gonadal axis drive the menstrual cycle ?

A
  1. Hypothalamic neurones release gonadotropin-releasing hormone (GnRH) 1/hr
  2. Hypophyseal portal system connects hypothalamus to anterior pituitary
  3. G-protein coupled GnRH receptor: IP3, DAG, Ca2+ and triggers exocytosis of gonadotropins Follicle Stimulating Hormone and Lutenising Hormone, increase in intracellular calcium
  4. Triggers release by GnRH binding to receptors in anterior pituitary
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11
Q

What does FSH and LH stimulate ovary to secrete ?

A

Theca: Progesterone
Granulosa: 17β-oestradiol
Inhibin
Activin

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12
Q

How is progesterone and 17β-oestradiol synthesized ?

A

By ovarian follicle granulose and theca cells

Theca cells synthesise and secrete progesterone (from cholesterol) (short pathway)
Androstenedione diffuses from theca to granulosa cells
Granulosa cells produce 17β-oestradiol

FSH and LH stimulate this pathway

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13
Q

What do 17β-oestradiol and progesterone do ?

A

Develop ovum
Maintain corpus luteum
Maintain pregnancy

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14
Q

What does 17β-oestradiol and progesterone control change ?

A

Endometrium
Feedback regulation of FSH and LH from pituitary
Cervix and vagina:
Cervical mucus

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15
Q

What does the secretion of 17β-oestra stimulate the growth of ?

A

Endometrium
Glands
Stroma
Spiral arteries elongate

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16
Q

Describe the secretory phase of the Endometrial cycle

A

Following ovulation dominated by progesterone
Endometrial proliferation slows, thickness decreases
Glands – tortuous with accumulated glycogen vacuoles, increased mucus
Stroma – oedamatous
Spiral arteries elongate and coil
Ending in menses

17
Q

What circumstances can inhibit ovulation ?

A

Negative feedback on anterior pituitary gonadotrophs to inhibit FSH/LH and prevent ovulation

Low LH (no LH surge) inhibit ovulation

18
Q

What are some examples of hormonal contraceptives ?

A

The oral contraceptive pill (OCP) most common UK contraceptive

Numerous combinations:
Oestrogen and progesterone
Progesterone only (mini-pill)
Monophasic or fixed-combination
Multiphasis or varying-dose
18
Q

What are some examples of hormonal contraceptives ?

A

The oral contraceptive pill (OCP) most common UK contraceptive

Numerous combinations:
Oestrogen and progesterone
Progesterone only (mini-pill)
Monophasic or fixed-combination
Multiphasis or varying-dose
19
Q

How does the morning after pill work ?

A

Inhibit ovulation
Interfere with implantation
Therefore can be used as a postcoital contraceptive

20
Q

How does a sperm fertilise an egg ?

A

Around 50-100 sperm reach the ampulla of the fallopian tube, this is through their own motile action, but also though the contraction of the uterus, cervix and fallopian tubes after the initial propelling action of cervical mucus

When the sperm encounters the egg it undergoes an acrosomal reaction, exocytosis of the acrosome structure releasing hydrolytic enzymes and enabling penetration through the granulosa cells.

When the sperm reaches the glycoprotein layer beneath called the zona pellucida, it attaches to the specific ZP3 sperm binding proteins and, through the action of hydrolysing enzymes and flagellum movement, moves through enabling fusion of the membranes between sperm and oocyte and entry of contents of the sperm cell into the oocyte

21
Q

What happens when oocyte is penetrated ?

A

Penetration of the oocyte raises intracellular calcium which triggers the second meiotic division of the oocyte

This cortical reaction also triggers small granules containing enzymes to fuse with the plasma membrane.

The exocytosis enables the enzymes to act on the glycoproteins of the zona pellucida to harden the layer, destroy the ZP receptors and prevent further entry of sperm

No polyploid

22
Q

How does a blastocyst invade the endometrium ?

A

Hatching
Apposition
Adhesion
Invasion

22
Q

How does a blastocyst invade the endometrium ?

A

Hatching
Apposition
Adhesion
Invasion

23
Q

How does the placenta develop ?

A

The placentas a life support system - ~120 maternal spiral arteries bring pulsatile blood

In mature placenta, foetal + maternal blood separated by:
Foetal capillary endothelium 
Mesenchyme 
Cytotrophoblasts
Syncytiotrophoblast
24
Q

What molecules does the mother transfer to the foetus ?

A

Glucose - Facilitated diffusion

Amino acids - secondary Active transport

Vitamins - Active transport

Large molecules by receptor-mediated endocytosis:
LDL, hormones, antibodies

Oxygen exchange facilitated by higher affinity for oxygen of foetal haemoglobin

25
Q

What does the foetus transfer to the mother ?

A

Waste urea, creatinine diffusion

26
Q

What does the foetus transfer to the mother ?

A

Waste urea, creatinine diffusion

27
Q

How do hormones change during Trimester 1 of pregnancy ?

A

Corpus Luteum:

continues secretion oestrogen and progesterone to support endometrium

28
Q

How does the placenta contribute to Trimester 2-3 ?

A

Placenta 1° hormone source
Human placental lactogens (human chorionic somatomammotropins [hCS]
Coordinate fuel economy, glucose to FA – energy source
Ketone storage for neonate
Development mammary glands
Progesterone synthesised from circulatory cholesterol
Oestrogen (oestriol): placenta-foetal synthesis

29
Q

What is Quiescence ?

A

Stage 0 of Parturition

Braxton-Hicks contractions

Relaxed uterus and insensitive to uterotonic hormones

95% of gestation

30
Q

What is Stage 1 of Parturition ?

A

Activation/transformation

Prior to labour

Oestrogen stimulates prostaglandin (PG) release
Prostaglandin :
Promotes formation of gap junctions
Softening, thinning and dilation of cervix

Cortisol increases to increase oestrogen and progesterone to increase contractility

31
Q

What happens during Stage 2 Parturition

A

Stimulation/Labour/Birth

Increased PG levels:
Myometrial contraction (+ OT)
Cervical dilation
Increased myometrial connectivity
Increased myometrial responsiveness (PG & OT)
Positive feedback:
Ferguson reflex – neuroendocrine regulation OT
Uterine contraction stimulates Prostaglandins 
Stages of labour and delivery:
Dilation (placental relaxin)
Expulsion
Placental (separation from decidua)
32
Q

What is Stage 3 of Parturition ?

A

Involution Recovery from birth

Haemostasis
Vasoconstriction spiral arteries (OT – myometrium) decreases haemorrhage 
decrease in placental oestrogen
Myometrial atrophy – involution
Regression uterine vasculature
Cervix remodelling

Reestablishment endometrial cycle - 3-5 months

33
Q

What is the difference between Colostrum and Milk ?

A 
Colostrum – first milk
High fat + protein
Antibodies 
Milk – fat emulsion in aqueous solution:
Sugar (lactose)
Protein (lactalbumin + casein)
Cations and anions
34
Q

How does the breast secrete milk ?

A

via Alveoli

35
Q

What are the hormones used to promote milk production postpartum ?

A

Mammogenic (promote cell proliferation) e.g. oestrogen
Lactogenic (promote initiation milk production) e.g. PRL
Galactokinetic (promote myoepithelial contraction) e.g. OT
Galactopoietic (maintain milk production) e.g. PRL + cortisol

36
Q

What does oestrogen and progesterone inhibit during pregnancy ?

A

Inhibits anterior pituitary prolactin (PRL)

36
Q

What does oestrogen and progesterone inhibit during pregnancy ?

A

Inhibits anterior pituitary prolactin (PRL)

Introduction to Physiology and Parmacology (7 decks)

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