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Reproduction And Pregnancy Flashcards

1
Q

What are the male and female chromosomes?

A

Male: XY
Female: XX

Determined at time of conception
-> Fetus remains undifferentiated in gonads until approximately 5 weeks

  1. Genetic Sex
  2. Gonadal Sex
  3. Phenotype
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2
Q

What is Gonadal Sex?

A

Series of events where sexually indifferent gonads and genitalia progressively acquire male or female characteristics
-> Specific GENES induce gonadal differentiation (occurs around week 5-7)

  • Drive by SRY gene on Y chromosome to develop TESTES
    -> ABSENCE of SRY will develop ovaries @ approx 9 weeks
    -> Internal and external genitalia will follow male pathway in presence of specific testicular hormones
    -> female pathway will follow in absence of these hormones
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3
Q

What are the Gonadal Sex cells?

A

Testes
- Germ cells: produce spermatogonia
- Sertoli cells: synthesize antimullerian hormone
- Leydig cells: synthesize testosterone

Ovaries
- Germ cells: produce oogonia
-> oogonia remain in primary oocyte stage of meiosis until puberty
- Granulosa Cells and Theca cells: work together to control hormone levels in follicle and bloodstream
-> synthesize progesterone and estradiol

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4
Q

What is phenotypic sex?

A

*Outward appearance of “maleness and femaleness” traits
-> Develops in response to gonadal hormones

2 Major differences in male female phenotype development:
Testosterone and Anti Mullerian Hormone (Produced in the testes)
-> In their PRESENCE, male genitalia develop -> WITHOUT it, female genitalia develop

Females have ABSENCE of androgens and PRESENCE of estrogen

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5
Q

What does Antimullerian hormone and testosterone do?

A
  • Testosterone stimulates growth and differentiation of wolffian ducts
    -> Wolffian ducts give rise to epididymis, vas deferens, seminal vesicles, and ejaculatory ducts
  • Antimullerian hormone causes atrophy of the Müllerian ducts
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6
Q

What makes up the Internal genital tract and External genitalia in males

A

Internal genital tract
- Prostate
- Seminal Vesicles
- Vas Deferens
- Epididymis

External genitalia
- Scrotum
- Penis
Differentiate at gestational weeks 9-10
Depends on conversion of testosterone to dihydrotestosterone and presence of androgen receptors on target tissue

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7
Q

What develops Female Phenotype?

A
  • Ovaries secrete ESTROGEN ! (Not antimullerian hormone or testosterone)
    -> No testosterone to stimulate growth and differentiation of wolffian ducts
    -> No antimullerian hormone to suppress differentiation of Müllerian ducts

Müllerian ducts develop into internal female tract (fallopian tubes, uterus, and upper 1/3 of vagina)

*Presence of estrogen needed for development of external female genitalia to normal size

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8
Q

What makes up female Internal Genitalia and External Genitalia

A

Internal Genitalia
- Fallopian Tubes
- Uterus
- Upper 1/3 of vagina

External Genitalia
- clitoris
- labia majora and minora
- lower 2/3 of vagina

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9
Q
A
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10
Q

Where is GnRH, FSH, and LH secreted from?

A

GnRH: hypothalamus
FSH and LH: anterior pituitary

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11
Q

What does GnRH do during puberty?

A

Pulsatile secretion of GnRH causes…
-> pulsatile secretion of FSH and LH
-> Increased sensitivity to GnRH receptors in anterior pituitary

Onset of maturational process at puberty is genetically programmed

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12
Q

What does FSH do for males?

A

Secreted by: anterior pituitary gland

Function
- Initiates production of sperm in the testes

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13
Q

What does LH do for males?

A

Secreted by: anterior pituitary gland

Function
- Stimulates secretion of testosterone by the testes

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14
Q

What does Inhibin do for males?

A

Secreted by: Testes (sustentacular cells)

Function
- Decreases secretion of FSH to maintain constant rate of spermatogenesis ( if we are good with the amount of sperm inhibin slows down the production)

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15
Q

What does Testosterone do for males?

A

Secreted by: Testes (Interstitial cells)

Functions
- Promotes maturation of sperm
- Initiates development of the secondary sex characteristics
- Growth of the reproductive organs
- Growth of the larynx
- Growth of facial and body hair
- Increased protein synthesis, especially in skeletal muscles

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16
Q

What do Male Androgens do?

A

(Responsible for secondary male sex characteristics)

Mediated by Testosterone
- differentiation of epididymis, vas deferens, and seminal vesicles
- increased muscle mass
- pubertal growth spurt
- Cessation of pubertal growth spurt (epiphyseal closure)
- growth of penis and seminal vesicles
- deepening of voice
- spermatogenesis
- negative feedback on anterior pituitary
- libido

Mediated by dihydrotestosterone
- differentiation of penis, scrotum, and prostate
- male hair pattern
- male pattern baldness
- sebaceous gland activity
- growth of prostate

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17
Q

What is Meiosis?

A

Complex cell division in sexually reproductive organisms
- 2 rounds of cell division that result in haploid gametes (1/2 the diploid number)
-> One cell with diploid (46) divides to 4 cells with haploid

Spermatogenesis
- meiosis that takes place in testes
Oogenesis
- meiosis that takes place in ovaries

Gamete (sex cell)
- sperm or egg cells
- Germ cells give rise to gametes

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18
Q

All about Spermatogenesis

A

Process of meiosis in the testes, the site of sperm production
-> FSH and Testosterone needed

Seminiferous Tubules
- contains spermatogonia (stem cells that generate sperm)

Spermatogonium
- Divides by mitosis to form a stem cell and a primary spermatocyte

Hormonal Regulation
- GnRH from hypothalamus stimulates pituitary to secrete FSH and LH, which regulate sperm production

Sperm Production
- Begins at puberty and continues throughout life
- Diminished with age

Spermatogonium -> spermatocytes -> secondary spermatocytes -> spermatids -> spermatozoa

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19
Q

All about Oogenesis

A
  • Meiosis for Egg Cell Formation *
    -> occurs in the ovaries, regulated by hormones after puberty

Ovarian Follicle Development
- Begins before birth, each containing an oogonium that becomes a primary oocyte

Meiosis (Prophase and Quiescence)
- Primary oocytes enter meiosis | prophase, then become quiescent until puberty

Puberty and Menstrual Cycle
- GnRH and FSH initiate follicle growth and estrogen production, one oocyte completes meiosis 1

Meiosis II and Fertilization
- Secondary oocyte reaches metaphase II, completes meiosis II upon fertilization

Egg Production Lifespan
- Begins at puberty, continues until menopause (30-40 years), with one mature ovum produced monthly

Meiosis and Chromosome Maintenance
- Meiosis reduces chromosome number by half, maintaining the diploid state in gametes

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20
Q

What do the testes do?

A

(Paired)

  • Responsible for producing sperm and testosterone
  • Located in scrotum
  • Contains seminiferous tubules (where sperm is produced)
  • Specific temp for sperm = 96 degrees
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21
Q

What does the epididymis do ?

A

(Paired)

  • Stores and matures sperm before they are ejaculated
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22
Q

What does the Ductus Deferens do?

A

(Paired)

  • Transports mature sperm from the epididymis to the ejaculatory ducts via peristalsis
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23
Q

What do the ejaculatory ducts do?

A

(Paired)

  • Carry sperm and seminal fluid from the ductus deferens and seminal vesicles to the urethra
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24
Q

What do the seminal vesicles do?

A

(Paired)

  • Produce an alkaline fluid that mixes with sperm to form semen (contains fructose for ATP)
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25
What does the prostate gland do?
- Produces a citric acid fluid that helps nourish and protect sperm - Smooth muscle contributes to force for ejaculation
26
What do the bulbourethtral glands do?
(Paired) - Located below the prostate gland, they empty into the urethra - Secretion is alkaline -> Helps to line the urethra prior to ejaculation and enhance sperm motility
27
What do the urethra do ?
- Carries semen to the exterior, within the penis
28
What does semen do?
- Composed of sperm and secretions from the seminal vesicles, prostate, and bulbourethral glands -> Alkaline pH -> Neutralizes the acidic pH of the female vagina
29
What do the ovaries do?
(Paired) - Produce and release eggs (ova) for potential fertilization - Ovulation stimulated by LH
30
What do Fallopian tubes do?
(Paired) - Transport the egg from the ovary to the uterus, where fertilization usually occurs - Fimbrae sweep ovum into tube -> Egg is moved by combination of peristalsis and ciliated epithelial tissue
31
What does the Uterus do?
- Provides a nourishing environment for the developing fetus during pregnancy - Myometrium: smooth muscle layer that contracts for delivery - Endometrium: lining that may become placenta -> Basilar layer is permanent -> functional layer is shed during menstruation and re generated
32
What does the Vagina do?
- Birth canal that allows for sexual intercourse and the passage of a baby during childbirth -> Extends from cervix to vaginal orifice -> Normal flora provides acidic pH that inhibits growth of pathogens
33
What do the external genitals of the female reproductive system do?
- Clitoris: small mass of erectile tissue that responds to sexual stimulation - Labia Majora and minora -> Folds of skin that enclose and cover vaginal and urethral openings
34
What does Bartholin’s Glands do?
- Open into vaginal orifice - Secretes mucus to function as lubricant
35
What do mammary glands do?
- Produce and secrete milk for the nourishment of offspring
36
What does estrogen do?
Secreted by: Ovary (follicle), Placenta during pregnancy Functions - Promotes maturation of ovarian follicles - Promotes growth of blood vessels in the endometrium - Initiates development of secondary sex characteristics -> growth of uterus and other reproductive organs -> growth of mammary ducts and fat deposition in breast tissue -> broadening of the pelvic bone -> subcutaneous fat deposition in hips and thighs
37
What does progesterone do?
Secreted by ovary (corpus luteum), Placenta during pregnancy Functions - Promotes successful implantation of embryo in endometrium - Promotes growth of blood vessels in endometrium and storage of nutrients - Inhibits contractions of myometrium
38
What does Inhibin do?
Secreted by: Ovary (corpus luteum) Functions - Inhibits secretion of FSH
39
What does Relaxin do?
Secreted by: Ovary (corpus luteum), Placenta during pregnancy Functions - Inhibits contractions of myometrium of facilitate implantation - Promotes stretching of ligaments of pubic symphasis
40
Describe hormone control in females?
- Varies during menstrual cycle - Follicular and lateral phases have NEGATIVE feedback control - Midcycle is characterized by positive feedback of estradiol
41
How does age affect the female reproductive system?
- Definitive end to reproduction - MENOPAUSE - Ovulation and menstrual cycles become irregular and finally cease - Perimenopause -> Stage preceding menopause -> Can start as early as 35 -> Irregular menses, hot flashes, mood changes - Menopause usually starts between 45 and 55 -> No menses for a full year -> Estrogen production decreases
42
What are the effects of decreased estrogen?
- Loss of bone mineral density -> may lead to osteopenia and osteoporosis - Increase in blood cholesterol -> more likely to develop CAD - Drying of vaginal mucosa -> more susceptible to infection - Urinary incontinence - Weight gain - Headaches, mood changes - Hotflashes
43
How does aging affect the male reproductive system?
- Testosterone secretion continues throughout life, as does sperm production - both diminish with advancing age Prostatic hypertrophy - Enlargement of the prostate gland - As urethra is compressed by the growing prostate gland, urination becomes difficult and residual urine in the bladder increases the chance of urinary tract infection - Usually benign -> cancer of the prostate is one of the more common cancers in elderly men
44
What is the time for normal gestation?
40 weeks -> Full term: 38-42 weeks Divided into 3 trimesters 1st trimester: weeks 0-12 2nd trimester: weeks 13-26 3rd trimester: weeks 27-40
45
What happens in the first trimester?
- Implantation of fertilized ovum in uterus (5-7 days after fertilization) - Increased fatigue - Increased urinary frequency - Possible nausea and/or vomiting “morning sickness” - Breast size may increase - Small weight gain (0-3lbs) - Emotional changes may occur - By end of 1st trimester… -> Fetus is 6-7cm long and weighs ~2oz -> Fetus has heartbeat, can kick, turn its head, and swallow -> Movements not yet felt by the mother
46
What happens in the second trimester?
- Pregnancy becomes visible to others - Mother begins to feel movement of fetus at ~20 weeks - Nausea and fatigue usually subside - By end of 2nd trimester… -> Fetus is ~14inches in length and weight ~ 1-2lbs -> Fetus has eyebrows, eyelashes, and fingernails
47
What happens in the third trimester?
-Uterus is very large and has regular contractions -> May be felt only occasionally -> Common complaints in 3rd trimester - Frequent urination - Back pain - Lower extremity edema - Fatigue - Shortness of breath - Constipation - By the time of birth… -> Baby is ~ 16-19 inches long and weighs 5-10lbs
48
Placental hormones: What does hCG do?
(Human chorionic gonadotropin hormone) - Maintains corpus luteum so it secretes estrogen and progesterone in first few months of gestation
49
Placental hormones: What does estrogen and progesterone do?
(Secretion begins w/in 4-6 weeks and continues until birth) Estrogen - Inhibit FSH and LH secretion during pregnancy - Prepare mammary glands for lactation Progesterone - Inhibits contractions of myometrium until just before birth - When progesterone secretion begins to decrease
50
Placental hormones: What does relaxin do?
- Inhibits contractions of myometrium - Creates laxity in pelvic ligaments
51
What are the key hormone changes during pregnancy?
- INCREASE in estrogen (released by placenta) - INCREASE in progesterone (released by placenta) -> important for development of uterus, maintenance of pregnancy, and preparation of breasts for lactation - INCREASE in Thyroxine release -> Increase BMR and heat production
52
What are other changes during pregnancy?
- Significant INCREASE in size of uterus - Number of blood vessels in uterus greatly increases - As fetus and uterus grow, organs are displaced upward and pressure is exerted on surrounding structures - Avg recommended weight gain during pregnancy: 23-35lbs
53
What Musculoskeletal changes occur during pregnancy?
- Postural changes as COM shifts ANTERIORLY -> Increased lumbar lordosis may occur with increased weight at front of abdomen -> Weakening of overstretched abdominal muscles -> Diastasis recti may occur -> Jt laxity due to relaxin -> Sacroiliac jts and pubic symphysis become more flexible prior to birth -> Higher rate of bone turnover for greater calcium availability
54
What cardiovascular changes occur during pregnancy?
- Increase Blood Volume -> Greater blood flow to uterus and kidneys needed to supply more oxygen to fetus uterine tissue -> Increased SV and CO - Increased HR -> Response to increased workload - Blood pressure changes -> Vascular resistance changes due to vasodilation caused by increased progesterone -> Decrease in BP in 1st and 2nd trimesters, then rises again to normal levels during last trimester - Blood Cell Changes -> Increase white blood cells -> Increased red blood cells - Physiologic anemia -> Increase in RBCs is not proportional to increase blood volume -> Hematocrit is decreased - Increased risk of blood clots -> Production of clotting factors -> Decreased fibrinolysis
55
What pulmonary changes occur during pregnancy?
- Increase oxygen consumption - Increase subcostal angle - Increase depth of respiration and rate - Increase TV and minute ventilatory volume - FRC is decreased - TLC is ~ same or slightly decreased
56
What digestive system changes occur during pregnancy?
- Decreased motility and secretions - Nausea and vomiting may occur in early pregnancy - Constipation may occur in later pregnancy
57
What urinary system changes occur during pregnancy?
- Increased GFR due to increased blood volume - Increased kidney activity - Frequency of urination increases in later pregnancy -> Bladder is COMPRESSED by uterus/fetus - Increased size of ureters and kidneys - Decreased motility of ureters - Ureters enter bladder at more perpendicular angle due to displacement -> Greater risk of urinary backflow and UTIs
58
What happens in Stage 0 of Labor?
Stage 0- Quiescence - Uterus is relaxed and cervix is closed - Braxton Hicks contractions start at the end of this stage
59
What happens in Stage 1 of Labor?
Stage 1-Activation - Uterus is readied for contractions -> Receptors for contractile stimuli (PGF 2 and oxytocin) are upregulated -> Cervix dilates in preparation for delivery
60
What happens in Stage 2 of Labor?
Stage 2- Active Labor - Myometrium maximally response to PGF 2 and oxytocin -> Strong coordinated contractions to move fetus down through birth canal - Begins with cervix 10cm dilated and ends in delivery - Passive phase- myometrium contractions - Active phase- mother pushing - Fetus position important for successful delivery
61
What happens in Stage 3 of Labor?
- After delivery of placenta - oxytocin maintains streng uterine contraction - Decrease estrogen levels leads to shrinking of uterus
62
How do Estrogen and Progesterone contribute to lactation ?
- Stimulate growth and development of breasts throughout pregnancy - Estrogen stimulates prolactin secretion by anterior pituitary -> prolactin levels steadily increase throughout pregnancy - Estrogen and progesterone BLOCK action of prolactin on breast -> Inhibitory effects released after delivery when levels of both drop Lactation - stimulated and maintained by suckling - Supply and demand - suppresses ovulation

Physiology’ (8 decks)

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