Reproductive System Flashcards
1
Q
The cervix has ____ qualities so it is less likely to have an infection above the cervix
A
Antibacterial
2
Q
The endometrium layer of the cervix secretes ____
A
Hormones
3
Q
The ____ is the muscle layer of the uterus
A
Myometrium
4
Q
The cervix connects to the ___ ___
A
Fallopian tubes
5
Q
The ____ (perimetrium) gives shape to the myometrium and keep the boundaries of the uterus and holds it in place
A
Cervosa
6
Q
The egg flows through the ___ ___ to get to the uterus
A
Fallopian tubes
7
Q
The ____ contain eggs
A
Ovaries
8
Q
The female reproductive system is driven by ____ function
A
Endocrine
9
Q
The hypothalamus releases gonadotropin-releasing hormone, which then stimulates the anterior pituitary to release what two hormones?
A
-Luteinizing hormone
-Follicular stimulating hormone
10
Q
Luteinizing hormone and follicular stimulating hormone stimulate the ovary to release ____ and ____ to prepare the uterus for pregnancy
A
Estrogen and progesterone
11
Q
Estrogen and progesterone provide negative feedback to the ____ and ___ ___ to stop production of these hormones during most of the female cycle
A
Hypothalamus and anterior pituitary
12
Q
It is only during days ___-___ of the menstrual cycle that estrogen and progesterone provide positive feedback to increase production of the hormones
A
12-14
13
Q
Gonadotropin-Releasing Hormone stimulates synthesis and secretion of the gonadotropins in the _____
A
Pituitary
14
Q
What are the gonadotropins that are released from the pituitary?
A
-Follicle-stimulating hormone
-Luteinizing hormone
15
Q
Luteinizing hormone binds with and stimulates the ____ cells of the ovaries which leads to androstenedione production
A
Theca
16
Q
Follicular stimulating hormone stimulates the ____ cells of the ovaries and leads to increased production of estadiol
A
Granulosa
17
Q
Androgens get converted to ____
A
Estrone
18
Q
____ is the most common estrogen and is produced in the ovaries and a small amount by the cortex of the pituitary
A
Estradiol
19
Q
____ is the metabolite of estradiol and estriol
A
Estrone
20
Q
____ is a risk factor for many reproductive cancers because fat cells produce hormones and estrogen
A
Obesity
21
Q
Estrogen has effects on the brain and is important for ____ formation and retention
A
Memory
22
Q
Estrogen stimulates ____ development as well as milk production
A
Breast
23
Q
Estrogen also regulates _____, so it has an impact on the heart and the liver
A
Cholesterol
24
Q
Estrogen also helps to preserve ____ ____
A
Bone density
25
Estrogen regulates proliferation of _____ cells
Squamous
26
Secretion of the vagina promotes ____ and ____ of sperm to increase rate of pregnancy
Motility and movement
27
____ is an ovarian hormone that the ovaries and the adrenal gland produce at a steady rate
Progesterone
28
Progesterone is increased during _____ which helps prepare the uterus to lay the egg into the clinging and mature the growing fetus
Pregnancy
29
8 weeks into pregnancy, the ____, instead of the uterus, begins making progesterone
Placenta
30
Progesterone prevents ____ labor
Premature
31
Roles of progesterone:
-Relaxation of myometrium
-Thickening of myometrium
-Promotes development of breast tissue
32
Adrenal hormones (androgens) are released from the ____ ____
Adrenal cortex
33
Androgens are precursors to ___ and ___
Estrogen and progesterone
34
Androgens contribute to ____ growth during pregnancy
Skeletal
35
Androgens are also responsible for the development of _____ sex characteristics
Secondary
36
Hormone release during the menstrual cycle is related to ____ changes
Tissue
37
The menstrual cycle is ____ days on average
28
38
Levels of follicular stimulating hormone and luteinizing hormone are higher in the first half of the cycle (follicular phase) and peak right before ____
Ovulation
39
High levels of ___ ___ trigger ovulation
Luteinizing hormone
40
Levels of estrogen are also highest before ____
Ovulation
41
Levels of ____ increase after ovulation
Progesterone
42
_____ occurs early in the menstrual cycle
Menstruation
43
The endometrium increases in ____ over the cycle
Thickness
44
The first half of the menstrual cycle is the ____ phase and the second half is the ____ phase
Follicular; luteal
45
____ occurs due to the cessation of ovarian function
Menopause
46
During menopause, there is a gradual decrease in the size of the ____
Ovaries
47
Menopause usually occurs between ages ___ and ___
45-52
48
There will be variability in the frequency and flow of menstruation ____ years prior to menopause
10
49
Mechanism of menopause:
-Atresia of oocytes
-Decreased estrogen and progesterone from the ovaries
-Increased production of follicular-stimulating hormone and luteinizing hormone
-Estrogen is still produced in the adrenal cortex and adipose tissue (conversion to androstenedione)
50
During menopause, estrogen secretion is insufficient to maintain ____ sexual characteristics
Secondary
51
Manifestations of menopause:
-Headaches and hot flashes
-Teeth loosen and gums recede
-Risk of cardiovascular disease
-Backaches
-Hair becomes thinner
-Bones lose mass and become more fragile
-Breasts droop and flatten
-Nipples become smaller and flatten
-Skin and mucous membranes become dried and develop a rough texture
-Abdomen loses some muscle tone
-Stress of urge incontinence
-Vaginal dryness, itching, and shrinking
52
___ ___ ___ may alleviate some symptoms of menopause, but it increases the risk of coronary heart disease
Hormone replacement therapy
53
Who should take hormone replacement therapy?
-People under 47 years old
-Those with severe hot flashes
-Those with osteoporosis
54
Hormone replacement therapy should be given in the ____ effective doses for the shortest period time
Lowest
55
____ is the absence or suppression of menstruation
Amenorrhea
56
Primary amenorrhea is a failure of ____ (no onset of menses; age 14 if there is no sex characteristics, 16 if there is sex characteristics)
Menarche
57
What are the compartments of primary amenorrhea?
I: Uterus
II: Ovary
III: Anterior pituitary
IV: Hypothalamus
58
Amenorrhea caused by a defect in the ovaries is common in girls with ____ ____
Turner's syndrome
59
Secondary amenorrhea is the absence of menstruation for ___ or more cycles or 6 months in women who have previously menstruated
3
60
Secondary amenorrhea is normal during...
-Early adolescense
-Peri-menopausal period
-Pregnancy
-Lactation
61
Secondary amenorrhea can be caused by...
-Diseases
-Dramatic weight loss (malnutrition, excessive exercise)
62
Pathophysiologic categories of secondary amenorrhea:
-Normal ovarian hormone secretion (pregnancy, uterine dysfunction->hysterectomy, adhesions)
-Increased ovarian hormone secretion (feminizing tumors, masculinizing hormones, PCOS)
63
Secondary amenorrhea can also be caused by decreased ____ hormone secretion
Ovarian
64
High ____ levels can cause secondary amenorrhea by stimulating menopause as well as acquired ovarian failure
Gonadotropin
65
What can cause acquired ovarian failure?
-Autoimmune disease
-Chemotherapy
-Resistance to gonadotropins
-Environmental toxins
66
Low gonadotropin levels can cause secondary amenorrhea by causing things like...
-Hyperprolactinemia
-Tumor or trauma to hypothalamus or pituitary
-Disorders extrinsic of H-P tract like starvation, stress, psychogenic disorder, and endocrine disease)
67
PCOS affects ___-___% of all women
5-10
68
PCOS is the leading cause of _____
Infertility
69
PCOS is diagnosed by 2 or more of what three symptoms?
-Oligo/anovulation
-Elevated adrogens
-Polycystic ovaries
70
The pathophysiology of PCOS is ___-___
Mult-factorial
71
____ may cause PCOS because it increases free testosterone levels
Hyperinsulinemia
72
High testosterone levels can...
-Suppress follicular apoptosis
-Cause excess androgen to be converted to estrogen
73
High estrogen continues to suppress what two hormones?
-FSH
-LH
74
The high estrogen (and low FHS and LH) perpetuates follicular _____ ____, but not maturation and ovulation
Tissue development
75
The accumulation of follicular tissue causes...
-Ongoing androgen secretion
-Ongoing cycle
76
There may be ____ and ____ factors that contribute to the development of PCOS
Genetic and lifestyle
77
Manifestations of PCOS:
-Acne
-Hirsutism
-Obesity
-Hormone irregularities
-Irregular menstrual cycles
-Infertility
-Insulin resistance
-Diabetes
-Dyslipidemia
-Endometrial carcinoma
-Cardiovascular disease
-Non-alcoholic liver disease
78
There are both ____-____ and ___ ___ related manifestations of PCOS
Hormone-driven; metabolic syndrome
79
With ____ ____ disorders, the endopelvic fascia and perineal muscles stretch and lose tone/strength
Pelvic relaxation
80
People with pelvic relaxation disorders are unable to maintain ____ in the proper position
Organs
81
Precipitating factors for pelvic relaxation disorders:
Anything that increases intra-abdominal pressure
82
____ helps to maintain elasticity of tissues
Estrogen
83
A ____ ____ is a descent of the cervix or entire uterus into the vaginal canal
Uterine prolapse
84
First-degree uterine prolapse is a descent of the cervix/uterus within the ____
Vagina
85
Second degree uterine prolapse is when the cervix protrudes through the ____
Introitus
86
Third-degree uterine prolapse is when the vagina is completed ____
Everted
87
The goal is to prevent uterine prolapse with ____ ___ (Kegel)
Muscular exercise
88
____ can be useful for those at risk for uterine prolapse post-manopause
Estrogen
89
A ____ can be used to prevent prolapse, and surgery can be done as a last resort
Pessary
90
____ is the descent of the bladder into the vaginal canal
Cystocele
91
Cystocele causes...
-Feelings of pressure
-Difficulty in completely emptying the bladder
-Can increase the risk of bladder infections
92
Cystocele can be treated with ____ exercises to strengthen the pelvic floor muscles or the use of a vaginal pessary
Kegel
93
_____ is usually caused by trauma to the fascia during childbirth
Rectocele
94
Chronic _____ contributes to the development of rectocele
Constipation
95
Rectocele causes symptoms like...
-Constipation
-Feelings of rectal fullness
-Difficult defecation
96
____ ____ ____ is inflammation caused by infection
Pelvic Inflammatory Disease
97
The incidence of pelvic inflammatory disease is ___ million per year and causes ____ cases infertility per year
1; 100,000
98
Consequences of pelvic inflammatory disease are associated with ____
Scarring
99
The etiology of pelvic inflammatory disease is mediated by a failure of normal ____ ____
Defense mechanisms
100
Pelvic inflammatory disease can cause...
-Inflammation
-Scar tissue formation with adhesions to nearby tissues and organs
-Can lead to necrosis and abscess formation
101
_____ is caused by the presence of functioning endometrial tissue outside of the uterus
Endometriosis
102
The endometrial tissue that is outside of the uterus also responds to ____ fluctuations in the menstrual cycle
Hormonal
103
There is a ___-___% incidence of endometriosis
3-15
104
___-___% of infertile women have endometriosis
30-40%
105
What are possible etiology/mechanisms of endometriosis?
-Retrograde flow (common in most women)
-Decreased immune response to endometrial cells outside of the uterus
-Genetic pre-dispositioin
106
In 80% of cases of endometriosis, uterine tissue implants in the ____
Ovary
107
Timeline of endometriosis:
-Bleeding adhesions
-Inflammation
-Pain, fibrosis, scarring
108
Manifestations of endometriosis:
-Dysmenorrhea
-Abnormal bleeding
-Pain with intercourse
-Constipation
-Infertility
109
____ cancer is the 2nd most common cancer in women worldwide (12,000 new cases and 4,000 deaths/year in the United States)
Cervical
110
There has been a dramatic decrease in incidence of cervical cancer (45%) since the ____ screening was developed
PAP
111
Infection with the ___ ___ virus is necessary for the development of cervical cancer
Human Papilloma
112
What are the two general types of HPV?
-Low-risk types
-High-risk types
113
Low-risk types of HPV are associated with...
-Genital warts
-Mild pap test abnormalities
114
High-risk types of HPV are associated with...
-Mild to severe Pap test abnormalities
-Cervical cancer
115
Most genital HPV infections are transient and ____, and have no clinical consequences
Asymptomatic
116
HPV ___ and ____ account for the majority of cervical cancer cases (all 3 vaccines fight against these two)
16; 18
117
HPV is also associated with what other types of cancers?
-Vagina
-Vulvar
-Penile
-Anal
-Oropharyngeal
118
What are three available HPV vaccines?
-Bivalent (Cervarix)
-Quadrivalent (Gardasil)
-9-valent (Gardasil 9)
119
Genital warts have a very high incidence; as many as ____ out of every 100,000 people have HPV-associated genital warts
100
120
Incidence of cervical cancer is about ___ people out of every 100,000
8.3
121
Transmission of genital HPV can be from...
-Anal
-Oral
-Vaginal
122
Transmission of HPV can occur from ____ and subclinical patients
Asymptomatic
123
Cervical cancer risk factors for women:
-Immune status
-Smoking as a co-factor
-Multiple births
-Long-term oral contraceptive use
-Chronic inflammation
-Poor oral hygiene (for oropharyngeal cancers)
124
With cervical cell abnormalities, the HPV infects stratified squamous epithelium and stimulates ____ ___
Cellular proliferation
125
Cervical cancer requires persistent ____ (many clear the infection, but there are some high risk types)
Infection
126
Grading systems for cervical cell abnormalities:
-Pap
-Colposcopy
-Bioposy
127
Cervical cancer symptoms:
-Usually asymptomatic in pre-invasive stages
-Abnormal vaginal bleeding
-Lower extremity bleeding due to pelvic lymph node obstruction
-Metastasis to bone and lung
128
_____ carcinoma arises from glandular epithelium of the uterine lining
Endometrial
129
Endometrial cancer is the most frequent cancer in the _____ and is responsible for 7% of all cancers diagnosed in females
Pelvis
130
The peak occurrence of endometrial cancer is between age ___ and ___
55 and 65
131
Each year, there are ____ new cases of endometrial cancer with 6,800 deaths
40,100
132
Risk factors for endometrial cancer:
-Unopposed estrogen (high levels)
-Insulin
-HNPCC
-Obesity
-Nuliparity
-Diabetes
-PCOS
133
____ ____ could possibly be protective against endometrial cancer by decreasing estrogen levels
Cigarette smoking
134
Manifestations of endometrial cancer:
-Asymptomatic
-Post-menopausal bleeding
-Late symptoms include cramping, pelvic discomfort, postcoital bleeding
-Large tumors may be necrotic and hemorrhagic
135
There are about ____ new cases of ovarian cancer per year with about 16,000 deaths per year
25,000
136
Ovarian cancer is the top cause of ____ related to gynecologic cancers
Death
137
1 in ____ women will develop ovarian cancer
70
138
What are some types of ovarian cancer?
-Epithelial
-Germ cell malignancies
-Stromal tumors
-Mucinous
-Endometrioid and clear cell
-Serous
139
____ endometrial cancer is the least common
Mucinous
140
Endometrioid and clear cell ovarian cancer are associated with _____
Endometriosis
141
Low-grade serous ovarian cancer is asymptomatic but ___-___
Chemotherapy-resistant
142
High-grade serous ovarian cancer accounts for ___% of tumors (only 5% are stage I at diagnosis); this is the most common and most lethal for of ovarian cancer
70
143
There is new evidence that ovarian tumors originate in the ___ ___
Fallopian tubes
144
What factors increase the risk of ovarian cancer?
-Age
-Family history of cancer
-Obesity
-Nulliparity (has not given birth)
-Increased number of lifetime ovulatory cycles
-Hormone replacement therapy
145
What factors decrease the risk of ovarian cancer?
-Oral contraceptive use
-Oopherectomy
-Hysterectomy
-Tubal ligation
-Lactation
-Salpingectomy
-Bilateral salpingo-oophorectomy
146
Manifestations of ovarian cancer:
-Urinary frequency and urgency
-GI upset (indigestion, constant feeling of fullness)
-Pelvic and/or abdominal pain or discomfort
-Pelvic and/or abdominal bloating or swelling
-Unexplained weight loss or gain
-Fatigue
-Abnormal postmenopausal bleeding
-Pain during intercourse
147
The ____ are located in the scrotum outside the body; they are composed of tightly coiled tubules that produce sperm
Testes
148
Testes produce what two hormones?
-Testosterone (more potent and abundant)
-Androsterone
149
Production of testosterone throughout the lifecycle:
-Begins during fetal development and continues for a short time after birth
-Nearly stops during childhood
-Resumes at puberty
150
Testosterone is a steroid hormone and is responsible for...
-Growth and development of the male reproductive structures
-Increased skeletal muscle growth
-Enlargement of the larynx accompanied by voice changes
-Growth and distribution of body hair
-Increased male sex drive
151
Newly produced sperm is stored in the _____, which is just outside and to the rear of each testicle; this is where the sperm develops
Epididymis
152
The ___ ___ is a muscular duct that connects the epididymis and the ejaculatory duct; it carries sperm out toward the urethra during ejaculation
Vas deferens
153
The ___ ___ is the area formed by the union of the two vas deferens ducts (one from each testis) and the duct from the seminal vesicles
Ejaculatory duct
154
The ____ is the tube that runs through the penis and drains the excretory and reproductive systems
Urethra
155
____ ____ are a gland located behind the bladder and empty into the ejaculatory duct; mucous, amino acids, fructose, and prostaglandins are found making up the fluid; makes up 60% of semen volume
Seminal vesicles
156
The ____ ____ is a large gland that surrounds the upper portion of the urethra; it gives off a thin, milky secretion containing several enzymes; it neutralizes the acidic urine residue in the urethra and activates sperm
Prostate gland
157
The ___ is composed of 3 cylinders of spongey erectile tissue
Penis
158
Follicular stimulating hormone stimulates ____ cells to make sperm; this inhibits further FSH from being produced (negative feedback)
Sertoli
159
Luteinizing hormones stimulates ____ cells that make testosterone; this is also a negative feedback loop
Leydig
160
The ____ muscle raises and lowers the scrotum to help regulate temperature and promote spermatogenesis
Cremaster
161
In summary, the male reproductive system is all about supporting ____ production and its transport to the ovum
Sperm
162
____ cancer is responsible for only 1% of all cancers in men, but is the most common cancer in men who are between 15-35 years old
Testicular
163
Etiology and risk factors for testicular cancer:
-Cryptorchidism (undescended testes): 50% of cases
-Exogenous estrogen during mother's pregnancy
-Trauma
-Infection
-Chromosomal abnormalities (loss of chromosome 11, 13, 18, abnormal chromosome 12p)
-The link between vasectomy and testicular cancer is weak; a vasectomy could increase the rate of progression of an existing, undetected tumor
164
Classifications of testicular cancer:
-Germ cell tumors (Seminoma, non-seminoma)
-Stromal (less common)
165
Manifestations of testicular cancer:
-Painless testicular enlargement
-Ache in abdomen/groin
-Heavy feeling in scrotum
-10% have acute scrotum pain
-5% present with gynecomastia
-Misdiagnosis as epididymitis (25%)
-10% have metastases at diagnosis (typical delay in diagnosis of 3-6 months)
166
___ ___ are used to identify metastases and to track response to treatment
Tumor markers
167
What tumor markers are used to identify testicular cancer?
-Alpha Feto-Protein: glycoprotein
-Human chorionic gonadotropin (HCG)
-Lactate dehydrogenase
168
Testicular cancer is extremely _____ (95% cure rate!)
Chemosensitive
169
___% of people with testicular cancer will have a recurrence and 99% can be cured if discovered and treated early
10%
170
Disease free survival of ___ years is indicative of cured testicular cancer
3
171
Negative prognostic indicators for testicular cancer:
-Presence of liver, bone, or brain metastasis
-Very high serum markers
-Primary mediastinal nonseminoma
-Large number of lung metastases
172
____ ___ ___ is an abnormal increase in the number of cells (hyperplasia) (NOT hypertrophy, or size of cells)
Benign prostatic hyperplasia
173
Benign prostatic hyperplasia is a ____ disease, most frequently affecting those aged 40-45
Common
174
Benign prostatic hyperplasia may be due to a metabolic product of testosterone called _____ if testosterone production is blocked
Dihydrotestosterone
175
Investigation of Benign prostatic hyperplasia is focused on levels and ratios of various ____ factors
Endocrine
176
With Benign prostatic hyperplasia, hyperplasia occurs near the ____ in the periurethral glands
Urethra
177
Manifestations of Benign prostatic hyperplasia:
-Firm, enlarged prostate upon rectal exam
-Decreased vigor of urinary stream, increased frequency, urgency, urinary hesitancy and dribbling, hematuria, infections
-Progressive bladder distension with diverticular outpouchings of the bladder wall
-Ureter obstruction (can lead to hematuria, infections, and bladder calculi)
-If untreated, urine backs into kidneys causing hydronephrosis and possible renal failure
178
____ cancer is the most frequently diagnosed cancer in men
Prostate
179
Prostate cancer is the ___ leading cause of cancer death in men
2nd
180
Prostate cancer is a disease of ___, and is often found on post-mortum exams
Aging
181
Etiology of prostate cancer:
-Adenocarcinoma with unknown etiology
182
Prostate cancer is an ____-sensitive tumor
Androgen
183
Prostate cancer may be due to an increased ___/___ ratio
Estrogen/Dihydrotestosterone
184
Risk factors for prostate cancer:
-Aging
-Hereditary/genetics
185
What are the four stages of prostate cancer? (These indicate the mitotic rate of the cancer cells)
-A
-B
-C
-D
186
___ ___ ___ can be used to screen for prostate cancer
Prostate screening antigen
187
Prostate cancer can lead to ____ ____ metastasis
Lymph node
