Reproductive System Flashcards

1
Q

What does gonadotropin-releasing hormone stimulate the anterior pituitary to produce?

A

FSH and LH

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2
Q

What cells around the follicles in the ovary produce oestrogen?

A

Theca and granulosa cells

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3
Q

What effect does oestrogen have on hypothalamus and anterior pituitary?

A

Supress the release of GnRH from hypothalamus and LH+FSH from anterior pituitary

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4
Q

What is the most prevalent and active version of oestrogen?

A

17-beta oestradiol

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5
Q

What changes does the action of oestrogen on its receptors stimulate in the body?

A

Breast tissue development, development of female sex organs in puberty, blood vessel development in uterus, development of endometrium

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6
Q

What are oestrogen and progesterone?

A

Steroid sex hormones

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7
Q

where is progesterone produced normally and during pregancy?

A

Corpus luteum after ovulation normally
In pregnancy progesterone is produced from placenta after 10 weeks gestation

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8
Q

What does progesterone cause?

A

Thickening of cervical mucus
Thickens and maintains the endometrium
Increase body temperature

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9
Q

Why is it that overweight girls tend to undergo puberty earlier?

A

Aromatase enzyme is found in adipose tissue. The more adipose tissue the more aromatase which is important in creation of oestrogen

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10
Q

How is GnRH produced in puberty?

A

Initially during sleep, then throughout the day in later stages

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11
Q

What are the four stages of development a follicle undergoes in the ovary?

A

Primordial follicles
Primary follicles
Secondary follicles
Antral follicles

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12
Q

Which stages of development of the follicles in the ovary occurs independently to the menstrual cycle?

A

Primordial follicles developing into primary and secondary follicles

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13
Q

After what stage do follicles develop receptor for FSH and require FSH stimulation for further growth?

A

Secondary follicles develop FSH receptors

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14
Q

What is a dominant follicle?

A

A follicle that develops further than the rest during a menstrual cycle

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15
Q

A spike in what hormone causes ovulation?

A

LH

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16
Q

What maintains corpus luteum if ovum becomes fertilised?

A

HCG produced from the syncytiotrophoblast of embryo maintains corpus luteum

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17
Q

What happens with corpus luteum if egg is not fertilised and how does this affect hormone levels?

A

Initially corpus luteum produces progesterone and smaller amounts of oestrogen, it degenerates if ovum isnt fertilised and stops producing hormones so there is a drop in progesterone and oestrogen

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18
Q

What does a drop in the oestrogen and progesterone levels cause?

A

Causes the endometrium to break down and menstruation to occur
Drop in negative feedback to hypothalamus and pituitary also allows LH and FSH to rise

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19
Q

What are the 3 layers of a primary follicle?

A

Primary oocyte in centre
Zona pellucida
Granulosa cells

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20
Q

What are the two layers of the theca folliculi?

A

Inner layer- secretes androgen hormones
External layer- smooth muscle and collagen

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21
Q

What is the change seen from development from secondary follicle to antral?

A

Development of an antrum which is a single fluid filled areas within granulosa cells

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22
Q

What happens in a follicle at ovulation?

A

LHsurge causes contraction of smooth muscle in external thecal layer bursting follicle. Digestive enzymes from follicle create a hole in ovary wall for ovum to pass through

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23
Q

How doe the granulosa and thecal cells change in corpus luteum?

A

They become luteal cells producing steroid hormones- particularly progesterone

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24
Q

What is the decidua?

A

Cells of the stroma (supportive outer tissue of endometrium) converted into a tissue specialised to provide nutrients to the trophoblast

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25
Q

What tissues are derides from the ectoderm?

A

CNS, skin, hair, teeth, nails

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26
Q

What tissues are derived from the mesoderm?

A

Bone, Muscle, Heart, connective tissue, blood, kidneys

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27
Q

What tissues are derived from the endoderm?

A

GI tract, lungs, liver, pancreas, thyroid, reproductive system

28
Q

At what week gestation does the fetal heart form and start to beat?

A

Six weeks

29
Q

What are spiral arteries in the uterus?

A

Artery branches from the myometrium into the endometrium which are thicker walled and coiled

30
Q

What are chorionic villi?

A

Finger like projections of the syncytiotrophoblast which grow in the endometrium when the blastocyst implants on the endometrium. They contain fetal blood veesels

31
Q

What is the chorion frondosum?

A

Vascular area of chronic villi near connecting stalk which contain mesoderm. This proliferates and becomes the placenta

32
Q

what does the connecting stalk become?

A

The umbilical cord

33
Q

When is placenta development complete?

A

Usually by ten weeks gestation

34
Q

Which direction do the umbilical arteries and vein take blood to and from the baby?

A

The 2 umbilical arteries carry deoxygenated blood from the baby to the placenta
The umbilical vein carries oxygenated blood from the placenta to the baby

35
Q

How is oxygen able to be taken up by fetal blood from placenta?

A

Fetal haemoglobin has a higher affinity for oxygen

36
Q

What are the five main function of the placenta?

A

Respiration, nutrition, excretion, endocrine, immunity

37
Q

What does oestrogen help with in pregnancy?

A

Helps soften tissues allowing muscles and ligaments of the uterus and pelvis to expand and cervix to soften ready for birth
Enlarges breasts and nipples for birth

38
Q

what does progesterone help with in pregnancy? What are some side effects?

A

Maintains endometrial blood supply, relaxes muscles so uterus doesn’t contract
Relaxing of other muscles like lower oesophageal sphincter (heart burn), bowel (constipation) and blood vessels (flushing, hypotension, headaches)

39
Q

What physiological change in pregnancy may lead to improvement in autoimmune conditions and increased susceptibility to diabetes and infections?

A

Increase in ACTH production causing increased steroid hormones like cortisol

40
Q

Why are skin changes like linea nigra and melisma more common in pregnancy?

A

Increased melanocyte stimulating hormone production from anterior pituitary

41
Q

How do thyroid test levels changes in pregancy?

A

TSH level remains the same, T3 and T4 increase

42
Q

How do HCG levels change in early pregnancy?

A

The levels rise doubling every 48 hours, plateauing around 8-12 weeks then gradually fall

43
Q

What changes are seen in the cervix and vagina with increased oestrogen?

A

Increased cervical and vaginal discharge, cervical ectropion more likely and hypertrophy of vaginal muscles

44
Q

What effect do prostaglandins have on the cervix during childbirth?

A

They break down the collagen in the cervix allowing it to dilate and a face during childbirth

45
Q

What cardiovascular changes are seen in pregnancy?

A

Increased blood volume, plasma volume, cardiac output, stroke volume and heart rate. Reduced peripheral resistance with decreased blood pressure

46
Q

Why are varicose veins seen in pregnancy?

A

Peripheral vasodilation and obstruction of inferior vena cava by uterus

47
Q

What are some respiratory changes seen in pregnancy?

A

Increased tidal volume and respiratory rate in later pregnancy

48
Q

What renal changes are seen in pregnancy?

A

Increased GFR from increased blood flow to kidneys
increased aldosterone so more water and salt reabsorption
increased protein excretion
dilatation of ureters and collecting system

49
Q

What are some haematological changes seen in pregnancy?

A

Increased RBC production (not as much as plasma volume so haematocrit falls resulting in anaemia)
Clotting factors increase- hypercoagulable state
Decreased platelets
Increased WBCs

50
Q

What are some biochemistry changes seen in pregnancy?

A

Increased ALP (due to secretion from placenta)
Reduced albumin (increased loss from kidneys)

51
Q

Is postpartum hair loss normal?

A

Yes and usually improves within 6 months

52
Q

What is the first stage of labour?

A

From the onset of true contractions until 10cm cervical dilatation

53
Q

what is the second stage of labour?

A

From 10cm dilatation to delivery of baby

54
Q

What is the third stage of labour?

A

Delivery of baby to delivery of placenta

55
Q

Pessaries containing what can be used to induce labour?

A

Prostaglandin E2 (dinoprostone)

56
Q

What are Brixton hicks contractions?

A

Occasional and irregular contractions of uterus, which can cause temporary and irregular cramping or tightening feelings. They dont indicate onset of labour.

57
Q

In the first stage of labour, what is meant by ‘show’?

A

The mucus plug in the cervix preventing bacteria entering uteru falls out breathing space for baby to come out

58
Q

What are the three phases seen in the first stage of labour?

A

Latent phase: 0-3cm at 0.5cm an hour, irregular contractions
Active phase: 3-7cm at 1cm an hour, regular contractions
Transition phase: 7-10cm at 1cm an hour, strong and regular contractions

59
Q

What are the 3 Ps which determine the success of the second stage pf labour?

A

Power, passenger and passage

60
Q

In labour what are the 4 descriptive qualities of the foetus?

A

Size
Attitude (posture e.g how back is rounded/limb or heads flexed),
Lie (position of foetus in relation to mum)
Presentation (part of foetus closest to cervix)

61
Q

What are the different possible lies of a foetus?

A

Longitudinal- foetus is straight up and down
Transverse lie- foetus straight side to side
Oblique- foetus at an angle

62
Q

What are the different presentations of a foetus?

A

Cephalic
Shoulder
Breech (legs first)

63
Q

What are the different types of breech presentation?

A

Complete breech- hips and knees flexed (cannonball into pool)
Franck breech- hips flexed and knees extended, bottom first
Footling breech- with a foot hanging through the cervix

64
Q

What are the seven cardinal movements of labour?

A

Engagement, descent, flexion, internal rotation, extension, restitution and external rotation, expulsion

65
Q

When is active management of the third stage of labour considered?

A

Haemorrhage or more than 60 minute delay in delivery of placenta

66
Q

What is active management of the third stage of labour?

A

Intramuscular oxytocin