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Phase 1 Cards > SUGER > Flashcards

SUGER Flashcards

1
Q

What are the two parts of the pituitary?

A

anterior and posterior

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2
Q

How many hormones does the anterior and posterior pituitary secrete?

A

anterior- 7

posterior- 2

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3
Q

What hormones does the anterior pituitary secrete?

A 
FSH- follicle stimulating hormone)
LH- luteinising hormone
ACTH- adrenocorticotropic hormone
GH- growth hormone
TSH- thyroid stimulating hormone
MSH- melanocyte stimulating hormone
Prolactin
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4
Q

What hormones are secreted by the posterior pituitary?

A

ADH- antidiuretic hormone / vasopressin

Oxytocin

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5
Q

What does LH and FSH do in women?

A

LH: stimulates ovulation, ovarian follicle maturation and corpus luteum formation
FSH: regulates development and growth of ovarian follicle

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6
Q

What does LH and FSH do in males?

A

LH: testosterone formation
FSH: stimulates production of androgen-binding protein (ABP) and spermatogenesis

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7
Q

What type of hormones are FSH and LH?

A

gonadotrophins

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8
Q

How does oestrogen levels affect FSH and LH?

A

MODERATE levels of oestrogen present experts NEGATIVE feedback on FSH and LH

HIGH oestrogen (with low progesterone) exerts POSITIVE feedback on LH and FSH

Oestrogen in PRESENCE OF PROGESTERONE exerts NEGATIVE feedback on FSH and LH

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9
Q

What is ACTH?

A

adrenocorticotrophic hormone

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10
Q

Where is ACTH produced?

A

corticotrophs

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11
Q

What does ACTH do?

A

produce cortisol

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12
Q

What are the functions of cortisol?

A 
gluconeogenesis 
carbohydrate metabolism
reduction of inflammation
proteolysis and lipolysis 
reduction of bone formation (can lead to osteoporosis over time)
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13
Q

What is GH produced?

A

somatotrophs

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14
Q

What is the function of GH?

A 
skeletal growth and bone density 
muscle strength
protein synthesis
glycogenolysis 
lipolysis
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15
Q

Where is TSH produced?

A

thyrotrophins

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16
Q

What does TSH do?

A

increases metabolism

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17
Q

Where is prolactin produced?

A

lactotrophs

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18
Q

What inhibits release of prolactin?

A

dopamine

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19
Q

How is prolactin release initiated?

A

suckling

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20
Q

What is the function of prolactin?

A

initiates milk production in breasts

maintain milk production once It has been established

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21
Q

What are the two main groups of anterior pituitary hormones and what do they do?

A

hypophysiotropic hormones- control secretion of anterior pituitary
peptide hormones- control secretion of other endocrine glands

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22
Q

What is GnRH and what does it do?

A

gonadotrophin-releasing hormone, stimulates release of FSH and LH

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23
Q

What is CRH and what does it do?

A

corticotrophin-releasing hormone, stimulates release of ACTH

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24
Q

What is GHRH and what does it do?

A

growth hormone releasing hormone, stimulates release of GH

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25
Q

What is TRH and what does it do?

A

thyrotrophin-releasing hormone, stimulates release of TSH

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26
Q

What is the affect of dopamine on the anterior pituitary?

A

inhibits release of prolactin

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27
Q

What is the affect of somatostatin on the anterior pituitary?

A

inhibits secretion of GHRH

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28
Q

Where is oxytocin made?

A

paraventricular nucleus of hypothalamus

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29
Q

What is the function of oxytocin?

A

acts on breasts to allow milk to flow from lactiferous ducts and out of nipple
acts on uterus to cause uterine contractions during labour
exerts positive feedback on itself

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30
Q

Where is ADH made?

A

supraoptic nucleus oh hypothalamus

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31
Q

Describe the action of ADH?

A

osmoreceptors in hypothalamus detect change
ADH binds to V2 receptors on collecting ducts
mobilisation of aquaporin 2 (AQP2) and insertion into cell membranes
allows passage of water from collecting ducts into blood to reduce plasma osmolality
increased water reabsorption

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32
Q

How is blood pressure maintained under action of ADH?

A

maintains blood pressure by acting on smooth muscle cells, causing vasoconstriction and increasing blood pressure

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33
Q

What bodily factors cause ADH release?

A

low blood volume/ blood loss
low blood oxygen
high blood carbon dioxide
high oncotic pressure of blood

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34
Q

Where are the islets of langerhans found and what is their general function?

A

pancreas

manufacture and release peptide hormones

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35
Q

What cells are found in the islets of langerhans and what do each secrete?

A

alpha cells- secretes glucagon
beta cells- secretes insulin
delta cells- somatostatin

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36
Q

What is the function of glucagon?

A

mobilises glucose, free fatty acids and triglycerides from stores
stimulates breakdown of fat and muscle into glucose

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37
Q

What does insulin do?

A

decrease glucose output by liver
increase storage of glucose, free fatty acids and triglycerides
stops breakdown of fat and muscle

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38
Q

What does somatostatin do?

A

inhibits GHRH release

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39
Q

Describe the action of insulin?

A

insulin binds to insulin receptors on muscle and fat cells
triggers intercellular signalling cascade
this mobilises intracellular GLUT4 vesicles to cell membrane
GLUT4 vesicle integrates into cell membrane, which:
1. increases number of glucose transports
2. increases rate of glucose facilitated diffusion
3. decreases blood glucose levels

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40
Q

What happens as glucose levels rise in the blood?

A

insulin is released and glucagon release is inhibited
increased glycogenesis in liver and muscles
glyconeogenesis is inhibited
this reduces blood glucose level

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41
Q

What happens as blood glucose levels fall?

A

glucagon is released and insulin release is inhibited
glycogenolysis occurs to release glucose from liver and muscles into blood
gluconeogenesis occurs
blood glucose level is increased

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42
Q

What does the thyroid gland produce?

A

triiodothyronine (T3) and thyroxine (T4)

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43
Q

Describe the anatomy of the thyroid.

A

butterfly shaped gland
2 lobes: left and right
4 parathyroid gland on posterior surface

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44
Q

Describe the location of the thyroid.

A

anterior neck between C5-T1

wraps around cricoid cartilage + superior tracheal rings

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45
Q

Describe the blood supply to the thyroid.

A

supplied by superior and inferior arteries

superior: branch of external carotid
supplies superior and anterior portion of gland

inferior: branch of subclavian
supplies posterior and inferior portion of gland

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46
Q

How is T3 and T4 produced?

A

mnemonic- ATE ICE

A: (secondary) active transport of iodide via Na/I symporter
T: thyroglobulin is produced in the follicular cells
E: exocytosis of thyroglobulin into follicular lumen

I: iodination of tyrosine residues on thyroglobulin to form monoiodothyronine (MIT) and diiodothyrine (DIT)
C: coupling of MIT and DIT (T3) and DIT and MIT (T4)
E: endocytosis of T3 and T4 into follicular cells. Proteolysis occurs to free T3 and T4 from thyroglobulin

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47
Q

What is the general action of T3 and T4?

A

increase BMR, important for brain maturation

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48
Q

What is the role of T3 in brain maturation?

A 
in fetus: 
formation of axon terminal 
production of synapses 
growth of dendrites and dendritic extensions
formation of myelin

in adult:
provides proper nerve-muscle reflex and normal cognition

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49
Q

What are the layers of the skin from outermost to innermost?

A

epidermis, dermis, subcutaneous layer

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50
Q

What are the 5 layers of epidermis from outermost to innermost?

A 
stratum corneum
stratum licidim
stratum granulosum 
stratum spinosum
stratum basale
51
Q

What provides cell-cell adhesion for the skin?

A

primary adherens junctions
desmosomes (striatum spinosum)
tight-junctions

52
Q

What do tight junctions in the skin do?

A

make it waterproof

53
Q

What do corneodesmosomes do?

A

keep corneocytes together

54
Q

What is filaggrin and what does it do?

A

natural moisturising factor (NMF)

allows skin to remain hydrated and maintains slightly acidic pH of skin

55
Q

Why is the skin slightly acidic?

A

prevents protease activity to stop breakdown of corneodesmosomes

56
Q

What is the affect of increased pH on the skin?

A

proteases no longer inhibited by low pH so they break down corneodesmosomes

impairs formation of lipid lamellae
this allows skin cells to move apart
this reduces water retention in skin
allergens can then penetrate

57
Q

What is the affect of allergens on the skin?

A

allergens penetrate skin and attract lymphocytes which release inflammatory cytokines giving an inflammatory response

gives:
red skin/ erythema- dilation of vessels to bring more lymphocytes to area
itchy skin- stimulation of proprioceptors by release of histamine (from mast cells)
dry skin- skin cells leak water

58
Q

What secretes sebum?

A

sebaceous glands

59
Q

How does acne occur?

A

hair follicle gets blocked with sebum, skin cells and bacteria
inflammation and attraction of neutrophils
pus formation

60
Q

Describe the nerve supply of the bladder.

A

AUTONOMIC:

sympathetic:
hypogastric nerves: relaxation of detrusor muscle (urine retention)

parasympathetic:
pelvic splanchnic: contraction of detrusor muscles (micturition stimulation)

SOMATIC:

pudendal nerves: innervated external urethral sphincter (contraction or relaxation)

61
Q

What is micturition?

A

release of urine from bladder

62
Q

Describe the bladder stretch reflex arc

A

bladder fills and stretches
activates stretch receptors
afferent sensory nerves transmit signal to brain
interneurons relay signal to parasympathetic efferent nerves (pelvic nerve)
contracts detrusor muscle
stimulations micturition

63
Q

What is the name for emptying the bladder

A

voiding

64
Q

Describe how the bladder voids

A

detrusor muscle contracts to increase pressure in the bladder
internal urethral sphincter relaxes
once its appropriate to void, external; urethral sphincter will be continuously relaxed to allow voiding

65
Q

Where does the pelvic splanchnic nerve exit the spinal cord?

A

S2-S4

66
Q

Where does the hypogastric nerve exit the spinal cord?

A

T12-L2

67
Q

Where does the pudendal nerve exit the spinal cord?

A

S2-S4

68
Q

What is the function of oestrogen in pregnancy?

A

regulates levels of progesterone
prepares uterus for baby
prepares breasts for lactation
induces synthesis of receptors for oxytocin

69
Q

Where is oestrogen made during pregnancy?

A

first 2 months- corpus lute in ovaries, then placenta

70
Q

What is the function of progesterone in pregnancy?

A

prevents miscarriage by building up endometrium for support of placenta

inhibits uterine contractility so gets is not expelled prematurely

71
Q

What produces progesterone in first 2 months of pregnancy?

A

corpus luteum of ovaries

72
Q

What is the function of hCG?

A

stimulates oestrogen/ progesterone production by ovary

73
Q

What hormone gives a positive pregnancy test?

A

hCG- human chorionic gonadotrophin

74
Q

When does hCG diminish?

A

when placenta is mature enough to take over oestrogen/ placenta production

75
Q

What produces prolactin?

A

anterior pituitary

76
Q

What is the function of prolactin?

A

increase cells that produce milk

prevent ovulation

77
Q

What action stimulates prolactin release?

A

suckling

78
Q

When is relaxin level highest?

A

in early pregnancy

79
Q

What produces relaxin?

A

ovary and placenta

80
Q

What is the function of relaxin?

A

softens cervix
helps limit uterine activity
cervical ripening for delivery

81
Q

What is the function of oxytocin in pregnancy?

A

triggers ‘caring’ reproductive behaviour

uterine contractions during pregnancy and labour

82
Q

What drug is used to induce labour?

A

oxytocin, synthetic prostaglandins

83
Q

What is the function of prostaglandins?

A

tissue hormones- roles in initiation of labour

84
Q

What is the main prostaglandin?

A

PGF2a

85
Q

What changes can be seen in a pregnant woman vascular system?

A 
increased CO
decreased systemic BP
decreased total peripheral resistance 
increased uterine blood flow 
increased blood volume 
increased plasma and blood cell mass
varicose veins
86
Q

What respiratory changes occur in a pregnant woman?

A

increased alveolar ventilation

87
Q

What GI changes can be observed in a pregnant woman?

A

increased acid reflux

gastroparesis (delayed emptying)

88
Q

What changes in the skin can be seen in pregnant women?

A

linea nigra
striae gravidarum
darkened areola

89
Q

What is linea nigra?

A

hyperpigmentation in pregnant women- dark vertical line that runs down abdomen

90
Q

What is the proper term for a ‘pregnancy line’?

A

linea nigra

91
Q

What is the proper name for stretch marks?

A

striae gravidarum

92
Q

What are some biochemical changes in pregnant women?

A

weight gain
increased protein and liid synthesis
insulin resistance

93
Q

What type of women have less weight gain in pregnancy?

A

obese women, as they already have fat stores

94
Q

What is a other term for labour?

A

parturition

95
Q

When does labour occur?

A

40 weeks after the 1st day of last cycle

96
Q

What is the term for softening of the cervix?

A

cervical ripening

97
Q

How many stages are there in labour?

A

3

98
Q

Why does cervical ripening need to occur before birth?

A

the allow dilation

99
Q

How does cervical ripening occur?

A

occurs in response to oestrogen, relaxin and prostaglandins breaking down cervical connective tissue

100
Q

What initiates uterine contractions?

A

oxytocin

101
Q

What signals the first stage of labour and what occurs?

A

from beginning of labour until cervix is fully dilated (10cm)

2 phases:

latent phase: slow cervical dilation over several hours

active phase: faster dilation until 10cm

102
Q

What happens in the 2nd and 3rd stage of labour?

A

second: from full dilation until baby is delivered
third: after delivery until placenta has been delivered

103
Q

What are the layers of the uterus from outermost to innermost?

A

perimetrium
myometrium
endometrium

104
Q

What happens to endometrium during menstrual cycle?

A

changes thickness

105
Q

What layer of the uterus contains the smooth muscle?

A

myometrium

106
Q

Describe the development of the placenta.

A

blastocyst implants on endometrium
this is a synctiotrophoblast
goes into the endometrium
forms fingerlike projections called chorionic villi
these contain fetal blood vessels
villi closest to connecting stalk of developing embryo are most vascular and contain mesoderm
this area is the chorion frondosum
cells in this area proliferate and become placenta
the connecting stalk becomes the umbilical cord

107
Q

When is placental development usually complete?

A

by 10 weeks gestation

108
Q

What is gestation?

A

time between conception and birth

109
Q

What is hcS and what is its function?

A

somatotropin

stimulates mammary development

110
Q

Describe follicular development

A

this is when granulose cells surround oocyte forming the follicle

primordial follicle
small spidery follicle
secondary (preantral) follicle
pre-ovulatory (antral) then ovulation
luteinization
corpus luteum
luteolysis/ regression of follicle
111
Q

What are the phases of the menstrual cycle?

A

follicular phase
ovulation
luteal phase

112
Q

How long is the follicular phase of menstruation?

A

start of menstruation to ovulation- 14 days

113
Q

What occurs in the follicular stage of the menstrual cycle?

A
  • when follicles reach secondary follicle stage they develop FSH receptors
  • they then require FSH stimulation to develop further
  • as follicles grow the granulose cells secrete more and more oestrogen, which has negative feedback on pituitary gland, leading to decreased LH and FSH
  • increasing oestrogen also makes cervical mucus more permeable which allows sperm to penetrate
  • one follicle develops further than others becoming dominant follicle
  • LH spikes before ovulation causing dominance follicle to release ovum from ovary
  • ovulation occurs 14 days before end of cycle
114
Q

How long is the luteal phase of menstruation?`

A

from ovulation to start of menstruation- 14 days

115
Q

What occurs in the luteal phase of the menstrual cycle?

A
  • follicle which releases ovum collapses and becomes corpus luteum
  • corpus luteum secretes high levels of progesterone to maintain endometrial lining and thicken cervical mucus
  • corpus luteum also secretes small amount of oestrogen
  • at fertilisation,, synchotrophoblast of embryo secrete hCG which maintains corpus luteum
  • if no fertilisation, corpus luteum degenerates causing a fall in oestrogen and progesterone
  • this causes endometrium to break down and menstruation to occur
  • stromal cells of endometrium release prostaglandins which encourage breakdown of endometrium

-

116
Q

On what day of the menstrual cycle does menstruation begin?

A

day 1

117
Q

How does ceasing of negative feedback allow the menstrual cycle too restart?

A

negative feedback from oestrogen and progesterone on the hypothalamus and pituitary gland ceases, allowing LH and FSH levels to rise so the cycle restarts

118
Q

Describe the steps of fertilisation

A
  • around ovulation the primary oocyte undergoes meiosis leaving a haploid cell, the other 23 chromosomes become a polar body
  • fertilisation occurs at ampulla of Fallopian tube
  • sperm attempt to penetrate corona radiate and zone pellucida to fertilise egg
  • usually only 1 sperm will get through before layers shut other sperm out
  • when sperm enters the 23 chromosomes of egg multiple into 2 sets
  • one set combines with 23 chromosomes from sperm and the other 23 create second polar body
119
Q

Where does fertilisation occur?

A

ampulla of Fallopian tube

120
Q

Describe the process of implantation.

A
  • fertilised egg is called a zygote
  • zygote divides rapidly to form the morula
  • during this process the mass of cells travel along Fallopian tube towards uterus
  • while travelling it becomes a blastocyst and loses the outer two layers
  • by the time the blastocyst enters the uterus (8-10 days after ovulation) it contains 100-150 cells
  • the cells of the trophoblast adhere to stroma of endometrium
  • the synchtiotrophoblast forms projections into the stoma
  • when implantation occurs, the synctiotrophoblast starts to produce hCG
  • hCG helps maintain corpus luteum in ovary so that it continues to produce progesterone and oestrogen
121
Q

What ducts are involved in embryology of a human?

A

mesonephric/ wolffian

paramesonephric/ mullerian

122
Q

When does development of external genitalia begin?

A

3rd week

123
Q

What is oogenesis and spermatogenesis?

A

processes of formation of female or male gametes

Phase 1 Cards (9 decks)

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