TBL 12 (Module VI) Flashcards
(168 cards)
1
Q
Hormones produced by ovary
A
Estradiol, progesterone, action, relaxin, inhibin
2
Q
Define menarche
A
Initiation of menses (~12 years)
3
Q
Phases of ovarian cycle and when they occur
A
Follicular phase (1-14), ovulation (14-15), luteal phase (15-28)
4
Q
Phases of uterine cycle and when they occur
A
Menstrual phase (1-5), proliferative phase (6-14), secretory phase (15-26), pre-menstrual phase (27-28)
5
Q
Follicle stages in order
A
Primordial, primary, secondary, Graafian
6
Q
Where do the majority of ovarian cancers arise from?
A
Germinal epithelium
7
Q
Define corona radiata
A
1st layer of granulose cells right next to zone pellucida
8
Q
What differentiates primary follicle from primordial?
A
Begin to see differentiation of granulose cells; fibroblasts in outermost edge
9
Q
What differentiates a secondary follicle from primary?
A
Presence of theca interna and externa
10
Q
What differentiates a Graafian follicle from a secondary follicle?
A
Location within the ovary; follicle will try to migrate towards the surface
11
Q
When can follicular atresia occur?
A
Any stage of follicular development
12
Q
Which hormones are involved in the regulation of follicle development?
A
GnRH, FSH, LH, estradiol, inhibin B
13
Q
What hormones are produced by the developing ovarian follicle?
A
Estrogen and progesterone (in response to FSH, LH)
14
Q
Where is GnRH synthesized? Where is it released to?
A
Neuroendocrine cell bodies in arcuate and preoptic nuclei; primary capillary plexus of median eminence
15
Q
What happens to GnRH pulses during late follicular phase?
A
Incr. GnRH pulse frequency d/t positive feedback of estradiol on both hypothalamus and gonadotrophs of ant. pituitary
16
Q
What happens to GnRH pulses during luteal phase?
A
Decr. GnRH pulse frequency d/t negative feedback of progesterone on both hypothalamus and gonadotrophs of ant. pituitary
17
Q
Regulation of GnRH pulses
A
Stimulatory: Estradiol, NE
Inhibitory: Progesterone, dopamine, endorphins, melatonin, CRF
18
Q
Where is inhibin B secreted from? Describe its effect.
A
Granulosa cells (of follicle); selectively decr. FSH secretion, causing LH surge, and high occupancy of LH receptors, which leads to suppression of LH-induced synthesis of androgen precursors, and therefor decr. estradiol synthesis
19
Q
Where is inhibin A secreted from? Describe its effect.
A
Granulosa lutein cells; decr. secretion of both FSH and LH
20
Q
Follicular FSH target
A
Granulosa cells (only of primary follicle, not primordial)
21
Q
Aromatase function
A
Convert androgens to estradiol
22
Q
Follicular LH target
A
Theca and granulosa cells
23
Q
Describe the “LH surge” and when it occurs
A
In late follicular phase, high occupancy of LH receptors (induced by FSH) on theca cells by LH blocks the androgen precursors needed for estradiol synthesis
24
Q
Effects of LH surge (5)
A
Incr. GnRH pulse freq.; incr. responsiveness of gonadotrophs to GnRH; luteinization of granulosa cells (thus incr. progesterone prod.); oocyte completes 1st meiotic division; activation of proteolytic enzymes which degrade follicular wall to create “stigma” (through which Graafian follicle will burst
25
Why does LH "come down" in late luteal phase? What is the result of this?
Negative feedback of progesterone: progesterone from corpus lute feeds back to decrease GnRH, also down regulating GnRH receptors on gonadotrophs, causing decreased LH. As a result corpus lute becomes the corpus albicans.
26
What is responsible for "rescuing" the corpus luteum?
hCG from implanting blastocyst
27
What hormone is hCG similar to?
LH
28
From what structure do ovarian cysts originate?
Graafian follicles
29
Describe the hormonal changes associated with polycystic ovarian syndrome
Elevated androgens and LH but decreased FSH
30
What are the possible sites that ovarian tumors originate from?
Surface epithelium, oocytes, follicular cells or stromal cells
31
What hormones are decreased in menopause? What are the associated symptoms, and which deficiency is to blame?
Progesterone, estrogen, inhibin; estrogen, causing bone loss, hot flashes, increased risk for coronary artery disease
32
One possible treatment for menopause
Estrogen, progesterone replacement therapy to counteract symptoms
33
3 layers of oviduct
Mucosa, muscularis, serosa/adventitia
34
Where does fertilization occur?
Ampulla
35
Which oocyte structure contains receptors for sperm?
Zona pellucida
36
What process precipitates formation of the 2nd polar body?
Sperm nuclei entering oocyte, which triggers completion of meiosis II
37
What process prevents polyspermia?
Cortical reaction
38
Describe the acrosome reaction
Enzymes associated with acrosome digest path through zona pellucida
39
Acanthosis nigricans
Insulin resistance
40
3 layers of uterus (incl. cell type)
Endometrium (simple columnar epi), myometrium (muscularis), perimetrium (serosa/adventitia)
41
Describe the composition of the myometrium
Bundles of smooth m. interlaced with collagen fibers
42
What is the stratum vasculare?
Middle circular and thickest of the 3 layers of the myometrium, contains arcuate arteries
43
Where are arcuate arteries found in the uterus?
Stratum vasculare
44
Hormones that affect uterus and their function
Estrogen (proliferation, maintains/increases contractility, formation of gap junctions), progesterone (decr. contractility), relaxin (inhibits contractions), oxytocin (stimulates contractions)
45
Name the layers of the endometrium. Which grows and is lost with each cycle?
Stratum basale, stratum functionale; stratum functionale
46
Describe cervix at time of ovulation
Glands here secrete watery mucus that facilitates entry of sperm
47
Describe cervix at times other than ovulation
Glands here secrete viscous mucus that prevents entry of sperm and other microorganisms
48
Where are nabothian cysts found?
Transition zone between simple columnar epithelium and stratified squamous at external os of cervix; caused by mucus retention in gland as squamous epithelium grows over mucus-secreting columnar epithelium
49
What area is sampled by a pap smear?
Transition zone between simple columnar epithelium and stratified squamous at external os of cervix
50
Hormones that affect cervix and their function
Estrogen (induces watery mucus), progesterone (indices viscous mucus) and relaxin (softens cervix at parturition by breakdown of collagen fibers; produced by corpus lute and placenta
51
Layers of the vagina
Mucosa (stratified squamous epi, lamina propria), muscularis (bilayer; thinner inner circular and thicker outer longitudinal), adventitia/serosa (dense fibroelastic CT)
52
Hormones that affect vagina and their function
Estrogen (maintains thickness and stimulates production of glycogen which is converted tot lactic acid by vaginal flora to maintain acidic pH) and progesterone (decr. proliferation and increases differentiation)
53
Endometriosis cause and symptoms
Uterine endometrial tissue undergoes retrograde; pain, sterility, scarring
54
Describe pubertal changes to breast tissue
Estradiol causes nipples and areola to enlarge, proliferation of duct system and increase in stroma
55
4 possible stages/forms of breast tissue
Immature, pregnant, lactant, postmenopausal
56
When is glandular tissue present in the breast?
Pregnancy and lactation
57
What stage(s) of breast development exhibit no glandular tissue
Inactive/resting
58
Cell types in lactiferous ducts
Stratified sqamous and stratified cuboidal
59
Cell types in terminal lobular ducts
Simple columnar/cuboidal epithelium
60
What type of connective tissue is present in interlobar stroma?
Dense irregular connective tissue
61
What type of connective tissue is present in interlobular stroma?
Dense irregular connective tissue
62
What type of connective tissue is present in interlobular stroma?
Loose connective tissue
63
P'eau d'orange
Dimpling of skin d/t edema s/t advanced breast ca
64
Where does mammary gland drain to (lymphatics)?
Axillary node(s)
65
Describe phases of pregnancy with regards to breast tissue development
1st half: proliferative, in that secretory alveoli develop
| 2nd half: lobules enlarge from hypertrophy of secretory alveoli and secretion of colostrum
66
List all changes to breast tissue that occur during pregnancy
Nipples enlarge and become more pigmented; ductal system completes development; CT and adipose tissue reduced in stroma; glandular tissue develops (alveoli fill lobules, vascularity increases, connective tissue reduced)
67
Important components of colostrum
Protein, vitamin A, IgA
68
Important components of breast milk
Protein, fat, lactose, IgA
69
When does breast milk production begin?
Day 4 after birth (transition from colostrum)
70
Function of oxytocin (with respect to breast tissue)
Contraction of myoepithelial cells
71
Where are mucous glands of Little found? Function?
Surrounding urethra of corpus spongiosum; secrete a clear mucus on erection
72
What hormone suppresses prolactin in non-pregnant women?
Dopamine
73
What hormone stimulates pubertal breast development and further breast hyperplasia during pregnancy?
Prolactin
74
What hormone stimulates milk synthesis and secretion after the drop in estrogen and progesterone at the end of pregnancy?
Prolactin
75
List the "background hormones" associated with breast development
Glucocorticoids, insulin, GH, thyroxine, IGFs
76
What 2 neuroendocrine reflexes are associated with lactation?
Lactogenesis and milk "let-down"
77
What hormone is responsible for lactogenesis? Where does it come from?
Prolactin; pars distalis
78
What hormone is responsible for milk ejection/"let-down"? Where does it come from?
Oxytocin; pars nervosa
79
Describe lactational amenorrhea
Prolactin inhibits release of GnRH to prevent another pregnancy, causing less FSH and LH to be secreted, in turn decreasing follicle development
80
2 components of mammary gland regression after cessation of pregnancy
Resorption of alveolar/duct tissue and re-establishment of adipose
81
2 changes to breast tissue in post-menopausal women
CT decreases in amount and density, further involution of ducts
82
When does implantation occur, with respect to menstrual cycle?
Secretory phase, days 21-24
83
What hormone is responsible for corpus luteum rescue? What secretes it?
beta-hCG; synctitiotrophoblasts
84
Define decidual reaction
Continued production of estrogen and progesterone causes hypertrophy of endometrial stromal cells in preparation for pregnancy
85
Describe the changes in stromal cells associated with the decimal reaction
Hypertrophy, will also contain large amounts of glycogen and lipids to become decidual cells
86
Describe function(s) of decidual cells
Provide nutrients to fetus before mother-fetus vascular exchange is established; provide a barrier to further invasion of uterine wall; hormone release - prolactin (suppress maternal immune response to fetus), prostaglandins (soften cervix, contrition of uterine smooth m.), relaxin (stimulated by hCG and also produced by corpus luteum and placenta; suppresses myocetrial contractions in early pregnancy and softens cervix)
87
Changes to myometrium during pregnancy
Hypertrophy and hyperplasia
88
2 layers of trophoblast and their functions? Which is mitotically active?
Cytotrophoblast (inner layer) contains trophoblast-producing cells, synctitiotrophoblast (outer layer) is a multinucleate cytoplasmic mass that invades epithelium + stroma of endometrium; cytotrophoblast is mitotically active
89
Endometrium cell type
Simple columnar epi
90
What is meant by the placenta being a "transient endocrine organ"?
Synthesizes and secretes hormones that are not subject to maternal or fetal regulation
91
Define chorion
Fetal side of placenta (plate, free + anchoring villae)
92
Define decidua basalis
Maternal side of placenta
93
What crosses the placental barrier?
Steroid hormone, Transferrin (caries iron), Alcohol and drugs, Gases and nutrients, Maternal Antibodies ("STAGMA")
94
Cytotrophoblast secretions
IGF-I, IGF-II
95
Synctitiotrophoblast secretions
hCG, human placental GH, human chorionic ACTH, human chorionic thyrotropin, human chorionic somatomammotropin, inhibit A, estrogen and progesterone (last 2 from fetal adrenal gland)
96
What hormone can be used to assess fetal health? Why?
Estrogen (not progesterone, synthesis of which is independent of fetus); synthesis of these steroid hormones during pregnancy requires a concerted effort between mother and fetus in that placenta takes over secretion at end of 1st trimester, because sex steroid suppress maternal hypothalamic-pituitary axis
97
What causes prolactin's lactogenic effect to commence?
Drop in estrogen and progesterone at parturition; previously they were blocking the effect of prolactin on mammary gland
98
2 functions of the testes
Spermatogenesis and steroidogenesis
99
What histologic tissue type is interstitial tissue of the testis? What are the components found here?
Loose connective tissue; fibroblasts and Leydig cells with significant cytoplasm
100
Leydig cell function
Synthesize and secrete testosterone
101
3 parts of convoluted seminiferous tubule
Lamina, basement membrane, seminiferous epithelium (Sertoli cells + spermatogenic cells)
102
What cells give structural organization to the seminiferous tubules?
Sertoli cells
103
5 types of spermatogenic cells (in order of increasing maturity)
Spermatogonia, primary spermatocyte, secondary spermatocyte, spermatid, spermatozoa
104
Define spermatogenesis. What are the 3 phases?
Process of spermatogonia maturing to become spermatozoa; mitosis, 2 rounds of meiosis and spermiogenesis (spermatids becoming spermatozoa)
105
What process/structure is associated with the "cytoplasmic bridge," and what's the point?
Spermatogenesis, seminiferous tubules of testis; sharing of gene products between haploid cells so they can be supplied with protein and RNA for diploid cells
106
Defining characteristic of spermatogonia
Always in contact with basal lamina
107
Defining characteristic(s) of primary spermatocyte
Largest germ cell present, strands of heterochromatin
108
What step of spermatogenesis introduces genetic variation?
Primary spermatocytes undergo meiosis II to become secondary spermatocytes
109
Steps of spermiogenesis
Nuclear condensation, acrosome formation, flagella formation, cytoplasm reduction (by Sertoli cells), release into lumen
110
Where do spermatozoa develop motility?
Epididymis (non-motile in seminiferous tubules)
111
Sertoli cell functions (5)
Support and nurse sperm; structural organization of tubules; phagocytose unneeded cytoplasmic portions of spermatids; tight junctions between cells separate epithelia into basal and adluminal components; provide structural basis for blood-testis barrier
112
Sertoli exocrine secretions
Fluid, androgen-binding protein (stimulated by FSH)
113
Sertoli endocrine secretions
Estradiol (neonatal/prepubertal Sertoli cells contain aromatase), inhibin B, Mullerian inhibiting factor, growth factors
114
Importance of blood-testis barrier
Isolates genetically different antigenic haploid material from immune system
115
What 2 factors is spermatogenesis highly sensitive to?
Temperature and hormones (cryptorchidism could degenerate most spermatogenic cells)
116
What reflex is responsible for positioning the testes away from heat of the body
Cremaster
117
What muscle contracts to draw testes closer to body in cold temperature
Dartos
118
Where do 90% of cervical cancers occur?
Squamocolumnar junction
119
Pap smear sampling site?
External os/transformation zone (of cervix)
120
Worrisome cytologic features on Pap smear?
High N:C ratio, nuclei irregularity, mitotic figures, "clumping"
121
Pap smear classifications
LSIL, HGSIL, invasive cancer
122
Standard tx for early stage cervical ca?
Radical hysterectomy
123
Define kolicytic atypia
Nuclear alterations with perinuclear "halo" on a Pap smear, which are associated with HPV/LSIL/HSIL
124
Hemosiderin-laden macrophages with endometrial stroma appearance on ovary mass...
Endometrioma (ectopic chocolate-filled cyst, characteristic of endometriosis)
125
Define endometriosis
Presence of ectopic endometrial tissue outside uterus
126
What causes the brown appearance of fluid seen in endometriomas?
Previous hemorrhage that occurs in response to hormonal stimulation
127
Effect of LH on testicles?
Stimulates Leydig cells to secrete testosterone
128
Effect of FSH on testicles?
Stimulates Sertoli cells to secrete estrogen, ABP, and initiate spermatogenesis during puberty
129
What hormone stimulates Sertoli cells to initiate spermatogenesis?
FSH
130
What hormone provides negative feedback on anterior pituitary to inhibit FSH production?
Inhibin B
131
Levels of which hormone correlate with total sperm count?
Inhibin B
132
Testosterone target?
Androgen receptor
133
Effect of placental hCG on fetal testes?
Produce moderate amounts of testosterone
134
What hormone (in men) experiences diurnal rhythm during puberty?
FSH (increases at night)
135
Causes of male hypogonadism (3)
After age 40: decr. LH pulse freq., decr. SHBG, decr. DHT
136
Effect of hypergonadism after puberty
Hair loss
137
Hypergonadism causes (5)
Hypothalamic tumor; gene causing activating mutation of LH receptor; congenital adrenal hyperplasia; androgen-producing tumors; pinealoma (destroys pinealocytes)
138
Nocturnal pineal gland secretion
Melatonin
139
Primary hypogonadism labs
Hypergonadotropic hypogonadism: High LH, low T
140
Secondary hypogonadism labs
Hypogonadotropic hypogonadism: low FSH, LH, T
141
Rete testis cell type
Simple cuboidal/"low columnar"
142
Define tubuli recti
Very short, straight section of terminal seminiferous tubules
143
What structure(s) connect the rate testis to the epididymis?
Excurrent (efferent) ductules
144
Excurrent ductules cell type? What cells comprise line these tubules?
Pseudostratified columnar epi; tall cells (with cilia), short cells (with microvilli) combine to give a "wavy" appearance
145
What tubules/ductules reabsorb most of the fluid generated by the seminiferous tubules?
Excurrent (efferent) ductules (and later by epididymis)
146
Where do spermatozoa gain motility?
Body of epididymis (inhibitory proteins prevent motility until after ejactulation)
147
Main function of tail of epididymis?
Reservoir for mature sperm
148
Where are principals cells found in the male reproductive tract? What is their function?
Ductus epididymis (embedded in pseudo stratified epithelium); possess stereocilia for absorption
149
Cell type of the mucosa in vas deferens
Stereociliated pseudostratified columnar epithelium
150
Layers of vas deferens
Mucosa, lamina propria, muscularis (3 layers, middle circular thickest relatively of any in the body), adventitia
151
What differentiates ejaculatory duct from vas deferens?
No muscularis layer in ejaculatory duct
152
Control over seminal vesicle muscularis is carried out by what?
Testosterone
153
Main function of seminal vesicle
Store fluid that washes sperm out, dilutes sperm, and neutralizes acidity
154
Seminal vesicle secretions
Fructose (nurture sperm), fibrinogen, prostaglandins
155
What is the largest accessory sex gland in men?
Prostate
156
Prostate function
Secretes and stores a thin, milky, alkaline substance that comprises 25-30% of ejaculate; also adds clotting enzymes (groups sperm) and fibrinolysin (breaks it up 15-30 min later)
157
Prostate serum secretions
PSA and PAP (phosphatase, important in metastatic CaP)
158
Characteristic feature of prostate tissue
Corpora amlylacea (concretions)
159
What are androgens converted to in prostate? Which enzyme is responsible?
DHT; 5-alpha-reductase
160
5 zones of the prostate
Peripheral, transition, central, fibromuscular, periurethral
161
What prostate zone is the site of most cancers?
Peripheral
162
What prostate zone is the site of the 2nd most cancers?
Transition
163
What prostate zone is the site of BPH?
Transition
164
Difference between orchiectomy and GnRH agonist's effect on labs in CaP patients
FSH, LH levels will increase with orchiectomy
165
Cowper's gland function
Pre-ejaculate: neutralize traces of acidic urine, lubricate urethra, flush out any traces of residual urine or foreign matter
166
What binds the 3 portions of the penis together?
Tunica albuginea
167
Where are helicine arteries found?
Corpus cavernosa
168
Where are Peg cells found?
Oviduct
