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Zero to Finals: Women's Health > The Reproductive System > Flashcards

The Reproductive System Flashcards

1
Q

what is GnRH? where is it released from?

A
  • gonadotropin-releasing hormone

- hypothalamus

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2
Q

what does GnRH do?

A

stimulates the anterior pituitary to produce LH and FSH

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3
Q

where are LH and FSH released from? what do they do?

A
  • anterior pituitary
  • FSH: stimulates follicles to develop in the ovaries
  • LH: stimulates egg maturity
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4
Q

which cells secrete oestrogen? where are these found?

A
  • theca granulosa cells

- around the follicles in the ovaries

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5
Q

what is the role of oestrogen?

A
  • negative feedback to the hypothalamus and anterior pituitary (suppresses GnRH, LH and FSH release)
  • stimulates female secondary sexual characteristics
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6
Q

what stimulates oestrogen release?

A

LH and FSH

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7
Q

which changes does oestrogen cause to the body?

A
  • breast development
  • growth and development of vulva / vagina / uterus
  • blood vessel development in the uterus
  • development of the endometrium
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8
Q

where is progesterone produced in a non-pregnant person? when is it produced?

A
  • corpus luteum

- after ovulation

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9
Q

where is progesterone produced in a pregnant person?

A
  • corpus luteum and then the placenta

- placenta takes over at 10w gestation

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10
Q

actions of progesterone?

A
  • thickens and maintains endometrium
  • thickens cervical mucus
  • increases body temp
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11
Q

when does puberty start in girls?

A

ages 8 - 14

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12
Q

when does puberty start in boys?

A

ages 9 - 15

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13
Q

why do overweight females enter puberty earlier?

A

having more adipose tissue increases oestrogen production

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14
Q

which children enter puberty later?

A
  • underweight ones
  • children with chronic disease
  • children with eating disorders
  • athletes
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15
Q

order of signs of puberty in girls?

A
  1. breast buds (thelarche)
  2. pubic hair (pubarche)
  3. menstruation (typically 2 years after the start of puberty)
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16
Q

what is the first menstruation called?

A

menarche

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17
Q

how can pubertal development be staged?

A

tanner staging

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18
Q

which characteristics does tanner staging take into account for females?

A
  • pubic hair

- breast development

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19
Q

hormonal changes in puberty?

A
  • GH increases
  • hypothalamus starts secreting GnRH
  • triggers HPG axis to start
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20
Q

what causes growth to slow down in puberty? why?

A
  • increasing oestrogen levels
  • oestrogen inhibits GH action
  • this is why growth spurts stop earlier in girls
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21
Q

what are the 2 phases of the menstrual cycle?

A
  • follicular phase

- luteal phase

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22
Q

what marks the start and end of the follicular phase of the menstrual cycle? how long does it last?

A
  • start: first day of menstruation
  • end: ovulation
  • lasts 14 days
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23
Q

what marks the start and end of the luteal phase of the menstrual cycle? how long does it last?

A
  • start: ovulation
  • end: first day of menstruation
  • lasts 14 days
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24
Q

which structures make up an ovarian follicle?

A

1 oocyte surrounded by granulosa cells

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25
Q

4 stages of follicular development?

A
  1. primordial follicles (contains primary oocyte)
  2. primary follicles
  3. secondary follicles
  4. antral follicles
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26
Q

what’s the other name for antral follicles?

A

graafian follicles

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27
Q

which receptors can be found on the secondary follicle surface? why is this important?

A
  • FSH receptors

- FSH is needed for it to develop into an antral follicle

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28
Q

what do granulosa cells secrete? how does this impact the HPG axis?

A
  • oestriadol (oestrogen)
  • negative feedback effect on the hypothalamus and pituitary
  • reduces LH and FSH production
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29
Q

how does oestrogen affect the cervical mucus? why is this important?

A

makes it more permeable to sperm

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30
Q

which hormone stimulates ovum release from the dominant follicle?

A

LH

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31
Q

how can the ovulation date be calculated?

A

length of cycle - 14

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32
Q

what happens in the luteal phase of the menstrual cycle if the egg is not fertilised?

A
  • dominant follicle turns into corpus luteum
  • CL secretes progesterone to maintain endometrial lining and thicken cervical mucus
  • CL eventually degenerates and stops secreting oestrogen and progesterone
  • endometrial lining breaks down and sheds (menstruation)
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33
Q

what happens in the luteal phase of the menstrual cycle if the egg is fertilised?

A
  • embryo forms
  • syncytiotrophoblast of embryo secretes hCG
  • hCG maintains corpus luteum
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34
Q

what is actually happening when you menstruate? what causes this?

A
  • endometrial lining is being shed

- lack of oestrogen and progesterone from CL

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35
Q

which cells secrete prostaglandins? what does this cause?

A
  • stromal cells of endometrium

- causes endometrial breakdown and uterine contraction

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36
Q

how long does menstruation last?

A

1 - 8 days

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37
Q

where are primary oocytes found? be specific

A
  • pregranulosa cells of primordial follicles
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38
Q

how does a primary oocyte develop into a mature ovum?

A

meiosis

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39
Q

what happens to the primary oocyte before ovulation? how many chromosomes does it have?

A
  • undergoes meiosis again
  • chromosomes go from 46 (diploid) to 23 (haploid)
  • the other 23 chromosomes form a polar body
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40
Q

which layers does the sperm cell need to penetrate in order to fertilise the egg?

A
  • corona radiata

- zona pellucida

41
Q

what makes up a zygote?

A

23 chromosomes from the egg and 23 from the sperm

42
Q

what does the zygote become? how many cells does this have? what happens at this point?

A
  • morula (16 cells)

- moves along fallopian tube

43
Q

what does the morula become? how many cells does this have when it enters the uterus?

A
  • blastocyst

- 100-150 cells

44
Q

what are the 3 layers of the embryonic disc?

A
  • ectoderm
  • mesoderm
  • endoderm
45
Q

what does the endoderm become?

A
  • GI tract
  • lungs
  • liver
  • pancreas
  • thyroid
  • reproductive system
46
Q

what does the mesoderm become?

A
  • heart
  • muscles
  • bone
  • connective tissue
  • blood
  • kidneys
47
Q

what does the ectoderm become?

A
  • skin
  • nails
  • hair
  • teeth
  • CNS
48
Q

at which gestation does the foetal heart form and start to beat?

A

week 6

49
Q

at which gestation do major organs other than the heart start to develop?

A

week 8

50
Q

what are the spiral arteries? where are they found?

A

branches of myometrial arteries that penetrate the endometrium making it highly vascular

51
Q

different roles of the placenta?

A
  • supplies oxygen + nutrition and removes CO2
  • excretes urea and creatinine
  • endocrine role
  • transfers antibodies
52
Q

describe the endocrine role of the placenta

A

it produces oestrogen and progesterone to prepare the mother for birth

53
Q

role of oestrogen in pregnany?

A
  • muscles of uterus and pelvic expand
  • cervix softens
  • breasts enlarge
54
Q

role of progesterone in pregnancy?

A
  • uterine muscles relax
55
Q

important SE of progesterone in pregnancy? hint: causes common problems

A

relaxes muscles:

  • LOS (heartburn)
  • bowel (constipation)
  • blood vessels (hypotension, headaches, skin flushes)
56
Q

hormonal changes seen in pregnancy?

A
  • anterior pituitary produces more ACTH, prolactin and melanocyte stimulating hormone
  • T3 and T4 rise
  • hCG levels double every 48h until 8-12 weeks
  • oestrogen rises
57
Q

what does higher ACTH cause in pregnancy?

A
  • increased cortisol and aldosterone levels

- higher risk of diabetes and infection

58
Q

what does higher melanocyte stimulating hormone cause in pregnancy?

A

increases skin pigmentation:

  • linea nigra
  • melasma
59
Q

which organ produces oestrogen in pregnancy?

A
  • placenta
60
Q

changes to uterus seen in pregnancy?

A
  • hypertrophy of myometrium and blood vessels
61
Q

what might increased oestrogen in pregnancy cause?

A
  • cervical ectropion
  • increased vaginal discharge
  • increased risk of bacterial infections and thrush
  • vaginal muscle hypertrophy
62
Q

what is the role of prostaglandins in labour?

A
  • break down the collagen in the cervix

- allows it to dilate and efface

63
Q

cardiovascular changes seen in pregnancy?

A
  • increased blood volume
  • increased plasma volume
  • increased CO (BOTH SV and HR go up)
  • reduced peripheral vascular resistance (causes vasodilation, flushing and hot sweats)
  • BP drops then normalises
  • varicose veins form
64
Q

how does BP change through pregnancy?

A
  • drops in 1st and 2nd trimesters

- normalises by full term

65
Q

respiratory changes seen in pregnancy?

A
  • increase in tidal volume

- increased RR

66
Q

renal changes seen in pregnancy?

A

the following go up:

  • blood supply
  • GFR
  • aldosterone
  • protein excretion

ureters dilate, causing physiological R-sided hydronephrosis

67
Q

why do pregnant women require increased iron, folate and B12?

A

there is increased RBC production

68
Q

explain how haematocrit drops in pregnancy

A

plasma volume increases MORE than the RBC count does, making the red cells more diluted

69
Q

how does a physiological anaemia occur in pregnancy?

A

Hb becomes diluted by the large increase in plasma volume

70
Q

why does risk of VTE increase in pregnancy?

A

there is an increase in fibrinogen and clotting factors VII, VIII and X

71
Q

changes seen on blood results in pregnancy?

A
  • increased WCC
  • reduced platelets
  • increased ESR and D-dimer
  • increased ALP
  • reduced albumin (increased protein excretion)
72
Q

how is hair affected in pregnancy?

A
  • postpartum hair loss is normal

- should improve by 6 months

73
Q

skin changes seen in pregnancy?

A
  • linea nigra
  • melasma
  • striae gravidarum
  • pruritus
  • spider naevi
  • palmar erythema
74
Q

which weeks of gestation would you expect labour and delivery to happen?

A

37 - 42 weeks

75
Q

how many stages of labour are there?

A

3

76
Q

describe the first stage of labour

A

from onset of labour with true contractions until cervix is fully dilated by 10cm

77
Q

describe the second stage of labour

A

from 10cm dilation to delivery of the baby

78
Q

describe the third stage of labour

A

from delivery of baby to the delivery of placenta

79
Q

how can a pessary be used to induce labour?

A
  • they contain prostaglandin E2 (dinoprostone)

- used to induce dilation and effacement of the cervix

80
Q

what are braxton-hicks contractions? what is their significance?

A
  • occasional irregular contractions of the uterus

- they are not true contractions and do not progress or become regular

81
Q

when are braxton-hicks contractions felt?

A

2nd and 3rd trimesters

82
Q

presentation of braxton-hicks contractions?

A
  • irregular tightening in abdomen

- mild cramping

83
Q

how can braxton-hicks contractions be reduced?

A
  • relaxing

- hydration

84
Q

what are the 3 phases of the first stage of labour?

A
  • latent phase
  • active phase
  • transition phase
85
Q

first stage of labour: describe the latent phase

A
  • cervix dilates from 0 to 3cm
  • progresses at 0.5cm / hr
  • contractions are irregular
86
Q

first stage of labour: describe the active phase

A
  • cervix dilates from 3 to 7cm
  • progresses at 1cm / hr
  • contractions become regular
87
Q

first stage of labour: describe the transition phase

A
  • cervix dilates from 7 to 10cm
  • progresses at 1cm / hr
  • contractions become stronger
88
Q

3Ps: factors which affect second stage of labour?

A
  • power
  • passenger
  • passage
89
Q

what does “power” describe in the second stage of labour?

A

strength of uterine contractions

90
Q

what does “passenger” describe in the second stage of labour?

A

qualities of the fetus

  • size of fetal head
  • attitude (posture) of fetus
  • fetal lie
  • fetal presentation
91
Q

different types of fetal lie?

A
  • longitudinal
  • transverse
  • oblique
92
Q

different types of fetal presentation?

A
  • cephalic
  • shoulder
  • breech
93
Q

types of breech presentation?

A
  • complete
  • frank
  • footling
94
Q

what does “passage” describe in the second stage of labour?

A

size and shape of pelvis

95
Q

what are the 7 cardinal movements of labour?

A
  1. engagement
  2. descent
  3. flexion
  4. internal rotation
  5. extension
  6. restitution and external rotation
  7. expulsion
96
Q

how is the descent of the baby’s head measured in labour?

A
  • measured in cm against the mother’s ischial spines
  • -5cm = head is high up around the pelvic inlet
  • 0cm = head is at ischial spines (“engaged”)
  • +5cm = head has descended further out
97
Q

what is involved in the active management of the third phase of labour? advantages of this?

A
  • midwife / doctor assists in delivery of the placenta
  • IM oxytocin used
  • traction of umbilical cord
  • shortens duration and reduces risk of bleeding
98
Q

when is active management indicated in the third phase of labour?

A

when there is either haemorrhage or >60 min delay in delivery of the placenta

Zero to Finals: Women's Health (3 decks)

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