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Endo/Repro > Unit 3 > Flashcards

Unit 3 Flashcards

1
Q

Location of sperm development.

A

Uhh… idk….. testes?!

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2
Q

Sperm storage location

A

Epididymis

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3
Q

Sperm transport from vas deferens, through the prostate to the urethra

A

Ejaculatory duct

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4
Q

Urethra parts of the males

A

Prostatic

Membranous

Penile

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5
Q

Male reproductive glands

A

Prostate

Seminal vesicles

Bulbourethral gland (cowpers)

Urethral glands

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6
Q

Where do primordial germ cells originate?

A

The yolk sac

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7
Q

Where do the primordial germ cells migrate to?

A

The testes seminiferous tubules

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8
Q

When do spermatogonia underdog mitosis?

A

They start beginning at puberty (average 13 years and continues throughout life)

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9
Q

Spermatogonia is stimulated by:

A

Pituitary gonadotropic hormones

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10
Q

The testis is filled with

A

Seminiferous tubules

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11
Q

Seminiferous tubules go into the:

A

Rete Testis (where the sperm will thrives through)

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12
Q

The Sperm will travel from the Rete testis to the:

A

Epididymis

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13
Q

Spermatogonia enlarge to become:

A

Primary spermatocytes

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14
Q

Primary spermatocytes undergo _____ to become______

A

Meiosis

Secondary spermatocytes

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15
Q

Secondary spermatocytes complete _______ to become _______

A

Meiosis II

Spermatids

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16
Q

Spermatids differentiate into:

A

Spermatozoa (mature sperm)

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17
Q

Process of spermatogenesis takes about _____ days

A

74

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18
Q

What stages of spermatogenesis will have only 1 chromosome ?

A

Spermatids and mature sperm cells

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19
Q

Reductional division (becomes haploid)

Separation of homologous pairs

A

Meiosis I

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20
Q

Equational division

Separation of sister chromatids

A

Meiosis II

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21
Q

What is the gender of offspring determined by?

A

Sperm upon fertilization of an egg

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22
Q

Meiosis phases

A

Interphase

Prophase I

Metaphase I

Anaphase I

Telophase I

Cytokinesis

Interkinesis

Prophase II

Metaphase II

Anaphase II

Telophase II

Cytokinesis

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23
Q

Review picture in slide 9

A

Slide 9

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24
Q

Male sperm contains a ___ chromosome

Female contains:

A

Y

X

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25
Q

Ooytes always have a(n) ___ chromosome

A

X

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26
Q

Transition between spermatid to mature sperm

A

Spermiogenesis

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27
Q

Review slide 11 picture

A

Slide 11

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28
Q

Sperm head contains:

A

Condensed nucleus

Thin cytoplasm

Acrosome

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29
Q

Acrosome is derived from:

It includes:

A

Golgi apparatus

Proteolytic enzymes hyluronidase

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30
Q

Central microtubule skeleton of the sperm (axoneme)

A

Tail (flagellum)

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31
Q

______ is in the proximal part of the sperms tail

A

Mitochondria

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32
Q

Contents of a sperm tail

A

Plasma membrane

Central microtubules

Radial spokes

Inner sheath

Nexin

doublet microtubule (A and B tubules)

Dynein arms

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33
Q

Hormones that regulate spermatogenesis

A

Testosterone

Luteinizing hormone (LH)

Follicle-stimulating hormone (FSH)

Estrogen

Growth hormone

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34
Q

Cells that secrete testosterone

A

Leydig cells

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35
Q

Testosterone is essential for what?

A

Growth and division of testicular germinal cells (first stage of spermatogenesis)

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36
Q

What secretes the Luteinizing hormone?

A

Anterior pituitary

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37
Q

The luteinizing hormone stimulates _____ ____ to:

A

Leydig cells

Secrete testosterone

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38
Q

FSH (follicle stimulating hormone) comes from:

A

Anterior pituitary

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39
Q

FSH stimulates ____ _____ for the process of:

A

Sertoli cells

Spermatogenesis

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40
Q

Sertoli cells produce small amounts of _____ from testosterone in response to:

A

Estrogen

FSH

probably required for spermatogenesis

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41
Q

Intermediate converting testosterone to estradiol (estrogen)

A

Aromatase and

-HCO2H

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42
Q

What is required for support of gonad metabolic function in general?

A

Growth hormone

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43
Q

Growth hormone promotes early:

A

Mitotic divisions of spermatogonia

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44
Q

What hormone stimulates the pituitary gland to secrete FSH and LH?

A

Gonadotropin-releasing hormone (GnRH)

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45
Q

Negative feedback for hypothalamus secreting GnRH

A

Testosterone and other androgens

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46
Q

Size of prostate

A

Size of a walnut

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47
Q

The prostate gland supplies about __% of volume to semen

A

30%

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48
Q

What does the prostate secrete?

A 
Calcium
Citrate
Phosphate
Clotting enzyme
Fibrinolysin
Alkaline pH
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49
Q

The seminal vesicle contributes to ___% of seminal fluid

A

60%

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50
Q

Seminal vesicle secretes:

A

Fructose
Citric acid
Prostaglandins
Fibrinogen

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51
Q

Prostaglandins react with:

They reverse:

A

Cervical mucus

Peristalsis of uterus and tube

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52
Q

Semen consists of:

A

Sperm + fluid from testes (10%)

Prostate fluid (30%)

Seminal vesicles (60%)

Small amounts of mucous from the bulbourethral glands

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53
Q

Semen alkalinity helps to keep sperm _____.

It is neutralized by:

A

Inactive

Femal repro tract

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54
Q

Purpose of clotting of the semen

A

Keeps semen together and sperm inactive until it dissolves (fibrinolysin) about 30 min after ejactulation

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55
Q

The process of transforming mature but inactive sperm to active sperm

A

Capacitation

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56
Q

Sperm cannot fertilize eggs until ____ occurs:

A

Capacitation

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57
Q

How long does capacitation take?

A

1-10 hours

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58
Q

Process of capacitation

A

Uterin and oviduct fluids wash away inhibitory factors

Cholesterol “bath” in semen is diluted, weakening the acrosome

Calcium influx which increases flagellum activity, and prepares sperm membrane for “acrosome reaction”.

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59
Q

What does the acrosome contain?

A

Hyaluronidase

Proteolytic enzymes

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60
Q

What does hyaluronidase do?

A

Depolymerizes hyaluronic acid in the intercellular matrix (holds corona radiata cells together)

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61
Q

What do proteolytic enzymes do?

A

Digests the zona pellucida

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62
Q

Review pictures in slide 24

A

Slide 24

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63
Q

At fertilization, the sperm contacts the :

What happens here?

A

Cell membrane of the oocyte

Membrane fusion happens- oocyte and sperm genetic material combine

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64
Q

The “cortisol reaction” of the oocyte releasing substances the harden the zona pellucida

A

Prevention of polyspermy

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65
Q

Review slide 25 picture

A

Slide 25

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66
Q

Types of male infertility

A

Bilateral orchitis

Excess temperature

Cryptorchidism

Sperm count

Sperm abnormalities

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67
Q

A side effect of mumps, causing permanent sterility

A

Bilateral orchitis

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68
Q 
Excess temperature causes \_\_\_\_\_\_ of most cells of the \_\_\_\_\_\_ \_\_\_\_.
This is (REVERSIBLE/IRREVERSIBLE)
A

Degeneration

Seminiferous tubules (not sperm, however)

Reversible

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69
Q

Failure of testes descent; tubular epithelium degenerates; surgical relocation may be necessary

A

Cryptochidism

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70
Q

Sperm count in infertile male

A

Below 20 million/ml

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71
Q

Neuronal stiumulus of the male sexual act

A

Sensory innervation of glans penis- via pudendal nerve

Psychological stimuli- sexual thoughts

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72
Q

NS of Penile erection

A

Parasympathetic- releases nitric oxide, VIP and Ach

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73
Q

For penile erection, _____ is produces to cause artery relaxation in the corpora cavernous a and spongiosum

A

cGMP

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74
Q

Bulbourethral glands

A

What release mucus secretions for lubrication- caused by parasympathetics

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75
Q

Emission and ejaculation is controlled by:

A

Sympathetic nervous system

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76
Q

Emission- contraction of:

Forms:

A

Vas deferens, prostate and seminal vesicles

Forms semen into the internal urethra

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77
Q

Ejaculation- contraction of:

A

Ischiocavernosus and bulbospongiosus muscles moves through the rest of the urethra

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78
Q

Androgens include:

A

Androstenedione

Testosterone (most abundant)

Dihydrotestosterone- (most active)

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79
Q

Androgen is synthesized from:

A

Cholesterol

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80
Q

Testosterone binds to:

A

Plasma proteins (albumin or sex hormone-binding globulin)

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81
Q

Testerosterone is converted to:

Where?

A

Dihydrotestosterone

In the tissues- especially prostate gland, seminal vesicles, epididymis, skin, hair follicles, liver and brain

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82
Q

In male fetal development, SRY gene on ____ chromosome is activated k

A

Y

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83
Q

SRY gene causes:

A

Genital ridge to develop into testes that secrete testosterone

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84
Q

In male fetus, testosterone begins to be secreted at what week?

A

7th week

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85
Q

Fetal development-

Testosterone stimulates development of:

A

Male parts at 7th week

Descent of the testes - 2-3 months gestation

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86
Q

Review slide 32 graph

A

Slide 32

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87
Q

Testosterone functions after puberty

A

Growth of external genitalia

2ndary sex characteristics - Body hair growth (though suppresses hair on head)
Voice- Larynx development
Skin thickens, increases secretions (acne)

Increases muscle protein

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88
Q

Testosterone is most often converted to _______ in the _____ of target cells

A

Dihydrotestosterone

Cytoplasm

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89
Q

Dihydrotestosterone binds to:

A

Androgen receptor

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90
Q

Dihydrotestosterone bound androgen receptor enters the ______ to induce:

A

Nucleus

Transcription of select genes (androgen-response elements)

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91
Q

Testosterone inhibits:

A

GnRH
LH
FSH

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92
Q

Inhibit from the _____ cells inhibits:

A

Sertoli

Anterior pituitary

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93
Q

LH and FSH are both secreted by ______ cells in the:

A

Gonodotrope

Adenohypophysis

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94
Q

Gonodotrophins are extremely dependant on _____ to trigger:

A

GnRH

LH and FSH

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95
Q

LH and FSH are both ________- they use:

A

Glycoproteins

cAMP second messenger system

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96
Q

How long are LH and FSH produced after puberty?

A

Throughout life- some spermatogenesis continues until death

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97
Q

What happens to males in late 50’s-60’s? Why is this?

A

Decline in sexual function

Mainly due to decreased testosterone secretion

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98
Q

Male climacteric is known as:

It may be treated with:

A

Decreased testosterone secretion

With exogenous androgens

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99
Q

Benign prostatic hypertrophy

Due to:

May cause

A

Abdnormal prostate growth- NOT increased testosterone

Urinary obstruction

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100
Q

percentage of male deaths from prostate cancer

A

2-3%

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101
Q

Prostate cancer is sensitive to:

A

Testosterone and estrogen

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102
Q

In the absence of testosterone , fetal sexual organs tend to form the:

A

Female pattern

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103
Q

Loss of testes before puberty

A

Eunichism

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104
Q

Eunichism pts continue to have:

A

Infantile sex organs and characteristics

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105
Q

Male castration after puberty

A

Secondary sex characteristics recede
Loss of some musculature and male hair pattern

Organs and voice don’t lose much of the normal male pattern

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106
Q

Leydig cell tumors - hypersecretion of _______

In children causes:

A

Testosterone

Acceleration of male characteristics, but increased closure of epiphyseal plates

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107
Q

Why isLeydig Cell tumor difficult to diagnose in adults?

A

Male characteristics are already present

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108
Q

Tumors of germinal epithelium can form:

Not usually associated with:

A

Multiple cell/tissue types “teratoma”

Hormone secretion, but if they do, it is most likely hCG (functions like LH)

Gynecomastia

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109
Q

ED is most often caused by:

A

Underlying vascular disease (uncontrolled hypertension, diabetes, atherosclerosis)

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110
Q

ED can also be due to:

A

Prostate surgery (damage to PNS neurons)

Deficient testosterone

Some drugs (nicotine, alcohol , antidepressants)

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111
Q

Female repro anatomy includes

A

Ovaries

Uterine tubes (ovaducts, Fallopian tubes)

Uterus

Vagina

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112
Q

Female hormones:

A

GnRH

FSH and LH

Estrogen and progesterone

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113
Q

Review picture in slide 45

A

Slide 45

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114
Q

Duration of female repro cycle:

A

28 days (though can range from 20-45 days)

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115
Q

How many ovum are usually released per month from an overly?

A

1

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116
Q

The uterine edometrium must prepare for what?

A

Potential implantation

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117
Q

Ovaries are inactive without what hormones

A

FSH and LH

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118
Q

What does the pituitary begin to secrete more FSH and LH?

A

Around age 9-12

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119
Q

Menarche (puberty) starts typically around:

A

11-15 years old- periods start here

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120
Q

target tissue of FSH and LH

A

Ovary
CAMP pathway
Protein Kinase -> enzyme phosphorylation

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121
Q

Phases of ovarian cycle

A

Follicular phase

Ovulation

Luteal

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122
Q

Uterine repro phases

A

Proliferation

Secretory

Menstrual

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123
Q

Day one of the uterine cycle technically starts at what phase?

A

Mentrual

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124
Q

Primordial follicle:
Provides:
Secretes:

A

Nourishment

Oocyte maturation-inhibiting Factor

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125
Q

What keeps the ovum in prophase 1 of meiosis?

A

Maturation-inhibiting factor

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126
Q

Prenatal follicle consists of:

A

Zona pellucida

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127
Q

What is in the middle of the primordial follicle

A

Egg cell

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128
Q

Primordial follicles enlarge into:

A

Primary follicles

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129
Q

What causes primary follicles to form

A

FSH and LH during puberty cause

Enlargement of the ovum

Granulosa cells to proliferate to form more layers

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130
Q

Oocyte is in what phase in primary follicles?

A

Prophase 1 (still)

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131
Q

Antral Follicles form when-

A

An increase in FSH accelerates growth of about 6-12 follicles (EACH MONTH)

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132
Q

Formation of the ____ ____ and ______ layers happen in the antral follicles

A

Theca interna

Externa

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133
Q

In antral follicles, _______ ____ containing ____ collects into an antrum

A

Follicular fluid

Estrogen

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134
Q

In antral follicles, estrogen increases _____ cells sensitivity to ____

Both increase sensitivity to ___

A

Granulosa

FSH

LH

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135
Q

Oocyte phase in antral follicles

A

Completes Meiosis 1 and arrests in metaphase II

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136
Q

Preovulatory follicle AKA

A

Mature / graffian follicle

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137
Q

Preovulatory follicle- usually how many follicles make it to maturity?

A

Only 1

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138
Q

What happens to the follicles that started the process of maturation but do not make it to preovulatory phase?

A

They undergo “involution” and become and atretic follicle

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139
Q

Preovulatory follicle properties (outside, in)

A

Corona radiata

Zona pellucida

Plasma membrane

First polar body

Cytoplasm

Nucleus

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140
Q

Ovulation happens on what day of repro cycle?

A

Usually day 14

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141
Q

What happens to the outer wall of the follicle at ovulation

A

It swells and protrudes (stigma)

Follicle ruptures, releasing the ovum and some granulosa cells (corona radiata)

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142
Q

Ovulation is triggered by a surge in:

A

LH

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143
Q

LH also converts granulosa cells and thecal cells into:

A

Progesterone secreting cells

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144
Q

Ovulation process from LH

A

LH -> Follicles produce progesterone -> collegenase weakens follicle wall -> prostaglandins cause follicle swelling -> follicle rupturesa releasing ovum

145
Q

Remaining granulosa and thecal cells change into ____ _____ and make up the:

A

Lutein cells

Corpus luteum

146
Q

Leutinization means “____”

Lutein cells gather _____ causing this.

A

Yellowizing

Lipids

147
Q

3 stages Lutein cells go through

A

Enlargement (after ovulation)

Secretion (more progesterone than estrogen)

Involution (to form corpus Albicans)

148
Q

What maintains the lutein cells in the secretory state?

149
Q

Involution of corpus luteum-

____ and ____ negatively feedback on pituitary

Levels of FAH and LH (RISE/DROP)

Lutein cells secrete ____

A

Estrogens and progesterone

Drop

Inhibin

150
Q

What happens to corpus luteum without adequate FSH and LH?

A

It degenerates to form the corpus albicans

151
Q

3 estrogens

A

Beta-estradiol

Estrone

Estriol

152
Q

Many estrogens promote:

A

Secondary sex characteristics

153
Q

Progestin

A

Progesterone

Hydroxyprogesterone

154
Q

Progestins mainly prepare:

A

Uterus for pregnancy and breasts for lactation

155
Q

What secretes estrogen- non-pregnant

A

Mostly ovaries, small amounts by adrenal vortices

156
Q

What secretes estrogen when pregnant?

157
Q

What secretes progesterone when not pregnant ?

A

Corpus luteum of the ovary (during luteal phase)

158
Q

What secretes progesterone when pregnant?

159
Q

Estrogens and progestins are transported in the blood bound to:

A

Albumin

Estrogen and progesterone binding proteins

160
Q

_______ convertes estrogens and progestins to less potent forms, then excreted how?

A

Liver

In the bile or urine

161
Q

Size of ovaries, oviducts, uterus and vagina after puberty :

A

Increases in size

162
Q

Vaginal epithelium changes from ____ to _____ due to estrogen

A

Cuboidal

Stratified

163
Q

Oviduct increases _______ in the epithelium due to estrogen

164
Q

Due to estrogen, what happens to external genitalia

A

Will also enlarge

165
Q

Estrogen effects on breasts

A

Development of breast stromal tissue

Growth of ductal tissue

Fat deposition

166
Q

The supportive framework of an organ (or gland or other structure), usually composed of connective tissue

167
Q

Estrogen effects on skeleton

A

Stimulates bone growth

Stimulates epiphyseal plate closure

168
Q

Estrogen effect on metabolism

A

Increases fat deposition (breasts and subcutaneous tissue)

169
Q

Estrogen effects on hair

A

Less potent than testosterone, but females do get hair in pubic an axillary areas

170
Q

Progesterone effects in uterus

A

Promotes secretory changes in the uterine endometrium (latter half of uterine cycle)

Decreases uterine contractions (maintains pregnancy)

Increases oviduct secretions

171
Q

Progesterone effects on breasts

A

Promotes glandular development (but not milk production)

172
Q

Proliferation phase follows menstration where most of the endometrium is:

173
Q

Epithelium is restored within ____-___ days from the beginning of menstruation followed by:

A

4-7

Thickening of the stroma underneath

174
Q

What also grows in the proliferative phase?

A

Glands and blood vessels

175
Q

By day 14, how thick is the endometrium ?

A

3-5 mm thick

176
Q

phase after ovulation

A

Secretory phase (day 14)

177
Q

Secretory phase, aka

A

Progesterone phase

178
Q

Proliferative phase, aka

A

Estrogen phase

179
Q

Secretory phase causes:

A

Swelling and secretory development of the endometrium “uterine milk”

180
Q

In secretory phase, what happens to endometrium

A

It thickens some more due to the continues estrogen production

181
Q

Phase if ovum is not fertilized

A

Menstruation

182
Q

What happens in menstruation cycle?

A

Corpus luteum involutes and decreases estrogen and progesterone production

Involution and necrosis of the endometrium

Spasm of uterine blood vessels

Shedding

183
Q

What organs secrete hormones for female hormonal cycle regulation?

A

Hypothalamus—- secretes GnRH

Anterior pituitary ——- LH and FSH

Ovarian follicles/corpus luteum—-
Secretes estrogen
Progesterone
Inhibin

184
Q

What inhibits LH and FSH in small amounts, but paradoxically stimulates LH surge at high levels before ovulation?

185
Q

What inhibits LH and FSH only in conjunction with estrogen?

A

Progesterone

186
Q

What inhibits LH and FSH particularly at the end of the cycle?

187
Q

Follicle stages during ovarian cycle

A

Follicle development

Ovulation

Corpus luteum formation

Mature corpus luteum

Corpus albicans

188
Q

Endometrial changes during the uterine cycle

A

Menses- Destruction of functional zone

Proliferative- Repair and regeneration of functional zone

Secretory- Secretion by uterine glands

189
Q

What secrets inhibin?

A

Granulosa cell

190
Q

What does the theca cell secrete?

A

Androgens and progestins

191
Q

What does the granulosa cell secrete?

A

Inhibin

Estrogens

Progestins

192
Q

Cause of puberty

A

Gradual increase in gonadotropic hormone secretion

193
Q

Puberty starts about ____ and ends with____

A

8

Menarche (11-16)

194
Q

First menstrual cycle, AKA:

195
Q

Age of menopause

A

Between 40-50 years (on average)

196
Q

What happens to ovulation during menopause?

A

It often fails to occur

197
Q

About _____ primordial follicles make it to ovulation

198
Q

Amount of follicles that degenerate

A

Hundreds of thousands

199
Q

Primordial follicales by age 45

A

Only a few follicles remain. As this number approaches zero, there are fewer cells to produce estrogen

200
Q

Symptoms of menopause

A

Hot flashes

Sensations of displeasure

Irritability

Fatigue

Anxiety

Decreased strength and bone calcification

201
Q

____% of women feel symptoms of menopause severe enough to seek tx

202
Q

Hormonal abnormalities in females

A

Hypogonadism (female eunichism)

Hypersecretion

203
Q

In female hypogonadism, what happens?

A

Secondary sexual characteristics do not develop

Prolonged growth of long bones

If occurs in adult (ovary removal), 2ndary sex characteristics regress, uterus and vagina become smaller- similar changes from menopause

204
Q

Factors that drive female sexual function

A

Psychological and physiological

205
Q

Sensory signals from the _____ nerve involves in female sexual function

206
Q

Pudendal nerve’s functions in female sexual function

A

Conscious sensation of sexual activity

Local reflexes (clitoris “erection”
Bartholin gland secretion- lubrication
Smooth muscle contraction in uterus and Fallopian tube)

207
Q

Time of ovum viability

A

No longer than 24 hours following ovulation

208
Q

Viability of sperm in female repro tract

A

Up to 5 days

209
Q

Types of contraception

A

Rhythm method (estimate time of ovulation)

Hormonal suppression

210
Q

Most effective method birth control

A

Implants

IUD

Female sterilization

Vasectomy

211
Q

Very effective method birth control, but not most effective

A

Injectables

LAM (lactational amenorrhea)

Pills

Patch

Vaginal ring

212
Q

Somewhat effective method birth control

A

Condoms

Diaphragm

Female condom

Fertility awareness methods

213
Q

Least effective birth control methods

A

Spermicides

214
Q

Most common female infertility

A

Ovulation failure due to abnormal hormonal pattern

215
Q

Endometriosis

A

Endometrium-like tissue grows in the pelvic cavity surrounding the uterus, oviduct, and ovaries

216
Q

Endometriosis leads to:

A

Fibrosis and ova from the ovary fail to find their way into the oviduct

217
Q

Inflammation of the oviducts, often due to gonococcal infection

A

Salpingitis

218
Q

What can salpingitis lead to?

219
Q

Causes of female infertility

A

Ovulation failure

Endometriosis

Salpingitis

Abnormal mucus production

220
Q

Review slide 82

221
Q

What part of the uterine tube surrounds the ovary

222
Q

What creates a current to draw in ovum?

223
Q

% of ova that find their way into the oviduct

224
Q

Fertilization usually occurs where?

A

In the ampulla of the oviduct

225
Q

What aids in transport of sperm?

A

Uterine and oviduct smooth muscle contraction

226
Q

In order for fertilization, sperm must penetrate the:

A

Corona radiata and Zona pellucida

227
Q

Upon fertilization, the ovum undergoes ____ ____ ____ and expels :

A

Second meiotic division

Second polar body

228
Q

After the second meiotic division of the ovum, what happens (after fertilization)

A

Fusion of the pronuclei

Genetic sex determination

229
Q

How long does it take for a zygote to travel to the uterus?

A

5-7 days after ovulation, or 3-5 days after fertilization

230
Q

What causes transport of the zygote?

A

Fluid current resulting from epithelium and secretions

Contractions of uterine tube

Progesterone from the corpus luteum relaxing tube smooth muscles in the isthmus allowing passage into the uterus

231
Q

Embryo with about 100 cells is known as a:

A

Blastocyst

232
Q

Trophoblast cells secrete _____ ____

They transport ________ to developing embryo

They proliferate to develop into _____

A

Proteolytic enzymes

Nutrients

Placenta

233
Q

Placenta cells

A

Cytotrophoblast

Syncytiotrophoblast

234
Q

What provides nutrition to the embryo in the oviduct

A

Secretory cells produce secretions that nourish the traveling embryo

235
Q

What provides nutrition to the embryo in the uterus before implantation

A

“Uterine milk” from endometrial secretions

236
Q

What provides nutrition to the embryo in the uterus after implantation

A

Decidual cells

Then placenta after 16 days

237
Q

What causes decidual cells to be stimulated?

What happens to them when placenta takes over?

A

Simulated by progesterone (causes them to swell to store nutrients)

They are “digested” by invading trophoblast

238
Q

Review pic in slide 92

239
Q

What forms Collin containing embryonic circulation?

A

Cytotrophopblasts

240
Q

Synchiotrophoblasts invades ____ _____ ____

This causes what to happen?

A

Maternal blood vessels

They bleed into cavities called lacuna (blood sinuses)

241
Q

(T/F)- Maternal and embryonic blood directly mix

A

False

  • exchange between mother and embryo blood is via diffusion
242
Q

PO2 in mothers blood:

In fetal blood:

A

50 mm Hg

30 mm Hg

243
Q

Which Hb has a higher affinity for O2?

A

Fetal Hb

Concentration is also greater

244
Q

What does Bohr effect state?

A

As CO2 leaves fetal circulation, fetal Hb accepts more O2

245
Q

Why does CO2 simply diffuse?

A

Because of its relatively high solubility

246
Q

Glucose in the placenta uses ______ diffusion

A

Facilitated

Rate of glucose usage rivals that of the grown mother

247
Q

What will diffuse with relative ease

A

Fats
Ketone bodies
Ions

248
Q

What happens to wastes in the placenta

A

Ure, uric acid, creatinine diffuses toward maternal blood

249
Q

The placenta is also an _____ gland

250
Q

What hormones does the placenta release?

A

Human chorionic gonadotropin

Estrogens

Progesterone

Human chorionic somatomammotropin. (Aka human placental lactose)

251
Q

What hormone is high in weeks 4-24 of pregnancy?

A

Human chorionic gonadotropin

Highest around week 12

252
Q

When does estrogen and progesterone begin to peak during pregnancy?

A

Approx week 24

253
Q

What secretes human chorionic gonadotropin? (HCG)

When?

A

Syncytiotrophoblast

Shortly after implantation

254
Q

hCG prevents:

A

Involution of the corpus luteum- will continue to secrete hormones

255
Q

Corpus luteum secretes :

A

Large amounts of estrogen and progesterone

256
Q

Involution of corpus luteum prevention purpose

A

To prevent menstruation

Maintains “decidual” cells for nutrition

257
Q

When does the corpus luteum involute?

Why?

A

After 13-17 weeks of gestation

The placenta makes enough estrogen and progesterone to maintain pregnancy

258
Q

hCG in male fetuses help stimulate _____ ____ (of ____) to produce:

This is needed for:

A

Interstitial cells (of leydig)

Testosterone

Needed for male organ development and testes descent into the scrotu

259
Q

What secretes placental estrogen?

A

Syncytiotrophoblast

260
Q

Placental estrogen is _____ times that of normal

261
Q

Placental estrogen is produces from:

A

DHEA from both mother’s and fetus’s adrenal glands

262
Q

Function of placental estrogen:

A

Enlargement of:
Uterus
breasts and their ducts
External genitalia

Relaxes: 
Pelvic ligaments (SI and pubic symphysis)
263
Q

Function of placental progesterone

A

Decidual cell formation (nutrition for embryo)

Decreases contractility of uterus

Increases oviduct secretion (nutrition)

Synergistic with estrogen for breast preparation for lactation

264
Q

Human chorionic somatomammotropin (HCS) AKA

A

Human placental lactose

265
Q

Rate of HCS secretion increases as:

A

Placenta enlarges

266
Q

Potention purpose of HCS

A

May help with lactation similar to prolactin

Actions similar to GH; increasing protein synthesis

Decreases insulin sensitivity; makes more glucose available to the fetus

267
Q

Anterior pituitary changes in pregnancy

A

Increases ACTH, T-SHIRT and prolactin

Decreases FSH and LH (due to inhibitory effects of estrogen and progesterone)

268
Q

Adrenal cortex changes in pregnancy

A

Increased glucocorticoids and aldosterone

Mobilizes amino acids and causes sodium and fluid retention (increases blood pressure)

269
Q

Thyroid changes in pregnancy

A

Produces more thyroxine

270
Q

Parathyroid changes in pregnancy

A

Increases to release Ca+2

271
Q

Hormone that may be used to soften cervix in humans during pregnancy

272
Q

HCG maintains:

A

Corpus luteum

273
Q

Placental progesterone maintains:

A

Uterine lining

Inhibits uterine contraction

274
Q

Placental estrogen function

A

Maintains uterine lining

Stimulates mammary glands

275
Q

Placental lactose function

A

Stimulates mammary glands

Supplies energy to fetus

276
Q

Placental parathyroid hormone RP function

A

Increases blood CA+2

277
Q

Placental relaxin function

A

Softens cervix and weakens pubic symphysis

278
Q

Placental CRH function

A

Pressure, blood glucose, and stimulates partuition

279
Q

Average weigh gain in pregnancy

280
Q

Average weigh of: (lbs)
Fetus:

Amniotic fluid, placenta, and membranes:

Uterus

Breasts

Blood fluids

Fat

A

8

4

3

2

5

3-13

281
Q

In pregnancy, basal metabolic rate (INCREASES/DECREASES) 15%, especially ___.

A

Increases

Late

282
Q

Increase of basal metabolic rate in pregnancy is due to:

A

Increases hormone production

283
Q

Common nutrition deficiency during pregnancy

A

Ca

Phosphates

Iron

Vitamins

284
Q

Preeclampsia occurs in ____% of women

It causes a rise in:

A leakage of ____ into the _____

Causes _____ and ____ retention , and ____

A

15

Arterial blood pressure

Protein
Urine

Water
Salt
Edema

285
Q

Progression of preeclampsia

286
Q

Symptoms of eclampsia

A

Systemic vascular spasm

Seizures and coma

Extreme hypertension

Decreases kidney output

may be fatal without treatment

287
Q

increased uterine contractility

A

Parturition

288
Q

What causes parturition

A

Increases ration of estrogens to progesterone during late pregnancy

And oxytocin

289
Q

Weak slow intermittent contractions, “false” labor

A

Braxton hicks contractions

290
Q

Difference between labor contractions and Braxton hicks

A

Labor contractions are stronger

Stretch the cervix

And provide positive feedback- stretch/oxytocin cycle

291
Q

3 stages of labor

A

Cervical dilation (effacement) - 8-24 hours with first baby

Delivery of baby: 30 min or more with first baby

Placenta delivery: 10-45 min

292
Q

During lactation, estrogen stimulates:

A

Mammary glands ductal system and fat deposition in puberty

High estrogen state in pregnancy develops breasts further

293
Q

What hormone causes growth of breast lobules and alveoli in lactation

A

Progesterone

294
Q

Prolactin promotes ____ ____ from:

A

Milk secretion

Anterior pituitary

295
Q

HCS supports:

A

Prolactic production

296
Q

What suppresses milk production?

A

Estrogen and progesterone

High during pregnancy and rapidly decreases after birth

297
Q

Early milk

298
Q

What does colostrum contain

A

Protein and lactose, but little fat

299
Q

Hormones important for milk production?

A

GH

Cortisol

PTH

Insulin

Prolactin

300
Q

Nursing stimulates ______ secretion

301
Q

Nursing inhibits secretion of ____ _____ from hypothalamus

A

Gonadotropin-releasing hormone

302
Q

Gonadotropin releasing hormone’s effect is to:

A

Suppress the reproductive cycle, and therefore decrease fertility

303
Q

____ is released during suckling, causing ______ cells to move milk from the alveoli to the ducts

A

Oxytocin

Myopithelial

304
Q

Review chart on slide 117

305
Q

Fetal growth first 2-3 weeks after implantation

A

Embryo stays small

Hallmarked by placental development and growth

306
Q

Fetal growth after 2-3 weeks

A

Embryo/fetal growth increases

Most weight is gained in the last trimester

307
Q

Average newborn weight

A

7lbs

Healthy range: 4.5-11lbs

308
Q

Energy source for fetus

A

Mainly glucose

309
Q

Ossification of bones is most rapid when? (In fetus)

A

Last 4 weeks of gestation

310
Q

Most iron is found in _____, which is formed when?

A

Hemoglobin

Beginning the 3rd week after fertilization

311
Q

Iron utilization increases most rapidly when?

A

Durning the time of rapid fetal growth

312
Q

Much iron in the fetus is stores where?

A

In the liver

Enough iron to last the neonate for several months

313
Q

A coenzyme in the catabolism of sugars and amino acids

A

Thiamine (vitamin B1)

314
Q

A precursor of cofactors FAD and FMN

A

Riboflavin (B2)

315
Q

Review chart in slide 125

Won’t ask many questions, but good to review

316
Q

What vitamins from vitamin B group are especially important in the fetus? Why?

A

Folate (vitamin B9) and vitamin B12

Important in general growth, RBC formation, nervous system development

317
Q

Deficiency of folate and vitamin B12 can lead to:

A

Anemia

Low birth weigh

Intrauterine growth retardation

318
Q

Other vitamins important for fetal development

A

Vitamin C, D, K

319
Q

Vitamin needed for bone growth matrix and connective tissue growth

320
Q

Vitamin needed for skeletal growth (calcium hemeostasis)

321
Q

Vitamin used for prevention of perinatal hemorrhage

322
Q

Infants must store vitamin K in the liver where?

A

In the liver

They have no source of it after birth until the colon is colonized by bacteria

323
Q

Post-natal breathing is likely stimulated by what?

A

Normal slight hypoxia and exposure to cooler environment at birth

324
Q

What can excessive or prolonged hypoxia cause?

A

May suppress the brain and respiratory centers

325
Q

Breathing effect may be suppressed by:

A

Anesthetic during delivery

Or head trauma or slow delivery

326
Q

Sources of hypoxia

A

From umbilical cord compression,

Uterine ischemia due to contractions

Premature separation of the placenta

Anesthesia

327
Q

When does the first breath usually occur?

A

In less than 1 minute after birth

328
Q

Neonates can survive as long as _____ minutes without breathing after birth. However, closer to that time will more likely develop:

A

10

Brain damage

329
Q

Adults can survive ___ minutes without breath

330
Q

At birth, ____ are collapsed. Why?

A

Alveoli

Surface tension of the viscous fluid inside

331
Q

What is required to oppose the effects with the first breath?

A

25 mm of negative inspiratory pressure

332
Q

Subsequent breaths get easier as:

A

More alveoli open

333
Q

When is surfactant secreted?

A

In the last 1-3 months of pregnancy

334
Q

Pulmonary surfactant is deficient in:

A

Premature infants and babies born to diabetic mothers

335
Q

Surfactant deficiency leads to:

A

Respiratory distress syndrome (hyaline membrane disease)

336
Q

% of fetal blood that goes through the placenta

A

Approx 55%

45% goes everywhere else

337
Q

% of fetal blood flows through the lungs

338
Q

Post natal changes in blood flow

A

Placenta blood flow stops -> doubles the systemic vascular resistance -> increases aortic pressure and left heart pressure

339
Q

Post natal lung changes

A

Expansion of the lungs

Causes decrease pulmonary vascular resistance (less compression of pulmonary vessels with inflated lungs)

Causes decreased pulmonary arterial pressure and right heart pressure

340
Q

What closes the foramen ovale

A

Changes in heart pressure

341
Q

The changes in pulmonary and aortic pressures start to reverse flow through _____ _____ (___ ___), leading to ____ ____ ____

A

Ductus arteriosus (more O2)

Smooth muscle contraction

342
Q

What causes ductus vascular contraction?

A

Reduction of prostaglandin E2

Causes ductus arteriosus to close

343
Q

When does the ductus venosus close?

A

After circulation stops in the umbilical vein

344
Q

Where does the fetus derive all its glucose from?

A

From the mother

345
Q

Neonates deplete glycogen in liver and muscle within _____. What is not developed well yet?

A

Hours

Liver gluconeogenesis

346
Q

After blood glucose drops, what does the baby use until mother’s milk comes in? (2-4 days)

A

Stored fats

347
Q

Baby weigh drops ___-___% within the first days of life. Most weight loss is due to:

A

5-10%

Fluid loss, rather than fat loss

348
Q

Why are starches less adequately used in neonate?

A

Secretion of pancreatic amylase in the neonate is deficient

349
Q

Why is cow’s milk not well tolerated in the neonate?

A

It is high in fats, and absorption in fats from the GI tract is lower

350
Q

Neonate liver is not fully developed. This makes:

A

Blood sugar unstable and a bit low

351
Q

Neonate is excellent in:

A

Synthesizing and storing proteins

352
Q

Respiratory rate of neonate

A

40 breaths per min

353
Q

Blood volume of neonate if cord is immediately cut

A

300 milliliters

354
Q

Neonate cardiac output

A

500 ml/min

355
Q

Arterial pressure increases from ___/__ to ___/__ writhing:

A

70/50

90/60

Adult pressure levels begin around adolescence

356
Q

Bilirubin levels in neonate

A

They rise then return to normal after a few weeks as the liver gains function

357
Q

Premature respiration

A

Vital capacity and functional residual capacity are especially small

Surfactant secretion is depressed or absent

358
Q

GI phys in prematurity

A

Digestive and absorptive capacity is inadequate

Absorption of fat is so poor they musc have a low fat diet

Rickets can develop due to poor absorption of Ca+2

359
Q

Other premature phys

A

Immaturity of liver (edema, bleeding tendency, poor intermediary metabolism)

Immaturity of kidneys (tend towards acidosis and fluid balance issues)

Immaturity of bone marrow (anemias and infections result)

Body temp regulation is poor (often needs incubator)

Endo/Repro (4 decks)

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