Week 13 Female Reproductive System Flashcards
Whats proliferating are the cells that make up the?
stratum compactum and stratum spongiosum, and the glands in stratum spongiosum and spiral arteries in stratum spongiosum
at the end menstruation, thickness of endometrium was about half a milimeter but by the end of the proliferative phase, how thick is it?
2-3 mm
- all of that increase in thickness is due to adding cells
- the cells are proliferating and that is what’s making the endometrium thicker there
the proliferative phase is followed by ?
ovulation
- not a span of time, it is an event
after ovulation, our spinal phase is going to lead to ?
a bigger increase in the thickness of endometrium
that thickness increase thats under the control of progesterone is mostly due to?
endometrium retaining fluid
progesterone levels drop, spiral arteries spasm, and then we will return to where we started which was?
the beginning of the cycle of menstruation
MORE IN DEPTH:
first part of cycle approximately how long?
Day 1 to Day 5 is menses (menstruation)
- all about getting rid of the old endometrium or old stratum compactum and stratum spongiosum to build a newer and fresher compactum and spongiosum
Menses is followed by a phase that has many names:
- post menstrual phase (which tells you what’s happening with the endometrium)
- pre ovulatory phase (bc the next phase is ovulation)
- estrogenic phase (main hormone in this phase of menstrual cycle is estrogen)
- follicular phase (granulosa cells of the follicle that are making the estrogen)
- proliferative phase (stratum compactum and spongiosum cells are proliferating and thats whats causing thickness)
how long is this phase?
day 6 to day 13
- most variation
- in a woman who has longer overall cycle, this phase tend to be longer than one who has a shorter cycle
what’s going on here?
we’re proliferating cells that thicken the endometrium, estrogen levels go up and that’s gonna cause the endometrium glands and cervical mucus glands to secrete things that tend to block the passage of sperm
why would you want to block the passage of sperm at this point?
if you haven’t ovulated yet, there’s nothing to fertilize, the menstrual cycle is about effective use of resources so you can use the most possible resources to support a full pregnancy
- sperm can live 2-3 days in female reproductive tract and so anything that arrives more than 2-3 days before ovulation or after is something else to get rid of so we tend to block it
glands are growing and spiral arteries are growing
the next phase is ovulation and in the mythical 28 day cycle, this would be on day?
day 14
what is ovulation?
the rupture of a follicle in the release of an egg into the fallopian tubes
- before we had OTC kits to test for ovulation, we used to look at basil body temp for an indication of ovulation (basil body temp is absolute resting body temp when you have done nothing)
- if woman is tracking body temp to see if shes ovulating, grabs thermometer to see temp with no coffee, bathroom breaks, immediately upon waking up.
- before she ovulated, the temp will drop a little bit
our last phase that will take us back to menses is ?
Day 15 to Day 28
- post ovulatory
- premenstrual
- proliferative
- gluteal (corpus luteum is now the endocrine structure thats driving this. previously it was hormones being produced by granulosa cells of follicle, not its corpus luteum)
- progesterone (big hormone from corpus luteum is progesterone)
- secretory (corupus luteum is secreting a whole bunch of hormones that are all having the same goal: create the most supportive conditions for pregnancy from preceeding ovulation)
whats happening here?
progesterone levels go up cause us to increase thickness of myometrium, primarily by holding onto fluid.
- body temp goes up bc progesterone makes body temp go up
from the time the one follicle thats supposed to rupture ruptures, and we have ovulation, we start formation of?
corpus luteum
- now we’re getting a lot of progesterone, some estrogen, also inhibin and relaxin
very little variability in this phase bc?
it takes 7 days to develop a fully functioning luteum and takes about 7 days for it to die off
- as corpus luteum dies off, progesterone levels are dropping and hit a critical level that causes a spasming of spiral arteries and here we go again: we cut off blood supply to stratum compactum and spongiosum and they die and we shed and then back to menstruation
FUNCTIONS OF UTERUS:
1) where do most fertilization (conception) happen in?
fallopian tubes
- the rest of it that doesn’t lead to ectopic pregnancy happens in uterus (also site of implantation)
2) uterus is also site of implantation and bc of that, its gonna be a source of?
nutrients for developing embryo and fetus
the secretions of uterine glands is an early source of?
nutrients once a placenta is developed, the maternal blood supply in the uterus is gonna be the source of nutrients
3) contractions of myometrial is gonna help with?
expelling fetus at end of gestation
4) uterus has an important role in menstruation, not just in the shedding of endometrium but also?
myometrial activity, to help break endometrium so its easier to shed, we have myometrial contraction which causes myometrial to fatigue causing menstrual cramps
what is the beginning of the cycle of women?
Menarche
- 1st menstrual flow
- definition of onset puberty in a female
age of onset can change for all sorts of reasones:
- race
- genetics
- nutrition
- health
from onset of menarche, a woman except for pregnant is going to menstruate approx every?
28 days for 30 years
poor nutrition, low calories, not enough fat are likely to ?
delay menarche
most of those who are in competitive gymnast with 2% body fat are not menstruating bc?
not having body fat thats taken by body is not having enough resources to support you and a growing fetus
when they retire what happens>
almost instantaneously, growth spurt. gain more weight and start to menstruate bc their body fat percentage is now high enough bc theyre not working out 24 hours a day 8 days week and now their body has enough reserve to stay alive and support a developing fetus (really good nutrition but too much work)
as nutrition got better, lifespan got longer. as medical care got better. as that happens, we started moving from puberty at?
9 or 10 to 12 or 14 or 16
definition of menopause:
non-pregnant woman has gone 12 consecutive months without menstruating
- signals the end of a woman’s reproductive life
what are we gonna see in menopause?
levels of those hypothalamic and pituitary hormones are gonna go up bc the levels of those hormones are controlled by estrogen and progesterone and inhibin
whats happening here in menopause is that the ovaries which has been running the cycles aren’t running anything anymore
the average age of menopause at the time the book was published was ?
50 years old
- menarche is getting earlier, menopause is getting later
- for reasons of better nutrition, medical care, even hormones and milk
the phase before menopause called paramenopause..
fertility in women drops off pretty quickly after 30, menstrual cycles become more variability in the length and in that time, fertility is dropping and getting harder for women to get pregnant and we’re starting to see more fertility problems bc they want to settle down with career before making family and they run into symptoms of paramenopause that make it harder and harder to get pregnant
where is the location of the vagina?
- posterior to bladder and urethra
- anterior to rectum
- it extends backwards at an angle
there is an 90 degree turn between the end of cervix and beginning of vaginal canal, what is the reason for this?
to harder to have an accidental delivery with a 90 degree angle than if the uterus was vertical and the vagina was vertical
the opening of vagina passes through the layer of muscles included are?
levator ani muscles
not just the vagina that passes through the levator ani muscles but also?
urethra, anus, rectum
vaginal delivery of a full term infant can damage what?
levator ani muscles
- can lead to urinary or fecal incontinence
its not uncommon for women who have had vaginal deliveries to get?
stress incontinence
- not a lot of damage to levator ani muscles, its jsut the external urethral sphincter doesn’t close as well as it used to and so in situations in laughing, sneezing, picking up something heavy, they might dribble a little bit
in cases of a more severe damage to levator ani muscles, what happens?
uterus (dropping further into pelvic cavity as time and age goes on), large tears to those muscles can cause uterine prolapse
vagina itself is a muscular tube that is how long?
7-8 cm long (3 inches)
in the vaginal wall what do we have?
stratified squamous epithelium lining, connective tissue with glands
the anterior wall is shorter than the posterior wall because?
of the angle
the epithelial lining of cervix covers?
the entrance to the vagina and that region is called the hymen
the hymen has been historically been used as no previous intercourse. theres a problem here which is?
if hymen is connected all around, theres no way for shed endometrium to exit the body and the vast majority of women don’t have a completely attached hymen or they wouldn’t be menstruating
- having hymen be completely attached presents a problem bc what you would see as a nurse is a young women w physical changes and puberty but not menstruating. well they are but it just can’t leave the body
the vagina has rugae, what is the reason?
- gives more surface area for secretion (lots of glands in wall of vagina that will secrete to keep surface moist)
- stimulates penis during intercourse
- lets vagina stretch
vagina is a receptical for semen
- where semen is deposited and sperm will swim from there
- lower portion for birth canal
- important in transporting shed endometrium during menstruation
mons pubis is a region that’s typically hair covered, theres a fat pad just over pubic symphysis. why would you want to but a fat pad there?
padding for intercourse
labia majora is more lateral than labia minora. labia majora involve a lot of?
fat, sebaceous glands, and sweat glands
labia majora is homologous to?
scrotum
- we don’t know why they are similar, maybe the location
why would you want a lot of sebaceous and sweat glands in this area?
- sebaceous glands make sebum and sebum is sticky, this is protection against things that might try to enter vagina (organisms, microorganisms)
- part of sexual arousal naturally raises temp in this area and so the sweat glands
labia minora is not hair covered. it has a mucosa and the labia minora meet at midline to cover?
vestibule which is the entrance to vagina
- physical protection
what is the erectile tissue in a female?
the clitoris
- the structure and function of clitoris is homologous to penis
- labia minora meet around the clitoris and the labia majora will cover it as well. it generally makes sense to give protection to sensitive tissue.
greater vestibular glands also called bartholin glands which is homologous to?
cowper glands
the greater vestibular glands you can see with naked eye. its not the function that makes it interesting but what likes to take up residence there :
gonococcal bacteria
- once they start living there, its very difficult to get them out
the lesser vestibular glands are very small, also called Skene glands. They have a similar problem:
gonococci bacteria also likes to take up residency
what does gonococcal bacteria cause?
gonorrhea
functions of vulva:
- protect clitoris and vestibule
- provide feedback to sexual response to regions of brain (mostly hypothalamus)
anatomy: boundary between internal and external genitalia
breast tissue is actually superficial to ?
pectoralis major muscle
the size of the breast is related to?
how much fat is associated with it
- not an indication of how much mammary glands or milk production ability
men also have mammary glands, what they generally don’t have is?
white hormonal situation to make them develop to produce milk
- certain meds can cause them to lactate
- pituitary tumors can also cause lactation
what does permissiveness mean?
for one hormone to have an affect, the tissue had to have been exposed to another specific hormone first and in the case of development of mammary glands and ducts, estrogen controls development of the ducts and progesterone controls the development of mammary glands BUT for the gland tissue to develop under the control of progesterone, the glands have to had been exposed to estrogen first
- just progesterone won’t get you development, you have to have estrogen THEN progesterone
breast tissue is divided into lobules and the lobules are made up of?
alveoli
- each gland is connected to duct system and all ducts from all mammary glands attached to nipple so there are multiple exits for milk from nipple
ducts broaden as they get close to the nipple and those areas are called
lactiferous sinuses
- they are placed right about where gums of infant would hit when infant is suckling
each alveoli, there is a very interesting type of epithelial cell called?
myoepithelial cell
- not muscle but it contracts
those myoepithelial cells, on the outside of the alveoli, when they’re exposed to a particular hormone…
contract and push milk into the duct system
the hormone that controls the myoepithelial cells are called?
oxytocin
what hormone causes production of milk?
prolactin
- if you are able to make and deliver milk to a nursing infant, you need both prolactin and oxytocin bc without the prolactin, you can’t make milk and without oxytocin, you can’t move it into duct system where it can actually be accessed by a suckling infant
all of the adipose tissue and mammary glands need to be anchored to pectoralis muscle. thats done by these bands of connective tissue called?
suspensory ligaments (suspensory ligaments of cooper)
we also have a pigmented area around the nipple called the areola. in the areola we have a lot of sebaceous glands. why would you need sebaceous glands here?
sebum helps to keep skin flexible and keeps skin of nipple from cracking
what is the function of the breast?
lactation
where does oxytocin come from?
posterior pituitary gland
prolactin stimulates?
alveolar cells to produce milk
oxytocin causes ?
milk ejection by causing epithelial cells to contract
the first few days after delivery, mother isn’t making milk, shes making what?
colostrum
- in colostrum we have antibodies which is important
milk secretion isn’t going to actually start till?
2-4 days
in a neonate, for about the first 30 days, they can absorb antibodies whole which means?
they can get antibodies from mom to give them some protection while they’re getting exposed to things. specific immunity and immune response requires exposure, in utero you didn’t have any exposure.
after 30 days, those antibodies become?
just any protein and they get digested
- we don’t know the transition or how we can absorb them whole but we know it happens and there is a transition
why is the ability to lactate important?
- human breast milk is made with the right proportions of protein, fat, calcium, and other things for a developing human
- passive immunity you get from colostrum
- oxytocin also is our bonding hormone (when oxytocin levels go up when mom is nursing, it may be involved in mom bonding with baby. baby oxytocin goes up as well as dad when hes watching)
different functions of oxytocin here
- it causes uterus smooth muscle to contract
- causes myoepithelial cells in breast tissue to contract
- and enhanced emotional bond between mother and child
milk ejection is controlled by positive feedback and the main stimulus for secretion of prolactin is?
suckling
FSH causes?
follicle development
- going from primary follicle that has single layer of granulosa cells to most mature with antron and multiple layers of granulosa cells and thick interna cells and externa cells
FSH stimulates those granulosa cells to make?
large amounts of estrogen and a little but of progesterone
as we go through endometrial cycle, FSH drops but all of a sudden it goes up a bit, FSH goes up at about day 12, estrogen goes up a the same time. whats going on here is?
except for a period of about 36 hours just before ovulation, estrogen inhibits release of GnRH.
but in the 36 hours before ovulation, what happens to estrogen?
estrogen stimulates release of GnRH
- flips to a negative feedback control syst to a positive feedback control syst
so FSH goes up and that causes GnRH to go up and so the LH goes way high. This is called the ?
LH surge
- trigger for ovulation. no LH surge, no ovulation
- what we look for in OTC ovulation tests
we know it has to work like this bc studies have been done where they have given women high levels of LH to keep them at the peak level and not have a surge and then don’t ovulate. its that jump up that triggers ovulation.
once you get that LH surge, we switch back to?
estrogen inhibiting GnRH release
what LH does is?
- cause ovulation
- cause development of corpus luteum called luteinization
- before we get to the full on surge as it is starting to go up a bit, it also will help support follicle development by supporting FSH
we get LH surge, ovulation, we start corpus luteum developing, and as it develops, progesterone goes way up
after progesterone has been high for a while, we get a gradual drop and then it drops dramatically.
its the dramatic drop of progesterone that causes?
spasming of spiral arteries in stratum spongiosum and its this drop where estrogen is dropping at the same time but not as dramatically
that big drop in estrogen is what’s gonna be leading to?
death of stratum compactum and spongiosum and so we shed and get menstruation
PT2:
The fem repro syst is driven from bottom up.
What are hormones are running the show?
The ovarian hormones
- if you know whats going on with the estrogen and progesterone, you’ll be able to know whats going on with everything else
what does estrogen get us?
- proliferation of the endometrium
- parade of effects of progesterone and estrogen - cause endometrial glands to grow and spiral arteries to grow
- when we menstruate, the damage to those structures broke them and made them smaller
a small part of the endometrial thickening under the control of estrogen is caused by what?
an increase in water content
- most of this thickening is bc we’re increasing the number of cells but holding on to a lil more water
in the estrogen driven part of the cycle, we also have more what?
myometrial contractions
in the first part of menstruation, that increase of myometrial contraction is gonna help us do what?
clean out the old endometrium and have a solid foundation to build a new endometrium
progesterone goes up a little bit before ovulation, that beginning of progesterone going up before corpus luteum forms is ?
follicular cells making progesterone, that progesterone is going to cause increase secretion by endometrial glands. it will cause and continue causing after ovulation, a lot of water retention in the endometrium. (most of the thickening of endometrium that happens after ovulation is retention of fluid. very little of it is proliferation of endometrial cells)
Progesterone is going to quiet down the myometrium. estrogen is going to make it contract more, progesterone is going to make it contract less.
when we get to the part of the cycle where progesterone is running the show, that is part of the cycle where pregnancy is a possibility
if corpus luteum dies off, what happens?
estrogen and progesterone both drop, which will cause FSH and LH to both drop and we get menstruation
whats controlling the level of GnRH and FSH and LH in a female?
primarily estrogen
- if you control the GnRH, that controls the FSH and LH for the most part. you got a lil inhibin to deal with as well
if estrogen and progesterone are controlling GnRH levels and estrogen and progesterone are cyclical, that is gonna cause?
GnRH to be cyclical too which will cause FSH and LH to be cyclical too
the fact the hypothalamus is involved in all of this, bc the hypothalamus releases GnRH and the hypothalamus is connected to other things like controlling your autonomic nervous system. what does that mean?
that means that other things that impact whats going on in hypothalamus can affect the cyclical nature of the femal repro syst.
stress for example is going to lead to hormonal situations that prevent ?
the breakdown of the corpus luteum and prevent the shedding of the endometrium
what is the most common stressor is to delay menstruation in a reproductive age woman ?
- thinking your pregnant if you don’t want to be
- trying to get pregnant
the reason that all the cycles in fem repro syst is?
they create the circumstances that make a successful pregnancy most likely
after a particular stage of endometrium has been around a while, what happens?
it can’t support pregnancy as well as a fresh endometrium
- pregnancy is better supported with fresh endometrium than endometrium that can hang around fro 4 years between pregnancies.
we can make sure the blood supply is good. we can make sure the endometrial glands have ducts that are connected and can secrete properly bc those secretions are going to be important to nutrition for that embryo as its implanting.
GnRH stimulates what hormones?
LH and FSH
- FSH comes from anterior pituitary
FSH stimulates what?
- production of estrogen by granulosa cells
- little bit of progesterone
estrogen inhibits?
GnRH release
what does LH stimulate?
formation of corpus luteum. the hormones that we get from corpus luteum is:
- lots of progesterone
- a little estrogen
- inhibin
- relaxin
- WIF (not involved in controlling any of these hormones)
Progesterone inhibits what?
GnRH release
36 hours before ovulation, all of a sudden estrogen that inhibits GnRH release starts stimulating it for a short span of time.
estrogen that comes from follicular cells and estrogen coming from corpus luteum are chemically identical.
there are times where estrogen stimulates GnRH release. most of the time it inhibits, sometimes it stimulates
inhibin, just like it does in a male, inhibits?
FSH but we want it to inhibit FSH for a reason
- these things come from a corpus luteum which means ovulation has happened and theres a possibility of pregnancy. as that happens, we don’t want another group of follicles to start developing bc we don’t want to waste them and so while we have a corpus luteum, we want to block development of another follicle.
when corpus luteum breaks down, what happens?
the inhibin levels get low and we start stimulating follicle development again
