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Block 3; Week 8 > Yan > Flashcards

Yan Flashcards

1
Q

T/F Morning erections for males is a bad sign of health.

A

False. It is a good sign of health, cardiovascular health. Also, semen quality is indicative of general health.

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2
Q

Erectile Dysfunction is indicative of which 2 problems?

A

aging

heart problems

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3
Q

What happens to the amount of viable follicles as a woman ages?

A

They decrease! The atretic follicles increase with age. Growing & ovulating follicles are greatest for a fertile woman.

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4
Q

Which hormones are involved in the female reproductive system?

A 
GnRH
FSH
LH
Estrogen 
Progesterone
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5
Q

What does FSH do to the female reproductive system?

A
  • stimulates development of secondary follicles
  • stimulates granulosa cells to convert androgen to estrogen
  • causes LH receptors on granulosa cells
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6
Q

What does LH do to the female reproductive system?

A
  • stimulates ovulation
  • triggers primary oocyte to complete Meiosis I & move it into Meiosis II
  • transforms remaining granulosa cells & theca interna cells into granulosa lutein cells & theca lutein cells.
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7
Q

What does estrogen do to the female reproductive system?

A

**maintains female reproductive system, secondary sexual characteristics of females, rebuilding the uterus during the proliferative phase
**induces LH surge
**causes inhibition of FSH
Note: granulosa cells secrete inhibin, follistatin, & activin

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8
Q

What does progesterone do to the female reproductive system?

A
  • *inhibits LH production
  • *converts from proliferative phase to secretory phase (perfect for implantation)
  • *maintains secretory phase during pregnancy
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9
Q

What is the ovarian cycle? What is the average length? What is the range of length?

A

menstrual cycle, one ovum released, endometrium prepared for implantation

  • *28 days–>average
  • *20-45 days
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10
Q

What is menarche?

A

the first menstrual period

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11
Q

When does the normal sexual cycle begin? What hormonal changes accompany it?

A

age 11-15 years

Pituitary secretion of FSH & LH starts increasing…

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12
Q

What types of follicles are present in a person’s childhood?

A

primordial follicles

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13
Q

What does FSH & LH do to follicles?

A

causes follicular growth during puberty…

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14
Q

How many follicles are recruited each month for ovulation?

A

6-12 primordial follicles recruited

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15
Q

Describe the progression of follicles from primordial to ovulation.

A 
Primordial Follicles
Primary Follicles
Secondary Follicles (pre-antral)
Antral Follicles
Preovulatory (Graafian) follicles
Ovulation
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16
Q

In primary & secondary follicles–>what types of receptors are present? In Graafian follicles–>what types of receptors are present?

A

Primary & Secondary Follicles: FSH receptors
Graafian Follicles: FSH & LH receptors
**LH receptors make luteinization possible.

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17
Q

LH causes theca interna cells to make androstendione. This diffuses into follicular cells. Under stimulation of ____ it produces ______.

A

FSH stimulation

Estrogen

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18
Q

At what point in follicular development do the follicular cells make estradiol under FSH stimulation?

A

as primary follicles

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19
Q

At what point in follicular development do the follicular cells gain LH receptors?

A

as Graafian follicles

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20
Q

What causes luteolysis?

A

regression of the corpus lutuem is caused when the FSH & LH release tapers off…this begins 7 days after ovulation if there is no pregnancy…

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21
Q

Which hormones lessen after luteolysis? Which increase?

A

Decrease: Progesterone, Estrogen, Inhibin
Increase: FSH

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22
Q

T/F Estrogen & Progesterone stimulate the secretion of FSH & LH.

A

False, they inhibit FSH & LH release.

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23
Q

2 hormones cause LH receptors to develop on granulosa cells. Which hormones? Then, the LH receptors allow LH to stimulate follicular cells to make what?

A

Estrogen & FSH cause LH receptors to go on follicular/granulosa cells. Then w/ LH stimulation, they make progesterone.

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24
Q

What is required to have FSH receptors on granulosa cells?

A

Estrogen

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25
Q

What is required to have LH receptors on granulosa cells?

A

FSH

Estrogen

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26
Q

What is required for rapid growth of follicles?

A

FSH
estrogen
LH

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27
Q

The surge of LH peaks how many hours before ovulation?

A

16 hours before ovulation

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28
Q

Aside from LH, what other hormone coincidentally increases?

A

FSH also increases

doesn’t induce ovulation

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29
Q

LH surge converts granulosa cells & theca interna cells to become -____ secreting.

A

Progesterone secreting

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30
Q

Estrogen levels decrease how long before ovulation?

A

1 day before ovulation

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31
Q

What are the 3 things that make a good environment for ovulation?

A

Rapid growth of follicles
progesterone secretion
decreased estrogen secretion

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32
Q

What folds soon after ovulation forming the corpus luteum?

A

follicular cell layer

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33
Q

Describe what happens during ovulation @ the stigma w/ a surge of LH.

A

Surge of LH
Increased Progesterone
Fibroblasts release proteases & lysosomes of theca externa release proteases
& more blood vessels in theca interna & prostaglandin secretion
Break down Stigma & Collagen fibers of tunica albuginea & theca externa degradation starts & plasma gets into follicle…
Follicle Swelling
Follicle Rupture
Evagination of Ovum

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34
Q

Describe the corpus luteum.

A

Folded Follicular cell layer. Now, considered granulosa lutein cells (larger w/ lipid droplets).
B/w the folds are theca lutein cells (larger w/ lipid droplets) & blood vessels & CT.

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35
Q

Why can blood vessels now occupy the antral space?

A

b/c the basement membrane was degraded & the blood vessels from the theca interna layer invaded.

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36
Q

What originally occupied the antrum that has now become CT? Which cells reside here?

A

Fibrin–>CT

fibroblasts are here laying down CT.

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37
Q

Describe in ridiculous detail the corpus luteum.

A

Follicular cell layer folds & becomes granulosa lutein cells. These cells enlarge & hold lipid droplets.
Spaces are between these folds.
**Here, there are theca lutein cells. They also enlarge & store lipids.
**Here, there are also blood vessels (b/c basement membrane broke down& now blood vessels from theca interna can invade)
**Antrum is filled w/ fibrinbecomes CT. There are fibroblasts making it.

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38
Q

Prior to ovulation, why does an LH surge necessarily cause an increase in progesterone?

A

b/c LH receptors on follicular cells allow for progesterone production.

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39
Q

What does LH do to the corpus luteum?

A

theca lutein cells cause release of progesterone & androstenedione

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40
Q

What does FSH do to the corpus luteum?

A

granulosa lutein cells produce progesterone & estradiol (from androstenedione & aromatization)

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41
Q

What does estrogen do to granulosa lutein cells?

A

causes more progesterone synthesis via cholesterol uptake from blood & lipid storage

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42
Q

Which 2 hormones increase during pregnancy? What does that do to estrogen?

A

Prolactin & placental lactogens

**increases effects of estrogen by increasing estrogen receptors…

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43
Q

When does the corpus albicans form if not pregnant? How about if you are pregnant?

A

Corpus luteum stops after 12 days if not pregnant, then corpus albicans
Corpus luteum stops after 2-4 months of pregnancy, then probably corpus albicans.

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44
Q

During the luteal phase of the ovarian cycle, what causes FSH & LH to decrease?

A

Inhibin (from lutein cells) –>FSH decreases

Estrogen & Progesterone –>FSH & LH decreases

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45
Q

T/F Estrogen & progesterone decrease at end of luteal phase–>FSH & LH start to increase.

A

True. With the increase of FSH & LH can start follicular phase again.

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46
Q

If you are not pregnant, where does most of your estrogen come from?

A

ovary (follicular cells)

small amount from adrenal cortex

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47
Q

If you are pregnant, where does most of your estrogen come from?

A

placenta

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48
Q

What are the 3 types of estrogen? List them from most potent to least potent.

A

Most potent: beta-estradiol
Estrone
Least Potent: Estriol

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49
Q

Where does beta-estradiol come from?

A

ovaries

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50
Q

Where does estrone come from?

A

peripheral tissues (adrenal & ovarian androgens)

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51
Q

Where does estriol come from?

A

derived from estradiol & estrone in the liver

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52
Q

Where do your progestins come from when you are NOT pregnant?

A

from corpus luteum during the luteal phase

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53
Q

Where do your progestins come from when you are pregnant?

A

from the placenta

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54
Q

What are the 2 types of progestin? Which one is the most abundant?

A

Progesterone (most abundant).

17-α-hydroxyprogesterone (less abundant).

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55
Q

On a basic level, where do progestins & estrogens come from?

A

made from cholesterol from the blood in the ovaries.

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56
Q

During the follicular phase: where does estrogen & progesterone come from?

A

Progesterone–>theca interna cells

Estrogen–> follicular cells (made from andrestendione from theca interna cells)

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57
Q

During the follicular phase: where does estrogen & progesterone come from?

A

Progesterone–>Follicular Lutein cells & theca lutein cells

Estrogen–> granulosa lutein cells (from andrastenedione from theca lutein cells)

58
Q

Describe estrogen degradation in the liver.

A

it conjugates w/ stuff in the liver to form: glucuronnides & sulfates
This is excreted via bile & urine

59
Q

Describe progesterone degradation in the liver.

A

it happens w/i a few minutes…

the major degradation product–>pregnanediol.

60
Q

What is hyperestrinism?

A

diminished liver function–>increased estrogen activity.

61
Q

What does estrogen do in the female to the internal & external sex organs?

A

Internal: increases size of ovaries, uterine tubes, uterus
External: increases size of vagina, fat deposition in mons pubis, labia majora, labia minor

62
Q

What does estrogen do to the vaginal epithelium?

A

It changes the epithelium from cuboidal to stratified squamous.

63
Q

Aside from changing the epithelium of the vagina, what else does estrogen do to it?

A

It makes it more resistant to trauma & infection.

64
Q

What is the effect of estrogen on the uterus?

A

It increases its size 2-3 fold.
Helps with the development of endometrial glands.
Helps w/ proliferation of endometrial stroma.

65
Q

What does estrogen do to the uterine tubes?

A

It increases their size.
It causes proliferation of their epithelium.
It increases the number of ciliated epithelial cells.
It increases the cilia activity.

66
Q

What is the effect of estrogen on the breasts?

A

initiates the growth of breasts & the milk-producing apparatus…
it develops the stromal tissues
it grows an extensive ductile system
it deposits fats in the breast

67
Q

For continued breast growth & development, what other hormones do you need?

A

Progesterone

Prolactin

68
Q

What is the effect of estrogen on the skeleton?

A

stimulates bone growth @ puberty
unites epiphyses of shafts of long bones
**if estrogen is greater than testosterone–>stop growing.
**if estrogen levels are low–>females tend to be taller.

69
Q

After menopause, estrogen levels drop in women, & they often get osteoporosis. Describe why.

A

increased osteoclast activity
decreased bone matrix.
decreased deposition of calcium & phosphate

70
Q

Describe other effects of estrogen in the body.

A 
increase in protein deposition
increase in metabolic rate
increase in fat deposition in buttocks & thighs
specific hair distribution
soft, smooth, vascular skin
71
Q

What is the effect of estrogen on electrolyte imbalance in pregnant women?

A

retention of sodium & water in the kidney tubules

72
Q

What is the effect of progesterone on the uterus?

A

causes uterine endometrium to be secretory during 2nd half of ovarian cycle.
helps w/ implantation of ovum in the uterus, prevents expulsion
decreases frequency & intensity of uterine contractions

73
Q

What does progesterone do to uterine tubes?

A

promotes secretion from peg cells–>nutrition for the ovum.

74
Q

What is the effect of progesterone on the breasts?

A

helps develop lobules & alveoli, proliferation & enlargement of alveolar cells

75
Q

T/F Progesterone alone can stimulate milk production in the breast.

A

FALSE–>totally need prolactin for milk production.

76
Q

Describe what happens in the proliferative phase.

A

this phase is under the influence of estrogens
this is after menstruation, before ovulation
stromal & epithelial cells proliferate rapidly
4-7 days after menstruation: re-epithelialization is complete
next 1.5 weeks: stromal cells increase, epithelial glands increase, new blood vessels grow, thickness of endometrium increases

77
Q

At the end of the proliferative phase, what is the average thickness of the endometrium?

A

3-5mm

78
Q

When is the endometrium most thick? What is its average thickness @ this point?

A

peaks @ 1 week after ovulation–>5-6 mm

79
Q

Describe what happens in the secretory phase.

A

this phase is under the influence of estrogens & progesterone
this is after ovulation & before menstruation
Estrogen causes more cellular proliferation
Progesterone–>swelling & secretory development of endometrium

80
Q

Describe in detail what happens to the endometrium during the secretory phase.

A

glands become curvy.
a bunch of secretory substances in the glandular epithelial cells
stromal cell cytoplasm increases
blood supply increases

81
Q

Why does the stromal cell cytoplasm increase during the secretory phase?

A

increases w/ the deposition of glycogen & lipids.

82
Q

Why is it important to have a highly secretory endometrium?

A

provides a large amount of stored nutrients for the fertilized ovum when it enters the uterus & implants

83
Q

Around which days does the fertilized ovum enter the uterus? Around which days does the fertilized ovum implant?

A

Enter uterus: 3-4 days after ovulation

Implants: 7-9 days after ovulation

84
Q

How does a secretory endometrium help w/ implantation?

A

trophoblast cells digest nutrients to provide to the early implanting embryo

85
Q

Which layer of the endometrium is affected by changes in blood levels of progesterone & estrogen? Which layer isn’t?

A

Functional layer: is affected by these hormonal changes

Basal layer: isn’t affected by hormonal changes

86
Q

What types of arteries supply the functional layer of the endometrium? Which types of arteries supply the basal layer of the endometrium?

A

functional layer: spiral arteries

basal layer: basal straight arteries

87
Q

In the follicular phase, which cells produce progesterone?

A

theca interna cells

88
Q

Menstruation only happens when there is no______. At this point something degenerates…what? 2 hormones are reduced–which ones?

A

no fertilization
corpus luteum degenerates
estrogen & progesterone are reduced

89
Q

As the corpus luteum regresses…what happens?

A

rapid involution of the endometrium

vasospasm of blood vessels–prostaglandin release

90
Q

T/F FSH & estrogen causes LH receptors to increase on secondary follicles/Graafian follicles.

A

TRUE

91
Q

Describe menstruation in detail.

A

Necrosis of endometrium & its blood vessels.
hemorrhage 2-2.5 days
Necrotic layers separates from the uterus.
2 days into menstruation–>superficial layers are desquamated
Uterine contraction
75 mL fluid lost

92
Q

How much fluid is lost in menstruation–>how much of this blood? What about the other portion?

A

75 mL fluid lost
40 mL of blood
35 mL of serous fluid

93
Q

What causes hypoxia of the functional layer preceding menstruation?

A

a reduction in progesterone causes periodic contractions of the spiral artery
this causes hypoxia

94
Q

Describe the release of GnRH. What does this do to FSH?

A

It is pulsatile. Released for 5-25 minutes every 1-2 hours. This causes the pulsatile release of FSH every 1.5 hours.

95
Q

Where is GnRH released from?

A

mediobasal hypothalamus

specifically: arcuate nuclei

96
Q

What is the regulatory effect of estrogen by itself?

A

It inhibits FSH & LH release.

97
Q

What is the regulatory effect of progesterone by itself?

A

It doesn’t have much of an effect by itself.

98
Q

What is the regulatory effect of progesterone & estrogen together?

A

Strong inhibition of FSH & LH on the pituitary & hypothalamic levels…

99
Q

What is inhibin released from? What does it do for regulation?

A

granulosa cells

inhibits release of FSH & LH

100
Q

Describe FSH & LH levels during the first half of the ovarian cycle.

A

They are both at first suppressed. Then they rapidly increase at the end, LH moreso than FSH.

101
Q

What happens if you don’t have an LH surge?

A

No ovulation. Anovulatory cycle.
corpus luteum doesn’t develop & you don’t get major progesterone production
cycle is a few days shorter

102
Q

When are anovulatory cycles most common in a woman?

A

the first few cycles after puberty

the cycles about a year after menopause

103
Q

How can you have a cycle w/o progesterone production?

A

Progesterone controls the rhythm of things, but is not necessary to have a cycle.

104
Q

What is the period of the reign of FSH? What does it do?

A

helps w/ follicular development during the first half of the cycle…
causes granulosa cells to make estradiol

105
Q

What is the period of the reign of LH? What does it do?

A

during the first half of the cycle when there is a mature follicle, during ovulation, & the luteal phase…not once the corpus luteum is dying

106
Q

When does estrogen have its reign? By itself?

A

once the follicles are more mature

during the proliferative phase

107
Q

When does estrogen & progesterone together have their reign?

A

once you have a corpus luteum, even when it is dying…

secretory phase

108
Q

Describe GnRH release before puberty & after puberty?

A

Before puberty: there are suppressive factors in the brain that stop GnRH secretion
After puberty: gradual increase in GnRH release, pulsatile.

109
Q

Describe what happens to the ovaries & hormone levels in menopause.

A

ovarian “burning out”
after age 45, only a few follicles remain to respond to FSH & LH levels
Estrogen decreases
FSH & LH levels rise dramatically.

110
Q

Before age 45, how many follicles are maturing & ovulating?

A

400

111
Q

What is the menopausal syndrome? What causes it?

A 
Lack of estrogen causes the symptoms of the menopausal syndrome.
Hot flashes
shortness of breath
Irritability
Fatigue
Anxiety
Decreased bone strength, calcification
112
Q

Describe the cause of hyper secretion of estrogen by the ovaries.

A

can be associated w/ a granulosa cell tumor

inhibin deficiency

113
Q

What does it mean to be a eunuch?

A

absence of testes/gonads

lack of sexual function & secondary male characteristics

114
Q

What is female eunuchism?

A

ovaries absent at birth
or the ovaries becomes nonfunctional before puberty
**no secondary sexual characteristics
*sex organs infantile
*taller: more growth of long bones & delayed epiphyseal fusion

115
Q

What happens to a woman if she is fully developed & her ovaries are removed?

A

sex organs regress

similar things happen as happen to a woman in menopause

116
Q

Which hormone is totally vital for a normal cycle?

A

estrogen

117
Q

What are the effects of hypogonadism on a female?

A

irregularity of menses & sometimes amenorrhea.

118
Q

What are the 2 things that stimulate the female sexual act?

A

psychic stimulation

local stimulation

119
Q

What causes female erection & lubrication?

A

parasympathetic signals

120
Q

Describe erection of the clitoris.

A

similar to penile erection

121
Q

Describe lubrication in the female.

A

Vaginal epithelium secreted mucus

Mainly: Bartholin’s glands under the labia minora secrete mucus.

122
Q

The female orgasm is analogous to what in the male?

A

emission & ejaculation

123
Q

Why is female orgasm important for fertilization?

A

perineal muscles contract rhythmically (spinal cord reflex)
uterus & fallopian tube motility increases
cervical canal dilated for 30 minutes (easy sperm passage)
oxytocin secretion (contraction of the uterus)
**all these things helps w/ sperm transport

124
Q

When is a woman most fertile?

A

up to 24 hours after ovulation

125
Q

How long can sperm survive in a woman?

A

4-5 days

**if you have sex 4-5 days after ovulation could still be pregnant

126
Q

Describe the rhythm method of contraception.

A

you avoid intercourse b/w 4-5 days before calculated day of ovulation, & 3 days after ovulation.
**only works if you have regular periodicity of menstrual cycle

127
Q

How many days b/w ovulation & menstruation?

A

13-15 days

128
Q

If you have a 28 day cycle…when will ovulation occur?

A

w/i 1 day of day 14 usually

129
Q

If you have a 40 day cycle…when will ovulation occur?

A

w/i 1 day of the 26th day of the cycle usually…

130
Q

How do hormonal contraceptive pills work?

A

maintain estrogen & progesterone levels in the first half of the cycle so that there is no LH surge & no ovulation.
taken in early stage of cycle
stop taking pills to allow for menstruation

131
Q

Why are synthetic estrogen & progestin used in hormonal contraceptive pills?

A

b/c they can then avoid liver degradation.

132
Q

What percentage of couples experience infertility? In those couples, what percentage of them experience this b/c of a female issue? What are the 3 general causes

A 
15% of couples
50% of the time-->females
**could be:
endocrine
structural
genetic
133
Q

Describe which types of genetic abnormalities that can cause female infertility.

A

mutations in genes essential for follicular genesis

134
Q

When you get multiple ovulations, what are you at risk for?

A

multiple births

135
Q

What kind of an endocrine abnormality can lead to anovulation?

A

hyposecretion of gonadotropins–>not enough to induce ovulation

136
Q

What are 2 ways to test for endocrine anovulation?

A

urine pregnanediol levels

body temperature raises 0.5 degrees F w/ progesterone.

137
Q

What is the treatment for endocrine anovulation?

A

hCG

138
Q

What are 4 structural abnormalities that could explain anovulation?

A

Ovarian anatomic abnormalities
Endometriosis
Salpingitis
abnormal secretion of mucus by the uterine cervix.

139
Q

What is salpingitis?

A

inflammation of the fallopian tubes

140
Q

What is endometriosis?

A
  • *the endometrial tissues (in the uterine tubes too) grow into the pelvic cavity
  • *this tissue menstruates into the pelvic cavity, causes fibrosis in the pelvis
  • *obstructs ovulation & capture @ the fimbrae

Block 3; Week 8 (8 decks)

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