38 - Female Reproduction II Flashcards Preview

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Flashcards in 38 - Female Reproduction II Deck (92):

What are the four main steps of ovulation?

1 - Follicular changes right before ovulation
2 - Follicle ruptures
3 - Secondary oocyte becomes suspending in metaphase II
4 - The oocyte is ovulated and enters the fallopian tube


What are the follicular changes that occur right before ovulation?

- Blood flow to the cortical tissue of the ovary (which covers the follicle) ceases
- Clear pale spots called stigma form, covering the follicle
- Proteases breakdown the cortical tissue


What happens when the follicle ruptures?

The liquor folliculi is also released


How does the oocyte get from the ovary where it is ovulated to the fallopian tube?

The fallopian tubes contain fimbriae or "fringes" at the distal open end which assists in the capture of the oocyte from the ovary


What happens following ovulation in the ovary?

The granulosa and thecal cells are transformed into a temporary endocrine gland


What is the temporary endocrine gland formed by granulosa and thecal cells called?

Corpus luteum or "yellow body" because it looks yellow in fresh specimen


What is the specific endocrine function of the corpus luteum post-ovulation?

Release estrogen and progesterone in order to prepare the lining of the uterus to receive the blastocyst


If implantation does not occur, what happens to the corpus luteum?

The corpus luteum will persist as the "corpus luteum of menstruation" during day 15-28 of the cycle and will continue to release estrogen and progesterone to influence to endometrial lining


What happens to the corpus luteum after day 28?

It will degerate and become the corpus albicans, which is a "tiny white scar" tissue formation in the ovarian cortex


If implantation does occur, what happens to the corpus luteum?

The corpus luteum will persist as the "corpus luteum of pregnancy" and is maintained by hCG


Before sperm is able to fertilize the oocyte, it must penetrate through two layers. What are they?

1 - Corona radiate (granulosa layer)
2 - Zona pellucida (contains glycoproteins)


Which glycoproteins are found in the zona pellucida of an oocyte?

ZP-1, ZP-2, ZP-3


What happens when a sperm penetrates both layers?

It eventually passes into the cytoplasm of the oocyte


What phase is the oocyte suspended in?

The secondary oocyte is suspended in metaphase II


What needs to happen in order for the secondary oocyte to complete meiosis II?

When a sperm passes into the cytoplasm


What does the sperm release to aid in fertilization?

The acrosome (tip of head) releases enzymes that breakdown the first barrier of the oocyte, the corona radiate


What does the sperm do when it reaches the zona pellucida?

Binds to ZP-3, a glycoprotein which serves as the spermatozoa-binding receptor


What does the sperm binding to ZP-3 induce?

More enzymes to be released from the acrosome that help it to perforate the zona pellucida


What happens once one sperm has completely perforated the zona pellucida?

The "zona reaction" occurs, which changes the composition of the zona pellucida to make it impermeable to other sperm


How many sperm can fertilize a single oocyte?

Only one


Once the sperm is inside the cytoplasm of the oocyte, what will occur?

Meiosis II (anaphase and telophase)


Once the fertilized oocyte forms a zygote, how many cells is this structute?



Are any two zygotes the same?



What happens to a zygote as it travels through the fallopian tube?

It under goes cleavage - a series of mitosis


How many cells will from during cleavage?

2 cell --> 4 cells --> 8 cells --> Morula (12-16 cells)


What happens to the morula that causes it to form into a blastocyst?

Fluid fro the uterine cavity passes into the morula and causes the cells to rearrange, forming a blastocyst


What happens after the blastocyst enters the uterus?

It implants in the posterior uterine wall


How many days after fertilization does implantation occur?

21 days


The fallopian tube has two ends. What are they called?

- The end that is attached to the uterus is called the "attached end"
- The end that is open near the ovary is called the "open end"


What are the "fringe-like structures" of the fallopian tube's open end called?



What is the normal function of fimbria?

Fimbria normally hover over the ovary so when an oocyte is released, the oocyte can easily pass into the lumen of the fallopian tube


When looking at a fallopian tube in cross section, what will the mucosa look like?

"Leaf-shaped" structures


What is the mucosa of the fallopian tube made of?

Epithelium and lamina propria (loose connective tissue)


Why is there a "leaf-shaped" structure to the fallopian tube mucosa?

Increase surface area


What other layers are found in the fallopian tube beyond the mucosa?

Muscularis and serosa


What does the muscularis layer of the fallopian tube consist of?

- A thick inner layer of circular (spiral) fibers
- An outer layer of longitudinal fibers


What type of muscle cells are found in the fallopian tube?

Smooth muscle
- Paristaltic waves produced by the smooth muscle helps to move the oocyte/zygote toward the uterus


Describe the serosa of the fallopian tube

- Single layer of epithelial cells
- Visceral peritoneum (mesothelium and a thin layer of loose connective tissue)


What type of epithelium would you find on the mucosal folds of the fallopian tube?

Simple columnar epithelium


There are two types of cells found in the epithelium of the mucosal folds. What are they?

- Ciliated cells
- Nonciliated peg cells


What is the function of the ciliated epithelial cells of the fallopian tube mucosal folds?

Move the oocyte through the fallopian tube


What is the function of the non-ciliated peg cells of the fallopian tube mucosal folds?

- Secrete glycoproteins
- Supply nutrients to the oocyte/zygote since there is no placenta yet


What is an ectopic tubal pregnancy?

The zygote implants in the fallopian tube


What happens as the zygote grows in an ectopic tubal pregnancy?

The wall of the fallopian tube stretches and eventually ruptures - this causes a hemorrhage


What does "ectopic" mean?

Outside the normal location where the zygot is supposed to implant


What are the three layers of the uterus?

1 - Perimetrium (outer)
2 - Myometrium
3 - Endometrium (inner)


What does the myometrium consist of?

A middle smooth muscle layer


What arteries run through this layer?

The uterine artery gives rise to the arcuate arteries, which will run circumferentially around the uterus


What do we call the branches of the arcuate arteries that radiate toward the surface of the uterus?

Radial branches


What do the radial branches branch off into? What do these branches supply

Radial artery
- Straight arteries: supply basal layer
- Spiral arteries: supply functional layer


What type of epithelium do we find in the innermost endometrial layer of the uterus?

Simple columnar


There is also a lamina propria of the endometrium. What is this called?

Endometrial stroma


What does the endometrial stroma consist of?

- Uterine glands
- Dense irregular collagenous tissue
- Blood vessels


What does the tissue of the uterine cervix consist of?

- 85% dense collagenous connective tissue
- Elastic fiber
- Some smooth muscle (not as much as myometrium)


The endometrium and cervix have one type of epithelium, but the vagina has a different type. What are these two types?

Endocervical = simple columnar, mucous-secreting
Vaginal = stratified squamous, nonkeratinized


Describe the glands of the cervix

- Branched pattern
- Lined with mucous-secreting columnar epithelium


What does a normal cervical smear look like?

- Each squamous epithelial cell contains a pyknotic nuclei
- Abundant cytoplasm around nucleus
- RBCs
- Neutrophils


What does an abnormal cervical smear look like?

- Large nuclei
- Little cytoplasm around nucleus
- Neutrophils


There are three phases of the menstrual cycle. What are they?

1 - Menstrual phase (day 1-4)
2 - Proliferative phase (day 5-14)
3 - Secretory phase (day 15-28)


What occurs during the menstrual phase?

Day 1-4
- Menstrual flow


What occurs during the proliferative phase?

Day 5-14
- Follicular maturation in preparation for ovulation
- Estrogen stimulates the proliferation of tissues in the functional layer of the endometrium


What exactly proliferates in the functional layer of the endometrium?

- Building up of the lamina propria
- Uterine glands proliferate
- Spiral arteries proleferate


What occurs during the secretory phase?

(AKA luteal phase, progestational phase)
Day 15-28
- Formation of the corpus luteum
- Progesterone stimulates the synthesis and secretion of glycoproteins by uterine glands


Does the basal layer of the endometrium shed?

NO - just the functional layer


What histological features will you see in poly cystic ovary syndrome? (PCOS)

- Tunica albuginea is excessively thick
- Under the tunica albuginea there are many small immature primordial follicles


What is the tunica albuginea again?

A layer of dense irregular collagenous connective tissue that lies immediately deep to the germinal epithelium


What are the consequences of these histological features of PCOS?

- Incomplete follicular development
- Infrequent or lack of ovulation


How do the cysts form in PCOS?

The abnormally thick tunica albuginea does not let oocytes in the follicles be released during ovulation, so over time, the follicles accumulate and the antrum becomes enlarged, forming the follicular cyst


Will patients with PCOS be fertile?

No, the lack of an ovulatory menstrual cycle results in infertility


Will the corpus luteum form in patients with PCOS?

No, since oocytes are not ovulating


Will there be normal levels of estrogen and progesterone present?

There will be an imbalance in the estrogen/progesterone ratio...
- Estrogen will be produced
- Progesterone will not be produced


What do granulosa cells produce?

Androgens, which are converted to estrogen


How is the menstrual cycle changed in PCOS due to the levels of estrogen and progesterone present?

Estrogen will stimulate the uterine lining, but since there is no progesterone present, the lining will not develop normally

Infrequent menstrual bleeding will be seen in patients with PCOS


What do FSH and LH control?

The growth of follicles and the release of eggs


What happens during the proliferative phase?

Day 5-14
- Functional layer of the endometrium proliferates
- Formation of follicle, which releases estrogen
- This stimulates formation of connective tissue, blood vessels and glands


What happens during the secretory phase?

Begins around day 15
- This corresponds to the time when the corpus luteum forms
- Progesterone, produced by the corpus luteum, stimulates the glands in the endometrium to release glycoproteins
- These glycoproteins will nourish the implanting blastocyst if implantation occurs


What happens during the menstrual phase?

Day 1-4
- If the ovulated oocyte is not fertilized and implantation does not occur, the corpus luteum stops functioning at about day 14
- Progesterone and estrogen levels drop
- The functional layer of the endometrium sheds


What histological features will we see during the menstrual phase?

- Smooth muscle in the wall of spiral arteries will undergo spasmodic contraction
- Blood flow to the functional layer ceases
- Ischemia leads to necrosis (tissue degeneration) of the functional layer
- The functional layer is "sloughed off"
- The blood vessels break off
- Bleeding occurs


Describe the postmenopausal endometrium

- Thin, atrophic endometrium
- Consists of only stratum basale
- Sparce, inactive glands will be present


What can happen to the glands of the postmenopausal endometrium?

They can form dilated cystic spaces


Are dilated cystic spaces from the glands in the postmenopausal endometrium normal?

Yes - common and normal


What is uterine leiomyoma?

AKA fibroids
Benign smooth muscle neoplasm that is found in the myometrium

(neoplasm is a tumor or abnormal growth)


What three regions can a uterine leiomyoma occur?

- Subserosal
- Intramural
- Submucosal


What is one side effect that can occur if the leiomyoma is in the submucosal layer

- Increase in surface area of the uterine endometrium
- Causes heavy menstrual bleeding


How common is it that a leiomyoma will transform into a malignant leiomyosarcoma?

Only about 1% of leiomyomas will transform into a malignant leiomyosarcoma


What type of epithelium is found in the vagina?

Stratified squamous nonkeratinized epithelium


What layers will you find in the vagina wall?

- Epithelium
- Lamina propria
- Muscularis
- Adventitia


What is important to note about the lamina propria of the vagina?

It has elastic fibers


Will there be any glands present in the vaginal wall?



Describe a non-pregnant mammary gland

- Branching duct system of a lobule
- Dense fibrous interlobular tissue


Describe a mammary gland during pregnancy

- The terminal duct epithelium proliferates to form secretory acini
- Separate lobules will be present
- Septa will separate these lobules


What is the "look alike" tissue of a lactating mammary gland?

The thyroid gland