A&P II Repro (Female)

Question 1

What hormones do female gonads produce?

Answer 1

• Progesterone
• Estrogen
• Inhibin
• Relaxin

Question 2

What are the ligaments that hold the Uterus, Ovaries, Fallopian Tubes in place?

Answer 2

Broad ligament
● Encompasses ovaries, fallopian tubes, uterus

Ovarian ligament
● Anchors ovaries to uterus

Suspensory ligament
● Attaches them to pelvic wall

Question 3

Cells that surround follicles

Answer 3

Granulosa cells

● Begin with cells in single layer awaiting oogenesis (Example: primordial follicle)

● Under the influence of FSH, cells multiply into layers (Example: primary and secondary follicles)

Question 4

What is a large, fluid-filled follicle that is ready to rupture and expels the secondary oocyte (process of ovulation)?

Answer 4

Mature (graafian) follicle

Question 5

What contains remnants of mature follicle after ovulation?

What does it produce?

Answer 5

Corpus luteum (yellow body)

Produces progesterone, estrogens, relaxin and inhibin until it degenerates

Question 6

When does Oogenesis begin?

What’s different in comparison to males?

Answer 6

Begins in females before birth

*Remember spermatogenesis begins in males at puberty*

• Mitosis takes place (this is not continual in females like it is in males though)
• Meiosis takes place
• Resulting germ cells undergo maturation

Question 7

What are the steps to Oogoniea?

Answer 7

• primordial germ cells migrate from yolk sac to gonadal ridge (4th week of fetal development) -> oogonia (immature germ cells) diploid (2n)
• • Undergo mitosis to produce 6-7 million oogonia (mid-gestational period (20 weeks))
• Begin meiosis I which then changes their classification into primary oocytes
• Become “arrested” in the prophase of meiosis I until puberty
  
  • The primary oocyte is surrounded by a single layer of granulosa cells
  • Entire structure at this point is called a primordial follicle
• FSH/LH stimulate development of 10-30 primordial follicles
  
  • Primordial follicles morph into primary follicles
• primary follicles -> Secondary follicle​ -> Tertiary follicle -> Mature (graafian) follicle

Question 8

stromal cells surrounding basement membrane surrounding the primary oocyte?

Answer 8

Theca folliculi

Question 9

What does the theca folliculi differentiate into?

Answer 9

● Theca interna: highly vascularized cells, secretes precursor androgen that granulosa cells convert into estrogen
● Theca externa: outer layer of stromal cells and collagen fibers

Question 10

What cells produce/secrete small amounts of progesterone which is thought to attract sperm and promote motility, in Secondary Follicle cells?

Answer 10

cumulus-granulosa cells in the Corona radiata layer

*produce/secrete small amounts of progesterone which is thought to attract sperm and promote motility*

Question 11

gel-like matrix that coats itself, helps to adhere the cumulus-granulosa cells to it, and is this process that begins in primary follicles but completes as secondary follicles is called?

Answer 11

Zona pellucida

Question 12

Just before ovulation of the mature follicle, what occurs?

Answer 12

The diploid primary oocyte completes meiosis I

• This produces two haploid (n) cells of UNEQUAL size
• Each has 23 chromosomes

first polar body: smaller haploid cell -> degenerates or divides to form non-functional cells

secondary oocyte: Begins meiosis II but stops in metaphase, Is then released (ovulation)

Question 13

What occurs during ovulation?

Answer 13

• Secondary OOCYTE expelled into pelvic cavity (also expelled is the first polar body)
• If fertilization does not occur, all cells degenerate
• If sperm present and penetrates secondary oocyte, meiosis II resumes
• Secondary oocyte splits into two haploid cells
• Ovum- larger cell (+ nuclei of sperm = diploid zygote)

Question 14

What occurs after ovulation?

Answer 14

• Currents produced by fimbriae surround mature follicle
• Current pulls the OOCYTE from the peritoneal cavity into the fallopian tube
• Peristaltic movements of tubal layers move the secondary oocyte toward the uterus
• If not fertilized at time of uterus arrival, the oocyte will begin to disintegrate (menses)

Fertilization

• Sperm cell usually encounters secondary oocyte in the ampulla of fallopian tube (fertilization)
• Can happen in the peritoneal cavity but this is rare
• Haploid(n) nuclear materials unite -> Becomes diploid (2n) (now called a zygote)
• Begins cell division while moving towards uterus -> Implantation occurs in uterine wall

Question 15

Location of the uterus in relation to the bladder and rectum?

Answer 15

Superior to the bladder / Anteflexion- body of uterus projects anteriorly over bladder

Anterior to the rectum

Question 16

What are the anatomical variances of the uterus?

Answer 16

Question 17

Define the portions of the Uterus

Fundus:
Body:
Cervix:

Isthmus:
Uterine cavity:
Cervical canal:

Internal os:

External os:

Answer 17

Fundus: top of the uterus
Body: central portion
Cervix: inferior extension of uterus into vaginal canal

Isthmus: region between the body and the cervix.
Uterine cavity: interior of the body
Cervical canal: interior of the cervix

Internal os: opening of the canal into the uterus

External os: opening of the canal into the vagina

Question 18

Three histological layers of the uterus?

Answer 18

1. Perimetrium: Laterally becomes broad ligament
   
   • Anteriorly covers bladder, forms vesicouterine pouch
   • Posteriorly covers rectum, forms rectouterine pouch (Tends to be where fluid collects)
2. Myometrium: consisting of three layers of smooth muscle
3. Endometrium
   
   • Stratum functionalis layer- shed each month during menstruation
   • Stratum basalis layer- permanent, gives rise to a new stratum functionalis after each menstruation

Question 19

Broad Ligaments encompass?

Answer 19

ovaries, fallopian tubes, uterus

Question 20

Uterosacral Ligaments connect?

Answer 20

Connect uterus (specifically cervix) to sacrum

Lie on either side of rectum

Question 21

Cardinal (lateral) Ligaments connect?

Answer 21

Extend from pelvic wall to cervix and vagina

Question 22

Round Ligaments connect?

Answer 22

Extend from point on uterus just inferior to fallopian tubes to portion of labia majora

Question 23

Supply blood to the uterus?

Answer 23

Uterine arteries: branches of internal iliac artery

• Arcuate arteries: Arranged in circular fashion in myometrium
  
  • Radial arteries: Penetrate deeply into myometrium
    • endometrium
    • Straight arterioles- supply stratum basalis
    • Spiral arterioles-​ supply stratum functionalis*​

Question 24

Never had fetus pass through cervix

Answer 24

Nulliparous

(Could mean someone who had a c-section though)

Question 25

Had child pass through cervix

Answer 25

Parous

Question 26

Cervix lined by two types of cells

Answer 26

**_Ectocervix:_** lined with multi-layered stratified squamous epithelium **_Endocervix:_** lined with single-layer tall columnar epithelium

Question 27

Where the two types of cells meet of the cervix meet

Answer 27

Squamocolumnar Junction (SCJ)

Question 28

Space between original and new SCJ, shiny are? benign mucous cysts located here = ?

Answer 28

Transformation Zone Nabothian **_very vulnerable to human papilloma virus (HPV) infection_**

Question 29

Premenarchal Cervix looks like?

Answer 29

Question 30

Early Reproductive Age Cervix looks like?

Answer 30

Question 31

Later Reproductive Age Cervix looks like?

Answer 31

Question 32

Perimenopausal Cervix looks like?

Answer 32

Question 33

Menopausal Cervix looks like?

Answer 33

Question 34

Recess (area) that surrounds vaginal attachment to cervix

Answer 34

Fornix

Question 35

Layers of the Vagina?

Answer 35

* **_Adventitia_**- anchors vagina to adjacent organs * **_Muscularis_**- composed of an outer circular layer and inner longitudinal layer of smooth muscle * This allows the vagina to stretch during intercourse and childbirth * **_Mucosa_**- continuous with that of the uterus

Question 36

Vulva consists of?

Answer 36

Mons pubis: adipose tissue, cushions pubic symphysis Labia majora: Covered by pubic hair, composed of adipose tissue, sebaceous glands, sudoriferous glands Labia minora: Contains many sebaceous glands, Devoid of pubic hair and fat

Question 37

Gland, embedded in the wall of the urethra, lateral to urethral orifice, secrete mucous?

Answer 37

**Paraurethral (Skene’s) glands**

Question 38

lateral to vaginal orifice, produce mucous during sexual arousal to provide lubrication

Answer 38

**Greater vestibular (Bartholin’s) glands**

Question 39

Has two masses of erectile tissue that engorge during sexual arousal to narrow the vaginal orifice applying pressure during intercourse

Answer 39

**Bulbs of the vestibule**

Question 40

Erectile and very sensitive tissue that fill with blood during sexual arousal as well

Answer 40

Corpus cavernosum of Clitoris

Question 41

Diamond shaped area medial to thighs and buttocks

Answer 41

Perineum

Question 42

run between breast skin and fascia (ligament)

Answer 42

Cooper’s Ligaments

Question 43

found within lobules, secrete milk

Answer 43

Alveoli

Question 44

Milk _production_ stimulated Milk _ejection_ stimulated

Answer 44

_production:_ prolactin _ejection:_ oxytocin

Question 45

Includes changes that occur during and after maturation of the oocyte (Cycle)

Answer 45

Ovarian cycle

Question 46

Involves changes in the endometrium that prepare it for implantation of the developing embryo (Cycle)

Answer 46

Uterine cycle (If fertilization does not occur, the ovarian hormones recede and cause sloughing of the stratum functionalis)

Question 47

Stimulates ovarian follicles to produce estrogen Stimulates the release of LH and FSH

Answer 47

**_Gonadotropin-releasing hormone (GnRH)_** * Released from the hypothalamus * Controls both the ovarian and uterine cycles

Question 48

Initiates follicular growth

Answer 48

**_Follicle Stimulating Hormone_** Androgens (made by LH) taken up by the granulosa cells and turned into estrogen (under influence of FSH)

Question 49

Stimulates further development of ovarian follicles Stimulates theca cells to produce androgens triggers ovulation (mid-cycle)

Answer 49

**_Luteinizing Hormone_** forms the corpus luteum * Estrogen * Progesterone * Relaxin\*-Very small amounts produced unless fertilization occurs * Inhibin\*-Very small amounts produced unless fertilization occurs

Question 50

**Promotes development and maintenance of Reproductive structures, Breasts, 2° sex characteristics** Increases protein anabolism Lower blood cholesterol moderate levels inhibit release of GnRH and secretion of FSH/LH

Answer 50

**_Estrogen_** Includes building of strong bones Synergistic with hGH

Question 51

2° sex characteristics include?

Answer 51

● Distribution of adipose tissue in breasts, abdomen, mons pubis, hips ● Voice pitch ● Broad pelvis ● Pattern of hair growth (head and body)

Question 52

Synergistic with estrogen to prepare and maintain endometrium Helps to prepare the mammary glands for milk secretion High levels of progesterone also inhibit secretion of GnRH and LH

Answer 52

**_Progesterone_** Secreted mainly by cells of the corpus luteum

Question 53

**_Relaxes the uterus by inhibiting contractions_** Thought to help increase flexibility of pubic symphysis and help dilate cervix during labor

Answer 53

**_Relaxin_**

Question 54

Secreted by granulosa cells (of growing follicles) and corpus luteum after ovulation Inhibits secretion of FSH and (too a lesser extent) LH

Answer 54

**Inhibin**

Question 55

Phases of Reproductive Cycle

Answer 55

* Menstrual: follicular phase * Preovulatory: luteal phase * Ovulation: proliferative phase * Postovulatory: secretory phase

Question 56

Menstrual Phase? What is are the levels of hormones, what do they cause, etc.

Answer 56

**_Increased FSH_** = primordial follicles into primary follicles Menses- 50-150mL of blood, tissue fluid, mucus and epithelial cells shed from endometrium **Decline** of **progesterone and estrogen** = release of **prostaglandins** = **spiral arterioles to constrict** **stratum functionalis** layer cells are oxygen deprived and start to die

Question 57

**Preovulatory Phase?** What is are the levels of hormones, what do they cause, etc.

Answer 57

**primary follicles** -\> **secondary follicles** secondary follicles secrete **estrogen and inhibin** = _decreases_ the release of **FSH** one of the secondary follicles has outgrown all others to become the **dominant follicle** **dominant follicle** -\> **mature (graafian) follicle** **estrogen** production is increased as size of the follicle **increases** Estrogen by growing follicles stimulate the repair of the endometrium

Question 58

**_Ovulation Phase_** What is are the levels of hormones, what do they cause, etc.

Answer 58

Rupture of the mature (graafian) follicle = release of the **_secondary oocyte_** secondary oocyte surrounded by the **zona pellucida** and **corona radiate** (cumulus cells) High **estrogen** causes _increased_ **GnRH** from hypothalamus, and **LH** from anterior pituitary _LH (surge) = rupture of mature follicle / expulsion of secondary oocyte_

Question 59

**_Postovulatory Phase_** What is are the levels of hormones, what do they cause, etc.

Answer 59

the mature (graafian) follicle collapses -\> become corpus luteum cells LH stimulates corpus luteum to secrete _Progesterone, Estrogen, Inhibin, Relaxin_ **NOT FERTILIZED =** hormones decline degenerate into _corpus albicans_ _progesterone, estrogen, inhibin_ **decrease** = _GnRH, FSH, LH_ **rise** **FERTILIZED​ =** sperm penetrates the zona pellucida, it signals the secondary oocyte to complete meiosis II ovum and a second polar body -\> sperm + ovum = ZYGOTE (diploid) **_hCG_** is produced by the chorion -\> stimulates corpus luteum to secrete

Question 60

What are the four stages of female orgasm?

Answer 60

Excitement phase Plateau Phase Orgasm phase Resolution phase

Question 61

What stage of the orgasm is parasympathetic response

Answer 61

Excitement phase and Plateau Phase

Question 62

What stages of the orgasm is sympathetic?

Answer 62

Orgasm phase Resolution phase

Question 63

Non-incisional Sterilization of a women?

Answer 63

Essure

Question 64

Types of oral contraceptives?

Answer 64

**_progestin_** (hormone with actions similar to progesterone) = thicken cervical mucous to block sperm / block implantation in the uterus **_estrogen and progestin_** = inhibit ovulation by suppressing the FSH/LH prevents development of dominant follicle

Question 65

Oral Contraceptives may not be advised for women with?

Answer 65

* blood clotting disorders * cerebral blood vessel damage * migraine headaches * hypertension * liver malfunction * heart disease

Question 66

pain with ovulation is called?

Answer 66

mittelschmerz

Question 67

Medication used for abortions

Answer 67

mifepristone (anti-progestin)

Question 68

Surge of what hormone causes hot flashes?

Answer 68

GnRH

Question 69

What happens to estrogen post menopause?

Answer 69

estrogen **declines** no matter how much FSH/LH is released from ant. pit