Ch. 19 The Menstrual Cycle

Question 1

The last menstrual cycle relates to the

Answer 1

onset of menses

Question 2

The average menstrual cycle lasts ___ days with ovulation occurring on day ___.

Answer 2

28, 14

Question 3

The first menstrual cycle is termed

Answer 3

menarche

Question 4

Primary amenorrhea may be caused by congenital abnormalities or congenital obstructions, such as an ______

Answer 4

imperforate hymen

Question 5

if an individual does not experience menarche before age 16, she is said to have _____

Answer 5

primary amenorrhea

Question 6

_______may be associated with endocrinologic abnormalities or pregnancy

Answer 6

Secondary amenorrhea

Question 7

Secondary amenorrhea that is not associated with pregnancy is characteristically diagnosed in the postmenarchal woman who has had ____ to ____months without a menstrual cycle.

Answer 7

3 to 6

Question 8

The ________is the complex interactions that take place between the hypothalamus, pituitary gland, and ovaries as part of the female reproductive cycle.

Answer 8

hypothalamic–pituitary–gonadal axis

Question 9

The _______is an area within the brain that is located just beneath the thalamus. The primary responsibility of the ______, as it relates to the menstrual cycle, is to regulate the release of hormones by the anterior pituitary gland.

Answer 9

hypothalamus

Question 10

the hormone released by the hypothalamus that stimulates the pituitary gland to release the hormones that regulate the female menstrual cycle

Answer 10

gonadotropin-releasing hormone (GnRH)

Question 11

The pituitary gland, often referred to as the “________,” is an endocrine gland located within the brain that consists of an anterior and a posterior lobe

Answer 11

master gland

Question 12

The anterior lobe of the pituitary gland is responsible for the release of two chief hormones that influence the menstrual cycle: ____and____(*both act upon the ovaries)

Answer 12

follicle-stimulating hormone (FSH) and luteinizing hormone (LH)

Question 13

FSH causes the development of multiple_______on the ovaries, whereas LH surges around day 14 of the menstrual cycle, resulting in ______.

Answer 13

follicles; ovulation

Question 14

The ovaries produce two hormones called

Answer 14

estrogen & progesterone

Question 15

Estrogen is initially produced by the __________of the secondary follicles during the first part of the menstrual cycle.

Answer 15

theca internal cells

Question 16

cells of the follicle that produces estrogen

Answer 16

theca internal cells

Question 17

______ has many other important functions, such as the regeneration of the endometrium after menses and the induction of salt and water retention. It also stimulates contractile motions within the uterine myometrium and the fallopian tubes.

Answer 17

Estrogen

Question 18

progesterone is produced by the _______ of the ovary

Answer 18

corpus luteum

Question 19

the temporary endocrine gland that results from the rupture of the Graafian follicle after ovulation

Answer 19

corpus luteum

Question 20

______responsible for maintaining the thickness of the endometrium and inducing its secretory activity as the endometrium prepares for the possible implantation of a pregnancy.

Answer 20

progesterone

Question 21

The ovary produces estrogen and progesterone, which influence the _______.

Answer 21

endometrium

Question 22

The ovarian cycle consists of two phases: the _______ and ______

Answer 22

follicular phase and the luteal phase

Question 23

The _____of the ovarian cycle is considered to begin on day 1 and lasts until day 14, thus, in effect, ending with ovulation.

Answer 23

follicular phase

Question 24

During the follicular phase the anterior pituitary gland secretes ___, which initiates the follicular development of the ovary.

Answer 24

FSH

Question 25

only one follicle will progress from primordial follicle to primary follicle and then to become a secondary follicle. This secondary follicle will eventually mature to become the _______ or dominant follicle before ovulation

Answer 25

Graafian follicle

Question 26

the structure that contains the developing oocyte

Answer 26

cumulus oophorus

Question 27

This Graafian follicle, which can grow as large as 2.7 cm, contains the developing oocyte (egg) within a region called the _____

Answer 27

cumulus oophorus

Question 28

Around day 14, ____, produced by the anterior pituitary gland, stimulates ovulation, at which time the Graafian follicle, which has grown to a size of 15 to 27 mm, ruptures and expels a small amount of fluid and the ovum into the peritoneum. , produced by the anterior pituitary gland, stimulates ovulation, at which time the Graafian follicle, which has grown to a size of 15 to 27 mm, ruptures and expels a small amount of fluid and the ovum into the peritoneum.

Answer 28

LH

Question 29

At the time of ovulation, the individual may feel a twinge of pain, and this is termed_______

Answer 29

mittelschmerz

Question 30

the fingerlike extension of the fallopian tube located on the infundibulum

Answer 30

fimbria

Question 31

The second phase of the ovarian cycle, days 15 to 28, is termed the _____

Answer 31

luteal phase

Question 32

a temporary structure formed immediately following ovulation as the dominant follicle collapses and fills with blood; after the trauma heals, this becomes the corpus luteum

Answer 32

corpus hemorrhagicum

Question 33

The corpus hemorrhagicum then rapidly converts into a temporarily endocrine gland in the form of the _____

Answer 33

corpus luteum

Question 34

The _______, which is literally interpreted “yellow body,” while producing estrogen in small amounts, primarily produces progesterone to maintain the thickness of the endometrium and prepares the endometrium for the (conceivably) fertilized ovum.

Answer 34

corpus luteum

Question 35

While the corpus luteum depends on LH to be maintained, ________negatively inhibits the production of LH by the anterior pituitary gland, resulting in the regression of the corpus luteum.

Answer 35

progesterone

Question 36

The remaining structure of the corpus luteum is now termed the _______, which can often be seen sonographically as a small echogenic scar on the ovary.

Answer 36

corpus albicans

Question 37

during the early follicular phase and late luteal phase, the ovarian artery will demonstrate a ____-resistive pattern, with ______impedance, and _____or low end-diastolic velocity.

Answer 37

high;increased;absent

Question 38

During the late follicular and early luteal phases, the ovary will demonstrate a ____-resistive pattern, with____impedance and _____ levels of diastolic flow.

Answer 38

low;low;higher

Question 39

Remember this chain of events: primordial follicle > ______ follicle > secondary follicle > Graafian (dominant) follicle > ______ > corpus hemorrhagicum > corpus luteum > _______

Answer 39

primary;ovulation;corpus albicans

Question 40

The innermost layer of the endometrium that is stimulated by the hormones of the ovary to undergo changes throughout the menstrual cycle; provides an appropriate location for the implantation of the products of conception

Answer 40

functional layer (stratum funtionale)

Question 41

The outermost portion of the endometrium consists of dense, cellular stroma slightly altered by the menstrual cycle

Answer 41

basal layer (stratum basale)

Question 42

The endometrial cycle consists of two phases: the____ and ______

Answer 42

proliferative phase;secretory phase

Question 43

The proliferative phase occurs ___menstruation and lasts until ovulation.

Answer 43

after

Question 44

During the first half of the menstrual cycle, the endometrium undergoes thickening as a result of estrogen stimulation. Thus, proliferation of the endometrium, which is described as the multiplication of similar forms, occurs during the ______of the endometrial cycle because the functional layer increases in thickness.

Answer 44

proliferative phase

Question 45

The proliferative phase may be divided into two phases, early and late, with the late proliferative phase often being referred to as the _______ phase.

Answer 45

periovulatory

Question 46

The _______of the endometrial cycle occurs after ovulation and is stimulated by progesterone.

Answer 46

secretory phase

Question 47

Should fertilization not take place, menses begin on day 1 of the cycle, resulting from a lack of _____and______.

Answer 47

estrogen and progesterone

Question 48

If fertilization does occur, the endometrial thickness is maintained by the continual production of progesterone by the ________of pregnancy

Answer 48

corpus luteum of pregnancy

Question 49

The ____ phase of the endometrial cycle occurs after menstruation and lasts until ovulation

Answer 49

proliferative (day 1-14)

Question 50

The ___ phase of the endometrial cycle occurs after ovulation and it stimulated by progesterone

Answer 50

secretory (day 15-28)

Question 51

the corpus luteum that is maintained during early pregnancy for the purpose of producing estrogen and primarily progesterone

Answer 51

corpus luteum of pregnancy

Question 52

Mnemonic to recall correlation of the menstrual cycle phases "ovaries freely let every period start"

Answer 52

ovary, follicular, luteal, endometrium, proliferative, secretory

Question 53

Sonographic appearance of endometrium during menses

Answer 53

thin & echogenic (up to 4mm)

Question 54

Sonographic appearance of endometrium during early proliferative phase

Answer 54

thickening hypoechoic functional layer (4-8mm)

Question 55

Sonographic appearance of endometrium during preovulatory (late proliferative phase) (days 5-14)

Answer 55

"three line sign" (6-10mm)

Question 56

Sonographic appearance of endometrium during secretory phase

Answer 56

thick & echogenic (7-14mm)

Question 57

Fertilization of conception typically occurs on what day of the menstrual cycle with the union of the egg & sperm in the fallopian tube?

Answer 57

day 15

Question 58

The thickness measurement of the endometrium obtained with sonography should not include the adjacent hypoechoic ______ and is considered accurate when the double-layer thickness measurement is performed

Answer 58

myometrium

Question 59

The ______ includes only the distance from basal layer to basal layer. If there is fluid within the endometrium, then the measurement of the two separate layers of the endometrium, excluding the fluid, should be obtained and then added together to obtain the true thickness

Answer 59

double-layer thickness

Question 60

A difference in frequency, duration and amount of menstrual bleeding is referring to

Answer 60

abnormal uterine bleeding (AUB)

Question 61

The production of ____ maintains the corpus luteum. Thus, ____ allows the corpus luteum to continue to produce estrogen and progesterone, which, in turn, maintains the thickness of the endometrium so that implantation can take place and the pregnancy can continue to progress normally

Answer 61

hCG

Question 62

The cells that surround the blastocyst, the syncytiotrophoblastic cells (trophoblastic cells), then begin to produce __________

Answer 62

human chorionic gonadotropin (hCG)

Question 63

the stage at which the conceptus implants within the decidualized endometrium

Answer 63

blastocyst

Question 64

the trophoblastic cells surrounding the blastocyst that are responsible for producing human chorionic gonadotropin

Answer 64

syncytiotrophoblastic cells

Question 65

the hormone produced by the trophoblastic cells of the early placenta; may also be used as a tumor marker in nongravid patients and males

Answer 65

human chorionic gonadotropin (hCG)

Question 66

Measurement of the endometrium should be from ____ layer to ______ layer.

Answer 66

basal;basal

Question 67

One of the more common suspicious pathologies that results in AUB is the presence of fibroid tumors or ______within or abutting the uterine cavity.

Answer 67

leiomyomas

Question 68

Causes of AUB: Uterine fibroids (leiomyoma) Adenomyosis Cervical polyps Endometrial polyps Endometrial hyperplasia Endometrial cancer Hypothyroidism Anovulation Iatrogenic Ovulatory dysfunction Coagulopathy

Answer 68

abnormal uterine bleeding

Question 69

a condition that is the result of medical treatment; may be due to exposure to a pathogen, toxin, or injury following a treatment or procedure

Answer 69

Iatrogenic

Question 70

blood clotting disorders

Answer 70

Coagulopathy

Question 71

Absence of menstruation; can be classified as either primary amenorrhea or secondary amenorrhea

Answer 71

Amenorrhea

Question 72

Monthly symptoms of menstruation without bleeding

Answer 72

Cryptomenorrhea

Question 73

Painful or difficult menstruation

Answer 73

Dysmenorrhea

Question 74

Abnormally heavy and prolonged menstruation

Answer 74

Menorrhagia (hypermenorrhea)

Question 75

Irregular menstrual bleeding between periods

Answer 75

Metrorrhagia (intermenstrual bleeding)

Question 76

Excessive or prolonged bleeding at irregular intervals

Answer 76

Menometrorrhagia

Question 77

Irregular cycles >35 days apart

Answer 77

Oligomenorrhea

Question 78

Frequent regular cycles but <21 days apart

Answer 78

Polymenorrhea

Question 79

Regularly timed menses but light flow

Answer 79

Hypomenorrhea

Question 80

What hormone stimulates the contractile motion within the uterine myometrium?

Answer 80

Estrogen