Female Phys review

Question 1

what ages does FSH and LH spike?

Answer 1

2nd trimester of fetal development
around 4-5 months of age
small rise at puberty
cyclically until menopause
rises with menopause dt loss of neg feedback by E

Question 2

Pituitary-ovary x-talk

Answer 2

• corpus luteum dies and E and P fall
• pit responds to loss of neg feedback -> increased FSH
• FSH recruits cohort of large antral follicles which secrete E and inhibin
• E and inhibin inhibit FSH secretion
• loss of FSH causes all but dominant follicle to die which then produces lots of E
• E switches to pos feedback get LH (and some FSH) surge
• LH surge induces metabolic maturation, ovulation, and luteinization and produces high P, E and inhibin
• high P, E, and inhibin inhibit LH and FSH
• corpus luteum become less sensitive to LH and dies unless there is an hCG rescue

Question 3

stages of follicular development

Answer 3

primordial follicle -> primary follicle -> secondary preantral follicle -> small antral follicle -> large recruitable antral follicle -> dominant follicle

Question 4

mural granulose cells

Answer 4

highly steriodogenic and differentiate into corpus luteum

Question 5

cumulus cells

Answer 5

released with oocyte upon ovulation and faciliatate oocyte capture by oviduct

Question 6

stages of gamete

Answer 6

oogonium -> primary oocyte arrested at prophase 1 -> shortly before ovulation oocyte completes meiosis I -> secondary oocyte arrested at metaphase II -> completes meiosis at fertilization

Question 7

thecal cells

Answer 7

produce angrogen androstenedione

have low levels of 17beta hydroxysteroid dehydrogenase so produce very little T

Question 8

follicular phase

Answer 8

FSH induces expression of LHR on mural granulosa cells

Question 9

luteal phase

Answer 9

mural granulosa cells experience

• transient inhibition of CYP19 expression and E prodution turning off pos feedback
• vascularization of granulosa cells making cholesterol available for steroidogenesis
• expression of StAR proteins, CYPIIA1 and 3beta HSD -> Progesterone secretion

Question 10

E effects on oviduct

Answer 10

increases endosalpinx epi size
increases blood flow
increases oviduct specific glycoproteins
increases ciliogenesis
increases mucus and muscular tone

Question 11

P effects on oviduct

Answer 11

decrease epi size
deciliation
decrease mucus
relaxes mm tone

Question 12

aa supply

Answer 12

uterine a -> arcuate a -> radial br -> splits into straight and spiral aa in basal zone -> spiral anatamous with venous lakes in functional zone

Question 13

late menstrual phase is what days?

Answer 13

3-5

Question 14

late proliferative phase is what days

Answer 14

10-13

Question 15

early secretory is what days

Answer 15

15-18

Question 16

late secretory is what days

Answer 16

22-25

Question 17

which endometrial phases coincide with the ovarian follicular phase?

Answer 17

proliferative

days 0-14 when ovulation occurs

Question 18

which endometrial phases coincide with ovarian luteal phase?

Answer 18

secretory (begins at ovulation) and menstrual

days 14-28

Question 19

structure and fnx of cervix

Answer 19

• highly elastic lamina propria
• gateway to upper female tract
• during luteal phase passage of sperm is impeded d/t changes in endocervical canal

Question 20

hormonal regulation of cervical mucus

Answer 20

E-> stimulates production of thin watery slightly alkaline mucus
P-> stimulates production of scant, viscous, slightly acidic mucus

Question 21

P transport

Answer 21

bound to cortisol binding protein and albumin

Question 22

fertilization is how may days after ovulation

Answer 22

1

Question 23

blastocyst enters uterine cavity is how may days after ovulation

Answer 23

4

Question 24

implantation is how may days after ovulation

Answer 24

5

Question 25

trophoblast forms and attaches to endometrium is how may days after ovulation

Answer 25

6

Question 26

trophoblast begins to secrete hCG is how may days after ovulation

Answer 26

8

Question 27

HCG resuces corpus luteum is how may days after ovulation

Answer 27

10

Question 28

limitations of placenta

Answer 28

cannot make adequate cholesterol lacks enzymes for estrone and estradiol lacks enzyme for etriol

Question 29

what does the mother contribute for hormone synthesis

Answer 29

LDL cholesterol

Question 30

what does the placenta contribute for hormone synthesis

Answer 30

3beta HSD | aromatase (P-450)

Question 31

what does the fetus contribute for hormone synthesis

Answer 31

17alpha hydroxylase (for E1 and E2) 17,20 desmolase (E1 and E2) 16 alpha hydroxylase (E3)

Question 32

P synthesis

Answer 32

mom give cholesterol to placenta which creates P for both mom and baby

Question 33

E3 synthesis

Answer 33

mom gives chol to placenta which makes pregnolone -> converted to DHEA by fetus -> placenta converts to E3 for mom

Question 34

hPL

Answer 34

human placental lactogen aka hCS structurally similar to GH and PRL dectectable in moms blood at 3 weeks and continues to increase

Question 35

fnx of hPL

Answer 35

antagonistic to insulin -> diabetogenic effect increases glucose for fetus stimuluates mammary growth and development

Question 36

pituitary changes in pregnancy

Answer 36

2x increased size | ADH set point lowered

Question 37

adrenal changes in pregnancy

Answer 37

cortisol and aldosterone levels rise | E stimulates activity RAAS

Question 38

thyroid changes in pregnanacy

Answer 38

total T4 and T3 increase, but free T4 normal | TSH levels decrease in first trimester

Question 39

CV changes in pregnancy

Answer 39

``` increased vascular volume decreased peripheral resistance increased SV increased HR increased contractility increased CO ```

Question 40

respiratory changes in pregnancy

Answer 40

``` increased minute volume increased tidal volume decreased PCO2 decreased FRC decreased IRV respiratory alkalosis ```

Question 41

renal changes in pregnancy

Answer 41

increased ADH and RAAS | increased GFR

Question 42

stages of labor

Answer 42

strong uterine contractions delivery of fetus delivery of placenta

Question 43

initiation of parturition

Answer 43

``` placental CRH E Oxy prostaglandins uterine size ```

Question 44

endocrine changes after parturition

Answer 44

E and P falls close to 0, bc inhibited by prolactin | prolactin remains cyclical if mom breast feeds