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Flashcards in female physiology Deck (70):
1

female hormones

1. estrogen
2. progesterone

2

estrogen - source

1. ovary (17β-estradiol)
2. placenta (estriol)
3. adipose tissue (estrone via aromatization)

3

adipose produce ... (estrogen) via ...

estrone via aromatization

4

estrogen hormones - potency (from most potent to least)

1. estradiol
2. estrone
3. estriol

5

estrogen hormones - function

1. development of genitalia and breast
2. female fat distribution
3. growth of follicle
4. increase myometrial excitability
5. increase transport proteins, SHBG
6. increase HDL
7. decrease LDL
8. effects on other hormones

6

estrogen hormones - effects on other hormones

1. uperegulation of estrogen, LH, progesterone receptors
2. feedback inhibition of FSH and LH
3. LH surge
4. stimulation of prolactin secretion

7

estrogen - concentrations in pregnancy

1. 50-fold increase in estradiol and estrone
2. 1000-fold increase in estriol (indicatior of fetal well being)

8

estrogen - indicator of a fetal well-being

1000-fold increase in estriol

9

estrogen receptors mechanism

expressed in cytoplasm --> trasnlocate to nucleus when bound by estrogen

10

estrogen production - control

pulsatile GnRH --> LH and FSH
- LH --> desmolase (cholesterol to antogens) in theca interna cell
- FSH --> aromatase (Androgens --> estrogens) in granulosa cells

11

FSH vs LH location action according ot estrogen production

LH --> theca internal cells
FSH --> granulosa cells

12

1. theca internal cells
2. granulosa cells
homolog in mlaes

1. Leyding cells (endocrine cells)
2. Sertoli (non gem)

13

progesterone source

1. corpus lateum
2. placenta
3. adrenal cortex
4. testes

14

increased progesterone is indicator of

ovaluation

15

progesterone function

1. stimulation of endometrial grandular secretions and spiral artery development
2. Maintenance of pregnancy
3. decreases myometrial excitability
4. production of thick cervical mucus (inhibits sperm entry into uterus)
5. increases body temperature
6. uterine smooth muscle relaxation (preventing contraction)
7. prevents endometrial hyperplasia
8. effects on other hormones

16

progesterone effects on other hormones

1. inhibition of gonadotropins (LH, FSH)
2. decrease estrogen receptor expression
3. fall in progesterone after pregnancy disinhibits prolactin --> lactation

17

progesterone - production of thick cervical mucus --> ...

inhibits sperm entry into uterus

18

gametes - types/definition/origin

types: 1. Oocytes 2. Spermatozoa
they are descendants of primordial germ cells that originate in the wall of yolk sac of the embryo --> migrate into the gonadal cells (6th week)

19

gametes originate in the

yolk sac of the embryo

20

meiosis occurs during

the production of gametes (only)

21

oogenesis - all the process

primordial cells from yolk sac to embryo and becomes oogonia (6th week) --> Oogonia (2N, 2C) undergo DNA replication to form 1ry oocytes (2N, 4C) and undergro begin meiosis during fetal life (5 mth) --> arresterd in prophase I complete meiosis I just prior to ovulation (1 1ry oocyte per ovaluation) --> 2ry oocyte (1N, 2C) + polar body --> Meiosis II is arrested in metaphase until fertilization --> if fertilization, ovume (1N, 1C), if not fertilization within 1 day, the 2ry oocytes degenerates

22

fate of polar body after meiosis I

can degenerate or give rise to 2 polar body (meiosis 2)

23

oogenesis - DNA status of cells

n=chromosomes
C=1 DNA
oogonioum --> Diploid (2n) and 2C
1ry oocyte --> diploid (2n) and 4C (46 doubled chromosomes, sister chromatides)
2r oocyte --> haploid (1n) and 2C (23 doubled chromosomes)
ovum --> haploid --> (1n) and 1c

24

1ry oocytes --> 2ry oocyte

1ry oocytes begin meiosis during fetal life (5 mth) --> arresterd in prophase I complete meiosis I just prior to ovulation --> 2ry oocyte (1N, 2C) + polar body
(1 1ry oocyte per ovaluation)

25

1ry oocytes are arrested in

prophase I

26

2ry oocytes are arrested in

metaphase of meiosis 2

27

hormone status during evaluation

1. increased estrogen
2.increased GnRH receptor on anterior pituitary
3. estrogen surge tehn stimulates LH release --> ovulation (rupture of follicle)
4. increased temperature (progensterone induced)

28

ovulation occurs as a result of

estrogen-induced LH surge

29

Mittelschmerz - definition/mechanism

transiet mid-cycle ovulatory pain --> classically associated with peritoneal irratation (eg. follicular swelling/rupture, fallopian tube contraction)

30

Menstrual cycle - periods (and time)

1. funicular phase (vary in length - 0-14 in normal cycle)
2. ovulation (14 days before menses, regardless the cycle length
3. Luteal phase (after ovaluation for 14 days)
4. mesnes (0-4 days)

31

Menstrual cycle - periods (and time)

1. funicular phase (vary in length - 0-14 in normal cycle)
2. ovulation (14 days before menses, regardless the cycle length
3. Luteal phase (after ovaluation of 14 days)
4. mesnes (0-4 days)

32

Folicular phase - events

1. primordial follicle develops (with atresia of neighboring follicles) - growth fastest during 2nd week
2. LH and FSH receptors are upregulated in Theca and and granulosa cells (on follicles) --> estradiol levels --> decreases FSH/LH levels
3. at the end --> a burst of estradiol --> + feedback on LH/FSH secretion (LH surge) --> ovaluation

33

Folicular phase - progesterone levels

low

34

LH, FSH, estradiol levels during follicular phase

LH/FSH decrease, estrogen increase
at the end of the phase burst of estradiol --> + feedback on LH/FSH secretion (LH surge)

35

estrogen effects on uterus follicular phase

1. growth of follicle
2. endometrial proliferation
3. increased myometrial excitability

36

developing follicle is developed by

1. FSH
2. LH
3. estrogen

37

ovaluation day + ...(number) days = menstruation

14

38

ovulation occurs as a result of

estrogen-induced LH surge

39

follicle after ovulation

corpus lateum

40

Luteal phase - events (generally)

corpus lateum produce estrogen + progesteron

41

Luteal phase - progesterone -->

1. stimulation of endometrial grandular secretions and spiral artery development
2. decreases myometrial excitability
3. production of thick cervical mucus (inhibits sperm entry into uterus)
4. increases body temperature
5. uterine smooth muscle relaxation (preventing contraction)
6. prevents endometrial hyperplasia
7. inhibition of gonadotropins (LH, FSH)
8. decrease estrogen receptor expression

42

progesterone - pregnancy

Progesterone maintains endometrium to support implantation

43

estrogen vs progesterone according to myometrial excitability

progesterone --> decrease
estrogen --> increase

44

Dysmenorrhea?

pain with menses

45

dysmenorrhea is often associated with

endometriosis

46

oligomenorrhea?

more than 35 days cycle

47

polymenorrhea?

less than 21 day cycle

48

Metrorrhagia?

frequent or irregular mestriation

49

Menorrhagia?

Heavy menstrual bleedin
more than 80ml loss or more than 7 days

50

Menometrorrhagia

heavy, irregular menstruation

51

Fertilization - location and time

MC in upper end of fallopian tube (the ampulla)
day 0 (within 1 day of ovulation)

52

implantation within the wall of the uterus occurs (when)

6 days after fertilization (6-10)

53

gestational vs embryonic age according to calculation

gestational --> from date of last menstrual period
embryonic --> from date of conception (gestational minus 2 weeks)

54

Physiologic adaptions in pregnancy (namely)

1. increased cardiac ouput
2. anemia
3. hypercoagulability
4. hyperventilation

55

Physiologic adaptions in pregnancy - increased cardiac ouput - explain

increased preload, decreased afteload, increased HR
--> increased placental and renal perfusion

56

Physiologic adaptions in pregnancy - anemia - explain

increased plasma and RBCs (but plasma more) --> decreased hematocrit --> decreased viscosity

57

Physiologic adaptions in pregnancy - hyperventilation - explain

to eliminate fetal CO2

58

Physiologic adaptions in pregnancy - hypercoagulability - explain

low blood loss at delivery

59

hcG - source/secretion begins/peak

syncitiotrophoblast of placenta
around the time of implantation of blastocyst (within 1 week). peak: 8-10 weeks

60

hcG - function

maintains corpus luteum (and thus progesterone) for first 8-10 weeks of pregnancy by acting like LH --> After 8-10 weeks, placenta syntehsizes its own estriol and progesterone and corpus lateum degenerates

61

fate of corpus lateum in pregnancy

hcG maintains it (and thus progesterone) for 8-10 weeks --> then degenerates

62

hcG - structure

α subunit --> as LH, FSH, TSH
β subunit --> unique (detected by pregnancy test)

63

hcG - thyroid function

α subunit is similar to TSH --> states of increased hcG can cause hyperthyroidism

64

increased hCG - ddx

1. multiple gestation
2. hydatidiform moles
3. choriocarcinomas
4. Down syndrome
5. testicular cancer
6. Large cell Ca of lung

65

low hcG - ddx

1. ectopic/failing pregnancy (spontaneous abortion)
2. Edward syndrome
3. Patau syndrome

66

estorgne and progesteron in pregnancy

increasing levels --> maintain endometrium for the fetus, suppress ovarian follicular function (by inhibiting FSH/LH secretion) and stimulates the development of the breast

67

action of estorgne and progesteron in pregnancy

1. maintain endometrium for the fetus
2. suppress ovarian follicular function (by inhibiting FSH/LH secretion)
3. stimulates the development of the breast

68

estrogen and progesteron production during pregnancy

until 7-8 weeks from corpus luteum, then a transition state, and then from placenta

69

levels of hormones in pregnancy (generally)

placental hormone secretion generally increases over the course of pregnancy (estrogens, progesteron, human placental lactogen), but hCg peaks ta 8-10 weeks

70

human placental lactogen levels

increasing during pregnancy --> a peak/platue at the end of pregnancy and after birth