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female physiology Flashcards

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1
Q

female hormones

A
  1. estrogen

2. progesterone

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2
Q

estrogen - source

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

adipose produce … (estrogen) via …

A

estrone via aromatization

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4
Q

estrogen hormones - potency (from most potent to least)

A
  1. estradiol
  2. estrone
  3. estriol
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5
Q

estrogen hormones - function

A
  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
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6
Q

estrogen hormones - effects on other hormones

A
  1. uperegulation of estrogen, LH, progesterone receptors
  2. feedback inhibition of FSH and LH
  3. LH surge
  4. stimulation of prolactin secretion
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7
Q

estrogen - concentrations in pregnancy

A
  1. 50-fold increase in estradiol and estrone

2. 1000-fold increase in estriol (indicatior of fetal well being)

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8
Q

estrogen - indicator of a fetal well-being

A

1000-fold increase in estriol

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9
Q

estrogen receptors mechanism

A

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

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10
Q

estrogen production - control

A

pulsatile GnRH –> LH and FSH

  • LH –> desmolase (cholesterol to antogens) in theca interna cell
  • FSH –> aromatase (Androgens –> estrogens) in granulosa cells
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11
Q

FSH vs LH location action according ot estrogen production

A

LH –> theca internal cells

FSH –> granulosa cells

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12
Q
  1. theca internal cells
  2. granulosa cells
    homolog in mlaes
A
  1. Leyding cells (endocrine cells)

2. Sertoli (non gem)

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13
Q

progesterone source

A
  1. corpus lateum
  2. placenta
  3. adrenal cortex
  4. testes
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14
Q

increased progesterone is indicator of

A

ovaluation

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15
Q

progesterone function

A
  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
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16
Q

progesterone effects on other hormones

A
  1. inhibition of gonadotropins (LH, FSH)
  2. decrease estrogen receptor expression
  3. fall in progesterone after pregnancy disinhibits prolactin –> lactation
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17
Q

progesterone - production of thick cervical mucus –> …

A

inhibits sperm entry into uterus

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18
Q

gametes - types/definition/origin

A

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)

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19
Q

gametes originate in the

A

yolk sac of the embryo

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20
Q

meiosis occurs during

A

the production of gametes (only)

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21
Q

oogenesis - all the process

A

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

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22
Q

fate of polar body after meiosis I

A

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

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23
Q

oogenesis - DNA status of cells

A

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

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24
Q

1ry oocytes –> 2ry oocyte

A

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)

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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

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