Female Reproductive

Question 1

what is the broad ligament consist of?

Answer 1

double layer of peritoneum (smooth muscle)

Question 2

what are the 3 subdivisions of the broad ligament?

Answer 2

mesometrium: surroudns the uterus

Mesovarium: projects from posterior surface and attaches to ovary (does not cover surface of ovary itself)

mesosalpinx: superior to mesovarium, encloses the fallopian tubes

Question 3

what are the ligaments associated with the ovary and their functions? (2)

Answer 3

ovarian ligament: attached inferiorly, connects ovary to side of uterus

Suspensory ligament of ovary: extends outward from ovary to lateral abdominal wall. Connects ovarian vessels and nerves

Question 4

what ligaments supports the superior aspect of the uterus? (uterine ligaments)

Answer 4

broad ligament and round ligaments

Question 5

what ligaments support the middle aspect of uterus? (cervical ligaments)

Answer 5

cardinal, pubocervial, uterosacaral

note: inferior aspect is supported by the pelvic floor

Question 6

The ovarian ligament connects the ovary to the ______?

Answer 6

lateral surface of the uterus

Question 7

what section of the broad ligament encloses the fallopian tubes?

Answer 7

the mesosalpinx

Question 8

what ligament contains the ovarian vessels and nerves?

Answer 8

the suspensory ligament of the ovary

Question 9

what is the function of the round ligament of the uterus?

Answer 9

attaches to the ovarian ligament and extends antero-inferiorly to the mons pubis and labia majora

passively pulls the uterus forward, helping to maintain the uterus anterverted

Question 10

what is the function of the cardinal (transverse cervical) ligament?

Answer 10

it attaches from the cervix and superior vagina -> lateral wall of pelvis

passively (no muscular contraction) holds the uterus in place

Question 11

what does the broad ligament connect to?

Answer 11

the lateral walls and floor of pelvis

Question 12

what is the normal position of the uterus?

Answer 12

anteverted (lies over the bladder) and anteflexed (angle at the cervix)

this position is maintained by the cardinal and uterosacral ligaments

Question 13

what is the vasculature of the ovary

Answer 13

ovarian artery from abdominal aorta which runs within the suspensory ligament of the ovary

venous drainage from pampiniform plexus into left renal vein

Question 14

lymphatic drainage of the ovary

Answer 14

internal iliac and/or the para-aortic lymph nodes. some drainage into inguninal lymph nodes

Question 15

what is the infundibulum?

Answer 15

funnel-shaped peripheral opening of fallopian tube

lined with fimbriae to draw ovulated oocytes into the infundibulum

Question 16

what region where fertilization usually occurs in the fallopian tube?

Answer 16

ampulla

Question 17

what is the region called where fallopian tube attaches to and opens into the lumen of the uterus

Answer 17

isthmus

Question 18

what is the vasculature of the uterus?

Answer 18

ovarian and uterine arteries (internal iliac artery), venous drainage into the uterine plexus -> internal iliac veins

Question 19

lymphatic drainage of the uterus?

Answer 19

aortic lymph nodes, internal and external iliac

Question 20

what layer of the uterus mucosa is shed?

Answer 20

functional layer is shed during menses

the basal layer is not

Question 21

what are lacunae in the uterus?

Answer 21

“little lakes” of blood that drain into the veins

Question 22

spiral arteries what androgen are they sensitive to?

Answer 22

progesterone, bc withdrawal at the end of cycle -> constriction and ischemia of the functional layer of the endometrium

Question 23

what is the transformation zone in the cervix?

Answer 23

squamocolumnar junction (goes from columnar to stratified squamous)

around the opening of the cervix

Question 24

what contributes to the selection of the dominant follicle at ovulation

Answer 24

growth factors

the antral follicles develop into graafian follicles just before ovulation and these are enriched with growth factors

note: the dominant follicle also has a lot of FSH receptors making it very sensitive to FSH

Question 25

what does the dominant follicle release?

Answer 25

large stores of estradiol which trigger the midcycle LH surge

Question 26

How is the LH surge stimulated and what does the LH surge do?

Answer 26

it is stimulated by + feedback on GnRH during late follicular stage. leads to maturation of primary oocyte into secondary oocyte and ovulation

Question 27

the LH surge promotes release of histamine, prostaglandins and bradykinins, which cause _____?

Answer 27

vasodilation -> follicle swells note: histamine can cause dilation or constriction but here its dilation.

Question 28

when does the basement membrane begin to disintegrate allowing for LDL can enter granulosa cell and make progesterone?

Answer 28

ovulation, the rupture of the mature follicle breaches the basement membrane

Question 29

why do we see a rise in progesterone after ovulation?

Answer 29

after ovulation, the follicle ruptures and basement membrane rupture, granulosa cells now have access to vasculature and LDL to make hormones.

Question 30

what does the aromatase enzyme do?

Answer 30

it converts testosterone to estradiol in the granulosa cells

Question 31

what cells are responsible for making estrogen from androgens during the proliferative phase?

Answer 31

granulosa cells

Question 32

What maintains thickness of the endometrial lining during the secretory phase?

Answer 32

progesterone

Question 33

what nuclei in the hypothalamus is GnRH released from?

Answer 33

arcuate and preoptic

Question 34

How does GnRH promote synthesis and release of LH and FSH? Role of GnRH agnoists medications?

Answer 34

pulsiltile slow = FSH rapid = LH GnRH agonist is a steady stream, shut down menstrual cycle.

Question 35

When does the menstrual cycle estradiol have a negative feeback loop to regulate FSH

Answer 35

most of the cycle. FSH promotes follicular growth in the ovary, leading to estradiol production by the granulosa cells.

Question 36

when does the menstrual cycle (28 days) switch to positive feedback? How is this accomplished?

Answer 36

late follicular phase to ovulation as estradiol promotes GnRH release resulting the LH surge. prolonged periods of elevated estradiol

Question 37

When does the menstrual cycle switch back to negative feedback?

Answer 37

at ovulation Estradiol negative feed drives down FSH.

Question 38

how is the dominant follicle selected?

Answer 38

on day 5-7 based on size and steroidogenic activity (needs more resources)

Question 39

when does estradiol peak? what day and stage of menstrual cycle?

Answer 39

late follicular phase peaks at day 12 for 24 to 36 hours and initials the LH surge

Question 40

what secretes progesterone and when?

Answer 40

the corpus luteum! while FSH and LH production declines

Question 41

what type of epithelium in in the endometrium?

Answer 41

secretory columnar

Question 42

how does the endometrium get nutrients to grow during the proliferative phase?

Answer 42

spiral arteries

Question 43

when is peak thickness of the endometrium achieved?

Answer 43

secretory phase about 6-8 days post ovulation

Question 44

what hormones decreases the spontaneous myomeetrial contraction in preparation for implantation?

Answer 44

progesterone

Question 45

what surge needs to happen in order for the LH surge to happen? (rapid pulse of GnRH?)

Answer 45

estradiol increases as follicular phase progresses! this increases pulse frequency and thus LH. So we need estrogen in order for ovulation to occur.

Question 46

what causes an ovarian cyst ?

Answer 46

follicular cyst: when the follicle fails to rupture during ovulation in the luteal cyst: corpus luteum fails to dissolve/fibrosis instead = cyst

Question 47

where are most of the follicles found in the ovary?

Answer 47

cortex

Question 48

what is the medulla of the ovary

Answer 48

where loose CT and larger blood vessels are