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PHYSIOLOGY MED1 > Female Reproductive System > Flashcards

Female Reproductive System Flashcards

1
Q

The ovary is located within a fold of peritoneum, known as ________

A

Broad ligament

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2
Q

Functional units of the ovary with gametogenic and endocrine functions

A

Ovarian follicles

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3
Q

Which division of the ovary contains neurovascular elements?

A

Inner medulla

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4
Q

The midway point of the fallopian tube where the cumulus-oocyte complex is transferred after capture and where fertilization takes place

A

ampullary-isthmus junction

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5
Q

How long is the implantation window of the uterus?

A

3 days

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6
Q

The outer-lying connective tissue layer of the oviduct

A

Perisalpinx

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7
Q

The two-layered muscularis layer of the oviduct

A

Myosalpinx

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8
Q

Cilia of the endosalpinx is most numerous at which part of the oviduct?

A

infundibulum

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9
Q

The sole mechanism for transport of the ovulated cumulus-oocyte complex

A

Cilia on the fimbriae

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10
Q

Which of the following is true of the isthmus of the oviduct?
A. An area where the cumulus-oocyte complex slows
B. Produces thick mucus
C. Demonstrates increase tone of the muscularis
D. Section of the oviduct next to the infundibulum
E. AOTA

A

E. AOTA

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11
Q 
Which zone of the endometrium is sloughed off during non-fertile menstrual cycle?
A. Functional zone, 1/3 of luminal side
B. Functional zone, 2/3 of luminal side
C. Basal zone, 1/3 of luminal side
D. Basal zone, 2/3 of luminal side
A

B. 2/3 of the luminal side of the endometrium known as the Functional zone is lost during menstruation

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12
Q

Which part of the uterus does not undergo menstruation?

A

Cervix (cervical mucosa)

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13
Q

The part of the cervix that extends into the vaginal vault is called ______ which is seen during speculum exam

A

Ectocervix

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14
Q 
Oogonia undergo mitosis only during:
A. Prenatal period
B. Postnatal period
C. Ovulation
D. Fertilization
A

A. Prenatal period

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15
Q 
In oogenesis, once the premordial germ cells reach the germinal epithelium, they migrate to the ovarian cortex and become:
A. Primary oocytes
B. Oogonia
C. Primary follicles
D. Secondary oocytes
E. NOTA
A

B. Oogonia or primordial ova

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16
Q 
The ovum surrounded by a single layer of granulosa cells is called a:
A. Primary oocyte
B. Oogonium
C. Primary follicle
D. Secondary oocyte
E. NOTA
A

C. Primary follicle

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17
Q 
By the 5th month of fetal development, at what stage of meiosis does the oogonia arrests and becomes the primary oocyte?
A. Prophase I
B. Metaphase I
C. Prophase II
D. Metaphase II
E. NOTA
A

A. Prophase I

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18
Q 
Which cell from the oocyte is ovulated after the secondmeiotic division?
A. Primary oocyte
B. Oogonium
C. First Polar body
D. Secondary oocyte
E. NOTA
A

D. Secondary oocyte

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19
Q 
At which stage of meiosis does the secondary oocyte arrest until fertilization begins?
A. Prophase I
B. Metaphase I
C. Prophase II
D. Metaphase II
E. NOTA
A

D. Metaphase II

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20
Q

The largest follicle with the most FSH and LH receptors of the recruited follicles becomes the _______

A

Dominant follicle

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21
Q 
Ovulation is a response to the surge of which hormone?
A. Estrogen
B. Progesterone
C. FSH
D. LH
A

D. LH

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22
Q 
A high frequency of GnRH pulses (1 pulse per 60-90 minutes) promotes the production of:
A. Estrogen
B. Progesterone
C. FSH
D. LH
A

D. LH

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23
Q 
A slow frequency of GnRH pulses promotes the production of:
A. Estrogen
B. Progesterone
C. FSH
D. LH
A

C. FSH

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24
Q 
The process of selection is driven by an extreme dependency of follicles on which hormone in the face of this hormone's declining secretion?
A. Estrogen
B. Progesterone
C. FSH
D. LH
A

C. FSH
Event 5: The ovary’s response to declining FSH levels is follicular atresia of all of the recruited follicles except for one dominant follicle (B807)

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25
Q

In most instances, the relationship of Estrogen/Inhibin levels to FSH levels is _____
A. Directly proportional
B. Inversely proportional
C. No relationship

A

B. Inversely proportional

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26
Q 
The absence of progesterone in event 4 promotes an increase in the frequency of GnRH pulses. What is expected to happen?
A. LH:FSH ratio decreases
B. LH:FSH ratio increases
C. Decrease in estrogen
D. Decrease in inhibin B
A

B. LH:FSH ratio slowly increases

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27
Q 
Which hormone exerts a positive feedback on the gonadotrope to produce the midcycle LH surge?
A. Estrogen
B. Progesterone
C. FSH
D. LH
A

A. Estrogen

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28
Q

The relationship of progesterone levels to LH levels is:
A. Directly proportional
B. Inversely proportional
C. No relationship

A

B. Inversely proportional

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29
Q

A rapid rise in estrogen secretion by the granulosa cells leads to positive feedback to the hypothalamus through which cells?

A

Kisspeptin neurons

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30
Q

What structure takes over in the progesterone production by the corpus luteum during pregnancy?

A

Placenta

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31
Q

Which hormones act upon the follicular cells: Granulosa cells and Theca cells respectively?

A

FSH on Granulosa (F-G), note that LH-receptors are also present in granulosa
LH on Theca (L-T)

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32
Q 
Which follicular cell produces testosterone?
A. Granulosa cell
B. Theca cell
C. They don't produce testosterone
D. Leydig cell
A

B. Theca = “T”estosterone

Granulosa = Estro”G”en and Pro”G”esterone

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33
Q 
Theca cell will initially produce testosterone and later be converted by \_\_\_\_\_\_\_ activity producing estrogen
A. CPY19
B. Aromatase
C. Estrogen synthase
D. A and B
E. AOTA
A

E. AOTA
CYP19 is the gene that that provides instructions for making an enzyme called aromatase (aka estrogen synthase) responsible for estrogen biosynthesis

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34
Q 
Which of the following hormones has an inhibitory effect on the anterior pituitary?
A. Estrogen
B. Progesterone
C. Inhibin
D. AOTA
E. NOTA
A

D. AOTA

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35
Q

Which of the following is true of the Theca cells?
A. It has LH receptors only
B. Androgens it produces will need to diffuse to granulosa cells to be converted to estrogen
C. Androgens it produces will be converted by aromatase within its cytosol
D. Theca is primarily under the control of FSH
E. NOTA

A 
B. 
Theca cells (like Granulosa cells) have both LH and LDL receptors, but is primarily under the control of LH  which produces androgens/testosterone that will diffuse to the granulosa cells to be acted upon by aromatase to be converted into estrogen
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36
Q

Precursor hormone of androgens within the theca cell

A

Progesterone

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37
Q 
The principal estrogen produced by ovary
A. Estrone
B. β-estradiol
C. Estriol
D. E1
E. E3
A

B. β-estradiol (E2) is the primary form of estrogen in the female body during reproductive years. It’s the most potent form of estrogen and the principal estrogen produced by the ovaries

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38
Q 
The primary form of estrogen that the body makes after menopause:
A. Estrone
B. β-estradiol
C. Estriol
D. E2
E. E3
A

A. Estrone (E1)

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39
Q 
The primary form of estrogen during pregnancy:
A. Estrone
B. β-estradiol
C. Estriol
D. E1
E. E2
A

C. Estriol (E3)

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40
Q

Metabolic degradation of estrogen in the liver produces the form type _______ which is excreted through the urine?
A. E1
B. E2
C. E3

A

C. E3 or Estriol

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41
Q

Most important progestin

A

Progesterone

42
Q

Progesterone is secreted by the placenta after the ___ month of gestation

A

4th month

43
Q

Form of progesterone excreted through the urine

A

Pregnanediol (after metabolic degradation in the liver)

44
Q

Which of the following are effects of Estrogen?
A. Stimulates intestinal calcium absorption
B. Increase expression of HDL receptor
C. Promotes vasoconstriction
D. Increase set point for thermoregulation

A

A. only
B should be LDL
C should be vasodilation due to NO
D is the effect of progesterone

45
Q 
The primary hormone responsible for epiphyseal closure:
A. Estrogen
B. Progesterone
C. Testosterone
D. FSH
E. LH
A

A. Estrogen

46
Q 
Females are expected to increase their height along which stage of pubertal events?
A. Thelarche
B. Breast Stage 2 to 3
C. Thelarche
D. Breast Stage 3 or 4
A

B. Breast stage 2-3 = Peak height velocity/Growth spurt

47
Q 
The first menstruation is expected to happen around which pubertal events?
A. Thelarche
B. Breast Stage 2 or 3
C. Thelarche
D. Breast Stage 3 or 4
A

D. Breast Stage 3 or 4 = Menarche

48
Q 
Which of the following is part of the Endometrial cycle?
A. Follicular phase
B. Luteal phase
C. Proliferative phase
D. AOTA
A

C. Endometrial cycle includes Menstrual, Proliferative and Secretory phases

49
Q

What are the phases of ovarian cycle?

A

Follicular and Luteal phase which are separated by Ovulation at Day 14

50
Q

What inhibitory factor keeps the ovum suspended in its primordial state in prophase I and which cells secrete it?
A. Inhibin by Granulosa cells
B. Inhibin by Theca cells
C. Oocyte maturation inhibiting factor by Granulosa cells
D. Oocyte maturation inhibiting factor by Theca cells

A

C. Oocyte maturation inhibiting factor by Granulosa cells

51
Q 
Which of the Ovarian cycle phases is the most variable?
A. Follicular
B. Luteal
C. Proliferative
D. Secretory
A

A.

C and D are part of the Endometrial cycle

52
Q 
The recruitment and growth of a large antral follicle (tertiary follicle) during the ovarian cycle coincides with which phase of the Endometrial cycle?
A. Follicular
B. Luteal
C. Proliferative
D. Secretory
A

C. Proliferative

53
Q 
The luteal phase coincides with which phase of the Endometrial cycle?
A. Follicular
B. Menstrual
C. Proliferative
D. Secretory
A

D. Secretory

54
Q 
Menstruation coincides with which phase of the Ovarian cycle?
A. Follicular
B. Luteal
C. Proliferative
D. Secretory
A

A. Follicular phase

55
Q 
Why does the endometrium degenerates during the Menstrual phase?
A. Involution of the corpus luteum
B. Decrease in Estrogen and Progesterone
C. Decrease in FSH and LH
D. Both A and B
E. All of the above
A

D.

56
Q 
Which hormone induces the growth and division of all cell types in the stratum basale of the endometrium during the proliferative phase?
A. Estrogen
B. Progesterone
C. LH
D. FSH
A

A. Estrogen = functions for cell proliferation

57
Q

Main function of the Secretory phase of the endometrial cycle:
A. For cell growth and division
B. To provide appropriate conditions for implantation of fertilized ovum
C. To increase FSH and LH
D. For the subsequent degeneration of the endometrium

A

B.
To produce a highly secretory endometrium with large amounts of stored nutrients to provide appropriate conditions for implantation of a fertilized ovum

58
Q 
The cause of menstrual cycle cessation during menopause:
A. Decreased estrogen
B. Diminished number of primordial cells
C. Decreased follicular cells
D. Both A and B
E. AOTA
A

D.

59
Q

The primary estrogen produced in adipose tissue:
A. E1
B. E2
C. E3

A

A. Estrone or E1
→ The primary estrogen produced in adipose tissue
→ Becomes the predominant estrogen in postmenopausal women

60
Q

Which content of the seminal fluid stimulates contraction of the uterus and fallopian tube to help the transport of sperm?

A

Prostaglandin

61
Q

Specific portion of the FT where fertilization takes place (according to Guyton)

A

Ampullae

62
Q

Which of the following affects the transport of fertilized ovum to the cavity of the uterus?
A. Weak fluid current in the FT
B. Beating of ciliated epithelium
C. Weak contractions of the fallopian tube
D. AOTA

A

D. AOTA

63
Q 
Which part of the FT remains spastically contracted for about the first 3 days after ovulation?
A. Ampulla
B. Infundibulum
C. Isthmus
D. Uterine FT
A

C. Isthmus

64
Q 
Which hormone secreted by the corpus luteum activates its receptors allowing the entry of the fertilized ovum through the isthmus?
A. Estrogen
B. Progesterone
C. hCG
D. LH
A

B. Progesterone

65
Q 
Implantation of the fertilized ovum occurs on the \_\_\_\_ day after ovulation
A. 3rd-5th
B. 5th-7th
C. 7th-9th
D. Variable days
A

B. 5th-7th

66
Q 
The only source of nutrients to the embryo during the first weel after the implantation for up to 8 weeks
A. Uterine milk
B. Decidual cells
C. Placenta
D. NOTA
A

B. Decidual cells
Uterine milk is the source of nutrition of the blastocyst (prior to implantation)
Placenta provides nutrition about 16th day after fertilization (1 week after implantation)

67
Q 
How many days after fertilization does blood begin to be pumped by the heart of the embryo?
A. 3-5
B. 7
C. 16
D. 21
A

D. 21 days after fertilization

3-5 days after fertilization is the length of time required for transport of fertilized ovum through the FT into the cavity of uterus

16 days after fertilization is when the placenta begins to supply nutrition to the embryo

68
Q 
In the placenta membrane, the mean partial pressure of oxygen of the maternal and fetal blood respectively is:
A. 40:20 mmHg
B. 50:30 mmHg
C. 60:40 mmHg
D. 70:50 mmHg
A

B. 50:30 mmHg

→ Mean pressure gradient for diffusion of O2 through the placental membrane is 20 mmHg

69
Q

The low partial pressure of oxygen in fetal blood is still capable of supplying adequate oxygen to the fetal tissues because:
A. The Hgb of the fetus is Fetal Hemoglobin
B. The Hgb concentration of fetal blood is 50% greater than that of the mother
C. The Double Bohr effect
D. AOTA

A

D. AOTA

Fetus has fetal hemoglobin, which has an oxygen dissociation curve that is shifted to LEFT = higher affinity of oxygen to Hgb = at low PO2 levels, Fetal Hgb can carry 20-50% more O2

Hgb concentration in fetal Hgb is 50% greater

Bohr effect = Hgb can carry more O2 at low PCO2 + Fetal blood carries large amounts of CO2 that diffuses to the maternal blood

*Bohr effect:
Inc CO2 = low pH (acidity) = low affinity of O2

70
Q

Which of the following is true of the diffusion of molecules through the placental membrane?
A. The fetus uses less glucose
B. Fatty acids diffuse more slowly than glucose
C. Glucose passes through simple diffusion while fatty acids use carrier molecules in the trophoblast cells
D. Ketone bodies, K, Na, and Cl ions pass through facilitated diffusion
E. Non-protein nitrogen (urea, uric acid and creatinine) pass through facilitated diffusion

A

B. Because of the high solubility of fatty acids in cell membranes, these fatty acids also diffuse from the maternal blood into the fetal blood, but more slowly than glucose, so glucose is used more easily by the fetus for nutrition.

A more
C glucose is FD while FA is SD
D & E should be SD

71
Q 
Hormone secreted by the syncytial trophoblast cells into the fluids of the mother, 8-9 days after ovulation
A. Estrogen
B. Progesterone
C. hCG
D. LH
A

C. hCG

72
Q

Which of the following poses risk for spontaneous abortion?
A. hCG reaches maximum at about 10-12 weeks of pregnancy
B. Corpus luteum involutes at 6th week of pregnancy
C. Corpus luteum involutes after 13th-17th week
D. AOTA

A

B. If corpus luteum is removed before the seventh week of pregnancy, spontaneous abortion almost always happens

A and C are normal

73
Q

Which of the following is NOT a function of estrogen during pregnancy?
A. Enlargement of uterus, external genitalia, and breast
B. Limber SI joints
C. Elasticity of the Symphysis pubis
D. Relaxation of pelvic ligaments
E. NOTA

A

E. NOTA

74
Q

Which of the following is true of estrogen produced by placenta?
A. Estrogens are also synthesized de novo by the placenta like the ovaries
B. Formed from Dehydroepiandrosterone and 16-hydroxydehydroepiandrosterone
C. Precursors are formed only by the fetal adrenal glands
D. Weak androgens are converted by the embryonic cells into E1, E2, E3
E. NOTA

A

B.
Secretion of estrogens by the placenta is quite different from secretion by the ovaries
→ Estrogens secreted by the placenta are not synthesized de novo from basic substrates in the placenta
→ Formed almost entirely from androgenic steroid compounds, dehydroepiandrosterone and 16-hydroxydehydroepiandrosterone
▪ Formed both in the mother’s adrenal glands and in the adrenal glands of the fetus
→ Weak androgens are transported by the blood to the placenta and converted by the trophoblast cells into estradiol, estrone, and estriol

75
Q

The following are the functions of progesterone in pregnancy, except:
A. Development of decidual cells in the uterine endometrium
B. Increase contractility of the pregnant uterus
C. Contributes to the development of conceptus
D. Helps prepare mother’s breast for lactation along with estrogen

A

B should be ‘decrease’ to prevent abortion

76
Q 
Which hormone can be attributed to gestational diabetes?
A. Estrogen
B. Human Chorionic Gonadotrophin
C. Progesterone
D. Human Placental Lactogen
E. AOTA
A

D. aka Human Chorionic Somatomammotropin

77
Q

Which of the following is a function of hCG?
A. Stimulates Leydig cells of male fetus to produce testosterone
B. Decreases glucose utilization of mother
C. Promotes release of free fatty acids for mother
D. Increased protein formation

A

A. Exerts an interstitial cell-stimulating effect on the testes of the male fetus resulting in the production of testosterone in male fetuses until birth
→ Causes the fetus to grow male sex organs instead of female sex organs

All other choices are functions of hCS

78
Q 
Which hormones are responsible for the maternal blood volume increase during pregnancy?
A. Estrogen
B. Aldosterone
C. Progesterone
D. both A and B
E. both B and C
A

D.

79
Q 
During parturition, which reflex is stimulated by stretching of uterine cervix?
A. Spinal cord neurogenic reflex
B. Hypothalamic neurogenic reflex
C. Myogenic reflex
D. Braxton Hicks contractions
A

B. stretching of the uterine cervix, as occurs during labor, can cause a neurogenic reflex through the paraventricular and supraoptic nuclei of the hypothalamus that causes the posterior pituitary gland (the neurohypophysis) to increase its secretion of
oxytocin

80
Q 
Periodic episodes of weak and slow rhythmical contractions during most of the months of pregnancy
A. Pituitary neurogenic reflex
B. Hypothalamic neurogenic reflex
C. Myogenic reflex
D. Braxton Hicks contractions
A

D. Braxton Hicks contractions

81
Q

How many types of positive feedback work during labor?

A

Two types of positive feedback increase uterine contractions during labor
→ Stretching the cervix causes entire body of the uterus to contract
→ Cervical stretching causes the pituitary gland to secrete oxytocin which increase the uterine contractions

82
Q 
Pain signals originating both from the uterus and from the birth canal, elicits what reflex to the abdominal muscles and contractions of these muscles?
A. Spinal cord neurogenic reflex
B. Hypothalamic neurogenic reflex
C. Myogenic reflex
D. Braxton Hicks contractions
A

A. Neurogenic reflexes from the spinal cord

83
Q 
Which hormone is formed at the placental separation site vasoconstricts the BV during labor?
A. Estrogen
B. Prostaglandin
C. Progesterone
D. Nitric oxide
E. NOTA
A

B. Prostaglandin

84
Q 
Nerves responsible for the cramping labor pains due to hypoxia
A. Pudendal nerve
B. Hypogastric nerve
C. Spinal Cord
D. Somatic nerve
A

B. Hypogastric nerve

85
Q

The Vaginal discharge known as Lochia in earlier days after parturition is:
A. Mucous
B. Serous
C. Bloody

A

C. Bloody

86
Q

Hormones important for the development of the ductal system of lactation:

A

Growth hormone
Prolactin
Adrenal glucocorticoid
Insulin

87
Q 
Which of the following hormones increases steadily from the 5th week of pregnancy until the birth of the baby?
A. Growth hormone
B. Prolactin
C. Adrenal glucocorticoid
D. Insulin
E. NOTA
A

B. Prolactin

88
Q 
Which of the following hormones is needed for the development of breast into a milk-secreting organ?
A. Progesterone
B. Estrogen
C. hCS
D. Prolactin
A

A. Progesterone

- required for full development of the lobule-alveolar system

89
Q 
Which of the following hormones inhibits the actual secretion of milk; hence, is decreased after birth of baby?
A. Progesterone
B. Estrogen
C. Prostaglandin
D. Both A and B
E. AOTA
A

D. Estrogen and progesterone

90
Q

Part of the brain that releases the prolactin inhibitory hormone

A

Hypothalamus

91
Q

Hormone for milk let down

A

Oxytocin

92
Q 
Compared to cow's milk, human milk is higher in which constituent? (2 answers)
A. Water
B. Lactose
C. Fat
D. Protein
A

A and B

93
Q

Human milk has antibodies and macrophages that destroy which microorganism?

A

E. coli

94
Q

Which of the following statements is INCORRECT about the diffusion of oxygen through the placental membrane?
A. The Bohr shift operates in one direction in the maternal blood and in another in the fetal blood
B. Hemoglobin of the fetus is mainly fetal hemoglobin
C. The mean pO2 in the fetal blood is only 30 mmHg
D. Hemoglobin concentration of fetal blood is the same as maternal blood

A

D. Hemoglobin concentration of fetal blood is the same as maternal blood (WRONG since Hgb concentration is greater in fetal blood)

95
Q

Which of the following is TRUE in follicular growth in the ovaries?
A. At birth, each primordial follicle contains an oocyte arrested in metaphase I and surrounded by several layers of granulosa cells
B. Few hours before ovulation, the oocyte completes meiosis I and has synthesized enough MAPK pathway proteins to arrest at metaphase II
C. During childhood, the granulosa cells secrete an oocyte maturation inhibiting factor that keeps the primary oocyte arrested in metaphase I
D. During puberty, follicular growth begins as a direct response to significant level of gonadotropins produced by hypothalamus.

A

B is true since a few hours before ovulation, the primary oocyte previously arrested in Prophase I completes meiosis I and extrudes the first polar body. It has synthesized enough MAPK pathway proteins to arrest at metaphase II. (B802)

A should be prophase I
C should be prophase I
D gonadotrophic hormones (FSH and LH), after puberty, are secreted in significant quantities from the anterior pituitary gland and the ovaries (together with some of the follicles within them) begin to grow.

96
Q 
Thelarche, which is the earliest sign of puberty in female adolescents, results from secretion of this hormone:
A. Estradiol
B. Prolactin
C. Gonadotropin-releasing hormone
D. Progesterone
A

A. Estradiol

97
Q 
Which of the following hormones can detect pregnancy at 2 weeks?
A. Human chorionic somatomammotropin
B. Estrogen
C. Progesterone
D. Human chorionic gonadotropin
A

D. Human chorionic gonadotropin

98
Q 
The posterior pituitary is formed from the
A. Nervous tissue
B. Connective tissue
C. Muscle tissue
D. Epithelial tissue
A

A. nervous tissue

99
Q

Important functions of growth hormone, EXCEPT:
A. Decreases rate of glucose utilization in the body
B. Stimulates cartilage and bone growth
C. Functions through a target gland and exerts its effect on different tissues of the body
D. Increases rate of protein synthesis

A

C. functions through a target gland and exerts its effect on different tissues of the body

Metabolic effects of GH:

(1) increased rate of protein synthesis in most cells of the body;
(2) increased mobilization of fatty acids from adipose tissue, increased free fatty acids in the blood, and increased use of fatty acids for energy; and
(3) decreased rate of glucose utilization throughout the body.

Thus, in effect, growth hormones enhance body protein, decreases fat stores, and conserves carbohydrates.

100
Q 
After parturition, this hormone is responsible for synthesis and milk production
A. Prolactin
B. FSH
C. Estrogen
D. Oxytocin
A

A. Prolactin

PHYSIOLOGY MED1 (15 decks)

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