Female reproductive system Flashcards

Question

Symptoms indicative of ovulation

Answer 1

An increase in a woman's basal body temperature occurs due to the LH surge. As a result, the rise in body temperature indicates that ovulation is likely to occur in the next 24-48 hours. The cervical mucus also becomes thinner around the time of ovulation to allow easier passage of sperm.

Answer 2

Days 9-16 The most fertile period of the menstrual cycle is from 5 days before ovulation to 1-2 days after. Couples often use this knowledge to increase their chances of conception.

Answer 3

Formation and maintenance of the corpus luteum Thinning of the Graafian follicles membrane

Answer 4

The LH surge usually occurs on day 12. This occurs due to oestrogen levels reaching a peak level which stimulates large amounts of LH production. The high LH level causes the membrane of the Graafian follicle to become thin. As a result, 24-48 hours after the LH surge ovulation usually occurs due to the rupture of the Graafian follicle.

Answer 5

Inhibition of LH and FSH production Initiation of the secretory phase of the endometrium Increase in basal body temperature

Answer 6

Thinning of cervical mucous Thickening of the endometrium

Answer 7

Pregnancy Sexual arousal Menstrual cycle variation

Answer 8

Vaginal: candidiasis, trichomoniasis, gardnerella associated, forigen body, post menopausal vaginitis Cervical: gonorrhoea, non specific genital infection, herpes, cervical ectopy (rare), cervical neoplasm e.g. polyp

Answer 9

during menstruation: 2-4 mm early proliferative phase (day 6-14): 5-7 mm late proliferative / preovulatory phase: up to 11 mm secretory phase: 7-16 mm following dilatation and curettage or spontaneous abortion: <5 mm, if it is thicker consider retained products of conception

Answer 10

vaginal bleeding (and not on tamoxifen): suggested upper limit of normal is <5 mm no history of vaginal bleeding: the acceptable range of endometrial thickness is less well established in this group, cut-off values of 8-11 mm have been suggested if on tamoxifen 3: <5 mm

Answer 11

Proliferitive phase Not pregnant, endometrium thinnest so can visualise cervix best

Answer 12

Increase in: Steroid hormones (anterior pituitary gland produces more ACTH leading to increased steroid production, particular aldosterone and cortisol) T3/T4 (TSH remains normal) Prolactin (anterior pituitary gland produces more) Melanocyte stimulating hormone (anterior pituitary gland produces more) Oestrogen (Produced by placenta throughout pregnancy) Progesterone (The corpus luteum produces progesterone until ten weeks gestation. The placenta produces it during the remainder of the pregnancy) HCG (roughly doubling every 48 hours until they plateau around 8 – 12 weeks, then gradually start to fall) Decrease in: FSH and LH (Increased prolactin acts to suppress FSH and LH)

Answer 13

Tidal volume and respiratory rate increase in later pregnancy, to meet the increased oxygen demands.

Answer 14

Increase in: Blood flow EGFR Sodium reabsorption (Increased aldosterone) Water reabsorption (Increased aldosterone) Protein excretion Physiological hydronephrosis (Dilatation of the ureters and collecting system, leading to a physiological hydronephrosis (more right-sided)

Answer 15

Increase in: RBC WBC ALP (up to 4 times normal, due to secretion by the placenta) Clotting factors (Clotting factors such as fibrinogen and factor VII, VIII and X increase in pregnancy, making women hyper-coagulable) ESR D Dimer Platelets Decrease in: Albumin (due to loss of proteins in the kidneys) Platelets Haematocrit ( Plasma volume increases more than red blood cell volume, leading to a lower concentration of red blood cells. High plasma volume means the haemoglobin concentration and red cell concentration (haematocrit) fall in pregnancy, resulting in anaemia.) {Calcium requirements increase, but so does gut absorption of calcium, meaning calcium levels remain stable}

Answer 16

Linea nigra (Increased melanocyte stimulating hormone from AP causes increased pigmentation) Melasma (Increased melanocyte stimulating hormone from AP causes increased pigmentation) Striae gravidarum Spider naevi Palmar erythema General itchiness (pruritus) can be normal, but can indicate obstetric cholestasis

Answer 17

Increase: Blood volume Plasma volume Cardiac output Decrease in: Vascular resistance Blood pressure (in early and middle pregnancy, returning to normal by term) Peripheral Vasodilation (also causes flushing and hot sweats) Varicose veins (can occur due to peripheral vasodilation and obstruction of the inferior vena cava by the uterus)

Answer 18

Aprox 100g to 1.1kg There is hypertrophy of the myometrium and the blood vessels in the uterus.

Answer 19

Hypertrophy

Answer 20

Increased discharge Ectropian Both due to increased oesterogen (produced by placenta)

Answer 21

Increased discharge Hypertrophy Candida Bacteria All due to increase in oestrogen (produced by placenta)

Answer 22

Progesterone levels rise throughout pregnancy. Progesterone acts to maintain the pregnancy, prevent contractions and suppress the mother’s immune reaction to fetal antigens.

Answer 23

Before delivery, prostaglandins break down collagen in the cervix, allowing it to dilate and efface during childbirth.

Answer 24

The first stage is from the onset of labour (true contractions) until 10cm cervical dilatation. The second stage is from 10cm cervical dilatation to delivery of the baby. The third stage is from delivery of the baby to delivery of the placenta.

Answer 25

prostaglandin E2 (dinoprostone)

Answer 26

The first stage of labour is from the onset of labour (true contractions) until the cervix is fully dilated to 10cm. It involves cervical dilation (opening up) and effacement (getting thinner from front to back). The “show” refers to the mucus plug in the cervix, that prevents bacteria from entering the uterus during pregnancy, falling out and creating space for the baby to pass through.

Answer 27

Latent phase: From 0 to 3cm dilation of the cervix. This progresses at around 0.5cm per hour. There are irregular contractions. Active phase: From 3cm to 7cm dilation of the cervix. This progresses at around 1cm per hour, and there are regular contractions. Transition phase: From 7cm to 10cm dilation of the cervix. This progresses at around 1cm per hour, and there are strong and regular contractions.

Answer 28

The second stage of labour lasts from 10cm dilatation of the cervix to delivery of the baby. The success of the second stage depends on “the three Ps”: power, passenger and passage. Power: the strength of the uterine contractions. Passenger: the four descriptive qualities of the fetus: size, attitude, lie and presentation. Passage: the size and shape of the passageway, mainly the pelvis.

Answer 29

The third stage of labour is from the completed birth of the baby to the delivery of the placenta. Physiological management is where the placenta is delivered by maternal effort without medications or cord traction. Active management of the third stage is where the midwife or doctor assist in delivery of the placenta. Active management shortens the third stage and reduces the risk of bleeding. Haemorrhage, or more than a 60-minute delay in delivery of the placenta, should prompt active management. Active management can be associated with nausea and vomiting. Active management involves giving a dose of intramuscular oxytocin to help the uterus contract and expel the placenta. Careful traction is applied to the umbilical cord to guide the placenta out of the uterus and vagina.

Answer 30

Respiration Nutrients Excretion Endocrine Immunity

Answer 31

The placenta is the only source of oxygen for the fetus. Fetal haemoglobin has a higher affinity for oxygen than adult haemoglobin. The fetal haemoglobin is more attractive to oxygen molecules than the maternal haemoglobin. As a result, when maternal blood and fetal blood are nearby in the placenta, oxygen is drawn off the maternal haemoglobin, across the placental membrane, onto the fetal haemoglobin. Carbon dioxide, hydrogen ions, bicarbonate and lactic acid are also exchanged in the placenta, allowing the fetus to maintain a healthy acid-base balance.

Answer 32

This nutrition is mostly in the form of glucose, which is used for energy and growth. The placenta can also transfer vitamins and minerals to the fetus, as well as potentially harmful substances if the mother is consuming medications, alcohol, caffeine or cigarette smoke.

Answer 33

The placenta performs a similar function to kidneys in a child or adult, filtering waste products from the fetus. These waste products include urea and creatinine.

Answer 34

The placenta produces oestrogen, which helps to soften tissues and make them more flexible. Oestrogen allows the muscles and ligaments of the uterus and pelvis to expand, and the cervix to become soft and ready for birth. It also enlarges and prepares the breasts and nipples for breastfeeding.

Answer 35

Human Chorionic Gonadotrophin Progesterone Oestrogen

Answer 36

hCG levels increase in early pregnancy, plateau at around ten weeks gestation, then start to fall.

Answer 37

It causes side effects by relaxing other muscles, such as the lower oesophageal sphincter (causing heartburn), the bowel (causing constipation) and the blood vessels (causing hypotension, headaches and skin flushing). It also raises the body temperature between 0.5 and 1 degree Celsius.

Answer 38

It is produced in the hypothalamus, but travels to the pituitary before being released into the general circulation.

Answer 39

Posterior pituitary gland.

Answer 40

Oxytocin stimulates the ripening of the cervix and contractions of the uterus during labour and delivery. It also plays a role in lactation during breastfeeding.

Answer 41

The transformation zone is the border between the columnar epithelium of the endocervix (the canal), and the stratified squamous epithelium of the ectocervix (the outer area of the cervix visible on speculum examination). When the transformation zone is located on the ectocervix, it is visible during speculum examination as a border between the two epithelial types.

Answer 42

The upper vagina, cervix, uterus and fallopian tubes develop from the paramesonephric ducts (Mullerian ducts). These are a pair of passageways along the outside of the urogenital region that fuse and mature to become the uterus, fallopian tubes, cervix and upper third of the vagina. Errors in their development lead to congenital structural abnormalities in the female pelvic organs. In a male fetus, anti-Mullerian hormone is produced, which suppresses the growth of the paramesonephric ducts, causing them to disappear.

Answer 43

In a male fetus, anti-Mullerian hormone is produced, which suppresses the growth of the paramesonephric ducts, causing them to disappear.

Answer 44

Primordial follicles each contain a primary oocyte which is contained within the pregranulosa cells surrounded by the basal lamina layer The oocytes are the germ cells (first generation of sex cell) that eventually undergo meiosis to become the mature ovum, ready for fertilisation. They contain the full 46 chromosomes. These primordial follicles and oocytes spend the majority of their lives in a resting state inside the ovaries, waiting for their time to develop into primary follicles

Answer 45

The oocytes are the germ cells (first generation of sex cell) that eventually undergo meiosis to become the mature ovum, ready for fertilisation. They contain the full 46 chromosomes. The primary oocyte is contained within the pregranulosa cells, surrounded by the outer basal lamina layer.

Answer 46

Primordial follicles grow and become primary follicles. These primary follicles have three layers: The primary oocyte in the centre The zona pellucida The cuboidal shaped granulosa cells The granulosa cells secrete the material that becomes the zona pellucida. They also secrete oestrogen. As the follicles grow larger, they develop a further surrounding layer called the theca folliculi. The inner layer of the theca folliculi is called the theca interna. The theca interna secretes androgen hormones. The outer layer, called the theca externa, is made up of connective tissue cells containing smooth muscle and collagen.

Answer 47

The granulosa cells secrete the material that becomes the zona pellucida. They also secrete oestrogen.

Answer 48

The primary oocyte in the centre The zona pellucida The cuboidal shaped granulosa cells As the follicles grow larger, they develop a further surrounding layer called the theca folliculi. The inner layer of the theca folliculi is called the theca interna. The theca interna secretes androgen hormones. The outer layer, called the theca externa, is made up of connective tissue cells containing smooth muscle and collagen.

Answer 49

Theca folliculi develops as follicle grows bigger Two layers: The theca interna secretes androgen hormones. The outer layer, theca externa, is made up of connective tissue cells containing smooth muscle and collagen.

Answer 50

The process of primordial follicles maturing into primary and secondary follicles is always occurring, independent of the menstrual cycle. As primary follicles become secondary follicles, they grow larger and develop small fluid-filled gaps between the granulosa cells. Once the follicles reach the secondary follicle stage, they have receptors for follicle stimulating hormone (FSH). Further development after the secondary follicle stage requires stimulation from FSH. At the start of the menstrual cycle, FSH stimulates further development of the secondary follicles.

Answer 51

When they become secondary follicles

Answer 52

Further development after the secondary follicle stage requires stimulation from FSH. At the start of the menstrual cycle, FSH stimulates further development of the secondary follicles.

Answer 53

FSH stimulation at the start of the menstural cycle causes the secondary follicle develops a single large fluid-filled area within the granulosa cells called the antrum. This is the antral follicle stage. This antrum fills with increasing amounts of fluid, making the follicle expand rapidly. The corona radiata is made of granulosa cells, and surrounds the zona pellucida and the oocyte. At this point, one of the follicles becomes the dominant follicle. The other follicles start to degrade, while the dominant follicle grows to become a mature follicle. This follicle bulges through the wall of the ovary.

Answer 54

At this point, one of the follicles becomes the dominant follicle. The other follicles start to degrade, while the dominant follicle grows to become a mature follicle. This follicle bulges through the wall of the ovary.

Answer 55

When there is a surge of luteinising hormone (LH) from the pituitary, it causes the smooth muscle of the theca externa to squeeze, and the follicle to burst. Follicular cells also release digestive enzymes that puncture a hole in the wall of the ovary, allowing the ovum to pass escape. The oocyte is released into the area surrounding the ovary. At this point, it is floating in the peritoneal cavity, but it is quickly swept up by the fimbriae of the fallopian tubes.

Answer 56

The leftover parts of the follicle collapse and turn a yellow colour becoming the CORPUS LUTEUM. The cells of the granulosa and theca interna become luteal cells. Luteal cells secrete steroid hormones, most notably progesterone.

Answer 57

The corpus luteum persists in response to human chorionic gonadotropin (HCG) from a fertilised blastocyst when pregnancy occurs. When fertilisation does not occur, the corpus luteum degenerates after 10 to 14 days.

Answer 58

Just before and around the time of ovulation, the primary oocyte undergoes meiosis. This process splits the full 46 chromosomes in the oocyte (a diploid cell) into two, leaving only 23 chromosomes (a haploid cell). The other 23 chromosomes float off to the side and become something called a polar body. It is then a secondary oocyte. The female egg (ovum) at this stage still has the surrounding layers from its time in the follicle. In the middle is the oocyte with the first polar body, surrounded by the zona pellucida and the granulosa cells that make up the corona radiata.

Answer 59

When sperm from the male enter the fallopian tube via the vagina and uterus, they will attempt to penetrate the corona radiata and zona pellucida to fertilise the egg. Usually, only one sperm will get through before the surrounding layers shut the other sperm out. When a sperm enters the egg, the 23 chromosomes of the egg multiply into two sets. One set of 23 chromosomes combine with the 23 chromosomes from the sperm to form a diploid set of 46 chromosomes, and the other set of 23 chromosomes float off to the side and create the second polar body.

Answer 60

At fertilisation, the combination of the 23 chromosomes from the egg and 23 chromosomes from the sperm combine to form a fertilised cell called a zygote.

Answer 61

The combination of the 23 chromosomes from the egg and 23 chromosomes from the sperm combine to form a fertilised cell called a zygote. This cell divides rapidly to create a mass of cells called the morula.

Answer 62

During this process, the mass of cells travels along the fallopian tube toward the uterus.

Answer 63

The combination of the 23 chromosomes from the egg and 23 chromosomes from the sperm combine to form a fertilised cell called a zygote. This cell divides rapidly to create a mass of cells called the morula. During this process, the mass of cells travels along the fallopian tube toward the uterus. While travelling, a fluid-filled cavity gathers within the group of cells, and it becomes a blastocyst.

Answer 64

The blastocyst contains the main group of cells in the middle, called the embryoblast. Alongside the embryoblast is a fluid-filled cavity called the blastocele. Surrounding the embryoblast and the blastocele is an outer layer of cells called the trophoblast. At this point, it gradually loses the corona radiata and zona pellucida. When the blastocyst enters the uterus, it contains 100-150 cells.

Answer 65

When the blastocyst arrives at the uterus, 8 – 10 days after ovulation, it reaches the endometrium. The cells of the trophoblast (the outer layer of the blastocyst) undergo adhesion to the stroma (supportive outer tissue) of the endometrium. The outer layer of the trophoblast is called the syncytiotrophoblast. This layer forms projections into the stroma. The cells of the syncytiotrophoblast mix with the cells of the endometrium (stroma). The cells of the stroma convert into a tissue called decidua that is specialised in providing nutrients to the trophoblast. When the blastocyst implants on the endometrium, the syncytiotrophoblast starts to produce human chorionic gonadotropin (HCG). This HCG is very important for maintaining the corpus luteum in the ovary, allowing it to continue producing progesterone and oestrogen.

Answer 66

The outer layer of the trophoblast (which is the outer layer of the blastocyst) When the cells of the trophoblast form adhesions to the storma of the endometrium, the synchiotrophoblast’s cells of the mix with the cells of the endometrium (stroma). The syncytiotrophoblast starts to produce human chorionic gonadotropin (HCG). This HCG is very important for maintaining the corpus luteum in the ovary, allowing it to continue producing progesterone and oestrogen.

Answer 67

Fertilisation occurs, fertilised egg becomes ZYGOTE Zygote divides to become mass of cells - MORULA Fluid filled cavity forms within the morula becomes the BLASTOCYST BLASTOCYST implants into the stroma of the endometrium

Answer 68

(1 week after fertilisation) The cells of the embryoblast (main group of cells contained in the middle of the blastocyst) split in two: - with the yolk sac on one side - and the amniotic cavity on the other. The embryonic disc sits between the yolk sac and the amniotic cavity. The cells of the embryonic disc develop into the fetal pole, and eventually into the fetus. The chorion surrounds this complex. The chorion has two layers: the cytotrophoblast and the syncytiotrophoblast. The cytotrophoblast is the inner layer and the syncytiotrophoblast is the outer layer, which is embedded in the endometrium.

Answer 69

The embryonic disc sits between the yolk sac and the amniotic cavity. The cells of the embryonic disc develop into the fetal pole, and eventually into the fetus.

Answer 70

Over a short time, a space called the chorionic cavity forms around the yolk sac, embryonic disc and amniotic sac. These structures are suspended from the chorion by the connecting stalk, which will eventually become the umbilical cord.

Answer 71

At around 5 weeks gestation

Answer 72

The ectoderm (outer layer) The mesoderm (middle layer) The endoderm (inner layer) These three layers go on to become all the different tissues of the body.

Answer 73

*GI TRACT * LUNGS * LIVER * PANCREAS * THYROID * REPRODUCTIVE SYSTEM

Answer 74

*HEART * MUSCLE * BONE * CONNECTIVE TISSUE * BLOOD * KIDNEYS

Answer 75

* SKIN * HAIR * NAILS * TEETH * CENTRAL NERVOUS SYSTEM

Answer 76

At around six weeks gestation, the fetal heart forms and starts to beat. The spinal cord and muscles also begin to develop. The embryo (fetal pole) is about 4mm in length.

Answer 77

During the follicular phase of the menstrual cycle, the endometrium thickens and gets ready for a fertilised egg to arrive. The myometrium sends off artery branches into the endometrium. Initially, these arteries grow straight outwards like plant shoots. As they continue to grow, they coil into a spiral. These thick-walled and coiled arteries are bunched together, making the endometrial tissue highly vascular. These are known as the spiral arteries.

Answer 78

When the blastocyst implants on the endometrium, the outermost layer, called the syncytiotrophoblast, grows into the endometrium. It forms finger-like projections called chorionic villi. The chorionic villi contain fetal blood vessels.

Answer 79

The chorionic villi nearest the connecting stalk of the developing embryo are the most vascular and contain mesoderm. This area is called the chorion frondosum. The cells in the chorion frondosum proliferate and become the placenta. The connecting stalk becomes the umbilical cord. Placental development is usually complete by 10 weeks gestation.

Answer 80

Trophoblast invasion of the endometrium sends signals to the spiral arteries in that area, reducing their vascular resistance and making them more fragile. The blood flow to these arteries increases, and eventually they break down, leaving pools of blood called lacunae (lakes). Maternal blood flows from the uterine arteries, into these lacunae, and back out through the uterine veins. Lacunae form at around 20 weeks gestation. These lacunae surround the chorionic villi, separated by the placental membrane. Oxygen, carbon dioxide and other substances can diffuse across the placental membrane between the maternal and fetal blood.

Answer 81

When the process of forming lacunae is inadequate, the woman can develop pre-eclampsia. Pre-eclampsia is caused by high vascular resistance in the spiral arteries. High vascular resistance in the spiral arteries results in a sharp rise in maternal blood pressure, and leads to a number of complications in the mother and fetus.

Answer 82

Endometrium, the inner layer that contains connective tissue (stroma), epithelial cells and blood vessels Myometrium, the middle layer that contains smooth muscle Perimetrium, the outer layer, which is a serous membrane similar to the peritoneum (also known as serosa)

Answer 83

Usually the placenta attaches to the endometrium. This allows the placenta to separate cleanly during the third stage of labour, after delivery of the baby.

Female reproductive system Flashcards

(115 cards)