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Flashcards in Menstrual Cycle Deck (100):
0

Around what age does the menstrual cycle begin?

around age 11-13

1

Around what age does the menstrual cycle typically end?

around age 50

2

How long does a menstrual cycle last?

Typically 28 days from first day of bleeding

varies from patient to patient

3

What regulates the menstrual cycle?

the hypothalamus

dependent upon cyclic release of estrogen and progesterone from ovaries

4

What is Premenarch?

prepuberty - prior to the onset of menses

5

What is Menarch?

after reaching puberty

menses occurs normally every 28 days (1st menses to menopause)

6

What is menopause?

the cessation of menses

7

What are the menstrual statuses?

Premenarch

Menarch

Menopause (no period for one solid year)

8

What are the gonadotropins?

Hormonal substance which stimulates the function of the testes and ovaries

9

What hormones do the gonadotropins release?

FSH (follicle stimulating hormone)

LH (luteninizing hormone)

LTH (luteotropic hormone)

Estrogen

Progesterone

10

What is Estrogen?

Steroid

Released by theca interna and granulose cells of ovarian follicle

promotes growth of endometrium durning menstrual cycle

11

What is ovulation?

explosive release of ovum from ruptured graafian follicle

12

what is an oocyte?

primordial or incompletely developed ovum

13

who regulates ovulation?

the hypothalalmus

14

What does the Anterior Pituitary gland do?

secretes varying levels of gonadotropins (FSH, LH, LTH)

15

What is the first half of the menstrual cycle called?

proliferative, follicular or estrogenic phase

16

When is the first half of the menstrual cycle?

usually days 1-14 may vary in length accounts for shortere or longer menstrual cycle

17

What happens on day 1 of the first half of the menstrual cycle?

first day of bleeding ( menstrual flow)

18

What happens day 1 through day 4-5?

estrogen levels decreases

FSH releases/stimulates follicular growth and maturity

19

What happens day 4-5 of the first half of the menstrual cycle?

menstrual flow complete

endo lining ready for new growth (proliferation)

20

What happens day 5-14 of the first half of the menstrual cycle?

follicles grow

21

what is a mature follicle called?

a graafian follicle

22

What does estrogen trigger?

new growth of endometrial lining (proliferation)

23

When does ovulation occur?

approx day 14

24

What is the lutenizing surge?

LH surge peaks 10-12 hours prior to ovulation - used for ovulation prediction for conception

25

What released the egg, who catches it?

Released by: Graafian follicle

directed by fimbria into the infundibulum of the Fallopian tube.

26

Where would you find fluid after the follicular rupture?

usually associated with release of fluid into posterior cul-de-sac

27

What is Mittleschmerz (middle pain)

fluid causes irritation to membranes (fluid from released ovum during ovulation...this is normal)

causes pain during ovulation

28

What is the second half of the menstrual cycle called?

pro-gestational, luteal or secretory phase

29

What is the measurement for a follicle?

2-2.5 cm

30

what is the measurement for an ovarian cyst?

2.5cm or bigger

31

When does the second half of the menstrual cycle begin?

begins with ovulation

lasts approx 14 days

**does not vary in length**

32

What happens during the second half of the menstrual cycle?

follicle ruptured - corpus luteum

33

what does corpus luteum mean?

Yellow body

34

how is the endometrium affected by the ovulatory cycle?

affected by varying levels of progesterone and estrogen

35

what are the three phases of the menstrual cycle that affect the endometrium?

the menstrual phase

proliferative phase

secretory phase

36

what is the menstrual phase?

decreasing progesterone levels

spiral arterioles constrict

zona functionalis ischemia - shedding

37

what is the proliferative phase?

days 6-14

lasts until ovulation

lasts until luteinization of Graafian follicle - ovulation

38

what happens to the superficial layer of the endometrium during the proliferative phase?

it regenerates and grows

follicles regrow with FSH stimulation (estrogen rises)

39

what is the periovulatory phase or late proliferative?

days 10-14

endometrium triple layer appearance

slide 25 finish

40

When is the secretory phase?

15-28 days or the on set of menses

when the person starts to bleed

41

what happens during the secretory phase?

**the thickest point of the endometrium***

progesterone secreted by ovary

spiral arteries and endometrial glands enlarge

finalizes endometrial lining for implantation if fertilization occurs

42

What is an anovulatory patient?

birth control users or post menopausal or prepubescent

endometrium is thin and has an echogenic line

birth control will be <5mm

43

What does a postmenopausal endometrium NOT on hormone replacement therapy measure?

endometrial thickness <5mm

**a thickened endometrium with no HRT and bleeding can be cancer so know this!!**

44

what is menorrhagia?

abnormally heavy or long periods

associated with fibroids, IUd, hormonal imbalance

can lead to anemia

45

What is oligomenorhea?

abnormally short or light periods

associated with polycystic ovary syndrome (POS)

emotional/physical stress, chronic illness, tumors secreting estrogen, poor nutrition, eating disorders, heavy exercise

46

what is polymenorrhea?

cycle occurs at intervals of <21 days

47

what is dysmenorrhea?

painful periods (severe pain)

associated with endometriosis (the endometrium outside the uterus goes through the same changes as the stuff inside)

48

what is Amenorrhea - primary?

absence of menstruation

delayed beyond 18 yr old

due to:

ovarian dysfunction

pituitary disease

other endocrine disturbances

49

what is amenorrhea - secondary?

cessation of menstruation in women who previously menstruated

due to:

congenital vaginal or cervical stenosis

infection

trauma

pituitary disease

other endocrine distrubances

50

What is progesterone?

Produced by corpus luteum

prepares and maintains endometrium for arrival and implantation of embryo

51

What does FSH do?

Causes follicle to develop during first half of menstrual cycle

estrogen level rises with follicle maturation

52

what does LH do?

triggers ovulation

53

what does LTH do?

maintains corpus luteum

54

what is a steriod?

chemical which stimulates growth or maturation

55

What two steroids are produced in the female body for menstruation?

Estrogen

progesterone

56

What is Progesterone?

Steroid

produced by corpus luteum

Prepares and maintains endometrium for arrival and implantation of embryo

57

During ovulation how often in an ovum released?

Monthly

58

when does ovulation occur in the month?

occurs midcycle

day 14 of a 28 day cycle

59

When is the ovum released from each left or right ovary?

ovulation alternates monthly between the two ovaries

60

At what stage of life does a female begin developing ova?

development begins during embryonic life

61

How many oocytes will a female have at the time of birth?

approx 200,000

62

How does the hypothalamus regulate ovulation?

releases gonadotropin releasing hormones (GnRHs)

63

During ovulation what gland does the hypothalamus stimulate?

the anterior pituitary gland

64

What does FSH (follicle stimulating hormone) do during ovulation?

causes follicle to develop during first half of menstrual cycle

65

what happens to the estrogen level during follicle maturation?

it rises

66

What does LH (lutenizing hormone) do during ovulation?

triggers ovulation

67

What does LTH (Luteotropic hormone) do during ovulation?

maintains the corpus luteum

68

What happens to estrogen production during the first half of the menstrual cycle?

decreased - no pregnancy

69

What does the anterior pituitary gland do during the first half of the menstrual cycle?

secrets FSH

70

What does FSH do during the first half of the menstrual cycle?

stimulates ovarian follicles to grow and mature

71

What happens on day 5-8 of the first half of the menstrual cycle?

follicles begin to develop

72

What does a follicle do when it develops in the first half of the menstrual cycle

days 5-8

the follicles fill with fluid

secrete increasing amounts of estrogen


73

What happens to FSH levels during day 5-8 of the first half of the menstrual cycle?

FSH level decreases

74

In the first half of the menstrual cycle what is the follicle called that reaches maturity around day 14?

a Graafian follicle

75

Describe the Graafian follicle on day 14 of the first half of the menstrual cycle...

usually only 1 follicle reaches maturity

approx 2 cm in diameter

76

What does estrogen do during the 5-14 days of the first half of the menstrual cycle?

triggers new growth of endometrial lining (proliferation)

77

What does the corpus luteum release during the second half of the menstrual cycle?

progesterone

78

What happens to the basal body temperature during the second half of the menstrual cycle?

body temp increases

79

Is LTH released in the first or second half of the menstrual cycle?

LTH is released in the second half of the menstrual cycle

80

What happens in the second half of the menstrual cycle if the ovum is released?

hCG is released

81

What happens in the second half of the menstrual cycle if the ovum is NOT fertilized?

Menses will occur

82

What happens to the corpus luteum if the ovum is not fertiziled?

it gradually decreases after 9 days

83

What happens on day 25-26 of the second half of menstrual cycle if fertilization has taken place?

9-11 days after ovulation

hCG (human chorionic gonadotropin) produced by zygote

corpus luteum persists (maintained by LTH) and secrets progesterone for three months until placenta takes over. corpus luteum gradually dissolves


84

What happens on day 25-26 of the second half of menstrual cycle if no fertilization occurs?

9-11 days after ovulation...
If no fertilization occurs:

LTH subsides

corpus luteum degenerates

progesterone levels drop

menstruation begins




85

What happens to the spiral arteries on day 25-26 of the second half of the menstrual cycle?

spiral arteries contract due to decreased progesterone and estrogen

blood supply to inner 2/3 of endometrium is cut off which creates endometrium necrosis and then it sloughs off

86

what happens on approx day 28 of the second half of the menstrual cycle

decreased estrogen

increased FSH

process starts again

87

What correlates with the ovulatory cycle of the ovary?

Endometrial changes....which also correlates with patients menstrual status

88

What ovarian cycle phase coincides with the menstrual phase?

the follicular phase of the ovarian cycle

89

How long does the menstrual phase last?

Lasts approx 1-5 days

90

What does the endometrium look like during the menstrual phase?

thin line...late in the menstrual phase

91

What does the proliferative phase prepare the endometrium for?

the endometrium is prepared for implantation

92

During the proliferative phase, how does the endometrium look?

the endometrium is in it's 3 line phase

average measurement is 4-8mm

made of the zona basalis A &P and the uterine cavity creates the central line

93

In the proliferative phase, what is the thickened three line?

The endometrium thickens and three lines are able to be seen

occurs late in the phase - ovulation

average measurement is 6-10mm

appears isoechoic to myometrium

94

The secretory phase corresponds to which ovarian phase?

the luteal phase of the ovary

95

What happens to the endometrial lining during ovulation?

It continues to grow because of the stimulation of increasing estrogen levels

96

What does an increased level of estrogen trigger during ovulation?

release of LH from the anterior pituitary gland

97

What does LH do during ovulation?

rapidly increases over a 24-36 hour time period

triggers ovulation

98

What is the measurement for a postmenopausal endometrium for a patient taking HRT or tamoxifen (ta MOX a phen)?

endometrium up to 8mm

99

What are the measurements of the endometrium during the secretory phase?

average 7-14 mm

thick endometrium with posterior acoustic enhancement

becomes echogenic