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Normal Female Physiology Flashcards

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1
Q

The uterine and vaginal arteries branch off of the _

A

The uterine and vaginal arteries branch off of the internal iliac artery

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2
Q

The ovarian artery branches off of the _

A

The ovarian artery branches off of the abdominal aorta (directly)

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3
Q

The ovaries drain into the _ lymph nodes

A

The ovaries drain into the para-aortic lymph nodes

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4
Q

The labia majora and minora drain into the _ lymph nodes

A

The labia majora and minora drain into the superficial inguinal nodes lymph nodes

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5
Q

The uterus and cervix drain into the _ lymph nodes

A

The uterus and cervix drain into the external iliac nodes

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6
Q

_ is the primary sensory innervation to the genitalia

A

Pudendal nerve is the primary sensory innervation to the genitalia

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7
Q

The _ is the ligament that contains the ovarian vessels

A

The suspensory ligament is the ligament that contains the ovarian vessels

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8
Q

There is a risk of damaging the ureter during hysterectomy when operating around the _ ligament

A

There is a risk of damaging the ureter during hysterectomy when operating around the suspensory or cardinal ligament

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9
Q

The normal menstrual cycle is around _ days with menses lasting _ days

A

The normal menstrual cycle is around 28 days with menses lasting 3-7 days

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10
Q

Two phases of the ovarian cycle include _ and _

A

Two phases of the ovarian cycle include follicular phase and luteal phase

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11
Q

Days 1-14 are the (follicular/luteal) phase of the ovarian cycle

A

Days 1-14 are the follicular phase of the ovarian cycle

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12
Q

Days 15-28 are the (follicular/luteal) phase of the ovarian cycle

A

Days 15-28 are the luteal phase of the ovarian cycle

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13
Q

In the beginning of the follicular phase, _ is the rising hormone that is responsible for ovarian follicle development

A

In the beginning of the follicular phase, FSH is the rising hormone that is responsible for ovarian follicle development

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14
Q

As the ovarian follicle is developing, _ cells are producing more and more estrogen

A

As the ovarian follicle is developing, granulosa cells are producing more and more estrogen
* (This is in the follicular phase)

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15
Q

During the follicular phase, what happens to FSH levels?

A

During follicular phase:
* FSH is originally rising (to develop the follicles)
* Then it starts to fall because estrogen sends negative feedback
* At ovulation, estrogen causes positive feedback to increase FSH again

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16
Q

Ovulation involves a surge of _ and the rupture of a tertiary follicle

A

Ovulation involves a surge of LH and the rupture of a tertiary follicle

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17
Q

The tertiary follicle remnant becomes the _ structure

A

The tertiary follicle remnant becomes the corpus luteum

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18
Q

The corpus luteum normally only lasts for around 14 days unless in the case of _

A

The corpus luteum normally only lasts for around 14 days unless in the case of pregnancy, which prolongs it for 10 weeks

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19
Q

When fertilization occurs, we have devlopment of _ cells which make beta-hCG

A

When fertilization occurs, we have devlopment of trophoblast cells which make beta-hCG

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20
Q

The corpus luteum is maintained during pregnancy by _

A

The corpus luteum is maintained during pregnancy by beta-hCG
* This is our source of progesterone for the first 10 weeks of pregnancy before the placenta takes over

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21
Q

At the end of luteal phase, if there is no fertilized egg, then _ and _ levels drop and we get _

A

At the end of luteal phase, if there is no fertilized egg, then estrogen and progesterone levels drop and we get menses

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22
Q

_ hormone is responsible for producing our spiral arteries and secretory endothelium

A

Progesterone is responsible for producing our spiral arteries and secretory endothelium

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23
Q

The three phases of the uterine cycle include _ , _ , _

A

The three phases of the uterine cycle include menstrual cycle , proliferative phase , secretory phase

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24
Q

Days 1-7 of the uterine cycle make up the _ phase

A

Days 1-7 of the uterine cycle make up the menstrual phase
* The corpus luteum regresses
* Causes progesterone to drop –> vasospasm of spiral arteries –> bleeding

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25
Days 7-14 of the uterine cycle make up the _ phase
Days 7-14 of the uterine cycle make up the **proliferative phase**
26
The proliferative phase of the uterine cycle is mediated by _ hormone
The proliferative phase of the uterine cycle is mediated by **estrogen** * "Estrogen establishes" aka causes **endometrium growth** * The follicle is producing the estrogen which is stimulating endometrium
27
Days 14-28 of the uterine cycle make up the _ phase
Days 14-28 of the uterine cycle make up the **secretory phase**
28
The secretory phase is mediated by _
The secretory phase is mediated by **progesterone**
29
What is the purpose of the secretory phase?
The purpose of the secretory phase is to **prepare the endometrium for possible pregnancy** * Corpus luteum is making progesterone (pro-gestation hormone) * Spiral arteries are extending the full length of the endometrium * The endometrial glands get more tortuous (twisty)
30
The external, squamous epithelial layer of the follicle are the _ cells
The external, squamous epithelial layer of the follicle are the **theca cells**
31
The cuboidal cells in the ovarian follicle are called _ cells
The cuboidal cells in the ovarian follicle are called **granulosa cells**
32
The primordial follicle begins with a simple squamous epithelium; it must gain _ receptors to reach maturity
The primordial follicle begins with a simple squamous epithelium; it must gain **FSH** receptors to reach maturity
33
Another name for the tertiary follicle is _
Another name for the tertiary follicle is the **graafian follicle**
34
What are the functions of estrogen?
1. Development/maintainance of female reproductive tract 2. Female secondary sex characteristics 3. Induces progesterone receptors 4. Prepares for/maintains pregnancy 5. Increases HDL and decreases LDL 6. Increases bone mass
35
Women are at risk of atherosclerosis and osteoporosis after menopause due to estrogen's important roles of:
Women are at risk of atherosclerosis and osteoporosis after menopause due to estrogen's important roles of: * **Increasing HLD and decreasing LDL** * **Increasing bone mass**
36
Cholesterol diffuses across the (theca/granulosa) cell membrane
Cholesterol diffuses across the **theca cell membrane**
37
Cholesterol is converted to _ in the theca cell before moving into the granulosa cell
Cholesterol is converted to **androstenedione** in the theca cell before moving into the granulosa cell
38
Once androstenedione diffuses into the granulosa cell, it is converted to _ via _
Once androstenedione diffuses into the granulosa cell, it is converted to **estrone** via **aromatase** * Estrone can then --> estrogen
39
(Theca/Granulosa) cells contain aromatase
**Granulosa cells** contain aromatase
40
Explain the pathway of estrogen synthesis starting from the hypothalamus
Hypothalamus- GnRH Anterior pituitary- FSH, LH Ovary (theca cell)- androstenedione Ovary (granulosa cell)- estrogen
41
Theca cells have (LH/FSH) receptors while Granulosa cells have (LH/FSH) receptors
Theca cells have **LH receptors** while Granulosa cells have **FSH receptors**
42
Androstenedione is converted to estrogen via _
Androstenedione is converted to estrogen via **aromatase**
43
Aromatase can create extragonadal estrogen in low levels in the following tissues:
Aromatase can create extragonadal estrogen in low levels in the following tissues: * Adipose tissue * Liver * Pancreas * Bone * Adrenal glands * Skin * Brain * Breast
44
Name the three forms of estrogen
**Estradiol** (E2) > **estrone** (E1) > **estriol** (E3) (listed by potency)
45
17-B estradiol is made by the _
17-B estradiol is made by the **ovary** * Also called E2
46
Estriol is made by the _
Estriol is made by the **placenta** * Also called E3
47
Estrone is made by the _
Estrone is made by the **adipose tissue** (via aromatization) * Also called E1
48
Name the functions of progesterone:
Name the functions of progesterone: * Prepares the uterus for pregnancy * Prepares the breast for lactation * Allows for secretory endometrium that is needed for implantation * Maintains uterine endometrium during pregnancy * Developing breast * Increases body temperature
49
After ovulation, the theca interna cells differentiate into _ cells which make androgens and progesterone
After ovulation, the theca interna cells differentiate into **theca leukin cells** which make androgens and progesterone
50
(True/False) The theca leukin (cells of the corpus luteum) make small amounts of estrogen
True; The theca leukin (cells of the corpus luteum) make small amounts of estrogen * Progesterone can get converted back into androstenedione
51
Explain the steps of progesterone synthesis
Cholesterol --> Pregnenolone --> Progesterone --> Androstenedione --> estrone --> estradiol Androstenedione --> testosterone --> estradiol
52
Only (estrogen/progesterone) can provide negative feedback at the level of the hypothalamus
Only **estrogen** can provide negative feedback at the level of the hypothalamus * Progesterone provides negative feedback to the anterior pituitary
53
Positive feedback of estrogen that allows for a high sustained estrogen level is responsible for _
Positive feedback of estrogen that allows for a high sustained estrogen level is responsible for **ovulation** * Prolonged estrogen causes massive LH release * LH surge causes ovulation of oocyte
54
_ is the hormone that "rescues the corpus luteum" if implantation of an embryo occurs
**Beta-hCG** is the hormone that "rescues the corpus luteum" if implantation of an embryo occurs
55
After about 7-10 weeks of pregnancy, the _ begins to take over production of progesterone
After about 7-10 weeks of pregnancy, the **placenta** begins to take over production of progesterone
56
Estrogen and progesterone bind (intracellular/extracellular) receptors and cause changes in _
Estrogen and progesterone bind **intracellular** receptors and cause changes in **transcription and translation**
57
Explain the ovulatory and menstrual cycles
58
LH/FSH act on the testes to produce _ LH/FSH act on the ovaries to produce _
LH/FSH act on the testes to produce **testosterone, inhibin** LH/FSH act on the ovaries to produce **estradiol, progesterone, inhibin**
59
Inhibin is a hormone released by the gonads with the purpose of _
Inhibin is a hormone released by the gonads with the purpose of **inhibiting LH/FSH release** aka providing negative feedback
60
Estrogen has _ effect on the uterus
Estrogen causes **proliferation of functional layer of columnar epithelial cells** + **formation of tubular glands** * Estrogen also induces progesterone receptors on endometrial cells
61
The dominant follicle produces increasing amounts of estrogen; granulosa cells express more _ receptors making the cells highly sensitive
The dominant follicle produces increasing amounts of estrogen; granulosa cells express more **LH/FSH** receptors making the cells highly sensitive
62
The LH surge causes _
The LH surge causes **ovulation of oocyte** * The LH binding causes secretion of enzymes that break down the follicle wall
63
Progesterone causes _ growth and _ secretions in the uterus
Progesterone causes **decreased growth** and **increased secretions** in the uterus
64
Progesterone causes glands to become _ shaped and secrete _
Progesterone causes glands to become **coiled (tortuous)** and **secrete glycoprotein**
65
If pregnancy does not occur, the lack of _ leads to degeneration of the corpus luteum and thus decline in hormone levels that leads to menses
If pregnancy does not occur, the **lack of LH** leads to degeneration of the corpus luteum and thus decline in hormone levels that leads to menses
66
If pregnancy does occur we have _ of the corpus luteum
If pregnancy does occur we have **rescuing of the corpus luteum by hCG** * hCG binds LH receptors
67
_ acts on the theca cells to induce androgen production
**LH** acts on the theca cells to induce androgen production
68
_ stimulates the granulosa cells to convert androgen --> estradiol (driving the proliferative phase)
**FSH** stimulates the granulosa cells to convert androgen --> estradiol (driving the proliferative phase)
69
_ mediates the pain experienced with uterine contractions and menstrual cramping during menstruation
**Prostaglandin E2** mediates the pain experienced with uterine contractions and menstrual cramping. Most of the production and release of prostaglandins occurs during the first 48 hours of menstrual flow * Ibuprofen is first line treatment to block prostaglandins
70
A fall in _ (hormone) levels after baby delivery disinhibits prolactin to allow lactation
A fall in **progesterone** levels after baby delivery disinhibits prolactin to allow lactation
71
_ is a transient mid-cycle ovulatory pain; it is classically associated with pertitoneal irritation
**Mittelschmerz** is a transient mid-cycle ovulatory pain; it is classically associated with pertitoneal irritation
72
Follicular growth is fastest during week _ of the follicular phase
Follicular growth is fastest during **week 2** of the follicular phase
73
Fertilization of an egg occurs within _ days of ovulation; implantation within the utuerus occurs _ days after fertilization
Fertilization of an egg occurs within **1 day** of ovulation; implantation within the utuerus occurs **6 days** after fertilization
74
Blood and urine pregnancy tests detect hCG secreted by _
Blood and urine pregnancy tests detect hCG secreted by **syncytiotrophoblasts** * Blood test after 1 week of conception * Urine test after 2 weeks of conception
75
Beta hCG has an alpha subunit that closely resembles _ , _ , _
Beta hCG has an alpha subunit that closely resembles **LH** , **FSH** , **TSH** * Allows it to act on LH receptors * Also means high hCG can cause hyperthyroidism

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