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Ovarian And Menstrual Cycles Flashcards

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1
Q

Meiosis begins at 8-9 weeks gestation. Primordial oocytes become primary oocytes. What are primary oocytes held in until ovulation?

A

Prophase I in meiosis I

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2
Q

What cell in oogenesis is held in prophase I until ovulation?

A

Primary oocytes

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3
Q

At puberty/menarche, primary oocyte ends meiosis I to become secondary oocyte. What is the secondary oocyte held in until fertilization?

A

Metaphase II

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4
Q

What cell in oogenesis is held in metaphase II until fertilization?

A

Secondary oocyte

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5
Q

Describe the ovaries

A

Paired, pelvic organs found within broad ligament
Supplied by ovarian vessels (suspensory ligament)
Temporary endocrine gland to prepare uterus for implantation and to maintain the developing embryo

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6
Q

What are the functions of the ovaries?

A

Produce female gametes
Secrete estrogen and progesterone
Regulate postnatal growth of reproductive organs
Control development of secondary sex characteristics

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7
Q

Describe the structure of the ovary

A

Germinal epithelium
Tunica albuginea
Cortex: oocyte-containing follicles
Medulla: stroma and blood supply

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8
Q

What are the phases of the ovarian cycle?

A

Follicular (days 1-14)
Ovulation
Luteal (days 15-28)

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9
Q

The follicular, ovulation, and luteal phases make up what cycle?

A

Ovarian cycle

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10
Q

Describe follicular phase

A

Growth of dominant follicle
Primordial to tertiary (Graafian) follicles
Typically lasts 10-14 days
Duration of phase is variable due to length of menstruation

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11
Q

What phase of the ovarian cycle is characterized by the growth of the dominant follicle, which is primordial to tertiary follicles?

A

Follicular phase

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12
Q

Describe ovulation

A

Oocyte ruptures out of Graafian follicle
Occurs mid-cycle at 14
In response to LH surge

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13
Q

What phase in the ovarian cycle is characterized by the oocyte rupturing out of the Graafian follicle in response to the LH surge?

A

Ovulation

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14
Q

Describe the luteal phase

A

Corpus luteum forms and secretes progesterone and estrogen to accommodate potential gestation
Phase is relatively constant lasting 14 days

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15
Q

What phase of the ovarian cycle is characterized by the formation of the corpus luteum, which secretes progesterone and estrogen to accommodate potential gestation?

A

Luteal phase

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16
Q

Describe the primordial follicle

A

Primary oocyte surrounded by squamous epithelium

Before puberty, inactive follicle

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17
Q

What follicle is characterized by primary oocyte surrounded by squamous epithelium?

A

Primordial follicle

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18
Q

What is the early primary or unilayered follicle?

A

Single layer of cuboidal follicular epithelium around primary oocyte
Zona pellucida begins to form

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19
Q

What follicle is characterized by single layer of cuboidal follicular epithelium surrounding primary oocyte with the zona pellucida beginning to form?

A

Early primary or unilayered follicle

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20
Q

What is the late primary or multilayered follicle?

A

Several layers of cuboidal follicular epithelial cells around primary oocyte
Zona pellucida forms glycoprotein coat around oocyte

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21
Q

What follicle is characterized by several layers of cuboidal follicular epithelial cells around primary oocyte with zona pellucida forming a glycoprotein coat around oocyte?

A

Late primary or multilayered follicle

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22
Q

Describe the secondary follicle

A

Follicular cells continue to proliferate -> stratum (zona) granulosum
Ovarian stroma around follicle differentiates into theca interna and theca externa
Call-Exner bodies, which are fluid-filled cavities, appear between follicular cells. Fluid is liquour folliculi
Antrum begins to form

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23
Q

What follicle is characterized with stratum (zona) granulosum, theca interna and externa, Call-Exner bodies filled with liquor folliculi, and antrum?

A

Secondary follicle

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24
Q

Describe theca interna

A

Squamous cells surrounding follicular cells

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25
What part of ovarian stroma has squamous cells surrounding follicular cells?
Theca interna
26
Describe theca externa
Capsule-like layer continuous with connective tissue of ovary
27
What part of the ovarian stroma has capsule-like layer continuous with connective tissue of ovary?
Theca externa
28
Liquor folliculi is rich in what?
Hyaluronic acid
29
Call-Exner bodies are also seen in ovarian tumors of __ orgin
Granulosal
30
Describe mature (Graafian) follicle
``` Antrum occupies much of space Oocyte displaced to one side Developed corona radiata Developed cumulus oophorus Primary oocyte nearing completion of meiosis I ```
31
What follicle is characterized by an antrum that occupies much of the space, oocyte displaced to one side and near completion of meiosis I, developed corona radiata, and developed cumulus oophorus?
Mature (Graafian) follicle
32
What is the corona radiata?
Layer of follicular cells surrounding oocyte
33
What is the layer of follicular cells surrounding oocyte?
Corona radiata
34
What is the cumulus oophorus?
Pedestal of follicular cells anchoring oocyte to the wall
35
What is the pedestal of follicular cells anchoring oocyte to the wall?
Cumulus oophorus
36
Describe the progression of follicles
``` Primordial follicle Early primary follicle Late primary follicle Secondary follicle Mature Graafian follicle ```
37
What molecules are important for control ovarian follicle development?
Members of TGF-beta superfamily GDF-9, BMP-15 AMH, activin, inhibin
38
Described polycystic ovarian syndrome (PCOS)
Enlarged ovaries with multiple cysts Results from disrupted folliculogenesis caused by a defect in paracrine oocyte-granulosa cell signaling mechanism Infrequent or prolonged menstrual periods, excess hair growth acne, and obesity In adolescents, infrequent or absent menstruation may raise suspiciion for the condition
39
What syndrome is characterized by infrequent or prolonged menstrual periods, excess hair growth, acne, obesity, and enlarged ovaries with multiple cysts?
Polycystic ovarian syndrome
40
Blood vessels of theca interna invade the antrum to become ___
Corpus hemorrhagicum
41
Describe mittelschmerz
Mid-cycle pain due to ovulation Discomfort in lower abdomen due to peritoneal irritation Follicle ruptures and releases fluid and blood that irritates surrounding tissues Right or left side depends on which ovary produced oocyte Can mimic appendicitis Pain varies by person. Most do not experience discomfort
42
__ stimulates tubal motility, while __ inhibits tubal motility
Estrogens | Progesterone
43
Describe tubal motility at ovulation
Contractions become vigorous Mesoalpinx contracts to bring tube in more contact with ovary, while fimbria contracts rhythmically to sweep over ovarian surface
44
Describe tubal motility at 4-6 days after ovulation
Progesterone levels rise and inhibit tubal motility | This may lead to relaxation of tubal musculature to allow passage of ovum into uterus by action of tubal cilia
45
Describe the luteal phase
After ovulation, residual components of rupture follicle forms corpus luteum (yellow body)
46
What ovarian phase is characterized by residual components of the ruptured follicle that forms corpus luteum?
Luteal phase
47
What are the functions of the corpus luteum?
Synthesize and secrete steroid hormones that are necessary if pregnancy occurs (stimulus HCG)
48
What synthesizes and secretes steroid hormones that are necessary if pregnancy occurs (stimulus HCG)?
Corpus luteum
49
What does the corpus luteum consist of?
Follicular (granulosa) cells that make estrogen Theca cells that makes androstenedione and progesterone Both follicular and thecal cells accumulate lipids because cholesterol is a precursor for steroid hormones
50
What is corpus albicans?
Dense connective tissue scar formed form degeneration of corpus luteum Remains for variable period Gradualy absorbed by macrophages within stroma
51
What is dense connective tissue scar from degeneration of corpus luteum that is gradually absorbed by macrophages within stroma?
Corpus albicans
52
Describe hormonal control in follicular phase
Early on, estrogen and progesterone levels are low -> feedback to increase FSH and LH (via GnRH from hypothalamus) and thus, see rising levels of estrogen Initially rising estrogen levels inhibit further FSH and LH release (negative feedback) Later as follicle is developing, rising estrogen levels stimulate FSH an LH release (positive feedback)
53
Describe hormonal control in luteal phase
Corpus luteum makes estrogen and progesterone -> feedback to inhibit FSH and LH release FSH and LH levels fall Thus, estrogen and progesterone levels fall
54
What are the three layers of the uterus?
Endometrium Myometrium Perimetrium
55
What is the histology of perimetrium?
Simple squamous epithelium
56
What layer of the uterus has simple squamous epithelium?
Perimetrium
57
Describe the endometrium
``` Simple columnar epithelium Lines endometrial glands Lamina propria: fibroblasts, ground substance, type II collagen Functional layer (stratum functionalis) Basal layer (stratum basalis) ```
58
What layer of the uterus has simple columnar epithelium and has stratum functionalis and stratum basalis?
Endometrium
59
Describe stratum functionalis
Part of endometrium Proliferates and sloughs off during menstruation Hormone sensitive Cyclical changes
60
What layer in the endometrium proliferates and sloughs off during menstruation, is hormone sensitive, and has cyclical changes?
Stratum functionalis
61
Describe stratum basalis
Part of endometrium Regenerates functional layer Not hormone sensitive
62
What layer of endometrium regenerates functional layer (stem cells) and is not hormone sensitive?
Stratum basalis
63
Describe myometrium
3 layers of circularly arranged smooth muscle Middle layer is thickest and contains arcuate arteries, "stratum vasculare" Does not change with menstrual cycle Does not undergo hypertrophy and hyperplasia during pregnancy
64
What layer of the uterus has 3 layers of smooth muscle that has arcuate arteries or "stratum vasculare" and does not change with menstrual cycle or undergo hypertrophy and hyperplasia during pregnancy?
Myometrium
65
Describe endometrial blood suppply
Uterine arteries give off arcuate arteries in myometrium Arcuate arteries branch to form 2 sets of arteries (endometrium gets dual blood supply) Straight arteries to stratum basalis Spiral (helical) arteries to stratum functionalis Important in cyclic shedding of stratum functionalis
66
What is leiomyoma (uterine fibroid)?
Benign tumors that arise from overgrowth of smooth muscle and connective tissue in uterus Classified based on location Genetic predisposition exists
67
What are benign tumors that arise from overgrowth of smooth muscle and connective tissue in uterus?
Leiomyoma (uterine fibroid)
68
What is myomectomy?
Removal of fibroids with preservation of the uterus
69
What is uterine artery embolization?
Radiologic alternative to surgery that involves partial blockage of the uterine arteries with polyvinyl alcohol (PVA) particles and decreases the blood flow to uterus and fibroids
70
What are the phases of the menstrual cycle?
1. Proliferative phase 2. Secretory phase (3. Ischemic) 3/4. Menstrual phase
71
Describe the proliferative phase
Functional layer begins to thicken Spinal arteries are short and deep in endometrium Endometrial glands are short, straight, and empty (no glycogen)
72
What menstrual cycle phase is characterized by the functional layer beginning to thicken, short and deep spiral arteries, and short, straight, and empty endometrial glands?
Proliferative phase
73
Describe secretory phase
Functional layer very thick Spiral arteries are long and growing superficially in endometrium Endometrial glands are tortuous and are filled with glycogen-rich secretory products
74
What menstrual cycle phase is characterized by very thick functional layer, long and superficial spiral arteries, and tortuous endometrial glands filled with glycogen-rich secretory products?
Secretory phase
75
What are the cells in oogenesis?
Primordial oocyte Primary oocyte Secondary oocyte
76
Describe the menstrual phase of the menstrual cycle
Initiated by regression of corpus luteum because no fertilization occured -> decrease in estrogen and progesterone Spiral arteries begin contracting to junction of straight arteries -> decreased O2 to functional layer -> necrosis Endometrial glands undergo necrosis and detach from functional layer Neutrophils and lymphocytes infiltrate Shedding of endometrial lining
77
What phase of the menstrual cycle is characterized by regression of corpus luteum, contraction of spiral arteries, necrosis and detachment of endometrial glands, infiltration of neutrophils and lymphocyte, and shedding of endometrial lining?
Menstrual phase
78
What is endometriosis?
Presence of endometrial tissue outside of uterus, usually uterine tubes, ovary, peritoneal lining of abdomen and pelvis Responds to ovarian hormones Trapped endometrial tissue can lead to cysts, scar tissue, and adhesions Dysmenorrhea (painful periods) Commonly first diagnosed in infertility workup
79
What is characterized by the presence of endometrial tissue outside of the uterus in the uterine tubes, ovary, peritoneal lining of abdomen and pelvis? The tissue responds to ovarian hormone and can lead to cysts, scar tissue, adhesions, and dysmenorrhea.
Endometriosis
80
What is dysmenorrhea?
Painful cramps that usually begin 1-2 days prior and/or during menstrual bleeding Mild to severe symptoms: lower abdominal discomfort to nausea and vomitting Pathophysiology: prostaglandins (PGE2, PGF2alpha) released from endometrial cells -> stimulate uterine contraction -> pain
81
What is Mulerian agenesis or Mayer-Rokitansky-Kuster-Hauser syndrome?
Absence of derivatives of paramesonephric ducts
82
What causes persistent Mullerian duct syndrome (46 XY)?
Defect in AMH gene or its receptor (AMHR2)
83
Describe the ovaries of Turner's syndrome (45X)
Atrophic
84
Cervical intraepithelial neoplasia (CIN) and human papillomavirus (HPV)) can develop into __
Carcinoma in situ (CIN) | Or progress to invasive carcinoma
85
Describe the transformation zone of the cervix
Most common site of squamous cell carcinoma Preceded by changes called cervical intraepithelial neoplasia (CIN) dysplasia within epithelial layer If proliferating epithelial cells cross basal lamina into underlying CT - invasive CA Detected by pap smear Majority of cervical CA are related to HPV
86
What does FSH do in the ovarian cycle?
Stimulates follicular phase to allow for follicle maturation and estrogen production
87
What stimulates the follicular phase to allow for follicle maturation and estrogen production?
FSH
88
What does LH do in ovarian cycle?
Gradually increases and stimulates ovulation at midcycle
89
What stimulates ovulation at mid-cycle?
LH
90
What hormone increases post-ovulation due to corpus luteum?
Progesterone
91
What menstrual cycle phases correspond with the follicular phase of the ovarian cycle?
Menstrual phase | Proliferative phase
92
Menstrual and proliferative phases of the menstrual cycle are associated with what ovarian cycle phase?
Follicular
93
What menstrual cycle phase is associated with luteal phase of the ovarian cycle?
Secretory phase
94
The secretory phase of the menstrual cycle is associated with what phase in the ovarian cycle?
Luteal phase

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