Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Women's Health > Physiology and Pathophysiology > Flashcards

Physiology and Pathophysiology Flashcards

(156 cards)

Start Studying
1
Q

What are the major functions of the HPO (Hypothalamic Pituitary Ovarian) Axis?

A
  • Development of sexual characteristics
  • Coordinating regular periodic body changes (ovarian and uterine cycle)
  • Role in cervix, vagina, breast function
  • Maintenance of pregnancy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is the pathway of hormones from the hypothalamus to the ovaries?

A

Hypothalamus releases GnRH –> anterior pituitary –> LH/FSH –> ovary –> estrogen and progesterone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

How is GnRH released from the hypothalamus?

A

In pulses

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What type of cells release LH and FSH?

A

Gonadotrope cells in the pituitary (FSH and LH then travel to ovary)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What does FSH and LH bind to in the ovary?

A

Theca and granulosa cells which causes folliculogenesis (maturation of the follicle)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

In addition to folliculogenesis, what do FSH and LH stimulate production of in the ovary?

A
  • Steroid hormones: estrogens, progesterone, androgens
  • Gonadal peptides: activins, inhibins, follistatins
  • Growth factors
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What are the functions of estrogens?

A
  • Induce surge of LH causing oocyte release
  • Encourage proliferation of endometrium, myometrium
  • Development of secondary sex characteristics
  • Libido
  • Thicken vaginal wall and increase lubrication
  • Reduce acne
  • Reduce cholesterol and atherosclerosis

Secondary sex characteristics: breast enlargement and areolar pigmentation, mature female body shape, increased scalp hair, less body hair

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What are the roles of progesterone?

A
  • Maintenance of pregnancy
  • Decrease uterine contractility
  • Breast development and differentiation
  • Falling progesterone triggers menses and signals lactation after pregnancy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is the role of activins?

A
  • Stimulate FSH secretion
  • WBC production and embryo development
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is the function of inhibins?

A

Inhibit FSH secretion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is the role of follistatins?

A
  • Regulate gonadotropin secretion
  • Bind to and inhibits activins
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is the role of relaxin?

A
  • Relaxes pubic symphysis, other pelvic joints in pregnancy
  • Inhibits uterine contractions
  • May help mammary gland and follicular development and ovulation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What are positive feedback mechanisms associated with the normal HPO axis?

A
  • High estrogen –> increased GnRH and LH
  • Activin promotes gonadotropin cell function
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What are negative feedback mechanisms associated with the normal HPO

A
  • Progesterone inhibits GnRH and LH
  • Inhibin inhibits FSH
  • Follistatin inhibits FSH
  • Lactation –> hyperprolactinemia causes increased dopamine and altered release of GnRH
  • Estrogen decreases LH
  • Estrogen decreases FSH
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What are examples of pathologic HPO axis feedback?

A
  • Hypogonadism
  • PCOS
  • hyperprolactinemia
  • Medications: steroids, hormones, opioids
  • Weight status (obesity = higher estrogen)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is the usual age for puberty?

A
  • 8-13 F, 9-14 M
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What factors influence the onset of puberty?

A
  • Weight and nutritional status
  • Genetic factors
  • Abnormal hormone levels
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What is adrenarche?

A

Increase in secretion of adrenal androgens, DHEA- prior to or at onset of puberty

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What is thelarche?

A
  • Breast development
  • First event of puberty in females
  • Estradiol duct growth
  • Progesterone lobule and alveoli growth
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What is pubarche?

A

Development of pubic and axillary hair, which is second event of puberty in females

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What is menarche?

A

First menstrual cycle
Typically anovulatory for first 12-18 months

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

How long does the average menstrual cycle last? How long is the flow? What is the average blood loss?

A
  • 28 days (+/- 7 days)
  • Flow- 3-5 days
  • Average blood loss of 30 mL
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

How long are menstrual cycles irregular?

A
  • 1-2 years after menarche
  • 2-3 years preceding menopause
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What are the 2 cycles that are part of the menstrual cycle?

A

Ovarian and uterine cycle

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
What are the phases of the ovarian cycle?
Follicular phase --> ovulation --> luteal phase
26
What are the phases of the uterine cycle?
* Proliferative phase * Secretory phase * Menses
27
What happens during the preovulatory phase of the follicular phase of the ovarian cycle?
* Rise in FSH > LH early in cycle * Several follicles enlarge * FSH causes production of inhibin B which decreases FSH release later in follicular phase
28
What is the midfollicular phase of the ovarian cycle?
* Day 6 * 1 follicule grows rapidly, becoming dominant follicle * Other follicles become atretic
29
What happens after the midfollicular phase of the follicular phase of the ovarian cycle?
Dominant follicle matures, develops LH receptors, and releases estrogens * Rising estrogen levels --> increased GnRH pulses --> LH surge --> ovulation
30
What happens during ovulation?
* About day 14 * Mature follicle ruptures * Ovum is extruded into abdominal cavity and transported into oviduct * Ruptured follicle fills with blood (corpus hemorrhagicum) * Mittelschmerz may occur
31
What happens during the luteal phase of the ovarian cycle?
* About 14 days post ovulation * Corpus luteum forms * If pregnancy does not occur, decline in FSH and LH --> atrophy of corpus luteum 3-4 days before menses (eventually becomes corpus albicans) * Declining levels of progesterone --> shedding of endometrial lining (menses)
32
What is the corpus luteum?
* Granulosa and theca cells of follicle lining proliferate post ovulation in luteal phase to form yellowish, lipid-rich luteal cells * Reacts to LH by making progesterone and estrogen * Rising levels of estrogen and progesterone --> negative feedback --> decline in FSH and LH
33
What happens during the preovulatory part of the Proliferative phase of the uterine cycle?
* At end of menses, all but stratum basale is sloughed
34
What happens during days 5-16 of the uterine cycle?
* Estrogen from developing follicles --> endometrium regenerates from stratum basale to form stratum functionale (outer 2/3) * Uterine glands lengthen but do not become convoluted or secrete anything
35
How long is the postovulatory phase of the uterine cycle?
14 days
36
What happens during the secretory phase of the uterine cycle?
* Postovulatory * Estrogen and progesterone from corpus luteum cause endometrium to become more vascularized and edematous * Glands coil and secrete clear fluid * Corpus luteum regresses --> estrogen and progesterone decline --> vascular spasms --> endometrial ischemia
37
What happens as the endometrium becomes ischemic during the secretory phase of the uterine cycle?
* Breakdown of extracellular matrix of strata functionalis and necrosis of endometrium and supplying arterial walls * Causes hemorrhage which coalesces into menstrual flow
38
What happens to the cervix during the menstrual cycle?
* Cervical mucus has cyclic changes * Estrogen and progesterone change mucus
39
What does cervical mucus do with greater quantities of estrogen?
* Thinner and more alkaline to enhance survival of sperm * Dries in fern-like pattern ## Footnote Around time of ovulation (day 14)
40
How does cervical mucus change with greater progesterone?
* Mucus is more thick, tenacious, cellular * Thickest around day 21 and continuing if pregnancy * No fern pattern on slide
41
How will a slide look if a patient undergoes an anovulatory cycle with estrogen present?
Complete ferning (vs partial ferning with ovulation since some progesterone still present)
42
How does the cervix change during puberty?
* Columnar epithelium extends from endocervix to ectocervix * Estrogen rises in puberty, cervical os opens to expose endocervix columnar epithelium causing squamous metaplasia during 20s-30s ## Footnote Acidic environment of vagina causes metaplasia
43
What can impact cervical metaplasia?
* OCP can cause persistence or reappearance of ectopy * Smoking accelerates metaplasia
44
Why is it important to know about cervical ectopy?
* Can mimic infectious endocervicitis * May increase susceptibility to STIs (columnar is more vulnerable than squamous)
45
What are the changes in the fallopian tubes that occur due to hormones?
* Progesterone reduces ciliary beat frequency * Estrogen increases ciliary beat frequency
46
What are the impacts of female hormones on muscle?
* Progesterone- reduces spasms, relaxes smooth muscle, and antagonizes effects of insulin on glucose metabolism * Estrogen- improves skeletal muscle contractility * Both estrogen and progesterone may help regulate protein metabolism
47
What are impacts of ovarian hormones on skin?
* Maintains skin collagen and moisture * Increases cutaneous wound healing and hair growth * Increases skin pigmentation
48
What are impacts of ovarian hormones on fat deposition?
* Increase fat deposition for "pear shape" * Progesterone- mediator of fat gain in pregnancy
49
What are impacts of ovarian hormones on sodium/water balance?
* Estrogen- sodium and water retention * Progesterone- sodium and water excretion
50
What are cardiovascular changes during pregnancy?
* PMI shifts laterally * Heart size increases 12% * Increase in myocardial mass and intracardiac volume * Supine hypotensive syndrome can occur * Stroke volume increases * HR increases * CO increases * BP decreases slighly with LE venous pressure increasing * PVR decreases * Blood flow distribution increases to uterus, kidneys, breasts, and skin
51
What are signs/symptoms of supine hypotensive syndrome?
* Hypotension * Bradycardia * Syncope
52
How is supine hypotensive syndrome treated?
R or L recumbent position
53
What could cause a greater increase in stroke volume during pregnancy?
Maternal position and multiple gestation
54
How much does pregnancy impact HR? What other factors can impact maternal HR?
* 15 bpm more at term than nonpregnant rate, progressively increasing throughout pregnancy * Exercise, stress, heat, meds * Multiple gestation
55
What causes CO increase during pregnancy?
* Hormonal changes, shunt of uteroplacental circulation * Transient increase during L&D
56
How does blood pressure change during pregnancy?
* Arterial pressure declines slightly and returns to prepregnancy levels at 36 weeks * Widened pulse pressure * LE venous pressure progressively increases --> edema and varicosities
57
How does peripheral vascular resistance change during pregnancy?
* Decreases due to enhanced vasodilators * At delivery 40% decrease in vascular resistance, offset by rise in CO
58
What can strenuous exercise do to blood flow distribution during pregnancy?
Divert blood
59
What are changes that occur in heart sounds and murmurs during pregnancy?
Heart sounds and murmurs: Systolic murmurs (up to 90%) * May see split S1 or loud S3 * Murmurs or bruits at left sternal edge d/t increased blood flow through internal thoracic (maternal) artery
60
What are changes to heart rhythm during pregnancy?
* Decreased threshold for reentrant SVT * May see sinus tachy, sinus brady, isolated PAC/PVCs
61
What are common changes to EKG during pregnancy?
* Left axis shift * ST depression * T-wave flattening
62
What are respiratory anatomy changes during pregnancy?
* Capillary dilation: engorged nasopharynx, larynx, trachea, bronchi--> may see prominent pulmonary vascular markings on CXR * Rib cage increasingly displaced upward with elevated diaphragm and increased thoracic circumference
63
What are lung volume and capacity changes in pregnancy?
* Less overall lung space, but less dead space and increased tidal volume
64
What are changes to respiration during pregnancy?
* More diaphragm-dependent * Little effect on respiratory rate * 50% increase in minute ventilation * Increased arterial O2 and O2 consumption * Mild respiratory alkalosis
65
What are anatomical renal changes during pregnancy?
* Increased renal size * Dilated renal calyces and pelves * Dilated and tortuous ureters * Bladder- displaced upward, flattened, decreased tone (capacity increased up to 1500 mL)
66
How is plasma flow changed with pregnancy?
Increases 50-85% --> decreased vascular resistance
67
How can kidney labs change with pregnancy?
* GFR increases significantly * Creatinine clearance increases with GFR, lower serum Cr and BUN * Saturation of tubular reabsorption capacity --> glucosuria and urinary protein loss (<300 mL/24 hrs) ## Footnote Shouldn't be super dramatic
68
What happens to renin during pregnancy?
Renin activity increases but doesn't cause pressor effects ## Footnote Increases renal blood flow (1st step in RAAS), aldosterone helps retain water and sodium to increase blood flow
69
What are changes to the GI system during pregnancy?
* Stomach pushes upward * Bowels pushed up and laterally * Gum hypertrophy and hyperemia * Increased salivation * Intestinal transit time decreases in 2nd and 3rd trimesters * Gallbladder emptying slows and is often incomplete * Reflux/heartburn more common * Decreased gastric emptying * Mild decrease in protein, esp. albumin * Increased serum alkaline phosphatase
70
Why does reflux/heartburn occur more commonly in pregnancy?
Greater production of gastrin, decreased esophageal peristalsis, hormone-mediated relaxation of LES
71
What happens to blood volume during pregnancy? Why?
* 50% elevation in plasma volume * Increased estrogen --> stimulates RAAS --> increased aldosterone --> Na+ reabsorption --> water retention
72
What are functions of maternal hypervolemia?
* Meets increased metabolic demands * Protects from effects of impaired venous return with postural changes * Compensates for maternal blood loss at delivery
73
What are hem/onc changes during pregnancy?
* RBC increase by 33% * Physiologic anemia (iron deficiency d/t enhanced erythropoeiesis) * WBC increase * Platelet increase in production and consumption --> overall decrease as pregnancy progresses * Increase in clotting factors, decrease in protein S and fibrinolytic activity --> procoagulant
74
What happens to immunologic function during pregnancy?
Overall slightly decreased --> predisposed to infections ## Footnote autoimmune disease generally gets better
75
What are endocrine changes during pregnancy?
* Enlarged pituitary gland * Increased growth hormone * Increased prolactin (10x) * Increase in thyroid hormone production * TSH naturally drops * Decreased PTH 1st trimester, increased 2nd and 3rd * Decreased calcium * Increased vitamin D * Increased ACTH and free cortisol * Increased aldosterone
76
Why is there such a significant increase in thyroid hormone production during pregnancy?
Fetus is dependent on maternal thyroid in 1st trimester
77
Why would TSH naturally drop during pregnancy? Why can this be confusing?
* hCG structurally similar to TSH * May be mistaken for subclinical hyperthyroidism * Low TSH can mask hypothyroidism during pregnancy ## Footnote Cretinism can occur in untreated hypothyroidism
78
79
Why is calcium decreased during pregnancy?
Increased plasma volume, increased GFR, fetal transfer, lower albumin
80
What is the function of increased ACTH and free cortisol in pregnancy?
May help maintain homeostasis with elevated plasma volume
81
What is the function of increased aldosterone in pregnancy?
RAAS activity can protect against natriuresis
82
What are ophthalmologic changes during pregnancy?
* Decreased intraocular pressure * Decreased sensitivity and increased thickness of cornea * Krukenberg spindles: brownish-red opacity on posterior cornea * May see transient loss of accommodation (blurry vision) * Visual function essentially normal
83
What are skin changes that occur during pregnancy?
* Hyperpigmentation of linea nigra and malasma * Striae gravidarum (stretch marks) * Spider angiomas * Palmar erythema * Cutis marmorata * Varicosities * Brittle nails with horizontal grooves (Beau's lines) * Thickened and increased hair
84
What is melasma?
* Uneven darkening in centrofacial-malar area that is exacerbated by sun exposure * "mask of pregnancy" * Also seen in women on OCPs
85
What is striae gravidarum?
* Stretch marks * Decreased collagen adhesiveness and increased ground substance formation * Usually on abdomen, breasts, thighs, buttocks * Begin in 2nd trimester * Increased risk with genetic predisposition, weight gain, young maternal age
86
Who more commonly gets spider angiomas? Palmar erythema?
* spider angiomas: white women (2/3) (10% black women) * Palmar erythema: white women (2/3) (1/3 of black women)
87
What is cutis marmorata?
Mottled appearance to skin secondary to vasomotor instability
88
Where are varicosities commonly seen in pregnancy?
* Legs, anus, vulva (waist down due to compression)
89
What are maternal changes to appetite/thirst and desire to rest?
Increased desire to rest, appetite, and thirst (also with breastfeeding)
90
What are changes to weight and fat metabolism during pregnancy?
* Increased weight (average 27.5 lbs) * Loss of 12 lb at delivery, 9 lb in next 2 weeks, remainder lost gradually or not at all with greater loss in breastfeeding women * Total body fat increase during pregnancy * Plasma lipids increase
91
What are changes to water metabolism and carbohydrate metabolism during pregnancy?
* Increased water retention --> often demonstrable pitting edema in LE * Mild fasting hypoglycemia * Postprandial hyperglycemia * Hyperinsulinemia and insulin resistance * Glucose metabolism changes disappear after delivery
92
What are changes to protein metabolism during pregnancy?
* Protein --> 1 kg of weight gain with 500 g fetus and placenta and 500 g uterine contractile protein, breast glandular tissue, plasma protein, and hemoglobin
93
What are changes to electrolyte and mineral metabolism during pregnancy?
* Sodium and potassium is slightly decreased * Increased retention of sodium and potassium but diluted due to increased plasma volume * Calcium and magnesium: decreased * Phosphate: little change * Iron: decreased, need supplemental iron for normal pregnancy; fetal RBC production not impaired
94
What is the recommended weight gain for a patient with a normal BMI during pregnancy?
* 25-35 lb
95
What are dietary recommendations during pregnancy?
* Balanced diet * Special need for iron, folic acid, calcium and zinc * 2300 kcal/day for avg 127 lb (58 kg) woman * additional 300 kcal/d during pregnancy * additional 500 kcal/d during lactation
96
What are recommendations for protein intake during pregnancy?
* 1 g/kg/day, plus 20 g/d in 2nd half of pregnancy * 60-80 g/d in the average woman * Lean animal, low-fat dairy, vegetable protein ## Footnote Crucial for embryonic development
97
What are recommendations for calcium during pregnancy?
* 1200 mg/d during pregnancy and lactation * If <600 mg/d maternal skeletal demineralization can occur
98
What are recommendations for iron during pregnancy?
* Adequate intake of iron-rich foods * Supplement 30-60 mg/day during 2nd/3rd trimester * Iron deficiency anemia 60-120 mg/day
99
What are recommendations for folic acid during pregnancy?
* At least .4 mg/day for 1 month prior to conception and through 1st 3 months of pregnancy * 1 mg/d insulin dependent DM or taking valproic acid or carbamazepine - increase risk for NTD * 4 mg/d if + hx of NTD ## Footnote Reduces risk of neural tube defects
100
What supplements can be given to specific pregnant patients?
* B12: vegetarians, hx megaloblastic anemia * B6: risk for inadequate nutrition
101
How much vitamin C should a pregnant patient get per day?
80-85 mg/day * typically can get through diet
102
How much zinc is suggested during pregnancy?
* No set recommended level, suggestion for 12 mg/d
103
How much iodine is recommended during pregnancy?
* Can get through diet via iodized salt * Pregnancy: 220 mcg/day * Lactation 290 mcg/day
104
What could be a problem with oversupplementation of iodine in pregnancy?
Thyroid disease
105
What are functions of the placenta?
* Release hormone and enzymes to maternal bloodstream * Transport of fetal nutrients and metabolic products * Exchange of O2 and CO2 for fetal circulation * Fetal in origin but relies on maternal blood
106
What are circulatory functions of the placenta?
* Transport blood to uterus (500-700 mL/min) with 85% to divisions of the placenta
107
How is arterial bleeding controlled?
Uterine contraction
108
What is the function of placental secretions?
* Control intrauterine growth, maturation of vital organs, and childbirth -7 weeks - term * Includes hCG, placental proteins, steroids (DHEAs and estriol)
109
What is the function of placental transport?
* High metabolism - consumes oxygen and glucose faster than fetus * Oxygen and nutrient transport to fetus * CO2, urea, and catabolites to mother * Very few drugs cross placental, especially large size or chage (heparin, insulin) * Albumin-bound drugs are more likely to cross due to higher unbound concentrations and higher placental gradient (ie warfarin, salicylates)
110
What happens during weeks 1-4 of gestation?
* Conception via sperm entering egg * Formation of zygote * Zygote divids to form ball of cells called morula * Enters uterus 3-5 days post fertilization * Accumulation of fluid in cells of morula --> blastocyst * Days 6-7 blastocyst implants and invades endometrium and myometrium * Day 10 blastocyst encased in endometrium * Outer cell group- chorionic villi become placenta * Inner cell group- becomes major cell lines that eventually create tissues
111
What does the inner cell group of the blastocyst become? Outer cell group?
Inner --> embryo Outer--> supportive tissues
112
What is the endoderm and what does it become?
* Innermost layer * Epithelial lining of multiple systems * GI, respiratory, endocrine, auditory, urinary
113
What is the mesoderm and what does it become?
* Middle layer * Connective tissue-pericardium, peritoneum, pleura * Muscle tissue, bone, most of circulatory and GU systems
114
What is the ectoderm and what does it become?
* Outermost layer * Skin-epidermis, sweat glands, hair, nails * Tooth enamel * "outer" epithelium- lining of mouth, nostrils, anus * Nervous system
115
What happens during week 5 of gestation?
* Development of brain, spinal cord, heart, and GI tract begins
116
What happens during weeks 6-7 of gestation?
* Development of eyes, ears, some bones begins * Limb buds and some cranial nerves visible * Brain divides into 5 areas * Heart begins to beat at regular rhythm: rudimentary blood in main vessels
117
What happens during week 8 of gestation?
* Lung development begins * Limbs lengthen, with foot/hand areas and early digits * Brain continues to develop
118
What happens during week 9 of gestation?
* All essential organs have begun to form * Nipples, hair follicles, elbows, toes develop
119
What happens during week 10 of gestation?
* Eyelids, external ear, facial features continue developing * Intestines rotate and swallowing begins * FHT (fetal heart tones) audible by doppler US * End of embryonic period
120
What happens during weeks 11-14 of gestation?
* Further refinement of face, limbs and genitals * Ability to distinguish genitalia on US * Fetus can make a fist with its fingers * RBC produced in liver * Urine produced and put into amniotic fluid * Centers of ossification in most fetal bones
121
What happens during weeks 15-18 of gestation?
* Fine hair called lanugo develops * More bone and muscle tissue develop * Active movements, including sucking * Meconium produced in intestinal tract * Fat begins to accumulate
122
What happens during weeks 19-21 of gestation?
* Fetus capable of hearing * Vernix caseosa covers body * Fetus moves every minute and begins to swallow * Mother may begin feeling fluttering fetal movement * Week 20 is midpoint of pregnancy
123
What happens during week 22 of gestation?
* Lanugo hair covers body * Fetal heartbeat can be perceived with fetoscope
124
What happens during weeks 23-25 of gestation?
* Bone marrow begins to make blood cells * Fingerprints and footprints form * Fetus is regularly sleeping and waking * Fetus may respond to sounds
125
What does fetal survivability look like in week 23, 25, and 26+?
23: 20-35% 25: 50-75% 26+: up to 90%
126
What happens during week 26 of gestation?
* Fetus has hand and startle reflex * Alveoli form in lungs
127
What happens during weeks 27-30 of gestation?
* Rapid brain development, enough to control some body functions * Eyelids open and close * Surfactant begins to be produced
128
What happens during weeks 31-34 of gestation?
* Rapid increase in body far * Bones fully developed but still soft and pliable * Fetus begins storing iron, calcium and phosphorus
129
What happens during weeks 35-38 of gestation?
* Lanugo begins to disappear * Body fat continues to increase
130
What happens during weeks 39-42 of gestation
* Lanugo gone except for upper arms and shoulders * Small breast buds present on both sexes
131
What is one of the systems with the highest rate of malformation?
GU tract
132
What is needed for the male GU tract?
Functional Y chromosome
133
What germ layer does most of the GU tract develop out of?
Intermediate mesoderm
134
When do the major GU structures develop?
Weeks 4-8 ## Footnote Including urogenital ridge and urogenital sinus, most likely to develop major anomalies at this time
135
What is the path of reproductive development?
Genetic --> gonadal --> ductal --> genital
136
How is genetic development of reproductive system determined?
at fertilization by sex hormones
137
How does gonadal tissue develop in males?
* Genetic sex expressed * Begins week 8 * Sex-determining region of Y chromosome encodes for testis-determining factor * TDF--> gonad differentiates into a testis with production of antimullerian hormone and testosterone
138
What happens during ductal development of male?
* Initially both male wolffian (mesonephric) ducts and female mullerian (paramesonephric) ducts exist in embryo * Antimullerian hormone suppresses female mullerian ducts * Testosterone encourages persistence and differentiation of male wolffian ducts
139
What happens during genital development of the reproductive system?
Wolffian or mullerian ducts develop into distinct sex-specific genitalia
140
What is agenesis?
Gonad did not form at all
141
What is agonadism?
Gonads formed initially and later degenerated
142
What happens with streak gonads?
Primordial gonadal formation * No differentiation --> lacks germ cells * May have release of antimullerian hormone without testosterone --> suppresses both ducts * May see ectopic gonadal tissue
143
What is a cloaca?
Precursor of urogenital structures
144
What happens during weeks 5-7 to the cloaca?
* Urorectal septum divides cloaca into urogenital sinus and anorectal canal * Male: becomes urinary bladder, urethra, and penis * Female: becomes urinary bladder, urethra, and vagina
145
What is vaginal agenesis?
vagina does not form
146
What is vaginal atresia?
lower portion is only fibrous tissue
147
What is vaginal septa?
Vagina has a transverse or longitudinal septum May have imperforate hymen
148
What are conditions that can arise from abnormal vaginal development?
* Vaginal agenesis * Vaginal atresia * Vaginal septa * Rectovaginal fistula
149
What do the wolffian/mesonephric ducts become in males?
* Epididymis, ductus deferens, ejaculatory ducts * Vestigial remnant- appendix epididymis * Requires presence of gonads to develop
150
What happens to the mullerian/paramesonephric ducts in males?
* Regress under hormonal influence * May persist as appendix testis
151
What is the process of relocation in male sex development?
* 28th week: testes descend through inguinal canal * 32nd week: testes in scrotum
152
What happens to the wolffian/mesonephric ducts in female sex development?
* Mostly regress * Small portion becomes trigone of bladder
153
What happens to the mullerian/paramesonephric ducts during female sex development?
* Midline fusion --> uterus * Distal ducts --> oviducts * Does not descend in abdomen * Can have complete or partial absence of uterine tube or problems with fusion
154
What abnormalities can occur during development impacting the labia majoria/minora?
* Fusion --> tissue separation failure or inflammatory reaction * May be hypertrophic or hypoplastic
155
What abnormalities can occur to the clitoris during development?
* Agenesis: atresia or lack of genital tubercule formation * Bifid/double: failure of fusion * Hypertrophy: in intersex disorders
156
What abnormalities of the perineum can occur in male/female?
* Imperforate anus * Anal stenosis * Anal agenesis with fistular ectopic anus

Women's Health (5 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions