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Flashcards in Puberty Deck (55)
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1

Adrenarche

Activation of adrenal cortex for the production of adrenal androgens, and typically occurs before the onset of puberty. Leads to pubarche (pubic and axillary hair growth) and doesn't require gonads.

2

Gonadarche

Activation of the gonads by the pituitary hormones FSH and LH and sex steroid secretion. Leads to thelarche (breast dev) and sexual maturation. Does not require the adrenal gland

3

Menarche

Age of onset of first menstural period

4

Where is DHEAS produced?

During andrenarche, the adrenal gland's zona reticularis produces DHEAS

5

Is adrenarche under direct control of ACTH/cortisol?

NO, has nothing to do with the gonads

6

What stimulates gonadarche

Onset of GnRH pulsitility

7

What usually comes first, thelarche or pubarche?

Thelarche, though in 8-15% of girls, pubarche occurs first

8

What causes breast dev?

Estrogen production by ovaries

9

Breast Tanner stage I

Prepubertal

10

Breast Tanner stage II

Breast bud forms, areola erect (11.2 y.o)

11

Breast Tanner stage III

Breast tissue enlarges beyond areola (12.2)

12

Breast Tanner stage IV

Areola and papilla form second mound (13.1y.o)

13

Breast Tanner stage V

Adult breast: areola and breast tissue same plane, papilla erect (15.3 y.o)

14

Limitations to Tanner staging

-Based off of limited pop
-Dif ethnicities=dif ages

(note seq of events is the same)

15

Normal breast dev occurs at a younger age in...

African Americans than in Whites

16

What age range of breast dev req further evaluation of any girl?

Dev at age 13

17

Which enzymes initiate adrenarche

P450c17 which inc DHEA, DHEA-s, androstenedione

18

How many years before the appearance of secondary sex charac does adrenarche occur?

2

19

What is adrenarche responsible for

Pubarche

20

Does andrenarche play a role in skeletal growth?

Not really

21

What is the relationship between adrenarche and gonadarche?

They are temporally related, but independent, functionally unrelated biologic events

22

F. Pubic Tanner stage I

Pre pubertal, no pubic hair

23

F. Pubic Tanner stage II

Coarse, curly, pigmented hair laterally (11.7)

24

F. Pubic Tanner stage III

Coarse, curly hair spread across pubis (12)

25

F. Pubic Tanner stage IV

Abundant adult pubic hair, limited to pubis (13)

26

F. Pubic Tanner stage V

Pubic hair present on medial thigh (14)

27

What race does pubarche usually occur in first

African American ealier than white

28

When does menarche occur?

Once there is sufficient gonadal estrogen, secretion occurs and the endometrial proliferation occurs. First period is not necessarily associated with ovulation. Postmenarcheal cycles are initially anovulatory. Sustained predictable LH surge responses to estradiol with ovulation are late pubertal events. Can be anovulatory for even 5 years.

29

How long after breast dev does menarche occur

approx 2 years

30

Why do we think age at menarche is dec?

Better nutritional status, improved standards of living