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Pathophysiology > Reproductive System > Flashcards

Reproductive System Flashcards

1
Q

The cervix has ____ qualities so it is less likely to have an infection above the cervix

A

Antibacterial

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2
Q

The endometrium layer of the cervix secretes ____

A

Hormones

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3
Q

The ____ is the muscle layer of the uterus

A

Myometrium

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4
Q

The cervix connects to the ___ ___

A

Fallopian tubes

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5
Q

The ____ (perimetrium) gives shape to the myometrium and keep the boundaries of the uterus and holds it in place

A

Cervosa

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6
Q

The egg flows through the ___ ___ to get to the uterus

A

Fallopian tubes

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7
Q

The ____ contain eggs

A

Ovaries

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8
Q

The female reproductive system is driven by ____ function

A

Endocrine

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9
Q

The hypothalamus releases gonadotropin-releasing hormone, which then stimulates the anterior pituitary to release what two hormones?

A

-Luteinizing hormone
-Follicular stimulating hormone

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10
Q

Luteinizing hormone and follicular stimulating hormone stimulate the ovary to release ____ and ____ to prepare the uterus for pregnancy

A

Estrogen and progesterone

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11
Q

Estrogen and progesterone provide negative feedback to the ____ and ___ ___ to stop production of these hormones during most of the female cycle

A

Hypothalamus and anterior pituitary

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12
Q

It is only during days ___-___ of the menstrual cycle that estrogen and progesterone provide positive feedback to increase production of the hormones

A

12-14

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13
Q

Gonadotropin-Releasing Hormone stimulates synthesis and secretion of the gonadotropins in the _____

A

Pituitary

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14
Q

What are the gonadotropins that are released from the pituitary?

A

-Follicle-stimulating hormone
-Luteinizing hormone

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15
Q

Luteinizing hormone binds with and stimulates the ____ cells of the ovaries which leads to androstenedione production

A

Theca

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16
Q

Follicular stimulating hormone stimulates the ____ cells of the ovaries and leads to increased production of estadiol

A

Granulosa

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17
Q

Androgens get converted to ____

A

Estrone

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18
Q

____ is the most common estrogen and is produced in the ovaries and a small amount by the cortex of the pituitary

A

Estradiol

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19
Q

____ is the metabolite of estradiol and estriol

A

Estrone

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20
Q

____ is a risk factor for many reproductive cancers because fat cells produce hormones and estrogen

A

Obesity

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21
Q

Estrogen has effects on the brain and is important for ____ formation and retention

A

Memory

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22
Q

Estrogen stimulates ____ development as well as milk production

A

Breast

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23
Q

Estrogen also regulates _____, so it has an impact on the heart and the liver

A

Cholesterol

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24
Q

Estrogen also helps to preserve ____ ____

A

Bone density

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25
Q

Estrogen regulates proliferation of _____ cells

A

Squamous

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26
Q

Secretion of the vagina promotes ____ and ____ of sperm to increase rate of pregnancy

A

Motility and movement

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27
Q

____ is an ovarian hormone that the ovaries and the adrenal gland produce at a steady rate

A

Progesterone

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28
Q

Progesterone is increased during _____ which helps prepare the uterus to lay the egg into the clinging and mature the growing fetus

A

Pregnancy

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29
Q

8 weeks into pregnancy, the ____, instead of the uterus, begins making progesterone

A

Placenta

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30
Q

Progesterone prevents ____ labor

A

Premature

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31
Q

Roles of progesterone:

A

-Relaxation of myometrium
-Thickening of myometrium
-Promotes development of breast tissue

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32
Q

Adrenal hormones (androgens) are released from the ____ ____

A

Adrenal cortex

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33
Q

Androgens are precursors to ___ and ___

A

Estrogen and progesterone

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34
Q

Androgens contribute to ____ growth during pregnancy

A

Skeletal

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35
Q

Androgens are also responsible for the development of _____ sex characteristics

A

Secondary

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36
Q

Hormone release during the menstrual cycle is related to ____ changes

A

Tissue

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37
Q

The menstrual cycle is ____ days on average

A

28

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38
Q

Levels of follicular stimulating hormone and luteinizing hormone are higher in the first half of the cycle (follicular phase) and peak right before ____

A

Ovulation

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39
Q

High levels of ___ ___ trigger ovulation

A

Luteinizing hormone

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40
Q

Levels of estrogen are also highest before ____

A

Ovulation

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41
Q

Levels of ____ increase after ovulation

A

Progesterone

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42
Q

_____ occurs early in the menstrual cycle

A

Menstruation

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43
Q

The endometrium increases in ____ over the cycle

A

Thickness

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44
Q

The first half of the menstrual cycle is the ____ phase and the second half is the ____ phase

A

Follicular; luteal

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45
Q

____ occurs due to the cessation of ovarian function

A

Menopause

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46
Q

During menopause, there is a gradual decrease in the size of the ____

A

Ovaries

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47
Q

Menopause usually occurs between ages ___ and ___

A

45-52

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48
Q

There will be variability in the frequency and flow of menstruation ____ years prior to menopause

A

10

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49
Q

Mechanism of menopause:

A

-Atresia of oocytes
-Decreased estrogen and progesterone from the ovaries
-Increased production of follicular-stimulating hormone and luteinizing hormone
-Estrogen is still produced in the adrenal cortex and adipose tissue (conversion to androstenedione)

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50
Q

During menopause, estrogen secretion is insufficient to maintain ____ sexual characteristics

A

Secondary

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51
Q

Manifestations of menopause:

A

-Headaches and hot flashes
-Teeth loosen and gums recede
-Risk of cardiovascular disease
-Backaches
-Hair becomes thinner
-Bones lose mass and become more fragile
-Breasts droop and flatten
-Nipples become smaller and flatten
-Skin and mucous membranes become dried and develop a rough texture
-Abdomen loses some muscle tone
-Stress of urge incontinence
-Vaginal dryness, itching, and shrinking

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52
Q

___ ___ ___ may alleviate some symptoms of menopause, but it increases the risk of coronary heart disease

A

Hormone replacement therapy

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53
Q

Who should take hormone replacement therapy?

A

-People under 47 years old
-Those with severe hot flashes
-Those with osteoporosis

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54
Q

Hormone replacement therapy should be given in the ____ effective doses for the shortest period time

A

Lowest

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55
Q

____ is the absence or suppression of menstruation

A

Amenorrhea

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56
Q

Primary amenorrhea is a failure of ____ (no onset of menses; age 14 if there is no sex characteristics, 16 if there is sex characteristics)

A

Menarche

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57
Q

What are the compartments of primary amenorrhea?

A

I: Uterus
II: Ovary
III: Anterior pituitary
IV: Hypothalamus

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58
Q

Amenorrhea caused by a defect in the ovaries is common in girls with ____ ____

A

Turner’s syndrome

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59
Q

Secondary amenorrhea is the absence of menstruation for ___ or more cycles or 6 months in women who have previously menstruated

A

3

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60
Q

Secondary amenorrhea is normal during…

A

-Early adolescense
-Peri-menopausal period
-Pregnancy
-Lactation

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61
Q

Secondary amenorrhea can be caused by…

A

-Diseases
-Dramatic weight loss (malnutrition, excessive exercise)

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62
Q

Pathophysiologic categories of secondary amenorrhea:

A

-Normal ovarian hormone secretion (pregnancy, uterine dysfunction->hysterectomy, adhesions)
-Increased ovarian hormone secretion (feminizing tumors, masculinizing hormones, PCOS)

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63
Q

Secondary amenorrhea can also be caused by decreased ____ hormone secretion

A

Ovarian

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64
Q

High ____ levels can cause secondary amenorrhea by stimulating menopause as well as acquired ovarian failure

A

Gonadotropin

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65
Q

What can cause acquired ovarian failure?

A

-Autoimmune disease
-Chemotherapy
-Resistance to gonadotropins
-Environmental toxins

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66
Q

Low gonadotropin levels can cause secondary amenorrhea by causing things like…

A

-Hyperprolactinemia
-Tumor or trauma to hypothalamus or pituitary
-Disorders extrinsic of H-P tract like starvation, stress, psychogenic disorder, and endocrine disease)

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67
Q

PCOS affects ___-___% of all women

A

5-10

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68
Q

PCOS is the leading cause of _____

A

Infertility

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69
Q

PCOS is diagnosed by 2 or more of what three symptoms?

A

-Oligo/anovulation
-Elevated adrogens
-Polycystic ovaries

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70
Q

The pathophysiology of PCOS is ___-___

A

Mult-factorial

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71
Q

____ may cause PCOS because it increases free testosterone levels

A

Hyperinsulinemia

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72
Q

High testosterone levels can…

A

-Suppress follicular apoptosis
-Cause excess androgen to be converted to estrogen

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73
Q

High estrogen continues to suppress what two hormones?

A

-FSH
-LH

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74
Q

The high estrogen (and low FHS and LH) perpetuates follicular _____ ____, but not maturation and ovulation

A

Tissue development

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75
Q

The accumulation of follicular tissue causes…

A

-Ongoing androgen secretion
-Ongoing cycle

76
Q

There may be ____ and ____ factors that contribute to the development of PCOS

A

Genetic and lifestyle

77
Q

Manifestations of PCOS:

A

-Acne
-Hirsutism
-Obesity
-Hormone irregularities
-Irregular menstrual cycles
-Infertility
-Insulin resistance
-Diabetes
-Dyslipidemia
-Endometrial carcinoma
-Cardiovascular disease
-Non-alcoholic liver disease

78
Q

There are both ____-____ and ___ ___ related manifestations of PCOS

A

Hormone-driven; metabolic syndrome

79
Q

With ____ ____ disorders, the endopelvic fascia and perineal muscles stretch and lose tone/strength

A

Pelvic relaxation

80
Q

People with pelvic relaxation disorders are unable to maintain ____ in the proper position

A

Organs

81
Q

Precipitating factors for pelvic relaxation disorders:

A

Anything that increases intra-abdominal pressure

82
Q

____ helps to maintain elasticity of tissues

A

Estrogen

83
Q

A ____ ____ is a descent of the cervix or entire uterus into the vaginal canal

A

Uterine prolapse

84
Q

First-degree uterine prolapse is a descent of the cervix/uterus within the ____

A

Vagina

85
Q

Second degree uterine prolapse is when the cervix protrudes through the ____

A

Introitus

86
Q

Third-degree uterine prolapse is when the vagina is completed ____

A

Everted

87
Q

The goal is to prevent uterine prolapse with ____ ___ (Kegel)

A

Muscular exercise

88
Q

____ can be useful for those at risk for uterine prolapse post-manopause

A

Estrogen

89
Q

A ____ can be used to prevent prolapse, and surgery can be done as a last resort

A

Pessary

90
Q

____ is the descent of the bladder into the vaginal canal

A

Cystocele

91
Q

Cystocele causes…

A

-Feelings of pressure
-Difficulty in completely emptying the bladder
-Can increase the risk of bladder infections

92
Q

Cystocele can be treated with ____ exercises to strengthen the pelvic floor muscles or the use of a vaginal pessary

A

Kegel

93
Q

_____ is usually caused by trauma to the fascia during childbirth

A

Rectocele

94
Q

Chronic _____ contributes to the development of rectocele

A

Constipation

95
Q

Rectocele causes symptoms like…

A

-Constipation
-Feelings of rectal fullness
-Difficult defecation

96
Q

____ ____ ____ is inflammation caused by infection

A

Pelvic Inflammatory Disease

97
Q

The incidence of pelvic inflammatory disease is ___ million per year and causes ____ cases infertility per year

A

1; 100,000

98
Q

Consequences of pelvic inflammatory disease are associated with ____

A

Scarring

99
Q

The etiology of pelvic inflammatory disease is mediated by a failure of normal ____ ____

A

Defense mechanisms

100
Q

Pelvic inflammatory disease can cause…

A

-Inflammation
-Scar tissue formation with adhesions to nearby tissues and organs
-Can lead to necrosis and abscess formation

101
Q

_____ is caused by the presence of functioning endometrial tissue outside of the uterus

A

Endometriosis

102
Q

The endometrial tissue that is outside of the uterus also responds to ____ fluctuations in the menstrual cycle

A

Hormonal

103
Q

There is a ___-___% incidence of endometriosis

A

3-15

104
Q

___-___% of infertile women have endometriosis

A

30-40%

105
Q

What are possible etiology/mechanisms of endometriosis?

A

-Retrograde flow (common in most women)
-Decreased immune response to endometrial cells outside of the uterus
-Genetic pre-dispositioin

106
Q

In 80% of cases of endometriosis, uterine tissue implants in the ____

A

Ovary

107
Q

Timeline of endometriosis:

A

-Bleeding adhesions
-Inflammation
-Pain, fibrosis, scarring

108
Q

Manifestations of endometriosis:

A

-Dysmenorrhea
-Abnormal bleeding
-Pain with intercourse
-Constipation
-Infertility

109
Q

____ cancer is the 2nd most common cancer in women worldwide (12,000 new cases and 4,000 deaths/year in the United States)

A

Cervical

110
Q

There has been a dramatic decrease in incidence of cervical cancer (45%) since the ____ screening was developed

A

PAP

111
Q

Infection with the ___ ___ virus is necessary for the development of cervical cancer

A

Human Papilloma

112
Q

What are the two general types of HPV?

A

-Low-risk types
-High-risk types

113
Q

Low-risk types of HPV are associated with…

A

-Genital warts
-Mild pap test abnormalities

114
Q

High-risk types of HPV are associated with…

A

-Mild to severe Pap test abnormalities
-Cervical cancer

115
Q

Most genital HPV infections are transient and ____, and have no clinical consequences

A

Asymptomatic

116
Q

HPV ___ and ____ account for the majority of cervical cancer cases (all 3 vaccines fight against these two)

A

16; 18

117
Q

HPV is also associated with what other types of cancers?

A

-Vagina
-Vulvar
-Penile
-Anal
-Oropharyngeal

118
Q

What are three available HPV vaccines?

A

-Bivalent (Cervarix)
-Quadrivalent (Gardasil)
-9-valent (Gardasil 9)

119
Q

Genital warts have a very high incidence; as many as ____ out of every 100,000 people have HPV-associated genital warts

A

100

120
Q

Incidence of cervical cancer is about ___ people out of every 100,000

A

8.3

121
Q

Transmission of genital HPV can be from…

A

-Anal
-Oral
-Vaginal

122
Q

Transmission of HPV can occur from ____ and subclinical patients

A

Asymptomatic

123
Q

Cervical cancer risk factors for women:

A

-Immune status
-Smoking as a co-factor
-Multiple births
-Long-term oral contraceptive use
-Chronic inflammation
-Poor oral hygiene (for oropharyngeal cancers)

124
Q

With cervical cell abnormalities, the HPV infects stratified squamous epithelium and stimulates ____ ___

A

Cellular proliferation

125
Q

Cervical cancer requires persistent ____ (many clear the infection, but there are some high risk types)

A

Infection

126
Q

Grading systems for cervical cell abnormalities:

A

-Pap
-Colposcopy
-Bioposy

127
Q

Cervical cancer symptoms:

A

-Usually asymptomatic in pre-invasive stages
-Abnormal vaginal bleeding
-Lower extremity bleeding due to pelvic lymph node obstruction
-Metastasis to bone and lung

128
Q

_____ carcinoma arises from glandular epithelium of the uterine lining

A

Endometrial

129
Q

Endometrial cancer is the most frequent cancer in the _____ and is responsible for 7% of all cancers diagnosed in females

A

Pelvis

130
Q

The peak occurrence of endometrial cancer is between age ___ and ___

A

55 and 65

131
Q

Each year, there are ____ new cases of endometrial cancer with 6,800 deaths

A

40,100

132
Q

Risk factors for endometrial cancer:

A

-Unopposed estrogen (high levels)
-Insulin
-HNPCC
-Obesity
-Nuliparity
-Diabetes
-PCOS

133
Q

____ ____ could possibly be protective against endometrial cancer by decreasing estrogen levels

A

Cigarette smoking

134
Q

Manifestations of endometrial cancer:

A

-Asymptomatic
-Post-menopausal bleeding
-Late symptoms include cramping, pelvic discomfort, postcoital bleeding
-Large tumors may be necrotic and hemorrhagic

135
Q

There are about ____ new cases of ovarian cancer per year with about 16,000 deaths per year

A

25,000

136
Q

Ovarian cancer is the top cause of ____ related to gynecologic cancers

A

Death

137
Q

1 in ____ women will develop ovarian cancer

A

70

138
Q

What are some types of ovarian cancer?

A

-Epithelial
-Germ cell malignancies
-Stromal tumors
-Mucinous
-Endometrioid and clear cell
-Serous

139
Q

____ endometrial cancer is the least common

A

Mucinous

140
Q

Endometrioid and clear cell ovarian cancer are associated with _____

A

Endometriosis

141
Q

Low-grade serous ovarian cancer is asymptomatic but ___-___

A

Chemotherapy-resistant

142
Q

High-grade serous ovarian cancer accounts for ___% of tumors (only 5% are stage I at diagnosis); this is the most common and most lethal for of ovarian cancer

A

70

143
Q

There is new evidence that ovarian tumors originate in the ___ ___

A

Fallopian tubes

144
Q

What factors increase the risk of ovarian cancer?

A

-Age
-Family history of cancer
-Obesity
-Nulliparity (has not given birth)
-Increased number of lifetime ovulatory cycles
-Hormone replacement therapy

145
Q

What factors decrease the risk of ovarian cancer?

A

-Oral contraceptive use
-Oopherectomy
-Hysterectomy
-Tubal ligation
-Lactation
-Salpingectomy
-Bilateral salpingo-oophorectomy

146
Q

Manifestations of ovarian cancer:

A

-Urinary frequency and urgency
-GI upset (indigestion, constant feeling of fullness)
-Pelvic and/or abdominal pain or discomfort
-Pelvic and/or abdominal bloating or swelling
-Unexplained weight loss or gain
-Fatigue
-Abnormal postmenopausal bleeding
-Pain during intercourse

147
Q

The ____ are located in the scrotum outside the body; they are composed of tightly coiled tubules that produce sperm

A

Testes

148
Q

Testes produce what two hormones?

A

-Testosterone (more potent and abundant)
-Androsterone

149
Q

Production of testosterone throughout the lifecycle:

A

-Begins during fetal development and continues for a short time after birth
-Nearly stops during childhood
-Resumes at puberty

150
Q

Testosterone is a steroid hormone and is responsible for…

A

-Growth and development of the male reproductive structures
-Increased skeletal muscle growth
-Enlargement of the larynx accompanied by voice changes
-Growth and distribution of body hair
-Increased male sex drive

151
Q

Newly produced sperm is stored in the _____, which is just outside and to the rear of each testicle; this is where the sperm develops

A

Epididymis

152
Q

The ___ ___ is a muscular duct that connects the epididymis and the ejaculatory duct; it carries sperm out toward the urethra during ejaculation

A

Vas deferens

153
Q

The ___ ___ is the area formed by the union of the two vas deferens ducts (one from each testis) and the duct from the seminal vesicles

A

Ejaculatory duct

154
Q

The ____ is the tube that runs through the penis and drains the excretory and reproductive systems

A

Urethra

155
Q

____ ____ are a gland located behind the bladder and empty into the ejaculatory duct; mucous, amino acids, fructose, and prostaglandins are found making up the fluid; makes up 60% of semen volume

A

Seminal vesicles

156
Q

The ____ ____ is a large gland that surrounds the upper portion of the urethra; it gives off a thin, milky secretion containing several enzymes; it neutralizes the acidic urine residue in the urethra and activates sperm

A

Prostate gland

157
Q

The ___ is composed of 3 cylinders of spongey erectile tissue

A

Penis

158
Q

Follicular stimulating hormone stimulates ____ cells to make sperm; this inhibits further FSH from being produced (negative feedback)

A

Sertoli

159
Q

Luteinizing hormones stimulates ____ cells that make testosterone; this is also a negative feedback loop

A

Leydig

160
Q

The ____ muscle raises and lowers the scrotum to help regulate temperature and promote spermatogenesis

A

Cremaster

161
Q

In summary, the male reproductive system is all about supporting ____ production and its transport to the ovum

A

Sperm

162
Q

____ cancer is responsible for only 1% of all cancers in men, but is the most common cancer in men who are between 15-35 years old

A

Testicular

163
Q

Etiology and risk factors for testicular cancer:

A

-Cryptorchidism (undescended testes): 50% of cases
-Exogenous estrogen during mother’s pregnancy
-Trauma
-Infection
-Chromosomal abnormalities (loss of chromosome 11, 13, 18, abnormal chromosome 12p)
-The link between vasectomy and testicular cancer is weak; a vasectomy could increase the rate of progression of an existing, undetected tumor

164
Q

Classifications of testicular cancer:

A

-Germ cell tumors (Seminoma, non-seminoma)
-Stromal (less common)

165
Q

Manifestations of testicular cancer:

A

-Painless testicular enlargement
-Ache in abdomen/groin
-Heavy feeling in scrotum
-10% have acute scrotum pain
-5% present with gynecomastia
-Misdiagnosis as epididymitis (25%)
-10% have metastases at diagnosis (typical delay in diagnosis of 3-6 months)

166
Q

___ ___ are used to identify metastases and to track response to treatment

A

Tumor markers

167
Q

What tumor markers are used to identify testicular cancer?

A

-Alpha Feto-Protein: glycoprotein
-Human chorionic gonadotropin (HCG)
-Lactate dehydrogenase

168
Q

Testicular cancer is extremely _____ (95% cure rate!)

A

Chemosensitive

169
Q

___% of people with testicular cancer will have a recurrence and 99% can be cured if discovered and treated early

A

10%

170
Q

Disease free survival of ___ years is indicative of cured testicular cancer

A

3

171
Q

Negative prognostic indicators for testicular cancer:

A

-Presence of liver, bone, or brain metastasis
-Very high serum markers
-Primary mediastinal nonseminoma
-Large number of lung metastases

172
Q

____ ___ ___ is an abnormal increase in the number of cells (hyperplasia) (NOT hypertrophy, or size of cells)

A

Benign prostatic hyperplasia

173
Q

Benign prostatic hyperplasia is a ____ disease, most frequently affecting those aged 40-45

A

Common

174
Q

Benign prostatic hyperplasia may be due to a metabolic product of testosterone called _____ if testosterone production is blocked

A

Dihydrotestosterone

175
Q

Investigation of Benign prostatic hyperplasia is focused on levels and ratios of various ____ factors

A

Endocrine

176
Q

With Benign prostatic hyperplasia, hyperplasia occurs near the ____ in the periurethral glands

A

Urethra

177
Q

Manifestations of Benign prostatic hyperplasia:

A

-Firm, enlarged prostate upon rectal exam
-Decreased vigor of urinary stream, increased frequency, urgency, urinary hesitancy and dribbling, hematuria, infections
-Progressive bladder distension with diverticular outpouchings of the bladder wall
-Ureter obstruction (can lead to hematuria, infections, and bladder calculi)
-If untreated, urine backs into kidneys causing hydronephrosis and possible renal failure

178
Q

____ cancer is the most frequently diagnosed cancer in men

A

Prostate

179
Q

Prostate cancer is the ___ leading cause of cancer death in men

A

2nd

180
Q

Prostate cancer is a disease of ___, and is often found on post-mortum exams

A

Aging

181
Q

Etiology of prostate cancer:

A

-Adenocarcinoma with unknown etiology

182
Q

Prostate cancer is an ____-sensitive tumor

A

Androgen

183
Q

Prostate cancer may be due to an increased ___/___ ratio

A

Estrogen/Dihydrotestosterone

184
Q

Risk factors for prostate cancer:

A

-Aging
-Hereditary/genetics

185
Q

What are the four stages of prostate cancer? (These indicate the mitotic rate of the cancer cells)

A

-A
-B
-C
-D

186
Q

___ ___ ___ can be used to screen for prostate cancer

A

Prostate screening antigen

187
Q

Prostate cancer can lead to ____ ____ metastasis

A

Lymph node

Pathophysiology (18 decks)

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