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Obstetrics And Gynaecology > Reproductive System > Flashcards

Reproductive System Flashcards

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1
Q

What does gonadotropin-releasing hormone stimulate the anterior pituitary to produce?

A

FSH and LH

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2
Q

What cells around the follicles in the ovary produce oestrogen?

A

Theca and granulosa cells

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3
Q

What effect does oestrogen have on hypothalamus and anterior pituitary?

A

Supress the release of GnRH from hypothalamus and LH+FSH from anterior pituitary

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4
Q

What is the most prevalent and active version of oestrogen?

A

17-beta oestradiol

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5
Q

What changes does the action of oestrogen on its receptors stimulate in the body?

A

Breast tissue development, development of female sex organs in puberty, blood vessel development in uterus, development of endometrium

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6
Q

What are oestrogen and progesterone?

A

Steroid sex hormones

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7
Q

where is progesterone produced normally and during pregancy?

A

Corpus luteum after ovulation normally
In pregnancy progesterone is produced from placenta after 10 weeks gestation

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8
Q

What does progesterone cause?

A

Thickening of cervical mucus
Thickens and maintains the endometrium
Increase body temperature

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9
Q

Why is it that overweight girls tend to undergo puberty earlier?

A

Aromatase enzyme is found in adipose tissue. The more adipose tissue the more aromatase which is important in creation of oestrogen

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10
Q

How is GnRH produced in puberty?

A

Initially during sleep, then throughout the day in later stages

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11
Q

What are the four stages of development a follicle undergoes in the ovary?

A

Primordial follicles
Primary follicles
Secondary follicles
Antral follicles

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12
Q

Which stages of development of the follicles in the ovary occurs independently to the menstrual cycle?

A

Primordial follicles developing into primary and secondary follicles

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13
Q

After what stage do follicles develop receptor for FSH and require FSH stimulation for further growth?

A

Secondary follicles develop FSH receptors

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14
Q

What is a dominant follicle?

A

A follicle that develops further than the rest during a menstrual cycle

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15
Q

A spike in what hormone causes ovulation?

A

LH

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16
Q

What maintains corpus luteum if ovum becomes fertilised?

A

HCG produced from the syncytiotrophoblast of embryo maintains corpus luteum

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17
Q

What happens with corpus luteum if egg is not fertilised and how does this affect hormone levels?

A

Initially corpus luteum produces progesterone and smaller amounts of oestrogen, it degenerates if ovum isnt fertilised and stops producing hormones so there is a drop in progesterone and oestrogen

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18
Q

What does a drop in the oestrogen and progesterone levels cause?

A

Causes the endometrium to break down and menstruation to occur
Drop in negative feedback to hypothalamus and pituitary also allows LH and FSH to rise

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19
Q

What are the 3 layers of a primary follicle?

A

Primary oocyte in centre
Zona pellucida
Granulosa cells

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20
Q

What are the two layers of the theca folliculi?

A

Inner layer- secretes androgen hormones
External layer- smooth muscle and collagen

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21
Q

What is the change seen from development from secondary follicle to antral?

A

Development of an antrum which is a single fluid filled areas within granulosa cells

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22
Q

What happens in a follicle at ovulation?

A

LHsurge causes contraction of smooth muscle in external thecal layer bursting follicle. Digestive enzymes from follicle create a hole in ovary wall for ovum to pass through

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23
Q

How doe the granulosa and thecal cells change in corpus luteum?

A

They become luteal cells producing steroid hormones- particularly progesterone

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24
Q

What is the decidua?

A

Cells of the stroma (supportive outer tissue of endometrium) converted into a tissue specialised to provide nutrients to the trophoblast

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25
What tissues are derides from the ectoderm?
CNS, skin, hair, teeth, nails
26
What tissues are derived from the mesoderm?
Bone, Muscle, Heart, connective tissue, blood, kidneys
27
What tissues are derived from the endoderm?
GI tract, lungs, liver, pancreas, thyroid, reproductive system
28
At what week gestation does the fetal heart form and start to beat?
Six weeks
29
What are spiral arteries in the uterus?
Artery branches from the myometrium into the endometrium which are thicker walled and coiled
30
What are chorionic villi?
Finger like projections of the syncytiotrophoblast which grow in the endometrium when the blastocyst implants on the endometrium. They contain fetal blood veesels
31
What is the chorion frondosum?
Vascular area of chronic villi near connecting stalk which contain mesoderm. This proliferates and becomes the placenta
32
what does the connecting stalk become?
The umbilical cord
33
When is placenta development complete?
Usually by ten weeks gestation
34
Which direction do the umbilical arteries and vein take blood to and from the baby?
The 2 umbilical arteries carry deoxygenated blood from the baby to the placenta The umbilical vein carries oxygenated blood from the placenta to the baby
35
How is oxygen able to be taken up by fetal blood from placenta?
Fetal haemoglobin has a higher affinity for oxygen
36
What are the five main function of the placenta?
Respiration, nutrition, excretion, endocrine, immunity
37
What does oestrogen help with in pregnancy?
Helps soften tissues allowing muscles and ligaments of the uterus and pelvis to expand and cervix to soften ready for birth Enlarges breasts and nipples for birth
38
what does progesterone help with in pregnancy? What are some side effects?
Maintains endometrial blood supply, relaxes muscles so uterus doesn’t contract Relaxing of other muscles like lower oesophageal sphincter (heart burn), bowel (constipation) and blood vessels (flushing, hypotension, headaches)
39
What physiological change in pregnancy may lead to improvement in autoimmune conditions and increased susceptibility to diabetes and infections?
Increase in ACTH production causing increased steroid hormones like cortisol
40
Why are skin changes like linea nigra and melisma more common in pregnancy?
Increased melanocyte stimulating hormone production from anterior pituitary
41
How do thyroid test levels changes in pregancy?
TSH level remains the same, T3 and T4 increase
42
How do HCG levels change in early pregnancy?
The levels rise doubling every 48 hours, plateauing around 8-12 weeks then gradually fall
43
What changes are seen in the cervix and vagina with increased oestrogen?
Increased cervical and vaginal discharge, cervical ectropion more likely and hypertrophy of vaginal muscles
44
What effect do prostaglandins have on the cervix during childbirth?
They break down the collagen in the cervix allowing it to dilate and a face during childbirth
45
What cardiovascular changes are seen in pregnancy?
Increased blood volume, plasma volume, cardiac output, stroke volume and heart rate. Reduced peripheral resistance with decreased blood pressure
46
Why are varicose veins seen in pregnancy?
Peripheral vasodilation and obstruction of inferior vena cava by uterus
47
What are some respiratory changes seen in pregnancy?
Increased tidal volume and respiratory rate in later pregnancy
48
What renal changes are seen in pregnancy?
Increased GFR from increased blood flow to kidneys increased aldosterone so more water and salt reabsorption increased protein excretion dilatation of ureters and collecting system
49
What are some haematological changes seen in pregnancy?
Increased RBC production (not as much as plasma volume so haematocrit falls resulting in anaemia) Clotting factors increase- hypercoagulable state Decreased platelets Increased WBCs
50
What are some biochemistry changes seen in pregnancy?
Increased ALP (due to secretion from placenta) Reduced albumin (increased loss from kidneys)
51
Is postpartum hair loss normal?
Yes and usually improves within 6 months
52
What is the first stage of labour?
From the onset of true contractions until 10cm cervical dilatation
53
what is the second stage of labour?
From 10cm dilatation to delivery of baby
54
What is the third stage of labour?
Delivery of baby to delivery of placenta
55
Pessaries containing what can be used to induce labour?
Prostaglandin E2 (dinoprostone)
56
What are Brixton hicks contractions?
Occasional and irregular contractions of uterus, which can cause temporary and irregular cramping or tightening feelings. They dont indicate onset of labour.
57
In the first stage of labour, what is meant by ‘show’?
The mucus plug in the cervix preventing bacteria entering uteru falls out breathing space for baby to come out
58
What are the three phases seen in the first stage of labour?
Latent phase: 0-3cm at 0.5cm an hour, irregular contractions Active phase: 3-7cm at 1cm an hour, regular contractions Transition phase: 7-10cm at 1cm an hour, strong and regular contractions
59
What are the 3 Ps which determine the success of the second stage pf labour?
Power, passenger and passage
60
In labour what are the 4 descriptive qualities of the foetus?
Size Attitude (posture e.g how back is rounded/limb or heads flexed), Lie (position of foetus in relation to mum) Presentation (part of foetus closest to cervix)
61
What are the different possible lies of a foetus?
Longitudinal- foetus is straight up and down Transverse lie- foetus straight side to side Oblique- foetus at an angle
62
What are the different presentations of a foetus?
Cephalic Shoulder Breech (legs first)
63
What are the different types of breech presentation?
Complete breech- hips and knees flexed (cannonball into pool) Franck breech- hips flexed and knees extended, bottom first Footling breech- with a foot hanging through the cervix
64
What are the seven cardinal movements of labour?
Engagement, descent, flexion, internal rotation, extension, restitution and external rotation, expulsion
65
When is active management of the third stage of labour considered?
Haemorrhage or more than 60 minute delay in delivery of placenta
66
What is active management of the third stage of labour?
Intramuscular oxytocin

Obstetrics And Gynaecology (8 decks)

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