Location of sperm development.
Uhh… idk….. testes?!
Sperm storage location
Epididymis
Sperm transport from vas deferens, through the prostate to the urethra
Ejaculatory duct
Urethra parts of the males
Prostatic
Membranous
Penile
Male reproductive glands
Prostate
Seminal vesicles
Bulbourethral gland (cowpers)
Urethral glands
Where do primordial germ cells originate?
The yolk sac
Where do the primordial germ cells migrate to?
The testes seminiferous tubules
When do spermatogonia underdog mitosis?
They start beginning at puberty (average 13 years and continues throughout life)
Spermatogonia is stimulated by:
Pituitary gonadotropic hormones
The testis is filled with
Seminiferous tubules
Seminiferous tubules go into the:
Rete Testis (where the sperm will thrives through)
The Sperm will travel from the Rete testis to the:
Epididymis
Spermatogonia enlarge to become:
Primary spermatocytes
Primary spermatocytes undergo _____ to become______
Meiosis
Secondary spermatocytes
Secondary spermatocytes complete _______ to become _______
Meiosis II
Spermatids
Spermatids differentiate into:
Spermatozoa (mature sperm)
Process of spermatogenesis takes about _____ days
74
What stages of spermatogenesis will have only 1 chromosome ?
Spermatids and mature sperm cells
Reductional division (becomes haploid)
Separation of homologous pairs
Meiosis I
Equational division
Separation of sister chromatids
Meiosis II
What is the gender of offspring determined by?
Sperm upon fertilization of an egg
Meiosis phases
Interphase
Prophase I
Metaphase I
Anaphase I
Telophase I
Cytokinesis
Interkinesis
Prophase II
Metaphase II
Anaphase II
Telophase II
Cytokinesis
Review picture in slide 9
Slide 9
Male sperm contains a ___ chromosome
Female contains:
Y
X
Ooytes always have a(n) ___ chromosome
X
Transition between spermatid to mature sperm
Spermiogenesis
Review slide 11 picture
Slide 11
Sperm head contains:
Condensed nucleus
Thin cytoplasm
Acrosome
Acrosome is derived from:
It includes:
Golgi apparatus
Proteolytic enzymes hyluronidase
Central microtubule skeleton of the sperm (axoneme)
Tail (flagellum)
______ is in the proximal part of the sperms tail
Mitochondria
Contents of a sperm tail
Plasma membrane
Central microtubules
Radial spokes
Inner sheath
Nexin
doublet microtubule (A and B tubules)
Dynein arms
Hormones that regulate spermatogenesis
Testosterone
Luteinizing hormone (LH)
Follicle-stimulating hormone (FSH)
Estrogen
Growth hormone
Cells that secrete testosterone
Leydig cells
Testosterone is essential for what?
Growth and division of testicular germinal cells (first stage of spermatogenesis)
What secretes the Luteinizing hormone?
Anterior pituitary
The luteinizing hormone stimulates _____ ____ to:
Leydig cells
Secrete testosterone
FSH (follicle stimulating hormone) comes from:
Anterior pituitary
FSH stimulates ____ _____ for the process of:
Sertoli cells
Spermatogenesis
Sertoli cells produce small amounts of _____ from testosterone in response to:
Estrogen
FSH
probably required for spermatogenesis
Intermediate converting testosterone to estradiol (estrogen)
Aromatase and
-HCO2H
What is required for support of gonad metabolic function in general?
Growth hormone
Growth hormone promotes early:
Mitotic divisions of spermatogonia
What hormone stimulates the pituitary gland to secrete FSH and LH?
Gonadotropin-releasing hormone (GnRH)
Negative feedback for hypothalamus secreting GnRH
Testosterone and other androgens
Size of prostate
Size of a walnut
The prostate gland supplies about __% of volume to semen
30%
What does the prostate secrete?
Calcium Citrate Phosphate Clotting enzyme Fibrinolysin Alkaline pH
The seminal vesicle contributes to ___% of seminal fluid
60%
Seminal vesicle secretes:
Fructose
Citric acid
Prostaglandins
Fibrinogen
Prostaglandins react with:
They reverse:
Cervical mucus
Peristalsis of uterus and tube
Semen consists of:
Sperm + fluid from testes (10%)
Prostate fluid (30%)
Seminal vesicles (60%)
Small amounts of mucous from the bulbourethral glands
Semen alkalinity helps to keep sperm _____.
It is neutralized by:
Inactive
Femal repro tract
Purpose of clotting of the semen
Keeps semen together and sperm inactive until it dissolves (fibrinolysin) about 30 min after ejactulation
The process of transforming mature but inactive sperm to active sperm
Capacitation
Sperm cannot fertilize eggs until ____ occurs:
Capacitation
How long does capacitation take?
1-10 hours
Process of capacitation
Uterin and oviduct fluids wash away inhibitory factors
Cholesterol “bath” in semen is diluted, weakening the acrosome
Calcium influx which increases flagellum activity, and prepares sperm membrane for “acrosome reaction”.
What does the acrosome contain?
Hyaluronidase
Proteolytic enzymes
What does hyaluronidase do?
Depolymerizes hyaluronic acid in the intercellular matrix (holds corona radiata cells together)
What do proteolytic enzymes do?
Digests the zona pellucida
Review pictures in slide 24
Slide 24
At fertilization, the sperm contacts the :
What happens here?
Cell membrane of the oocyte
Membrane fusion happens- oocyte and sperm genetic material combine
The “cortisol reaction” of the oocyte releasing substances the harden the zona pellucida
Prevention of polyspermy
Review slide 25 picture
Slide 25
Types of male infertility
Bilateral orchitis
Excess temperature
Cryptorchidism
Sperm count
Sperm abnormalities
A side effect of mumps, causing permanent sterility
Bilateral orchitis
Excess temperature causes \_\_\_\_\_\_ of most cells of the \_\_\_\_\_\_ \_\_\_\_. This is (REVERSIBLE/IRREVERSIBLE)
Degeneration
Seminiferous tubules (not sperm, however)
Reversible
Failure of testes descent; tubular epithelium degenerates; surgical relocation may be necessary
Cryptochidism
Sperm count in infertile male
Below 20 million/ml
Neuronal stiumulus of the male sexual act
Sensory innervation of glans penis- via pudendal nerve
Psychological stimuli- sexual thoughts
NS of Penile erection
Parasympathetic- releases nitric oxide, VIP and Ach
For penile erection, _____ is produces to cause artery relaxation in the corpora cavernous a and spongiosum
cGMP
Bulbourethral glands
What release mucus secretions for lubrication- caused by parasympathetics
Emission and ejaculation is controlled by:
Sympathetic nervous system
Emission- contraction of:
Forms:
Vas deferens, prostate and seminal vesicles
Forms semen into the internal urethra
Ejaculation- contraction of:
Ischiocavernosus and bulbospongiosus muscles moves through the rest of the urethra
Androgens include:
Androstenedione
Testosterone (most abundant)
Dihydrotestosterone- (most active)
Androgen is synthesized from:
Cholesterol
Testosterone binds to:
Plasma proteins (albumin or sex hormone-binding globulin)
Testerosterone is converted to:
Where?
Dihydrotestosterone
In the tissues- especially prostate gland, seminal vesicles, epididymis, skin, hair follicles, liver and brain
In male fetal development, SRY gene on ____ chromosome is activated k
Y
SRY gene causes:
Genital ridge to develop into testes that secrete testosterone
In male fetus, testosterone begins to be secreted at what week?
7th week
Fetal development-
Testosterone stimulates development of:
Male parts at 7th week
Descent of the testes - 2-3 months gestation
Review slide 32 graph
Slide 32
Testosterone functions after puberty
Growth of external genitalia
2ndary sex characteristics - Body hair growth (though suppresses hair on head)
Voice- Larynx development
Skin thickens, increases secretions (acne)
Increases muscle protein
Testosterone is most often converted to _______ in the _____ of target cells
Dihydrotestosterone
Cytoplasm
Dihydrotestosterone binds to:
Androgen receptor
Dihydrotestosterone bound androgen receptor enters the ______ to induce:
Nucleus
Transcription of select genes (androgen-response elements)
Testosterone inhibits:
GnRH
LH
FSH
Inhibit from the _____ cells inhibits:
Sertoli
Anterior pituitary
LH and FSH are both secreted by ______ cells in the:
Gonodotrope
Adenohypophysis
Gonodotrophins are extremely dependant on _____ to trigger:
GnRH
LH and FSH
LH and FSH are both ________- they use:
Glycoproteins
cAMP second messenger system
How long are LH and FSH produced after puberty?
Throughout life- some spermatogenesis continues until death
What happens to males in late 50’s-60’s? Why is this?
Decline in sexual function
Mainly due to decreased testosterone secretion
Male climacteric is known as:
It may be treated with:
Decreased testosterone secretion
With exogenous androgens
Benign prostatic hypertrophy
Due to:
May cause
Abdnormal prostate growth- NOT increased testosterone
Urinary obstruction
percentage of male deaths from prostate cancer
2-3%
Prostate cancer is sensitive to:
Testosterone and estrogen
In the absence of testosterone , fetal sexual organs tend to form the:
Female pattern
Loss of testes before puberty
Eunichism
Eunichism pts continue to have:
Infantile sex organs and characteristics
Male castration after puberty
Secondary sex characteristics recede
Loss of some musculature and male hair pattern
Organs and voice don’t lose much of the normal male pattern
Leydig cell tumors - hypersecretion of _______
In children causes:
Testosterone
Acceleration of male characteristics, but increased closure of epiphyseal plates
Why isLeydig Cell tumor difficult to diagnose in adults?
Male characteristics are already present
Tumors of germinal epithelium can form:
Not usually associated with:
Multiple cell/tissue types “teratoma”
Hormone secretion, but if they do, it is most likely hCG (functions like LH)
Gynecomastia
ED is most often caused by:
Underlying vascular disease (uncontrolled hypertension, diabetes, atherosclerosis)
ED can also be due to:
Prostate surgery (damage to PNS neurons)
Deficient testosterone
Some drugs (nicotine, alcohol , antidepressants)
Female repro anatomy includes
Ovaries
Uterine tubes (ovaducts, Fallopian tubes)
Uterus
Vagina
Female hormones:
GnRH
FSH and LH
Estrogen and progesterone
Review picture in slide 45
Slide 45
Duration of female repro cycle:
28 days (though can range from 20-45 days)
How many ovum are usually released per month from an overly?
1
The uterine edometrium must prepare for what?
Potential implantation
Ovaries are inactive without what hormones
FSH and LH
What does the pituitary begin to secrete more FSH and LH?
Around age 9-12
Menarche (puberty) starts typically around:
11-15 years old- periods start here
target tissue of FSH and LH
Ovary
CAMP pathway
Protein Kinase -> enzyme phosphorylation
Phases of ovarian cycle
Follicular phase
Ovulation
Luteal
Uterine repro phases
Proliferation
Secretory
Menstrual
Day one of the uterine cycle technically starts at what phase?
Mentrual
Primordial follicle:
Provides:
Secretes:
Nourishment
Oocyte maturation-inhibiting Factor
What keeps the ovum in prophase 1 of meiosis?
Maturation-inhibiting factor
Prenatal follicle consists of:
Zona pellucida
What is in the middle of the primordial follicle
Egg cell
Primordial follicles enlarge into:
Primary follicles
What causes primary follicles to form
FSH and LH during puberty cause
Enlargement of the ovum
Granulosa cells to proliferate to form more layers
Oocyte is in what phase in primary follicles?
Prophase 1 (still)
Antral Follicles form when-
An increase in FSH accelerates growth of about 6-12 follicles (EACH MONTH)
Formation of the ____ ____ and ______ layers happen in the antral follicles
Theca interna
Externa
In antral follicles, _______ ____ containing ____ collects into an antrum
Follicular fluid
Estrogen
In antral follicles, estrogen increases _____ cells sensitivity to ____
Both increase sensitivity to ___
Granulosa
FSH
LH
Oocyte phase in antral follicles
Completes Meiosis 1 and arrests in metaphase II
Preovulatory follicle AKA
Mature / graffian follicle
Preovulatory follicle- usually how many follicles make it to maturity?
Only 1
What happens to the follicles that started the process of maturation but do not make it to preovulatory phase?
They undergo “involution” and become and atretic follicle
Preovulatory follicle properties (outside, in)
Corona radiata
Zona pellucida
Plasma membrane
First polar body
Cytoplasm
Nucleus
Ovulation happens on what day of repro cycle?
Usually day 14
What happens to the outer wall of the follicle at ovulation
It swells and protrudes (stigma)
Follicle ruptures, releasing the ovum and some granulosa cells (corona radiata)
Ovulation is triggered by a surge in:
LH
LH also converts granulosa cells and thecal cells into:
Progesterone secreting cells
Ovulation process from LH
LH -> Follicles produce progesterone -> collegenase weakens follicle wall -> prostaglandins cause follicle swelling -> follicle rupturesa releasing ovum
Remaining granulosa and thecal cells change into ____ _____ and make up the:
Lutein cells
Corpus luteum
Leutinization means “____”
Lutein cells gather _____ causing this.
Yellowizing
Lipids
3 stages Lutein cells go through
Enlargement (after ovulation)
Secretion (more progesterone than estrogen)
Involution (to form corpus Albicans)
What maintains the lutein cells in the secretory state?
LH
Involution of corpus luteum-
____ and ____ negatively feedback on pituitary
Levels of FAH and LH (RISE/DROP)
Lutein cells secrete ____
Estrogens and progesterone
Drop
Inhibin
What happens to corpus luteum without adequate FSH and LH?
It degenerates to form the corpus albicans
3 estrogens
Beta-estradiol
Estrone
Estriol
Many estrogens promote:
Secondary sex characteristics
Progestin
Progesterone
Hydroxyprogesterone
Progestins mainly prepare:
Uterus for pregnancy and breasts for lactation
What secretes estrogen- non-pregnant
Mostly ovaries, small amounts by adrenal vortices
What secretes estrogen when pregnant?
Placenta
What secretes progesterone when not pregnant ?
Corpus luteum of the ovary (during luteal phase)
What secretes progesterone when pregnant?
Placenta
Estrogens and progestins are transported in the blood bound to:
Albumin
Estrogen and progesterone binding proteins
_______ convertes estrogens and progestins to less potent forms, then excreted how?
Liver
In the bile or urine
Size of ovaries, oviducts, uterus and vagina after puberty :
Increases in size
Vaginal epithelium changes from ____ to _____ due to estrogen
Cuboidal
Stratified
Oviduct increases _______ in the epithelium due to estrogen
Cilia
Due to estrogen, what happens to external genitalia
Will also enlarge
Estrogen effects on breasts
Development of breast stromal tissue
Growth of ductal tissue
Fat deposition
The supportive framework of an organ (or gland or other structure), usually composed of connective tissue
Stroma
Estrogen effects on skeleton
Stimulates bone growth
Stimulates epiphyseal plate closure
Estrogen effect on metabolism
Increases fat deposition (breasts and subcutaneous tissue)
Estrogen effects on hair
Less potent than testosterone, but females do get hair in pubic an axillary areas
Progesterone effects in uterus
Promotes secretory changes in the uterine endometrium (latter half of uterine cycle)
Decreases uterine contractions (maintains pregnancy)
Increases oviduct secretions
Progesterone effects on breasts
Promotes glandular development (but not milk production)
Proliferation phase follows menstration where most of the endometrium is:
She’d
Epithelium is restored within ____-___ days from the beginning of menstruation followed by:
4-7
Thickening of the stroma underneath
What also grows in the proliferative phase?
Glands and blood vessels
By day 14, how thick is the endometrium ?
3-5 mm thick
phase after ovulation
Secretory phase (day 14)
Secretory phase, aka
Progesterone phase
Proliferative phase, aka
Estrogen phase
Secretory phase causes:
Swelling and secretory development of the endometrium “uterine milk”
In secretory phase, what happens to endometrium
It thickens some more due to the continues estrogen production
Phase if ovum is not fertilized
Menstruation
What happens in menstruation cycle?
Corpus luteum involutes and decreases estrogen and progesterone production
Involution and necrosis of the endometrium
Spasm of uterine blood vessels
Shedding
What organs secrete hormones for female hormonal cycle regulation?
Hypothalamus—- secretes GnRH
Anterior pituitary ——- LH and FSH
Ovarian follicles/corpus luteum—-
Secretes estrogen
Progesterone
Inhibin
What inhibits LH and FSH in small amounts, but paradoxically stimulates LH surge at high levels before ovulation?
Estrogen
What inhibits LH and FSH only in conjunction with estrogen?
Progesterone
What inhibits LH and FSH particularly at the end of the cycle?
Inhibin
Follicle stages during ovarian cycle
Follicle development
Ovulation
Corpus luteum formation
Mature corpus luteum
Corpus albicans
Endometrial changes during the uterine cycle
Menses- Destruction of functional zone
Proliferative- Repair and regeneration of functional zone
Secretory- Secretion by uterine glands
What secrets inhibin?
Granulosa cell
What does the theca cell secrete?
Androgens and progestins
What does the granulosa cell secrete?
Inhibin
Estrogens
Progestins
Cause of puberty
Gradual increase in gonadotropic hormone secretion
Puberty starts about ____ and ends with____
8
Menarche (11-16)
First menstrual cycle, AKA:
Menarche
Age of menopause
Between 40-50 years (on average)
What happens to ovulation during menopause?
It often fails to occur
About _____ primordial follicles make it to ovulation
400
Amount of follicles that degenerate
Hundreds of thousands
Primordial follicales by age 45
Only a few follicles remain. As this number approaches zero, there are fewer cells to produce estrogen
Symptoms of menopause
Hot flashes
Sensations of displeasure
Irritability
Fatigue
Anxiety
Decreased strength and bone calcification
____% of women feel symptoms of menopause severe enough to seek tx
15
Hormonal abnormalities in females
Hypogonadism (female eunichism)
Hypersecretion
In female hypogonadism, what happens?
Secondary sexual characteristics do not develop
Prolonged growth of long bones
If occurs in adult (ovary removal), 2ndary sex characteristics regress, uterus and vagina become smaller- similar changes from menopause
Factors that drive female sexual function
Psychological and physiological
Sensory signals from the _____ nerve involves in female sexual function
Pudendal
Pudendal nerve’s functions in female sexual function
Conscious sensation of sexual activity
Local reflexes (clitoris “erection”
Bartholin gland secretion- lubrication
Smooth muscle contraction in uterus and Fallopian tube)
Time of ovum viability
No longer than 24 hours following ovulation
Viability of sperm in female repro tract
Up to 5 days
Types of contraception
Rhythm method (estimate time of ovulation)
Hormonal suppression
Most effective method birth control
Implants
IUD
Female sterilization
Vasectomy
Very effective method birth control, but not most effective
Injectables
LAM (lactational amenorrhea)
Pills
Patch
Vaginal ring
Somewhat effective method birth control
Condoms
Diaphragm
Female condom
Fertility awareness methods
Least effective birth control methods
Spermicides
Most common female infertility
Ovulation failure due to abnormal hormonal pattern
Endometriosis
Endometrium-like tissue grows in the pelvic cavity surrounding the uterus, oviduct, and ovaries
Endometriosis leads to:
Fibrosis and ova from the ovary fail to find their way into the oviduct
Inflammation of the oviducts, often due to gonococcal infection
Salpingitis
What can salpingitis lead to?
Fibrosis
Causes of female infertility
Ovulation failure
Endometriosis
Salpingitis
Abnormal mucus production
Review slide 82
Slide 82
What part of the uterine tube surrounds the ovary
Fimbria
What creates a current to draw in ovum?
Cilia
% of ova that find their way into the oviduct
98
Fertilization usually occurs where?
In the ampulla of the oviduct
What aids in transport of sperm?
Uterine and oviduct smooth muscle contraction
In order for fertilization, sperm must penetrate the:
Corona radiata and Zona pellucida
Upon fertilization, the ovum undergoes ____ ____ ____ and expels :
Second meiotic division
Second polar body
After the second meiotic division of the ovum, what happens (after fertilization)
Fusion of the pronuclei
Genetic sex determination
How long does it take for a zygote to travel to the uterus?
5-7 days after ovulation, or 3-5 days after fertilization
What causes transport of the zygote?
Fluid current resulting from epithelium and secretions
Contractions of uterine tube
Progesterone from the corpus luteum relaxing tube smooth muscles in the isthmus allowing passage into the uterus
Embryo with about 100 cells is known as a:
Blastocyst
Trophoblast cells secrete _____ ____
They transport ________ to developing embryo
They proliferate to develop into _____
Proteolytic enzymes
Nutrients
Placenta
Placenta cells
Cytotrophoblast
Syncytiotrophoblast
What provides nutrition to the embryo in the oviduct
Secretory cells produce secretions that nourish the traveling embryo
What provides nutrition to the embryo in the uterus before implantation
“Uterine milk” from endometrial secretions
What provides nutrition to the embryo in the uterus after implantation
Decidual cells
Then placenta after 16 days
What causes decidual cells to be stimulated?
What happens to them when placenta takes over?
Simulated by progesterone (causes them to swell to store nutrients)
They are “digested” by invading trophoblast
Review pic in slide 92
Slide 92
What forms Collin containing embryonic circulation?
Cytotrophopblasts
Synchiotrophoblasts invades ____ _____ ____
This causes what to happen?
Maternal blood vessels
They bleed into cavities called lacuna (blood sinuses)
(T/F)- Maternal and embryonic blood directly mix
False
- exchange between mother and embryo blood is via diffusion
PO2 in mothers blood:
In fetal blood:
50 mm Hg
30 mm Hg
Which Hb has a higher affinity for O2?
Fetal Hb
Concentration is also greater
What does Bohr effect state?
As CO2 leaves fetal circulation, fetal Hb accepts more O2
Why does CO2 simply diffuse?
Because of its relatively high solubility
Glucose in the placenta uses ______ diffusion
Facilitated
Rate of glucose usage rivals that of the grown mother
What will diffuse with relative ease
Fats
Ketone bodies
Ions
What happens to wastes in the placenta
Ure, uric acid, creatinine diffuses toward maternal blood
The placenta is also an _____ gland
Endocrine
What hormones does the placenta release?
Human chorionic gonadotropin
Estrogens
Progesterone
Human chorionic somatomammotropin. (Aka human placental lactose)
What hormone is high in weeks 4-24 of pregnancy?
Human chorionic gonadotropin
Highest around week 12
When does estrogen and progesterone begin to peak during pregnancy?
Approx week 24
What secretes human chorionic gonadotropin? (HCG)
When?
Syncytiotrophoblast
Shortly after implantation
hCG prevents:
Involution of the corpus luteum- will continue to secrete hormones
Corpus luteum secretes :
Large amounts of estrogen and progesterone
Involution of corpus luteum prevention purpose
To prevent menstruation
Maintains “decidual” cells for nutrition
When does the corpus luteum involute?
Why?
After 13-17 weeks of gestation
The placenta makes enough estrogen and progesterone to maintain pregnancy
hCG in male fetuses help stimulate _____ ____ (of ____) to produce:
This is needed for:
Interstitial cells (of leydig)
Testosterone
Needed for male organ development and testes descent into the scrotu
What secretes placental estrogen?
Syncytiotrophoblast
Placental estrogen is _____ times that of normal
30
Placental estrogen is produces from:
DHEA from both mother’s and fetus’s adrenal glands
Function of placental estrogen:
Enlargement of:
Uterus
breasts and their ducts
External genitalia
Relaxes: Pelvic ligaments (SI and pubic symphysis)
Function of placental progesterone
Decidual cell formation (nutrition for embryo)
Decreases contractility of uterus
Increases oviduct secretion (nutrition)
Synergistic with estrogen for breast preparation for lactation
Human chorionic somatomammotropin (HCS) AKA
Human placental lactose
Rate of HCS secretion increases as:
Placenta enlarges
Potention purpose of HCS
May help with lactation similar to prolactin
Actions similar to GH; increasing protein synthesis
Decreases insulin sensitivity; makes more glucose available to the fetus
Anterior pituitary changes in pregnancy
Increases ACTH, T-SHIRT and prolactin
Decreases FSH and LH (due to inhibitory effects of estrogen and progesterone)
Adrenal cortex changes in pregnancy
Increased glucocorticoids and aldosterone
Mobilizes amino acids and causes sodium and fluid retention (increases blood pressure)
Thyroid changes in pregnancy
Produces more thyroxine
Parathyroid changes in pregnancy
Increases to release Ca+2
Hormone that may be used to soften cervix in humans during pregnancy
Relaxin
HCG maintains:
Corpus luteum
Placental progesterone maintains:
Uterine lining
Inhibits uterine contraction
Placental estrogen function
Maintains uterine lining
Stimulates mammary glands
Placental lactose function
Stimulates mammary glands
Supplies energy to fetus
Placental parathyroid hormone RP function
Increases blood CA+2
Placental relaxin function
Softens cervix and weakens pubic symphysis
Placental CRH function
Pressure, blood glucose, and stimulates partuition
Average weigh gain in pregnancy
25-35 lbs
Average weigh of: (lbs)
Fetus:
Amniotic fluid, placenta, and membranes:
Uterus
Breasts
Blood fluids
Fat
8
4
3
2
5
3-13
In pregnancy, basal metabolic rate (INCREASES/DECREASES) 15%, especially ___.
Increases
Late
Increase of basal metabolic rate in pregnancy is due to:
Increases hormone production
Common nutrition deficiency during pregnancy
Ca
Phosphates
Iron
Vitamins
Preeclampsia occurs in ____% of women
It causes a rise in:
A leakage of ____ into the _____
Causes _____ and ____ retention , and ____
15
Arterial blood pressure
Protein
Urine
Water
Salt
Edema
Progression of preeclampsia
Eclampsia
Symptoms of eclampsia
Systemic vascular spasm
Seizures and coma
Extreme hypertension
Decreases kidney output
may be fatal without treatment
increased uterine contractility
Parturition
What causes parturition
Increases ration of estrogens to progesterone during late pregnancy
And oxytocin
Weak slow intermittent contractions, “false” labor
Braxton hicks contractions
Difference between labor contractions and Braxton hicks
Labor contractions are stronger
Stretch the cervix
And provide positive feedback- stretch/oxytocin cycle
3 stages of labor
Cervical dilation (effacement) - 8-24 hours with first baby
Delivery of baby: 30 min or more with first baby
Placenta delivery: 10-45 min
During lactation, estrogen stimulates:
Mammary glands ductal system and fat deposition in puberty
High estrogen state in pregnancy develops breasts further
What hormone causes growth of breast lobules and alveoli in lactation
Progesterone
Prolactin promotes ____ ____ from:
Milk secretion
Anterior pituitary
HCS supports:
Prolactic production
What suppresses milk production?
Estrogen and progesterone
High during pregnancy and rapidly decreases after birth
Early milk
Colostrum
What does colostrum contain
Protein and lactose, but little fat
Hormones important for milk production?
GH
Cortisol
PTH
Insulin
Prolactin
Nursing stimulates ______ secretion
Prolactin
Nursing inhibits secretion of ____ _____ from hypothalamus
Gonadotropin-releasing hormone
Gonadotropin releasing hormone’s effect is to:
Suppress the reproductive cycle, and therefore decrease fertility
____ is released during suckling, causing ______ cells to move milk from the alveoli to the ducts
Oxytocin
Myopithelial
Review chart on slide 117
Slide 117
Fetal growth first 2-3 weeks after implantation
Embryo stays small
Hallmarked by placental development and growth
Fetal growth after 2-3 weeks
Embryo/fetal growth increases
Most weight is gained in the last trimester
Average newborn weight
7lbs
Healthy range: 4.5-11lbs
Energy source for fetus
Mainly glucose
Ossification of bones is most rapid when? (In fetus)
Last 4 weeks of gestation
Most iron is found in _____, which is formed when?
Hemoglobin
Beginning the 3rd week after fertilization
Iron utilization increases most rapidly when?
Durning the time of rapid fetal growth
Much iron in the fetus is stores where?
In the liver
Enough iron to last the neonate for several months
A coenzyme in the catabolism of sugars and amino acids
Thiamine (vitamin B1)
A precursor of cofactors FAD and FMN
Riboflavin (B2)
Review chart in slide 125
Won’t ask many questions, but good to review
Slide 125
What vitamins from vitamin B group are especially important in the fetus? Why?
Folate (vitamin B9) and vitamin B12
Important in general growth, RBC formation, nervous system development
Deficiency of folate and vitamin B12 can lead to:
Anemia
Low birth weigh
Intrauterine growth retardation
Other vitamins important for fetal development
Vitamin C, D, K
Vitamin needed for bone growth matrix and connective tissue growth
Vitamin C
Vitamin needed for skeletal growth (calcium hemeostasis)
Vitamin D
Vitamin used for prevention of perinatal hemorrhage
Vitamin K
Infants must store vitamin K in the liver where?
In the liver
They have no source of it after birth until the colon is colonized by bacteria
Post-natal breathing is likely stimulated by what?
Normal slight hypoxia and exposure to cooler environment at birth
What can excessive or prolonged hypoxia cause?
May suppress the brain and respiratory centers
Breathing effect may be suppressed by:
Anesthetic during delivery
Or head trauma or slow delivery
Sources of hypoxia
From umbilical cord compression,
Uterine ischemia due to contractions
Premature separation of the placenta
Anesthesia
When does the first breath usually occur?
In less than 1 minute after birth
Neonates can survive as long as _____ minutes without breathing after birth. However, closer to that time will more likely develop:
10
Brain damage
Adults can survive ___ minutes without breath
4
At birth, ____ are collapsed. Why?
Alveoli
Surface tension of the viscous fluid inside
What is required to oppose the effects with the first breath?
25 mm of negative inspiratory pressure
Subsequent breaths get easier as:
More alveoli open
When is surfactant secreted?
In the last 1-3 months of pregnancy
Pulmonary surfactant is deficient in:
Premature infants and babies born to diabetic mothers
Surfactant deficiency leads to:
Respiratory distress syndrome (hyaline membrane disease)
% of fetal blood that goes through the placenta
Approx 55%
45% goes everywhere else
% of fetal blood flows through the lungs
Approx 12
Post natal changes in blood flow
Placenta blood flow stops -> doubles the systemic vascular resistance -> increases aortic pressure and left heart pressure
Post natal lung changes
Expansion of the lungs
Causes decrease pulmonary vascular resistance (less compression of pulmonary vessels with inflated lungs)
Causes decreased pulmonary arterial pressure and right heart pressure
What closes the foramen ovale
Changes in heart pressure
The changes in pulmonary and aortic pressures start to reverse flow through _____ _____ (___ ___), leading to ____ ____ ____
Ductus arteriosus (more O2)
Smooth muscle contraction
What causes ductus vascular contraction?
Reduction of prostaglandin E2
Causes ductus arteriosus to close
When does the ductus venosus close?
After circulation stops in the umbilical vein
Where does the fetus derive all its glucose from?
From the mother
Neonates deplete glycogen in liver and muscle within _____. What is not developed well yet?
Hours
Liver gluconeogenesis
After blood glucose drops, what does the baby use until mother’s milk comes in? (2-4 days)
Stored fats
Baby weigh drops ___-___% within the first days of life. Most weight loss is due to:
5-10%
Fluid loss, rather than fat loss
Why are starches less adequately used in neonate?
Secretion of pancreatic amylase in the neonate is deficient
Why is cow’s milk not well tolerated in the neonate?
It is high in fats, and absorption in fats from the GI tract is lower
Neonate liver is not fully developed. This makes:
Blood sugar unstable and a bit low
Neonate is excellent in:
Synthesizing and storing proteins
Respiratory rate of neonate
40 breaths per min
Blood volume of neonate if cord is immediately cut
300 milliliters
Neonate cardiac output
500 ml/min
Arterial pressure increases from ___/__ to ___/__ writhing:
70/50
90/60
Adult pressure levels begin around adolescence
Bilirubin levels in neonate
They rise then return to normal after a few weeks as the liver gains function
Premature respiration
Vital capacity and functional residual capacity are especially small
Surfactant secretion is depressed or absent
GI phys in prematurity
Digestive and absorptive capacity is inadequate
Absorption of fat is so poor they musc have a low fat diet
Rickets can develop due to poor absorption of Ca+2
Other premature phys
Immaturity of liver (edema, bleeding tendency, poor intermediary metabolism)
Immaturity of kidneys (tend towards acidosis and fluid balance issues)
Immaturity of bone marrow (anemias and infections result)
Body temp regulation is poor (often needs incubator)
