Yan Flashcards
(140 cards)
1
Q
T/F Morning erections for males is a bad sign of health.
A
False. It is a good sign of health, cardiovascular health. Also, semen quality is indicative of general health.
2
Q
Erectile Dysfunction is indicative of which 2 problems?
A
aging
heart problems
3
Q
What happens to the amount of viable follicles as a woman ages?
A
They decrease! The atretic follicles increase with age. Growing & ovulating follicles are greatest for a fertile woman.
4
Q
Which hormones are involved in the female reproductive system?
A
GnRH FSH LH Estrogen Progesterone
5
Q
What does FSH do to the female reproductive system?
A
- stimulates development of secondary follicles
- stimulates granulosa cells to convert androgen to estrogen
- causes LH receptors on granulosa cells
6
Q
What does LH do to the female reproductive system?
A
- stimulates ovulation
- triggers primary oocyte to complete Meiosis I & move it into Meiosis II
- transforms remaining granulosa cells & theca interna cells into granulosa lutein cells & theca lutein cells.
7
Q
What does estrogen do to the female reproductive system?
A
**maintains female reproductive system, secondary sexual characteristics of females, rebuilding the uterus during the proliferative phase
**induces LH surge
**causes inhibition of FSH
Note: granulosa cells secrete inhibin, follistatin, & activin
8
Q
What does progesterone do to the female reproductive system?
A
- *inhibits LH production
- *converts from proliferative phase to secretory phase (perfect for implantation)
- *maintains secretory phase during pregnancy
9
Q
What is the ovarian cycle? What is the average length? What is the range of length?
A
menstrual cycle, one ovum released, endometrium prepared for implantation
- *28 days–>average
- *20-45 days
10
Q
What is menarche?
A
the first menstrual period
11
Q
When does the normal sexual cycle begin? What hormonal changes accompany it?
A
age 11-15 years
Pituitary secretion of FSH & LH starts increasing…
12
Q
What types of follicles are present in a person’s childhood?
A
primordial follicles
13
Q
What does FSH & LH do to follicles?
A
causes follicular growth during puberty…
14
Q
How many follicles are recruited each month for ovulation?
A
6-12 primordial follicles recruited
15
Q
Describe the progression of follicles from primordial to ovulation.
A
Primordial Follicles Primary Follicles Secondary Follicles (pre-antral) Antral Follicles Preovulatory (Graafian) follicles Ovulation
16
Q
In primary & secondary follicles–>what types of receptors are present? In Graafian follicles–>what types of receptors are present?
A
Primary & Secondary Follicles: FSH receptors
Graafian Follicles: FSH & LH receptors
**LH receptors make luteinization possible.
17
Q
LH causes theca interna cells to make androstendione. This diffuses into follicular cells. Under stimulation of ____ it produces ______.
A
FSH stimulation
Estrogen
18
Q
At what point in follicular development do the follicular cells make estradiol under FSH stimulation?
A
as primary follicles
19
Q
At what point in follicular development do the follicular cells gain LH receptors?
A
as Graafian follicles
20
Q
What causes luteolysis?
A
regression of the corpus lutuem is caused when the FSH & LH release tapers off…this begins 7 days after ovulation if there is no pregnancy…
21
Q
Which hormones lessen after luteolysis? Which increase?
A
Decrease: Progesterone, Estrogen, Inhibin
Increase: FSH
22
Q
T/F Estrogen & Progesterone stimulate the secretion of FSH & LH.
A
False, they inhibit FSH & LH release.
23
Q
2 hormones cause LH receptors to develop on granulosa cells. Which hormones? Then, the LH receptors allow LH to stimulate follicular cells to make what?
A
Estrogen & FSH cause LH receptors to go on follicular/granulosa cells. Then w/ LH stimulation, they make progesterone.
24
Q
What is required to have FSH receptors on granulosa cells?
A
Estrogen
25
What is required to have LH receptors on granulosa cells?
FSH
| Estrogen
26
What is required for rapid growth of follicles?
FSH
estrogen
LH
27
The surge of LH peaks how many hours before ovulation?
16 hours before ovulation
28
Aside from LH, what other hormone coincidentally increases?
FSH also increases
| doesn't induce ovulation
29
LH surge converts granulosa cells & theca interna cells to become -____ secreting.
Progesterone secreting
30
Estrogen levels decrease how long before ovulation?
1 day before ovulation
31
What are the 3 things that make a good environment for ovulation?
Rapid growth of follicles
progesterone secretion
decreased estrogen secretion
32
What folds soon after ovulation forming the corpus luteum?
follicular cell layer
33
Describe what happens during ovulation @ the stigma w/ a surge of LH.
Surge of LH
Increased Progesterone
Fibroblasts release proteases & lysosomes of theca externa release proteases
& more blood vessels in theca interna & prostaglandin secretion
Break down Stigma & Collagen fibers of tunica albuginea & theca externa degradation starts & plasma gets into follicle...
Follicle Swelling
Follicle Rupture
Evagination of Ovum
34
Describe the corpus luteum.
Folded Follicular cell layer. Now, considered granulosa lutein cells (larger w/ lipid droplets).
B/w the folds are theca lutein cells (larger w/ lipid droplets) & blood vessels & CT.
35
Why can blood vessels now occupy the antral space?
b/c the basement membrane was degraded & the blood vessels from the theca interna layer invaded.
36
What originally occupied the antrum that has now become CT? Which cells reside here?
Fibrin-->CT
| fibroblasts are here laying down CT.
37
Describe in ridiculous detail the corpus luteum.
Follicular cell layer folds & becomes granulosa lutein cells. These cells enlarge & hold lipid droplets.
Spaces are between these folds.
**Here, there are theca lutein cells. They also enlarge & store lipids.
**Here, there are also blood vessels (b/c basement membrane broke down& now blood vessels from theca interna can invade)
**Antrum is filled w/ fibrinbecomes CT. There are fibroblasts making it.
38
Prior to ovulation, why does an LH surge necessarily cause an increase in progesterone?
b/c LH receptors on follicular cells allow for progesterone production.
39
What does LH do to the corpus luteum?
theca lutein cells cause release of progesterone & androstenedione
40
What does FSH do to the corpus luteum?
granulosa lutein cells produce progesterone & estradiol (from androstenedione & aromatization)
41
What does estrogen do to granulosa lutein cells?
causes more progesterone synthesis via cholesterol uptake from blood & lipid storage
42
Which 2 hormones increase during pregnancy? What does that do to estrogen?
Prolactin & placental lactogens
| **increases effects of estrogen by increasing estrogen receptors...
43
When does the corpus albicans form if not pregnant? How about if you are pregnant?
Corpus luteum stops after 12 days if not pregnant, then corpus albicans
Corpus luteum stops after 2-4 months of pregnancy, then probably corpus albicans.
44
During the luteal phase of the ovarian cycle, what causes FSH & LH to decrease?
Inhibin (from lutein cells) -->FSH decreases
| Estrogen & Progesterone -->FSH & LH decreases
45
T/F Estrogen & progesterone decrease at end of luteal phase-->FSH & LH start to increase.
True. With the increase of FSH & LH can start follicular phase again.
46
If you are not pregnant, where does most of your estrogen come from?
ovary (follicular cells)
| small amount from adrenal cortex
47
If you are pregnant, where does most of your estrogen come from?
placenta
48
What are the 3 types of estrogen? List them from most potent to least potent.
Most potent: beta-estradiol
Estrone
Least Potent: Estriol
49
Where does beta-estradiol come from?
ovaries
50
Where does estrone come from?
peripheral tissues (adrenal & ovarian androgens)
51
Where does estriol come from?
derived from estradiol & estrone in the liver
52
Where do your progestins come from when you are NOT pregnant?
from corpus luteum during the luteal phase
53
Where do your progestins come from when you are pregnant?
from the placenta
54
What are the 2 types of progestin? Which one is the most abundant?
Progesterone (most abundant).
| 17-α-hydroxyprogesterone (less abundant).
55
On a basic level, where do progestins & estrogens come from?
made from cholesterol from the blood in the ovaries.
56
During the follicular phase: where does estrogen & progesterone come from?
Progesterone-->theca interna cells
| Estrogen--> follicular cells (made from andrestendione from theca interna cells)
57
During the follicular phase: where does estrogen & progesterone come from?
Progesterone-->Follicular Lutein cells & theca lutein cells
| Estrogen--> granulosa lutein cells (from andrastenedione from theca lutein cells)
58
Describe estrogen degradation in the liver.
it conjugates w/ stuff in the liver to form: glucuronnides & sulfates
This is excreted via bile & urine
59
Describe progesterone degradation in the liver.
it happens w/i a few minutes...
| the major degradation product-->pregnanediol.
60
What is hyperestrinism?
diminished liver function-->increased estrogen activity.
61
What does estrogen do in the female to the internal & external sex organs?
Internal: increases size of ovaries, uterine tubes, uterus
External: increases size of vagina, fat deposition in mons pubis, labia majora, labia minor
62
What does estrogen do to the vaginal epithelium?
It changes the epithelium from cuboidal to stratified squamous.
63
Aside from changing the epithelium of the vagina, what else does estrogen do to it?
It makes it more resistant to trauma & infection.
64
What is the effect of estrogen on the uterus?
It increases its size 2-3 fold.
Helps with the development of endometrial glands.
Helps w/ proliferation of endometrial stroma.
65
What does estrogen do to the uterine tubes?
It increases their size.
It causes proliferation of their epithelium.
It increases the number of ciliated epithelial cells.
It increases the cilia activity.
66
What is the effect of estrogen on the breasts?
initiates the growth of breasts & the milk-producing apparatus...
it develops the stromal tissues
it grows an extensive ductile system
it deposits fats in the breast
67
For continued breast growth & development, what other hormones do you need?
Progesterone
| Prolactin
68
What is the effect of estrogen on the skeleton?
stimulates bone growth @ puberty
unites epiphyses of shafts of long bones
**if estrogen is greater than testosterone-->stop growing.
**if estrogen levels are low-->females tend to be taller.
69
After menopause, estrogen levels drop in women, & they often get osteoporosis. Describe why.
increased osteoclast activity
decreased bone matrix.
decreased deposition of calcium & phosphate
70
Describe other effects of estrogen in the body.
```
increase in protein deposition
increase in metabolic rate
increase in fat deposition in buttocks & thighs
specific hair distribution
soft, smooth, vascular skin
```
71
What is the effect of estrogen on electrolyte imbalance in pregnant women?
retention of sodium & water in the kidney tubules
72
What is the effect of progesterone on the uterus?
causes uterine endometrium to be secretory during 2nd half of ovarian cycle.
helps w/ implantation of ovum in the uterus, prevents expulsion
decreases frequency & intensity of uterine contractions
73
What does progesterone do to uterine tubes?
promotes secretion from peg cells-->nutrition for the ovum.
74
What is the effect of progesterone on the breasts?
helps develop lobules & alveoli, proliferation & enlargement of alveolar cells
75
T/F Progesterone alone can stimulate milk production in the breast.
FALSE-->totally need prolactin for milk production.
76
Describe what happens in the proliferative phase.
this phase is under the influence of estrogens
this is after menstruation, before ovulation
stromal & epithelial cells proliferate rapidly
4-7 days after menstruation: re-epithelialization is complete
next 1.5 weeks: stromal cells increase, epithelial glands increase, new blood vessels grow, thickness of endometrium increases
77
At the end of the proliferative phase, what is the average thickness of the endometrium?
3-5mm
78
When is the endometrium most thick? What is its average thickness @ this point?
peaks @ 1 week after ovulation-->5-6 mm
79
Describe what happens in the secretory phase.
this phase is under the influence of estrogens & progesterone
this is after ovulation & before menstruation
Estrogen causes more cellular proliferation
Progesterone-->swelling & secretory development of endometrium
80
Describe in detail what happens to the endometrium during the secretory phase.
glands become curvy.
a bunch of secretory substances in the glandular epithelial cells
stromal cell cytoplasm increases
blood supply increases
81
Why does the stromal cell cytoplasm increase during the secretory phase?
increases w/ the deposition of glycogen & lipids.
82
Why is it important to have a highly secretory endometrium?
provides a large amount of stored nutrients for the fertilized ovum when it enters the uterus & implants
83
Around which days does the fertilized ovum enter the uterus? Around which days does the fertilized ovum implant?
Enter uterus: 3-4 days after ovulation
| Implants: 7-9 days after ovulation
84
How does a secretory endometrium help w/ implantation?
trophoblast cells digest nutrients to provide to the early implanting embryo
85
Which layer of the endometrium is affected by changes in blood levels of progesterone & estrogen? Which layer isn't?
Functional layer: is affected by these hormonal changes
| Basal layer: isn't affected by hormonal changes
86
What types of arteries supply the functional layer of the endometrium? Which types of arteries supply the basal layer of the endometrium?
functional layer: spiral arteries
| basal layer: basal straight arteries
87
In the follicular phase, which cells produce progesterone?
theca interna cells
88
Menstruation only happens when there is no______. At this point something degenerates...what? 2 hormones are reduced--which ones?
no fertilization
corpus luteum degenerates
estrogen & progesterone are reduced
89
As the corpus luteum regresses...what happens?
rapid involution of the endometrium
| vasospasm of blood vessels--prostaglandin release
90
T/F FSH & estrogen causes LH receptors to increase on secondary follicles/Graafian follicles.
TRUE
91
Describe menstruation in detail.
Necrosis of endometrium & its blood vessels.
hemorrhage 2-2.5 days
Necrotic layers separates from the uterus.
2 days into menstruation-->superficial layers are desquamated
Uterine contraction
75 mL fluid lost
92
How much fluid is lost in menstruation-->how much of this blood? What about the other portion?
75 mL fluid lost
40 mL of blood
35 mL of serous fluid
93
What causes hypoxia of the functional layer preceding menstruation?
a reduction in progesterone causes periodic contractions of the spiral artery
this causes hypoxia
94
Describe the release of GnRH. What does this do to FSH?
It is pulsatile. Released for 5-25 minutes every 1-2 hours. This causes the pulsatile release of FSH every 1.5 hours.
95
Where is GnRH released from?
mediobasal hypothalamus
| specifically: arcuate nuclei
96
What is the regulatory effect of estrogen by itself?
It inhibits FSH & LH release.
97
What is the regulatory effect of progesterone by itself?
It doesn't have much of an effect by itself.
98
What is the regulatory effect of progesterone & estrogen together?
Strong inhibition of FSH & LH on the pituitary & hypothalamic levels...
99
What is inhibin released from? What does it do for regulation?
granulosa cells
| inhibits release of FSH & LH
100
Describe FSH & LH levels during the first half of the ovarian cycle.
They are both at first suppressed. Then they rapidly increase at the end, LH moreso than FSH.
101
What happens if you don't have an LH surge?
No ovulation. Anovulatory cycle.
corpus luteum doesn't develop & you don't get major progesterone production
cycle is a few days shorter
102
When are anovulatory cycles most common in a woman?
the first few cycles after puberty
| the cycles about a year after menopause
103
How can you have a cycle w/o progesterone production?
Progesterone controls the rhythm of things, but is not necessary to have a cycle.
104
What is the period of the reign of FSH? What does it do?
helps w/ follicular development during the first half of the cycle...
causes granulosa cells to make estradiol
105
What is the period of the reign of LH? What does it do?
during the first half of the cycle when there is a mature follicle, during ovulation, & the luteal phase...not once the corpus luteum is dying
106
When does estrogen have its reign? By itself?
once the follicles are more mature
| during the proliferative phase
107
When does estrogen & progesterone together have their reign?
once you have a corpus luteum, even when it is dying...
| secretory phase
108
Describe GnRH release before puberty & after puberty?
Before puberty: there are suppressive factors in the brain that stop GnRH secretion
After puberty: gradual increase in GnRH release, pulsatile.
109
Describe what happens to the ovaries & hormone levels in menopause.
ovarian "burning out"
after age 45, only a few follicles remain to respond to FSH & LH levels
Estrogen decreases
FSH & LH levels rise dramatically.
110
Before age 45, how many follicles are maturing & ovulating?
400
111
What is the menopausal syndrome? What causes it?
```
Lack of estrogen causes the symptoms of the menopausal syndrome.
Hot flashes
shortness of breath
Irritability
Fatigue
Anxiety
Decreased bone strength, calcification
```
112
Describe the cause of hyper secretion of estrogen by the ovaries.
can be associated w/ a granulosa cell tumor
| inhibin deficiency
113
What does it mean to be a eunuch?
absence of testes/gonads
| lack of sexual function & secondary male characteristics
114
What is female eunuchism?
ovaries absent at birth
or the ovaries becomes nonfunctional before puberty
**no secondary sexual characteristics
*sex organs infantile
*taller: more growth of long bones & delayed epiphyseal fusion
115
What happens to a woman if she is fully developed & her ovaries are removed?
sex organs regress
| similar things happen as happen to a woman in menopause
116
Which hormone is totally vital for a normal cycle?
estrogen
117
What are the effects of hypogonadism on a female?
irregularity of menses & sometimes amenorrhea.
118
What are the 2 things that stimulate the female sexual act?
psychic stimulation
| local stimulation
119
What causes female erection & lubrication?
parasympathetic signals
120
Describe erection of the clitoris.
similar to penile erection
121
Describe lubrication in the female.
Vaginal epithelium secreted mucus
| Mainly: Bartholin's glands under the labia minora secrete mucus.
122
The female orgasm is analogous to what in the male?
emission & ejaculation
123
Why is female orgasm important for fertilization?
perineal muscles contract rhythmically (spinal cord reflex)
uterus & fallopian tube motility increases
cervical canal dilated for 30 minutes (easy sperm passage)
oxytocin secretion (contraction of the uterus)
**all these things helps w/ sperm transport
124
When is a woman most fertile?
up to 24 hours after ovulation
125
How long can sperm survive in a woman?
4-5 days
| **if you have sex 4-5 days after ovulation could still be pregnant
126
Describe the rhythm method of contraception.
you avoid intercourse b/w 4-5 days before calculated day of ovulation, & 3 days after ovulation.
**only works if you have regular periodicity of menstrual cycle
127
How many days b/w ovulation & menstruation?
13-15 days
128
If you have a 28 day cycle...when will ovulation occur?
w/i 1 day of day 14 usually
129
If you have a 40 day cycle...when will ovulation occur?
w/i 1 day of the 26th day of the cycle usually...
130
How do hormonal contraceptive pills work?
maintain estrogen & progesterone levels in the first half of the cycle so that there is no LH surge & no ovulation.
taken in early stage of cycle
stop taking pills to allow for menstruation
131
Why are synthetic estrogen & progestin used in hormonal contraceptive pills?
b/c they can then avoid liver degradation.
132
What percentage of couples experience infertility? In those couples, what percentage of them experience this b/c of a female issue? What are the 3 general causes
```
15% of couples
50% of the time-->females
**could be:
endocrine
structural
genetic
```
133
Describe which types of genetic abnormalities that can cause female infertility.
mutations in genes essential for follicular genesis
134
When you get multiple ovulations, what are you at risk for?
multiple births
135
What kind of an endocrine abnormality can lead to anovulation?
hyposecretion of gonadotropins-->not enough to induce ovulation
136
What are 2 ways to test for endocrine anovulation?
urine pregnanediol levels
| body temperature raises 0.5 degrees F w/ progesterone.
137
What is the treatment for endocrine anovulation?
hCG
138
What are 4 structural abnormalities that could explain anovulation?
Ovarian anatomic abnormalities
Endometriosis
Salpingitis
abnormal secretion of mucus by the uterine cervix.
139
What is salpingitis?
inflammation of the fallopian tubes
140
What is endometriosis?
* *the endometrial tissues (in the uterine tubes too) grow into the pelvic cavity
* *this tissue menstruates into the pelvic cavity, causes fibrosis in the pelvis
* *obstructs ovulation & capture @ the fimbrae
