Gynecology charts quiz one
How many hours before ovulation does the estrogen feedback become positive and initiates a burst of LH secretion which produces ovulation?
36-48 hours
How many hours does ovulation occur after LH peak and FSH secretion?
9 hours
What are the naturally ocurring estrogens?
Estradiol (most potent) Estrone (E1) Estriol (least potent)
What happens 36-48 hours before ovulation?
Estrogen feedback becomes positive and initiates burst of LH secretion
Low levels of *what* promote secretion of GnRH, FSH, and LH?
Estrogens and progesterone
FEMALE HORMONES PAGE 19 BOTTOM HALF
FEMALE HORMONES PAGE 19 BOTTOM HALF
Proliferative phase also referred to as the follicular phase, the proliferative phase is the part of the menstrual cycle during which follicles inside the ovaries develop and mature in preparation for ovulation. The levels of ________ increase in the bloodstream during the proliferative phase, stimulating the maturation of follicles.
FSH
~ In the follicular phase when estrogen rises it causes a negative feedback on what hormone? In this loop, FSH and LH were secreted to start the development of the follicle. These two hormones work together to start estrogen secretion. The estrogen has a negative feedback on FSH, which causes it to stop being secreted.
FSH
~ During *Ovulation* what happens?
First meiosis completed Collagen decomposed Oocye ovulate
During the early parts of the follicular phase, inhibin is low and FSH is modestly elevated which does what?
Fosters follicular growth
In the liver, estrogens are oxidized or converted to what?
Glucuronide and sulfate conjugates, appriciable amounts are secreted in the bile and reabsorbed in the bloodstream (enterhepatic circulation). There are at least 10 different metabolites of estradiol in human urine
~ When the sex hormone *Estrogen* increases it causes positive feedback to release what? This occurs with the increased amount of estrogen that is experienced at the midpoint in the cycle. This increased amount of estrogen causes a positive feedback to occur on the LH cells in the pituitary. LH secretion will rise, and ovulation occurs.
GnRh releases from pituitary causing LH and FSH to rise
~ When Estrogen and progesterone drop this causes what hormones to raise through negative feedback?
LH FSH
~ When estrogen and progesterone rises this causes what hormones to drop through negative feedback? This is another negative feedback. After ovulation, the follicle cells are transformed into the corpus luteum. The corpus luteum secretes *estrogen* and *progesterone*. This buildup of progesterone and estrogen further increases the formation of the endometrial lining. These hormones work together and send a second negative feedback to *inhibit the release* of FSH and LH. This causes the corpus luteum to deteriorate, slowing the production of estrogen and progesterone. *The drop in these hormones signals menstruation.*
LH FSH
~ Estrogen peaks (>200pg/ml) causes what?
LH and FSH secretion will peak, and ovulation occurs.
A moderate constant level of circulating estrogen exerts what kind of feedback?
Negative feedback effect on LH secretion
What is the primary source of estrogen?
Ovaries; also synthesized in testicles, adrenal glands, and placenta.
PAGE 13 CHART HYPOTHALAMUS - PITUITARY OVARY (H-P-O) AXIS
PAGE 13 CHART HYPOTHALAMUS - PITUITARY OVARY (H-P-O) AXIS
PAGE 14 HYPOTHALAMIC PITUITARY OVARIAN AXIS AND HORMONE FEEDBACK HER NOTES
PAGE 14 HYPOTHALAMIC PITUITARY OVARIAN AXIS AND HORMONE FEEDBACK HER NOTES
PAGE 15 CHARTS NOT FROM BOOK FROM GOOGLE
PAGE 15 CHARTS NOT FROM BOOK FROM GOOGLE
PAGE 18 HER NOTES MENSTRUAL CYCLE and http://medcell.med.yale.edu/histology/ovary_follicle.php
PAGE 18 HER NOTES MENSTRUAL CYCLE and http://medcell.med.yale.edu/histology/ovary_follicle.php
PAGE 19 THE ENDOMETRIAL CYCLE
PAGE 19 THE ENDOMETRIAL CYCLE
An elevated estrogen level exert a exerts what kind of feedback?
Positive feedback and stimulates LH secretion
Large doses of *what* potentiate the inhibitory effects of estrogen preventing ovulation?
Progesterone inhibin LH secretion
~ When there is a raise in progesterone the *Vaginal mucosa* does what?
Secretions go down
~ When endocervical glands have a raise in progesterone what happens to the mucus?
Thick, opaque, tenacious
~ When there is a raise in estrogen the *Vaginal mucosa* does what?
Thickening and secretory changes
~ When endocervical glands have a raise in estrogen what happens to the mucus?
Thin, clear, watery --> maximal ovulation
What percent of circulating estradiol is free?
Two - the remainder is bound to protein 60% to albumin 38% to the same gonadal steroid-binding globulin (GBG) that binds testosterone
*Late Primary Follicle* The late primary follicle stage is reached when the follicular cells proliferate into a stratified epithelium known as the *what*. The zona pellucida enlarges and can be seen even more clearly in this image.
zona granulosa
*Early Primary Follicle* At the start of each menstrual cycle a limited number of primordial follicles are triggered to develop. The first apparent histological stage is the early primary follicle that consists of a central oocyte surrounded by a single layer of follicular cells which have become cuboidal. The *what* is a thin band of glycoproteins that separates the oocyte and follicular cells. Proteins on the surface of sperm will bind to specific glycoproteins in the zona pellucida.
zona pellucida
~What is primordial follicle?
*Before meiosis*
~During the *preantral* or *secondary follicle* stage what develops?
*Zona Pellucida* *Granulosa cells* (FSH receptor)
~ The antral follicle can be seen in the?
granulosa cell layer (LH receptor), E raises
~ Estrogen rises causing mitogen (a chemical substance that encourages a cell to commence cell division, triggering mitosis) which leads to stroma (the stroma of the ovary is a peculiar soft tissue, abundantly supplied with blood vessels, consisting for the most part of spindle-shaped cells with a small amount of ordinary connective tissue) becomming __________ which leads to the __________ ____________ (Day 1-13 in the protypical menstrual cycle of 28 days.) and a __________ _________ (________ - ________)
elongated proliferative endometrium Thickened endometrium (0.5 mm to 5 mm)
After ovulation, the follicle collapses, and the luteal stage of the menstrual cycle begins. Blood vessels and yellow lipo- chrome-bearing cells from the theca layer invade the granulose cells. A rapid accumulation of blood and fluid forms a mass called the corpus luteum. Leakage of this blood onto the peritoneal sur- face that surrounds the ovary is thought to contribute to the mittel- schmerz ("middle [or intermenstrual] pain") of ovulation.1 During the luteal stage, progesterone is secreted from the corpus luteum. If fertilization does not take place, the corpus luteum atrophies and is replaced by white scar tissue called the corpus albicans. At this point, the hormonal support of the endometrium is withdrawn and menstruation occurs. In the event of fertilization, the tropho- blastic cells in the blastocyst produce a hormone called human chorionic gonadotropin. This hormone prevents luteal regression. The corpus luteum remains functional for 7 to 10 weeks and pro- vides hormonal support for pregnancy until the placenta is fully functional.19 Figure 53.7B shows the hormonal changes that occur during the development of the ovarian follicle and ovulation.
end page 1374
*Secondary Follicle* The characteristic feature that distinguishes secondary from primary follicles is the appearance of a *_________ ________* within the __________ layer. The antrum contains fluid which is rich in hyaluronan and proteoglycans. Note the increase in cell layers of the zone granulosa, the thicker zone pellucida, and larger oocyte. At this stage, a layer of cells outside the follicle become evident. These cells compose the _______ ________ and contribute to the production of __________.
follicular antrum granulosa theca interna estrogens
*Graafian Follicle* The Graafian follicle is the stage after the first meiotic division has completed but before ovulation. The oocyte is now a 2N haploid. The follicle is characterized by a *_________ follicular _________* that makes up most of the follicle. The secondary oocyte, having undergone the first meiotic division, is located eccentrically. It is surrounded by the *_________ _________* and a layer of several cells known as the *_________ _________*. When released from the Graafian follicle and into the oviduct, the ovum will consist of three structures: *_________*, *_________ _________* and *corona _________*.
large follicular antrum zona pellucida corona radiata *oocyte*, *zona pellucida* and *corona radiata*.
~ The storma (a layer of connective tissue that varies in thickness according to hormonal influences) becomes ________ and edematous blood vessels entering the endometrium become ________ and ___________. Glands become tortuous and contain secretory material within the _________. Duration: ____ _____ Thickness: __-___
loose thickened and twisted lumina 2 weeks 5-6 mm
Estrogens are necessary for normal female physical mat- uration. In concert with other hormones, estrogens provide for the reproductive processes of ovulation, implantation of the products of conception, pregnancy, parturition, and lactation by stimulating the development and maintaining the growth of the accessory organs. In the absence of androgens, estrogens stimulate the intrauterine development of the vagina, uterus, and uterine tubes from the embryonic Müllerian system. They also stimulate the stromal development and ductal growth of the breasts at puberty, are responsible for the accelerated pubertal skeletal growth phase and for closure of the epiphy- ses of the long bones, contribute to the growth of axillary and pubic hair, and alter the distribution of body fat to produce the typical female body contours, including the accumula- tion of body fat around the hips and breasts. Larger quantities of estrogen stimulate pigmentation of the skin in the nipple, areolar, and genital regions.
page 1372 start
Endometrial Changes The endometrium consists of two distinct layers, or zones, that are responsive to hormonal stimulation: a basal layer and a func- tional layer.1 The basal layer lies adjacent to the myometrium and is not sloughed during menstruation. The functional layer arises from the basal layer and undergoes proliferative changes and menstrual sloughing. It can be subdivided into two compo- nents: a thin, superficial, compact layer and a deeper spongiosa layer that makes up most of the secretory and fully developed endometrium.1 The endometrial cycle can be divided into three phases: the proliferative, or preovulatory, phase, during which the glands and stroma of the superficial layer grow rapidly under the influence of estrogen; the secretory, or postovulatory, phase, during which progesterone produces glandular dilation and active mucus secretion and the endometrium becomes highly vascular and edematous; and the menstrual phase, during which the superficial layer degenerates and sloughs off (see Fig. 53.5).
page 1375
An ovarian follicle progresses through several distinct phases before it releases its ovum. During the first five months of development, a finite number of *what* form in the fetal ovary. These follicles consist of oocytes surrounded by a single layer of squamous follicular cells. These primordial follicles remain in the process of the first meiotic division. At puberty, they begin to develop further and become primary follicles.
primordial follicles
~ During the secretory or luteinizing phase (14th to 28th day) the endometrium differentiates itself due to the influence of ___________ (from the corpus luteum) and attains its full maturity. The glands and arteries begin to entwine. The connective tissue stroma becomes the place of edematous changes. *When the ____________ (differentiation) rises this phase can be called the _________ _________*
progesterone progesterone secretory endometrium
The hormonal control of the menstrual cycle is com- plex. For example, the biosynthesis of estrogens that occurs in adipose tissue may be a significant source of the hormone. There is evidence that a woman must have a minimum body weight and fat content in order for menarche to occur and for the menstrual cycle to be maintained. This is supported by the observation of amenorrhea in women with anorexia nervosa, chronic disease, and malnutrition and in those who are long-distance runners.8 In women with anorexia ner- vosa, gonadotropin and estradiol secretion, including LH release and responsiveness to the hypothalamic gonadotropin- releasing hormone (GnRH), can revert to prepubertal levels. With resumption of weight gain and attainment of sufficient body mass, the normal hormonal pattern is usually reinstated. Obesity or significant weight gain is also associated with oligomenorrhea or amenorrhea and infertility, although the mechanism is not well understood.
read but dont make extra page 1370 - 1371
The endometrium consists of a single layer of columnar epithelium plus the *________* on which it rests. The stroma is a layer of connective tissue that varies in thickness according to hormonal influences. Simple tubular uterine glands reach from the endometrial surface through to the base of the stroma, which also carries a rich blood supply of spiral arteries. In a woman of reproductive age, two layers of endometrium can be distinguished. These two layers occur only in endometrium lining the cavity of the uterus, not in the lining of the uterine (Fallopian) tubes:[1][2] The functional layer is adjacent to the uterine cavity. This layer is built up after the end of menstruation during the first part of the previous menstrual cycle. Proliferation is induced by estrogen (follicular phase of menstrual cycle), and later changes in this layer are engendered by progesterone from the corpus luteum (luteal phase). It is adapted to provide an optimum environment for the implantation and growth of the embryo. This layer is completely shed during menstruation. The basal layer, adjacent to the myometrium and below the functional layer, is not shed at any time during the menstrual cycle, and from it the functional layer develops.
storma
~The development and maturation of follicle has different stages what are they?
~*Primordial follicle: before meiosis *Preantral follicle: zona pellucida, granulosa cells (FSH receptor) *Antral follicle: granulosa cells (LH receptor), *E rises* *Mature follicle: Estrogen and progesterone rise ~Theca externa, theca interna, granulosa, follicular antrum, mound, radiate control ~ Follicular phase: day 1 to follicle mature (14 days)
