The Menstrual cycle

Which ovarian phase begins on day 1 and lasts until day 14, thus ending with ovulation.

The follicular phase

Day 14

This ultrasound image indicates a graafian follicle around day _____ in the menstrual cycle.

Pelvic inflammatory disease (PID):

an infection of the female genital tract that may involve the ovaries, uterus, and/or the fallopian tubes

During the luteal phase, cells in lining of ruptured ovarian follicle begin to multiply and create the __________ ______________, or yellow body.

corpus luteum

9 to 11 days after ovulation, the ________ _______ degenerates, causing progesterone levels to decline

corpus luteum.

The hypothalamus releases its own hormone called the ___________________ _________________ ________________, which in turn stimulates the release of hormones by the anterior pituitary gland.

gonadotropin-releasing hormone (GnRH)

The one follicle chosen every month for ovulation is called the ________________ ________________ which moves toward the outer wall of the ovary for ovulation.

graafian (dominant) follicle

The graafian follicle, contains the developing ______________.

oocyte (egg)

Define Amenorrhea:

the absence of mensuration

hCG is produced by

zygote

The ovarian cycle consists of two phases:

1. Follicular phase 2. The luteal phase

Typically the endometrial cycle is identified and described in three phases:

1. menstrual phase 2. proliferative phase (early/late) 3. Secretory phase

Define amenorrhea:

Absence of mensuration (primary or secondary)

During the LH surge, at what hour is LH at its peak?

At the 10-12th hour (prior to ovulation)

Define polymenorrhea

When the menstrual cycle occurs at intervals of less than 21 days

A menstrual cycle is approximately ________ in length, beginning with first day of menstrual bleeding.

28 days

Approximately how many follicles develop a day on each ovary?

5-7

Mensuration ends at around what age?

50 years old

During the late proliferative phase (periovulatory) the endometrial layers can measure between ____ and _____mm

6 to 10mm

Define menorrhagia:

Abnormally heavy and prolonged menstruation.

Which hormone is responsible of the development of reproductive organs and maintain their functions?

Estrogen

Which hormone is secreted by follicles and responsible for the development of reproductive organs and maintain their functions?

Estrogen

Which hormone stimulates the endometrium to thicken prior to ovulation?

Estrogen

During the menstrual cycle the ovaries produce what two hormones?

Estrogen and Proestrogen

What hormone causes the development of multiple follicles on the ovaries?

FSH

T/F: After ovulation, the anechoic fluid of the ruptured graafian follicle can be identified in the vesicouterine pouch.

False - rectouterine pouch

T/F: The corpus luteum secretes progesterone only.

False the CL primarily produces progesterone and small amounts of estrogen.

If conception and implantation occur, what hormone will now be produced?

Human chorionic gonadotropin (hCG)

Define Metrorrhagia:

Irregular mensural bleeding between periods, intermenstrual bleeding

Define menstrual cycle

Is a series of hormone induced changes within the ovaries and endometrium to prepare for implantation of the fertilized ovum.

On day 14, what triggers ovulation?

LH surge, accompanied by a smaller FSH surge

Which hormone surges around 14th day resulting in ovulation and is also responsible for corpus luteal development.

Luteinizing hormone (LH)

How does estrogen and progesterone effect the uterus?

Maintains the thickness of the endometrium and prepares the endometrium for the fertilized ovum.

When menarche is delayed beyond 18 years of age is called:

Primary amenorrhea

What is the primary responsibility of the hypothalamus?

Regulates the release of hormones by the anterior pituitary gland

Describe the sonographic characteristics of a dominant follicle:

Round or oval shape, with smooth bright walls, anechoic structure

When cessation of uterine bleeding occurs in women who have previously menstruated this is called:

Secondary Amenorrhea

What changes occur within the uterus to cause mensuration?

Spiral arterioles constrict, leading to a decreased blood flow to the endometrium, resulting in ischemia and shedding of zona functionalis.

What does FSH do?

Stimulates development of the follicle in the ovaries

hCG (human chorionic gonadotropin) causes?

The corpus luteum to persist; it will continue to secrete progesterone for 3 more months until placenta takes over.

Which layer of the endometrium thickens and thins as a result of estrogen and progesterone, produced by the ovary?

The functional layer

Once estrogen levels are at its peak what happens? (hormonally)

The pituitary gland is inhibited from further producing FSH and begins secreting luteinizing hormone (LH).

Which endometrial phase occurs after ovulation and is stimulated by progesterone?

The secretory phase

1 - 14

This ultrasound image demonstrates follicle production and would be days ____-____

15-28

This ultrasound image shows the corpus luteum on days _____-______ of the menstrual cycle.

T/F: The anterior pituitary gland consists of a anterior and posterior lobe.

True

All unchosen follicles undergo ______________, after ovulation.

atresia

Where is the hypothalamus located?

brain

Menopause:

cessation of menstruation

After the corpus luteum regresses, it leaves a small amount of hyperechoic scar tissue in the ovary called _____________ __________________.

corpus albicans

Following menses, the early proliferative endometrium appears ______________ and ____________.

echogenic and thin

When does ova development begin during life?

embryonic life

The functional layer on ultrasound is separated by a hyperechoic ______________ ________________.

endometrial stripe

As ovarian follicles grow, they fill with fluid and secrete increasing amounts of __________________.

estrogen

Following menses, the ovary is within the ___________________ phase while the endometrium is within the __________________ phase.

follicular, proliferative

After the ovum is released it is picked up by the ______________ of the fallopian tube and is propelled towards the uterus.

frimbria

The basal layer of the endometrium appears _________________ on ultrasound.

hyperechoic

The functional layer of the endometrium appears ________________ on ultrasound.

hypoechoic

After ovulation, the corpus luteum can appear ______________ in shape and contain multiply fine separations as a result of hemorrhage and blood clot.

irregular

LMP stands for:

last menstrual period - first day of bleeding

Following ovulation, the ovary begins the ____________ phase, while the endometrium enters the _________________ phase.

luteal, secretory

The creating of the corpus luteum is a process known as _________________________, and is stimulated by LH surge.

luteinization

What is progesterone's role is the endometrial phase?

maintains the thickness of the endometrium in preparation for implantation

The pituitary gland, often referred to as the "________________ ____________"

master gland

The first menstrual cycle is termed ______________

menarche

Define oligomenorrhea

menstrual cycles that are over >35 days, prolonged

What does menses mean?

menstrual flow

Which phase lasts approximately 1 to 5 days and begins with declining progesterone levels, causing spiral arterioles to constrict.

menstrual phase

As progesterone levels decline, ___________________ occurs and the cycle begins again.

menstruation

What occurs when estrogen and progesterone levels dissipate?

menstruation

Typically 5-8 prenatal follicles begin to develop; only _________ reaches maturity each month.

one

Remain in suspended animation within prenatal follicle as immature _____________ until onset of menarche.

oocyte

Define Dysmenorrhea:

painful periods

The proliferative phase may be divided into two phases, early and late, with the late proliferative phase often being referred to as the _______________________ _______________________.

periovulatory phase

premenarche

prepuberty, time before the onset of menstrual cycles

Corpus luteum immediately begins secreting _____________________.

progesterone

If fertilization does occur, the endometrial thickness is maintained by the continual production of _____________________ by the corpus luteum of pregnancy.

progesterone

Describe ovulation:

the explosive release of ovum, from ruptured graafian follicle

Menarche

the first occurrence of menstruation (every 28 days)

Which phase of the endometrial cycle occurs after menstruation and lasts until ovulation?

the proliferative phase

What is the LH surge?

the rapid increase in luteinizing hormone prior to ovulation

T/F: During menstruation the endometrium is thickest in the beginning and becomes a thin echogenic line during the early proliferative phase.

true

T/F: Surge is often used as a predictor for timing ovulation for conception.

true

T/F: The blood clot from the corpus luteum may become completely anechoic over time.

true

T/F: during the proliferative phase the endometrium typically measures 4 mm on day 4 and 8mm on day 8.

true

T/F: the endometrial cycle and ovarian cycles coincide.

true

Define ovulation:

when one or more oocytes are released from the ovary

The anterior lobe of the pituitary gland is responsible for the release of what two chief hormones that influence the menstrual cycle?

Follicle-stimulating hormone (FSH) and Luteinizing hormone (LH)

During the follicular phase the anterior pituitary gland secretes what hormone?

Follicular stimulating hormone (FSH)

menometerorrhagia

Heavy and prolonged bleeding between periods

Which hormone is produced by the corpus luteum of the ovary during the second half of the menstrual cycle, following the ovulation?

Progesterone

Which hormone is responsible for: 1. maintaining the thickness of the endometrium as the endometrium is prepared for implantation 2. stimulates uterine blood supply for pregnancy

Progesterone

The rupture of follicle during midcycle, can be associated with a dull pain on either side of the lower abdomen lasting a few hours. This pain is referred as ______________________.

Mittelschmerz

The rupture of a follicle is associated with small amounts of fluid in the __________________________________. This fluid is from the graafian follicle.

Posterior cul-de-sac (rectouterine pouch)

At what point does the LH surge occur in the menstrual cycle?

24 - 36 hours before ovulation

The graafian follicle is typically _______ to ______ cm in size.

1.6 - 2.8 cm [ 16 - 28 mm]

The females reproductive years begin ______ to _______ years of age at onset of menses.

11 to 13

At what point in the menstrual cycle does ovulation usually occur?

14 days

The luteal phase is the second phase of the ovarian cycle and is days _______- _______ of the menstrual cycle.

15-28

Each female ovary contains approximately _____ oocytes at time of birth.

200,000