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178 Cards in this Set
- Front
- Back
How do you drain the left ovary / testis? |
Left gonadal vein → Left renal vein → IVC |
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How do you drain the right ovary / testis? |
Right gonadal vein → IVC |
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What are the characteristics of the drainage of the left spermatic vein? |
Enters the left renal vein at a 90° angle, so flow is less continuous on the left than on the right → |
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Which testes is more likely to have a varicocele? Why? |
Left spermatic vein enters the left renal vein at a 90° angle, so flow is less continuous on the left than on the right → |
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What lymph nodes drain the ovaries and testes? |
Para-aortic lymph nodes |
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What lymph nodes drain the distal vagina, vulva, and scrotum? |
Superficial inguinal lymph nodes |
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What lymph nodes drain the proximal vagina and uterus? |
- Obturator lymph nodes |
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What ligament connects the ovaries to the lateral pelvic wall? |
Infundibulopelvic ligament (Suspensory Ligament of the Ovaries) |
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What ligament connects the cervix to the side wall of the pelvis? |
Cardinal ligament |
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What ligament connects the uterine fundus to the labia majora? |
Round ligament of the uterus |
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What ligament connects the uterus, fallopian tubules, and ovaries to the pelvic side wall? |
Broad ligament |
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What ligament connects the medial pole of the ovary to the lateral uterus? |
Ovarian ligament |
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What does the infundibulopelvic ligament (suspensory ligament of the ovaries) connect? What structures are contained in this ligament? |
- Connects ovaries to lateral pelvic wall |
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What does the cardinal ligament connect? What structures are contained in this ligament? |
- Connects cervix to the side wall of the pelvis |
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What does the round ligament of the uterus connect? What structures are contained in this ligament? |
- Connects fundus to labia majora |
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What does the broad ligament connect? What structures are contained in this ligament? |
- Connects uterus, fallopian tubules, and ovaries to pelvic side wall |
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What does the ovarian ligament connect? What structures are contained in this ligament? |
- Connects medial pole of ovary to lateral uterus |
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Which vessels do you ligate during an oophorectomy to avoid bleeding? How do you find these vessels? |
- Ligate ovarian vessels |
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What can compromise the safety of the ureters? |
Ureters may be damaged during ligation of ovarian vessels (during oophorectomy) andduring ligation of uterine vessels (during hysterectomy) |
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What female ligaments are derived from the gubernaculum? |
- Round ligament of the uterus |
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What is the relative location of the round ligament of the uterus? |
- Travels through the round inguinal canal |
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What are the components of the broad ligament? |
- Mesosalpinx: contains fallopian tubes |
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What type of epithelium is in the vagina? |
Stratified squamous epithelium, non-keratinized |
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What type of epithelium is in the ectocervix? |
Stratified squamous epithelium, non-keratinized |
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What type of epithelium is in the endocervix? |
Simple columnar epithelium |
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What type of epithelium is in the transformation zone? |
Squamocolumnar junction (most common area for cervical cancer) |
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What type of epithelium is in the uterus? |
Simple columnar epithelium with long tubular glands |
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What type of epithelium is in the fallopian tubules? |
Simple columnar epithelium, many ciliated cells, a few secretory (peg) cells |
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What type of epithelium is in the ovary (outer surface)? |
Simple cuboidal epithelium (germinal epithelium covering surface of ovary) |
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What are the phases of the female sexual response cycle? |
- Excitement |
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What happens during the excitement phase of the female sexual response cycle? |
- Uterus elevates |
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What happens during the plateau phase of the female sexual response cycle? |
Expansion of inner vagina |
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What happens during the orgasm phase of the female sexual response cycle? |
Contraction of uterus |
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What mediates the female sexual response cycle? Other consequences? |
Mediated by Autonomic Nervous System |
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What is the pathway of sperm ejaculation? |
SEVEN UP: |
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What mediates an erection in a male? What nerve? |
Parasympathetic nervous system (via pelvic nerve) |
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How does the parasympathetic nervous system mediate an erection? |
Pelvic nerve → NO → ↑ cGMP → smooth muscle relaxation → vasodilation → pro-erectile |
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How does the parasympathetic nervous system inhibit an erection? |
Pelvic nerve → NE → ↑ [Ca2+]in → smooth muscle contraction → vasoconstriction → anti-erectile |
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What mediates an emission in a male? What nerve? |
Sympathetic nervous system (via hypogastric nerve) |
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What mediates an ejaculation in a male? What nerve? |
Visceral and somatic nerves (via pudendal nerve) |
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What drugs can help mediate an erection? Mechanism? |
Sildenafil and Vardenafil → inhibit cGMP breakdown → smooth muscle relaxation → vasodilation → erection |
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What kind of cells are in the seminiferous tubules? |
- Spermatogonia (germ cells) |
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What is the function of the spermatogonia? Location? |
- Maintains the germ pool |
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What is the function of the Sertoli cells? |
- Secrete inhibin (inhibits FSH) |
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How does temperature affect the Sertoli cells? |
Temperature sensitive: ↓ sperm production and ↓ inhibin with ↑ temperature |
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What is the location of the Sertoli cells and Leydig cells? |
- Sertoli cells: lines seminiferous tubules |
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Where is the enzyme aromatase? Function? |
Within Sertoli cells and Leydig cells |
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What is the source and function of Inhibin? |
- Secreted by Sertoli cells |
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What is the source and function of androgen-binding protein? |
- Secreted by Sertoli cells |
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What forms the blood-testis barrier? Importance? |
- Tight junctions between Sertoli cells (lining seminiferous tubules) |
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What is source of Müllerian Inhibiting Factor? |
Sertoli cells |
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What supports and nourishes the developing spermatozoa? |
Sertoli cells |
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What conditions are associated with increased temperature in the testes? Potential consequences? |
- Varicocele and Cryptorchidism |
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What are the functions of Leydig cells? |
- Secretes Testosterone in the presence of LH |
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How are the Leydig cells affected by temperature? |
Unaffected, Testosterone secretion does not change with temperature changes |
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What is the source of estrogen? What type of estrogen is made by each source? |
- Ovary: 17β-estradiol |
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What is the relative potency of the types of estrogens? |
Estradiol > Estrone > Estriol |
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What female development is regulated by estrogen? |
Development of: |
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What are the effects of estrogen on the female reproductive tract? |
- Growth of follicle |
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What are the hormonal effects of estrogens? |
- Up-regulation of estrogen, LH, and progesterone receptors |
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What is the effect of estrogen on proteins and cholesterol? |
- ↑ Transport proteins (SHBG) |
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What happens to the levels of the types of estrogens during pregnancy? |
- 50-fold increase in estradiol (ovary) and estrone (adipose) |
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What is an indicator of fetal well-being during pregnancy? |
1000-fold increase in estriol (source: placenta) |
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Where are estrogen receptors? What happens to them when they bind estrogen? |
- Estrogen receptors expressed in cytoplasm of cells |
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What stimulates FSH and LH release? |
Pulsatile GnRH |
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What is the function of FSH in females? |
Stimulates aromatase: converts androstenedione → estrogens in Granulosa Cell |
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What is the function of LH in females? |
Stimulates Desmolase: converts cholesterol → androstenedione in Theca Cells |
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What happens in Theca cells in females? |
LH stimulates Desmolase: converts cholesterol → androstenedione (which is exported to granulosa cells) |
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What happens in Granulosa cells in females? |
FSH stimulates Aromatase: converts androstenedione (from theca cells) → estrogens (which is secreted) |
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What is the source of progesterone? |
- Corpus luteum |
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What are the functions of progesterone? |
- Stimulates endometrial glandular secretions |
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What is the effect of progesterone on other hormones? |
- Inhibits LH and FSH (gonadotropins) |
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What leads to lactation after delivery? |
Fall in progesterone disinhibits prolactin → lactation |
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What indicates ovulation? |
Increased progesterone |
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What are the Tanner stages of sexual development? |
- I: Childhood (pre-pubertal) |
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What Tanner stage is a pre-pubertal child? |
Tanner Stage I |
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What Tanner stage is a child with new pubic hair? |
Tanner Stage II |
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What Tanner stage is a child when the breast buds begin to form? |
Tanner Stage II |
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What Tanner stage is a child when the pubic hair darkens and becomes curly? |
Tanner Stage III |
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What Tanner stage is a child when there penis size / length begins increasing? |
Tanner Stage III |
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What Tanner stage is a child when the breasts begin enlarging? |
Tanner Stage III |
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What Tanner stage is a child when the penile width increases? |
Tanner Stage IV |
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What Tanner stage is a child when the scrotal skin becomes darker? |
Tanner Stage IV |
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What Tanner stage is a child when the glans develops? |
Tanner Stage IV |
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What Tanner stage is a child when the areolae are raised? |
Tanner Stage IV |
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What Tanner stage is an adult? |
Tanner Stage V |
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What Tanner stage is a person when the areolae are no longer raised? |
Tanner Stage V |
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What is the length of the Follicular phase and Luteal phase of the menstrual cycle? |
- Follicular phase: varies in length |
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When is follicular growth fastest? |
During 2nd week of proliferative (follicular) phase |
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What stimulates endometrial proliferation? |
Estrogen |
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What maintains endometrium to support implantation? |
Progesterone |
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How does the amount of progesterone related to fertility? |
↓ Progesterone → ↓ Fertility |
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What is the term for a menstrual cycle >35 days? |
Oligomenorrhea |
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What is the term for a menstrual cycle <21 days? |
Polymenorrhea |
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What is the term for frequent but irregular menstruation (intermenstrual bleeding)? |
Metrorrhagia |
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What is the term for heavy menstrual bleeding (>80 mL blood loss or >7 days of menses)? |
Menorrhagia |
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What is the term for heavy, irregular menstruation at irregular intervals? |
Menometrorrhagia |
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What does the graafian follicle mature? |
During proliferative (follicular) phase |
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When does ovulation occur? |
- After proliferative phase (follicular) |
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When does the corpus luteum develop? |
After ovulation, during the secretory (luteal) phase |
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When does the corpus luteum regress? |
During menstruation, after secretory (luteal) phase before beginning a new proliferative (follicular) phase |
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What stimulates the LH surge? Result? |
↑ Estrogen → LH surge → Ovulation |
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What stimulates ovulation? |
↑ Estrogen → LH surge → Ovulation |
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What does ovulation lead to? |
↑ Progesterone (from corpus luteum) |
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What stimulates menstruation? |
Fall in progesterone levels → Menstruation |
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What happens during menstruation? |
Apoptosis of endometrial cells |
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What are the relative blood hormone levels during the proliferative (follicular) phase? |
- FSH, LH, and Progesterone remain relatively low and steady |
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What are the relative blood hormone levels during the secretory (luteal) phase? |
- LH and FSH drops down after peak and remain relatively low throughout |
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What happens to your oocytes during fetal life? |
1° oocytes begin meiosis 1 and are arrested in prophase I |
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When do your oocytes complete meiosis 1? |
- 1° oocytes that are arrested in prophase I, complete meiosis 1 just prior to ovulation |
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When do your oocytes complete meiosis 2? |
Meiosis 2 continues from where it was arrested in metaphase II until completion during fertilization (2° oocytes) |
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How long does fertilization have to occur once the 2° oocyte is ovulated? |
Fertilization must occur within 1 day or the oocyte will degenerate |
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In what stages are oocytes arrested? Until when? |
- Meiosis I is arrested in Prophase I (until ovulation) |
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What is the type and amount of genetic material in an oogonium? |
2N, 2C (diploid) |
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What is the type and amount of genetic material in a 1° oocyte? |
2N, 4C (diploid) |
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What is the type and amount of genetic material in an 2° oocyte (after ovulation)? |
1N, 2C (haploid) |
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What is the type and amount of genetic material in an ovum (after fertilization)? |
1N, 1C (haploid) |
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How many polar bodies are made from a single oogonium? |
3 polar bodies |
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What stimulates ovulation? |
- ↑ Estrogen surge → LH release → ovulation |
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What happens during ovulation? |
Rupture of follicle |
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How the temperature change during the menstrual cycle? Cause? |
Temperature increases during ovulation (due to progesterone) |
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What is transient mid-cycle ovulatory pain called? What is it associated with? |
Mittelschmerz |
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What is Mittelschmerz? |
*Transient mid-cycle ovulatory pain |
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What is the most common location for fertilization? |
Commonly in the upper end of the fallopian tube (ampulla) |
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How soon after ovulation must fertilization occur? |
Must occur within 1 day of ovulation |
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When does implantation of the fertilized egg occur? |
Implantation within the wall of the uterus occurs 6 days after fertilization |
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What hormone is used for a pregnancy test? When does it become elevated? Source? |
hCG, secreted from Syncytiotrophoblasts, is used for pregnancy tests |
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What happens to the levels of hCG during pregnancy? |
- Peaks at about 10 weeks |
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What happens to the levels of Prolactin during pregnancy? |
Slowly increases throughout pregnancy, highest at 40 weeks |
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What happens to the levels of Proesterone during pregnancy? |
Increases throughout entire pregnancy |
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What happens to the levels of Estriol during pregnancy? |
Begins increases at around 8 weeks and steadily increases until 40 weeks; dips at birth |
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What prevents lactation during pregnancy, despite elevated prolactin levels? |
Progesterone and estrogen inhibit lactation |
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What allows lactation after labor? |
- ↓ in Progesterone and Estrogen disinhibit lactation |
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What is the function of prolactin? |
Induces and maintains lactation and ↓ reproductive function |
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What is the function of oxytocin? |
- Assists in milk letdown |
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When is breast milk the ideal nutrition for infants? |
Until they are 6 months old |
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What are the beneficial contents of breastmilk? |
- Contains maternal immunoglobulins (confers passive immunity, mostly IgA) |
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What are the benefits of breastmilk to the infant? |
- Reduces infant infections |
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What is required of infants who are exclusively breastfed? |
Require vitamin D supplementation |
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What kind of immunoglobulins are passed in breastmilk? |
Primarily IgA |
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What are the benefits of breastmilk to the mother? |
- Decreases maternal risk of breast and ovarian cancer |
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What is the source of hCG? |
Syncytiotrophoblasts of placenta |
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What are the functions of hCG? |
- Maintains corpus luteum in 1st trimester |
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When is hCG elevated? |
- During pregnancy and multiple gestations |
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How does hCG maintain the corpus luteum? |
During first trimester hCG maintains the corpus luteum by acting like LH (otherwise no luteal cell stimulation, and abortion results) |
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When does the corpus luteum degenerate during a pregnancy? Why? |
- In the 2nd and 3rd trimesters, placenta synthesizes its own estriol and progesterone |
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What are the subunits of hCG? Significance? |
- α subunit: structurally identical to those in LH, FSH, and TSH |
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What causes menopause? |
↓ Estrogen production due to age-linked decline in number of ovarian follicles |
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What is the average age of menopause in normal women? In smokers? |
- Average age: 51 years |
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What usually precedes menopause? |
4-5 years of abnormal menstrual cycles |
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What is the source of estrogen (estrone) after menopause? |
- Peripheral conversion of androgens to estrogen |
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What lab value is specific for menopause? |
↑↑ FSH (loss of negative feedback on FSH due to ↓ estrogen) |
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What are the hormonal changes in menopause? |
- ↓ Estrogen |
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What are the side effects of menopause? |
Menopause causes HAVOCS: |
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What does menopause before age 40 suggest? |
Can indicate premature ovarian failure |
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When does spermatogenesis begin? What is the first type of "sperm"? |
Puberty - spermatogenesis begins with spermatogonia |
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How long does full development of sperm take? Where does it take place? |
2 months - takes place in seminiferous tubules |
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What is the product of spermatogenesis? |
Spermatids that undergo spermiogenesis |
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What happens in spermiogenesis? |
Spermatids lose cytoplasmic contents and gain an acrosomal cap to form mature spermatozoon |
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What is the type and amount of genetic material in a spermatogonium? |
2N, 2C (diploid) |
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What is the type and amount of genetic material in a 1° spermatocyte? |
2N, 4C (diploid) |
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What happens to a 1° spermatocyte after meiosis 1? |
Forms 2 x 2° Spermatocytes: |
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What happens to a 2° spermatocyte after meiosis 2? |
Forms 4 x Spermatids |
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What happens to a spermatid after being formed by meiosis II? |
Spermiogenesis to form mature spermatozoon (haploid: 1N, 1C) |
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What syndrome causes impaired tail mobility of a spermatozoon? Consequences? |
Ciliary Diskinesia / Kartagener Syndrome → infertility |
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What are the types of androgens? |
- Testosterone |
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What are the sources of the androgen? |
- Testis: DHT and Testosterone |
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What is the relative potency of the androgens? |
DHT > Testosterone > Androstenedione |
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What are the functions of testosterone? |
- Differentiation of epididymis, vas deferens, seminal vesicles (genitalia, except prostate) |
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What structures differentiate via the action of testosterone? |
- Epididymis |
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What structures have a growth spurt because of testosterone? |
- Penis |
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What are the functions of Dihydrotestosterone (DHT)? |
- Early: differentiation of penis, scrotum, prostate |
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What structures differentiate via the action of dihydrotestosterone (DHT)? |
- Penis |
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What are the late effects of DHT? |
- Prostate growth |
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What is the function of 5α-reductase? |
Convert Testosterone to DHT |
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What drug inhibits 5α-reductase? Action? |
Finasteride (prevents conversion of T → DHT) |
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What is the function of cytochrome P-450 aromatase? |
Converts androgens to estrogen (primarily in adipose tissue and testis) |
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What are the effects of exogenous testosterone? |
- Inhibits hypothalamic-pituitary-gonadal axis |