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Female Reproductive Sys. Pregnancy & Lactation
Pasley 5/13/11 1.5 hrs
89
Physiology
Undergraduate 4
05/04/2011

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Term
egg viable and capable of fertilization around 24 hrs after ovulation
sperm viable around 72 hours

intercourse must occur 1-2 days before until 1 day after ovulation for fertilization
Definition
how long after ovulation is an ovum capable of fertilization? how long are sperm viable in the reproductive tract? so when must intercourse occur for fertilization?
Term
day 13-15
Definition
using the rhythm birth control method, when should you avoid sex?
Term
ampulla of fallopian tube
Definition
where does fertilization occur?
Term
when the sperm head contacts the zona pellucida of the ovum
Definition
when is the acrosome reaction initiated?
Term
-proteolytic enzymes
-hyaluronidase to digest the proteoglycan containing ECM
Definition
name the enzymes that are released from the acrosome of the sperm to help degrade the zona pellucida to allow sperm entry into the ovum
Term
sperm penetrating the ZP
Definition
what causes release of stored calcium into the cytoplasm, initiating the cortical reaction in the oocyte?
Term
causes hardening of the ZP
Definition
during the cortical reaction, what does the exocytosis of granules with enzymes do?
Term
the sperm receptors (zona proteins (ZP3/ZP2) no longer have sperm binding capacity, they are knocked out
Definition
during the cortical reaction, what is the slow component?
Term
induces completion of the oocyte's 2nd meitotic division and formation of the second polar body
Definition
what does the rise in intracellular Ca+ do to the oocyte?
Term
it remains constricted
Definition
what happens to the isthmus for 3 days following ovulation?
Term
allows it to divide and become a blastocyst (~100 cells)
Definition
what does the egg do for 4 days before it enters the uterus?
Term
high progesterone from the CL
Definition
what relaxes the contracted fallopian tubes after ovulation and movement of the egg to the uterus?
Term
1-3 days (aka 5-7 days after ovulation)
Definition
how long does the egg chill in the uterus before implantation?
Term
peg cells feed it in the tube, uterine milk feeds it in the uterus
Definition
what feeds the blastocyst while its waiting to implant in the uterus
Term
trophoblast cells steal nutrients and give it to the blastocyst
Definition
what chews through the endometrium (digests/liquifies/steals nutrients from)?
Term
decidualization
Definition
name this process: endometrial stromal cells transform into decidual cells that become laden with lipds, glycogen, and make prolactin and IGFBP-1
Term
the decidua
Definition
regulates embryo invasion of the endometrium and provides nutrition to the embryo
Term
1) peg cell secretions
2) uterine milk
3) trophoblastic nutrition (weeks ~2-12 after implantation)
4) placental diffusion (weeks 10 onward)
Definition
describe the nutrition of the fetus across pregnancy
Term
progesterone secretion by the CL
Definition
what induces decidualization?
Term
trophoblast cells invading the decidua
Definition
sole nutritive source of the embryo during 1st week following implantation
Term
placenta & fetal membranes
Definition
following implantation, decidual cells proliferate, forming _____ which begin to nourish the embryo about a week after implantation
Term
uterine artery
Definition
oxygentated blood from the ____ flows into the maternal sinuses of the placenta bathing the embryonic villi
Term
uterine vein
Definition
what vessel returns deoxy blood from the placenta to the mother?
Term
fetal tissues
Definition
what is the umbilicus, connecting the fetus to the placenta, derived from?
Term
1 vein oxy
2 arteries deoxy
Definition
fetal blood flow carries oxy blood to the fetus via single unbilical ___ and unoxy blood to placenta via 2 umbillical ___ into the capillaries of the placental villi
Term
facilitated diffusion
Definition
how do most nutrients diffuse through the placental villi?
Term
they diffuse directly through due to high solubility
Definition
how do FA's go through the fetal membranes?
Term
they diffuse down their concentration gradient from fetal to maternal circulation, like CO2
Definition
how are non-protein nitrogens (urea, uric acid & creatinine) excreted from the fetus?
Term
progesterone
Definition
responsible for:
implantation
maintenence of pregnancy
uterine quiescence until parturition (no contractions)
mammary growth and differentiation
Term
estrogen
Definition
responsible for:
increase in uterine blood flow
increase in LDL receptors on syncitiotrophoblast
increased levels of oxytocin receptors in the uterus for parturition
mammary growth
Term
corpus luteum, then/also the placenta makes estrogen, progesterone, HCG and HCS
Definition
what produces estrogen and progesterone for the first 2-4 months of pregnancy? what else helps?
Term
estrogen, progesterone, and HCG (possibly HCS too)
Definition
what hormones are necessary for normal pregnancy?
Term
estrogen, progesterone, HCG, HCS
Definition
name the 4 hormones secreted by the placenta
Term
human chorionic somatomammotrophin
Definition
what is HCS?
Term
HCG from the placenta
Definition
what maintains the CL, and thus prevents its involution and allows for continued secretion of estrogen and progesterone?
Term
HCG
Definition
prevents menstruation and spontaneous abortion, encourages development of the endometrium
Term
starts being secreted shortly after implantation, reaches max at 9-10 wks after implantation
Definition
when does max HCG secretion occur?
Term
stimulates Leydig cells to make testosterone and induces male sex organs to develop instead of female ones
Definition
what does HCG do in the testes of the male fetus?
Term
the alpha subunit (remember that beta varies)
Definition
what subunit of HCG is the same as the pituitary gonadotropins?
Term
5th week by placenta
Definition
when is HCS secreted and by what?
Term
1) uncertain function
2) induces lactation in most mammals
3) weak systemic action leads to deposition of protein, similar to GH
4) decreased insulin sensitivity and glucose utilization by the mother
5) increases FA's for utilization by the fetus
Definition
what does HCS do?
Term
estriol
Definition
what form is most of the estrogen secreted from the placenta as?
Term
estriol(estrogen) from the placenta
Definition
results in enlargement of uterus, external genitalia, breasts, and proliferation of the duct system in breats, also increases oxytocin receptors in the uterine myometrium and relaxes pelvic ligaments and pubic symphysis
Term
progesterone
Definition
increases fallopian tube secretions before implantation, results in development of decidual cells in the placenta, decreases uterine contractions
Term
maternal component only
Definition
cholesterol to the placenta comes from where?
Term
fetus and maternal components
Definition
Pregnenolone sulfate and DHES (dehydroepiandrosterone sulfate), to the placenta comes from where?
Term
fetal component only
Definition
where does hydroxydehydroepiandosterone sulfate to the placenta come from?
Term
progesterone, estrone-estradiol, estriol
Definition
what 3 things, synthesized by the placenta go to the maternal and fetal circulation?
Term
1) high levels of sex steroids supress the H-P-G axis, preventing ovulation
2) estrogens stimulate prolactin release beginning with the first trimester
3) somatotroph production of GH is reduced
4) ACTH levels are variable throughout pregnancy, but increase near parturition
Definition
what are the maternal endocrine changes in pregnancy to the hypothalmus?
Term
1) thyroid gland enlarges, but TSH levels are normal
2) T3 & T4 increase, but TBG also increases in response to estrogen
3) thus pregnant woman stays euthyroid
Definition
what are the maternal endocrine changes in pregnancy to the thyroid?
Term
PTH increases in 3rd trimester, thus enhancing calcium mobilization to provide calcium for fetal bone development
Definition
what are the maternal endocrine changes in pregnancy to the parathyroid?
Term
1) mineral & gluco -corticoid hormone secretion increases

2) plasma cortisol is higher because progesterone displaces it from transcortin (its binding globulin)

3) hypercotisolism not apparent during pregnancy
Definition
what are the maternal endocrine changes in pregnancy to the adrenals?
Term
uterus: 50g -> 1kg
breasts: double in size
Definition
how much bigger does the uterus get in pregnancy? the breasts?
Term
~24 lbs, in last 2 trimesters
Definition
about how much weight gain is there (in the mother) in pregnancy and when does this occur?
Term
1) BMR increases 15% in latter half of pregnancy due to thyroxine and adrenal hormones
2) maternal deficiencies in Ca, Fe, PO4, and vitamins is common
3) O2 use increases 20%
4) progesterone increases the minute ventilation by 50% decreasing her PCO2
5) pressure of the fetus against the diaphragm -> decreased exhalation -> increased RR
Definition
how does metabolism change during pregnancy?
Term
1) cardiac output increases 30-40% by 2nd trimester (falls in final weeks of pregnancy)
2) maternal blood volume increases 30% by end of pregnancy due to aldosterone/estrogen effects
Definition
how does maternal circulation change with pregnancy?
Term
625 ml/min
Definition
how much blood flows through the placenta per min?
Term
1) GFR increases up to 50%, increasing H2O and electrolyte loss and increased urine formation in pregnancy
2) aldosterone increases fluid retention, and Na/Cl/Ca resorption up to 50%
Definition
what changes in the urinary system during pregnancy?
Term
first half of pregnancy, caused by increased fat deposition from high progesterone which diverts glucose into fat synthesis (used later for the fetal metabolism)

also maternal glucose use declines and gluconeogenesis increases maxing the glucose available to the fetus (can cause beta cell exhaustion in pregnancy)
Definition
when is the major NET weight gain in pregnancy and what causes it?
Term
relaxation and dilation of the cervix
Definition
first stage of labor
Term
delivery of the baby
Definition
second stage of labor
Term
delivery of the placenta
Definition
third stage of labor
Term
cervical effacement, grows 10 cm in diameter
Definition
thinning and flattening of the cervix is called ____ and occurs in the first stage of labor
Term
8-24 hrs, but only a few min after multiple pregnancies
Definition
how long does the first stage of labor last?
Term
rupture of fetal membranes and loss of amniotic fluid
Definition
after dilation of the cervix, what follows in the first stage of labor?
Term
30 min in first pregnancy, but about a minute after several
Definition
how long does the second stage of labor last?
Term
1) increased uterine excitability near term
2) stretching of uterine myometrium increases contractility and force of contractions
3) stretching or irritation of the cervix also elicits uterine contractions
Definition
what are the mechanical factors that cause parturition?
Term
1) estrogen: progesterone ration increases
2) in last 2 months of pregnancy, estrogen secretion increases and progesterone plateaus or decreases
Definition
what are the hormonal factors that cause parturition?
Term
petuitary: makes oxytocin
membranes(and uterus): make prostaglandins
Definition
what does the fetal petuitary secrete? what do the fetal membranes secrete? (to assist with labor)
Term
PGF2 alpha, and PGE2: stimulate uterine smooth muscle contraction to induce cervical dilation
Definition
what are the prostaglandins, and what do they do to help with labor?
Term
increases gap junctions between smooth muscle cells
Definition
what do PGF2 alpha and estradiol do to potentiate the effects of oxytocin?
Term
uterine smooth muscle, PGF2 alpha
Definition
increases in oxytocin near time of labor activate calmodulin in the ____ and stimulate ___ production
Term
irritation or stretching of the uterus
Definition
what causes a neurogenic reflex (ferguson reflex) to secrete oxytocin?
Term
1) oxytocin (pitocin)
2) prostaglandins (PGF2 alpha and PGE2)
3) progesterone receptor blocker (mifepristone RU486 = plan B)
Definition
what is given to induce labor?
Term
cervix: softens, dilates, thins
neutrophils: release collagen, degrade protesases
Definition
during parturition, what happens to the cervix? neutrophils?
Term
prostaglandins
Definition
what induces cervical ripening?
Term
if they are born before 37 weeks
Definition
when is a baby considered premature?
Term
13million pre-mature, 1 million die
Definition
how many babies are born pemature each year? how many die?
Term
1) lack of prenatal care
2) diabetes
3) hypertension
4) infections
5) smoking
6) alcohol
7) pregnancy before age 16 or after age 35
8) pregnancies spaced too closely (less than 2 yrs apart)
9) carrying twins
10) early elective inductions and C-sections
Definition
what causes pre-mature births?
Term
active: CRH, PRF, ACTH, PRL, OT, Cortisol
inhibited: GnRH, DA, FSH, LH
Definition
what hormones are inhibited, and what hormones are active in lactation?
Term
oxytocin
Definition
what causes the myogenic cells of the breast to contract?
Term
prolactin
Definition
what hormone causes milk production?
Term
oxytocin
Definition
what hormone is released by the suckling reflex?
Term
blow on their vulva
Definition
what did ancient people do to cows to get milk?
Term
prolactin
Definition
what causes natural birth control after pregnancy by preventing release of gonadotropic hormones?
Term
dopamine
Definition
what inhibits prolactin?
Term
protein, then transitions to high fat in mature milk
Definition
is colostrum high in fat or protein?
Term
dopamine neurons
Definition
what neurons are inhibited by the suckling reflex(or emotional/psychogenic/sex) that normally blocks prolactin?
Term
Galactorrhea
Definition
what is the name of the condition where there is persistent milk production in a non-pregnant person due to an anterior petuitary tumor?
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