Term
primordial follicle -> primary follicle -> secondary (vesicular) follicle.
follicle ruptures
corpus luteum becomes the corpus albicans |
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Definition
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Term
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Definition
outer layer of a graafian follicle
synthesis androgens in response to LH |
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Term
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Definition
inner layer of a graafian follicle
converts androgens to estrogens |
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Term
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Definition
| stimulates the growth of an immature graafian follicle to maturation |
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Term
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Definition
secreted by the corpus luteum
prevents further ovulation if implantation occurs |
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Term
| human chorionic gonadotropin (HCG) |
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Definition
secreted by the chorion
prevents disintegration of the corpus luteum if implantation occurs |
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Term
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Definition
respond to FSH in males
are responsible for making sperm |
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Term
| leydig cells (interstitial cells) |
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Definition
respond to interstitial cell stimulating hormone (or LH) in males
responsible for making testosterone |
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Term
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Definition
| progestins, androgens, and estogens are steroid hormones derived from ___________. |
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Term
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Definition
| androstenedione is converted to estrone and testosterone is converted to estradiol through ___________. |
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Term
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Definition
| pulsatile secretion of GnRH will cause __________ in FSH and LH secretion. |
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Term
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Definition
| continuous administration of GnRH will cause a __________ in LH and FSH secretion |
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Term
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Definition
| during ovulation, estrogen _________ the release of LH and FSH |
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Term
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Definition
| blocks the secretion of FSH |
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Term
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Definition
| stimulates the secretion of FSH |
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Term
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Definition
| the binding of LH to the LH receptor (LH-R) in Leydig cells activates the synthesis of _________, which then diffuses into nearby Sertoli cells. |
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Term
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Definition
increased levels with the binding of FSH to its receptor, FSH-R, in the Sertoli cells
stabilizes high levels of testosterone in the Sertoli cells
promotes spermatogenesis after binding to testosterone |
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Term
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Definition
| LH binds to its receptor in thecal cells and promotes synthesis of ________, which then diffuses into nearby granulosa cells |
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Term
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Definition
increased levels after FSH binds to its receptor on the granulosa cell
converts androgen (testosterone not dihydrotestosterone) to estrogen in the granulosa cell |
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Term
| follicular or proliferative phase |
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Definition
development of ovarian follicle
estrogen is released by follicles
cellular proliferation of the endometrium
ovulation |
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Term
| luteal or secretory phase |
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Definition
corpus luteum produces progesterone
endometrium becomes secretory |
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Term
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Definition
converts endometrium to its secretory phase to prepare the uterus for implantation
during implantation and gestation:
decrease maternal immune response to allow the acceptance of the pregnancy
decrease contractility of the uterine smooth muscle
used by the fetus to synthesis mineralocorticoids and glucocorticoids
inhibits lactation during pregnancy
fall in levels facilitate the onset of the labor, and trigger milk production after delivery |
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Term
| polycystic ovarian syndrome |
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Definition
disruption of the hypothalamic-pituitary-reproduction axis
anovulation and increased androgen levels (masculinization, male pattern baldness, hirsutism) |
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Term
| LH hypothesis of polycystic ovarian syndrome |
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Definition
| elevated levels of LH, elevated levels of androgen synthesis by thecal cells of ovary, prevent normal follicle growth, prevent follicle secretion of large amounts of estrogen, prevents LH surge and ovulation |
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Term
| insulin theory of polycystic ovarian syndrome |
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Definition
| insulin resistance and elevated levels of insulin, decreased levels of sex hormone binding globulin (more androgens unbound and active), higher concentrations of androgens |
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Term
| ovarian hypothesis of polycystic ovarian syndrome |
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Definition
| greater thecal cell production of androgens |
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Term
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Definition
disruption of the hypothalamic-pituitary-reproduction axis
benign tumors of lactotrophs in the anterior pituitary
increased prolactin levels repress estrogen synthesis (antagonize release of GnRH and decreased gonadotroph sensitivity to GnRH)
crowding-out effect of the pituitary tumor
treatment: dopamine agonists (cabergoline or bromocriptine) |
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Term
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Definition
inappropriate growth of hormone dependent tissue
tissue expresses estrogen receptors and its growth is stimulated by estrogen
(elevated levels of estrogen is not the cause, but estrogen promotes the proliferation of the tissue) |
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Term
| prostate cancer and benign prostate hyperplasia |
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Definition
inappropriate growth of hormone dependent tissue
growth is androgen-dependent and requires the local conversion of testosterone to dihydrotestosterone (through 5-alpha reductase) |
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Term
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Definition
inappropriate growth of hormone dependent tissues
growth of endometrial tissue outside the uterus
usually estrogen dependent
grows and regresses with the menstrual cycle
symptoms include severe pain, abnormal bleeding, the formation of adhesions in the peritoneal cavity
treatment: long half life GnRH agonists |
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Term
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Definition
decreased estrogen or androgen secretion
if sex hormone production is impaired before adolescence, hormone replacement can allow the development of secondary sexual characteristics |
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Term
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Definition
normal physiological response to the exhaustion of the ovarian follicles
follicle depletion leads to a decrease in estrogen and inhibins, and an increase in LH and FSH
androstenedione continues to be converted to estrone (the primary estrogen in the blood)
decreased levels of estrogen can cause hot flashes, vaginal dryness, decreased libido, and osteoporosis |
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Term
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Definition
GnRH agonist
indicated for inhibiting premature LH surge, endometriosis, benign prostate hyperplasia |
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Term
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Definition
GnRH antagonist
indicated for inhibiting premature LH surge, endometriosis, benign prostate hyperplasia |
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Term
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Definition
competitive, specific inhibitor of 5-alpha reductase
reduces prostate hypertrophy by inhibiting synthesis of DHT (primary androgen that stimulates development of prostate tissue)
used to treat symptomatic benign prostate hyperplasia and male pattern baldness |
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Term
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Definition
aromatase inhibitor
used to treat metastatic breast cancer and prevents reoccurrence of cancers primarily treated with surgery and radiation |
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Term
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Definition
prototype of selective estrogen receptor modulators (SERM)
estrogen receptor antagonist in breast tissue
partial agonist at estrogen receptors in bone and endometrium
used as primary hormonal therapy for metastatic estrogen receptor-positive breast cancer
prevents postmenopausal osteoporosis
induces ovulation in anovulatory women by stimulating the hypothalamus to secrete GnRH |
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Term
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Definition
| estrogen receptor antagonist |
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Term
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Definition
a newer selective estrogen receptor modulator
possesses estrogen receptor agonist activity in bone, but antagonist activity in both breast and endometrial tissue
primarily used to prevent postmenopausal osteoporosis |
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Term
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Definition
selective estrogen receptor modulator
nonsteroidal fertility agent to induce ovulation in infrequently ovulating or anovulatory women
effecting in producing ovulation in patients with an intact hypothalamic-pituitary-ovarian axis and with ovaries that are capable of functioning normally
blocks the normal negative feedback of circulating estradiol on the hypothalmus
during therapy, the frequency and amplitude of GnRH pulses increase and stimulate the pituitary gland to release more FSH and LH |
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Term
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Definition
androgen receptor antagonist
an oral nonsteroidal antiandrogen
used to treat metastatic prostate cancer
inhibits the uptake and/or nuclear binding of testosterone and DHT by prostate tissue |
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Term
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Definition
androgen receptor antagonist
originally approved as an aldosterone receptor antagonist
indicated for hirsutism, hyperaldosteronism, hypertension |
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Term
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Definition
progesterone receptor antagonist
synthetic steroid with potent antiprogesterone and antiglucocorticoid activity
postcoital contraceptive agent
used in combination with prostaglandin as an abortifacient in early pregnancy
in the termination of pregnancy, it interrupts progesterone support to the endometrium and sensitizes the myometrium to prostaglanins (causing contraction of the uterus) |
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Term
| superior/inferior vena cava -> right atrium -> tricuspid valve -> right ventricle -> pulmonary valve -> pulmonary artery -> lung -> pulmonary vein -> left atrium -> mitral valve -> left ventricle -> aortic valve -> aorta |
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Definition
| blood flow through the heart |
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Term
| sinoartrial node (SA node) -> atrioventricular node (AV node -> common AV bundle -> right and left bundle branches (purkinje fibers) |
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Definition
| electrical conductance in the heart |
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Term
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Definition
| the longest delay of conduction impulses in the heart occurs in the _________. |
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Term
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Definition
| have a more rounded EKG trace due to Ca influx in the depolarization phase (raising) and K efflux in the repolarization phase (descending) |
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Term
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Definition
EKG tracing has a sharp rise and plateau
sharp raise is due to Na influx, plateau is due to Ca influx and K efflux (balance), and downward shape is K efflux. |
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Term
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Definition
| atrial contraction in EKG |
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Term
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Definition
| ventricle contraction in EKG |
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Term
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Definition
| repolarization of the ventricle in EKG |
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Term
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Definition
intraventricular blood volume
stretching of the ventricles
the volume of blood in the ventricle at the end of filling |
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Term
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Definition
the resistance against which the left ventricle ejects
pressure in the aorta |
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Term
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Definition
| the greater the volume of blood entering the heart during diastole (pre-load), the greater the volume of blood ejected during systolic contraction (stoke volume) |
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Term
| sympathetic effect on the heart |
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Definition
increase force of contraction
increase HR
increase automaticity
reduced cardiac efficiency (oxygen consumption is increased more than cardiac work)
faster pacemaker depolarization
shifts the threshold to more negative potential |
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Term
| parasympathetic effect on the heart |
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Definition
cardiac slowing and reduced automaticity
inhibition of AV conduction through M2 receptors
decrease in cAMP
increase permeability of K channels
hyperpolarization
slower pacemaker depolarization
shifts the threshold to more positive potential |
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Term
| atrial natriuretic peptide |
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Definition
stored and released by atrial cells in the heart (endocrine function)
stretching of the atria causes its release
increases Na and water excretion by the kidneys
increase in cGMP by NPR-A or NPR-B |
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Term
| right coronary, circumflex, left anterior descending |
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Definition
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Term
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Definition
slow SA node
a latent pacemaker initiates an impulse |
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Term
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Definition
latent pacemaker cells develop an intrinsic rate of firing that is faster than the SA nodal rate
caused by ischemia, electrolyte abnormalities, heightened sympathetic tone |
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Term
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Definition
caused by the conditions that prolong the action potential (allows Na channels to recover from refractory period and extra contractions occur)
generally occurs during the repolarization phase of the action potential, also can occur during the plateau phase
can trigger an arrhythmia |
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Term
| delayed afterpolarization |
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Definition
intracellular Ca accumulation activates the Na/Ca exchanger
occurs shortly after repolarization |
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Term
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Definition
a self sustaining electrical circuit stimulates an area of the myocardium repeatedly and rapidly
2 conditions required: unidirectional block, slowed retrograde conduction velocity
can result in sustained pattern of rapid depolarization that trigger tacharrhythmias |
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Term
| 1st degree AV conduction block |
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Definition
prolonged PR interval
takes longer for electricity to flow through the AV node |
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Term
| 2nd degree AV conduction block |
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Definition
skipped beats
missing QRS
electricity did not get to the ventricles |
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Term
| 3rd degree AV conduction block |
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Definition
need a pacemaker
the P and the QRS waves are independent
no communication between the atria and the ventricles |
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Term
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Definition
antidysrythmic drug
beta-adrenoceptor antagonism
beta blocker mainly effecting the AV bundle |
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Term
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Definition
antidysrhythmic drug
potassium channel block
block repolarization, prolong action potential duration |
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Term
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Definition
antidysrhythmic drug
calcium channel blocker |
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Term
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Definition
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Term
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Definition
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Term
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Definition
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Term
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Definition
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Term
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Definition
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Term
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Definition
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Term
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Definition
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Term
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Definition
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Term
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Definition
[image]
Class 1a antidysrhythmic drug
Open Na Channel Blocker - moderate (3-9s) (slower raise b/c of
Na channels block, also blocks K channels and causes delayed repolarization)
decrease myocardial conduction velocity, excitability, and contractility
increase refractory period
prolongs QRS and QT intervals |
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Term
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Definition
[image]
Class 1b Na Channel Blocker - mild (0.1s)
I>O
AP duration is shortened
fast onset and offset kinetics
decrease Vmax in partially depolarized cells (higher affinity for inactivated channels/damaged cells) |
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Term
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Definition
[image]
Class 1c Na Channel Blocker - marked (11s)
AP duration is unchanged
I=O
most potent Na channel blocking effects
decrease conductivity but do not change the action potential duration |
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Term
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Definition
Class II drug, beta blocker
beta 1 selective antagonist
decrease conduction through the AV node |
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Term
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Definition
[image]
Class III drug, K channel blocker
prolong repolarization
conduction velocity is not decreased
prolong action potential duration and refractory period |
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Term
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Definition
Class IV drug, Ca channel blocker
slow conduction in the SA and AV nodes
shorten the plateau of the action potential and reduce force of contraction
unlike beta blockers, allow the body to retain adrenergic control of heart rate and contractility |
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Term
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Definition
the principle clinical manifestation of chronic CAD
occurs when the oxygen supply to the myocardium is insufficient for its needs
K+, H+, adenosine are possible candidates that cause pain |
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Term
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Definition
variant angina, occurs at rest
doesn't have to do with arthrosclerosis
intense vasospasm |
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Term
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Definition
antianginal drug
decrease oxygen consumption (aorta is relaxed and heart doesn't have to work as hard)
redistribution of coronary flow toward ischemic areas via collaterals
metabolized with release of NO (relaxes blood vessels)
inactivated by hepatic metabolism |
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Term
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Definition
antianginal drugs
beta-andrenoceptor antagonists
prophylaxis of angina
decrease heart rate
reduce force of cardiac contraction
decrease cardiac oxygen consumption |
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Term
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Definition
antianginal drug
Ca Channel Blocker (L-type channels)
vasodilator effect; decrease after load
reduces oxygen demand of the heart
negative effect on heart rate |
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Term
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Definition
prostanoid
relaxes smooth muscle, inhibits platelet aggregation
natural blood thinning factor |
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Term
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Definition
prostanoid
direct vasodilator, inhibit NE release
both effects cause vasodilation |
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Term
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Definition
prostanoids
contraction via thromboxane
cause vasoconstriction |
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Term
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Definition
activates GC
vasodilates
inhibits vascular smooth muscle cell proliferation
inhibit platelet adhesion and aggregation
inhibit monocyte adhesion and migration |
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Term
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Definition
| action of C type natriuretic peptide |
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Term
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Definition
| action of adrenomedulin (peptide) |
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Term
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Definition
| action of angiotensin II (peptide) |
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Term
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Definition
| action of endothelin (peptide) |
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Term
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Definition
| action of endothelium derived hyperpolarizing factor (EDHF) |
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Term
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Definition
secreted by the juxtaglomerular apparatus
converts angiotensinogen to angiotensin I
stimulants of secretion: decrease in Na in the distal tubulle, decrease in renal profusion pressure, beta receptor agonists, PGI2, angiotensin II causes feedback inhibition, ANP also inhibits renin secretion |
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Term
| angiotensin converting enzyme |
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Definition
membrane bound enzyme on the surface of endothelial cells
converts angiotensin I to angiotensin II
particularly abundant in the lungs
actions: vasoconstriction, increase NE release, increase reabsorption of Na, stimulate secretion of aldosterone from the adrenal cortex, increase cell growth in the heart and arteries |
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Term
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Definition
beta-adrenoceptor antagonists (B-blockers)
reduction of heart rate and cardiac contractility; decrease CO
blocks B1 receptors in the heart and kidney; reduces renin secretion |
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Term
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Definition
beta-adrenoceptor antagonist (B-blocker)
reduces heart rate and cardiac contractility; decrease CO
blocks B1 receptors in the heart and kidneys; reduce renin secretion
peripheral vasodilation; partial agonist for B2 adrenoceptors causing vasorelaxation |
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Term
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Definition
alpha adrenoceptor antagonist (a-blocker)
blocks post synaptic a1 receptors only (located in blood vessels) |
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Term
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Definition
non selective alpha-adrenoceptor antagonist
blocks post synaptic a1 receptors in blood vessels
blocks presynaptic a2 receptors causing reflex tachycardia as a side effect |
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Term
| methyldopa, clonidine (may cause vasoconstriction by acting as an agonist to a2 receptors) |
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Definition
centrally acting antihypertensives
bind as an agonist to presynaptic a2 adrenoceptors in the CNS
reduce central sympathetic nervous outflow
increase parasympathetic outflow
reduce vessel tone |
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Term
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Definition
ACE inhibitor
reduces generation of angiotensin II and release of aldosterone
decrease vascular resistance
decrease cardiac after load
decrease blood volume
side effect: dry cough |
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Term
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Definition
angiotensin II receptor antagonist
release of aldosterone is inhibited
dry cough is not a side effect |
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Term
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Definition
diuretic
causes excretion of Na+, Cl-, and water
direct arterial dilation
increased secretion of K+ and HCO3- (side effect of hypokalemia) |
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Term
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Definition
Ca antagonist
more prominent effects on vasodilation and coronary flow relative to diltizem and verapamil |
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Term
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Definition
cause opening of K channel; hyperpolarization
a very potent, long lasting vasodilator
causes hirsutism (treat baldness)
causes salt and water retention (body's response to the drug, compensatory)
causes reflex tachycardia |
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Term
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Definition
nitrovasodilator
a very potent vasodilator
release NO
acts equally on arterial and venous smooth muscle |
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Term
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Definition
phosphodiesterase inhibitor
an inhibitor of cAMP phosphodiesterase isozyme
positive inotropic and vasodilatory activity
cause an increase of cAMP, more vasodilation
however, in the heart cAMP causes increase force of contraction, so opposing effects in vessels and heart |
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Term
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Definition
a condition where the heart cannot pump enough blood throughout the body
causes: CAD, high blood pressure, diabetes, cardiomyopathy (disease of the heart muscle), disease of the heart valves, arrhythmias, congenital heart disease |
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Term
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Definition
heart failure treatment
relax vascular smooth muscle
reduce after load
used in combination with organic nitrate |
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Term
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Definition
heart failure treatment
cardiac glycoside
inhibit Na/K ATPase
increase force of contraction
cardiac slowing and reduced rate of conduction through the AV node
to slow ventricle rate in rapid, persistent AF |
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Term
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Definition
heart failure treatment
beta adrenoceptor agonist
increase force of cardiac contraction |
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Term
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Definition
excretion of waste products: urea, uric acid, creatinine
regulation of NaCl, electrolyte content, volume of extracellular fluid
acid/base balance
receives about 1/4 of cardiac output
several hundred liters of plasma flow through
99% reabsorbed
1.5L of urine per day |
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Term
| afferent arteriole, efferent arteriole, distal tubule (cortical thick ascending limb) |
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Definition
| components of the juxtaglomerular apparatus |
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Term
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Definition
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