Term
| What is the purpose of the menstrual cycle? |
|
Definition
Prepares the uterus for pregnancy
Monthly coordinated events that take place b/w the pituitary, ovaries, and uterus |
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Term
When is the 1st day of the menstrual cycle?
What causes it? |
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Definition
Menses (1st day of period); lasts about 4-5 days
Occurs after luteal phase if no conception occurs; uterine lining and blood shed |
|
|
Term
| How long is the average Menstrual cycle? |
|
Definition
|
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Term
| What is the first half of the menstrual cycle called? |
|
Definition
| Follicular/proliferative phase |
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Term
| What is the purpose of the follicular/proliferative phase? |
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Definition
maturation of the follicle in ovary
endometrial proliferation (estrogen stimulates the endometrium to grow/thicken; cells multiply and tissue grows) |
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Term
| Which hormone is dominant during the follicular phase? |
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Definition
|
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Term
| What is the ovary follicle? |
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Definition
| anatomical structure in which the primary oocyte (egg) develops |
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Term
| During proliferative phase, what is happening in the ovary? |
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Definition
Several follicles are maturing
one follicle will rupture and release an egg |
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Term
| During the proliferative phase, what is happening to the endometrium? |
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Definition
| Estrogen acts on Endometrium cells and tissues to encourage multiplying/thickening (proliferation) so endometrium is prepared to receive fertilized egg (ovum) after ovulation |
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Term
| During the proliferative phase, what happens to the cervical mucosa? |
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Definition
| When estrogen predominates, cervical mucosa is watery |
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Term
| During the proliferative phase, what happens to the basal temperature? |
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Definition
| Cooler body temperature occurs |
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Term
| When does the proliferative phase occur? |
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Definition
|
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Term
| When does the secretory/luteal phase begin? |
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Definition
|
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Term
| When in the cycle does ovulation occur? |
|
Definition
Day 14 (approximate)
Mid cycle; also marks start of secretory/luteal phase |
|
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Term
|
Definition
| Egg released from ovarian follicles into oviduct/fallopian tubes |
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Term
| Which hormonal event allows ovulation? |
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Definition
Estrogen spikes, sends signal to anterior pituitary to shut off FSH
LH spikes
LH peak levels correspond with ovulation; cause follicle to swell, rupture, launch egg into fallopian tube
Ovulation occurs |
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Term
| What is the purpose of the secretory/luteal phase? |
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Definition
| CL secretes progesterone; prepares endometrium for embryo implantation |
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Term
| What happens if implantation of an egg does not occur during the secretory/luteal phase? |
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Definition
|
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Term
| What hormone is largely in control of building up the uterus? |
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Definition
estrogen; secreted by ovary
If rebuilding were to continue unchecked it would be dangerous, so progesterone takes over during secretory phase |
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Term
| What hormone dominates during the luteal phase? |
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Definition
|
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Term
| What is responsible for producing progesterone during the luteal phase? |
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Definition
| Progesteron produced by both ovaries and CL under the influence of LH |
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Term
| If pregnancy does occur, what happens to the CL in the luteal phase? |
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Definition
| Ovum will produce own hormone - Hcg (human chorionic gonadotropin) that acts on CL to produce progesterone until the placenta can take over estrogen/progesterone production during 2nd month of pregnancy |
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Term
| If pregnancy does not occur, what happens to CL in the luteal phase? |
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Definition
| CL degenerates, progesterone levels drop off, menses occurs |
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Term
| What happens to the endometrium during the secretory/luteal phase? |
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Definition
converted to a secretory phase
secretion of glycogen nutrient |
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Term
| What happens to the cervical mucosa during the secretory/luteal phase? |
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Definition
| cervical mucosa is thick, scant, vicious |
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Term
| Why are Progesterone OC effective? |
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Definition
| causes cervical mucosa to be thick/viscous; sperm cannot penetrate mucous barrier at cervix |
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Term
| What happens when progesterone is withdrawn? |
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Definition
|
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Term
| What happens to the basal temperature during the secretory/luteal phase? |
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Definition
| temperature is warmer/increases slightly |
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Term
|
Definition
During leuteal phase, LH directs estrogen synthesis by the CL
Spike in LH mid-cycle; corresponds to highest level of estrogen produced by ovary
LH causes follicle to swell, rupture, launch egg into fallopian tube
LH continues to exert effect on newly formed CL, to promote estrogen and progesterone |
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Term
|
Definition
During follicular phase, FSH directs estrogen synthesis by ovaries
During follicular/proliferative phase, FSH released and causes ovarian follicle maturation and secretion of estrogen from follicle.
Estrogen levels rise (enough to cause maturation of follicle and endometrial proliferation); estrogen negatively feeds back to the anterior pituitary to shut off FSH |
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Term
| Name the steps in the menstrual cycle and define the major events in each |
|
Definition
Menses: day 1-4; uterine lining and blood shed if egg fertilization does not occur during secretory phase
Proliferative phase: day 5-14; preparation for egg implantation occurs in case fertilization does take place during secretory phase, uterine lining proliferation occurs
Ovulation: around day 14; egg released from ovarian follicles when estrogen levels peak, egg anticipates fertilization
Secretory phase: Day 14-28; corpus luteum forms and secretes progesterone, preparing endometrium for embryo implantation; egg is available to be fertilized by sperm. If fertilization does not occur, the CL breaks down, progesterone drops off, and menses occurs. |
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Term
| Explain the HPT axis of estrogen, progesterone in females |
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Definition
| FEMALES: Hypothalamus secretes GnRH-> Anterior Pituitary secretes FSH & LH -> Acts on Ovary, ovary secretes progesterone and estrogen -> target organs |
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Term
| Explain HPT axis of testosterone in males |
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Definition
| MALES: Hypothalamus secretes GnRH-> Anterior pituitary secretes FSH & LH -> acts on Testis, within Testes LH stimulates Leydig Cells to release testosterone, FSH stimulates Sertoli Cells and maturation of sperm occurs-> LEYDIG cause testosterone, dihydrotestosterone, estradiol act on target organs and SERTOLI cause inhibit, activin act on target organs |
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Term
| In HPT axis in males, LH stimulates ________ which then _______ |
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Definition
| Leydig cells, release testosterone, act on target organs |
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Term
| In HPT axis in males, FSH stimulates _________ which then ______________ |
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Definition
| sertoli cells, allow maturation of sperm, release inhibit/activin and act on target organs |
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Term
| What are the effects of estrogen on sexual maturation? |
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Definition
| Maturation of the vagina, uterus, fallopian tubes, and breasts, plus development of the secondary sexual characteristics (pubic, axillary hair, pigmentation of the areola and genitalia |
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Term
| What are the effects of estrogen on the bone? |
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Definition
• Under normal circumstances, bone undergoes continuous deposition and resorption (breakdown) by the osteoblasts and osteoclasts, respectively
• This process is in a delicate balance
• In the absence of estrogen, as in menopause (or surgical menopause, if diseased ovaries are removed), osteoclast activity predominates and bone resorption/demineralization happens, making the bone weaker and more susceptible to fracture |
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Term
| What are the effects of estrogen on cholesterol? |
|
Definition
Estrogen promotes an increase in HDLs and a decrease in LDLs, which is good for prevention of CAD
Estrogen also causes and increased secretion of cholesterol into the bile, which may explain why certain women experience cholelithiasis (gallstone) when taking OCs |
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|
Term
| How does progesterone support a pregnancy? |
|
Definition
Inhibits uterine contractions and maternal antibodies that can cause rejection of fetus
Causes mucous to thicken and keeps things out of cervix |
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Term
| Which hormone/trope signals leydig cells to secrete testosterone? |
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Definition
|
|
Term
| Which hormone/trope signals sertoli cells to mature and eject sperm? |
|
Definition
|
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Term
| What are the anabolic effects of testosterone? |
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Definition
| build up body, male characteristics develop, growth of muscle mass and strength, increased bone density and strength, sebaceous gland stimulation, effect is the same in males and females, lessens as sexes age. |
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Term
| What are the virilizing effects of testosterone? |
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Definition
| maturation of the sex organs, deepening of the voice, growth of beard and axillary hair, subcutaneous fat in face decreases, growth of Adam’s apple, stimulation and maturation of sperm |
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Term
| What effects does testosterone have on RBCs? |
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Definition
| Promotes synthesis of erythropoietin; stimulates RBC production |
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Term
|
Definition
Absence of estrogen
Ostoclast activity predominates; bone resorption/demineralization occurs making bone weaker and more susceptible to fracture |
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Term
| What are menopause symptoms? |
|
Definition
• Vasomotor symptoms “hot flashes”
• Accelerated bone loss
• Joint Pain/stiffness
• Changes in GI function
• Tachycardia, palpitations, feeling faint
• Sleep disturbance
• Thinning skin
• Increased risk of CAD
• Atrophy of vaginal structures/breast tissue |
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Term
| What stress hormone mediates vasomotor symptoms/hot flashes? |
|
Definition
norepinephrine
Decreased estrogen --> increased NE production --> stimulation of the thermoregulatory center in the hypothalamus |
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|
Term
|
Definition
| Intense heat production, palpitations, nausea, HA, dizziness that can last from 30 sec to 5 min |
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Term
| What is a priapism? What is it's etiology? |
|
Definition
painful persistant erection due to engorgement with blood
Caused by idiopathic causes; sickle cell anemia, diabetes, leukemia, use of antidepressants, intracavernosal injections |
|
|
Term
| Clinical manifestations of priapism |
|
Definition
• Blood cannot leave penis
• Unwanted erection lasting 4+ hours
• Rigid penile shaft, soft tip
• Erection not related to sexual stimulation or persistent after stimulation
• painful/tender penis |
|
|
Term
| What are the treatment options for priapism? |
|
Definition
treat underlying cause
Aspiration of blood, injection of a-adrenergic agents, surgery |
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|
Term
What is phimosis?
What is it caused by?
How treat phimosis? |
|
Definition
Occurs when the uncircumcised foreskin cannot be retracted over the glans of the penis
Caused by chronic inflammation/infection from poor hygiene
May cause Calculi and squamous cell carcinoma
Treatment: treat infection, then circumcise |
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|
Term
What is paraphimosis?
What is it caused by?
How treat it? |
|
Definition
Foreskin that has been retracted over the glans up onto the shaft of the penis cannot be replaced in its normal position
Foreskin cuts off circulation, Constriction causes venous congestion with edema
Treatment: Reduce the paraphimotic foreskin; circumcise |
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Term
|
Definition
impotence or inability to attain erection
vascular issue |
|
|
Term
|
Definition
| lifelong problem, psychiatric related |
|
|
Term
What is Secondary ED
What are meds for secondary ED |
|
Definition
| no longer able to have an erection, can be related to endocrine problems ex. diabetes, peripheral vascular diseases, trauma (fractures pelvic or penile), Iatrogenic causes (surgeries), Medications: antihypertensives antihistamines, phenothiazines |
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Term
|
Definition
Determine psychogenic or organic cause
Surgical intervention
Insertion of prosthesis, Intracavernous injection, vacumn device
Vasoactive medications: papaverine, phentolamine, prostaglandin E
Selective inhibitors of cyclic guanosine monophosphate: Viagra, Levitra, Cialis
Viagra: nitric oxide mechanism improves vascular functions |
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Term
|
Definition
| Absense or suppression of menstruation, caused by hormonal disturbances, stress, neoplasm |
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|
Term
|
Definition
absence of menstruation
girl has not started her monthly periods, and she has gone through other normal changes that occur during puberty and is older than 15 |
|
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Term
|
Definition
| absence of menses for 3 cycles or 6 months, can be due to Lactation, adolescence, perimenopausal years, weight loss, malnutrition, intense exercise can contribute, an ovulation |
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Term
|
Definition
|
|
Term
| What is dysfunctional uterine bleeding? |
|
Definition
| abnormal endometrial bleeding not associated with tumor, inflammation, pregnancy, trauma, hormonal effects |
|
|
Term
| Causes of dysfunctional uterine bleeding in adolescents |
|
Definition
| immaturity in functioning of the pituitary and ovary |
|
|
Term
| causes of DUB in perimenopausal women |
|
Definition
| progressive function and failure of the ovary to produce estrogen |
|
|
Term
| Is DUB in women ages 20-30 normal? |
|
Definition
No- not normal.
only common around time of menarche and menopause |
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|
Term
|
Definition
|
|
Term
| What is primary dysmenorrhea |
|
Definition
develops 1-2 years after menarche-
From increase prostaglandin that promotes uterine contractions and ischemia of endometrial capillaries
Sharp, suprapubic cramping severe enough to limit activity, nausea, vomiting, diarrhea |
|
|
Term
| What is secondary dysmenorrhea |
|
Definition
Associated with pelvic disorders such as endometriosis or pelvic adhesions
-Of Dull quality, may increase with age |
|
|
Term
| Which endogenous substance usually is responsible for primary dysmenorrhea |
|
Definition
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|
Term
| Treatment of primary dysmenorrhea |
|
Definition
Heat, massage, ibuprofen, regular exercise
Prostaglandin inhibitors
Oral contraceptives
Laparoscopy, medical/surgical therapy |
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|
Term
| Nursing advice for pt with dysmenorrhea |
|
Definition
| Make sure to exercise regularly, take Ibuprofen when you know you will start your period, eat bananas, use heating pad ect. See Dr to check for secondary causes |
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|
Term
| What about bananas helps dysmenorrhea |
|
Definition
| Bananas contain high amounts of potassium and magnesium that work together to block the release of prostaglandins and occurrence of spasms/relax muscles |
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|
Term
|
Definition
• Infectious inflammation of any organ in the upper genital tract in women
Ex. Uterus, fallopian tubes (salpintitis), or ovaries (oophoritis)
– Usually bacterial, often sexually acquired, or resulted from STD |
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|
Term
|
Definition
-Sexually active and <25 years old
-Multiple sex partners, or involved with someone who has multiple partners
-IUD placed
-Frequent douching. Disrupts the normal vaginal flora
-History of PID or STDs |
|
|
Term
|
Definition
-Could be asymptomatic
-Lower abdominal pain/pelvic pain (r/o appendicitis)
-Lower back pain
-Odorous, heavy vaginal discharge
-Painful intercourse
-Fever
-Fatigue
-Vomiting, diarrhea, dysuria
-Complications: septic shock, ectopic pregnancy |
|
|
Term
|
Definition
-Antibiotic therapy
-Avoid intercourse until inflammation resolves |
|
|
Term
|
Definition
| • Contraception/safe sex, infrequent douching, good personal hygiene |
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|
Term
|
Definition
|
|
Term
|
Definition
| phase when menstrual cycle stops permanently |
|
|
Term
|
Definition
bleeding between menstrual periods
Causes:
Slight bleeding from endometrium during ovulation
Uterine malignancy
Cervical erosions
Endometrial polyps
Estrogen therapy |
|
|
Term
|
Definition
| Infrequent menstruation, Cause: Endocrine/systemic disorder causing failure to ovulate |
|
|
Term
|
Definition
| Deficient amount of menstrual flow, Causes: Endocrine or systemic disorders interfering with hormones or Partial obstruction of menstrual flow |
|
|
Term
|
Definition
| Increase in amount or duration of bleeding, Cause: Lesions of reproductive organs |
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