This document includes all the cases, lecture notes and skills labs and statistics/epidemiology from block 2.2 (from 2016). It is extensive and includes all the details you need to go from a general overview to a precise picture. This is the hardest block of the year and having this kind of detail ...
It were all very concise bullet points, which could have used some more explaining. Optimizing studying with this summary required a lot of individual additional research. The summary does cover some more in depth terms which was good.
Door: anasanchez-moreno • 6 jaar geleden
That is true, the summary does assume that you've followed the previous courses and have that prior knowledge.
I. Anatomy and Physiology of the Reproductive System
1. Female Anatomy: boobies are important
- ligaments:
, - Broad ligament: covers the uterine anatomy spreading to the lateral side ; connects uterine
vessels and nerves
- splits into the mesovarium (connects to ovary) and for tubes (mesosalpinx)
- sacrospinous lig.: connects the sacral spine to itself - uterosacral lig. = rectouterine lig.:
connects uterus to the anterior aspect of the sacrum ; contains splanchnic nerves
- cardinal lig. = lateral/transverse cervical lig.: base of the broad lig connecting the cervix to
the lateral pelvic wall (via attachment to the obturator fascia of the obturator internal muscle)
- proper ovarian lig.: binds ovary to the uterus
- round ligament: connects uterus horns (where the suspensory lig. connects) to the pelvis via
the inguinal canal and to the labia majora ; contains lymph vessels and connects to inguinal
lymph nodes
- infundibular-pelvic lig. = suspensory lig.: connects ovaries to the post abdominal walls (at
cervical level and below the pouch of Douglas) ; contains uterine artery
- fimbriae: pick up the egg during ovulation via the ciliated cells
- vessels: lateral to medial ; ureter: lateral and upwards to kidneys
- version:
- anteversion: angle between the vagina and the cervix is anterior
- retroversion: angle between the vagina and the cervix is posterior
- flexion
- anteflexion: angle between cervix and uterus corpus is anterior
- retroflexion: angle between cervix and uterus corpus is posterior
- anteversion - anteflexion is the most common (90%)
- vagina is at 45-60 degrees posteriorly and up
- uterus: 7-8 cm long, 4-5 cm wide, anterior and posterior sides touch
- cervix: 2-3cm
2. Female Physiology
Ovarian Cycle
- 3 phases: follicular, ovulation, luteal
Follicular:
- increase of FSH causes primordial follicles to become primary follicles (6-12) w/
development of granulosa cell + thecal cells
- granulosa cells produce estrogen, forms FSH receptors (positive feedback loop), formation of
antral follicle
, - estrogen has negative feedback loop of
hypothalamus; decrease of FSH leads to atresia of
weaker follicles
Ovulation:
- surge of LH, increased production of
progesterone, secretion of proteolytic enzymes
- small progesterone peak stimulates LH; inhibin
inhibits FSH
- prostaglandins weaken collagen fibres
- both combine to cause follicle swelling, rupture
and liberation of ovum into Fallopian tube
Luteal:
- LH causes luteinization: growth of cells,
filling of lipids
- granulosa/thecal cells become luteal cells
to form corpus luteum
- thecal cells produce androgens,
transformed by granulosa cells into
progesterone/estrogen (enzyme aromatase)
- estrogen/progesterone/inhibin: negative
feedback loop causes deterioration of corpus
luteum into corpus albicans
Uterine Cycle
- 3 phases: proliferative, secretive, menses
Proliferative (up to ovulation):
- estrogen stimulates reepithelization of endometrial stroma
Secretive (up to menstruation):
- progesterone stimulates secretions of lipids/glycogens; increase in vascularization
Menses:
- absence of estrogen/progesterone causes necrosis of blood vessel cells/endometrial cells
- constriction followed by widening of blood vessels causes break down (+ prostaglandins)
- expulsion of endometrium inner lining
, Fertilization
- occurs in the ampulla of the oviduct where the oocyte is located
- oocyte protected by two layers: corona radiata and zona pellucida with the perivitelline space
between the ZP and the plasma membrane
- spermatozoa directed towards oocyte by attraction signals
- corona radiata: thick cellular layer containing proteins/carbohydrates and high concentration of
hyaluronic acid
- spermatozoa pass it by their tail movements and (hypothetically) by releasing hyaluronidase
from the heads to break down the hyaluronic acid
- zona pellucida: layer consisting of glycoproteins
- spermatozoa binds to ZP3 protein activating the acrosomal reaction
- acrosomal reaction: GPCR reaction leads to fusion of plasma membrane and acrosomal
membrane releasing the contents of the acrosome
- enzymes (ie. acrosin) digest the way through the zona pellucida
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