Unit 4: Chapter 44

Question 1

Cervix

Answer 1

Round, the neck of the uterus that projects into the vagina.
It is a firm structure composed of a matrix of glands and muscular tissue.

is richly supplied with blood from the uterine artery and can be a site of significant blood loss during delivery.

Question 2

Cervix Function

Answer 2

The glands provide a rich supply of protective mucus; the muscular tissue becomes soft and pliable under the influence of hormones produced during pregnancy.

Question 3

Ovaries

Answer 3

are on either side of the uterus below the fimbriated ends of the fallopian tubes.
Attached to the posterior surface of the broad ligament and to the uterus by the ovarian ligament.
Covered with a thin layer of surface epithelium that is continuous with the lining of the peritoneum.
The integrity of this covering is periodically broken at ovulation.

Question 4

Ovaries Function

Answer 4

they store female germ cells (ova) and produce female sex hormones (estrogen and progesterone [EPT]).
Female gonads contain a fixed number of ova at birth that diminishes throughout a female’s reproductive life.

Question 5

Ovaries Structure

Answer 5

the mature ovary is divided into a highly vascular inner medulla, which contains supporting connective tissue, and an outer cortex of stroma and epithelial follicles (i.e., vesicles) that contain the primary oocytes, or germ cells.

Question 6

Ovarian Hormones

Answer 6

produce estrogens, progesterone, and androgens.
Secreted in a cyclic pattern as a result of the interaction between GnRH and the gonadotropic hormones FSH and LH.

Question 7

Estrogens

Answer 7

Female sex hormones
Secreted by ovaries in small amounts by the adrenal cortex.

Three estrogens occur naturally in humans: estrone (E1), estradiol (E2), and estriol (E3). Of these, estradiol is the most biologically potent and the most abundantly secreted product of the ovary.
Are secreted throughout the menstrual cycle.

Question 8

Estrogen Function

Answer 8

are necessary for normal female physical maturation.
With other hormones, estrogens provide for the reproductive processes of ovulation, implantation, pregnancy, parturition, and lactation by stimulating the development and maintaining the growth of the accessory organs

Question 9

Estrogen and Bone Resorption

Answer 9

Decreased rate of bone resorption

Question 10

Estrogen and Plasma Proteins

Answer 10

Increased production of thyroid and other binding globulins

Question 11

Estrogen and Lipoproteins

Answer 11

Increased high density and slightly decreased low density lipoproteins

Question 12

Menopause

Answer 12

the cessation of menstrual cycles. Like menarche, it is a process rather than a single event.
Most females stop menstruating between 48 and 55 years of age.
A female who has not menstruated for a full year or who has a persistently elevated FSH level (>20 mIU/mL) is considered menopausal.

Question 13

Perimenopause

Answer 13

The years immediately preceding and following menopause) begins approximately 4 years before the cessation of menstruation and is characterized by menstrual irregularity and other symptoms.

Question 14

Functional Changes from Menopause

Answer 14

represents the gradual cessation of ovarian function and resultant diminished levels of estrogen.
estrogen continues to circulate, it is not sufficient to maintain secondary sexual characteristics, and body hair, skin elasticity, and subcutaneous fat decrease.
Breasts decrease in tissue mass, ovaries and uterus decrease in size, cervix and vagina are pale and friable,8 and vaginal pH increases (pH > 4.5 indicates estrogen deficiency).

Question 15

Menopause Manifestations

Answer 15

vaginal dryness, urinary stress incontinence, urgency, nocturia, vaginitis, and urinary tract infection.
significant vasomotor instability secondary to the decrease in estrogens and relative increase in other hormones.
This hormonal instability may give rise to “hot flashes,” palpitations, dizziness, and headaches as the blood vessels dilate.
“Hot flashes,” vary in onset, frequency, severity, and duration. Occur at night

Question 16

Menopause Influence on Disease

Answer 16

cessation of ovarian function also results in changes that can influence the health and well-being of postmenopausal individuals. Consequences of long-term estrogen deprivation include osteoporosis and an increased risk for cardiovascular disease, which is the leading cause of death after menopause.8 Other potential health threats are loss of vision and cognitive impairment.

Question 17

CSEPT Hormone Therapy

Answer 17

progesterone is added to estrogen therapy for 12 to 14 days to induce the maturation of any endometrial tissue that developed in response to estrogen exposure.
Progesterone withdrawal results in endometrial shedding. When used continuously, a small amount is added to the daily estrogen regimen.
Continuous exposure to progesterone inhibits endometrial development and eventually results in the cessation of bleeding.

Question 18

Avoiding Risk with Hormone Therapy

Answer 18

Including CSEPT and ET.
Studies were terminated because it was detemined that the risks for breast CA and CVS diseases outweighed the benefits.

Question 19

Breast Cancer Cells and Estrogen

Answer 19

can be present in the body for 8 to 10 years before the cancer is detected.
Estrogen may accelerate the growth of these cells to the point that the cancer can be detected, possibly while it is still curable.
It is still not clear whether females with a history of breast cancer and symptoms of menopause can take HT safely.

Question 20

Breast

Answer 20

specialized glandular structures with an abundance of nervous, vascular, and lymphatic tissue
Males and females are born with rudimentary breast tissue, which includes ducts lined with epithelium.
Estrogen stimulates the growth and proliferation of the ductile system.
Progesterone stimulates growth and deveoplemt of ductile and alveolar secretory epi.

Question 21

Breast Structure

Answer 21

Breast mass consists of fat, fibrous connective tissue, and glandular tissue.
The superficial layer of fibrous CT is attached to the skin, allowing the skin to move smoothly over the breast to facilitate visual observation of superficial structures.
The breast mass is supported by the fascia of the pectoralis major and minor muscles and by the fibrous connective tissue within the breast.
Cooper Ligaments extend radially to the nipple area

Question 22

Breast Function

Answer 22

20 lobes that contain grape like cluster of alveoli or glands.

The alveoli are lined with secretory cells that can produce milk or fluid under specific hormonal conditions.
Breast milk is produced secondary to complex hormonal changes associated with pregnancy

Question 23

Montgomery Tubercles

Answer 23

Small bumps on the surface of the nipple

Question 24

Nipple

Answer 24

made up of epithelial, glandular, erectile, and nervous tissue. The areola is the darker, smooth skin surrounding the nipple.

Montgomery tubercles (bumps) are sebaceous glands whose secretions keep the nipple area soft and elastic.

Question 25

Changes during Pregnancy and Lactation

Answer 25

During pregnancy, increased levels of EPT significantly alter the breasts. Estrogen stimulates increased vascularity of the breasts and the growth and extension of the ductile structures, causing “heaviness” of the breasts. Progesterone causes marked budding and growth of the alveolar structures. The alveolar epithelium assumes a secretory state in preparation for lactation. Cellular changes that occur in the alveolar lining are thought to change the susceptibility of these cells to estrogen-mediated changes later in life.

Question 26

Lactation

Answer 26

During lactation, milk is secreted by alveolar cells, which are under the influence of the anterior pituitary hormone prolactin. Milk ejection from the ductile system occurs in response to the release of oxytocin from the posterior pituitary. The suckling of the infant provides the stimulus for milk ejection.

Question 27

Sucking of Infant on Breast

Answer 27

The suckling of the infant provides the stimulus for milk ejection. Suckling produces feedback to the hypothalamus, stimulating the release of oxytocin from the posterior pituitary. Oxytocin causes contraction of the myoepithelial cells lining the alveoli and ejection of milk into the ductal system.