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IUB MSCI-M 131 - Female Reproductive System

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MSCI 131 Diseases andthe Human Body Lecture2 Outline of Last Lecture I. Male Reproductive SystemCurrent LectureFemale Reproductive SystemI. Ovaries: until the 6th week of pregnancy, the sex organs in both sexes are bipotential – the sex organ present in the embryo may become either a testis or ovary. During the 7th week of pregnancy, the organ develops – testis-determining factor (TDF) on the Y-chromosome influences maleness and one or more female-determining genes influence femaleness. The ovaries descend to their normal position by the 12th week and attach to the uterusa. Structure: ovaries held in place by attachment to the uterus (Ovarian Ligament) and to the pelvic wall (suspensory Ligament). Internally, in the newborn, the outer portion of the ovary (cortex) contains several hundred thousand oogonia (cells that develop into eggs) – these are the only ones during whole lifetime, no new developI. Each oogonium is surrounded by a population of protective and nourishing cells,granulosa cells. Prior to birth, some oogonia increase in size and become primary oocytes – will lie dormant until pubertyII. Oogenesis: sequence of events leading to the development of egg cell. Two hormones responsible, released from brain every 28 days (average)1. Follicle stimulating hormone (FSH): responsible for increasing # of granulosa cells2. Luteinizing hormone: causes primary oocyte to divide into secondary oocyte and a polar body (which degenerates), and causes release of secondary oocyte = ovulation. a. After secondary oocyte is released, LH causes the corpus luteumto develop – produces estrogen and progesterone – hormones that prepare the uterus for secondary oocyte implantation after fertilization; estrogen also causes development of secondary sexcharacteristicsa. Contraception:These notes represent a detailed interpretation of the professor’s lecture. GradeBuddy is best used as a supplement to your own notes, not as a substitute.II. Birth control pills: usually contain mestranol, synthetic form of estrogen, and either norethynodrel or norethinodrone – synthetic form of progesterone1. Hormones go to brain, trick it into thinking corpus luteum is present, so the brain will stop producing LH and FSH to prevent another egg from developing (no need since the body thinks there is an egg ready for fertilization and implantation)a. Antibiotics can affect birth control – may induce liver metabolism of progestins, make it hard to absorb hormones, may make body get rid of hormones faster (can un-inhibit brain)b. Types vary on how much estrogen and progesterone present and form of introduction to bodyIII. “Morning –after Pill”: sold by prescription called preven – essentially birth control pills but with much higher doses of estrogen and prodestins. First dose must be taken within 72 hours of intercourse and the second must follow 12 hours later1. Unclear how high doses of hormones taken after intercourse prevent pregnancy, possible effects of treatment: to cause changes in the lining of the uterus that prevent implantation; inhibit or delay ovulation; impede tubal transport of egg or sperm – proved 98% effectiveIV. RU-486 (mifepristone) = abortion pill: FDA approved by Danco labs in 2000; anti-progesterone – very similar structure to progesterone but not activity: progesterone normally thickens uterine lining for implantation, but RU-486 binds to cells of the uterus and blocks progesterone from binding – causes menstruation, shedding the lining and taking embryo with it. Must be taken through 7th week (8th week brain waves are measureable), followed by mifeprex, which causes uterine contractions to expel tissueb. Ovarian Cysts: usually sacs on an ovary that contain fluid or semisolid material (cyst= fluid filled structure)I. Etiology unknown – actually make a cyst every monthII. Symptoms: Normally, produce no symptoms, large ones can be painful. Real concern is when cyst ruptures, b/c ovarian vessel may tear- result in hemorrhage. III. Treatment: usually regress or rupture on own within 60 days. However, large onemay block blood flow, need to be removed surgically c. Ovarian cancer: 4th most common female cancer. Peak incidence between 60-80 years. Most dangerous because seldom diagnosed in early stages – not diagnosed until it has metastasized.I. Etiology unknownII. Symptoms: abdominal swelling, abdominal pain, non-menstrual bleeding, weight loss, problems with urination and constipationIII. Detection1. Transvaginal sonography (TVS): ultrasound, may detect it in early stages2. MRI: great for visualizing soft tissue3. Blood test for CA125: cancer antigen (protein produced by cancer) but only has predictive value of 35%4. Proteomic fingerprinting: this is the detection of multiple proteins (tumor markers) in one blood sample (i.e. CA125, CA72-4, AFP, BH CG, CA19-9 and CEA). An elevation of these 6 proteins is more predictive of cancer IV. Treatment: usually removal of uterus, ovaries, and oviducts. Radiation therapy and chemotherapy may be used in conjunction with surgery – only 10-30% 5 year survival rateIII. Uterine tubes/ oviducts/ fallopian tubes: each oviduct has 4 parts:1. Infundibulum – nearest ovary, long, fingerlike projections – fimbriae- responsible for “sweeping” ovulated oocyte into the oviduct. Fimbriae cover the ovaries almost completely – pulse rhythmically 2. Ampulla – longest part of the oviduct – 95% of fertilization occurs here3. Isthmus – narrowed part, width about 4 hairs, just big enough for egg4. Interstitial segment – in wall of uterus a. Tubular pregnancy: since egg is fertilized in oviduct, it is common for egg to attach to thewall and begin dividing – type of ectopic pregnancy (anywhere but normal). 90-95% occur in oviduct. II. Symptoms: abdominal pain or discomfortIII. Problems: main concern is enlargement, rupture, and consequent hemorrhage of the uterine tube (very vascular structure)IV. Treatment: typically removal of the oviduct is required (salpingectomy). Recently, some eggs have been removed and transplanted to uterus with 15% successb. Salpingitis: inflammation of the oviducts. Untreated sexually transmitted diseases can cause the inflammation, as can a streptococcal or staphylococcal (bacterial) infection. I. Typically, these organisms cause a pus infection, and when the outer end of the tubes swell shut, pus accumulates – a pyosalpinx. When inflammation goesdown after antibiotic treatment, the tubes


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IUB MSCI-M 131 - Female Reproductive System

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