Exam #1 Content

• Gametogenesis


  The process by which germ cells (sperm and ovum) are produced
• Reproductive Cycle

  Average cycle is 28 days
• Menstrual Phase


  Day 1-5, shedding of endometrium and BLOOD, low estrogen
• Proliferative phase


  Day 5 to ovulation, LH converts follicle to corpus luteum→ makes progesterone
• Secretory (luteal phase)


  Ovulation to approximately 3 days before menstruation, estrogen decreases and progesterone increases
• Ischemic Phase


  3 days before menstruation to onset of menstruation, if no fertilization, corpus luteum degenerates and estrogen and progesterone drop
• Ovulation


  • Big event that marks middle of cycle (around day 14), release 1 egg each cycle (they are alive for 24 hours), sperm are alive for 48-72 hours, we have all our eggs when we are born
• Ovulation signs

  • Mittelschmerz (pain in middle of cycle when egg is released, usually on one side)
  • Spinnbarkeit (thinner cervical mucus)
  • Cervix opens slightly (it is usually closed and mucus is thick to keep things out)
  • Elevated basal body temp (BBT)
  • Ferning pattern, decreased estrogen, increased progesterone
• Day 1


  First day of menstrual period (LMP), important to know each cycle, getting rid of shit
• Fertilization


  Takes place in the ampula (outer third of fallopian tubes), they have cilia to pull egg in (can get damaged with STI's and smoking), when ova and sperm for a zygote (in the ampulla of fallopian tube), increased estrogen cause contractility of fallopian tube
• It takes a week for fertilized ovum to reach the uterus
• PID


  Chlamydia/gonorrhea/recurrent infections causes damage to the fallopian tubes over time, smoking (stiffens the fibria aka the fallopian fingers) which inhibits egg movement, can make pregnancy hard to achieve or create major complications, also affects sperm production (makes it "not as good")
• Progesterone


  Pro pregnancy/maintains pregnancy until placenta, may be used to maintain pregnancy with early labor (stop it), can buy some time in utero, may cause PMS symptoms (irritability and cramping), increases secretions of fallopian tube and uterus to provide appropriate nutritive matter, causes decidual cells to develop in uterine endometrium, decreases contractility of uterus, helps prepare breasts for lactation, inhibits spontaneous uterine contraction/abortions, increases during pregnancy and decreases if a person isn't pregnant
• Pituitary gland

  Releases hormones to cause ovulation
• Prostaglandins (PGs)


  Force contraction, work in inflammatory pathway, responds to stress, cramping, back pain and diarrhea and loose stool, we can give to promote to contractions or give INHIBITORS to stop them, low (HTN preeclampsia), okay until 28 weeks (after it can cause premature closing of ductus arteriosus), we want contractions at 40 weeks→ we monitor prostaglandins during pregnancy to see if body is wanting to contract or not
• Corpus luteum


  Responsible for hormones until placenta comes in, secretes progesterone and peaks 8 days after ovulation (same time implantation occurs)
• Placenta


  Had bloody dark red attached side and a shiny side, takes ten weeks to develop, needs to develop high to prevent blocking the cervix (previa can happen)
• Mitosis


  Exact copies of previous cell (2 identical daughters), often for growth
• Meiosis


  Differentiates germ cells, a process of cell division by which diploid cells give rise to haploid gametes (sperm and ova), decreases the number of chromosomes by half and occurs in 2 successive cell divisions, 46 chromosomes → 23 autosomal pairs, and 2 sex chromosomes, XX (female) and XY (male), mom always give X; dad can give either X or Y
• First division


  Chromosomes replicate, pair & exchange information → then pairs separate & cell divides
• Second division


  Chromatids separate, cells divide (daughter cells), mutations sometime occur
• Trisomy


  Down syndrome (Trisomy 21), edward's syndrome (Trisomy 18)
• Eggs

  Made in utero (all present at birth), increased risk with old age, alive for up to 24 hours, cancer radiation as a child damages them, oogenesis (mature, 3 polar bodies)
• Sperm


  Made at puberty (in testes), alive for 48-72 hours, millions are released but only 1 enters the egg (rip boys), pointy to penetrate egg (hyaluronidase to break down the hyaluronic acid "glue" of the ovum tissue), around 200-400 million per ejaculation, spermatogenesis (4 spermatids)
• Fraternal (more common about ⅔)


  Dizygotic (2 ova and 2 sperm), 2 placentas (chorion and amnion), each have their own placenta (dichorionic or amniotic), share 50% of DNA, like normal siblings, can be different sexes
• Identical (about a ⅓)


  Monozygotic (single fertilized ovum or random event), same genotype, share a placenta or each have their own "pocket of fluid", 1 chorion and 2 amnion, more at risk of TTTT or congenital anomalies
• Twin to Twin Transfusion Syndrome

  When babies share a placenta but have unequal circulation (can be poor outcome for both babies)
• Fetal Development

  • Preembryonic 1-2
  • Embryonic 3-8
  • Fetal 8-40
• 4 weeks


  • Baby's heart starts to beat (we don't hear it til around 10 weeks w a doppler), can see the heart beating on ultrasounds
• 1. 10 weeks


  • All organs systems and external structure is present, rest is devoted to refining function, if there is a defect in the midline, multiple organs can be affected (heart, brain, GI)
• 16 weeks


  • Sex can be seen with ultrasound (10-12 w other dna type tests)
• 18-20 weeks


  • Can hear heart with a fetoscope (special stethoscope), also when mom feels the baby move (quickening), big head (growth is top to bottom)
• 24 weeks


  • Age of viability (can live outside uterus with help)
• 28 weeks


  • Eyes open- baby can breathe; surfactant needed
• 32 weeks


  • Starts getting fat (regulate temp)
• 36 weeks


  • Lungs mature w surfactant
• 38 + weeks

  • Gets antibodies from mom
• Placenta


  Does job of lungs and liver, should be set by 10 weeks, dirty duncan/shiny shultz, sections missing or separated (impaired circulation), sections left after delivery (bleed until it comes out)
• Placenta Functions


  • Fetal respiration, nutrition, excretion, endocrine function, special immunologic properties, large particles can't pass through (nutrients, meds, alcohol, antibodies and viruses can), make HPL, estrogen and lactogen, acts as a barrier (will block bacteria but not viruses such as rubella, covid, zika)
• Umbilical cord

  Twisted appearance (implanted in middle of placenta to prevent issues with baby), umbilical vein takes oxygenated blood and the arteries take deoxygenated away, surrounded by wharton's jelly