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phys 2 exam 2.csv
2010-08-13 22:12:20
Medical Physiology

Pancreas, Sex hormones, reproductive physiology
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  1. What vertebral level is the adrenal gland at?
  2. What % of the supra renal gland is medulla and cortex?
    "Medulla- 20%
  3. Corticosteroids are made from what?
  4. What are the 3 zones of the supra renal cortex?
    1. Fasiculata. 2. Glomerulosa. 3. Reticularis.
  5. What are the catecholamine hormones?
    Epinephrine and norephinephrine
  6. 80% of Cholesterol used to make glucocorticoids mineralcorticoids and sex hormones comes from where?
    plasma LDL.
  7. Angiotenson II changes the conversion of cholesterol to what?
  8. Glucocorticoids got their name how?
    Because of their role in glucose metabolism.
  9. Glucocorticoids can bind to what?
    Cortisol receptors and trigger similar effects.
  10. What is the name of a synthetic glucocorticoid?
    Exogenous or synthetic glucocorticoid.
  11. Cortisol is as potent as what?
  12. What is about 4 times as potent as cortisol?
  13. What is about 5 times as potent as cortisol?
  14. What is about 30 times as potent as cortisol?
  15. What is the main corticosteroid hormone produced by the adrenal cortex?
  16. What is the most important human glucocorticoid?
  17. Cortisol is aka?
    The stress hormone.
  18. Where are corisol (glucocorticoid) receptors found at?
    In cells of almost all vertebrate tissues.
  19. What is CRH and where will it come from and what will it do?
    "Corticotrophin releasing hormone. Released in response to stress from the hypothalamus
  20. ACTH is released how from the ant. Pituitary gland?
    "As a preprohormone that contains melanocyte stimulating hormone (MSH)
  21. High ACTH levels will cause what?
    "Secretion of MSH and cortisol and we may get hyperpigmentation
  22. When will the diurinal variation of serum cortisol be present?
    between 2 weeks and 9 months after birth.
  23. Name a physical stressor that will cause variation in serum cortisol levels?
  24. What happens with a total loss of cortisol?
    Death in 3 days due to inability to cope with stressors.
  25. What happens to the negative feedback loop where cortisol inhibits CRH and ACTH during chronic stress?
    "The normal feedbacks breakdown
  26. What % of cortisol is bound to a protein?
    90-95 percent.
  27. What will the binding protein do to cortisol?
    It makes it slow to be eliminated and this creats a long half life of 60-90 minutes.
  28. What type of cortisol is available to be used by receptors?
    Free or the kind not bound to a protein.
  29. What will excess cortisol do to the immune system?
    Suppression of immune and inflammatory reactions.
  30. "What will excess cortisol do to CT
    and bones?"
  31. Why will excess cortisol have a weak effect of mineralcorticoids control of electrolytes?
    Because cortisol is similar to aldosterone.
  32. Cortisol is a physiological anatagonist to what?
  33. How is cortisol an anatagonist to insulin?
    "It increases gluconeogenesis
  34. Cortisol leads to what?
    "Increased circulation of glucose
  35. Insulin works how with cortisol around?
    Not as effective at increasing the plasma glucose uptake.
  36. What else will inhibit the effects of insulin?
    The increase in free fatty acid due to lipolysis of adipocytes.
  37. Cortisol and excess growth hormone are what?
  38. When cortisol is metabloized it makes more Amino Acids available to the liver how?
    Through protein catabolism.
  39. Protein catabolism to increase the AA available to the liver can lead to what?
    Muscle weakness.
  40. What happens to all protein storages with cortisol?
    All are reduced besides the liver.
  41. Decreased proteins can lead to what?
    Decreased immunity.
  42. Cortisol metabolism shifts energy production from what to what during stress or starvation?
    From utilization of glucose to utilization of fatty acids.
  43. Excess cortisol does what to the appetite?
    "Increases it
  44. What 3 ways will cortisol weaken the immune system?
    1. Decreases the number of eospinophils and lymphocytes. 2. atrophy of lymphoid tissues. 3. Decreased output of T cells and antibodies.
  45. What reason would you want to use cortisol to weaken the immune system?
    To prevent the immunological rejection of transplanted organs/tissues.
  46. What will cortisol do to inflammation?
    It is a potent anti-inflammatory agent.
  47. How will cortisol be an anti-inflammatory agent?
    "Blocks the early inflammatory process
  48. What will cortisol do to the healing process?
    It rapidly speeds it up.
  49. Cortisol stabalizes what to help with the anti-inflammatory process?
    Lysosomal membranes.
  50. How will cortisol inhibit tissue destruction?
    Decreases proteolytic enzyme release.
  51. How will cortisol decrease swelling?
    "By decreasing capillary permeability
  52. Increased cortisol does what to fevers?
    Attenuates (weaken or reduce) them.
  53. Cortisol inhibits the production of prostaglandin and leukotrienes and result in what?
    "Decreased WBC migration
  54. Mineralcorticoid receptors bind what normally?
  55. "Since cortisol is similar to aldosterone it can bind to mineralcorticoid receptors
    but what has a larger binding affinity cortisol or aldosterone to mineralcorticoid receptors?"
  56. For Cortisol to bind to mineralcorticoid receptors large amounts must be present in the body and once cortisol binds to mineralcorticoid receptors what happens?
    Increased reabsorption of sodium and water which leads to increased blood volume and therefore increased blood pressure.
  57. How will short term amounts of cortisol effect memory?
    "It will help create memories when exposure is short term and is a proposed mechanism for storage of ""flash bulb"" memories at times of good/bad stress."
  58. How will long term amounts of cortisol effect memory?
    Leads to cellular damage in the hippocampus resulting in impaired learning.
  59. Pharmacologic glucocorticoids are absorbed well where and are given how?
    "Given primarily by mouth
  60. When would hydrocortisone be used via injection?
    "Severe allergic reactions resulting in anaphylaxis and angioedema. Also can be injected in inflammed joints for gout
  61. What could happen with chronic use of hydrocortisone?
    Adrenal insufficiency.
  62. Chronic use of hydrocortisone can do what to blood sugar?
    Cause hyperglycemia.
  63. What will chronic use of hydrocortisone do to skin?
    Increase fragility and easy brusing.
  64. What will chronic use of hydrocortisone do to the CNS?
    Excitatory effect.
  65. Chronic use of hydrocortisone can impair what processes?
  66. What will chronic hydrocortisone do to the hands?
    Cause expansion of malaar fat pads and dilation of small vessels in the skin.
  67. What will chronic hydrocortisone do to the menstural periods?
    Anovulation or other irregularities.
  68. What will chronic hydrocortisone do to growth?
    "Growth failure
  69. What is a combination of effects produced by prolonged excess glucocorticoid synthetic or endogenous called?
    Cushing's syndrome.
  70. Visceral fat has high concentration of what type of receptors?
  71. Visceral fat promotes what?
    Fat cell differentiation.
  72. When will sex hormones released by the supra renal gland play an important role?
    During fetal development and puberty. Only a weak effect in adults.
  73. Where will the conversion of DHEA and Androstenedione to testoterone take place at?
    Outside the adrenal gland.
  74. What is hypercortisolism aka and what is it?
    AKA cushing's syndrome. It is excessive levels of cortisol in blood.
  75. What is hypocortisolism aka and what is it?
    AKA addison's disease and it is decreased levels of cortisol in blood.
  76. JFK had addison's disease and it stopped his body from being able to do what?
    Deal with stress.
  77. What is a primary hypercortisolism?
    Cushing's syndrome aka hypercortisolism aka hyperadrenalism aka hyperadrenocortiscism.
  78. What are 5 causes of cushing's syndrome?
    1. Abnormal function of hypothalamus and excess secretion of CRH. 2. Adenomas of anterior pituitary with excess ACTH. 3. Ectopic secretion of ACTH from abdominal carcinoma. 4. Adenoma of adrenal cortex. 5. Exogenous corticosteroid administration.
  79. What will a person with cushings syndrome look like?
    Buffalo-like torso from mobilization of fat from lower body to thoracic and upper adbominal regions. They have edematous face (moon-like). Acne and hirsuitism (excess hair).
  80. What is purple striae and what can cause it?
    Stretch marks can be caused by cushings syndrome.
  81. How is cushing's syndrome diagnosed?
    Dexamthasone challenge and by measuring ACTH levels and cortisol.
  82. What is primary and secondary hypercortisolism?
    Primary- Increased cortisol and decreased ACTH. Secondary- Increased cortisol and ACTH.
  83. What are 2 treatments for cushing's syndrome or hypercortisolism?
    1. Removal of a tumor. 2. Medications to block steroidogenesis or inhibit ACTH.
  84. The adrenal glands fail to do what with addison's disease?
    To produce mineralcorticoids and glucocorticoids.
  85. Addison's disease causes what?
    "Autoimmune mediated atropy (80%)
  86. Low aldosterone levels lead to what?
    "Decreased fluid
  87. Low plasma volume and high RBC concentration leads to what?
    "Decreased cardiac output
  88. What are the treatments for addison's disease aka hypoadrenalism?
    Small quantities of mineral- and glucocorticoids daily.
  89. What is the function of aldosterone?
    Volume regulation sodium retention and K+ loss.
  90. What cells are capable of producing aldosterone?
    Just those in the zona glomerulosa cells.
  91. What type of hormone is aldosterone?
  92. How much aldosterone is secreted per day?
    0.15 mg.
  93. Aldosterone is an acute _______ hormone.
  94. Aldosterone leads to na retention and K excreting in what part of the kindey?
    Collecting ducts and distal tubules.
  95. Since water follows Na with aldosterone when na is retained what happens?
    "Water is retained and this leads to increased thirst
  96. What is ACTH's role in aldosterone secretion?
    "It stimulates the synthesis of aldosterone from cholesterol
  97. Total loss of Mineralcorticoids leads to what?
    Death in 3-14 days.
  98. What is hyperkalemia?
    High levels of K+.
  99. A mineralcorticoid or aldosterone deficiency does what to sodium levels?
    Decreases them and this leads to decreased blood volume
  100. Hyperkalemia leads to what?
    "Cardiac toxicity
  101. Mineralcorticoid or aldosteron deficiency does what to the GI tract?
    Decreased water absorption and causes diarrhea.
  102. What is the cause of excess aldosteron or mineralcorticoids?
    Adrenal tumor.
  103. How will mineralcorticoid excess lead to alkalosis?
    With increased sodium H+ will exchanges for sodium
  104. What are the symptoms of alkalosis?
  105. What is primary aldosteronism?
    A tumor of the zona glomerulosa that leads to excess aldosterone secretion.
  106. Primary aldosteronism is aka?
    Conn's syndrome.
  107. What type of growths may cause excess aldosterone not cortisol?
    Hyperplastic growth of the adrenals.
  108. What are the 2 most important effects of primary aldosteronism aka conn's syndrome?
    1. Hypokalemia leading to muscle weakness and possible paralysis. 2. Increase extracellular volume leadign to hypertension.
  109. What are the cardiovascular effects from epi and norepinephrine?
    "Redistribution of blood flow from Skin
  110. What are the pulmonary effects of epi and norepinephrine?
    Increased rate and depth of breathing.
  111. What other 3 effects will epi and norepinephrine have?
    "Diaphoresis (sweating)
  112. What is pheochromocytoma?
    A rare tumor of the chromaffin cells from the medulla of the adrenal glands.
  113. Besides the adrenal medulla where are chromaffin cells found at?
    other nervous tissue.
  114. Can pheochromocytomas be found outside of the adrenal glands?
  115. Where are the common locations for pheocromocytoma?
  116. What is an indicator of a pheochromocytoma?
    Overproduction of the catecholamines (epi and norepinephron).
  117. "Pheochromocytoma can develop at any age
    but it is most commonly developed at what age?"
  118. Will pheochromocytomas be benign or malignant?
  119. What is the treatment given for pheochromocytomas?
    Normalizing blood pressure.
  120. What is von hippel-lindau disease?
    Rare multisystem disorder at high risk of developing a pheochromocytoma.
  121. With pheochromocytoma what will a blood test show?
    "Elevated epi and norepinephrine
  122. What type of imaging should be done to test for a pheochromocytoma?
    Abdominal CT scan/MRI
  123. A sudden release of catecholamines (epi and norepinephrine) can cause what?
    Hypertension as high as 250/150.
  124. Chronic excessive catecholamine exposure increases the risk of what?
  125. What is the treatment for pheochromocytoma?
    "Alpha/beta blockers (adrenergic antagonists)
  126. When was insulin isolated?
    In 1922
  127. Once the liver and skeletal muscles are filled with glycogen from insulin turning carbs into glycogen where will the extra glycogen go?
    Into adipocytes as fat.
  128. How is insulin synthesized?
    As a preprohormone.
  129. Where will preproinsulin be cleaved into proinsulin?
    In the ER.
  130. Where will proinsulin be cleaved into insulin?
    In the golgi apparatus.
  131. After proinsulin is cleaved to insulin what happens to it?
    It is stored in secretory granules and secreted into the blood when needed.
  132. When insulin is secreted into blood how long will it last?
    10-15 minutes because it is not bound to proteins it is free in the blood.
  133. How will insulin be degraded?
    By insulinase.
  134. Insulin will bind to what?
    Specific receptors which initiates effects through an enzymatic cascade.
  135. What happens to the bodies cells within seconds of insulin binding?
    80% of bodies cells increase glucose uptake.
  136. Which cells especially increase glucose uptake after binding to insulin?
  137. What type of glucose is used in metabolic functions?
  138. What happens to a cells membrane after it binds to insulin?
    "Becomes permeable to amino acids
  139. Insulin lasts in the blood 10-15 minutes but how long will the effects of insulin last?
    several hours to days.
  140. Insulin does what to blood sugar levels?
    Drops it because it.
  141. What type of hormone is insulin?
  142. With Growth hormone cortosl and Insulin which effects will trump?
  143. What 3 things will insulin do to carbohydrates?
    1. Increse glucose uptake. 2. Increase glycogenesis. 3. Decrease gluconeogenesis.
  144. What effects will insulin have on fat?
    "Increase triglyceride synthesis
  145. What are the effects of insulin on protein?
    "Increased synthesis
  146. What organs can only use glucose as a nutrietn?
  147. Why is it important between meals to have low serum insulin levels?
    So glucose can go to the brain and not to storage
  148. What happens to 60% of glucose immediately after a meal?
    It is stored in the liver as glycogen.
  149. When will glucose be converted into fatty acids?
    When the liver glucose storage is full and insulin is present.
  150. Insulin increases the use of what for energy and decreased the use of what for energy?
    Increases the use of glucose and decreases the use of fat.
  151. When blood glucose is low insulin is low and what is used as energy?
  152. When blood glucose is high insulin is high and what is used as energy?
  153. What other hormones play a role in the use of FAT instead of glucose as energy?
    "growth hormone
  154. A resting muscle preferentially uses what as energy?
    Fatty acids.
  155. What are the 2 conditions when muscles use glucose?
    1. Exercise. 2. After a meal when glucose is high.
  156. Why will muscles use glucose during exercise?
    The contractions make the muscles more permeable to glucose even without insulin.
  157. Why will muscles use glucose after a meal?
    high glucose levels and insulin levels will rapidly transport glucose into the muscle.
  158. What happens to glucose in the muscles after a meal if not used?
    It will be stored as glycogen.
  159. What will glucose be good for in muscles?
    Short bursts or extreme anaerobic activity.
  160. In general what is insulins effect on proteins?
    Increases formation and decreases degradation.
  161. Insulin will do what to Amino acids?
    Increase uptake into cells.
  162. Insulin and Growth hormone lead to what in general?
    Growth and storage.
  163. Combination of growth hormone and insulin causes what?
    dramatic growth portential.
  164. Growth hormone and insulin both promote uptake of what?
    Different amino acids and other substances needed for growth.
  165. What happens if growth hormone or insulin is absent?
    Decreased growth.
  166. What is the primary factor for insulin secretion?
    Increased blood glucose.
  167. How do Beta cells in the pancrease monitor blood glucose levels?
    They have glucose transporters which keep the glucose influx proportional to blood glucose levels.
  168. What converts glucose into glucose-6 phosphate?
  169. Glucose-6 phosphate leads to what?
    an influx of calcium and insulin secretion.
  170. What are the 3 major factors for decresing secretion of insulin?
    "Low blood glucose
  171. Glucagon is what type of hormone?
  172. What are glucagons typical actions?
    To oppose insulin.
  173. What is the most important role of glucagon?
    To increase blood glucose levels.
  174. What 2 ways will glucagon help increase blood glucose levels in the liver?
    1. glycogenolysis (turning glycogen into glucose). 2. Glucoenogenesis (turning amino acids into glucose).
  175. What 2 amino acids specifically increase the secreation of glucagon?
    Alanine and arginine.
  176. In general secretion of somatostatin by the delta cells of the pancrease happen when?
    Ingestion of food.
  177. What are the 2 main goals of somatostatin?
    1. To extend the period of time over which food/nutrients are assimilated into the blood. 2. Decrease the utilization of absorbed nutrients by tissues making food available over a longer period of time.
  178. Somatostatin is released by what other than the delta cells of the pancrease?
  179. Why will the hypothalamus secrete somatostatins?
    To suppress secretion of GH by the anterior pituitary gland.
  180. What happens when blood glucose falls below 20-50 mg/100ml?
    "Hypoglycemic shock
  181. What happens to proteins with lack of insulin?
    "Storage and synthesis of proteins stops
  182. With lack of insulin we have increased catabolism of what?
    Proteins from muscles to liberate the amino acids for immediate energy and to be used for gluconeogenesis.
  183. What happens to fat with a lack of insulin?
    This will increase the use of fat for energy.
  184. What tissues can use fat for energy?
    All besides the brain.
  185. What happens to increased fatty acids in the blood due to lack of insulin?
    "They are converted in the liver to phospholipids and triglycerides
  186. This release of phospholipids triglycerides and cholesterol can lead to what?
    Atherosclerosis of medium to large vessels.
  187. Excess usage of fats for energy can lead to production of what in the liver?
    acetyl CoA and acetoacetic acid.
  188. Execess acetyl CoA and acetoacetic acid in the tissues leads to what?
  189. When will extreme lack of insulin occur?
    With DM.
  190. What is Diabetes Mellitus?
    "Syndrome of impaired Carbohydrate
  191. Diabetes mellitus is caused by what 2 things?
    1. Lack of insulin secretion. 2. Decreased insulin sensitivity of tissues.
  192. Lack of insulin secretion is what type of DM?
    Type I aka Insulin dependent DM (IDDM)
  193. Decreased insulin sensitivity of tissues is what type of DM?
    Type II aka Non-insulin dependent DM (NIDDM)
  194. Diabetes mellitus will increase what?
    "Blood glucose levels
  195. Diabetes mellitus will decrease what?
    Cell utilization of glucose.
  196. What % of DM will be IDDM or NIDDM?
  197. What causes someone to get IDDM or type I DM?
    Genetic predisposition triggered by environmental factors like viruses lead to auto-immune disease.
  198. What happens to people with IDDM or Type I DM?
    Pancreatic Beta cells fail.
  199. What causes someone to get NIDDM?
    Genetic predisposition triggered by OVER-EATING of high glycemic foods.
  200. What happens to people with NIDDM?
    The body responds poorly to insulin and Pancreatic Beta cells cant keep up and begin to fail and can lead to IDDM.
  201. Generally when will people develop IDDM?
    Childhood to early adolescence.
  202. How long will it take to develop IDDM?
    IT develops abruptly.
  203. IDDM will do what to blood glucose?
    Increase it up to 300-12000mg/100ml.
  204. Why will people with IDDM become dehydrated?
    The high levels of blood glucose spill over into urine making them dehydrated.
  205. What is osmotic diuresis?
    Loss in urine.
  206. Chronic high blood glucose will do what to tissues?
    Damages them.
  207. A shift from carbohydrate metabolism to fat metabolism leads to what?
    Ketoacidosis and then metabolic acidosis and then diabetic coma.
  208. Hyperventilation leads to what?
    Increased expiration of CO2.
  209. Why will you have cardiovascular disease if you have diabetes?
    Increased cholesterol in circulation will lead to arteriosclerosis.
  210. When will people normally get NIDDM or type II?
    after age 30 but usually between 50-60.
  211. How long will it take to develop NIDDM?
    IT develops gradually.
  212. What is the greatest risk factor for NIDDM?
  213. What happens to insulin secretion with NIDDM?
    It is increased.
  214. What are the consequences of the warning signs of NIDDM?
    Progression to DM type II and atheroslerosis and other CVD.
  215. Name 2 hotmones that can lead to insulin resistance?
  216. How are the warning signs of NIDDM managed?
  217. You have what if you have been diagnosed with diabetes mellitus?
    Cardiovascular disease.
  218. When testing for DM what are you looking for in a Urine analysis?
    Glucose and ketones.
  219. How is bood tested for DM?
    Fasting blood glucose and insulin test.
  220. How is an oral glucose/insulin tolerance test done?
    Orally take lots of glucose and then measure glucose and insulin levels for the next few hours.
  221. With oral glucose/insulin tolerance test post-prandial(after a meal) levels should be normal when?
    2 hours after test.
  222. How long will it take for the levels to come down in an oral glucose/insulin test when the person has DM?
    Glucose wont return to normal for 4-6 hours.
  223. With the oral glucose/insulin tolerance test what will happen if the patient has DM type I?
    Insulin will be low or undetectable.
  224. With the oral glucose/insulin tolerance test what will happen if the patient has DM type II?
    Insulin high in early stage or low in the late stage.
  225. Insulinoma causes what?
    Hypersecretion of insulin from tumor of a pancreatic beat cell.
  226. What % of insulinoma's are malignant?
    10-15% are.
  227. What happens if a insulinoma is not treated?
    Can lead to insulin shock due to hypoglycemia.
  228. With a insulinoma what happens when blood glucose levels reach 50-70mg/100ml?
    "Nervous system excitability: Nervousness
  229. What happens when blood glucose falls to 20-50mg/100ml?
    Clonic seizures and loss of consciousness.
  230. What happens when blood glucose falls below 20 mg/100ml?
  231. What are 3 different ways of sexual differentiation?
    "genetic sex
  232. What is genetic sex?
    "male- XY
  233. What is gonadal sex?
    Males- testies. Females- ovaries.
  234. What is phenotypic sex?
    Determined by action of hormones produced by gonads during fetal life.
  235. What will the paramesonephric duct become in females?
    "Fallopian tubes
  236. In males what will the mesonephric ducts become?
    "Connections between testis and prostate: epididymis
  237. What leads to the development of female genital tract and genitalia?
    Lack of testosterone and MIS (which are produced by the fetal testies).
  238. In females high levels of androgens before external genitals have differentiated can result in what?
    Male phenotype or malformation.
  239. Where is GnRH synthesized at?
    In the hypothalamus.
  240. How will the hypothalamus release GnRH?
    In vesicles from the median eminence in a pulsatile fashion through the hypothalamohypophyseal portal blood.
  241. GnRH reaches the anterior pituitary gland and binds to what?
    membrane receptors on gonadotrophs.
  242. How is synthesis and secretion of GnRH regulated?
    By feedback control from gonadal hormones.
  243. Besides gonadal hormones how will the synthesis and secretion of GnRH regulated?
  244. What is the general functions of the gondaotrophes (LH & FSH)?
    "Promote gametogenesis
  245. LH and FSH are active in who males or females?
  246. What happens to levels of LH and FSH in a fetus and why?
    We get a spike of these hormones so there are more gonadal hormones secreted to help with development.
  247. What are levels of LH and FSH like in childhood?
    Low with no spikes.
  248. What are levels of LH and FSH like during puberty?
    They gradually increase.
  249. What are levels of LH and FSH like during the adult reproductive period?
    Females- rises and falls monthly. Males- levels off.
  250. What is Senescence?
    Growing old or aging. The period after the adult reproductive period.
  251. What are levels of LH and FSH like during senescence?
    Females- rises fast and then levels off. Males gradually rises
  252. During gestation GnRH is secreted when?
    Week 4.
  253. Secretion of GnRH starts during week 4 of gestation and remains low until when?
  254. During gestation secretion of FSH and LH begins when?
    Week 10-12.
  255. Secretion of FSH and LH begins during week 10-12 of gestation and remains low until when?
  256. What levels are higher in childhood FSH or LH?
  257. What is puberty?
    Transition from non-reproductive to reproductive state.
  258. Puberty is an essential event due to what?
    Pulsatile secretion of GnRH.
  259. During puberty what level is higher LH or FSH?
  260. During puberty plasma levels in females increase with what?
    Estrogen and inhibin.
  261. During puberty plasma levels in males increase with what?
    Testosterone and inhibin.
  262. Responsiveness of target cells to gonadal hormones that increase at puberty leads to what?
    Secondary sex characteristics.
  263. The ovaries produce what during puberty?
  264. What is menarche?
    Onset of menstrual cycles.
  265. When will female growth spurts be at?
    between 11-14 years old.
  266. During male puberty what cells will proliferate?
    Leydig cells.
  267. What are the 3 major functions of the male reproduction?
    1. Regulation and synthesis and secretion of hormones. 2. speratomgenesis. 3. Sexual act.
  268. What are the 2 jobs of the testes?
    "Produce sperm
  269. What hormone will the testes mainly secrete?
  270. What are the 2 compartment of the testes and what cells are found in the compartments?
    1. Connective tissue interstitium- leydig cells. 2. Seminiferous tubules- sertoli cells.
  271. The Leydig cells found in the connective tissue intersitium of the testes do what?
    They are the primary endocrine area.
  272. What cells produce sperm?
    Sertoli cells.
  273. What is inner male genitalia?
    The prostate.
  274. How many lobes does the prostate have?
  275. What will the prostate produce?
    A thin alkaline milky fluid.
  276. What is an out-pocketing of the vas deferens?
    The semial vesicles.
  277. What % of semen is from the semial vesicles?
  278. What is the semen like that is secreted from the seminal vesicles?
    "Energy for sperm because it is rich in fructose
  279. What are the male hormones secreted by the testes called?
  280. What is the major Androgen?
  281. Leydig cells make up what % of testes mass?
  282. Testoternone and FSH leads to what?
  283. What % of andorgens come from leydig cells and where else can they come from?
    95% from leydig cells and 5% can come from adrenals.
  284. Androgens are what type of compounds?
  285. How is dihydrotestosterone synthesized?
    From testosterone in some target tissues.
  286. What is androstenedione?
    a precursor of testosterone with 1/10th the activity.
  287. Testosterone is released on a diurinal pattern and is high when and low when?
    High- Night. Low-morning.
  288. What will testosterone levels be like as a fetus and why?
    High to masculinize the external genitalia.
  289. What happens to testosterone levels after birth?
    They are low until puberty when they start to ramp up and then they level off as an adult and then start to decline around age 60.
  290. What causes testosterone levels to drop off around 60 years of age?
    The leydig cells lose responisveness to LH.
  291. What are the results of testosterone levels droping off at age 60?
    "Loss of libido
  292. What is an androgen?
    A male sex hormone.
  293. What % of androgens circulate in blood bound to proteins?
    97-98 percent.
  294. Since most of the androgens are bound to proteins in the blood how long will they last before they are transferred to target tissues or degraded?
    30 minutes to several hours.
  295. What is the major protein that the androgens will bind to?
    "Sex hormone-binding globulin
  296. 2-3 % of testosterone in the blood is unbound and is active and will be converted to what in target tissues by what?
    Converted to dihydrotestosterone by 5-alpha reductase.
  297. Excess testosterone is exreted how?
    Through liver via bile or kidneys via urine.
  298. What part of target cells will testosterone bind to?
    Cytoplasmic receptors since it is a steroid hormone and can pass through the cell membrane.
  299. Once testosterone binds to receptors in the cytoplasm of target tissues what happens?
    "Testosterone will then enter the nucleus and affects DNA-RNA transcription
  300. Where will testosterone stimulate production of proteins?
    Almost everywhere in the body.
  301. What will the proteins do that were made by testosterone stimulation?
    These proteins are then responsible for various actions of the androgens like primary and secondary sex characteristics.
  302. Many target tissues of testosterone have enzymes that convert it to active metabolites. What will aromatase and 5 alpha-reductase convert testosterone into?
    Aromatase- E2 (estradiol). 5-alpha reductase- dihydrotestoterone.
  303. In utero what week will testosterone and metabolites start to be produced?
    Week 7.
  304. In utero what will stimulate the secretion of testosterone and metabolites?
    hCG from the placenta.
  305. What will stimulate the descent of the testis?
    hCG that will increase the fetal secretion of testosterone and metabolites.
  306. Testosteron is responsible for what during puberty?
    Development of primary and secondary sex characteristics.
  307. What will testosterone do to muscles during puberty?
    Increase size by 50% at puberty.
  308. What will make a males voice get deeper during puberty?
    Tesosterone secretion that enlarges the larynx and thickens the vocal cord.
  309. What will promote the secretion of male genital tract (prostate and seminal vesicles)?
    Testosterone and metabolites.
  310. What effects on the skin will testosterone and the metabolites have?
    Increases thickness of skin over entire body.
  311. What will testosterone do to the BMR?
    Increase it up to 15%.
  312. FSH most directly controls what?
  313. In early fetal life the fetal gonadotropins transform primordial germ cells into what?
  314. What type of receptors do spermatogonia have and what activates them at puberty?
    They have FSH receptors and are stimulated by FSH.
  315. What will testosteron do to inhibin?
    Stimulate secretion in a minor role.
  316. Sertoli cells envelop spermatogonia and then the spermatogonia does what?
    Enlarges to become primary spermatocyte.
  317. What happens to primary spermatocytes?
    They undergo meiotic division to become secondary spermatocytes with 46 chromosomes.
  318. What happens to secondary spermatocytes?
    They divided and become spermatid with 23 chromosomes.
  319. What will spermatid become?
  320. How long will the development from spermatogonia to spermatozoa take?
    70 days.
  321. How much sperm is produced each day by a male?
    70-100 million.
  322. Where and how long will it take sperm to mature?
    2 weeks in the epididymis.
  323. The number of sperm produced is directly related to what?
    Number of sertoli cells.
  324. What role will GH have in spermatogenesis?
    Controls metabolic function of testis and aids in division of spermatogonia.
  325. Semen is made of what % of fluids from where?
    vas deferens-10%. Prostate- 30%. Seminal vesicles-60%.
  326. What is the average pH of semen?
    around 7.5
  327. What will decrease viscosity of semen to increase motility?
    Fibrinolysin from prostate gland.
  328. What makes up the head of a sperm?
    Condensed nucleus a thick cap (acrosome) filled with proteolytic enzymes to aid in fertilization.
  329. What is the flagellum of sperm for?
    Back and forth movement creating motility.
  330. Sperm can be stored in the vas deferens of the testes for how long?
    Up to 1 month.
  331. How long can sperm live for in female?
    24-48 hours.
  332. Sperm can be frozen for how long?
  333. Each month females develop an ova in the ovaries that goes where when?
    Midcycle expulsion of this single ovum from ovary into ABDOMINAL CAVITY.
  334. When will GnRH be released from the Hypothalamus?
    pulses every 90 minutes in males and females.
  335. How will GnRH secretions change during the monthly cycle?
    It will not.
  336. In females when will the anterior pituitary gland start to secrete FSH and LH?
    At puberty.
  337. What are granulosa cells?
    Cells that provide norishment for ovum.
  338. What will granulosa cells secrete?
    Oocyte inhibiting factor
  339. What will oocyte inhibiting factor do?
    Keep ovum in primordial state until stimulated by FSH at puberty.
  340. What type of receptors do granulosa cells have?
    LH and FSH.
  341. GnRH is secreted when during fetal development?
    Midgestation and drop off before birth.
  342. When will plasma levels of estradiol increase?
    During puberty.
  343. Increased estradiol causes what?
    Growth and development of the female reproductive tract.
  344. What is the first sign of secondary sec characteristics in females?
    Budding breasts.
  345. How long after increased estradiol causing growth and development of the female reproductive tract until menarche?
    about 2 years.
  346. What happens to estrogen levels in adulthood?
    High and cyclic and correlate with the menstrual cycle.
  347. What causes menopause?
    Burn out of the ovaries when few follicles remain to be stimulated by FSH and LH.
  348. What happens to secretion of estradiol during menopause?
    Ovarian secretion virtually ceases.
  349. What happens to Plasma levels of FSH and LH during menopause?
    The levels rise due since there is no estrogen and progesterone to provide negative feedback of FSH and LH secretion.
  350. FSH caused what to happen in the ovaries?
    Growth of 6-12 ovum into primary follicles.
  351. Further growth of primary follicles is caused by what?
  352. Granulosa cells are more sensitive to what?
  353. Only 1 follicle matures each month and is called what?
    Mature follicle.
  354. Ovulation depends on what?
    A surge of LH.
  355. When will ovulation occur?
    14 days after 1st day of menses.
  356. When will there be a surge of LH?
    2 days before ovulation.
  357. When will the surge of LH peak?
    16 hours before ovulation.
  358. LH converts granulosa and theca cells to what after ovulation?
  359. When will estrogen and progesterone be secreted?
    Estrogen days 0-14. Progesterone- 14-28.
  360. When an ovum is ovulated it is surrounded by what?
    Thosands of granulosa cells called the corona radiata.
  361. After ovulation the remaining follicular cells do what?
    They become lutein cells.
  362. What causes the remaining follicular cells to become lutein cells?
  363. What do lutein cells do?
    They enlarge and fill with luteinization.
  364. What are lutein cells with luteinization called?
    Corpus luteum.
  365. What cells produce progesterone?
    Granulosa cells.
  366. Theca cells produce what?
    Androgens (testosterone).
  367. What happens to the androgens produced by theca cells?
    Most is converted by granulosa cells to female hormones.
  368. What is Mittelschmertz?
    Pain in the middle of the ovulation cycle.
  369. What happens after ovulation to body temperature?
    Basal body temperature rises.
  370. When will the corpus luteum involute with no pregnancy and why?
    12 days after ovulation due to low FSH and LH..
  371. What are corpus luteums called after they involute?
    Corpus albicans.
  372. What happens to corpus luteums during pregnancy?
    The placenta hCG causes the Corpus luteum to persist for 2-4 months.
  373. Once the corpus luteum involutes what causes menstruation?
    "The Corpus luteum is no longer secreting inhibin
  374. What is the most important estrogen?
    Estradiol aka E2.
  375. What is the most important progestin?
  376. What are the general functions of estrogens?
    Promote growth and development of genital tract and secondary sex characteristics.
  377. What are the general functions of Progestines?
    Prepare the uterus for pregnancy and breast for lactation.
  378. What type of receptors will Estrogens and progestins use and why?
    Intracellualr receptors because they are steroid hormones.
  379. How will estrogens and progestins work together?
    They complement or enhance each others actions.
  380. Can estrogens and progestins antagonize each others actions?
  381. From what are estrogens and progestins derived?
  382. What is the Follicular phase?
    Progesterone and testosterone are synthesized 1st and before being secreted they are converted to estrogen by granulosa cells.
  383. What is the Luteal phase?
    Too much progesterone is secreted to be completely converted to estrogen so serum levels rise.
  384. Synthesis of progesterone and estrogen is a function of what 3 cells in ovum?
  385. What converts testosterone into estrogen?
  386. Will males have aromatase?
  387. 98% of estrogen and progesterone circulate bound to what proteins?
    Albumin and SHBG.
  388. How tightly are the proteins boudn to estrogen and progesterone?
    Loose so the hormones are easily and rapidly relesed into tissues.
  389. How long will it take for estrogen and progesterone to be released into the tissues?
    30 minutes.
  390. Where is the primary and secondary sites for degradation of ovarian steroids?
    Primary- Liver into bile. Secondary- Kidneys for urine secretion.
  391. What else will the liver do to Estradiol?
    Converts it to E1 and E3.
  392. How active is E3?
    almost inactive.
  393. "Most estrogen comes from ___A___ and small amounts come from ___B___
    except in pregnancy where large amounts come from ___C____."
  394. "E2 is the most potent estrogen
    but E1 comes from where and is how potent?"
  395. E3 is how potent and comes from where?
    1/80 as potent as E2 and comes via oxidation of E1 and E2 in the liver.
  396. What will estrogen do to the ovaries during puberty?
    Promote follucular growth (granulosa cells).
  397. What will estrogen do to the uterus during puberty?
    Stimulate growth and proliferation of endometrium with its glands and spiral arteries.
  398. What will estrogen do to the vagina during puberty?
    "Creates stratified epithelium that is resistant to trauma and infection
  399. What will estrogne do to the fallopian tubes?
    "Promotes growth of glandular and ciliated epithelial cells
  400. What is required for growth and maintenance of external female genitalia?
  401. What will estrogen do to breasts?
    Promotes growth of the ducts and deposition of adipose.
  402. What will estrogen do to cervical mucus?
    "make it thinner
  403. Will estrogen have a general catabolic or anabolic activity?
  404. What type of anabolic activity will estrogen cause?
    "Increse of cell metabolism and BMR
  405. What type of effect will estrogen have on skeletal growth?
    Inhibit osteoclastic activity and stimulate bone growth.
  406. What leads to osteoporosis post menapause?
    almost no estrogen secretion and this increases the osteoclastic activity and decreases the bone matrix and deposition of calcium.
  407. What will estrogen do to skin?
    Increase the thickness.
  408. What will estrogen do to the kidneys?
    Cause sodium and therefore water to be retained.
  409. What effects will estrogen have on the CNS?
    "Increased Libido
  410. Estrogen in excess causes what?
    "Severe cramps
  411. What will estrogen deficiency cause?
    "scant menses
  412. What are the 2 types of progesterone and what do they do?
    1. Progesterone- most important progesterone. 2. 17-alpha-hydroxyprogesterone- same effects as progesterone.
  413. In non pregnant females when will progesterone be secreted?
    During last half of monthly cycle by corpus luteum.
  414. In pregnant females when and from where will progesterone be secreted?
    From the placenta in large amounts especially during the 4th month.
  415. What effects will progesterone have on the endometrium?
    Increases secretory changes to prepare uterus for implanation.
  416. What effects will progesterone have on the uterus?
    It will decrease contractions to prevent expulsion of implanted ovum.
  417. What effects will progesterone have on the fallopian tubes?
    Promotes secretion needed for nutrition of fertilized ovum as it travels through.
  418. Will progesterone help maintain pregnancy or not?
    It will help maintain a pregnancy.
  419. What will progesterone do to basal temperature?
    It will increase it by 0.3-0.5 degrees C.
  420. What will progesterones effects of the CNS be?
    "Increased appetite
  421. What happens with excess progesterone?
  422. What happens with progesterone deficiency?
    "Similar to anovulatory cycles
  423. What happens during days 1-13 of a 28 day ovarian cycle?
    Follicular growth.
  424. What happens on day 14 of a 28 day ovarian cycle?
  425. What happens during days 15-24 of a 28 day ovarina cycle?
    Corpus luteum growth.
  426. What happens during days 25-28 of a 28 day ovarian cycle?
    Luteal degeneration.
  427. What days of a 28 day ovarian cycle will menses occur on?
    days 1-4.
  428. When will the proliferative phase be?
    Days 5-14.
  429. What phase happens during days 15-28?
    Secretory phase.
  430. What is the average age of menarche in the US?
    12.77 years.
  431. How long will the average ovarian cycle be?
    21-35 days.
  432. How long will flow occur with menses?
    3-5 days on average but up to 7 days.
  433. How much flow will occur in a day?
    Up to 80ml/day.
  434. What will levels of FSH and LH look like during an ovarian cycle?
    Low besides the midcycle spike of LH.
  435. What will levels of progesterone and estrogen be like during an ovarian cycle?
    Estrogen- Slowly builds up until before ovulation and then drops down and levels off relativley high. Progesterone- is very low until after ovulation when it spikes until the end of the ovarian cycle when it drops off again.
  436. "What will regulate the changes in endometrium
    and secretion of FSH and LH?"
  437. Day 1 of an ovarian cycle marks what?
    The 1st day of menses.
  438. What hormone levels rise during day one and why?
    FSH rises because estrogen and progesterone decrease and this induces follicular growth or the proliferative phase.
  439. Once follicular growth has been induces what will stimulate the follicle to grow?
    The theca cells secrete testosterone which is converted to E2 by aromatase and the E2 promotes follicular growth.
  440. E2 will promote what else besides just follicular growth?
    Growth of the uterine lining.
  441. What happens as the follicles begin to mature?
    They create lots of inhibin which is a negative feedback to the anterior pituitary gland and secretion of FSH.
  442. What type of feedback in general will E2 have with the anterior pituitary gland?
  443. What happens midcycle with increasing E2 levels?
    It has a positive feedback that stimulates the high LH and FSH (lower than LH) secretion.
  444. What will the spike of LH and FSH (less than LH) do during the midcycle?
    "They lead to ovulation at day 14
  445. How long after ovulation will it take to develop a corpus luteum?
    10-18 hours.
  446. What will the corpus luteum do?
    Increases secretion of progesterone and estrogen (less than progesterone).
  447. What happens with progesterone and estrogen secretions during the luteal phase?
    They send a high negative feedback inhibiting LH and FSH.
  448. "Where will negative feedback of corpus luteum secretions (estrogen
  449. How will hormonal contraceptives work?
    They work on a negative feedback to anterior pituitary gland to inhibit FSH and LH preventing ovulation.
  450. What other effects will hormonal contraceptives have?
    "Thickenes cervical mucus
  451. Without implantation what happens 7-8 days post ovulation?
    Regression of corpus luteum.
  452. What % of ovulated ova make it from the abdominal cavity to the fallopian tubes?
    98% of them.
  453. Of the half a billion sperm inserted how many of them make it to the ovum?
    A few thousand.
  454. How long will it take for a fertilized ovum to travel to the uterus?
    3-5 days.
  455. What will help relax the smooth muscle of the fallopian tubes to help facilitate ovum transportation?
  456. When will implantation occur (days after ovulation)?
    5-7 days.
  457. What will trophoblast cells do?
    Provide nutrition and aid in implantation and form fetal part of placenta.
  458. Implantation depends on what levels of estrogen and progesterone?
    Low estrogen and high progesterone.
  459. What will the placenta secrete?
  460. hCG secreted by the placenta chemically resembles what?
  461. hCG is secreted by what and how long after implanation?
    originally secreted by syncytiotrophoblast cells 2-3 days after implantation.
  462. hCG will show up in urine how long after implantation and what is the use of this?
    8-9 days after implantation and this is used as a pregnancy test.
  463. What is the secretion of hCG like during pregnancy?
    It reaches a maximum around weeks 10-12 when the corpus luteum stops secreting and the placenta takes over. Then the levels of hCG drop off from weeks 16-20 and remain low.
  464. What is the function of hCG?
    To inform the corpus luteum that a pregnancy has occurred and to prevent it frominvoluting until the placenta is ready.
  465. Will the corpus luteum secrete hCG?
    No the syncyitiotrophoblasts which will later become the placenta.
  466. hCG directs the corpus luteum to secrete what?
  467. The corpus luteum during pregnancy will do what 3 things?
    1. Maintain uterine lining by inhibiting menstruation. 2. Promote endometrial growth and storage of nutrients. 3. Suppresses new follicular development.
  468. hCG will do what to the maternal breasts?
    Encourages development of alveoli.
  469. What will hCG do to fetal gonads?
    Males- it encourages the development of interstial cells and increases testoterone production for male genitalia growth. Females- nothing.
  470. What is hCS?
    a polypeptide hormone secreted by the placenta.
  471. When will the placenta secrete hCS?
    about week 5 of pregnancy.
  472. How will secretion levels of hCS increase?
    As the placenta increases.
  473. hCS is secreted in what type of quantities?
    Many times greater than other pregnancy hormones.
  474. What will hCS do to breasts?
    Partial development of breasts.
  475. hCS is similar to what hormone?
    GH but much weaker action on protein tissues.
  476. What will hCS do to insulin?
    decreases the bodies insulin sensitivity and decreased glucose utilization in mother making more glucose available to the fetus.
  477. In early stages of pregancy progesterone is secreted by the corpus luteum and then after week 12 it is synthesized by what?
    Syncytiotrophoblast of placenta.
  478. During pregnancy how much more progesterone will be around?
    10 fold increase.
  479. Progesterone is produced from what?
    Circulating maternal cholesterol.
  480. What converts the cholesterol to progesterone?
    The placenta.
  481. What will progesterone do to the uterus during pregnancy?
    "Develops decidual cells important for nourishment
  482. Estrogen is produced where during pregnancy?
    After the corpus luteum from the syncytiotrophoblast cells of the placenta.
  483. What is needed to synthesize estrogen?
  484. What is DHEA?
    A weak androgen produced in maternal and fetal adernals.
  485. Most DHEA comes from where?
    Fetal adrenals.
  486. DHEA is transported in the blood to the fetal liver and then to where?
  487. What will the placenta do with DHEA?
    "Make E1
  488. What is the general role of estrogen during pregnancy?
    "Enlargment fo uerus
  489. What will supply food stuff for the fetus?
    The placenta.
  490. What will the placenta aid in?
    diffusion of oxygen and removal of CO2.
  491. When will the placenta secrete steroid hormones?
    During the 2nd and 3rd trimesters.
  492. What happens to the anterior pituitary gland during pregnancy?
    "It enlarges 50% increasing CRH
  493. What happens to the thyroid gland with pregnancy?
    It enlarges 50% increasing T4 productin.
  494. Relaxin will be secreted by what?
    Corpus luteum and then the placenta.
  495. What will increase uterine contractions?
    Oxytocin synthesized in the hypothalamus and secreted by the posterior pituitary gland.

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