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31 Cards in this Set

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Corpus luteum
The structure that forms on the surface of the ovary after every ovulation and acts as a short-lived endocrine organ that secretes progesterone.
Phase 4 (luteal phase)
Ovaries
They function both as ENDOCRINE glands-producing sex steriod hormones "Estrogen & Progestin"
REPRODUCTIVE glands- producing mature ova.
Estrogen
Estradiol (sex steriod hormone)
a sex steriod hormone of estrogen that is the principle secretory product of the ovary. It regulates: -gonadotropin (FSH,LH) secretion via neg. feedback to the pituitary.
-the development of sex characteristics.
-monthly endometrial growth.
-thickening of vaginal mucosa.
-thinning of of cervical mucus
-growth of the "ductal" system of the breast.
Progestin
Progesterone (sex steriod hormone)
Is the principle secretory product of the corpus luteum. Also produced by the Placenta.
- aids in the tissue growth of the endometrium. Important for endometrial egg implatation and maintenance of pregnancy.
-induction of menstruation.
-during pregnancy,inhibits uterine contractions.
-increases viscosity of cervical mucus. (to protect baby from external contam.)
-aids in the growth of the "alveolar glands" of the breast.
Anterior pituitary
(gonadotropins)
FSH and LH.
Both play a role in hormonal communication between the pituitary gland and the ovaries in the regulation of the Menstrual cycle. Teste stimulation.
Endometrium
The mucous membrane lining the uterus.
Menarche
the first menses in a young woman's life, and the beginning of cycle menstrual function.
Ovarian follicle
The location of egg production and ovulation in the ovary; the precursor to corpus luteum.
Ovulation
The rupture of the ovaian follicle, resulting in the release of an unfertilized egg into the peritoneal cavity.
Phase 1
Menstruation phase
Initiates the cycle and last from 5 to7 days.
Phase 2
Follicular phase
1. FSH= creates mature ovum.
2. Increased estrogen= stimulates pit. to release LH and decrease FSH.
3. Increased estrogen=
proliferates uterine lining.
Phase 3
Ovulation phase
1. Estrogen and LH levels peak.
2. Release of the unfertilized ovum from the ovary.
Phase 4
Luteal phase
1. Ovarian follicle erupts (ovulation)= follicle now called corpus luteum that secretes progesterone - (Maintaining uterine lining)
2. Increased progesterone=
inhibits LH release.
* If egg is not fertilized, corpus luteum degenerates, progesterone decreases, & menstruation occurs.
What are Estrogen drugs used for? e.g. (Premarin)
-contraception
-treat dysmenorrhea
-treat ovarian failure
-hormone replacement
-relieve hot flashes
-treat atrophic vaginitis
-slow disease of prostatic cancer in men.
What are the actions of Estrogen on the body?
-Feminization
-Release of pit. gonadotropins
-Inhibit ovulation
-Capillary dilation
-Protien metabolism
-Increase clotting factors= enhanced blood coagulation
-Decreased rate of bone resorption by antagonizing parathyroid hormone.
-Promote renal Na and water retention, causing edema, wt. gain, breast tenderness & HTN.
-Affects libido
-Inhibits postpartum breast engorgement.
-Promote uterine lining development.
*Excessive exposure= endometrial hyperplasia.
What are the Side Effects of Estrogen?
Expected:
-Wt. gain
-Edema
-Breast tenderness
-Nausea ( most undesirable)
What are the Adverse Effects of Estrogen?
To Report:
-Thrombophlebitis (serious)
-HTN
-Hyperglycemia
-Breakthrough vaginal bleeding
-Wt. gain >5lbs/week or 2lbs. a day.
-Migraine HA
*Increased Risk of MI& HTN for smokers.
*Preg. category X
*Chloasma brn. spots on sun exposed skin.
What are the most concerns for Estrogen therapy?
Too much:
-Cardiovascular events
-Breast cancer
-Endometrial hyperplasia
-Endometrial Cancer
What are the Contraindications for Estrogen therapy?
Patient Hx of:
-Thromboembolic disorders
-CVD or CAD
-Breast cancer
-Estrogenic-dependent tumors
-Pregnancy
-Undiagnosed vaginal bleeding
-Migraine HA
What are the Actions of Progestin drugs?
-They inhibit secretion of LH from gonadotropins in ant. pit.
-Prevent release of ovarian follicles=inhibiting ovulation & lactation.
-Smooth muscle relaxation -Maintains lining of uterus
-Increases body temp.
-Inhibits aldosterone which leads to compensatory aldosterone release & Na/water retention.
What is Progestins used for?
-To treat amenorrhea
-Break-through uterine bleeding
-To help Tx endometriosis
-Used alone, or in combo with estrogenas contraceptives
-Tx of functional uterine bleeding caused by hormonal imbalance, fibroids, or uterine cancer.
-Prevent threatened miscarriages.
What are Progestins Side Effects?
Expected:
-Wt. Gain, Edema
-N/V/D
-Tiredness
-Oily scalp
-Acne
-Dysmenorrhea (cramps)
What are Progestins Adverse Effects?
Report:
-Hepatic dysfunction & Cholestatic jaundice (serious)
-Breakthrough bleeding
-Amenorrhea
-Continuing HA
-Mental depression
Common Progestin Drug
medroxyprogesterone:
-common use is to prevent endometrial cancer.
-Used to Tx amenorrhea
-Tx symptoms of PMS
-Contraception for 3 mo. (Depo-Provera)
-Preg. category X
What are Oral Contraceptives?
-The most effective form of birth control avail.
-Estrogen/Progestin combinations or progestins alone.
-Biphasic or triphasic dosing.
-They regulate the menstrual cycle.
-Estrogen inhibits the secretion of FSH from stimulating follicle maturation. Progestin inhibits LH release & prevents release of follicle from ovary this action increases mucous viscosity= decreasing sperm movement and fertilization.
-They decrease the incidence of cysts and ectopic preg.
What are Oral Contraceptives effected by?
-Barbiturates, antifungals, antibiotics.
-decrease effectiveness on Oral hypoglycemics, oral anticoagulants, vitamins, TCA's.
What are Oral Contraceptives Side Effects? (Expected)
Expected:
Nausea
Wt. Gain
Spotting
Missed periods
Depression, mood changes
Chloasma (Estrogen effect)
Headaches
What are Oral Contraceptives Side Effects? (To report)
Report:
-leg/chest pain
-SOB
-missed periods
-breakthrough vaginal bleeding
-yeast infection
-Blurred vision (a result of HTN)
-Continuing Headaches
-Dizziness
-Acute abdominal pain
*Risk of Thromboembolic events if: >15 cigs/day
Hx of Thromboembolism, HTN, CVD
What is Minipill?
-Contains only Progestin.
-It inhibits the release of LH.
-Causes cervical mucus to remain thick.
Thins the lining of the Uterus
-Less effective than combined Oral contraceptives.
-Women may continue to ovulate
-5% failure rate
-higher incidence of both uterine and tubal preg.
-Irregular vaginal bleeding
-Dysmenorrhea common S.E.
-Women unable to take estrogen due to hx of migraines may benefit from a "progestin only" pill.
What is Luteinizing Hormone (LH)?
Responsible for the release of the ovum from the follicle.
What are the Side Effects of Minipill? (To expect)
-Same as Progesterone.
-irregular menstruation
-*Ovulation may occur (patient could get pregnant)
Side Effects to Report:
-sudden severe abd. pain d/t increased incidence of ectopic pregnancy because ovulation may not be inhibited.