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What are the phases of the female sex act
- Excitement phase
- Plateau phase
- Orgasm
- Resolution
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What happens in the female excitement stage
- Erectile tissue becomes engorged (PNS)
- Vaginal secretions lubricate the vagina
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In the Plateau phase what happens
- Maintenance of lubricating state
- Uterus becomes vertical
- Lower one third of vagina constricts
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What happens in the orgasm stage
- Uterus and cervix contract rhythmically (SNS mediated)
- Uterus position to open
- Cervical opening becomes patent
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What happens in the resolution stage
- Uterus returns to original position above the bladder
- Cervical opening remains widely open for 20-30 min permitting the sperm to enter the uterus
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How many sperm are deposited by the male into the vagina during intercourse
150-600 million sperm
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How many sperm reach the ampulla portion of the fallopian tube
50-100
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How thick is the lumen of the fallopian tube
2x the thickness of a human hair
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What is the normal life of the egg after ovulation
24 hrs
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Motility of spermatozoa is aided by what secreted in the female
Oxytocin
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Motility of the uterine tube is aided by what secreted by the male
Prostaglandins in the seminal fluid
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Capacitation of the sperm is under the hormonal control of
- Fertilization-Promoting Peptide (FPP) (an inhibitory product of the prostate gland)
- Only when sperm is absent from it can capacitation begin
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What actions happen for sperm to undergo capacitation
- Ca++ influx
- FPP dissipation
- Loss of cholesterol on sperm head causing exposure of the acrosomal membrane
- Merging of acrosomal and plasma membrane of sperm
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Ca++ influx has what effect on the sperm
- The release of hydrolytic enzymes like hyaluronidase facilitating penetration of the zona pellucida
- Increased motility
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Polar bodies released from the ovum are what
A result of Meiosis II which discards the unused chromosomes
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What are the events of the fertilization of the egg by a sperm
- 1. Sperm swims through the granulosa cells (corona radiata) to reach the zona pellucida
- 2. Sperm binds to ZP3
- 3. Sperm releases enzymes and bind to ZP2 (orienting sperm)
- 4. Increase intracellular Ca+ and flagellar action
- 5. Sperm penetrates ovum membrane
- 6. Ova Ca+ rises blocking polyspermy
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What limits fertilization to one sperm
- Ca+ rise hardening the ovum to further penetration
- Cortical granules of oocyte fuse with the plasma membrane
- Sperm receptors on ovum are inactivated
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What removes the remaining zona pellucida before implantation on around day 6
Uterine secretions and contractions
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What does the uterus secrete to give nutrients to the blastocyst while it waits to be implanted
Fructose
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What hormones are secreted to prepare the uterus for implantation of the blastocyst
- Progesterone and estrogen from the corpus luteum
- hCG secretion from the Blastocyst
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What are the three layers of the uterus upon implantation
- Zona compacta - invasion zone
- Zona spongiosum - lipid, cholesterol stores, & glands
- Zona basalis
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What results from an absence of progesterone
- Implantation of the blastocyst fails
- Glands, lipids, and glycogen fail to proliferate in the endometrium
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What layer of the blastocyst makes contact with the maternal blood vessels
Synctiotrophoblast layer
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What are the PaO2 levels of the maternal and fetal blood
- Maternal - 50mmHg
- Fetal - 30mmHg
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What are the hemoglobin subunits in the maternal and fetal blood
- Maternal - 2 alpha and 2 beta
- Fetal - 2 alpha and 2 gamma (higher affinity for O2)
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How do carbon dioxide levels compare in the mother and fetus
The fetus has 2-3 mmHg higher then the mother
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Glucose is moved across the placenta how
Facilitated diffusion
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Lipids, free fatty acids, ions (Na, K+, Cl-) move across the placenta how
Simple diffusion
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hCG is produced by what and has what affect
- Produced by syncytiotrophoblasts
- This "rescues" the corpus luteum
- Also acts on LH receptors on embryonic Leydig cells in a male baby
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What are the main effects of progestins
- Support of the endometrium
- Suppression of contractility in uterine smooth muscle
- Prepares the breasts for lactation
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What is the role of placental estrogens
- Stimulates the growth of the myometrium
- Stimulates mammary gland development
- Stimulates growth of uterus
- Relaxation of pelvic ligaments
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The placenta produces primarily what type of estrogen
Estriol
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What replaces hCG after several weeks
Human chorionic somatomammotropin (hCS)
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Human chorionic somatomammotropin (hCS) is structurally related to what other hormones
Prolactin and Growth hormones
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hCS has what effects during pregnancy
- Maternal lypolysis
- Antagonizes insulin actions on carb. metabolism
- Switches metabolism from anabolic to catabolic
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Relaxin
A hormone thought to act synergistically with progesterone to maintain pregnancy, and relax pelvic ligaments
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How does pregnancy effect insulin levels
Increases them early in pregnancy and decreases sensitivity later in pregnancy potentially leading to gestational diabetes
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What are the main hormones made by the placenta
- Relaxin
- Inhibin
- Progesterone
- Estrogen
- "RIPE"
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Aldosterone levels are effected how in pregnancy
Secretion of Aldosterone goes up because renin and angiotensinogen are stimulated by estrogen, and because plasma levels are reduced
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What happens to cortisol levels during pregnancy
- Levels increase because of rise of estrogen
- This causes the cushy look of pregnant women
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What happens to Thyroxin (T4) levels during pregnancy
Levels increase because of estrogen induced increases in thyroid binding globulin
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What happens to the levels of Calcitriol (active vit D) during pregnancy
Production from the placenta increases ensuring adequate calcium absorption for fetal growth
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What happens to the PTH levels during pregnancy
They are decreased by 50%, but because vit D stays high, bone loss is limited while Ca+ goes to the fetus
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How is blood volume effected during pregnancy
40% increase
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By the end of pregnancy how much blood does the fetus receive a min
650 ml/min
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What happens to blood pressure at mid gestation
There is a decrease
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What happens to renal function during pregnancy
- GFR increase
- Urine increase
- Water absorption increase
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How does catabolism and anabolism change during pregnancy
During the first half of pregnancy anabolism is high preparing for needs of the fetus and for and the catabolism that takes place during the second half of pregnancy
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Why does insulin resistance set in during the second half of pregnancy
- Use of the carbohydrates and amino acids slows allowing the fetus to take the unused nutrients
- As a result lypolysis increases
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What happens to ventilation of the mother during pregnancy
It is increased due to the needs of the fetus as well as the CO2 production of the fetus
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What type of diabetes does gestational diabetes present as
Type 2
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