Menopause and Climacteric Phase Quiz
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Questions and Answers

What happens to the uterus during the resolution phase after orgasm?

  • It drops forward to its resting position. (correct)
  • It contracts dramatically.
  • It remains in a contracted state.
  • It expands significantly.
  • Which of the following is a common effect of menopause?

  • Enhanced skin thickness.
  • Increased libido.
  • Improved bone density.
  • Genital atrophy. (correct)
  • What marks the beginning of the climacteric phase in females?

  • Birth of the first child.
  • Menstrual irregularities.
  • Reduction to about 1,000 ovarian follicles. (correct)
  • Complete cessation of menstruation.
  • At what age does menopause typically occur?

    <p>45 to 55 years.</p> Signup and view all the answers

    What is one of the effects of declining estrogen and progesterone levels during climacteric?

    <p>Decline in bone mass.</p> Signup and view all the answers

    Which of the following symptoms may result from the dilation of blood vessels during menopause?

    <p>Hot flashes.</p> Signup and view all the answers

    What happens to the ability to conceive as women age?

    <p>It dramatically declines by age 35.</p> Signup and view all the answers

    How long must menstruation cease for menopause to be considered complete?

    <p>1 year.</p> Signup and view all the answers

    What is the primary function of the ovaries in the female reproductive system?

    <p>To produce egg cells and sex hormones</p> Signup and view all the answers

    What term describes the shedding of the functional layer of the endometrium during menstruation?

    <p>Menstrual flow</p> Signup and view all the answers

    Which hormonal feedback mechanism results in the regulation of FSH and LH secretion during the menstrual cycle?

    <p>Negative feedback</p> Signup and view all the answers

    What role does the fimbriae have in the reproductive process?

    <p>To capture the released egg from the ovary</p> Signup and view all the answers

    At what stage does the secondary oocyte complete meiosis II if fertilization occurs?

    <p>After sperm unites with its chromosomes</p> Signup and view all the answers

    Which structure connects the lumen of the uterus to the vagina?

    <p>Cervical canal</p> Signup and view all the answers

    What is the role of the myometrium in the uterus?

    <p>To produce labor contractions and expel the fetus</p> Signup and view all the answers

    Which is not a characteristic of the vagina?

    <p>Is primarily an endocrine organ</p> Signup and view all the answers

    What initiates the onset of puberty in females?

    <p>GnRH stimulating the release of FSH and LH</p> Signup and view all the answers

    What defines the luteal phase of the menstrual cycle?

    <p>The thickening of the endometrial lining</p> Signup and view all the answers

    What is the primary role of the clitoris in the female reproductive system?

    <p>To serve as a primary center for sexual stimulation</p> Signup and view all the answers

    What is the cortical reaction that occurs during the development of an egg?

    <p>Prevention of polyspermy</p> Signup and view all the answers

    Which structure is primarily affected when estrogen levels fluctuate during the menstrual cycle?

    <p>Uterine endometrium</p> Signup and view all the answers

    What is the main event that distinguishes the ovulation phase in the ovarian cycle?

    <p>Release of an egg from the mature follicle</p> Signup and view all the answers

    What hormone is primarily responsible for the surge that triggers ovulation?

    <p>Luteinizing Hormone (LH)</p> Signup and view all the answers

    Which phase of the menstrual cycle involves the thickening of the endometrium due to progesterone?

    <p>Secretory phase</p> Signup and view all the answers

    During which phase do the cervical mucus changes indicate the best time for conception?

    <p>Ovulation phase</p> Signup and view all the answers

    What occurs to the endometrium during the premenstrual phase?

    <p>It undergoes degeneration</p> Signup and view all the answers

    Which cells multiply and fill the space after the follicle ruptures?

    <p>Granulosa cells</p> Signup and view all the answers

    What is the key change in hormone levels during the luteal phase?

    <p>Increase in progesterone and decrease in LH</p> Signup and view all the answers

    What initiates the involution of the corpus luteum?

    <p>Decline in progesterone levels</p> Signup and view all the answers

    What is the typical ovulation day within the menstrual cycle?

    <p>Day 14</p> Signup and view all the answers

    How does estradiol affect the anterior pituitary during the ovarian cycle?

    <p>It triggers both FSH and LH secretion</p> Signup and view all the answers

    What is the average volume of menstrual fluid expelled during the menstrual phase?

    <p>40 mL</p> Signup and view all the answers

    What physical change occurs in the labia majora during the excitement phase?

    <p>They become reddened and enlarged</p> Signup and view all the answers

    What structure develops from the ruptured follicle after ovulation?

    <p>Corpus luteum</p> Signup and view all the answers

    What phase comes first in the female sexual response cycle?

    <p>Excitement</p> Signup and view all the answers

    What is uterine milk primarily composed of?

    <p>Glycogen-rich secretion</p> Signup and view all the answers

    Which phase of prenatal nutrition involves the consumption of decidual cells of the endometrium?

    <p>Trophoblastic nutrition phase</p> Signup and view all the answers

    When does placental nutrition become the primary source of nutrients for the developing fetus?

    <p>Beginning of week 9</p> Signup and view all the answers

    What significant development occurs by the end of 8 weeks of pregnancy?

    <p>Individual is now considered a fetus</p> Signup and view all the answers

    Which statement reflects a unique aspect of fetal circulation?

    <p>It contains circulatory shortcuts called shunts</p> Signup and view all the answers

    During which timeframe does the major transition to placental nutrition occur?

    <p>Week 8 to week 9</p> Signup and view all the answers

    What prominent developmental feature does a fetus exhibit by the end of 8 weeks?

    <p>Bones have begun to calcify</p> Signup and view all the answers

    What marks the end of the period of exclusive decidual cell consumption for the conceptus?

    <p>End of week 12</p> Signup and view all the answers

    What significant change occurs when an embryo is generally recognized as such?

    <p>When it is 16 days old and has three germ layers</p> Signup and view all the answers

    Which of the following statements about sperm migration is true?

    <p>Only a small number of sperm reach the egg after ejaculation</p> Signup and view all the answers

    What is the process that begins when the blastocyst adheres to the endometrium?

    <p>Implantation</p> Signup and view all the answers

    When does the secondary oocyte complete meiosis II?

    <p>Only if fertilized</p> Signup and view all the answers

    Which trimester is characterized by the most significant natural loss of embryos?

    <p>First trimester</p> Signup and view all the answers

    What stage follows the morula stage during preembryonic development?

    <p>Blastocyst</p> Signup and view all the answers

    What hormone is primarily secreted by the trophoblast soon after implantation?

    <p>Human chorionic gonadotropin (HCG)</p> Signup and view all the answers

    What role do ectoderm, mesoderm, and endoderm play in embryogenesis?

    <p>They differentiate into organs and organ systems.</p> Signup and view all the answers

    Which process occurs during the first three days after fertilization and involves mitotic divisions?

    <p>Cleavage</p> Signup and view all the answers

    What forms the placenta during embryonic development?

    <p>Only the trophoblast cells</p> Signup and view all the answers

    What key development occurs at approximately 8 weeks of gestation?

    <p>The embryo becomes a fetus</p> Signup and view all the answers

    What structure encloses the embryo and protects it from external factors?

    <p>Amnion</p> Signup and view all the answers

    How does amniotic fluid contribute to fetal development?

    <p>It stimulates lung development as the fetus inhales and exhales fluid.</p> Signup and view all the answers

    Study Notes

    Female Reproductive System

    • The female reproductive system is more complex than the male system because it serves more purposes, including producing and delivering gametes, providing nutrition and a safe harbor for fetal development, giving birth, and nourishing the infant.
    • The female system is more cyclic, and hormones are secreted in a more complex sequence than in males.
    • The genitalia include both internal and external parts. Internal genitalia include the ovaries, uterine tubes, uterus, and vagina. External genitalia include the clitoris, labia minora, labia majora, and the perineum, which contains the primary sex organs and other internal and external genitalia.
    • The ovaries are the primary sex organs, producing egg cells (ova) and sex hormones.
    • Ovaries are almond-shaped, nestled in the ovarian fossa of the posterior pelvic wall. They have a capsule, called tunica albuginea, similar to the testes' capsule, and the outer cortex contains germ cells which develop.
    • The inner medulla of the ovary contains major arteries and veins, and each egg develops within its own fluid-filled follicle. The follicle bursts, releasing the egg.
    • The uterine tube (oviduct) or fallopian tube is about 10 cm long and connects the ovary to the uterus. It is muscular and lined with ciliated cells, folded into longitudinal ridges.
    • Fimbriae are feathery projections on the infundibulum of the uterine tube.
    • The ampulla is the middle and longest part of the uterine tube.
    • The isthmus is the narrower end of the uterine tube, leading toward the uterus.
    • The uterus is a thick muscular chamber that opens into the roof of the vagina. It usually tilts forward over the urinary bladder. It harbors the fetus, providing nutrition, and expels the fetus at the end of development.
    • The uterus is pear-shaped. Its fundus is the broad superior curvature. The body (corpus) is the middle portion, and the cylindrical inferior end is called the body/corpus.
    • The cervical canal connects the uterine lumen to the vagina.
    • The internal os is the superior opening of the canal into the body of the uterus, while the external os is the inferior opening into the vagina.
    • The uterine wall consists of the perimetrium (external serosa layer), myometrium (middle muscular layer), and endometrium (inner mucosa). The myometrium is the primary muscular layer.
    • The endometrium, the inner mucosa, consists of simple columnar epithelium, compound tubular glands, and a stroma with leukocytes, macrophages, and other cells.
    • The superficial half of the endometrium is shed each menstrual period. The basal layer stays behind and regenerates a new functional layer each cycle.
    • The vagina is a distensible muscular tube (8-10 cm) allowing for discharge of menstrual fluid, receipt of penis and semen, and birth. It has outer adventitia, middle muscularis, and inner mucosa layers.
    • Fornices are blind-ended spaces at the top of the vagina that slightly extend beyond the cervix.
    • Vaginal rugae are transverse friction ridges at the lower end of the vagina.
    • Vaginal epithelium undergoes metaplasia from simple cuboidal in childhood to stratified squamous in puberty, under influence of estrogen.
    • Bacteria ferment glycogen in the vagina producing acidic pH, inhibiting pathogen growth.
    • External genitalia are collectively called the vulva (or pudendum).
    • The mons pubis is a mound of fat over the pubic symphysis, bearing most of the pubic hair.
    • The labia majora is a pair of thick skin and adipose tissue folds inferior to the mons.
    • The labia minora are thin, hairless folds medial to the labia majora. The space between them forms the vestibule, containing the urethral and vaginal openings.
    • The anterior margins of the labia minora form a hood-like prepuce over the clitoris.
    • The clitoris is the primary center for sexual stimulation (sensory organ) with a glans, body, and crura.
    • The vestibular bulbs are erectile tissues deep to the labia majora, bracketing the vagina. The greater and lesser vestibular and paraurethral glands open into the vestibule for lubrication.
    • The breasts are mounds of tissue overlying the pectoralis major. They enlarge at puberty and contain very little mammary glands most of the time.
    • Mammary glands develop in the breast during pregnancy and remain active in the lactating breast. They atrophy (shrink) when nursing ceases.
    • The breast has a body (conical to pendulous, with nipple apex) and axillary tail (extension toward armpit).
    • Lymphatics in the axillary tail, are important as a route for breast cancer metastasis.
    • The nipple has capillaries and nerves close to the surface, making this zone sensitive. Sensory nerve fibers of the areola trigger a milk ejection reflex in response to infant nursing.
    • Areolar glands (Montgomery glands) are intermediate between sweat glands and mammary glands. Secretion protects the nipple. Their smooth muscle fibers contract in response to cold, touch, or sexual arousal.
    • The nonlactating breast, consists mostly of adipose and collagenous tissue.
    • Breast size is determined by the amount of adipose tissue.
    • Suspensory ligaments (Coopers' ligaments) attach the breast to the dermis and fascia of the overlying pectoralis major.
    • Mammary ducts branch through their fibrous stroma and converge on the nipple.
    • The ducts end in sacs called acini surrounded by cells. 
    • Puberty begins at age 8-10 in most girls in the United States, triggered by rising GnRH levels.
    • GnRH stimulates the anterior pituitary to secrete FSH and LH.
    • FSH stimulates ovarian follicles to secrete estrogen, progesterone, inhibin, and a small amount of androgen. Estrogens are feminizing hormones with widespread effects on the body (estrone is most abundant, estriol and others).
    • At least 17% body fat is needed for the first menstrual period, with nutrition improving onset times to 12 years old in some cases. 
    • Leptin stimulates gonadotropin secretion; if body fat and leptin levels drop too low, gonadotropin secretion declines and menstruation might cease, typically when body fat drops below 22%.
    • Estradiol stimulates many changes in puberty, including vaginal metaplasia, growth of ovaries and secondary sex organs, hormone secretion increases in height and widening of the pelvis, stimulates fat deposition, and thickens the skin. (Girls' skin is still thinner, softer, and warmer than boys').
    • Estradiol primarily acts on the uterus, preparing it for possible pregnancy.
    • Estrogens and progesterone suppress FSH and LH secretion, through negative feedback.
    • Inhibin selectively suppresses FSH secretion.
    • Hormones are secreted in a distinctive cyclic sequence.
    • The reproductive cycle is the sequence of events from fertilization to giving birth, returning to fertility.
    • The sexual cycle is the cyclical events that recur monthly when pregnancy does not intervene. The sexual cycle consists of two interconnected cycles. The ovarian cycle involves events in the ovaries, and the menstrual cycle involves parallel changes in the uterus.
    • Oogenesis is egg production (haploid gametes) through meiosis. This is a distinctly cyclical event, releasing one egg each month. Cyclic changes in hormone secretion, and histological structure of the ovaries and uterus, accompanies oogenesis.
    • Embryonic development of the ovary transforms into primary oocytes; during early meiosis I, most degenerate (atresia).
    • By puberty, approximately 200,000 oocytes remain, with a lifetime egg capacity of probably only 480 ovulations.
    • Egg development resumes in adolescence; FSH stimulates monthly cohorts to complete meiosis I. During meiosis I, an oocyte divides into two haploid daughter cells.
    • Secondary oocytes are the large daughter cells resulting from meiosis I.
    • First polar bodies are the smaller cells, which disintegrate, discarding extra sets of haploid chromosomes.
    • Secondary oocytes proceed as far as metaphase II, arresting until after ovulation.
    • If not fertilized, the secondary oocyte dies and never finishes meiosis.
    • If fertilized, it completes meiosis II and casts off a second polar body; the chromosomes of the large remaining egg unite with those of the sperm.
    • Hormones of the hypothalamus regulate the pituitary gland.
    • Pituitary hormones regulate the ovaries and ovaries secrete hormones that regulate the uterus (basic hierarchy of hormonal control). Hypothalamus → pituitary → ovaries → uterus.
    • Ovaries exert feedback control on hypothalamus and pituitary.
    • The cycle begins with a two-week follicular phase.
    • Menstruation occurs during the first 3-5 days; the uterus replaces lost tissue, follicles grow through mitosis.
    • Ovulation occurs around day 14; the remainder of the follicle becomes the corpus luteum.
    • The next two weeks are the luteal phase, during which LH stimulates endometrial secretion and thickening.
    • If pregnancy does not occur, the endometrium breaks down in the last two days; menstruation begins and the cycle starts again.
    • The ovarian cycle has three principle phases (follicular, ovulation, luteal).
    • The uterine tube gets ready to catch the released oocyte. It swells with edema, its fimbriae envelop and caress the ovary with the woman's heartbeat's synchronous beat. Gentle currents from cilia in nearby peritoneal fluid help in movement and transport.
    • Couples seeking conception or pregnancy avoidance may want to use ovulation signals. Cervical mucus changes (becoming thinner and more stretchy). Resting body temperature rises a degree or so, and Mittelschmerz (ovulation pain) occurs.
    • Transformation from the ruptured follicle to the corpus luteum is controlled by LH. It triggers the growth and secretion of rising estradiol and progesterone levels. A 10-fold increase of progesterone is especially critical for the luteal phase. Progesterone plays a crucial role in preparing for pregnancy.
    • LH and FSH secretion decline through the cycle. High levels of estradiol and progesterone along with inhibin from the corpus luteum have negative feedback effects on the pituitary.
    • The corpus luteum begins shrinking (involution) after ovulation.
    • By day 26 of ovarian involution, completing the process to create a scar where the corpus luteum used to be.
    • With the declining steroid production in the ovaries, FSH rises to start the ripening of new follicles.
    • Ovulation occurs in one ovary per cycle, usually alternating. Ovulated oocytes begin ripening about 290 days before birth and are recruited into cohorts (a new cohort develops, usually).
    • The menstrual cycle involves a buildup of endometrium, breakdown, and discharge of the lining. It's divided into the proliferative phase, where endometrium rebuilds, the secretory phase, where it thickens, the premenstrual phase, which is the period of endometrial degeneration, and menstrual phase, involving vaginal discharge.
    • Proliferative phase: endometrium rebuilds, stimulated by estrogen. New follicles develop, secreting estrogen more, causing mitosis and blood vessel growth (Day 5 = 0.5mm, Day 14 = 2-3mm thick). Estrogen stimulates endometrial cells to create progesterone receptors.
    • Secretory phase: endometrium thickens due to progesterone secretion from the corpus luteum causing (Day 15 - 26) gland development and thickening due to glycogen secretion, rather than mitosis. Endometrium (5-6mm thick, soft, nutritious, etc.).
    • Premenstrual phase: progesterone levels fall; corpus luteum atrophies; causes tissue necrosis, menstrual cramps, and mixes with blood and serous fluid to become menstrual fluid.
    • The menstrual phase (menses) involves the discharge of menstrual fluids from the vagina. The first day of discharge marks the beginning of the next cycle. The average woman expels around 40mL of blood and 35mL of serous fluid over 5 days. It does not clot.
    • Sexual response is divided into excitement, plateau, orgasm, and resolution phases.
    • Excitement and plateau phases cause labia minora and majora engorgement and enlargement with fluid.
    • The vagina constricts during orgasm (orgasmic platform), and pelvic thrusting occurs with pelvic throbbing and spreading sensation of warmth.
    • Three to five strong pelvic platform contractions occur about 0.8 seconds apart.
    • The cervix plunges spasmodically into the vagina, stimulating peristaltic uterine contractions, anal and urethral sphincter contraction, and possible paraurethral gland fluid release (similar to prostatic fluid in males). Women may experience reddish flush on lower abdomen, chest, neck, and face as well as tachycardia (rapid heart rate) and hyperventilation.
    • Resolution phase involves uterus returning to its resting position; the orgasmic platform relaxes. Vagina returns to normal dimensions; flush disappears; areolae and nipples detumesce, and breasts take 5-10 minutes to return to normal size. Postorgasmic perspiration occurs; women do not have refractory periods.

    Senescence of the Female Reproductive System

    • Abrupt changes due to menopause occur when ovarian follicles are used up, gametogenesis ceases, and ovaries cease producing sex steroids; reduced libido, genital atrophy, elevated osteoporosis and atherosclerosis risks.

    Climacteric and Menopause

    • Climacteric is a midlife change in hormone secretion, with cessation of menstruation.
    • Menopause is the cessation of menstrual cycles, occurring usually between ages 45 and 55, with ages increasing in the past century. Menopause is considered complete when there has been no menstruation for a period of time.

    Fertility of Aging Females

    • Peak fertility occurs in the early 20s.
    • As females age, fertility dramatically declines by age 35.
    • Birth defects increase dramatically after age 40.
    • Xinju Tian, from China, age 65, gave birth during October 2019.
    • Mangayamma Yaramati, from India, age 74, gave birth during September 2019. These are examples of the oldest recorded pregnancies.

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    Description

    Test your knowledge on menopause and the climacteric phase in females. This quiz covers various aspects including physiological changes, age factors, and symptoms associated with menopause. Gain a better understanding of this important stage in women's health.

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