endocrine ch.29,32,33,34
Terms
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- Corpus luteum
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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
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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.
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Phase 1
Menstruation phase - Initiates the cycle and last from 5 to7 days.
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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?
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Expected:
-Wt. gain
-Edema
-Breast tenderness
-Nausea ( most undesirable) - What are the Adverse Effects of Estrogen?
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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?
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Too much:
-Cardiovascular events
-Breast cancer
-Endometrial hyperplasia
-Endometrial Cancer - What are the Contraindications for Estrogen therapy?
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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?
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-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?
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-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?
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Expected:
-Wt. Gain, Edema
-N/V/D
-Tiredness
-Oily scalp
-Acne
-Dysmenorrhea (cramps) - What are Progestins Adverse Effects?
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Report:
-Hepatic dysfunction & Cholestatic jaundice (serious)
-Breakthrough bleeding
-Amenorrhea
-Continuing HA
-Mental depression - Common Progestin Drug
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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?
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-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?
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-Barbiturates, antifungals, antibiotics.
-decrease effectiveness on Oral hypoglycemics, oral anticoagulants, vitamins, TCA's. - What are Oral Contraceptives Side Effects? (Expected)
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Expected:
Nausea
Wt. Gain
Spotting
Missed periods
Depression, mood changes
Chloasma (Estrogen effect)
Headaches - What are Oral Contraceptives Side Effects? (To report)
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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?
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-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)
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-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.