A&P Flashcards
Lupron
this is a GNRH inhibitor
used in tx of prostate cancer and in women who have endometriosis. If shut down activity of GnRH, the female will get menopause.
shuts down the whole thing
inhibiting the release of gonadotropin and eveyrthing stops
medically speaking, how do we target estradiol and progesterone
OTC
mimic the feedback into the HPO axis by keeping some level of estrogen and progesterone from the target organ at all times, thereby suppressing further ovulation events
when, during a women’s cycle, is a pap difficult to perform and why
low and closed
very dry
early in the cycle
better to do it around day 14
Stage 1 of follicular development
in utero: independent of FSH
a. Born with the follicles and they go under a state of arrested development until puberty
Stage 2/3
Estradiol from ovary (FSH) accelerates growth of 6-12 secondary follicles each cycle. Can see up to 20 per month – it is different in every woman
a. Dominant follicle determined at about 1 week – others die
probably
follicular development does not happen if there is no
if there is no LH
corona radiate
Outer wall of graffian follicle swells allowing stigma from center to protrude. Stigma ruptures and ovum is carried within fluid and cells
hormone responsible for the spike in body temperature
progesterone
-the likes this weird mortor analogy
maximum window of fertilization is
before the ovary release just prior to the LH surge
once estrogen is opposed by progesterone the cervix is low closed and dry
the pinbark height test is better than an ovulation kit
where does fertilization occur
Happens high in tube if implantation is to occur
- sperm needs travel time to get to the fimbria
if you can implant around day 8 you have a better chance.
_____ effects the pituitary which triggers the release of FSH
GNRH effects the pituitary which triggers the release of FSH
the ___phase is governed by the CL and is a solid ____ days
The luteal phase governed by the CL is a solid 12-16 days. After ovulation the cycle should be very consistent
- 3x more cycles than ever in
embryonic portion of the placenta responsible for sustaining the luteum through the first semester
initially by embryo (trophoblasts), then placenta
hCG keeps the corpus luteum from degenerating in the first trimester. So it can keep making the progesterone. If the progesterone levels fall, the wall falls down and menses start
when do we see the degradation of the CL in pregnancy what happens at this point
10-12 weeks
placenta becomes the major produce of steroids
HPL
human placental lactogen secreted into maternal circulation, rises throughout pregnancy
- Protein hormone, like prolactin, antagonizes maternal glucose consumption
Provide nutritional support by making glucose readily available to the fetus but also puts mom at risk for gestational DM
this hormone is indicated in GDM
chloasma
otherwise known as melasma
is the mask of pregnancy
seen with pigment changes related to hormones affecting melanocytes
role of relaxin in pregnancy
and what are the associated changes with this
enlarges ribacage and subcostal diaphragm diameter, volumes and capacities effected by mechanical changes
- DOE increases throughout pregnancy
- Pelvis is not as stable as it used to be so can be a fall risk
why do we see a decrease in BP early in pregnancy
iii. BP decreased early, then compensated
1. Vasodilation causes decrease in BP
iv. BP higher than pre-preg = MONITOR
what BP drugs should be avoided in pregnancy
Never use ACEi d/t renal damage
first line: Labetalol Hydralazine Nifedipine Methyldopa
renal changes seen in pregnancy (3)
i. Kidneys enlarge
ii. Increased GFR increases CrCl
iii. Glucose load and excretion increased d/t insulin insensitivity
iv. Trace protein in UA – normal from expanded volume, enhanced perfusion
bladder changes
reduced capacity, increased pressure
i. Nerves of the bladder respond to both internal/external pressure
when do we see blood volume increase in pregnancy
i. BV increased at 6 weeks
other than BV changes
what other hematological changes do we see in pregnancy
ii. Physiologic anemia – red cell production will not keep up early but it will come back
iii. Two fold normal risk of embolism
pregnancy is a hyper or hypo coagulable state?
hypercoaguble
hypertrophy or breast tissue is due to prolactin or progesterone?
progesterone
first form of milk produced by mammory glands is known as
iii. Colostrum expression pre-partum
musculoskeletal changes seen in pregnancy
i. Lumbar lordosis helps with weight repositioning
ii. Unsteady gait w/ separation of PS
iii. (relaxin effect on pelvis) – fall risk
changes in the reproductive organs with regards to cervix and uterine volume
i. Increased d/c
ii. Endocervix converts to ectocervix
iii. Mucus plug forms which will be extruded at the onset of labor
iv. Uterine volume increases x500
umbilical vein is how saturated with oxygen
i. Umbilical vein blood is 80% sat (carries blood from the placenta to the fetal heart)
physiological valve that exists in the liver of the fetus
- In order to get to the IVC, the umbilical vein has to travel to the liver. In the liver, you are going to encounter the DUCTUS VENOSUS which is a physiologic valve(structure that fxns like a valve but it does not have flaps)
how does the ductus venosus work exactly?
In the fetus, the ductus venosus (Arantius’ duct after Julius Caesar Aranzi) shunts a portion of the left umbilical vein blood flow directly to the inferior vena cava. Thus, it allows oxygenated blood from the placenta to bypass the liver.
how does the ductus venous and the greater liver protect the fetal heart
become a protective reservoir for excess flow when high pressure in the system so it is thought to control the pressures on the fetal heart.
The liver can take some of that volume when pressure is high and limit exposure to the heart. Under normal conditions, blood goes through DV, bypasses the liver and pours into the IVC.
what triggers the function of the lungs after delivery
Reduced resistance in lungs invites flow
Buildup of CO2 with loss of maternal flow which works on the brain and stimulates respiratory drive
why is the right ventricle thicker initially after birth
e. Greater workload on R ventricle in fetus means that wall of R ventricle is thicker until about 1 month of age. R ventricular wall atrophies
why would a blood shunt exist after brith?
when would this be normal?
Often a small shunt of blood persists from aorta to L pulmonary artery for 24-48 hours after birth – NORMAL
Neural tube formation (CNS primordium)
is a ___ week embryonic development
3 weeks
neural crest formation also occurs at this time
Coelom
body cavity occurs in week 3)
what is occuring around week .
Gastrulation forms
trilaminar embryo (meso, endo and ecto derm multi potent layers are formed)
primitive streak nad grove
primordial axis of the embryo is known as
notocord
this a transient embryonic structure that is seen as the nucleus pulpulses in the human
this is a solid structure that helps determine how the embyro folds
organogenetic period
4-8 weeks
what is the fetal period
i. 9th week – birth = fetal period
organogenetic period
Major portion of the embryonic period, all major organ systems form
C-shaped cylindrical embryo formed from embryonic disc by FOLDING IN 4th week
when do we see the incorporation of the yoke sac
Incorporation of yolk sac and formation of gut from the yolk sac in 4th week
Heart moves ventrally as brain forms
ductus venous
bypasses the liver and connects tot he IVC
mixed purple blood here mixes with the hepatic vein
all blood from placenta and body meet in the RA
hypoxic pulmonary vasoconstriction
this is what exists in the lungs because of the absence of oxygen results really high pressures in the RV and the RA
very little blood makes it to the RV ductus arterioses shunts blood form the pulmonary artery to the aorta
chemical that keeps the ductus arterioses open
prostaglandin
ductus venosus turns into the
Ligamentum venosum of the liver
the remnants of the umbilical vein turn into what in the adult
ROUND LIGAMENT
important CRL measurement in the 9 week fetus
head is ½ crown rump length
what is more saturated with oxygen the umbilical vein or the umbilical artery?
vein! 80%
arteries 58%
what occurs with regards to blood formation during the 9th week
Blood formation shifts from liver to spleen from 9th-12th weeks
Skeletal ossification and coordinated limb movements. Blood cell production is shifting into the bones
Scalp hair pattern determine by ____ week
Scalp hair pattern determine by 13-16th week
