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4 RED > AP05 Pregnancy and Childbirth > Flashcards

AP05 Pregnancy and Childbirth Flashcards

1
Q

What structres cross the pelvic brim?

A

ovarian and internal iliac vessels

ureters

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2
Q

What diameter might decrease to facilitate skull shape change in childbirth?

A

bipareital diameter

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3
Q

Which 4 key structures make up the pelvic diaphragm?

A

lavator ani
coccygeus
perineal membrane
deep perineal muscles

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4
Q

What 3 muscles comprise levator ani?

A

iliococcygeus
pubococcygeus
puborectalis

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5
Q

What is levator ani innervated by?

A

pudendal nerve S2-S4

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6
Q

Which ligament is pubococcygeus associated with

A

anococcygeus

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7
Q

Where does coccygeus extend from?

A

ischial spine and pelvic surface of the sacrospinous ligament to lateral margin of coccyx and related border of sacrum

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8
Q

What is the function of coccygeus?

A

pulls coccyx forwards after defecation

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9
Q

What is coccygeus innervated by?

A

S3-4

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10
Q

What are teh deep perineal muscles innervated by?

A

perineal branches of pudendal nerve

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11
Q

What are the deep perineal muscles comprised of?

A

external urethral sphincter
deep transverse perineal muscle
compressor urethrae
sphincter urethrovaginalis

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12
Q

Why is MRI pelvimetry not recommended in healthy mothers?

A

can increase C-seciton uptake unecessarily

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13
Q

What is measured in MRI pelvimetry?

A

sagittal pelvic inlet diameter
transverse inlet diameter
bispinous outlet
sagittal pelvic outlet diameter

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14
Q

What is the front and back of a baby’s head called?

A

front - sinciput

back - occiput

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15
Q

What happens to the uterus over the first 20 weeks?

A

hypertrophy
thickness constant
decreased size but not cell number

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16
Q

What happens to the uterus in the second 20 weeks?

A

distension

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17
Q

What has happened to the anatomical internal os by the 3rd trimester?

A

now contains the head

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18
Q

What is the height of the uterus at 12 weeks?

A

pubic symphysis

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19
Q

What is the height of the uterus at 20 weeks?

A

umbilicus

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20
Q

What is the height of the uterus at 36 weeks?

A

xiphisternum

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21
Q

What is significant about the uterus height at 24 weeks?

Why is this clinically significant?

A

accurate gestational age estimate

used to detect oligohydramnios

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22
Q

What are the 3 key stages of labour?

A

dilation of the cervix
Expulsion of the foetus
AFterbirth of the PLacenta

23
Q

What is the position of the head when the cervix dilates?

A

R/L occipitotransverse

24
Q

What causes the cervix to relax?

A

relaxin

25
Q

What are the stages to foetal expulsion?

A 
egagement
descent
flexion
medial rotation
extension
lateral rotation
expulsion
26
Q

What happens in engagement?

A

biparietal diameter enters pelvic inlet

27
Q

What causes flexion?

A

uterine contractions

28
Q

What happens in medial rotation?

A

from lateral to occipitoanterior

29
Q

What happens in extension?

A

head extends around pubic symphysis

30
Q

What happens in lateral rotation?

A

face laterally again to fit shoulders

31
Q

What might happen in placental afterbirth?

A

retro-placental haemorrhage

32
Q

What is oligohydramnios?

A

congenital kidney diseases no urine is being produces
shorter uterus because less amniotic fluid
(potters syndrome)

33
Q

What might impingement of the ureters in pregnancy cause?

A

hydronephrosis

34
Q

Where would ruptured uterine tubes bleed?

A

perineal pouches

35
Q

What might you have to watch out for and do if placental delivery is delayed 1 hour beyond childbirth

A

haemorrhage

hysterectomy

36
Q

What is the course of the pudendal nerve?

A

greater sciatic foramen inferior to piriformis
tuns anteriorly around sacrospinous foramen
leaves gluteal region through lesser sciatic foramen
into pudendal canal

37
Q

What does the pudendal nerve divide into in the pudendal canal?

A

1st inferior rectal nerve
2nd dorsal nerve of penis/clitoris
(perineal nerve)

38
Q

What variations are associated with the pudendal nerve?

A

S1/S5 contributions

additional accessory rectal nerve

39
Q

Name 3 types of nerve block used in pregnancy

A

Spinal block (lumbar puncture)
Caudal epidural block
Pudendal nerve block

40
Q

What strucutre do you have to watch out for in a pudendal block?

A

internal pudendal artery

41
Q

Where is the breast?

A

lateral border of sternum to mid-axillary line
2nd to 6th costal cartilages
cuperficial to pec major and serratus anterior

42
Q

What are the 2 key regions of the breast?

A

circular body

axillary tail

43
Q

How many lobules are in each mammary gland?

A

15-20

44
Q

What drains the alveoli of each secretory lobule in the breast?

A

lactiferous ducts

45
Q

What surrounds mammary glands?

A

connective tissue stroma

fibrous or fatty

46
Q

What does the fibrous connective tissue stroma of the breast condense to form?

A

suspensory ligaments of cooper

47
Q

What are the functions of the suspensory ligaments of cooper?

A

attach and secure breast to dermis and underlying pectoral fascia
separate the secretory lobules of the breast

48
Q

What as the pectoral facia?

A

attachment point forsuspensory ligaments

49
Q

What arteries supply the medial breast?

A

internal thoracic artery

50
Q

What arteries supply the lateral breast?

A

lateral thoracic artery
thoracoacromial artery
lateral mammary artery
mammary branches

51
Q

What lymph nodes drain the breast?

A

axillary nodes 75%
parastenal nodes 20%
posterior intercostal nodes 5%

52
Q

What nerves innervate the breast?

A

anterior and lateral cutaneous branches of the 4th to 6th intercostal nerves

53
Q

Which hormones regulate production and secretion of milk?

A

prolactin and oxytocin

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