Birth and childhood Flashcards
When does parturition occur?
AT 40 weeks (280 days) after the first day of the the last menstrual eriod
What are the 3 stages of labour?
Dilation, expulsion and placental stage
What occurs in the dilation stage of labour? How long does it take?
Uterine contractions and dilation of the cervix
Takes 3/24 hrs
Describe how contractions progress in the 1st stage of labour
Begin in upper part of uterus and move down towards the cervix
At start may last fir 20sec and be 30 mins apart
Progress and contractions are quicker and more intense
How far does the cervix dilate?
Up to roughly 10cm
What counts as premature labour?
Less than 37 weeks
What occurs in the second stage of labour?
Expulsion of infant from mother
Mother bears down, crowning occurs,
How long does the second stage of labour take?
1-2 hrs in 1st pregnancy
15 mins in subsequent pregnancies
How long does the second stage of labour take?
1-2 hrs in 1st pregnancy
15 mins in subsequent pregnancies
What happens in stage 3 of labour and how long does it usually take?
Delivery of the placenta (afterbirth), 15 mins
Uterine contractions continue for minimisation of blood loss, detachment of placenta and expulsion of placenta
What is crowning?
When the largest part of the baby’s head is in the vulva
Describe the normal presentation of the infant
Facing down with neck bent forwards and chin tucked in, arms folded across chest
What are the most common abnormal presentation of birth?
Breech (bum first, 3% of births)
Shoulder first (needs C-section)
Brow or face
Why is a breech delivery dangerous?
Head may be caught inside the mother as it is larger than the buttocks and the cervix will have not opened wide enough
-> pressure on umbilical cord
Why are women in late pregnancy advised not to lie supine?
Weight of uterus can put pressure on the inferior vena cava -> mother feels faint and dizzy due to decreased venous return-> lower bp
What is a fetus papyraceous?
A mummified fetus, retained in womb after death
What is a fetus papyraceous?
A mummified fetus, retained in womb after death
How does a neonate’s body differ from an adult?
Proportionally larger head and broad shoulders, small abdomen and poorly developed pelvis and lower limbs
What alters the composition of bone?
Amount of exercise taken, nutritional status, age and the presence of disease
What alters the composition of bone?
Amount of exercise taken, nutritional status, age and the presence of disease
What is secondary ossification?
When long bones grow, epiphyseal growth plate etc
Why are the location of epiphyseal growth plates clinically relevant?
To be able to differentiate fractures and growth plates in children’s xrays
When can babies hold their heads up?
3 months
What is the primary curvature of the spine?
C shaped
How does a neonates thorax differ from an adult?
Ribs lie horizontally, thoracic cage is circular
When do the legs undergo extension and medial rotation in a baby?
At 6 months, in preparation for standing
Where does growth in the legs and arms of babies occur?
More at shoulder and wrist and knee
TEAK- Towards Elbow, Away from Knee
Where does growth in the legs and arms of babies occur?
More at shoulder and wrist and knee
TEAK- Towards Elbow, Away from Knee
Which is the first carpal bone to ossify?
The capitate (in 1st year of postnatal life)
When does the last carpal begin to ossify?
In the 10th yr of life
What is the scientific name for the brain case?
The calvarium
When are the adult dimensions of the calvarium reached?
At 15-16yrs
When is the calvarium not unilaminar anymore?
By about 4 yrs, two tables of bone + diploe
What are ‘soft spots’?
The non bony areas of the skull, fibrous tissue instead
called fontanelles
Name the fontanelles
Anterior, posterior, mastoid (posterolateral) and sphenoidal (anterolateral)
Describe the closure of the fontanelles
Posterior and sphenoidals close after 2-3 months
Mastoids close by end of 1st yr
Anterior closed by end of 2nd yr
What happens by the end of the 2nd yr to the skull?
All fontanelles have close and sutures have formed, thus interlocking all bones
When do infants get teeth?
After about 6 months
Where are baby teeth before they erupt?
In the maxillae bone
When do adult teeth erupt?
Start erupting at about 6 yrs of age
What is the symphysis menti?
Unites the two halves of the mandible at birth
Describe the mandible at birth
In two halves, joined by the symphysis menti, ossified by 1 yr
Describe the temporal bone at birth
Internal ear, tympanic cavity, auditory ossicles and mastoid antrum are developed
Tympanic plate and mastoid process still need to develop
Describe the temporal bone at birth
Internal ear, tympanic cavity, auditory ossicles and mastoid antrum are developed
Tympanic plate and mastoid process still need to develop
Why is the absence of a mastoid process at birth clinically significant?
Means stylomastoid foramen is exposed so facial nerve is liable to injury
What is retention of the testes associated with?
Sterlity
What happens to the male reproductive system at puberty?
Testes enlarge as spermatogenesis begins
Prostate enlarges and the mucous membranes of the seminal vesicles become greatly thickened
Penis grows
Describe the ovaries and uterus at birth
Ovaries are small but contain all the primary oocytes the female will ever have
Uterus is relatively large due to maternal hormones, loses weight quickly
What is the first menstrual period called?
Menarche
When does axillary and facial hair appear in males?
About 2 yrs after pubic hair appears
What are the secondary sex characteristics of males?
Pubic, axillary and facial hair
Growth of larynx
Broadening of shoulders
What are the secondary sex characteristics of females?
Pubic and axillary hair, breast development, broadening of hips, distribution of fat to hips and buttocks
What happens to the brain after birth?
Grows rapidly until 5yrs when it is triple its birth weight
Mainly cerebral cortex growth
What happens to the brain after birth?
Grows rapidly until 5yrs when it is triple its birth weight
Mainly cerebral cortex growth
Where does the spinal cord reach in neonates compared to adults?
At birth- L2/L3
Adult- L1/L2 (but grows by about 30cm)
How do nerves and sensory nerve endings differ in neonates and adults?
Neonates have unmyelinated neurones (sensory is myelinated before motor) and closely packed nerve endings that space out as the body grows
How does the lens differ from the rest of the eye?
Eye grows in accordance with the neural pattern
Lens continues to grow throughout life
Describe neonatal kidneys
Not fully functional, renal corpuscles enlarge after birth
Kidneys appear lobulated as cortex is thinner
What shape is the urinary bladder at birth?
Cigar shaped due to small size of pelvis
Where is red marrow found in the adult?
Centrally
Vertebral bodies, sternum, ribs, pelvis and scapulae
What is prominent in the ileum of a child and reduced in size in an adult?
Peyer’s patches
What is prominent in the ileum of a child and reduced in size in an adult?
Peyer’s patches
What is allometric growth?
Change in shape during growth
Opposite of isometric growth
In what weeks do the uterus form/testes start descending?
Weeks 17-20
What isa neonate?
First 28days after birth
When can infants babble?
By 8 months of age
What are the changes in spine curvature? Name them
C shaped primary curvature (total kyphosis) Cervical lordosis (3-4months) Thoracic kyphosis (8-9 months) Lumbar lordosis (1 yr, starts walking)
Describe some of the pathology of aging
Atherosclerosis Hair loss, bone loss Weaker muscles Joint wear and tear Immune system declines
