Birth and childhood

Question 1

When does parturition occur?

Answer 1

AT 40 weeks (280 days) after the first day of the the last menstrual eriod

Question 2

What are the 3 stages of labour?

Answer 2

Dilation, expulsion and placental stage

Question 3

What occurs in the dilation stage of labour? How long does it take?

Answer 3

Uterine contractions and dilation of the cervix

Takes 3/24 hrs

Question 4

Describe how contractions progress in the 1st stage of labour

Answer 4

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

Question 5

How far does the cervix dilate?

Answer 5

Up to roughly 10cm

Question 6

What counts as premature labour?

Answer 6

Less than 37 weeks

Question 7

What occurs in the second stage of labour?

Answer 7

Expulsion of infant from mother

Mother bears down, crowning occurs,

Question 8

How long does the second stage of labour take?

Answer 8

1-2 hrs in 1st pregnancy

15 mins in subsequent pregnancies

Question 9

How long does the second stage of labour take?

Answer 9

1-2 hrs in 1st pregnancy

15 mins in subsequent pregnancies

Question 10

What happens in stage 3 of labour and how long does it usually take?

Answer 10

Delivery of the placenta (afterbirth), 15 mins

Uterine contractions continue for minimisation of blood loss, detachment of placenta and expulsion of placenta

Question 11

What is crowning?

Answer 11

When the largest part of the baby’s head is in the vulva

Question 12

Describe the normal presentation of the infant

Answer 12

Facing down with neck bent forwards and chin tucked in, arms folded across chest

Question 13

What are the most common abnormal presentation of birth?

Answer 13

Breech (bum first, 3% of births)
Shoulder first (needs C-section)
Brow or face

Question 14

Why is a breech delivery dangerous?

Answer 14

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

Question 15

Why are women in late pregnancy advised not to lie supine?

Answer 15

Weight of uterus can put pressure on the inferior vena cava -> mother feels faint and dizzy due to decreased venous return-> lower bp

Question 16

What is a fetus papyraceous?

Answer 16

A mummified fetus, retained in womb after death

Question 17

What is a fetus papyraceous?

Answer 17

A mummified fetus, retained in womb after death

Question 18

How does a neonate’s body differ from an adult?

Answer 18

Proportionally larger head and broad shoulders, small abdomen and poorly developed pelvis and lower limbs

Question 19

What alters the composition of bone?

Answer 19

Amount of exercise taken, nutritional status, age and the presence of disease

Question 20

What alters the composition of bone?

Answer 20

Amount of exercise taken, nutritional status, age and the presence of disease

Question 21

What is secondary ossification?

Answer 21

When long bones grow, epiphyseal growth plate etc

Question 22

Why are the location of epiphyseal growth plates clinically relevant?

Answer 22

To be able to differentiate fractures and growth plates in children’s xrays

Question 23

When can babies hold their heads up?

Answer 23

3 months

Question 24

What is the primary curvature of the spine?

Answer 24

C shaped

Question 25

How does a neonates thorax differ from an adult?

Answer 25

Ribs lie horizontally, thoracic cage is circular

Question 26

When do the legs undergo extension and medial rotation in a baby?

Answer 26

At 6 months, in preparation for standing

Question 27

Where does growth in the legs and arms of babies occur?

Answer 27

More at shoulder and wrist and knee | TEAK- Towards Elbow, Away from Knee

Question 28

Where does growth in the legs and arms of babies occur?

Answer 28

More at shoulder and wrist and knee | TEAK- Towards Elbow, Away from Knee

Question 29

Which is the first carpal bone to ossify?

Answer 29

The capitate (in 1st year of postnatal life)

Question 30

When does the last carpal begin to ossify?

Answer 30

In the 10th yr of life

Question 31

What is the scientific name for the brain case?

Answer 31

The calvarium

Question 32

When are the adult dimensions of the calvarium reached?

Answer 32

At 15-16yrs

Question 33

When is the calvarium not unilaminar anymore?

Answer 33

By about 4 yrs, two tables of bone + diploe

Question 34

What are 'soft spots'?

Answer 34

The non bony areas of the skull, fibrous tissue instead | called fontanelles

Question 35

Name the fontanelles

Answer 35

Anterior, posterior, mastoid (posterolateral) and sphenoidal (anterolateral)

Question 36

Describe the closure of the fontanelles

Answer 36

Posterior and sphenoidals close after 2-3 months Mastoids close by end of 1st yr Anterior closed by end of 2nd yr

Question 37

What happens by the end of the 2nd yr to the skull?

Answer 37

All fontanelles have close and sutures have formed, thus interlocking all bones

Question 38

When do infants get teeth?

Answer 38

After about 6 months

Question 39

Where are baby teeth before they erupt?

Answer 39

In the maxillae bone

Question 40

When do adult teeth erupt?

Answer 40

Start erupting at about 6 yrs of age

Question 41

What is the symphysis menti?

Answer 41

Unites the two halves of the mandible at birth

Question 42

Describe the mandible at birth

Answer 42

In two halves, joined by the symphysis menti, ossified by 1 yr

Question 43

Describe the temporal bone at birth

Answer 43

Internal ear, tympanic cavity, auditory ossicles and mastoid antrum are developed Tympanic plate and mastoid process still need to develop

Question 44

Describe the temporal bone at birth

Answer 44

Internal ear, tympanic cavity, auditory ossicles and mastoid antrum are developed Tympanic plate and mastoid process still need to develop

Question 45

Why is the absence of a mastoid process at birth clinically significant?

Answer 45

Means stylomastoid foramen is exposed so facial nerve is liable to injury

Question 46

What is retention of the testes associated with?

Answer 46

Sterlity

Question 47

What happens to the male reproductive system at puberty?

Answer 47

Testes enlarge as spermatogenesis begins Prostate enlarges and the mucous membranes of the seminal vesicles become greatly thickened Penis grows

Question 48

Describe the ovaries and uterus at birth

Answer 48

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

Question 49

What is the first menstrual period called?

Answer 49

Menarche

Question 50

When does axillary and facial hair appear in males?

Answer 50

About 2 yrs after pubic hair appears

Question 51

What are the secondary sex characteristics of males?

Answer 51

Pubic, axillary and facial hair Growth of larynx Broadening of shoulders

Question 52

What are the secondary sex characteristics of females?

Answer 52

Pubic and axillary hair, breast development, broadening of hips, distribution of fat to hips and buttocks

Question 53

What happens to the brain after birth?

Answer 53

Grows rapidly until 5yrs when it is triple its birth weight | Mainly cerebral cortex growth

Question 54

What happens to the brain after birth?

Answer 54

Grows rapidly until 5yrs when it is triple its birth weight | Mainly cerebral cortex growth

Question 55

Where does the spinal cord reach in neonates compared to adults?

Answer 55

At birth- L2/L3 | Adult- L1/L2 (but grows by about 30cm)

Question 56

How do nerves and sensory nerve endings differ in neonates and adults?

Answer 56

Neonates have unmyelinated neurones (sensory is myelinated before motor) and closely packed nerve endings that space out as the body grows

Question 57

How does the lens differ from the rest of the eye?

Answer 57

Eye grows in accordance with the neural pattern | Lens continues to grow throughout life

Question 58

Describe neonatal kidneys

Answer 58

Not fully functional, renal corpuscles enlarge after birth | Kidneys appear lobulated as cortex is thinner

Question 59

What shape is the urinary bladder at birth?

Answer 59

Cigar shaped due to small size of pelvis

Question 60

Where is red marrow found in the adult?

Answer 60

Centrally | Vertebral bodies, sternum, ribs, pelvis and scapulae

Question 61

What is prominent in the ileum of a child and reduced in size in an adult?

Answer 61

Peyer's patches

Question 62

What is prominent in the ileum of a child and reduced in size in an adult?

Answer 62

Peyer's patches

Question 63

What is allometric growth?

Answer 63

Change in shape during growth | Opposite of isometric growth

Question 64

In what weeks do the uterus form/testes start descending?

Answer 64

Weeks 17-20

Question 65

What isa neonate?

Answer 65

First 28days after birth

Question 66

When can infants babble?

Answer 66

By 8 months of age

Question 67

What are the changes in spine curvature? Name them

Answer 67

``` C shaped primary curvature (total kyphosis) Cervical lordosis (3-4months) Thoracic kyphosis (8-9 months) Lumbar lordosis (1 yr, starts walking) ```

Question 68

Describe some of the pathology of aging

Answer 68

``` Atherosclerosis Hair loss, bone loss Weaker muscles Joint wear and tear Immune system declines ```