Exam 1 Flashcards
Gonadal hormones
Estrogen, progesterone, testosterone
Menstrual cycle is mediated through which structures of the body
Hypothalamus, anterior pituitary gland, ovaries
What gland is responsible for stimulating the anterior pituitary gland to produce gonadotropin
Hypothalamus
What gland is responsible for stimulating the anterior pituitary gland to produce gonadotropin
Hypothalamus
Follicle-stimulating hormone
released by anterior pituitary gland
Function of FSH
stimulates growth and development of the Graafian follicle-which secretes estrogen
What hormone does the Graafian follicle secrete
estrogen
When does the anterior pituitary gland secrete luteinizing hormone (LH) and what does it stimulate?
It secretes LH before ovulation to stimulate the development of the corpus luteum
When does the anterior pituitary gland secrete luteinizing hormone (LH) and what does it stimulate?
It secretes LH after ovulation to stimulate the development of the corpus luteum
What hormone is responsible for maintaining pregnancy
Progesterone
Where is progesterone secreted from
Corpus luteum
What happens to the levels of estrogen and progesterone when pregnancy does not occur
They decline because the corpus luteum degenerates
What happens as a result of decreased levels of estrogen and progesterone
The uterus sheds its lining (period)
What is estrogen responsible for
development of secondary sex characteristics and deposition of fat in the buttocks and mon pubis
What does estrogen help regulate
Menstrual cycle by stimulating proliferation of the endometrial lining in preparation for pregnancy
What is the role of progesterone
Regulates menstrual cycle by decreasing uterine motility and contractility (which is caused by estrogen)
-“prolife” hormone because it helps pregnancy remain viable
-readies breasts for lactation
Where is human chorionic gonadotropin (hCG) produced
trophoblast (outermost layer of developing blastocyte)
What is the function of hCG
maintains corpus luteum by keeping levels of progesterone and estrogen elevated until the placenta takes over
-used to measure pregnancy
Menstrual phase
time of vaginal bleeding
signals beginning of follicular phase of ovarian cycle
What triggers the menstrual phase
Declining levels of estrogen and progesterone->poor endometrial support and constriction of endometrial blood vessels-> decreased O2 and nutrients to endometrium-> lining of uterus sheds
What is the role of prostaglandins
cause contractions of smooth muscle and decrease risk of hemorrhage
When does the proliferative phase begin
End of menses through ovulation (appx. days 7-14)
Characteristics of the proliferative phase
-gradually increasing levels of estrogen
-enlarging endometrial glands
-growth of uterine smooth muscle
When does the secretory phase occur
time of ovulation to period just before menses
Characteristics of the secretory phase
increasing amounts of progesterone which cause enlarged breasts, thinning of vaginal mucosa, and increased thickness and stickiness of cervical mucus
When does the ischemic phase occur
end of secretory phase to onset of menstruation (appx days 27-28)
How can toxoplasmosis occur
eating raw or undercooked meat; cleaning cats litter box (cat feces), transplacental
Rh factor concerns
if Mom is Rh- and baby is Rh+, moms body will react and will make antibodies against babies blood cells. Tx w/ Rhogam shot. If left untx, will effect later pregnancies
RPR
rapid plasma reagin during 1st prenatal visit, 3rd trimester, and at birth if high risk
What can untx UTIs cause
Preterm labor
Items considered PICA
ice, dirt, worms, laundry detergent
Reason for need of folic acid/iron in pregnancy
needed to meet demands of increased blood supply and fetus
presumptive signs of pregnancy
-breast changes
-amenorrhea
-N/V
-urinary frequency
-fatigue
-quickening (starts to feel movement)
probable signs of pregnancy
-goodell sign
-chadwick sign
-hegar sign
-positive hCG
-braxton hicks contractions
-ballottement
positive signs of pregnancy
-visualization of fetus by US
-FHT detected by US
-visual of fetus via radiographic study
-FHT detected by doppler, stethoscope
-fetal movements palpated and visible
expected maternal anatomic adaptations to pregnancy
-uterine change in size, shape, position
-enlarged breasts
-increased vaginal secretions
-nipples and areolas darken
-stretch marks
-superficial veins become prominent
expected CV changes in pregnancy
-increase in blood volume
-CO increases 25-50%
-clotting factors increase– hypercoagulable state
-O2 consumption increases by 15-20%
-breathing changes from thoracic to diaphragmatic
-SOB
-greater diaphragm excursions
-nasal congestion
-epistaxis
expected basal metabolism and acid-base balance changes in pregnancy
-BMR increases 10-20% by term
-respiratory alkalosis compensated by mild metabolic acidosis
what causes respiratory alkalosis in pregnancy
O2 consumption increases->diaphragm elevated by enlarging uterus->thoracic cage widens->hyperventilation->decreased CO2 levels-> alkalosis
expected renal system changes in pregnancy
-increased urinary frequency
-higher risk for UTIS
expected skin changes in pregnancy
-linea nigra
-stretch marks r/t stretching of connective tissue
-chloasma
-palmar erythema r/t hyperemia
expected musculoskeletal changes in pregnancy
-lumbar lordosis r/t center of gravity shifted forward
-lumber and dorsal curves more prominent-> lower back pain
-“waddling gait” d/t relaxin hormone that relaxes pelvic points
-muscle cramps r/t hypocalcemia, hypokalemia or hypomagnesia
expected neurological changes in pregnancy
-changes in sensorium r/t postural hypotension/hypoglycemia
-carpal tunnel, edema and compression of median nerve in wrist
-lordosis (back sway)
one major cause of cramps and tetany
hypocalcemia
common GI changes in pregnancy
-N/V
-reflux and constipation r/t relaxation of smooth muscle of esophagus, stomach and intestines
-pyrosis
-hemorrhoids
-gallbladder sluggish
-pica
how many weeks is a fetus considered viable
20 weeks
ballottement
passive movement of fetus
how would the provider assess the patient for ballottement
provider taps on cervix-> fetus rises-> may feel on abdomen
how would the provider assess for quickening
tap cervix gently and palpates fetal rebound in amniotic fluid
-usually present about 16 wks
what is hegar’s sign
softening and thinning of lower segment of uterus around the 6th week
what is lightening
fundal height decreases as fetus descends into pelvis in preparation for delivery (38-40 weeks)
goodell sign
velvety appearance of cervix due to increase vascularity and hypertrophy and hyperplasia of cervix
chadwick sign
violet-blue vaginal mucosa and cervix
normal AFI
> 10 cm
oligohydramnios
<5cm
