Harvluck B11 W2 Flashcards
Supplies blood to medial aspect of breast
Internal thoracic artery- branch of subclavian artery
Functions of the pelvis?
Locomotion, thermoregulation, labour
Android pelvis
Heart shaped inlet which is more common in taller and Afro-Carribean women. Increases risk of failure of rotation and deep transverse arrest.
Platypelloid pelvis
Wide inlet which makes it difficult for the head to engage.
Anthropoid pelvis
AP diameter is wider than transverse diameter. Increased risk of breech position
Epithelia lining breast ducts
Stratified squamous epithelia
Liver analytes in jaundice
Bilirubin, alkaline phosphatase, aspartate. Normal prothrombin time.
What is the shortest stage of labour?
3rd stage which is 20 minutes.
Complications of prolonged labour?
Incontinence, sepsis and prolapse
How does feedback inhibitor of prolactin work?
Distorts shape of mammary alveoli and suppresses secretion of prolactin.
Effect of oestrogen on mammogenesis
Stimulates mammary duct development and collection of fat in the collective tissue
Effect of progesterone on mammogenesis
In the second trimester, increases the volume of breast tissue. It causes the lobes and alveoli to grow and widening of the ducts.
Effect of oestrogen and progesterone on mammogenesis
Proliferation of the lactocytes/secretory tissues
Hormones for mammary gland growth and differentiation
LH, somatomammatrophin, oestrogen, progesterone, prolactin
What promotes mammary growth in pregnancy?
Growth hormone and adrenocorticotropic hormone.
Changes to the breast in pregnancy?
Alveolar cell differentiation, lobule formation, hypertrophy of ductar-lobular-alveolar system
Hormones important for breast development in puberty?
Oestrogen
Growth hormone
How are the alveoli formed?
From the epithelia of the milk hills.
What is the impact of epidurals?
Loss of motility such as bladder control, low blood pressure and slower breathing.
Source of progesterone production in pregnancy?
Placenta, myometrium and placental membranes.
Let-down reflex
Milk at ph7.0 is ejected first due to stimulation of mechanoreceptors which induces oxytocin release before prolactin, releasing milk already present.
What inhibits the let-down reflex?
Oestorgen, relaxin and prostaglandins.
Pain, embarassment and alcohol intake inhibits this.
What stimulates prolactin release?
Vasoactive intestinal protein and oxytocin which inhibit dopamine release.
Where is prolactin released?
Decidual cells
Anterior pituitary gland
What is important in cervical effacement?
Oestrogen, relaxin and prostaglandins.
Which hormone is only present in the serum during pregnancy?
Human placental lactogen/somatomammatropin which is involved in areola growth.
Composition of colostrum
Contains more immunogoblins and fat soluble vitamins than normal breast milk but less water soluble vitamins, fat and sugar.
Treatment of infective mastitis
Analgesia, increased fluid, frequent breast feeding and antibiotics
Treatment of non-infective mastitis
Massaging breasts, analgesics, bra fitting
Normal foetal heart rate
100-160bpm
What determines the size of the birth canal?
Size of pelvic inlet
Conditions screened for in newborn neonatal screening?
Sickle cell disease
Cystic fibrosis
Hypothyrodisim
Phenylketonuria
Acyl coA dehydrogenase
Maple syrup urine disease
Isovaleric acidaemia
Glutaric aciduria type 1
Homocystinuria
Location of oxytocin production
Posterior pituitary gland
Latent labour
Slow cervical dilatation until it reaches 4cm
How does oxytocin cause uterine contractions?
Lowers threshold for action potentials to increase the frequency of contractions via the Ferguson reflex. Afferent impulses from the cervix and vagina creates positive feedback loop for release.
Role of oestrogen in labour
Increases expression of oxytocin receptors and excitability of smooth muscle
What is a major component of breast milk?
Water
Major cause of infective mastitis?
Staphylcoccus aureus
-poor management of mastitis leads to breast abscess
Passenger in labour
Portion of the skull which first descends into pelvis, where foetal bones can be overlapped to reduce diameter
What increases myometrial excitability in labour?
CRH + Oestrogen (which increases oxytocin receptor expression)
Prostaglandin; increases muscle contractiliy
Hormones which induce labour
Cortisol, vasopressin, oxytocin, prostaglandin, uterine distention
Hormones which prevent labour
Adrenaline, relaxi, progesterone
Cervical ripening: reduced collagen and glcosaminoglycans that causes thinning
Analgesics in labour
Simple oral
Transcutaneous electrical stimulation
Systemic opiates
Epidural
Effect of systemic opiates in labour
Pain relief and slows breathing however it can lead to foetal respiratory distress
Preventable causes of labour death
Severe bleeding, infection, pre-eclampsia
Delivery of foetus in labour
Foetus reaches perineum and extends the head. It rotates to assist with shoulder delivery that comes out from under the pubic symphysis.
Which position does the foetus engage with the pelvis?
Occipital-transverse.
Cardinal movements of labour
Movements of the foetus to fit the pelvis
-engagement, descent, flexion, internal rotation, extension, external rotation, and expulsion
Partogram
Chart which measures cervical dilation
Contractility
Ability for uterus to contract in co-ordination.
Entonox
Mixture of NO2 and O2 which is a fast acting pain relief in labour that can cause nausea
