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Physio OB Midterm > Implantation And Formation Of Placenta 2 > Flashcards

Implantation And Formation Of Placenta 2 Flashcards

1
Q

Expands into to decidua
Outer pole faces the endometrial cavity
Inner pole forms the placenta

A

Blastocyst

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2
Q

Aka leafy chorion

Forms when chorionic villi proliferates upon contact with decidua basalis

A

Chorionic frondosum

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3
Q

As growth of embryonic and extra embryonic tissues continues

A

Blood supply to the chorion facing the endometrial cavity is restricted

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4
Q

Aka smooth chorion

Portion of chorion that becomes the avascular fetal membrane that touches the decidua parietalis

A

Chorion laeve

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5
Q

Chorion laeve composed of cytotrophoblast and fetal mesodermal mesenchyme that survives in

A

Low oxygen atmosphere

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6
Q

Chorion laeve

Separated from the amnion by exocoelomic cavity

A

Near the end of 3rd month

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7
Q

Important sites of molecular transfer and metabolic activity

A

Chorion laeve

Amnion

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8
Q

More translucent than the amnion

A

Chorion laeve

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9
Q

Paracrine arm of the fetal maternal communication system

A

Amniochorion

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10
Q

Accumulate in decidua and are found in direct contact with trophoblast during first half of pregnancy

A

Decidua natural killer cells

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11
Q

Decidua natural killer cells

Lacks of cytotoxic functions and are able to

A

Dampen inflammatory TH17 cells

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12
Q

Inhibits NK cells killing during pregnancy

A

Decidual macrophages

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13
Q

Decidua natural killer cells

It expresses both

A

IL8 and

Interferon inducible protein 10

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14
Q

Decidua natural killer cells

Produce proangigenic factors that promotes vascular growth in the decidua

A

VEGF

Placental growth factor (PIGF)

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15
Q

Secrete specific chemokines that attract the dNK cells to the maternal fetal interface

A

Trophoblasts

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16
Q

They form cell columns that extend from the endometrium to the inner third of the myometrial

A

Extra villus trophoblast

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17
Q

Requires invasion of endometrium and spinal arteries

Process occurs under low oxygen conditions

A

Hemochorial placental development

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18
Q

Secrete proteolytic enzymes that digest extracellular matrix and activate proteinase already present in the endometrium

A

Invasive trophoblast

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19
Q

Invasive trophoblast produce urokinase type plasminogen activator which converts plasminogen into

A

Plasmin

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20
Q

Degrades matrix proteins and activates matrix metalloproteases

A

Plasmin

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21
Q

Appears to be critical for human trophoblast invasion

A

MMP-9

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22
Q

Ability to invade maternal tissue in early pregnancy compared with limited Invasiveness in late pregnancy is controlled by?

A

Autocrine factors
Paracrine trophoblastic factors
Endometrial factors

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23
Q

Secrete insulin like growth factor 2 acts in an Autocrine manner

A

Trophoblast

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24
Q

Secrete insulin like growth factor binding protein type 4 that block Autocrine loops

A

Decidual cells

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25
Q

Degree of trophoblast invasion is controlled by

A

Matrix degradation regulation

Factors that cause trophoblast migration

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26
Q

Low estradiol levels in the first trimester are critical

A

For trophoblast invasion and

Remodeling of spinal arteries

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27
Q

Occurs in the first half of pregnancy

Important to utero placental blood flow

A

Invasion of spiral arteries

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28
Q

Invasion of spinal arteries

Integral to pathological conditions such as

A

Pre eclampsia
Fetal growth restriction
Preterm birth

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29
Q

Invasion of spinal arteries

Carried out by two populations of extravillous trophoblast

A

Interstitial trophoblasts

Endo vascular trophoblast

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30
Q

Aggregate around the spiral arteries

Vessel preparation for endo vascular trophoblast invasion

A

Interstitial trophoblast

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31
Q

Enter to the spiral arteries lumens

Initially from cellular plugs

A

Endo vascular trophoblast

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32
Q

Endo vascular trophoblast

Destroy vascular endothelium via

A

Apoptosis

33
Q

Invasion by trophoblast involves only the decidual spiral arteries

A

Not decidual veins

34
Q

2 stages of utero placental vessel development

A

First wave - before 12 weeks, post fertilization

Second wave - between 12-16 weeks

35
Q

Maternal blood enters the

A

Intervillous space

36
Q

Blood is propelled outside of the maternal vessels and sweep over and directly bathes the

A

Syncytiotrophoblast

37
Q

Placental growth and maturation

Placental growth is more rapid than fetus

A

First trimester

38
Q

Placental growth and maturation

Placenta and fetal weights are equal

A

17 weeks AOG

39
Q

Placental growth and maturation

Placenta weight is 1/6 of fetal weight

A

By term

40
Q

Placental growth and maturation

Slightly elevated convex areas from the maternal surface

A

Lobes

41
Q

Placental growth and maturation

Grossly visible lobes

A

Cotyledons

42
Q

Placental maturation

Abundant loose intercellular matrix in early pregnancy

A

Villous stroma

43
Q

Placental maturation

Fetal macrophages
Nearly round with vesicular, often eccenteric nuclei and very granular or vacuolated cytoplasm

A

Hofbauer cells

44
Q

Fetal circulation

Deoxygenated blood flows to the placenta through the

A

Two umbilical arteries

45
Q

Fetal circulation

Umbilical vessels branch repeatedly beneath the

A

Amnion and villi

46
Q

Fetal circulation

Oxygenated blood returns from the placenta bia

A

Umbilical vein

47
Q

Fetal circulation

Umbilical vessels that traverse along the fetal surface of the placenta in the chorionic plate.
Responsive to vasoactive substances

A

Placental surface

Chorionic vessels

48
Q

Fetal circulation

65% of placentas, chorionic arteries form a fine network supplying the

A

Cotyledons

49
Q

Fetal circulation

Perforating branches of the surface arteries that pass through chorionic plate.

A

Truncal arteries

50
Q

Each truncal arteries supplies

A

One main stem villus

One cotyledon

51
Q

Maternal circulation

Maternal blood enters through the ________ and is driven high up toward the ________ by arterial pressure.

A

Basal plate

Chorionic plate

52
Q

Maternal circulation

After bathing the external micro villus surface of chrorionic villi, maternal blood drains back through__________ in the _______ and enter _________.

A

Venous orifice
Basal plate
Uterine veins

53
Q

Maternal circulation

Maternal blood transverse the placenta randomly without

A

Performed channels

54
Q

Maternal circulation

Trophoblast invasion of the spiral arteries creates low resistance vessels that accomodate massive increase in

A

Uterine perfusion during gestation.

55
Q

Maternal circulation

Uterine wall

Spiral arteries are

A

Perpendicular to it

56
Q

Maternal circulation

Uterine wall

Veins are

A

Parallel to it

57
Q

Maternal circulation

Arterial openings into the Intervillous space becomes gradually reduced by

A

Cytotrophoblast invasion

58
Q

Maternal circulation

Uterine wall

How many spiral arteries entries into the Intervillous space at term

A

120

59
Q

Maternal circulation

Uterine wall

A prominent venous plexus separates the deciduas basalis from the myometrial and thus participates in providing a cleavage plane for placental separation

A

After the 30th week

60
Q

Maternal circulation

Uterine wall

Increased during contraction

A

Placental lenght
Thickness
Surface area

61
Q

Maternal circulation

Larger volume of blood is available for exchange even though the rate of flow is decreased.

A

During contractions

62
Q

Maternal circulation

Principal factors regulating Intervillous space blood flow

A

Arterial blood pressure
Intrauterine pressure
Uterine contraction pattern
Factors acting on arterial walls

63
Q

Immunological consideration of the Fetal Maternal Interface

With their inefficient cytotoxic abilities

A

Decidual natural killer cells

64
Q

Immunological consideration of the Fetal Maternal Interface

Populate the deciduas

A

Invasive trophoblast

65
Q

Immunological consideration of the Fetal Maternal Interface

Only fetal derived cells in direct contact with maternal tissues

A

Trophoblast

66
Q

Immunological consideration of the Fetal Maternal Interface

Act to control the invasion of trophoblast, which have adapted to survive in an immunologically hostile environment

A

Maternal NK cells

67
Q

Human analogue of the major histo compatibility complex

A

Human leukocyte antigen

68
Q

MHC clas 1 and 2 antigens are absent

A

Villus trophoblasts

69
Q

Express MHC class 1 molecules

A

Invasive extravillous cytotrophoblast

70
Q

Trophoblast HLA class 1 expression

Encodes the major class I class Ia

A

ABC

71
Q

Trophoblast HLA class 1 expression

Encodes major class Ib

A

EFG

72
Q

Trophoblast HLA class 1 expression

Combined with unique expression of three specific HLA class I genes in extravillous cytotrophoblast

A

Uterine decidual natural killer cells

73
Q

Trophoblast HLA class 1 expression

Expressed only in humans
Expression is restricted to extravillous cytotrophoblast adjacent to maternal tissues

A

HLa-G antigen

74
Q

Trophoblast HLA class 1 expression

A solute major isoform which has increased levels during pregnancy

A

HLA G2

75
Q

Distinctive lymphocytes originate in bone marrow and belong to the natural killer cell

A

Uterine Natural Killer Cells

76
Q

Uterine Natural Killer Cells

Infiltration is increased by

A

Progesterone
Stromal cell production of IL15
Decidual prolactin

77
Q

Uterine Natural Killer Cells

Secrete large amounts of _________ means that they are in an activated state

A

Granulocyte macrophage colony stimulating factor

78
Q

Distributed over the entire periphery of the chorionic membrane

A

Villi

Physio OB Midterm (6 decks)

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