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OBSTETRICS > Implantation and Placental Development > Flashcards

Implantation and Placental Development Flashcards

1
Q

how many days after fertilization does implantation in the uterine wall take place?

A

6-7 days

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2
Q

what are the three distinct phases of implantation by order?

A

apposition
adhesion
invasion

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3
Q

this phases is the initial contact of the blastocyst to the uterine wall

A

apposition

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4
Q

this phase is marked by the increased physical contact between the blastocyst and the decidua

A

adhesion

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5
Q

this phase is marked by the penetration and invasion of
syncytiotrophoblast and cytotrophoblast into the
decidua

A

invasion

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6
Q

these hormones are required to ensure success of implantation

A

estrogen and progesterone

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7
Q

Uterine receptivity is limited to days _____ of teh cycle

A

20-24

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8
Q

what is the dominant hormone during the luteal phase?

A

progesterone

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9
Q

adherence of the blastocyst is mediated by what?

A

cell mediated cell surface receptors that interact with blastocyst receptors

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10
Q

how many cells is blastocyst composed of during apposition

A

100-250 cells

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11
Q

apposition is also referred to as

A

initial unstable adhesion

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12
Q

what wall of the uterus does apposition occur?

A

posterior superior wall

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13
Q

what interaction does the blastocyst have with the decidua during implantation?

A

paracrine interactions

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14
Q

the embryonic microvilli interdigitates with the ____ of the decidua

A

pinopods

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15
Q

to further attachment of the blastocyst with the decidua, at day 6, these proteins and receptors interact with each other?

A

laminin and integrin

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16
Q

this protein stimulates migration

A

fibronectin

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17
Q

This implantation of the blastocyst is

the result of?

A

mutual trophoblastic and endometrial action.

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18
Q

trophoblasts differentiate into

A

syncytiotrophoblast and cytotrophoblast

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19
Q

this phase of implantation has a more stable connection is established
between the decidual wall and the embryo by the
modification of the expression of cellular adhesion
molecules (CAMs), especially of integrins.

A

adhesion phase

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20
Q

are cell-surface receptors that mediate

adhesion of cells to extracellular matrix proteins

A

Integrins

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21
Q

Give markers for receptivity expressed by integrins

A

αVβ3 and α4β1

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22
Q

phase where there is infiltration of mononuclear cytotrophoblast

A

invasion

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23
Q

what does the cytotrophoblast invade

A

entire endometrium
inner third of the myometrium
uterine vasculature

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24
Q

where does the human placental formation begin?

A

trophoectoderm

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25
Q

the invasiveness of the trophoblast promotes?

A

implantation
nutritional role for the conceptus
endocrine role

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26
Q

which of the differentiated trophoblasts is the inner layer, mononucleated
with a well-defined border

A

cytotrophoblast

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27
Q

which of the differentiated layer of the trophoblast is the outer
layer, polynucleated, has an amorphous
cytoplasm with no cell border

A

syncytiotrophoblast

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28
Q

the trophoblast is the inner or outer cell mass?

A

outer cell mass

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29
Q

what is the inner cell mass?

A

embryoblast

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30
Q

the differentiated embryoblast that becomes the germ layers

(endoderm, mesoderm, ectoderm) and the embryo

A

epiblast (columnar)

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31
Q

the differentiated embryoblast that becomes wall of yolk sac

A

hypoblast (cuboidal)

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32
Q

differentiated trophoblasts that generate chorionic villi,which
primarily transport oxygen, nutrients, and other
compounds between the fetus and mother

A

villous trophoblasts

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33
Q

differentiated trophoblasts that migrate into decidua
and myometrium and also penetrate maternal
vasculature, thus coming into contact with various
maternal cell types.

A

Extravillous trophoblasts

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34
Q

differentiated extravillous trophoblasts that nvade the decidua and
eventually penetrate the myometrium to form
placental-bed giant cells.

A

interstitial trophoblasts

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35
Q

differentiated extravillous trophoblasts that penetrates the lumen of the spiral artery

A

endovascular trophoblasts

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36
Q

on day 9 after fertilization, how many layers does the blastocyst have?

A

1 layer

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37
Q

when does the blastocyst become totally encased in the endometrium

A

10 days after fertilization

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38
Q

On what day after fertilization is the stage characterized by the
intercommunication of the lacunae filled with maternal
blood. This is also the day that : the hypoblast would have given rise to the
primitive yolk sac/extracoelomic cavity.

A

12 days after fertilization

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39
Q

cells from the yolk sac later forms the

A

extraembryonic mesoderm

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40
Q

this differentiated extraembryonic mesoderm becomes the (chorionic plate) - outer layer
becomes muscles, skin, skeleton etc

A

somatopleure

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41
Q

this differentiated extraembryonic mesoderm becomes the inner layer, becomes the viscera
(gut)

A

splanchnopleure

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42
Q

Cells of the syncytiotrophoblast penetrate deeper into the
stroma and erode the lining of the maternal capillaries
forming

A

sinusoids

The lacunae become continuous with the sinusoids
causing the maternal blood to enter the lacunar system

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43
Q

composed of trophoblasts and mesenchyme.

A

chorion

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44
Q
  • joins the embryo to the nutrient chorion (that is

your placenta) and later develops into the umbilical cord.

A

stalk

45
Q

day after fertilization where all teh cavities are formed: amniotic cavity, yolk sac, and chorionic cavity

A

day 13

46
Q

hypoblasts cells gradually proliferate and migrate along

the inside of the exocoelomic membrane forming the

A

secondary or definitive yolk sac

47
Q

when cytotrophoblasts penetrate the syncitiotrophoblasts, they form the

A

primary villi

48
Q

primary villi is composed of syncytiotrophoblast covered in cytotrophoblast? t or f?

A

False

cytotrophoblast core covered in syncytiotrophoblast

49
Q

these villi form approximately day 12 when
mesenchymal cords derived from extraembryonic
mesoderm invade the solid trophoblast columns. When primary chorionic villi acquire mesenchymal core

A

secondary villi

50
Q

these villi are formed when e angiogenesis begins in the
mesenchymal cords.
The definitive placental villi.
Forms when there is Development of capillaries in secondary chorionic villi

A

tertiary villi

51
Q

This is the day after fertilization when fetal blood vessels are functional and
placental circulation is established.

A

day 17

52
Q

The villi are covered by an outer layer of syncytiotrophoblast
and inner layer of cytotrophoblast also called as

A

langhans cells

53
Q

this villi extends from the chorionic plate to the decidua basalis

A

stem villi

54
Q

branches of stem villi are called?

A

free villi

55
Q

the base of the chorionic plate forms the

A

roof of the intervillous space

56
Q

this is formed by 8-10 weeks
as the amnionic and primary chorionic plate mesenchyme
fuse together.

A

chorionic plate

57
Q

Chorion in contact with decidua basalis with extensive

frond-like villous outgrowth into decidua

A

chorion fondosum

58
Q

chorion fondosum plus the decidua basalis forms the

A

placenta

59
Q

smooth chorion and this is an important site of molecular transfer and metabolic activity

A

Chorion leave

60
Q

which part of implantation is integral to some pathological conditions such as pre eclampsia, fetal growth restriction and pre term birth?

A

invasion of the spinal artery

61
Q

first wave of invasion of uteroplacental vessel development happens during when and up to what level

A

before 12 weeks post fertilization and up o the level of the border between the decidua and the myometrium

62
Q

the second wave of invasion of uteroplacental vessels happens and and up to what level?

A

12-16 weeks post fertilization and up to the level of intramyometrial segments of the spiral arteries

63
Q

remodeling of spiral arteries results in

A

dilated, low resistance uteroplacental vessels

64
Q

in the first trimester, what grows faster? the fetus or plaenta?

A

placenta

● Approximately 17 weeks’ gestation, placental and fetal
weights are approximately equal.
● By term, placental weight is approximately one sixth of
fetal weight

65
Q

what are the functional units of the placenta?

A

Lobes or cotyledons

around 10-38 cotyledons

66
Q

what separates the cotyledons in the placenta?

A

placental septa

67
Q

how heavy is the term placenta?

A

500-600 grams or 1/6 of the weight of the baby

68
Q

which surface of the placenta is cobblestone in appearance? fetal or maternal?

A

Maternal

fetal surface is smooth due to amnion

amnion is nearer fetal surface
chorion is nearer maternal surface

69
Q

what are the functions of the placenta?

A 
nutrition
excretion
respiration
protection
hormone production
70
Q

is the chorionic sac is fetal or maternal component of placenta?

A

fetal

decidua basalis is the maternal

71
Q

fetal macrophages that infiltrate the stroma are called?

A

Hofbauer cells

72
Q

the placental circulation has how many arteries and veins?

A

2 arteries and 1 vein

73
Q

the blood in the intervillous space is maternal or fetal?

A

maternal

fetal blood lies in the chorionic villi

74
Q

what carries the deoxygenated blood from the fetus to the mother?

A

umbilical artery

75
Q

what carries oxygenated bloodfrom the mother to the fetus?

A

umbilical vein

76
Q

the amnion is avascular? t or f?

A

True

77
Q

the inner surface of the amnion is made up of?

A

single layer of cuboidal cells

78
Q

the acellular compact layer of the amnion is composed primarily of

A

interstitial collagen

79
Q

the outer layer of the amnion is composed of?

A

fibroblast like mesenchymal cells

80
Q

the outer most layer of the amnion is composed of?

A

acellular zona spongiosa

81
Q

what is the second fetal membrane?

A

Chorion laeve

82
Q

when is the amnion first identifiable?

A

on the 7th or 8th day of embryo development

83
Q

where does the epithelium of the amnion originate?

A

fetal ectoderm

84
Q

amnion epithelial cells are metabolically active, what substances to these cells synthesize?

A

MMP1, PGE2 and fetal fibronectin (marker for pre term labor)

85
Q

interstitial collagen is produced by what cells of the amnion?

A

mesenchymal cells

86
Q

amnions tensile strength lies in the compact layer. What collagens are responsible for this strength?

A

Interstitial collagen I and II

87
Q

by the 16th week how many mL of amniotic fluid is available?

A

200 mL

30 mL at 10 weeks
800 mL at mid third trimester

88
Q

during the first half of pregnancy, there is transcutaneous flow on the skin of the fetus? t or f?

A

True

89
Q

this serves as the protective layer of the blood vessels in the umbilical cord

A

Wharton’s Jelly

90
Q

what is the major site of steroid and protein production in the placenta?

A

Syncytiotrophoblasts

91
Q

cross stimulation of HCG is possible with this hormone?

A

TSH

92
Q

as maternal serum hcg peaks, synthesis is almost solely in syncytiontrophoblast or cytotrophoblast?

A

syncytiotrophoblast

at 5 weeks, both syncytio and cyto

93
Q

when does hcg enter the maternal blood?

A

at blastocyst implantation

94
Q

hcg titer of what levels indicate intrauterine gestation?

A

1000-1500 IU/L

95
Q

maximal level of of hcg is achieved at how many weeks which may be the reason for symptoms such as hyperemesis gravidarum?

A

8-10 weeks

96
Q

lower plasma levels of hcg may be seen in

A

ectopic pregnancies

impeding spontaneous abortion

97
Q

8 days after ovulation or 1 day after implantation, what rescues the corpus luteum?

A

hcg

98
Q

what hormone is responsible for maternal lipolysis which increases free fatty acid levels in the maternal blood

A

HPL

99
Q

which hormone has a diabetogenic action which causes insulin resistance and provides higher maternal glucose levels available for the fetus

A

HPL

100
Q

hormone which is important in fetal lung maturation and timing of parturition

A

CRH

101
Q

produced by the human corpus luteum responsible for myometrial smooth muscle relaxation

A

relaxin

102
Q

what regulates trophoblastic production of hcg

A

GNRH

103
Q

normally secreted by adipocytes which regulate fetal bone growth and immune function

A

leptin

104
Q

what inhibits FSH release

A

Inhibin (inhibin A)

105
Q

what stimulates FSH production and secretion

A

Activin

106
Q

what is the precursor of progesterone?

A

Cholesterol

107
Q

what is the precursor of estrogen?

A

DHEA

108
Q

most important source of estrogen in pregnancy?

A

Fetal adrenal cortex

109
Q

what causes the synthesized estrogen in the syncitium to go to the maternal blood

A

hemochorioendothelial form of placentation

OBSTETRICS (36 decks)

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