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Y4R2 - Obstetrics I 🤰 > L1: Physiology of Pregnancy > Flashcards

L1: Physiology of Pregnancy Flashcards

1
Q

Phases of Early developed pregnancy

A
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2
Q

Def of Fertilization

A
  • Union of male gamete (mature capacitated sperm) +
    female gamete (mature ovum) to form zygote.
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3
Q

Site of Fertilization

A

Ampulla of tube

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4
Q

Time of Fertilization

A

24 hours after ovulation.

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5
Q

Fertilizable Life Span of Ovum

A

12 - 36 hours

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6
Q

Fertilizable Life Span of Sperm

A

24-72 hours.

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7
Q

Oocyte journey During Fertilization

A
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7
Q

Sperms journey During Fertilization

A
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8
Q

Factors helping in ascending of sperms in female genital tract

A
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9
Q

Def of Sperm Capacitation

A
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10
Q

Method of Sperm Capacitation

A
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11
Q

Acrosomal Reaction

A
  • Removal of decapacitating factors & activation of acrosomal
    enzymes (neuroamidase, hyaluronidase & acrosin enzymes).
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12
Q

How is acrosomal Cap lost?

A
  • May be attributed to proteolytic enzymes in estrogen dominant uterus.
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12
Q

Events occuring when sperm reach ovum

A
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13
Q

Events occuring when sperm reach ovum

  • Sperms start to release …..
A
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14
Q

Events occuring when sperm reach ovum

  • Sperms start to release ….. to penetrate corona radiata
A

Neuroamidase

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15
Q

Events occuring when sperm reach ovum

  • Sperms start to release ….. to penetrate Zona pellucida
A

Hyaluronidase

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16
Q

Events occuring when sperm reach ovum

  • Stimulation of Zona Pellucida receptor site
A
  • Allowing penetration of zona by 1 sperm only
  • Many sperms can penetrate corona radiata & participate in weakening of zona pellucida but only 1 sperm can penetrate zona).
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17
Q

Events occuring when sperm reach ovum

  • Reblocking of Zona Pellucida Receptor Site
A

to prevent further sperms entrance.

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18
Q

Events occuring when sperm reach ovum

  • Completion of 2nd Meiotic Division
A

(which was arrested in metaphase) → formation
of mature ovum & 2nd polar body.

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19
Q

Events occuring when sperm reach ovum

  • Penetration of Oocyte Membrane
A
  • Penetration of oocyte membrane (by acrosin) & only head & midpiece of sperm enter ovum.
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20
Q

Results of Fertilization

A
  • Union of female pronucleus (contains 22 + X chromosomes) with male pronucleus (contains 22 + X or Y chromosomes) to form zygote (l-cell stage) which contains 46 chromosomes then zygote undergoes cleavage
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21
Q

Steps of Morula Formation

A
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22
Q

When does Morula reach the uterine cavity?

A

at 3rd - 4th post-fertilization day.

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23
Q

what is the morula?

A

16-cell stage

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24
Q

Blastocyst Formation

A
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25
Q

Def of Decidua

A

Thickened vascular endometrium prepared for implantation
(endometrium of pregnancy)

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26
Q

Layers of Decidua

A
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27
Q

Factors maintaning Decidua

A
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28
Q

Functions of Decidua

A
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29
Q

Def of Implantation

A
  • Embedding of blastocyst in decidua
  • (so, pregnancy is defined as implantation of blastocyst in decidua).
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30
Q

Normal Sites of Implantation

A

In Upper uterine segment UUS (60% posteriorly & 40% anteriorly).

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31
Q

Abnormal Sites of Implantation

A
  • In Lower Uterine Segment LUS (placenta previa).
  • Outside normal uterine cavity (ectopic pregnancy)
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32
Q

Time of Implantation

A

6th - 7th post fertilization day (one week post fertilization).

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33
Q

Mechanism of Implantation

A
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34
Q

Main Steps of Implantation

A
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35
Q

Differentiation of Decidua

A
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36
Q

Decidua Basalis

  • Site
  • Formed of
  • Function
A
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37
Q

Decidua Capsularis

  • Site
  • Formed of
  • Function
A
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38
Q

Decidua Parietalis (Vera)

  • Site
  • Formed of
  • Function
A
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39
Q

Origin of Trophoblasts

A

Outer cell mass of blastocyst.

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40
Q

layers of Trophoblasts

A
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41
Q

Types of Chorionic Villi

A
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42
Q

Formation of 1ry Villi

A
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43
Q

Components of 1ry Villi

A
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44
Q

Foemation of 2ry Villi

A
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45
Q

Components of 2ry Villi

A
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46
Q

Formation of 3ry Villi

A
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47
Q

Components of 3ry Villi

A
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48
Q

Intervillous Space (Choriodecidual Space)

A
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49
Q

Functional Types of Villi

A

All are anchoring but not all are nutritive.
✓ Anchoring For supporting embryo.
✓ Nutritive For nutrition via choriodecidual space.

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50
Q

Fate of Chorionic Villi

A
  • Villi related to decidua basalis:
    Form chorion frondosum (shares e decidua basalis in formation of placenta).
  • Villi related to decidua capsularis:
    Form chorion leave (forms outer layer of fetal membranes).
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51
Q

Origin of Embryo

A

From inner cell mass of blastocyst.

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52
Q

Def of Placenta

A

Unit of connection ( ) fetus & uterus ( mother)

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53
Q

Development of Placenta

A

Decidua basalis (maternal part)
+
Chorion frondosum (fetal part).

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54
Q

Anatomy of Placenta

A
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55
Q

Shape of Placenta

A

at full term, disc shaped or ovoid (circular cake - Discoid)

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56
Q

Diameter of Placenta

A

15-20 cm.

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57
Q

Thickness of Placenta

A

2 inch in center & thinner inch at periphery (1/2 inch)???

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58
Q

Weight of Placenta

A

300- 500 gm (at full term).

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58
Q

Color of Placenta

A

Dark red (due to maternal blood in intervillous space)

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59
Q

Surfaces of Placenta

A
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60
Q

Attachment of Placenta

A
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61
Q

Function of Placenta

A
  • Respiratory function
  • Nutritive function
  • Secretory function
  • Excretory function
  • Hemopoietic function
  • Mechanical function
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62
Q

Function of Placenta

  • Respiratory
A
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63
Q

Function of Placenta

  • Nutritive
A

Transport of glucose, lipids, proteins, vitamins & minerals.

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64
Q

Function of Placenta

  • Secretory
A
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65
Q

Function of Placenta

  • Secretory (Hormones)
A
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66
Q

Function of Placenta

  • Secretory (Enzymes)
A
67
Q

Function of Placenta

  • Secretory (Placental Proteins)
A
68
Q

Function of Placenta

  • Excretory
A

Placenta acts as a kidney for fetus.

69
Q

Function of Placenta

  • Hemopoietic
A

Production of fetal Hb.

70
Q

Function of Placenta

  • Mechanical
A

Fixation of fetus to mother.

71
Q

Def of Placental Barrier

A
  • It is formed of layers of tertiary chorionic villi which separate maternal & fetal blood.
  • It prevents mixing of both maternal & fetal blood and allow exchange of gases.
72
Q

Thickness of Placental Barrier

A
73
Q

Layers of Placental Barrier

A
74
Q

Functions of Placental Barrier

A
75
Q

Mechansim of transport in Placental Barrier

A
76
Q

Examples of Placental Hormones

A
  • HCG
  • HPL
  • Progesterone
  • Estrogen
  • Prolactin
  • PGs
  • Relaxin
77
Q

Chemical Nature of HCG

A

Glycoprotein hormone formed of 2 subunits:
1. a-subunit: Similar to all anterior pituitary gonadotropins.
2. b-subunit: Specific to HCG.

78
Q

Source of HCG

A

Syncytiotrophoblast

79
Q

Half Life of HCG

A

30-40 hours.

80
Q

Levels of HCG

A
81
Q

Actions of HCG

A
82
Q

Clinical Uses of HCG

A

 Diagnosis of early pregnancy.
 Diagnosis of ectopic pregnancy.
 Tumor marker in HCG secreting tumors
 Induction of ovulation.
 Diagnosis & follow up of GTD.
 Treatment of LPD

83
Q

Source of HPL

A

Syncytiotrophoblast

83
Q

Chemical Nature of HPL

A

Large protein hormone structurally similar to prolactin.

84
Q

Levels of HPL

A
85
Q

Actions of HPL

A
  • Somatotropic (growth).
  • Lactogenic (milk formation).
  • Erythropoietic
86
Q

Clinical Uses of HPL

A
  • Used as a placental function test (if its level is < 4 µg/ml in 3rd trimester → fetal risk).
87
Q

Chemical Nature of Estrogen

A

Steroids (18c)

88
Q

Source of Estrogen

A

Fetoplacental (90%) & maternal (10%).

89
Q

Types of Estrogen

A

All types are produced during pregnancy, but main type is E3.

90
Q

levels of Estrogen

A

Urinary E3 level is 30-35 mg\day at term.

91
Q

Actions of Estrogen

A
92
Q

Clinical Uses of Estrogen

A
  • Indicator for fetal wellbeing (if urinary E3 level is < 4 mg/dl → fetal risk).
  • Marker for some congenital anomalies (as anencephaly)
93
Q

Chemical Nature of Progesterone

A

Steroids (21C)

94
Q

Source of Progesterone

A

Corpus luteum then placenta

95
Q

Levels of Progesterone

A
96
Q

Actions of Progesterone

A

 Prepare endometrium for implantation.
 Maintains decidua.
 Inhibits uterine activity throughout pregnancy.
 May have role in pelvic relaxation.

97
Q

Clinical Uses of Progesterone

A

Given in cases of threatened abortion

98
Q

Chemical Nature of Relaxin

A

..

99
Q

Source of Relaxin

A

..

100
Q

Levels of Relaxin

A
101
Q

Types of Abnormalities of Placenta

A

Notes

102
Q

Abnormalities of Placenta

  • Abnormal Size & Weight
A

Increased or Decreased

103
Q

Abnormalities of Placenta

  • Abnormal Size & Weight (Increased)
A

In multifetal pregnancy, Rh isoimmunization & DM.

104
Q

Abnormalities of Placenta

  • Abnormal Size & Weight (Decreased)
A

In HTN, heart diseases & IUGR.

105
Q

Abnormalities of Placenta

  • Abnormal Shape
A
  • Placenta membranacea (diffuse placenta)
  • Bilobate or multilobate placenta
  • Bipartite & multipartite placenta
  • Succenturiate placenta: (Accessory loop)
  • Circumvallate placenta
  • Placenta fenestrata
  • Placenta annularis
106
Q

Abnormalities of Placenta

  • Abnormal Shape (Placenta Membranacea - Diffuse Placenta)
A
  • Thin & large placenta (occurs in cases of ↓↓ blood flow → placenta accommodates by ↑↑ its size to get more blood)
107
Q

Abnormalities of Placenta

  • Abnormal Shape (Bilobate or Multilobate Placenta)
A

Placenta is made of 2 or more lobes connected by placental tissue.

108
Q

Abnormalities of Placenta

  • Abnormal Shape (Bipartite & Multipartite Placenta)
A

Placenta is made of 2 separate parts almost equal in size connected by membranes.

109
Q

Abnormalities of Placenta

  • Abnormal Shape (Succenturiate Placenta)
A

Placenta is made of 2 separate unequal parts (large part & small accessory part) connected by membranes.

110
Q

Abnormalities of Placenta

  • Abnormal Shape (Circumvallate Placenta)
A
  • Thick Whitish ring (composed of decidua) is seen around edge of placenta on its fetal surface.
111
Q

Abnormalities of Placenta

  • Abnormal Shape (Placenta Fenestrata)
A
  • Gap is seen in placenta covered by membranes giving appearance of window (the placenta is empty eccentrically).
112
Q

Abnormalities of Placenta

  • Abnormal Shape (placenta Annularis)
A

Absent central part of placenta

113
Q

Abnormalities of Placenta

  • Abnormal Site of Implantation
A

➲Placenta previa: In the lower uterine segment

➲ Ectopic pregnancy: In the tube, in the cervix and in the peritoneum.

➲ Transverse lie: In the fundu

114
Q

Abnormalities of Placenta

  • Abnormal Adhesions
A
115
Q

Diseases of Placenta

A
116
Q

Another Name of Umbilical Cord

A

Funis

117
Q

Def of Umbilical Cord

A

Vascular cord connecting fetus to placenta.

118
Q

Development of Umbilical Cord

A

From connecting stalk & mesoderm.

119
Q

Anatomy of Umbilical Cord

A
120
Q

Length of Umbilical Cord

A

50 cm

121
Q

Diameter of Umbilical Cord

A

1-2 cm

122
Q

Shape of Umbilical Cord

A

Thick, soft & tortuous.

123
Q

Attachment of Umbilical Cord

A
  • Fetus: At umbilicus.
  • Placenta: Eccentric (70%) or centric (30%).
124
Q

Structure of Umbilical Cord

A
125
Q

Function of Umbilical Cord

A
  • Carries fetal blood to & from placenta.
126
Q

Abnormalities of Umbilical Cord

A
  • Abnormal length
  • Abnormal insertion into placenta
  • Abnormalities of blood vessels
  • Knots
127
Q

Abnormalities of Umbilical Cord

  • Abnormal Lenghts
A
128
Q

Abnormalities of Umbilical Cord

  • Abnormal Insertion
A
129
Q

Abnormalities of Umbilical Cord

  • Abnormal Blood Vessels
A
  • Single umbilical artery: Most common vascular anomaly.
  • 2 umbilical veins.
130
Q

Abnormalities of Umbilical Cord

  • Knots
A
131
Q

Abnormalities of Umbilical Cord

  • Other Abnormalities (Diseases)
A
132
Q

Examples of Fetal Membranes

A

Chorion & Amnion

133
Q

Characters of Chorion

A
134
Q

Characters of Amnion

A
135
Q

Abnormalities of Fetal Membranes

A
136
Q

Another Name of Amniotic Fluid

A

Liquor Amnii

136
Q

Definition of Amniotic Fluid

A

Watery Fluid Enclosed in Amniotic Cavity

137
Q

Volume of Amniotic Fluid

A
138
Q

Color of Amniotic Fluid

A

Pale Yellow

139
Q

Shape of Amniotic Fluid

A

Clear & becomes opaque at term due to

  • Presence of Fetal epithelial cells, lanugo Hair & vernix caseosa
140
Q

pH of Amniotic Fluid

A

Slightly Alkaline (pH = 7-7.5)

141
Q

Composition of Amniotic Fluid

A
142
Q

Sources of Amniotic Fluid

A
143
Q

Sources of Amniotic Fluid

  • Fetal Source
A
144
Q

Sources of Amniotic Fluid

  • Maternal Souce
A
145
Q

Main source of AF

  • In early Pregnancy
A

Transudation from Maternal Circulation Througth The placenta

146
Q

Main source of AF

  • In mid Pregnancy
A

Transudation from fetal circulation Throught non-keratinized skin

147
Q

Main source of AF

  • In Late Pregnancy
A

Fetal Urine

148
Q

Circulation of Amniotic Fluid

A
149
Q

Functions of Amniotic Fluid

A
150
Q

Functions of Amniotic Fluid

  • During Pregnancy
A
151
Q

Functions of Amniotic Fluid

  • During Labor
A
152
Q

Clinical Importance of Amniotic Fluid

A

Amniocentesis

153
Q

Abnormalities of Amniotic Fluid

A
  • In Volume or Color
154
Q

Abnormalities of Amniotic Fluid

  • Abnormal Volume
A
  • Polyhydraminous
  • Oligohydraminous
155
Q

Abnormalities of Amniotic Fluid

  • Yellowish Green Af
A

D2 Meconium D2 fetal distress

156
Q

Abnormalities of Amniotic Fluid

  • Golden Yellow AF
A

D2 excess bilirubin

157
Q

AFI

A
158
Q

Def of Amniocentesis

A

Aspiration of an amount of AF for Dx & TTT

159
Q

Indications of Amniocentesis

A
160
Q

Dx Uses of Amniocentesis

A
161
Q

Therapeutic Uses of Amniocentesis

A
162
Q

Timing of Amniocentesis

A
163
Q

Early Amniocentesis

A
164
Q

2nd Trimester Amniocentesis

A
165
Q

Technique of Amniocentesis

A
166
Q

Complications of Amniocentesis

A
167
Q

done

A

..

Y4R2 - Obstetrics I 🤰 (33 decks)

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