L2:physiology of pregnancy

Question 1

weeks of trimester 1 (T1)

Answer 1

1-12

Question 2

weeks of trimester 2 (T2)

Answer 2

13-26

Question 3

weeks of trimester 3 (T3)

Answer 3

27-40

Question 4

4 parts of T1 for foetus

Answer 4

fertilisation
implantation
initial development
placentation

Question 5

5 parts of T2 for foetus

Answer 5

nervous system 
hair 
spine straightens 
pain 
proportions change

Question 6

5 changes to mother in T2

Answer 6

placental growth 
uterus rises 
hypervolemia 
cardiac remodelling 
breast remodelling

Question 7

5 changes to foetus in T3

Answer 7

growth 
fat deposition 
brain growth 
lung development 
blood cells

Question 8

4 changes to mother in T3

Answer 8

braxton hicks
tiredness
restricted breathing
lactation

Question 9

overall what happens to mother heart rate

Answer 9

increases

Question 10

overall change to mothers blood pressure

Answer 10

doesn’t

Question 11

overall change to mothers blood volume

Answer 11

increases

Question 12

what happens to mother haematocrit

Answer 12

decreases

Question 13

pattern of foetal heart rate change

Answer 13

dramatically increases in 1st trimester then plateaus

Question 14

official start of pregnancy=

Answer 14

last menstrual period

Question 15

when is conception in pregnancy

Answer 15

3 weeks

Question 16

when is implantation in pregnancy

Answer 16

4 wks

Question 17

other name for luteal phase

Answer 17

secretory phase

Question 18

what does the blastocyst need to do before implantation

Answer 18

hatch from zona pellucida

Question 19

3 factors of uterine epithelia

Answer 19

tight inter-cellular gap junctions
villi
glycocalyx

Question 20

what in the uterine epithelia attracts the embryo

Answer 20

glycocalyx

Question 21

what breaks down the zona pellucida

Answer 21

protease

Question 22

what breaks down the glycocalyx

Answer 22

blastocyst signals uterine epithelium to break it down

Question 23

what cells of the blastocyst integrate with the cell lining the uterus epithelia

Answer 23

trophoblasts

Question 24

3 changes in the uterine epithelium the interaction between trophoblasts and uterine epithelium causes

Answer 24

migration of nuclei to basal compartment
changes in structure of stromal cells
start of decidualisation

Question 25

what causes decidualisation

Answer 25

trophoblasts invade into primary decidua and produce protease and destroy these cells

Question 26

an important cytokine involved in decidualisation

Answer 26

leukaemia inhibiting factor

Question 27

what 2 cells do trophoblasts differentiate into after implantation

Answer 27

syncytial trophoblasts | cytotrophoblasts

Question 28

outer layer of trophoblast=

Answer 28

syncytial trophoblasts

Question 29

what are syncytial trophoblasts

Answer 29

multicellular --> big nucleated structure

Question 30

what are cytotrophoblasts

Answer 30

single cellular inner layer

Question 31

where does embryo development happen

Answer 31

in uterine wall itself

Question 32

what forms in the cytoplasm of the syncytial trophoblasts

Answer 32

trophoblastic lacunae

Question 33

what do trophoblastic lacunae contain/ do

Answer 33

nutrients for support (histotroph)

Question 34

what rescues the corpus luteum

Answer 34

hCG

Question 35

6 things progesterone leads to in early pregnancy

Answer 35

``` suppression of menses tender/ enlarged breasts fatigue urinary frequency nausea/ vomiting constipation ```

Question 36

2 things pluriblast divide into

Answer 36

epiblast | hypoblast

Question 37

epiblast -->

Answer 37

ectoderm

Question 38

hypoblast -->

Answer 38

endoderm

Question 39

what forms inbetween ectoderm and endoderm

Answer 39

mesoderm

Question 40

amnion=

Answer 40

ectoderm and mesoderm

Question 41

chorion=

Answer 41

trophoblast and mesoderm

Question 42

yolk sac=

Answer 42

endoderm and mesoderm

Question 43

what overtakes histotrophic support

Answer 43

haematrophic support

Question 44

how does the embryo switch to haematrophic support

Answer 44

prompting remodelling of uterine spiral arteries

Question 45

why do spiral arteries need remodelling

Answer 45

they have high blood pressure which can damage the embryo

Question 46

what cells grow into the maternal spiral arteries

Answer 46

syncytial and cytotrophoblasts

Question 47

what happens when the syncytial and cytotrophoblasts grow into the spiral arteries

Answer 47

leads to widening so blood can pool

Question 48

how does the embryo access pool of blood

Answer 48

uses vili

Question 49

what forms the embryo vili

Answer 49

syncytial trophoblasts

Question 50

when does haematrophic support happen

Answer 50

around 5 weeks post conception

Question 51

what happens at the same time of haematrophic support

Answer 51

foetal circulation system begins to develop

Question 52

what is a primary vili

Answer 52

solid trophoblast

Question 53

what is a secondary vili

Answer 53

invasion of mesoderm within trophoblast

Question 54

what is a tertiary vili

Answer 54

foetal blood vessels penetrate vili

Question 55

vili at week 9=

Answer 55

tertiary vili stem lengthen forming mesenchymal vili

Question 56

vili at week 16

Answer 56

terminal extensions reach maximal length

Question 57

vili at week 32

Answer 57

mature intermediate tertiary vili produce secondary branches = terminal vili

Question 58

what is the umbilical cord

Answer 58

coiling of 2 veins around artery which feeds into villous tree

Question 59

4 things transported in the placenta

Answer 59

respiratory gases glucose free fatty acids lipids

Question 60

how is glucose transported into foetus

Answer 60

via GLUT and oxidised in placenta

Question 61

can foetus do gluconeogenesis

Answer 61

NO

Question 62

what does the placenta express for lipid delivery

Answer 62

lipoprotein lipase

Question 63

peak of hCG conc

Answer 63

3 weeks

Question 64

2 things oestrogen's do

Answer 64

relaxation of pelvic ligaments and increase elasticity of pubic synthesis

Question 65

what is needed for oestrogen synthesis

Answer 65

foetal and placental cooperation

Question 66

what can indicate placental function

Answer 66

progesterone

Question 67

3 roles of progesterone

Answer 67

causes decidualization increase oviductal/ uterine secretions reduce uterine contractions

Question 68

when is somato mammotropin secreted from

Answer 68

week 5

Question 69

what is hypervolemia

Answer 69

too much fluid in blood --> maternal glow

Question 70

effect of oestrogen in trimester 2

Answer 70

- increasing angiogenesis (via NO increase) | - act on hepatic system increasing ang2, renal absorption and aldosterone

Question 71

effects of progesterone in trimester 2

Answer 71

- increases vasodilation, decreases peripheral resistance | - increases aldosterone levels

Question 72

downside of progesterone in trimester 2

Answer 72

oedema

Question 73

what does HR and stroke volume increase by in T2

Answer 73

HR 20% SV 20%

Question 74

increase in heart size=

Answer 74

12%

Question 75

what does breathing become in T2

Answer 75

thoracic

Question 76

what happens to sensitivity to chemoreceptors in T2

Answer 76

lowered (--> deeper breathing)

Question 77

what in the lungs stays to same

Answer 77

vital capacity

Question 78

why does vital capacity stay the same

Answer 78

lose residual volume

Question 79

what happens to the kidneys in T2

Answer 79

enlarge

Question 80

enlarged kidneys causes (3)

Answer 80

increase waste excretion increase Na+ absorption increase blood flow

Question 81

what is pregnant urine richer in

Answer 81

glucose and AA

Question 82

what happens to the fetus at the end of pregnancy

Answer 82

engages

Question 83

average weight gain in pregnancy =

Answer 83

24lb

Question 84

what urine related pathology are you at higher risk of in pregnancy

Answer 84

UTIs