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Y4R2 - Obstetrics I 🤰 > L4: Labor (Mechanism) > Flashcards

L4: Labor (Mechanism) Flashcards

1
Q

Def of Mechanism of Normal Labor

A
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2
Q

Mechanism of Normal Labor

  • Steps
A
  • Head
  • Shoulders
  • Trunk
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3
Q

Steps of Delivery of Head

A
  • Descent
  • Engagment
  • Increased Flexion
  • Internal rotation
  • Extension
  • Restitution
  • External Rotation
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4
Q

Steps of Delivery of Head

  • Descent
A
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5
Q

Descent in Delivery of Head

  • Nature of This Process
A

Continous through the whole process

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6
Q

Descent in Delivery of Head

  • Causes
A

a Uterine contraction.
b) Fetal axis pressure.
c) Auxiliary forces of bearing down.

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7
Q

Engagement in Delivery of Head

A
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8
Q

Increased Flexion in Delivery of Head

A
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9
Q

Increased Flexion in Delivery of Head

  • Causes
A
  • As soon as head meets resistance of pelvic floor, flexion is Incresed, so that chin lies in contact è chest wall.
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10
Q

Increased Flexion in Delivery of Head

  • Benefits
A
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11
Q

Increased Flexion in Delivery of Head

  • Theories
A
  • Lever Theory
  • Cylinder Theory
  • Pelvic Theory
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12
Q

Theories of Increased Flexion in Delivery of Head

  • Lever Theory
A
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13
Q

Theories of Increased Flexion in Delivery of Head

  • Cylinder Theory
A
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14
Q

Theories of Increased Flexion in Delivery of Head

  • Pelvic Theory
A
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15
Q

Internal Rotation in Delivery of Head

A
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16
Q

Internal Rotation in Delivery of Head

  • Def
A
  • Rotation of head on its vertical axis around wall of pelvis so that longitudinal diameter of head is gradually carried to occupy A-P diameter of pelvic outlet.
17
Q

Internal Rotation in Delivery of Head

  • Direction & Degree
A
  • In OA, head rotates forwards 1/8 circle (sagittal suture rotates from oblique diameter to A-P diameter while shoulders remain in opposite oblique diameter so, neck undergoes twist of 45°)
18
Q

Internal Rotation in Delivery of Head

  • Time
A
  • It takes place usually during 2nd stage (it starts to occur when head occupies plane of greatest pelvic dimension & meets resistance of sloping pelvic floor).
19
Q

Internal Rotation in Delivery of Head

  • Theories
A
  • Sloping character of pelvic floor
  • Pelvic shape theory (rifling action of pelvis)
  • Sellheim’s Theory
20
Q

Theories of Internal Rotation in Delivery of Head

  • Sloping Pelvic Floor
A
21
Q

Theories of Internal Rotation in Delivery of Head

  • Pelvic Shape Theory (Rifling)
A
22
Q

Theories of Internal Rotation in Delivery of Head

  • Sellheim’s Theory
A
23
Q

Extension in Delivery of Head

A
24
Q

Extension in Delivery of Head

  • Causes
A
25
Q

Extension in Delivery of Head

  • Diameters Extending Vulva
A
  • Diameters extending vulva are: SOB, SOF & finally OF diameters (i.e. gradual extension which prevents perineal tears).
26
Q

Restitution in Delivery of Head

A
27
Q

Restitution in Delivery of Head

  • Def
A
  • Movement to undo twist of head on trunk caused by internal rotation (as head rotates anteriorly while shoulders remain in oblique diameter).
28
Q

Restitution in Delivery of Head

  • Direction & Degree
A
  • In opposite direction of internal rotation to bring head at right angle to shoulders again.
29
Q

External Rotation in Delivery of Head

A
30
Q

External Rotation in Delivery of Head

  • Def
A
  • Movement that represents external manifestation of internal rotation of shoulders from oblique diameter of pelvic brim to A-P diameter of outlet.
31
Q

External Rotation in Delivery of Head

  • Direction & Degree
A
  • It is continuation of restitution & it is in the same direction (head rotates another 1/8 circle in the same direction of restitution → occiput becomes direct lateral in position facing maternal thigh).
32
Q

Steps in Delivery of Shoulder

A
33
Q

Steps in Delivery of Shoulder

  • Descent
A

Due to the same causes.

34
Q

Steps in Delivery of Shoulder

  • Engagemnet
A

While head is emerging in A-P diameter of outlet, shoulders engage in oblique diameter of inlet opposite to that traversed by head.

35
Q

Steps in Delivery of Shoulder

  • Internal Rotation
A
  • Anterior shoulder reaches pelvic floor 1st → rotates anteriorly 1/8 circle (in opposite direction of that of head).
36
Q

Steps in Delivery of Shoulder

  • Lateral Flexion
A
  • Anterior shoulder impinges under pubic arch & by lateral flexion of fetal spines, posterior shoulder is born 1st followed by anterior shoulder.
37
Q

Steps in Delivery of Trunk & Extremities

A

Once shoulder is born, the rest of fetus is delivered easily è no special mechanism of labor.

Y4R2 - Obstetrics I 🤰 (33 decks)

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