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Embryology Exam 2 > Lecture 12 > Flashcards

Lecture 12 Flashcards

1
Q

functions of placenta

A
  • diffusion of oxygen and carbon dioxide
  • diffusion of foodstuff
  • excretion of waste products
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2
Q

Describe the early placenta

A
  • thick
  • permeability low
  • small surface area
  • total diffusion conductance is minuscule
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3
Q

Describe the late placenta

A
  • thin
  • permeability high
  • large surface area
  • large increase in placental diffusion
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4
Q

What is the PO2 of the mother

A

50 mm Hg

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5
Q

What is the PO2 of the fetus

A

30 mm Hg

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6
Q

What are the reasons why adequate oxygenation can occur with such a low pressure gradient?

A
  • fetal hemoglobin has a higher affinity for oxygen
  • fetal blood hemoglobin concentration is about 50% greater than maternal
  • Bohr effect
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7
Q

Hemoglobin can carry ______ oxygen at low PCO2

A

more

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8
Q

Changes (from the Bohr effect) cause what?

A
  • increase capacity of fetal blood to combine with oxygen

- decrease capacity of maternal blood to combine with oxygen

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9
Q

What is the double Bohr effect?

A

refers to the double shift in the maternal blood and in the fetal blood

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10
Q

PCO2 of fetal blood is ______ times higher than maternal blood

A

2-3

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11
Q

The placenta does _______ diffusion of glucose via trophoblast cells and does slower diffusion of fatty acids into ______ blood.

A

facilitated; fetal

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12
Q

What cells secrete human chorionic gronadotropin (HCG)?

A

syncytial trophoblast cells into maternal fluids

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13
Q

What are the functions of Human chorionic gonadotropin?

A
  • prevents involution of corpus luteum
  • causes CL to increase secretion of progesterone and estrogen
  • causes increase growth in CL
  • exerts interstitial cell stimulating effect of testes of male fetus
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14
Q

Estrogen are secreted by ______ cells of placenta

A

syncytiotrophoblast

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15
Q

What are the functions of estrogens?

A
  • uterine enlargement
  • breast enlargement
  • growth of breast ductal surface
  • enlargement of maternal external genitalia
  • relaxation of pelvic ligaments
  • may also affect aspects of fetal development
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16
Q

Progestrone is secreted in large quantities by the ______

and small quantities by the _______

A

placenta; corpus luteum early

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17
Q

What are the functions of progesterone?

A
  • causes decidual cells to develop in the endometrium
  • decreases contractility of pregnant uterus
  • increases secretions of Fallopian tubes and uterus
  • may work with estrogen to prepare breasts for lactation
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18
Q

When is human chorionic somatomammotropin secreted?

A

by the placenta in beginning of 5th week of pregnancy

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19
Q

What are the functions of human chorionic somatomammotropin?

A
  • causes decreased insulin sensitivity and decreased utilization of glucose by mother
  • general metabolic hormone
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20
Q

What are the theories regarding placental immunology?

A
  • lack of expression of major histocompatibility antigens by placental components
  • paralysis of mother’s immune system during pregnancy
  • decidual immune barrier
  • inactivation of mother’s immune system components by molecules formed on fetal placental surface
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21
Q

Define malformations

A

primary errors of morphogenesis. Usually multifactorial, involving a number of etiological agents including genetic and environmental factors

22
Q

Define disruptions

A

disturbances in otherwise normal morphogenetic processes (example: amniotic bands)

23
Q

Define deformations

A

disturbances in otherwise normal morphogenetic processes that are typically caused by abnormal biomechanical forces such as uterine contraints (example: clubfoot)

24
Q

Define sequences

A

series (cascade) of events triggered by one initiating factor (sort of like a complement cascade). Example: decreased amniotic fluid (oligohydramnios) which leads to a variety of events, including fetal compression and other problems stemming from that

25
Q

Define sydromes

A

constellations of congenital anomalies that are though to be pathologically related but cannot be explained on the basis of a single local initial event. Caused by a single event usually, such as viral infection.

26
Q

The three group causes of congenital anomalies

A

genetic
environmental
multifactorial

27
Q

Describe gene mutations

A
  • include inborn errors of metabolism (rare)
  • inherited most commonly as autosomal recessive or X linked diseases, few inherited as dominant traits
  • often affect enzymes and biochemical pathways
28
Q

Describe phenylketonuria

A

Congenital deficiency of phenylalanine 4-monooxygenase. Causes inadequate formation of L-tyrosine, elevation of serum L-phenylalanine, excretion of phenylpyruvic acid, and accumulation of phenylalanine.

29
Q

Describe galactosemia

A

Congenital deficiency of galactosyl-1-phosphate uridyltransferase. Results in tissue accumulation of galactose 1-phosphate.

30
Q

Describe cystic fibrosis

A

Inherited disorder that affects mostly the Lungs but also the pancreas, liver, kidneys, and intestine. CF is inherited in an autosomal recessive manner with mutations in both copies of the cystic Fibrosis transmembrane conductance regulator (CFTR) protein gene. The CFTR protein is a membrane protein chloride channel/transporter.

31
Q

Describe Turner syndrome

A

genotype X0, 1 in 3000 incidence
characteristics: female with underdeveloped sex characteristics, low hairline, broad chest, folds on neck, usually sterile, usually of normal intelligence

32
Q

Describe Poly-X syndrome

A

XXX genotype, 1 in 1000 incidence

characteristics: usually tall and thin, often fertile, most have normal intelligence

33
Q

Describe euploidy

A

addition of a complete set of chromosomes in addition to diploid (2N) stage
often the result of retention of polar body or by fertilization by more than one sperm, typical results in early spontaneous abortion

34
Q

What are the major risk factors of prematurity?

A
  • preterm premature rupture of placental membranes
  • intrauterine infections
  • uterine, cervical, and placental structural abnormalities
  • multiple gestation
35
Q

What are the hazards of prematurity?

A
  • hyaline membrane disease
  • necrotizing enterocolitis
  • sepsis
  • interventricular hemorrhage
  • long term complications (developmental delay)
36
Q

What are the fetal factors resulting in fetal growth restrictions?

A
  • chromosome disorders
  • congenital anomalies
  • congenital infections
37
Q

What are the placental factors resulting in fetal growth restriction?

A
  • Umbilical-placental vascular anomalies
  • Placenta previa
  • Placental thrombosis and infarction
  • Multiple gestations
  • Placental genetic mosaicism
38
Q

What are the maternal factors resulting in the fetal growth restriction?

A
  • Preeclampsia
  • Chronic hypertension
  • Maternal use of drugs, narcotics, alcohol, nicotine
  • Maternal malnutrition
39
Q

What is the fundamental deficiency in neonatal respiratory syndrome?

A

lack of pulmonary surfactant

40
Q

What is fetal hydrops?

A

accumulation of edema fluid in the fetus during intrauterine growth

41
Q

What causes immune hydrops?

A

blood group incompatibility between mother and fetus

42
Q

What are the major causes of non immune hydrops?

A
  • cardiovascular defects such as congenital cardiac defects and arrhythmias
  • chromosomal anomalies
43
Q

Define pregnancy induced hypertension

A

persistent elevated blood pressure (140/190) that develops after 20 weeks of gestation and returns to normal after birth

44
Q

Describe preeclampsia

A
  • blood pressure is higher
  • proteinuria
  • weight gain
  • edema
45
Q

describe eclampsia

A
  • extremely serious condition
  • extremely high blood pressure
  • grand mal seizures or coma
46
Q

What causes fetal alcohol syndrome?

A

excessive alcohol ingestion by the mother

47
Q

What causes erythroblastosis fetalis?

A

When Rh-positive fetuses are attacked by the maternal anti- Rh IgG antibodies

48
Q

What causes hydrops fetalis?

A

when bilirubin released from lysed blood cells ( due to erythroblastosis fetalis) causes water accumulation in the fetus with jaundice, brain damage and anemia

49
Q

What is placenta previa?

A

abnormal implantation site within the uterine cavity

50
Q

What is a hydatidiform mole?

A

noninvasive condition in which many of the chorionic villi are characterized by nodular swelling. Embryo is absent or not viable.

51
Q

What are some environmental factors that influence changes in chromosome number?

A
  • infections
  • radiation
  • maternal diabetes
  • drugs and other chemicals (thalidomide, alcohol, retinoic acid, folic acid)

Embryology Exam 2 (8 decks)

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