Lecture 25 -- review questions Flashcards

1
Q

during the first weeks of pregnancy, what organ is the primary source of pregnancy-related hormones?

and after that few weeks, what organ takes control of the hormone production?

A

corpus luteum –> first weeks

placenta –> later weeks

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2
Q

what does hCG stand for?

A

human chorionic gonadotropin

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3
Q

what is the function of the human chorionic gonadotropin?

A

prevents involution of corpus luteum

stimulates its growth and secretory activity

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4
Q

when do hCG levels peak: early, mid, or in late (~week 40) pregnancy?

A

early (~week 10)

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5
Q

what is one of the functions of the placental lactogen?

A

makes glucose more available to the fetus

fatty acids more available to the mom

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6
Q

when do placental lactogen levels peak: early, mid, or in late (~week 40) pregnancy?

A

around late pregnancy

~week 30

right before birth

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7
Q

what are the 3 functions of progesterone in pregnancy?

A

1) inhibit premature uterine contractions and menstruation

2) stimulate endometrial stromal cell differentiation into decidual cells that control embryo implantation

3) stimulate mammary alveoli development

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8
Q

what hormone prevents premature uterine contractions and menstruation (=destruction of the functional layer of the endometrium) during pregnancy?

A

progesterone

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9
Q

what does progesterone do to the endometrium?

A

stimulate endometrial stromal cells to differentiate into decidual cells –> control embryo implantation

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10
Q

when do progesterone levels peak: early, mid, or in late (~week 40) pregnancy?

A

late pregnancy

around birth

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11
Q

when do estradiol (estrogen) levels peak: early, mid, or in late (~week 40) pregnancy?

A

late pregnancy

around birth

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12
Q

when do cortisol levels peak: early, mid, or in late (~week 40) pregnancy?

A

late pregnancy

around birth

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13
Q

what is one of the functions of cortisol in pregnancy?

A

to mobilize amino acids for fetal protein synthesis

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14
Q

are progesterone and estradiol being synthesized during the first weeks of pregnancy or only at the end?

A

during first weeks and at the end

start –> synthesized by corpus luteum
end –> synthesized by placenta

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15
Q

what does relaxin do?

A

(from ovaries and placenta)

relaxes the pelvis and widens the cervix

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16
Q

what organs synthesize relaxin?

A

ovaries and placenta

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17
Q

during pregnancy, what happens to the tidal volume? why? (tip: 2 reasons)

A

increase:

1) greater need for oxygen

2) progesterone increases the sensitivity of the medullary respiratory center to CO2

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18
Q

what results from the influence of progesterone on the maternal respiratory system?

A

increases the sensitivity of the medullary respiratory center to CO2

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19
Q

what does dyspnea mean?

A

(difficult breathing)

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20
Q

why is dyspnea typical of the 3rd trimester of pregnancy?

A

diaphragm is pushed superiorly by the increasing size of the uterus

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21
Q

why do pregnant women suffer from heartburn?

and hemorrhoids, varicose veins, or edema?

A

enlarging uterus presses upward on stomach –> causes gastric reflux

uterus puts pressure on the large pelvic blood vessels –> interferes w/ venous return from the legs and pelvic regions

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22
Q

what are varicose veins?

A

twisted, enlarged, damaged veins

blood doesn’t flow well back to the heart

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23
Q

what happens with the total body water of the pregnant: increase or decrease?

how about blood volume and cardiac output?

and urine volume?

A

total body water –> increase

blood volume –> increase

cardiac output –> increase

urine volume –> increase

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24
Q

why are frequent urination and urgency common in pregnancy?

A

kidneys produce more urine

enlarged uterus puts pressure on bladder

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25
Q

what causes constipation in pregnancy?

A

decreased intestinal mobility

more nutrients absorbed

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26
Q

what are 2 typical changes that happen in the skin during pregnancy?

A

changes in pigmentation:
- more melanocyte activity –> darker skin in some areas

stretch marks

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27
Q

what is the linea nigra? which cells are implicated in the emergence of the linea nigra?

A

linea nigra == dark line from umbilical to pubic region –> line on belly

increased melanocyte activity

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28
Q

what is labor?

A

a series of continuous, progressive contractions of the uterus
–> help the cervix to dilate and to thin
–> allow the fetus to move thru the birth canal

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29
Q

what is parturition?

A

process of giving birth

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30
Q

what are Braxton Hicks contractions?

A

“false labor”

weak, irregular contractions

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31
Q

what hormone is responsible for Braxton Hicks contractions?

A

estrogens from placenta

32
Q

at the end of pregnancy, estrogen levels are pretty high

what is one of the effects of these high estrogen levels in the uterus? (tip: increase the receptors for one hormone, which one? why to increase those receptors?)

A

increases oxytocin receptors on uterus

–> oxytocin stimulates the uterus to contract

33
Q

what stimulus for secretion of oxytocin by the pituitary gland of the pregnant mother just before labor?

A

cervical stretching –> fetus’s head pushes against the cervix

34
Q

is oxytocin only produced by the mom?

A

no; both from fetus and mother’s posterior pituitary gland

35
Q

what is the role of oxytocin during labor? (tip: 2 things)

A

stimulate uterus to contract

stimulate placenta to release prostaglandins (which stimulate more vigorous contractions)

36
Q

what is the role of prostaglandins during labor?

A

stimulates more vigorous uterus contractions

causes positive feedback loop –> more prostaglandins == oxytocin is released == more prostaglandins released

37
Q

what 2 factors are responsible for the “true” labor contractions? (tip: one is a hormone, and the other an eocisanoid derived from arachidonic acid)

A

oxytocin
- stimulates uterus to contract
- stimulates placenta to release prostaglandins

prostaglandins
- stimulates more vigorous contractions of uterus
- positive feedback loop to release more oxytocin == more prostaglandins

38
Q

what is the positive feedback loop of uterine contraction?

A

cervical stretching
== more oxytocin secretion
== stimulates uterus to contract
== releases prostaglandins
== stimulates uterus to vigorously contract
== stimulates more oxytocin secretion (== more contractions == more prostaglandins == more vigorous uterine contractions)

39
Q

what are the 3 stages of labor?

A

1) dilation stage

2) expulsion stage

3) placental stage

40
Q

what happens in each stage of labor?

A

1) dilation stage
- cervix opens (dilates) and becomes thinner (effaces)
- from onset of true labor contractions until cervix is fully dilated

2) expulsion stage
- full cervical dilation until birth of infant

3) placental stage
- placenta and other fetal membranes are expelled by uterine contractions

41
Q

can the cervix dilate up to 10 cm?

A

yes, when fully dilated

10 cm is diameter of baby’s head

42
Q

what is the “breaking of the waters”?

A

fetal membranes rupture and the amniotic fluid is discharged

43
Q

what is crowning?

A

when the top of baby’s head is visible at the vaginal opening

44
Q

how are the placental and other fetal membranes expulsed from the mom after delivery?

A

uterine contractions

45
Q

what is the stage of puerperium?

A

6 weeks after childbirth –> mother’s reproductive organs return to their original non pregnant condition

46
Q

what is lochia?

A

vaginal discharge that comes from shrinkage of uterus (involution) and self-digestion (autolysis) of uterine cells by their own lysosomal enzymes

47
Q

how does the uterus shrink during the following weeks after labor?

A

self-digestion (autolysis) of uterine cells by their own lysosomal enzymes –> produces lochia (vaginal discharge)

48
Q

what is the name of the muscle located under the breast?

A

pectoralis major muscle

49
Q

is breast size determined by the amount of adipose tissue or the number of mammary glands each breast contains?

A

amount of adipose tissue

50
Q

what is the function of the suspensory ligaments?

A

attach breast to the dermis and to the fascia of pectoralis major

51
Q

what is the function of the lactiferous ducts?

A

drain each lobe, dilates to form a lactiferous sinus opening onto the nipple

52
Q

where are the lactiferous sinuses located?

A

opening into the nipple

53
Q

what is the difference b/n a lobule and a lobe in the mammary gland?

A

lobule == group of alveoli clusters

lobe == group of lobules

54
Q

what do lobules contain?

A

clusters of alveoli

55
Q

what are alveoli (regarding the mammary gland?) and an alveolus?

A

alveoli == hollow cavities lined with milk-secreting cuboidal cells (lactocytes) and surrounded by myoepithelial cells

alveolus = single alveoli

56
Q

what cells are in the alveoli of the mammary gland? (tip: 2)

A

lactocytes == milk-secreting cuboidal cells

myoepithelial cells == surround the lactocytes in the alveoli

57
Q

what cells found in the mammary gland’s alveoli are responsible for milk production and secretion?

A

lactocytes == milk-secreting cuboidal cells that line the alveoli

58
Q

where do the alveoli drain the milk: directly into the lactiferous duct or the lactiferous sinuses?

A

lactiferous duct, then into lactiferous sinuses

59
Q

concerning mammary gland development, at which stage of life do terminal end buds form?

and the alveolar buds?

and the alveoli?

A

terminal end buds –> puberty

alveolar buds –> pregnancy

alveoli –> formed during pregnancy but fully matured during lactation

60
Q

what is the hormone that promotes the creation of TEB at puberty?

A

estrogens

61
Q

where are TEB located?

A

ends of lactiferous ducts

62
Q

what do terminal end buds do?

A

highly proliferative structures that are responsible for development of almost the entire ductal system

63
Q

what happens to the lactiferous duct after puberty under the influence of estrogens and progesterone?

A

elongates and branches

64
Q

which hormones stimulate the formation of the alveolar buds at the end of the lactiferous ducts?

A

1) prolactin

2) progesterone

3) placental lactogens

65
Q

what is alveologenesis?

A

formation of alveolar buds

66
Q

what is lactogenic differentiation?

A

growth and differentiation of alveolar buds into alveoli at the end of pregnancy

67
Q

can a non-pregnant woman produce breast milk? (tip: does she contain alvoeli?)

A

no –> she does not contain alveoli

she must become pregnant to form alveolar buds –> fully matured, milk-producing alveoli

68
Q

can a pregnant woman produce breast milk during the first trimester of pregnancy?

A

no;

alveolar buds don’t fully mature into milk-producing alveoli until end of pregnancy

69
Q

what does ductal elongation mean?

A

lactiferous ducts lengthen and side branch

70
Q

what is lactation?

A

infant suckle –> hormones –> mammary glands produce milk

71
Q

what stimulates prolactin and oxytocin secretion during the lactation period?

A

baby suckling –> stimulates neural receptors in the nipple

72
Q

what gland secretes prolactin and oxytocin?

A

AP PO

anterior == prolactin

posterior == oxytocin

prolactin –> anterior pituitary gland

oxytocin –> posterior pituitary gland

73
Q

how do oxytocin and prolactin work together during lactation?

A

prolactin –> milk synthesis by mammary alveolar cells

oxytocin –> contraction of the myoepithelial cells produces milk ejection

74
Q

if a more neither feeds the baby with breast milk for several weeks nor extracts breast milk with a breast pump, would she be able to produce milk again?

A

no –> continued breast-feeding is required for continued milk production

75
Q

what is colostrum?

A

pre-milk fluid

a fat-poor fluid that contains more protein, vitamin A, and minerals than does true milk

76
Q

colostrum vs. milk – what’s the difference in composition?

A

colostrum
- fat-poor
- more protein
- more vitamin A
- more minerals

77
Q

considering this graph, why do prolactin and oxytocin levels increase and decrease (= are unstable) during lactation (last part of the graph)?

(tip: check what is the stimulus for their release from the pituitary gland)

A

stimulus for their release is dependent on suckling of baby

suckle == prolactin and oxytocin levels increase

no suckle == prolactin and oxytocin levels decrease