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PSYC 207 Midterm 1 > Lecture 4 > Flashcards

Lecture 4 Flashcards

1
Q

What influences most of the changes during pregnancy?

A

hormones

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2
Q

During pregnancy, what does contractility seem to be controlled by? how is this different from normal?

A

predominantly controlled by hormones. Different from normal which is usually neurological (nerves etc)

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3
Q

What is growing during pregnancy? (3 main things)

A
  • the baby
  • the uterus
  • the placenta
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4
Q

What could be a potential reason for why we have pain during labour?

A

could be the body’s way of preventing injury

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5
Q

What layer of the uterus do hormones predominanly influence the uterus through? how is this area innervated? Does it dennervate?

A

hormones influence the uterus predominantly throuhg the inside layer (the endometrium)/ The more muscular layer is the myometrium.

That is innervated through autonomic nerve fibres in the non-pregnant uterus. But, in the pregnant uterus these nerve fibres disappear and the muscle is not innervated by this muscle anymore.

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6
Q

What is the endometrium mostly made up of? What do these things deliver through the uterus? What does this tell us about what is influencing the uterus?

A

The endometrium mostly has glands and tiny blood vesself which deliver hormones through the uterus which is why the influence is mainly hormonal.

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7
Q

What happens to the endometrium during mensturation? During pregnancy?

A

during menstruation the endometrium thickens and then is shed. During pregnancy the endometrium thickens even further (it thickens while preparing for preg and continues)

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8
Q

What are the vasculature? Where are the blood vessels in the uterus? How does the release of hormones work through the blood vessels? What effects the quantity of hormones that will be released through the blood vessels? What happens to the blood vessels when the myometirum contracts?

A

the vascuature are the ends of the big blood vessels.

The blood vessels in the endometrium (the thickr the blood vessel the less release there will be in the space surrounding it, the thinner it is the more hormones will be released in the space.

The myometrium contracts and the blood vessels become compressed

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9
Q

UNDERSTAND DIAGRAM ON LECTURE 4 SLIDE FIVE OF ENDO AND MYO METRIUM AND VASCULATURE

A
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10
Q

What layer of the uterus is most affected by denervation?

A

the myometrium is usually connected to the sensory network and in this case it is disconnected. In the endometrium there are more muscle fibres retained.

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11
Q

Why is there less denervation in the endometrium?

A

The endometrium is releasing fluids, hormones etc. It will need to detect changes in the chemical composition of the endometrium. The sensory fibres are detecting the level of oxytocin etc.

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12
Q

What layer of the uterus does the stretch sensation apply to? Does this apply to anywhere else?

A

The stretch sensation only applies to the myometrium except that the blood vessels themselves have sensory receptors as well. The tiny muscles in the blood vessel can also stretch and relax.

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13
Q

What does motor denervation mean about what is no longer influencing the uterus?

A

motor denervation: uterus is no longer influenced by neurons

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14
Q

Why do senses usually carried from the uterus no longer reach the brain during sensory denervation?

A

Sensory: senses usually carried from the uterus to the brain is no longer carried because there are less neural fibres in the uterus.

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15
Q

What is one of the functionalities that is proposed for sensory denervation?

A

One of the functionalities that we propose for sensory denerv is that it could serve to reduce the contraction of the uterus. Might help maintain quescence/

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16
Q

Why would it logically make sense for labour not to hurt?

A

If there is sensory denervation and you are no longer feeling your uterus (particularly before labour starts), why does labour hurt, you shouldn’t be able to feel anything from there. This is a big question

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17
Q

What are normal labour contraction/ where do they come from?

A

normal labour contractions are a contraction of the uterine muscle so what are we feeling if we can’t feel the myometrium anymore?

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18
Q

Is there a great scientific explanation for why labour would be painful?

A

no

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19
Q

What are 2 common explanations of pain associated with normal labour contractions (including medical knowledge?

A
  • Stretching of the cervix
  • Contraction of uterine muscle
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20
Q

Why has science found the common explanations of pain associated with normal labour contractions (ie stretching of cervix and contraction of uterine muscle) to be potentially inaccurate? (3 things)

A
  • Stretch receptors in the uterus disappear during pregnancy (so why can we feel it?)
  • Stretch receptors in the cervix disappear at the onset of labour
  • Muscle fibres in the cervix are almost completely replaced by connective tissue (extra-cellular matrix, or ECM) (the cervix has some muscle fibres during pregnancy and in the non-pregnant state. But these are replaced by connective tissue.)
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21
Q

What are the 3 stages of labour plus additional stage?

A

“Stage 1”: The uterus contracts and stretches the cervix to open to approximately 10 cm diameter. (this is when most of the labour is happening (the thing that takes a long time)

“Stage 2”: The baby passes through the ‘birth canal’ and is born. (not usually very long compared to stage one)

“Stage 3”: The placenta is born (‘expelled’)

Post-partum: Uterus contracts in order to return to its original shape

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22
Q

is birth really in stages?

A

most of the medical literature talks about these different stages. These stages are not really easily marked but if you didn’t know about the stage, birth would look like one continuous process.

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23
Q

KNOW THE DIAGRAM ON LECTURE 4 PG 12 OF DIALATION

A
24
Q

What does effacing and dialation of the cervix happen? during pregnancy or around the time labour begins?

A

during pregnancy: cervix is not effaced and there is no dialation

around the time labour begins: cervix is fully effaced and 1cm dialated

25
Q

What is effacing? What happens to the cervix during labour? What is one of the indication that the body is ready to give birth?

A

effacing is a technical term for the dialation of the cervix.

The tiny “opening” will become open during the labour. This diagram is before stage one begins. The big changes that you see is the solid structure that maintains and holds the weight of the baby thins out to a very thin layer that starts open when the baby is getting readt to be born. This is one of the indications that the body is ready to give birth.

26
Q

What is usually
the longest, hardest, and potentially most painful part of giving birth?

A

Getting to “full dilation’ (10 cm diameter) is usually
the longest, hardest, and potentially most painful part of giving birth

27
Q

What is stage one of labour defined by?

A

Stage one is defined by the intensity of contraction rather than dialation. End of stage one is when full dialation is reached .

28
Q

What is the difference between dialation during the beginning of labour, the beginning of stage one, and the end of stage one/beginning of stage 2?

A

beginning of labour: 1 cm
Beginning of stage 1: 5 cm
End of stage one/beginning of stage 2 (10 cm, fully dialated) doesn’t always have to be exactly 10

29
Q

When is pain during normal labour felt? Where are the strongest sensations coming from?

How is this different from back labour? What percentage of labours are back labours?

A

in general:
Pain during labour is felt only during contractions
* In between contractions there is no pain
* The strongest sensations come from the inside of the body

‘back labour’
* Pain may continue to be felt in between contractions * The strongest sensations are felt at the lower back
- 7-10%

30
Q

Where does the belief that the uterus causes pain during pregnancy come from?

A

The strongest sensations come from the abdomen during labour, around the uterus etc. This is where a lot of our belief that it is the uterus that is giving us pain

31
Q

What defines back labour? How does this change pain? What do lots of dulas do to help this? Why can you feel pain other than contractions in back labour?

A

posterior presentation of the baby.

women have back labour where the back of the baby ios facing the back of the mom. What happens then is that the pain can come in between the contractions and the pain comes from the back bone. This is because the head of the baby is pressing towards the back bone of the mom. So lots of dula’s will take 2 tennis balls and put tennis balls against the vertabrae of the mom which alleviates soem of the pain. This is an exception to when pain can come between the contractions. the muscles around the spinal cord have not become denervated which is why you feel this pain

32
Q

What is a babies usual presentation anterior or posterior?

A

anterior

33
Q

What are 4 potential explanations for labour being painful that are not currently contradicted by scientific knowledge?

A
  • Vasoconstriction of uterine blood vessels (There is stretching going on in the blood vessels themselves but threi s also compression (vasoconstriction), when this happens to the uterus blood vessels this could still be sent because the denervation is not as thorough in the endometrium )
  • Release of chemicals from muscle exertion (Chemicals from the muscle exertion. This is similar to muscle pain from the build up of lactic acid. Chemical changes can sometimes be perceived by the body as pain)
  • Inflammation 9Inflammation is known to be contributor to the onset of labour. This is not as well known. (don’t take Ibuprophen when you feel like ur having labour because inflammation has a role in the birth process). The inflammation can also be detected as pain. )
  • Reduced oxygen delivery to tissues (ischemia)
    (recpetors that pick up chemical changes cna also pick up lack of oxygen to the muscles/ in the blood and can cause pain associated with ischemia)
34
Q

When in labour, when should you go to the hospital?

A

before going to the hospital, you should wait until ur contractions are proper contractions at a certain frequency (something liek every 3 or 4 minutes)

35
Q

What brings labour about? What can inflammation lead to the activation of?

A

oxytocin is what brings labour about but inflammation is one of the factors that helps start labour. Inflammation cna lead to the activation of the pain system. The pain aches we fill during the flu is from inflammation. The new concept is that pain is not just due to mechanical things but also chemical things.

36
Q

What does injecting muscle metabolites do?

A

Injecting muscle metabolites evokes sensations of muscle fatigue and pain

37
Q

What deos the Polak et al study show us? how?

A

dose dependency

What happens is that people feel all sorts of sensations and some peopel reported pain. What you see is that if you start injecting a smal amount, 1/10 subjects said they felt something, when you increase the dose increases the number of people that feel somethin (no one is reporting pain yet), when you increase the dose further (peopel start reporting pain) and some people say they experience other things like tension etc, once you release the max amount, everyone reports pain and/or something else.

38
Q

Is there a difference between individual pain and the sensation of pain?

A

There are individual pains and there is also the sensation of pain. Some peopel feel it faster than others as well.

39
Q

What does the Polak et al study show us about possible explanation for labour pain?

A

Antoher thing that is changing with the increase of dose is the duration of the pain sensations. People are asked - how long does the pain sensation go on for and the higher the pain, peopel reported longer durations of pain. Proof of principle that chemicals involved with exertion of muscles are tightly linked with sensory sensations including pain

40
Q

What are metabolites?

A

chemicals involved with the exertion of muscles

41
Q

How does the vasoconstriction of uterine blood vessels work?

A
  • To give birth to the baby, the uterus needs to contract
  • Contractions reduce blood flow to the uterus (and the baby)
  • the contracting myometrium compresses the blood vessels that course through it
  • the stronger (and longer) the contraction, the more blood flow is reduced
  • some hypoxia happens during every contraction
  • Innervation of blood vessels and the endometrium (especially its vascular part) remain during pregnancy and childbirth
42
Q

Why do babies get less blood flow during a contraction?

A

one of the consequences of the vasoconstriction is that the contractions reduce the blood flow to the uterus. The more intesne the contraction, the more squishinfg of the blood vessel is stronger meaning the reduction of blood flow is much larger as well .

43
Q

How does vasoconstriciton during contractions effect oxygen levels for the baby and the muscles in the uterus?

A

Thre is less oxygen going to the baby and the muscles in the uterus

Hypoxia is local in most cases. The baby gets everything from the placena but there is less oxygen bein delivered to the placenta. These blood vessels are also supplying the uterus

44
Q

KNOW THE DIAGRAM ON LECTURE 4 PG 21 of blood vessels constricting

A
45
Q

Why do blood vessels get compressed?

A

This is a microscope image of what the blood vessel looks like in real life. These blood vessels get compressed as the tissue around it contracts.

46
Q

UNDERSTAND THE PICTURE ON LECTUR 4 Pg 22

A
47
Q

What is the modern western cultural view of pain?

A

Pain is an awful, unnecessary part of life that we should eliminate whenever possible.

48
Q

What happens to people with congenital insensitivity to pain?

A

the reason this disorder is possible, is because there is a specific gene related to pain. Pain is also connected to other sensations but what can happen in the case of the person who does not experience pain is that an action doesn’t just feel a certain way, it has the potential to give you an injury. Kids who are born with this disorder sometimes do not make it past 12 because they don’t get this feedback about what not to do. This kind of relates to pain becasue pain tells us what to do and what not to do

49
Q

What are 3 potential benefits of labour pain?

A
  • Guides the birthing woman through the birth process (How to move, how to stand, what to do) (helps them learn how to move their bodies and what not to do. It can guide the person on what to do because we tend to look for things that are less painful when in pain to remove it / This is not necessarily true for excrutiating pain but it is likely true for mild pain)
  • Focuses the woman’s mental and physical resources on the birth process
  • Can regulate the strength of contraction. this greatly benefits the baby - and the mother (There is a physiological level which could also be of benefit. Regulating the strenth of the contractions may help the baby and the mother because of the hypoxia part of it)
50
Q

What does the placenta do?

A

Transports oxygen, nutrients, and waste products

51
Q

How do the mother’s and baby’s blood vessels interact? What separates their blood vessels?

A

Some of the fetus’s blood vessels are contained in a tiny hairlike projections (villi) of the placenta
The mother’s blood passes through the space surrounding the villi (intervillous space). Only a thin membrane (placental membrane) separates the mother’s blood in the intervillous space from the fetus’s blood in the villi.

52
Q

What are villi? What do they look like?

A

villi = the endings of the smallest blood vessels like little mushrooms

53
Q

Why does the baby’s blood vessels interact with the mother’s?

A

The mother’s blood vessels release chemicals like oxygen and nutrients in the space in the middle. The baby also releases waste into the mother’s blood stream (e.g. CO2). the baby is doing the oxygen exchange but it can’t ‘breath it out’ so it breaths out through the blood stream . There is only a thin membrance between the maternal and the baby’s bloodstream.

54
Q

What does the mother’s blood flow deliver to the baby? Where is the placenta usually?

A

the maternal blood flow delivers oxygen and nutrients through the placenta.In many cases the placenta is on the side of the uterus.

55
Q

Does the mother’s blood and the baby’s blood ever actually interact? Why? Where?

A

babies can have different blood tyes but there has to be some exchange between the baby’s and the mom’s blood systems so they can recieve oxygen, nutrients etc. This happens through the placenta

56
Q

UNDERSTAND THE DIAGRAM ON LECTURE 4 PG 25

A

PSYC 207 Midterm 1 (13 decks)

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