Male Reproduction Flashcards
Mastery
Fetal Circulation
… shunts
what are they?
… blood flow
Lung …
7 Weeks Gestation
length?
Foot and hand …
… development
8 Weeks Gestation
length?
Genitalia …
Bones ….
Rays…
The first trimester is the main period of…
Second and third trimesters
- …
Fetal Circulation
Four shunts - F DDP
Foramen ovale, Ductus venosus, Ductus arteriosis, Placenta
Mixed blood flow
Lung by-pass
7 Weeks Gestation
13 - 17 mm
Foot and hand rays
Muscle development
8 Weeks Gestation
23 - 28 mm
Genitalia differentiate, external
Bones start to ossify
Rays separate into toes and fingers
The first trimester is the main period of organogenesis
Second and third trimesters
growth
Fetal Growth Period
…. weeks
continued … of organs and tissues
Growth…
12 weeks
Bone …
length…?
expression?
features?
movement?
hormone?
16 weeks
movement?
reactions?
20 weeks
inside and outside development?
24 weeks?
Fetal Growth Period
9-36 weeks
continued differentiation of organs and tissues
Growth in size and weight
12 weeks
Bone ossification continues
6-9 cm long
smiling, sucking, frowning
Has bone/skin/hair
kicking and moving
Hormone secretion
16 weeks
Grasping, Kicks can be felt
Reacts to sound
20 weeks
Scalp hair and Lung development
Can survive outside womb as young as 24 weeks
Gestation - what is it?
About … weeks from conception. for mom?
Physical changes within Mom
* Uterine …
* Breasts … and develop …
* Volume of blood increases …%
* … gain
* Respiratory activity increases by about …%
* Urinary output …
* Kidneys excrete… from fetus
* Nutritional requirements …
Uterus Changes
Uterus
… size (from ….g)
… volume (from ….L)
… blood supply (from …% of CO)
Braxton Hicks contractions
* sporadic, irregular, asymmetrical, and painless,
not regular or concerning. More common nearer to pregnancy
* low pressure, lasting < 30 sec
Gestation - Pregnancy
About 38 weeks from conception. mom 40 week
Physical changes within Mom
* Uterine enlargement
* Breasts enlarge and develop ability to produce milk
* Volume of blood increases 30%
* Weight gain
* Respiratory activity increases by about 20%
* Urinary output increases
* Kidneys excrete additional wastes from fetus
* Nutritional requirements increase
Uterus Changes
Uterus
↑ size (from 50g-1100g)
↑ volume (from <10ml – 5L)
↑ blood supply (from 1.5% to 20-25% of CO)
Braxton Hicks contractions
* sporadic, irregular, asymmetrical, and painless,
* low pressure, lasting < 30 sec
The Placenta
… factory - what type?
Receives up to …% of CO
… ml/min
Uses as much O2 as ….
Combined – ….
Umbilical cord – …cm long
Maternal Changes
… heart rate / …. stroke volume
… cardiac output
… blood volume
… breathing
The Placenta
Hormone factory - HCG - Cytokines / Growth factors
Receives up to 20% of CO
750-1000 ml/min
Uses as much O2 as fetus
Combined – much more than mother
Umbilical cord – 30-70 cm long
Maternal Changes
Faster heart rate / greater stroke volume
Greater cardiac output
More blood volume
Faster breathing
Gastro-Intestinal Effects
- …. intestines …
- …. motility
- Progesterone effects
↑ …., but leads to … - … and …
- Dietary cravings and pica (non-food cravings)
… – induced - Hyperemia and softening of the gums (epulis)
- Hemorrhoids and …
- Compression of …. by …
Gastro-Intestinal Effects
- Lower and upper intestines raised
- Decreased gastrointestinal motility
- Progesterone effects
↑ absorption, but leads to constipation - reflux and heartburn
- Dietary cravings and pica (non-food cravings)
Progesterone – induced - Hyperemia and softening of the gums (epulis)
- Hemorrhoids and constipation
- Compression of rectum by uterus
Postural / Joint / Other Changes
- Progesterone and relaxin
what does it do?
- Lordosis
what happens?
Postural / Joint / Other Changes
- Progesterone and relaxin
More movement in joint
- Lordosis
keep center of gravity over the legs
back pain…
Weight Gains
Overall gain = …
Fetus = …
Placenta = …
Uterus = …
Breasts = …
Blood and fluid retention = …
Maternal fat = …
Parturition - Stages of labour
Cervical dilation (HIGHER……)
* length?
Delivery of baby
* … is complete
* lasts ~ … minutes
Delivery of placenta
* uterine contractions separates …
* when?
After delivery, uterus …
Weight Gains
Overall gain = ~12.5kg
Fetus = 3.5kg
Placenta = 0.65kg
Uterus = 1kg
Breasts = 0.5kg
Blood and fluid retention = 2kg
Maternal fat = 4kg
Stretch marks
Parturition - Stages of labour
Cervical dilation (higher oxytocin)
* Longest stage
* 2- 24 hours
Delivery of baby
* cervical dilation and effacement is complete
* lasts ~ 30 to 90 minutes
Delivery of placenta
* uterine contractions separates placenta from uterine wall
* usually within 15 to 30 minutes after baby is born
After delivery, uterus shrinks to pregestational size
(involution)
Delivery Complications
- Episiotomy / tears - Slow progression - Vacuum Extraction - C-section - Bleeding - Baby position – breech delivery - Umbilical cord - Uterus rupture / bladder damage
Ectopic Pregnancy
what is it?
* Usually in…
Symptoms:
* pelvic …
* Vaginal …
Pregnancy …
Miscarriage
Aka …
Natural …
* Most common in …
Symptoms:
* Vaginal …
* Cramping and pelvic pain
D and C
Ectopic Pregnancy
Non-uterine implantation, ovum attaches outside uterus
* Usually in fallopian tubes
Symptoms:
* Acute pelvic pain
* Vaginal bleeding
Pregnancy termination
Miscarriage
Aka Spontaneous abortion
Natural termination before fetus is viable
* Most common in first trimester
Symptoms:
* Vaginal bleeding
* Cramping and pelvic pain
D and C
Disorders of Pregnancy
Hyperemesis gravidarum
WHAT IS IT?
Treatment:
* …
second pregnancy …
Toxemia (aka pre-eclampsia)
… trimester
Symptoms:
* …tension
* … weight
* Proteinuria
* … in face, hands, and feet
Treatment:
* Frequent monitoring
* delivery
Disorders of Pregnancy
Hyperemesis gravidarum
Excessive vomiting during pregnancy
Treatment:
* IV fluids
* oral fluids
second pregnancy better
Toxemia (aka pre-eclampsia)
third trimester
Symptoms:
* Hypertension
* Sudden weight gain
* Proteinuria
* Edema in face, hands, and feet
Treatment:
* Frequent monitoring
* delivery
Abruptio placentae
what is it?
* Partial separation may be asymptomatic
- Complete separation
⬧ … pain
⬧ vaginal …
⬧ S…
⬧ ↓ fetal heart tones - HAVE TO DELIVER
Placenta previa
WHAT IS IT
* near or over cervix
Symptoms:
* vaginal …
⬧ third trimester
* …. – if mild
* … - if severe
Abruptio placentae
Separation of placenta from uterus
* Partial separation may be asymptomatic
- Complete separation
⬧ severe abdominal pain
⬧ vaginal bleeding
⬧ Shock
⬧ ↓ fetal heart tones - Delivery
Placenta previa
placenta in lower uterus
* near or over cervix
Symptoms:
* bright red vaginal bleeding
⬧ third trimester
* Vaginal delivery – if mild
* C-section if severe
Division errors
Identical twins
…. division early stage
Conjoined …. division
Later blastula stages
Cleft Lip / Palate
Division errors in weeks …
Genetic ….
Environmental factors
* Alcohol
* cigarette use
* organic solvents
* exposure to lead
* illegal drugs
* Vitamin deficiency
Division errors
Identical twins
Complete division early stage
Conjoined Incomplete division
Later blastula stages
Cleft Lip / Palate
Division errors in weeks 2-8
Genetic disposition
Environmental factors
* Alcohol
* cigarette use
* organic solvents
* exposure to lead
* illegal drugs
* Vitamin deficiency
By teratogens
Eg.
Congenital rubella syndrome (CRS)
…. of the fetus
time of maternal … determines type and severity
* Malformation of heart, eyes, or brain
* liver, spleen, and bone marrow problems.
* growth retardation
* Deafness
Smoking
Effects
… fertility
Placental abruption
Spontaneous abortion
Low birth weight
↑ perinatal death (20+ weeks)
↑ neo-natal mortality
Premature births
Congenital malformations
Behavioural problems – eg. ADHD
↑ childhood cancers
Defects during Pregnancy
By teratogens
Eg. X-rays, syphilis
Congenital rubella syndrome (CRS)
malformations of the fetus
time of maternal infection determines type and severity
* Malformation of heart, eyes, or brain
* liver, spleen, and bone marrow problems.
* growth retardation
* Deafness
Smoking
Effects
↓ fertility
Placental abruption
Spontaneous abortion
Low birth weight
↑ perinatal death (20+ weeks)
↑ neo-natal mortality
Premature births
Congenital malformations
Behavioural problems – eg. ADHD
↑ childhood cancers
Fetal Alcohol Syndrome
premature differentiation of mesenchyme
First … weeks
Cell apoptosis
* leads to…
variable degree of birth defects and mental
retardation
* Cell apoptosis / neural tube cells
DNA damage?
ADHD?
Dietary
what acid do you need
* WHAT DOES IT DO?
* Found in …
Fetal Alcohol Syndrome
premature differentiation of mesenchyme
First 8 weeks
Cell apoptosis
* reduced head size and distinctive facial feature
* Neural effects
variable degree of birth defects and mental
retardation
* Cell apoptosis / neural tube cells
DNA damage?
ADHD?
Dietary
Folic acid
* synthesizes, repairs, and methylates DNA
* Needed for cell division
* RBC production
* Found in fruits and veggies
Neural tube Defects
Due to…
Spina bifida
what is it?
Meningocoele
…
Cerebral Palsy
what causes it?
leads to?
Neural tube Defects
Due to folic acid deficiency
Spina bifida
Incomplete vertebrae formation
Incomplete closure
Meningocoele
Spinal cord lining protrudes
Cerebral Palsy
Decreased oxygen delivery during pregnancy and delivery
muscle tightness or spasms
difficulty with motor skills
* walking or running
* writing or doing up buttons
difficulty in perception and sensation
