Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Physio II (mine) > Maternal, Fetal, and Neonatal > Flashcards

Maternal, Fetal, and Neonatal Flashcards

1
Q

Name the three hormones important to pregnancy

A
  1. hCG (Human chorionic gonadotropin)
  2. Estrogen
  3. Progesterone
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

1st Trimester

A

Corpus Luteum: hCG (Human chorionic gonadotropin) increase
Ovarian: Estrogen and Progesterone increase

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

2nd Trimester

A

Corpus Luteum (regresses): hCG decreased
Placenta: takes over Estrogen and Progesteron production (and increase)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

3rd Trimester

A

Placenta:
* hCG plateaus after decrease
* Decrease in Progesterone
* Continued increase in Estrogen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What do “take home” pregnancy tests check for?

A

hCG

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Two physiological changes in mom

A

Blood Volume increases (1-2 L or 30%)
* Plasma increases more than RBC’s

Hypercoagulability
* Increased Fibrinogen in plasma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Why does moms blood volume increase?

A

Aldosterone = increase in RAAS
RAAS + Estrogen = increased ADH

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Why does mom need more coagulation factors?

A

Body is preparing for blood loss during natural birth
Up to 25% loss

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Moms CO increases by ~30%, Why?

A

SV increased due to more volume (RAAS)
slight HR increase

CO=HRxSV

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Moms BP(MAP) decreases by 5-7%, why?

A

SVR decreases by 25%
release of Nitric Oxide vasodilates peripherals

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Supine Hypotension Syndrome

in 5-10% of women

A

Instead of an increase in SVR to compensate there is a paradoxical parasympathetic response causing hypotension and fetal bradycardia

Treatment: Lay on her left side to decompress IVC

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Increased Progesterone changes pulmonary function, how?

A

Increase in Tidal Volume
1. Progesterone= ⬆ CO2 sensitivity
2. ⬆ VO2 = ⬆ CO2 = ⬆ ventilation
3. (MV=RRxTV) no change in RR but ⬆ in TV = ⬆ PaO2 and ⬇ PaCO2

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Uterine size changes pulmonary function, how?

A

Uterine size ⬆
Pushes up on diaphram (~4cm)
⬇ in RV and FRC
⬇ ERV and ⬆ in IC

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Why does TLC and VC basically remain the same?

A

Increase in abdominal and thoracic dimensions compensate for larger lung expansion (⬆ TV)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

⬆GFR in mom, why?

up to 40% and maintanence

A
  1. Nitric Oxide
  2. Relaxin

Both are vasodilators, ⬆ blood flow

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Relaxin also does what?

A

Makes the pubic symphysis more compliant for birth

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

⬇RBF in 3rd trimester, why?

RBF: Renal Blood Flow

A

ANG II

vasoconstrictor

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

If RBF is ⬇ in the 3rd trimester how does GFR remain elevated?

A

ANG II vasoconstricts after the glomerulus, so bloodflow for filtration does not decrease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Creatinine in mom

A

0.5-0.6 mg/dL
* Normal levels 0.6-1.3

If you see a 1 it is likely pre-eclampsia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Placental hCS in mom

human chorionic somatomammotropin

A

makes mom IR
metabolizes glucose for baby
starts lipolysis (to form FFA) for mom

Gestational Diabetes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Increased Calcitriol and Calcitonin in mom

A

Lower PTH
⬆Ca2+ absorption
⬆PO4- absorption

Not through bone turnover

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Thyroid in mom

A

bone turnover
neural development
At risk: cretinism (hypothyroidism)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What else can hCG bind to?

A

TSH receptors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Trophoblastic nutrition is also called what

A

Uterine milk

yuck

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Main trophoblastic nutrition hormone?
Progesterone
26
Three phases to placental development
1. Adhesion 2. Invasion (two steps) 3. Implantation
27
Adhesion Phase
Trophoblasts stick to endometrial tissue
28
Invasion Phase
Trophoblasts differentiate into two cell types 1. Cytotrophoblasts 2. Syncytiotrophoblasts Sync cells form lacuna which digests moms blood vessels Sync cells directly exposed to moms blood Sync cells produce placental hormones (mostly hCG and some hCS) | hCG: Human chorionic gonadotropin and hCS: human chorionic somatomammotropin
29
Growth Factors | 3
1. IGF (Insulin like) 2. TGF (transforming) 3. EGF (epidermal)
30
Cytotrophoblasts
Inner layer of the trophoblast This anchors the blastocyst to the uterine wall
31
Syncytiotrophoblast
* Fused cytotrophoblasts create this * they extend outward to blood and glands
32
Implantation Phase
Cytotrophoblasts makeup the chorionic cilli -Fetal capillary network -serves as the border between maternal and fetal blood
33
What is Pre-eclampsia | usually in older / diabetic / and obese women
Trophoblasts can not invade deeply into tissues -Growth restrictions
34
What is placenta accreta
Attachment extends into muscle layer (myometrium) -results in continued placental bleeding after birth
35
What are the functions of the placenta | G-LIKE
Acts as the: * Gut * Lungs * Immune modulator * Kidneys * Endocrine glands
36
Increased transfer of drugs across placenta are: | 4 things
1. Low molecular weight 2. Lipid soluable 3. Non-charged 4. Non-protein binding
37
What drugs can cross the placenta? | MOVABLE-II
Most Anticholinergics (Atropine) Opioids Vasopressors Antihypertensives Benzos Local anesthetics Ethanol Induction agents Inhalation anesthetics
38
What drugs cross poorly?
Heparin (Large and charged) Insulin (Large) Muscle relaxants (Ionized and not lipid soluable)
39
1st & 2nd Trimester; which hormone is more important
Progesterone
40
3rd Trimester; which hormone is more important
Estrogen
41
Prostaglandins in the uterus?
These help create contractions
42
What does Progesterone do? | 4 things
Decrease gap junctions decrease oxytocin receptors inhibits prostaglandins creates a more negative resting membrane potential | Basically makes any contraction (aka labor) less likely to occur
43
What does Estrogen do? | 4 things
Increases gap junctions increases oxytocin receptors increases prostoglandin receptors creates a more positive resting membrane potential (enchancing contractions)
44
Braxton hicks contractions?
Flase Labor contractions Does not increase in rate or strength
45
what two things trigger birth?
hormone factors: increase E2:P ratio, prostaglandins and oxytocin mechanical factor: Ferguson reflex
46
what are the phases of birth?
0 - quiescence 1 - myometrial activation 2 - stimulation 3- involution
47
what happens in quiescence?
trimesters 1-2 progesterone and NO high decrease in intracell calc = relax
48
what happens in myometrial activation?
last 6-8 wks increases E:P ratio, PG, relaxin, oxy receptors, gap junc braxton hicks
49
what happens in stimulation?
oxytocin, PG, stretch, uterine contraction
50
what happens in involution
ocytocin, PG decrease post bleed increase uterine repair
51
how much is full dilation?
10 cm
52
labor and delivery stages (stimulation phase)
dilation stage (6-12 hr) contrac to full dilation expulsion stage (20m-2hr) full dilation to baby out placental phase (15m) baby out to placenta out
53
describe ferguson reflex
baby head stretches cervix and positive feedback for oxy and increased contraction at fundus pushes baby down
54
what things would result in decreased contraction?
beta adrenergic, cAMP or NO, if you increase cAMP or cGMP that inhibits contraction
55
what things would result in increased contractions?
Prostaglandin (PGE2 & PF2a) Oxytocin activation of IP3 and DAG IP3 and DAG increase intercellular calc = more muscle contraction
56
what is the APGAR?
10 pt scale of baby check at 1min and 5 min <7 you need to be concerned
57
what does APGAR stand for?
appearance (blue?) pulse (>100) grimace (crys and pulls away) activity (active mvmt) respiration (strong cry) 2-1-0 pts | Less than 7 is bad
58
Twins can be? | 2 types of twins
1. Monozygotic: identical 2. Dizygotic: fraternal
59
Dichorionic diamnionic
Own Sac Own placenta | Twin with*
60
Monochorionic diamniotic
Own sac One placenta | Twin with*
61
Monochorionic monoamniotic
One Sac One Placenta | Twin with*
62
Monochorionic monoamniotic: conjoined twins
One Sac One Placenta the two fetus' are joined
63
how does crying/suckling relay information to the CNS?
sensory afferents
64
regulation of lactation summary
stimulated by decrease in E2 and P after birth sensory information inhibits PIH (dopamine) stimulates oxytocin and Prolactin to be released prolactin causes milk secretions oxytocin causes muscle contraction in breast
65
lactational amenorrhea
prolactin inhibition of FSH and LH *Temporary infertility that accompanies breastfeeding and is marked by the absence of monthly periods*
66
what is bilirubin?
yellow compound made when the liver is breaking down Hb
67
what do neonates do after birth with their Hb?
they try to replace HbF with HbAdult
68
what are the 4 shunts in fetal circulation?
placenta shunt: umbilical vein to liver ductus venosus: umbilical vein to IVC ductus arteriosus: PA to Aorta foramen ovale: opening between LA and RA
69
what are the 6 circulatory changes with fetal vs neonate?
1- loss of placental BF (2x increase in SVR) 2- PVR decreases (lung expand and oxygen) 3- disintegration of umbilical cord (umb vein repaced with round ligament; umbilical artery is now iliac artery) 4- closure of ductus venosus (1-3 hr) blood flows to portal vein 5- ductus arteriosus closes at birth 6- foramen ovale closes at birth
70
what types of mothers/birth would you see low surfactant
premature diabetic
71
fetus vs neonate lungs
fetus- amniotic fluid and movements of breaths neonate- ENaC pump moves water out of lungs
72
transient tachypnea
abnormal fast breathing starts after 4-6 hr from birth give oxygen and wait 1-2 days
73
respiratory distress syndrome
lack of surfactant give surfactant and cpap/vent
74
what are the 3 neonatal respiratory triggers
sensory (being born) mechanical (birth, squeezes lung) chemical stimulation (cut umbilical = acidosis (increased CO2)
75
what are the 3 challenges a neonate faces at birth
hypoxia hypoglycemia hypothermia
76
what things in a neonate cause hypoxia
anesthestic depression Hb phenotype nasal breather soft tissue obstruction ETT may be difficult
77
why is hypoglycemia a problem in neonates?
limited gluconeogensis glucose dependent brain
78
what are the threats for hypothermia for neonates?
radiation conduction convection evaporation

Physio II (mine) (6 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions