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NM705 PP and Newborn > NM702: Module 3/4 > Flashcards

NM702: Module 3/4 Flashcards

1
Q

Processes of Implantation:

1) Loss of the ________ ___________ (“hatching of the _________”) ___ days after fertilization, followed by rapid proliferation of the trophectoderm to form the__________cell mass. This is when the _________ becomes able to attach to the uterus.
2) Adherence of the___________ to the __________surface, which leads to the __________ reaction.
3) Erosion of the epithelium of the __________surface, with burrowing of the__________beneath the surface.

A

1) zona pellucida; “hatching” of the blastocyst; 5 days after fertilization; trophoblast. blastocyst
2) blastocyst; endometrial surface; decidual reaction
3) endometrial surface; blastocyst

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2
Q

Endometrial changes during pregnancy are known as the ___________ ___________.

A

decidual reaction

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3
Q

Blastocyst receives nutrition from digestion of substances in the _____________ tissue and capillaries

A

endometrial

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4
Q

The decidua is divided into _____ sections.

A

3

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5
Q

DECIDUA CAPSULARIS- covers growing ________ and regresses as the__________ grows. Disappears as the ________ fills the lumen of the uterus

A

embryo; chorion; embryo

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6
Q

DECIDUA BASALIS- spongy vascular bed on which the ____________rests. The site of the future__________. Forms _________ portion of ________. Where the interface between the mom and_________ is- changes happen here to support__________ and_________.

A

blastocyst;
placenta;
maternal, placenta;
trophoblast; adhesion migration

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7
Q

DECIDUA PARIETALIS- the remaining ________. Fuses with the __________and ________at ________weeks and the uterine cavity is __________.

A

decidua;
amnion and chorion; 18-20 weeks;
obliterated

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8
Q

The trophoblast attaches to endometrium ____ days after fertilization, fully implanted by day _________.

A

5-6 days; 10 to 12

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9
Q 
The \_\_\_\_\_\_\_\_\_ is responsible for:
Erode maternal tissue to make space for implantation and growth
Secrete hormones
Transport nutrients and waste products
Placental attachment
Migration and arterial transformation
A

trophoblast

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10
Q

The _________ layer of the trophoblast produces __________ which maintains the __________ _________.

A

outer; hCG; corpus luteum

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11
Q

The _______________ is the _________ layer of the blastocyst and develops into the __________

A

trophoblast; outer; placenta

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12
Q

_________ __________ can occur if trophoblast invasion is too extensive.

A

Placenta accreta

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13
Q

When does the amniotic cavity form?

A

During the 2nd week following fertilization.

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14
Q

What is the source of early amniotic fluid?

A

maternal serum

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15
Q

When does blood flow into the intervillous space begin? And when do the spiral arteries become patent and fetal oxygen levels increase?

A

8-9 weeks; 11-12 weeks

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16
Q

An ectopic pregnancy is an ___________ pregnancy.

A

extrauterine.

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17
Q

What do we believe has caused a rise in ectopic pregnancies in recent years?

A

the rise in STI’s and PID

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18
Q

Initial placental and embryonic development occur in a _____________ environment.

A

hypoxic

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19
Q

What disease is associated with alteration in hypoxia inducible factors in development of the placenta?

A

Preeclampsia

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20
Q

When is fetoplacental circulation established between the villi and embryo?

A

about day 21

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21
Q

Alterations in development of the villous system can lead to _______ or _________ ________ __________.

A

miscarriage; fetal growth restriction

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22
Q

Placenta reaches full maturation at ___ to ___ days and is indicated by ___________ of the maternal _______ ___________.

A

40-50; erosion of maternal spiral arterioles; also when chorion or outer fetal membrane is formed.

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23
Q

What causes placenta to continue to grow?

A

Proliferation of terminal villi results in increased surface area.

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24
Q

The placenta covers _____ of the inner uterine surface.

A

1/3 or 33%

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25
Q

Fetus becomes larger than placenta at __ to __ wks.

A

15-16

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26
Q

Fetus is ________ times heavier than the placenta at birth.

A

5-6

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27
Q

The fetal side of the placenta is covered by the ____________ ____________.

A

chorionic plate

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28
Q

____________ refers to the lobes of the placenta on the maternal side.

A

Cotyledon

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29
Q

What is the purpose of the placental membrane?

A

separate maternal and fetal circulation

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30
Q

When can the umbilical cord be seen on u/s?

A

by 42 days

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31
Q

The cord has two ___________ and one ________.

A

arteries; vein

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32
Q

The twist or spiral of the cord is established by ____ wks gestation. An uncoiled cord is associated with _________, _____________, ____________, and ___________.

A

9; fetal growth restriction, oligohydramnios, fetal anomalies, and preterm delivery.

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33
Q

Insertion of the cord within 1.5cm of the placental margin is called ____________ ____________ or ___________ _____________.

A

battledore placenta; marginal insertion

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34
Q

With a _________________ insertion the cord inserts into the membranes, causing the vessels to run between the _________ and _______ before entering into the placenta. This is more common in ____________.

A

velementous; chorion and amnion; multiples.

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35
Q

Maximal cord length is usually reached by _______ weeks and average length is _______ to ________cm. Shortest cord for vaginal delivery is thought to be _____ cm.

A

30 weeks; 55-60cm; 32cm

36
Q

The ___________ adheres to the decidua.

A

chorion

37
Q

What happens to produce FFN?

A

Protein expelled when the decidua and chorion separate.

38
Q

The umbilical arteries carry _________ blood and the umbilical vein carries ____________ blood.

A

deoxygenated; oxygenated

39
Q

Name five placental functions:

A

1) Metabolic-contributes to quality & quantity of nutrient supply
2) Endocrine- important for maintaining pregnancy and inducing metabolic adaptations
3) Immunologic- Protection from pathogens and prevention of rejection by mother
4) Transport- bidirectional movement of gases, nutrients, waste, drugs, and other substances
5) Radiator - 85% of fetal heat production transmitted to mother via placenta

40
Q

What four major hormones are sythesized by the placenta?

A

hCG, hPL, progesterone, and estrogen

41
Q

hCG is detected in maternal serum and urine ___ to ___ days after ofulation.

A

7 to8

42
Q

When is there enough hCG to give a pos pregn test?

A

3 weeks after conception

43
Q

hCG levels double every ___ to ___ days and peak at __ to __ days after conception.

A

2 to 3; 60 to 90

44
Q

Low hCG levels are associated with ________ ______ or ______ _______; high hCG levels are associated with _______ or ________ _________.

A

abnormal placenta; ectopic pregnancy;

hydatiform mole; multiple gestation

45
Q

Primary role of hPL is to regulate ___________________

A

glucose availability for the fetus.

46
Q

What is the major mechanism of placental transport?

A

Diffusion

47
Q

What transport mechanisms do protein and other transport substances mediate?

A

facilitated diffusion and active transport.

48
Q

What is simple diffusion? what substances are transported by this route?

A

Movement of substance from higher concentration to lower concentration.
Water, electrolytes, o2, CO2, urea, etc.

49
Q

What is facilitated diffusion? what substances are transported by this route?

A

Transplacental protein mediated diffusion. higher to lower concentration.
Glucose and some O2, waste products (lactate)

50
Q

What is active transport? what substances are transported by this route?

A

Uses energy-dependent carrier systems and other protein transporters; lower to higher concentrations.
amino acids, potassium, water sol vits, calcium, phosphate, iron, iodine

51
Q

Endocytosis and exocytosis are necessary for:

A

transfer of molecules too large for diffusion and which no carrier transport exists.

52
Q

Bulk flow, solvent drag, and water channels all refer to:

A

water crossing the placenta.

53
Q

What type of bacteria can cross the placenta through independent moverment?

A

Treponema pallidum (syphilis)

54
Q

What are the two functions of the ovary?

A

gametogenesis and steroid hormone synthesis

55
Q

______________ and ______________ have significant effects on tubal and uterine motility, endometrial proliferation and the properties of the cervical mucus.

A

Estrogen and progesterone

56
Q

How many follicles mature and are ovulated each month? How does one follicle become dominant?

A

One; Dominant follicle begins to function independent of FSH by secreting inhibin. Inhibin then inhibits secretion of FSH by the pituitary which causes the other follicles, dependent on FSH, to regress and degenerate.

57
Q

When does estrogen peak before ovulation and what is the role?

A

Peaks 24 hrs before ovulation; stimulates proliferation of the endometrium, thinning of cervical mucus, and LH secretion.

58
Q

When does progesterone peak before ovulation and what is the role?

A

Peaks 12-24 hrs before ovulation; elicits a rapid and marked surge in LH secretion, which stimulates ovulation.

59
Q

The first meiotic division occurs ____ to ________ __________ before ovulation.

A

10 to 12 hours

60
Q

The second meiotic division occurs at ___________. It ________ in metaphase and is not complete until ___________.

A

ovulation; arrests; fertilization

61
Q

An unfertilized ovum will generally live _____ hours.

A

less than 24 hours.

62
Q

The ______ ____________ is formed when the granulosa cells undergo a _____________ process.

A

corpus luteum; lutenizing

63
Q

When does the corpus luteum start secreting progesterone?

A

Within 30-40 hrs of the LH surge.

64
Q

What secretes hCG? What are the functions of hCG?

A

Trophoblast secretes hCG.

1) stimulates the corpeus luteum to continue to function
2) prevent release of substances that result in luteal regression

65
Q

If fertilization does not occur, the corpus luteum will undergo ____________ mediated by _______________ and ____________ begins.

A

apoptosis; prostaglandins; involution

66
Q

The mucleus of the sperm is reactivated when the sperm enter the ____________ of the ___________.

A

cytoplasm; ovum

67
Q

Normal ejaculate is ___ to ___ ml. There are approx _____________ sperm per ml.

A

2 to 6 ml; 100 million sperm per ml.

68
Q

Men with less than ________ sperm per ml are likely to be sterile.

A

10 million

69
Q

Sperm become motile after reaching __________________.

A

the female reproductive tract.

70
Q

To be considered fertile, ___% of sperm should be motile within ___ hrs after ____________.

A

40%; 2 hours; ejaculation

71
Q

Sperm retain the ability to fertilize the ovum for ___ to ___ days, but most do not live longer than ___ hours.

A

1 to 3; 48 hours

72
Q

Cervical mucus has _________ _________ at mid cycle ( ___ to ___ days) which facilitates the sperm migration.

A

reduced viscosity; 9 to 16;

73
Q

Fertilization usually occurs in the _____ ____ of the fallopian tube.

A

upper 1/3

74
Q

_________ to ___________ sperm are found in the fallopian tube at any given time.

A

300 to 500

75
Q

Why does it require more than one sperm for fertilization to occur?

A

It takes many sperm to produce the enzymes needed for the acrosome reation.

76
Q

In the acrosome reaction small openings appear in the _____ of the sperm and ___________ are released that are needed to open the __________ _____________.

A

head; enzymes; zona pellucida

77
Q

The zona pellucida is responsible for:

A

sperm activiation, preventing fertilization by more than one sperm, protecting the ovum before fertilization and protecting the fertilized ovum until shortly before implantation.

78
Q

The ___________ is formed when the male and female ________________ fuse.

A

zygote; pronuclei

79
Q

The zygote divides about ___ hours after fertilization.

A

30

80
Q

Pregnancy test measure __________ the first 10 days after fertilization.

A

EPF (Early pregnancy factor)

81
Q

Cell division occurs every _____ to _________ hours following the first division.

A

12 to 24

82
Q

The _____________ is formed approximately 3 days after fertilization.

A

Morula

83
Q

Embryonic genome is activated when?

A

by the 2 to 4 cell stage.

84
Q

When is the preembryonic period?

A

From conception and zygote formation to 2weeks gestation

85
Q

The embryonic period lasts from ____ weeks after fertilization to the ____ of the ____ week.

A

2; end of the 8th week

86
Q

The embyronic period is the period of _______________.

A

organogenesis

87
Q

The ___ week of development coincides with the first missed period.

A

3rd

NM705 PP and Newborn (3 decks)

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