OB exam 1- Repro Health & Fam Flashcards by Jane Daum

mons pubis

protects pelvic bone

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labia majora

protects underlying tissue

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labia minora

inner folds of skin that protect the opening of the vagina and produce bactericidal secretions

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clitoris

female erectile tissue

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urethral meatus

the structure urine comes out of

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skene’s glands

lubricates the vaginal opening

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hymen

surrounds vaginal opening

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perineal body

fibromuscular area of the vulva between the anus and vagina that stretches for delivery

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vagina

a muscular membranous tube that connects the external genitals w/ the uterus “birth canal”

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fundus of the uterus

the rounded muscular upper portion of the uterus that we massage after birth to control bleeding

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anterior fornix

the area closer to the front of mom’s body

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posterior fornix

the area around the cervix where semen can pool and collect near the backside of mom’s body

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when not pregnant, the female uterus is typically tilted in what direction

posterior then as pregnancy goes on it moves more anteriorly

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where does implantation of the fertilized egg occur

endometrium (the inner most layer)

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broad ligament

the sheet that covers the pelvic cavity to help provide stability for the uterus in the pelvis and keeps it centrally placed

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round ligament

help keeps the uterus in place and pulls the uterus down & forward to help the fetal presenting part get into the cervix in a good position bounces -> pulls up and down which can cause pain

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cardinal ligament

chief uterine support helps suspend the uterus in the true pelvis which helps the uterus from prolapsing into the vagina
if prolapse occurs, think cardinal dysfunction

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what is a common reason for prolapsing of the uterus

when the mother has a history of having large babies bc the ligaments become more stretched

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isthmus

connects fallopian tube to the uterus
what we cut when a women gets her tubes tied

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ampulla

the site where fertilization occurs

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fimbriae

finger like projections that help to reach in and grab the egg to bring into the fallopian tube

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ovaries

holds all the women’s egg and helps control hormones

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what is the primary source for estrogen and progesterone before pregnancy

the ovaries

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what is the primary source of progesterone once pregnant

the placenta once formed

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what is a complication if progesterone levels are low

women struggle to get pregnant and/or struggles to maintain pregnancy

false pelvis

supports the weight of an enlarged pregnant uterus and helps to direct the fetus into the true pelvis **the hips**

true pelvis

the size must be adequate for the baby to pass through to allow for a vaginal delivery **if not then cephalic pelvic disproportion** made up of the pelvic: inlet, cavity & outlet

pelvic inlet

determines if engagement of the baby's head can occur

pelvic cavity

the curved bath

pelvic outlet

can the baby pass through the pubic arch and if not then can have outlet or shoulder dystocia

ischial spine

narrowest part of the bony pelvis and plays a role in fetal station **determines if the baby can be delivered vaginally (part of the true pelvis)**

breast reduction & implants and breastfeeding

breast reductions takes tissue so it will make it harder to BF but it is still possible with lots of stimulation **feed more often & pump** implants add to the breast so do not cause a problem

estrogen

**female like characteristics** breasts, widening of hips & uterus, increases body hair and sexual desire

progesterone

stabilizes uterus for implantation after fertilization, makes cervix secrete thick protective mucus, involved with lactation & increased breast granular tissue

prostaglandins

fatty acids that work together to both relax then constrict smooth muscles in the arteries

FSH

"follicle stimulating hormone" helps egg follicle to mature

"luteinizing hormone" causes a decrease in estrogen production while allowing progesterone' secretions to continue

what are the two phases of the ovarian cycle

follicular (days 1-14) Luteal phase (days 15-28)

follicular phase

-immature follicle matures (producing egg) as result of **FSH & estrogen** -Oocyte grows in follicle -ovum (mature egg) discharged into fimbria of fallopian tube **at the same time, the endometrial lining will shed (menstrual phase) and then build back up (prolif pahse)**

luteal phase

-ovum leaves follicle -ovum remains in ampulla if fertilized -reaches uterus in 72-96 hrs after release then implants into endometrium & secrets human chorionic gonadotropin (hCG) **if not fertilized, ischemic phase** **if fertilized, secretory phase**

what days in a 28 day cycle is a women most fertile

days 13-15 **during ovulation**

what is day 1 of a cycle

the first day of bleeding

what day in a 28 day cycle is considered ovulation

day 14

in the proliferative phase, what change occurs to the women's discharge to make it better for sperm

cervical mucus will become more elastic, thin and clear

if the egg is fertilized, what will the follicle turn into

the corpus luteum and will produce progesterone to support the pregnancy until the placenta is developed

secretory phase

after ovulation & fertilization has occurred, progesterone causes marked swelling of epithelium, vascularity of uterus increases to provide nourishing bed for implantation

four phases of the menstrual cycle

1) menstrual 2) proliferative 3) secretory 4) ischemic

when does the ischemic phase occur and what happens

happens if fertilization/implantation does not occur -> estrogen and progesterone levels decrease, corpus luteum degenerates and bleeding occurs *AKA start of menstrual phase*

what is the purpose of the male scrotum

protect and control temperature of sperm

where is sperm produced

the testes

how long are the ova fertile after ovulation

12-24 hours

how long does sperm live

48-72 hours

how many chromosomes from each sperm and egg

23 **female = XX** **male = XY**

when chromosomes pair up what are they called

diploid zygote (46 chromosomes)

mitosis

-growth and tissue repair -process by which our body cells divide and replace themselves -exact copies of original cell

meiosis

process leading to development of egg & sperm to create a complete embryo **occurs during gametogenesis**

of the sac attached to the placenta, what is the inner and outer layer

inner: amnion outer: chorion

what provides nutrition to the fetus until placenta takes over

the yolk sac (first 12 wks)

polyhydramnios

have more fluid than anticipating for either GA or >2000ml **seen in twin pregnancy's or in mothers w/ uncontrolled DM**

Oligohydramnios

less than 400ml of amniotic fluid or when AFI is less than 5 (normal is 5-25) **seen w/ htn, kidney issue w/ baby or bladder obstruction**

placental function

-immunologic properties -excretion -fetal respiration -production fetal nutrients -production of hormones

twins: two separate eggs each fertilized by a different sperm

fraternal

twins: one egg that is fertilized by the same sperm that then splits

identical

twins: one egg fertilized by one sperm and then the blastocyst divides around day 5, fetuses share a chorion and placenta but each have their own bag of water

identical mono/di

twins: two eggs, two sperms and the blastocyst divides quickly creating two water bags and two chorion

fraternal di/di

twins: one egg, one sperm and the blastocyst divides quickly creating two water bags and two chorion w/ a fused placenta

identical di/di **risk is that one baby hogs the placenta**

twins: one egg, one sperm and the blastocyst divides around days 8-12, fetuses share a chorion and water bag

identical mono/mono **high risk for cord tangling**

functions of amniotic fluid

-cushions -controls temp -allows movement -can be analyzed -promotes G&D **esp lungs**

what L/S indicates the baby's lungs have matured

>/ 2:1

umbilical cord structure

2 arteries: carries deoxygenated blood and waste from baby to placenta 1 vein: carries oxygenated blood from placenta to baby

embryonic development: week 4

-**heart beat** -arm & leg buds are present -somites develope (vertebrae) -primary lung buds present -eyes and ears begin to form

embryonic development: week 6

-body is straighter -trachea developed -nares present -liver produces blood cells -**heart begins circulating blood** -digits develop -tails begins to recede

embryonic development: week 12

-**spontaneous movements** -face well dev -eyelids closed -tooth buds appear -genitals are well differentiated -urine is produced -**fetal heart tones w/ doppler**

embryonic development: week 20

-**fetal movement felt by mother** -brown fat -vernix begins to form -lanugo over entire body -nipples and nails are present -fetal heartbeat head by fetoscope

embryonic development: week 24

-eyes complete -vernix caseosa covers skin -alveoli beginning to form -both grasp & startle reflex -finger & foot prints **considered viable at this stage**

embryonic development: week 28

-brain develops rapidly -**nervous system begins to regulate** -eyelids open -testes begin to descend -lungs can provide gas exchange

embryonic development: week 36

-increase in subcutaneous fat -**lanugo begins to disappear**

embryonic development: week 38

-official full term (**37 is term**) -**skin smooth & polished** -**vernix caseosa only in creases and folds** -head bigger than chest