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Term 2 > OB (outcome 2 & 3) > Flashcards

OB (outcome 2 & 3) Flashcards

1
Q

What 2 phases is the endometrial cycle divided into?

A
  • proliferative/follicular phase

- secretory/luteal phase

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2
Q

Proliferative/Follicular Phase

A
  • 1st half of menstrual cycle
  • gradual thickening of functional layer (proliferation)
  • in response to estrogen
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3
Q

Secretory/Luteal Phase

A
  • 2nd half of menstrual cycle
  • increased vascularity and preparation for implantation (differentiation)
  • in response to progesterone (mostly) and estrogen
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4
Q

What day does menstrual bleeding mark?

A

1

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5
Q

What does menstrual bleeding happen in response to?

A
  • decrease in estrogen and progesterone levels

- endometrium starts to break down and shed

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6
Q

After menses, what do rising levels if estrogen form?

A

-new functional layer of endometrium

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7
Q

How many mm is the endometrium in the later proliferative phase (trilaminar)?

A

11mm

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8
Q

What happens in the secretory phase?

A
  • after ovulation

- levels of estrogen and progesterone prepare endometrium to accept the blastocyst

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9
Q

How do estrogen and progesterone prepare endometrium to accept the blastocyst?

A
  • thickening of endometrium
  • more blood vessels develop
  • uterine glands get bigger
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10
Q

What is the sono appearance of the endometrium in the secretory phase?

A

-hyperechoic

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11
Q

Series of Ovarian Events Involved in Ovulation

A
  • oocyte maturation
  • ovulation
  • release of mature ovum into fallopian tube
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12
Q

3 Phases of Ovarian Cycle

A
  • follicular
  • ovulatory
  • luteal
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13
Q

Follicular Phase (ovarian cycle)

A
  • group of primary follicles begin to develop (FSH)
  • produce estrogen
  • 1 follicle becomes dominant (produces more estrogen and the rest of the follicles undergo atresia)
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14
Q

What does the dominant follicle become?

A
  • graafian follicle

- moves toward ovarian wall

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15
Q

Cyclical Endometrial Changes

A
  • occur at a young age (11 to 13)
  • 1st menstrual period (menarche)
  • absent before puberty
  • absent in post menopausal women
  • can be absent with hormonal imbalances, BCP and hormone therapies
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16
Q

Ovulatory Phase (ovarian cycle)

A
  • LH surge causes follicular and ovarian wall to rupture
  • ovulation occurs
  • mature ovum gets picked up by fimbriae
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17
Q

Mittelschmerz

A
  • mid cycle pain

- symptom of ovulation

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18
Q

Signs of Ovulation

A
  • mittelschmerz (mid cycle pain)

- small amounts of fluid in PCDS

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19
Q

Luteal Phase (ovarian cycle)

A

-graafian cavity collapses and forms into corpus luteum (CL)

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20
Q

What hormones does the corpus luteum secrete?

A
  • progesterone (mostly)

- estrogen (some)

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21
Q

How many days does the corpus luteum last?

A
  • 12 to 14 days

- unless it receives hCG from gestational sac

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22
Q

What happens to the corpus luteum without fertilization?

A
  • corpus luteum degenerates
  • becomes corpus albicans
  • decrease in progesterone
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23
Q

What does the hormonal cycle involve?

A

Interactions of Several Hormones:
-GnRH (gonadotropin releasing hormone)

  • FSH (follicle stimulating hormone)
  • LH (luteinizing hormone)
  • estrogen
  • progesterone
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24
Q

What is the hormonal cycle controlled by?

A

-negative and positive feedback loops

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25
Q

Day 1 to 5 of Menstrual Cycle

A
  • low levels of estrogen and progesterone initiate + feedback to hypothalamus (increase in GnRH, FSH and LH)
  • FSH stimulates follicles
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26
Q

Day 5 to 13 of Hormonal Cycle

A
  • growing follicles produce estrogen (done by Graafian follicle later on)
  • high levels of estrogen lead to endometrial thickening
  • FSH causes maturation of dominant follicle into graafian follicle
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27
Q

Day 14 (ovulation) of Hormonal Cycle

A
  • high estrogen levels cause LH surge
  • enzymes released that degrade follicular wall (ovulation)
  • LH also stimulates formation of CL from collapsed dominant follicle
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28
Q

Day 15 to 28 of Hormonal Cycle

A
  • CL produces progesterone and estrogen (endometrium continues to thicken)
  • high levels of progesterone and estrogen (activate negative feedback to hypothalamus and ant. pituitary gland)
  • no FSH and LH
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29
Q

Amenorrhea (symptom of early pregnancy)

A
  • consistant levels of estrogen and progesterone from corpus luteum and placenta later
  • results in complete cessation of menstrual cycle
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30
Q

Symptoms of Early Pregnancy

A
  • amenorrhea
  • morning sickness
  • breast changes
  • urinary frequency
  • abd enlargement
  • quickening
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31
Q

Morning Sickness (symptom of early pregnancy)

A
  • high levels of hormones
  • altered metabolism
  • physical changes
  • fluctuating BP
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32
Q

Hyperemesis Gravidarum

A

-severe nausea and vomiting

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33
Q

Breast Changes (symptom of early pregnancy)

A
  • sensitive to changes in estrogen

- enlargement may be felt as early as 6 weeks

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34
Q

Urinary Frequency

A
  • caused by hCG
  • blood volume increases, causing more filtration through kidneys
  • pressure of enlarged uterus on bladder
  • stress incontinence (caused by coughing, sneezing, laughing or exercise)
35
Q

Abd Enlargement @ 10 to 12 Weeks

A

-fundus is just above symphysis pubis

36
Q

Abd Enlargement @ 16 Weeks

A

-half way between symphysis and umbilicus

37
Q

Abd Enlargement @ 20 Weeks

A

-@ umbilicus

38
Q

Abd Enlargement @ 36 Weeks

A

-fundus just below xiphoid process

39
Q

Quickening (symptom of early pregnancy)

A
  • perception of movement by mother
  • 1st pregnancy is let between 18 to 20 weeks
  • 2nd/3rd pregnancy is felt at 16 weeks
40
Q

B-hCG

A
  • glycoprotein produced during pregnancy

- detected in mothers blood and urine

41
Q

In the initial stages of pregnancy, B-hCG is important in maintaining what?

A

-corpus luteum (allows continued production of estrogen and progesterone, maintaining the thickened, vascular endometrium)

42
Q

2 Types of Pregnancy Tests

A
  • qualitative

- quantative

43
Q

Qualitative Pregnancy Test

A

-assess amount of B hCG in urine

  • will show positive or negative based on amount
  • if negative, if can be repeated a few days later (hCG rises quickly)
44
Q

Quantitative Pregnancy Test

A

-assesses amount of B hCG in blood

  • for singelton pregnancy between 3 to 5 weeks, B hCG will double every 2 to 3 days
  • after 6 weeks, it slows down and peaks at 8 to 12 weeks
45
Q

Gravida

A

-# of pregnancies

  • twins are 1
  • miscarriage is 1
  • includes current pregnancy
46
Q

Nulli Gravida (G0)

A

-never pregnant

47
Q

Primi Gravida (G1)

A

-1st pregnancy or has only been pregnant once

48
Q

Multi Gravida (ex. G3)

A

-has been pregnant more than once

49
Q

Para/Parity

A

-# of viable births

  • twins are 1
  • any birth over 20 weeks (including stillbirths) counts
50
Q

Abortus

A

-# of pregnancies lost for any reason

  • ex. A#
  • includes abortions and miscarriages
51
Q

TPAL

A

-used to provide patient obstetrical history

T- term births (after 37 weeks gestation)
P- premature births
A- abortions/miscarriages
L- living children

52
Q

Ho many weeks do most pregnancies last?

A
  • 40 weeks from LMP
  • 280 dyas
  • can be +/- 2 weeks
53
Q

A pregnancy before ___ weeks in considered premature.

54
Q

Trimesters

A

1st- 1 to 13 weeks
2nd- 14 to 26 weeks
3rd- 27 weeks to term

55
Q

Gestational Age (GA)

A

= conceptual age + 2 weeks

-aka menstrual age

56
Q

How is gestational age measured?

A

-weeks from last normal menstrual period to the current date

57
Q

Conceptus Period

A

-3rd to 5th weeks since LMP

58
Q

Embryonic Period

A
  • 6th to end of 10th week since LMP
  • involves the completion of organogenesis (formation of organs)
  • after this, it is a fetus
59
Q

EDD

A
  • estimated date of delivery

- expected due date

60
Q

EDC

A
  • estimated date of confinement

- expected date of confinement

61
Q

How is due date calculated?

A

-wheel or software on US machine

62
Q

Conception

A

-combining of an oocyte (mature ovum) and a spermatozoon

63
Q

When does conception occur?

A
  • within 24 to 36hours of ovulation

- day 14/15 of cycle

64
Q

Where does conception occur?

A

-ampullary region of fallopian tube

65
Q

What does conception form?

A

-single cell zygote

66
Q

How many chromosomes does a zygote have?

A
  • 46 (23 from each parent)

- 22 autosomal pairs, plus 1 pair of sex chromosomes (XY/XX)

67
Q

3 Parts of a Blastocyst/Blastula

A

1) trophoblast
2) embryo blast/ICM
3) blastocele

68
Q

Trophoblast (blastocyst)

A
  • future placenta (embryonic part)

- produces hCG that supports CL

69
Q

Embryoblast/ICM (blastocyst)

A

-will develop into embryo

70
Q

Blastocele (blastocyst)

A

-fluid filled cavity

71
Q

What day does the blastocyst implant?

A
  • 20 to 23 of LMP (5 days after fertilization)

- continues to develop after it burrows

72
Q

What does development of an embryo involve?

A
  • decidua
  • blastocyst
  • amniotic cavity
  • chorion
  • yolk sac
  • gastrulation
73
Q

Decidua

A

-endometrium during pregnancy

74
Q

Blastocyst

75
Q

Amniotic Cavity

A

-houses pregnancy within gestational sac

76
Q

Chorion

A

-develops into placenta

77
Q

Yolk Sac

A

-provides nutrients to fetus

78
Q

Gastrulation

A

-3 germ cell layers

79
Q

Decidual Reaction

A
  • changes that occur in the endometrium
  • due to estrogen and progesterone from the CL
  • involves further development and growth of endometrium
80
Q

3 Layers of Decidualized Endometrium

A

1) decidua basalis
2) decidua capsularis
3) decidua parietali/vera

81
Q

Decidua Basalis

A
  • aka decimal plate
  • site of blastocyst attachment
  • develops into maternal part of placenta
82
Q

Decidua Capsularis

A

-covers blastocyst and separates it from endometrial cavity

83
Q

Decidua Parietalis/Vera

A

-remainder of endometrium (not directly in contact with blastocyst)

84
Q

How long does implantation of the blastocyst take?

Term 2 (19 decks)

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