OB unit 1 Flashcards

0
Q

III. OOGENESIS

A

A. The process of female gamete production

B. The female gonad is the ovary

C. The female gamete is called the ovum or egg

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1
Q

Spermatogenesis

A

A. The process of male gamete production

B. The male gonad is the testis

C. The male gamete is called spermatozoa

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2
Q

XII. FUNCTION OF PROGESTERONE

A

A. Called the hormone of pregnancy
B. Causes the endometrium to increase in vascularity
C. Increases glycogen stores in endometrium
D. Supports endometrial lining
E. Causes cervical mucus to become “thick and sticky”
F. Relaxes smooth muscles

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3
Q

Progesterone

A
  • increase causes maturation of mammary gland tissue
  • hCG continues the supply of estrogen and progesterone needed to maintain pregnancy.
  • miscarriage occurs if the corpus luteium stops functioning b4 the placenta is producing sufficient estrogen and progesterone.
  • The placenta eventually produces more of the steroid hormone progesterone than the corpus luteium does during the first months of pregnancy.
  • Progesterone maintains the endometrium, decreases the contractility of the uterus, and stimulates maternal metabolism and development of breast alveoli.
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4
Q

XI. FUNCTION OF ESTROGEN

A

A. Causes the endometrium lining to thicken in preparation for implantation
B. Controls the development of secondary sexual characteristics
C. Aids in maturation of the ovum
D. Causes changes in cervical mucus
1. Becomes more thin and watery – “spinnbarkheit”
E. Increase contractibility of tubes
1. Propel large ovum thru tube
-stimulates growth of breasts by inducing fat deposition in the breasts.
- estrogen also increases the vascular its of Breast tissue

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5
Q

Estrogen

A
  • Women over 50 experience menopause associated with decreased estrogen.
  • Decrease causes numerous cytologic and structural changes of the vagina, vulva, and lower urinary tract.
  • Deficiency leads to narrowing and shortening of the vagina and thinning of the vaginal walls, resulting in vaginal dryness, itching, burning, and dyspareunia.
  • Loss causes reduced smooth muscle relaxation, decreased vaginal secretions.
  • It plays a role in formation of bone matrix, and a decrease mY lead to osteoporosis.
  • Declining estrogen can increase the risk for heart disease.
  • Decrease can cause a relaxation of ligaments and connective tissue, which effects the support of the bladder and uterus.
  • Decrease affects the hypothalamus, causing hot flashes.
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6
Q

estrogen

A
  • miscarriage occurs if the corpus luteium stops functioning before the placenta is producing sufficient estrogen and progesterone.
  • By 7 weeks after fertilization the placenta is producing most of the maternal estrogens.
  • The major estrogen secreted by the placenta is estriol, whereas the ovaries produce mostly estradiol.
  • estriol levels may be measured to determine placental functioning.
  • It stimulates uterine growth and uteroplacental blood flow.
  • Causes a proliferation of the breast glandular tissue and stimulates myometrial contractility.
  • Placental estrogen production increases greatly toward the end of pregnancy.
  • lactation delays the production of cervical and other estrogen-influenced mucus and mucosal characteristics.
  • Postpartum estrogen deprivation is responsible for the thinness of the vaginal mucosa and absence of rugged
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7
Q

I. Implantation

A

A. The trophoblasts attaches itself to surface of endometrium
1. Most frequent site of attachment is fundus
B. 6-10 days after conception, burrows into uterine lining
C. Cells of trophoblast grow down into the endometrium forming fingerlike projections called
“chorionic villi” which allow early exchange of oxygen and carbon dioxide

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8
Q

II. CELLULAR DIFFERENTIATION

A

A. 10 - 14 days after fertilization, blastocyst cells differentiate into primary germ layers
B. All tissues, organs and structures will develop from one of these three layers

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9
Q

III. DEVELOPMENT OF EMBRYONIC MEMBRANES

A

A. Chorion-outermost
1. Encloses amnion and embryo
2. Chorionic villi on the surface
3. Villi grow into endometrium & form fetal part of placenta
4. Rest of chorion lose villi except where attached to uterine wall
B. Amnion-inner
1. Thin, protective membrane
2. Contains amniotic fluid
3. As baby grows, comes in contact with chorion
**Eventually the chorion and the amnion “fuse” to form the “bag of waters”

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10
Q

IV. AMNIOTIC FLUID

A

A. Functions as cushion to protect FETUS & CORD against injury
B. Helps control embryo’s temperature
C. Allows symmetrical external growth of embryo
D. Prevents adherence of amnion to embryo
E. Allows freedom of movement
F. Can analyze to determine fetal health and maturity
G. Amount of amniotic fluid
—10 weeks ~ 30 ml
—20 weeks ~ 350ml
—After 20 weeks ~ 800 - 1200 ml
H. Amniotic Fluid index
1. Method to evaluate the ‘wellness’ of the baby
a. Oligohydramnios-deficiency of amniotic fluid.
b. Polyhydramnios-excessive amniotic fluid

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11
Q

V. DEVELOPMENT OF PLACENTA

A

A. Means of O2, CO2 and nutrient exchange btw embryonic and maternal circulation
B. Begins to function about 3rd week after fertilization (5 weeks after LMP)
C. Two parts
1. Maternal portion - red & flesh-like
2. Fetal portion - shiny gray
D. Eventually form a single layer of cells called the “syncytium” where exchange takes place
1. Fetal blood and maternal blood should not mix!
E. Blood flow within the intervillous spaces of the placenta depends on maternal BP
1. Blood flows from area of high pressure to area of low pressure
2. Braxton - Hicks enhances circulation
3. Labor & High BP decreasecirculation
F. As placenta “ages”, circulation can decrease
G. Fetal RBCs can pass into maternal circulation thru breaks in placental membrane
1. RH sensitization

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12
Q

VI. FUNCTIONS OF PLACENTA

A
A. Fetal Respiration
B. Nutrition
C. Excretion
D. Protection
E. Endocrine
      1. Produces HCG, progesterone, estrogen, human chorionic somatomammotropin
F. Immunity-passive
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13
Q

VII. UMBILICAL CORD DEVELOPMENT

A

A. Formed from amnion
B. 1st referred to as “body stalk”
C. Fuses with fetal portion of placenta to provide circulatory pathway
D. One VEIN AND Two ARTERIES
1. Vein carries oxygenated blood, arteries carry unoxygenated blood
E. Contains special connective tissue called Wharton’s Jelly

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14
Q

VIII. FETAL CIRCULATION

A

A. Most of fetal blood _____________ the ______________
B. Key to fetal circulation is right to left shunting Placenta OXYGEN RICH through umbilical vein Liver Ductus Venosus Inferior Vena Cava Right Atrium Foramen Ovale Left Atrium Mitral Valve to Left Ventricle Aorta Head & Neck

DEOXYGENATED Superior Vena Cava Right Atrium Tricuspid Valve to Right Ventricle Pulmonary Artery Ductus Arteriosus Aorta Trunk and Lower Extremities

MIXED blood throughout systemic circulation then back to placenta via umbilical arteries

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15
Q

IX. FETAL DEVELOPMENT

A

A. Embryonic stage - conception to 8 weeks
1. This period of development most vulnerable to teratogens
2. By end of the 3rd week (after conception), primitive heart is beating
3. At 8 weeks, resembles a human
4. Beginnings of all essential internal and external structures are present
B. Fetal stage - end of 8th week to term
1. Every organ system and external structure found in full-term infant is present
2. Heart tones can be heard between 8 & 12 weeks
a. Normal range 110-160 bpm
b. May be heard with Doppler at 8-12 weeks
c. Heard with “fetoscope” at 16-20 weeksl
3. 20 weeks - fetal movements can be felt by mom. Called “quickening”
4. At 24-25 weeks, fetus has sufficient lung & CNS development to potentially survive outside the uterus
5. Last 12 weeks, period of rapid weight gain
6. lung maturity occurs around 35 weeks gestation

16
Q

1st Trimester

A
Heart beating
Genitals distinguishable
Kidneys urinating
Liver
Bladder
Intestines
Teeth
Legs, Arms
Hands, Feet
Fingers/Toes/Nails
Lungs
Ears
Spinal column/CSF circulates
Bones
Nervous System/Brain Waves detectable
Eyes/Eyelids fuse at 8wks
Nose
Mouth
Vocal Cords
Sucking and Grasping
17
Q

2nd Trimester

A
Taste Buds
Bone Marrow
REM Sleep
Sweat Glands
Alveoli/Bronchioles
Nostrils open
Vernix Caseosa
Lanugo
Scalp Hair
Internal Ear Canal
Meconium in Bowel/Anus open
“Practices” Breathing
18
Q

Third trimester

A
  • eyelids reopen- open and close
  • pupils react to light
  • senses present-vision, hearing, taste, touch, smell
  • Sleep & Wake Cycles
  • SubQ Fat produced and stored
  • Antibodies present
  • Glycogen stores present
  • Muscle tone increases
19
Q

Teratogens

A

Any agent (drug, virus or radiation) that can cause development of abnormal structures
GREATEST RISK during embryonic period
- The woman may be exposed to teratogenic agents before knowing about being pregnant.
- Pre conception counseling can educate the woman about the effects of these agents and disease.
- pre conception counceling can help prevent harm to the fetus or allow the woman to make an informed decision about her willingness to accept potential hazards should a pregnancy occur.

20
Q

Teratogens

A
  • chemicals, cleaning agents, paints, sprays, herbicides, and pesticides are included and can be found in the yard, home, workplace, soil, and water.
  • –read labels for ingredients and proper use of products
  • –ensure adequate ventLation with clean air
  • –wear gloves when handling chemicals
  • –change job assignments or workplace if necessary
  • –avoid travel to high-altitude regions, which could jeopardize oxygen intake.
21
Q

teratogens control.

A
  • During the embryo stage, from day 15 until aprox. 8 weeks after conception is the most critical stage in development of the embryo.
  • —Because of these areas with rapid cell division they are most vulnerable to malformation caused by environmental teratogens.
  • Congenital malformations ( meaning present at birth) can be a result of teratogens.
  • disabilities caused by teratogens are theoretically totally preventable.
  • Known teratogens are certain drugs and chemicals, infections, exposures to radiation, and certain maternal conditions such as diabetes and PKU.
  • They have their greatest effects on organs and parts of an embryo during its periods of rapid growth and differentiation during the embryonic period specifically from day 15-60.
  • During the first 2 weeks they either have no effect or have effects so severe that they cause miscarriage.
  • brain growth and development continue during the fetal period and teratogens can severely effect mental development throughout gestation.
22
Q

Teratogens

A
  • Smoking impairs fertility in women and men.
  • –during pregnancy it can cause a decrease in placental perfusion and is a cause of low birth weight.
  • Alcohol can lead to fetal alcohol syndrome
  • Prescription drugs, especially psychotherapeutic drugs, can have some effect on the fetus when taken during pregnancy and must be very carefully monitored.
  • Illicit drugs cause many problems for the fetus and mother
23
Q

Risk factors of Teratogens found on assessment can include

A
  • Medications and medical treatments
  • –prescription medications, especially those contraindicated during pregnancy, over the counter meds, radiation exposure
  • Personal behaviors and exposures
  • –smoaking, alcohol consumption, illicit drug use
  • –environmental agents, toxic chemicals, radiation.
24
Q

VIII. FUNCTION OF GONADOTROPINS

A

MALE
A. Causes maturation of the sperm
B. Causes the testis to produce the male hormones
C. Primarily testosterone

25
Q

Function of gonadotropin

A

FEMALE
A. Causes maturation of the egg
B. Stimulates the ovary to produce the female hormones
C. Primarily estrogen and progesterone

26
Q

IX. INTERACTION OF FEMALE GONADOTROPINS AND OVARIAN HORMONES

A

First half of cycle
A. FSH primarily responsible for beginning maturation of ovarian follicle (ovum)
B. As follicle matures, it secretes increased amounts of estrogen (level peaks just before ovulation)
C. Assists in development of follicle but also affects development of endometrium
D. Estrogen causes endometrial lining to proliferate (increase in thickness)

27
Q

IX. INTERACTION OF FEMALE GONADOTROPINS AND OVARIAN HORMONES

A

Second half of cycle
A. High levels of estrogen inhibit FSH production and stimulate LH production
B. LH causes final maturation of ovum (level peaks 18-24 hrs. before ovulation)
C. Follicle becomes the corpus luteum
D. Estrogen decreases and progesterone increases
E. Progesterone causes endometrium to become more vascular. Also increases glycogen stores (the uterus becomes ready for implantation)

28
Q

X. FUNCTION OF THE CORPUS LUTEUMy

A

A. Produce large amounts of progesterone
B. 7 to 8 days after ovulation the corpus luteum degenerates
C. If fertilization occurs, the corpus luteum will continue to function
D. Maintained by hormones produced by developing egg (embryo)
E. If fertilization does not occur, hormone levels will decrease
F. Corpus luteum will degenerate
G. Endometrial lining will be sloughed off

29
Q

XIII. OVULATION

A

A. Theoretically occurs at about day 14 of a 28 day cycle
B. Discharged near the fimbriated end of the Fallopian tube
C. Fertile for about 6 - 24 hrs
D. Reach uterus 72 - 96 hrs. After ovulation occurs
E. May be associated with “mittelschmerz” (mid-cycle pain) &/or spotting

30
Q

VII. GONADOTROPHINS

A

A. Small amounts of these hormones present prior to puberty
B. Amount increases after puberty
C. Follicle stimulating hormone is referred to as FSH
D. Luteinizing hormone is referred to as LH

31
Q

IX. INTERACTION OF FEMALE GONADOTROPINS AND OVARIAN HORMONES

A

A. FSH and LH act on ovary to produce mature egg
B. Stimulate secretion of estrogen and progesterone
C. Cause changes in the endometrium of uterus

32
Q

XV. MEIOSIS

A

-is process by which gametes are produced
A. Gametes (sperm and ovum) must have a haploid (half) number of chromosomes
B. When the egg and sperm unite, the diploid number of chromosomes is reestablished
C. The cell formed when the ovum and sperm unite is called a zygote (a zygote has 23 pairs of chromosomes)
D. Consists of two separate divisions
E. End up with 4 cells each having 23 single chromosomes

33
Q

XVI. Oogenesis

A

A. Produces cells of unequal size
B. Meiotic cellular division occurs to form 4 cells with 23 single chromosomes
C. Primary oocyte has most of the cytoplasm
1. Remaining three polar bodies are reabsorbed by the body

34
Q

XVII. SPERMATOGENESIS

A

A. Division occurs to form 4 sperm
B. Equal size
C. Each has a haploid number of chromosomes - 23 single chromosomes
D. Lost most of cytoplasm
E. Head of sperm covered by a cap called the acrosome
F. Long tail formed from one of the centrioles

35
Q

XVIII. SEX DETERMINATION

A

A. The 2 sex chromosomes determine the sex of the offspring
B. Females have 2 “X” chromosomes
C. Males have an “X” and a “Y” chromosome
D. Sex chromosomes also carry other genes ex) color blindness

36
Q

XIX. FERTILIZATION

A

A. Takes place in the ampulla or outer third of tube
B. Ovum large but high levels of estrogen help propel the egg
C. Ovum fertile for 24 hrs
D. Sperm survive for 72 hrs
E. Male deposits 200 - 500 million sperm in vagina
F. Prostaglandins in semen cause smooth muscle contractions

37
Q

The sperm undergoes two processes for fertilization to occur:

A
  1. CAPACITATION - removal of plasma membrane covering the area
  2. ACROSOMAL REACTION - as the sperm comes in contact with the cell membrane of the ovum, it deposits an enzyme which allows breakdown of the cell membrane and allows penetration by the sperm
38
Q

XXII. CELLULAR MULTIPLICATION

A

A. Period of rapid mitotic division - called cleavage
B. Cells called blastomeres
C. Eventually form solid ball called a morula
D. Takes 3 days to reach uterus, float in uterine cavity for few days
E. Cavity forms within the cell mass
F. Inner solid mass called blastocyst
1. Develops into embryo
2. Also develops into inner embryonic membrane, the amnion
G. Outer layer of cells called trophoblast
1. Develops into chorion (outer embryonic membrane)
2. Part eventually develop into placenta