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Physio OB Midterm > Parturition II > Flashcards

Parturition II Flashcards

1
Q

Characteristics of smooth muscle

A

Shortening with contractions
Forces in multiple directions
Not organized as skeletal muscle
Greater multidirectional force

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2
Q

The interaction of myosin and actin activates

A

ATPase which hydrolyses ATP and generate force

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3
Q

Uterine relaxation

Maintained by

A

Increase Myocyte cAMP

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4
Q

Uterine relaxation

Activates protein kinase A to promote phosphodiesterase activity with de phosphorylation of

A

Myosin light chain kinase

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5
Q

Actin assumes a fibrillar form, and calcium enters the cell to combine with calmodulin to form complexes.

A

Uterine contraction

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6
Q

The complexes activate MLCK to bring about the phosphorylation of the myosin light chains

A

Uterine contraction

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7
Q

Generates ATPase activity to cause sliding of myosin over the actin fibrils, which is a uterine contractor

A

Uterine contraction

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8
Q

Agents that promote contraction act on myometrial cells to increase intracellular cytosolic calcium concentration.

A

Intracellular calcium

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9
Q

Conditions that decrease calcium and increase intracellular concentration of cAMP and cGMP ordinarily promote

A

Uterine contraction

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10
Q

Cellular signals that control myometrial contraction and relaxation can effectively transferred between cells through intercellular junctional channels

A

Myometrial gap junction

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11
Q

Proteins of gap junction

A

Connexon 1 and 2

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12
Q

Cell surface receptors

Categorized into 3

A

G protein linked - activate phospholipase C
Ion channel linked
Enzyme linked

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13
Q

Cell surface receptors are transferred to the uterus by either

A

Endocrine- via maternal blood
Paracrine - near target cell
Autocrine - itself

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14
Q

Phase 1

A

Uterine quiescence and cervical competence

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15
Q

Phase 1 Uterine Quiescence and Cervical Competnce

Factors

A

Estrogen and progesterone
Increase in cAMP
Generation of cGMP
Modification of myometrial cell ion channels

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16
Q

Phase 1 Uterine Quiescence and Cervical Competnce

Components of a broader based molecular system that implements and maintains uterine quiescence.

A

Progesterone

Estrogen

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17
Q

Phase 1 Uterine Quiescence and Cervical Competnce

Inhibit parturition
Maintains uterine quiescence by various mechanism that cause decreased expression of the contraction associated proteins (prostaglandin, oxytocin, connexin)

A

Progesterone

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18
Q

Phase 1 Uterine Quiescence and Cervical Competnce

Directly precedes progression of phase 1 into phase 2 of parturition

A

Pretogestrone withdrawal

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19
Q

Phase 1 Uterine Quiescence and Cervical Competnce

Promote parturition

A

Estrogen

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20
Q

Phase 1 Uterine Quiescence and Cervical Competence

Would promote myometrial gap junction thereby, promoting uterine contraction

A

Estrogen

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21
Q

Phase 1 Uterine Quiescence and Cervical Competnce

A number are associated with Gas mediated activation of adenyl cyclase and increased levels of cAMO are present in myometrium

A

G protein Coupled Receptors

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22
Q

Phase 1 Uterine Quiescence and Cervical Competnc

Mediate gas stimulated increases in adenylyl cyclase, increased levels of cAMP, and myometrial cell relaxation

A

Beta adrenoreceptors

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23
Q

Phase 1 Uterine Quiescence and Cervical Competnce

Has been demonstrated in myometrial smooth muscle and blood vessels.

A

LH and HCG receptors

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24
Q

Phase 1 Uterine Quiescence and Cervical Competnce

Acts to activate adenyly cyclase by way of a plasma membrane receptors Gas linked system

A

Chorionic gonadotropin

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25
Phase 1 Uterine Quiescence and Cervical Competnce This decreases contraction frequency and force and decreases the number of tissue specific myometrial cell gap junctions. High circulating levels of HCG may be one mechanism causing quiescence
LH and HCG receptor
26
Phase 1 Uterine Quiescence and Cervical Competnce Peptide hormone that is a member of insulin like GF
Relaxin
27
Phase 1 Uterine Quiescence and Cervical Competnce Relaxin originate exclusively from the
Corpus luteum
28
Phase 1 Uterine Quiescence and Cervical Competnce Relaxin greates amount found between
8-12 weeks gestation
29
Phase 1 Uterine Quiescence and Cervical Competnce Mediates activation of adenylyl cyclase Effect on cervical softening Promote myometrial quiescence
Relaxin
30
Phase 1 Uterine Quiescence and Cervical Competnce Synthesized in the placenta and hypothalamus
CRH
31
Phase 1 Uterine Quiescence and Cervical Competnce CRn increase during the
Final 6-8 weeks of normal pregnancy
32
Phase 1 Uterine Quiescence and Cervical Competnce CRH has dual effect
Utero relaxant at first | Utero contraction later
33
Phase 1 Uterine Quiescence and Cervical Competnce These interact with a family of different G protein coupled receptors, several of which are expressed in myometrial
Prostaglandin
34
Phase 1 Uterine Quiescence and Cervical Competnce Prostaglandin usually considered as
Uterotonins
35
Phase 1 Uterine Quiescence and Cervical Competnce Prostaglandins with diverse effects
Prostacyclin E2 - relaxation | Prostacyclin F2- contraction
36
Phase 1 Uterine Quiescence and Cervical Competnce Prostaglandin produced using plasma membrane derived arachidonic acid, which usually is released by the action of the
Phospholipase A2 or C
37
Phase 1 Uterine Quiescence and Cervical Competnce Activation of gaunylyl cyclase increases intracellular cGMP levels, which promotes smooth muscle relaxation
ANP and BNP and cGMP
38
Phase 1 Uterine Quiescence and Cervical Competnce Striking increases in the activity of enzymes that degrade or inactivate endogenously produced uterotonins
``` PGDH and prostaglandins Enkephalins and endothelins Oxytocinase and oxytocin Diamine oxidase and histamine Cetechol O methyl transferase and cathecolamines Angiotensinases and angiotensin II PAF acetylhydrolase and PAF ```
39
Phase 2
Uterine activation and cervical ripening
40
Phase 2 Uterine activation and cervical ripening May be used to prevent preterm labor has been studied in trials
Progesterone containing injections or vaginal suppositories
41
Phase 2 Uterine activation and cervical ripening Administered during the latter phase of the ovarian cycle, which induces menstruation prematurely
Mifepristone (RU-486)
42
Phase 2 Uterine activation and cervical ripening Effective abortifacients in early pregnancy, not so much in the latter part
Mifepristone
43
Phase 2 Uterine activation and cervical ripening Must play a central role in spontaneous labor
Oxytocin
44
Phase 2 Uterine activation and cervical ripening Primary regulators of oxytocin receptor expression
Progesterone and estradiol
45
Phase 2 Uterine activation and cervical ripening In vivo or in myometrial explants increases myometrial oxytocin receptor concentration, Promote parturition
Estradiol treatment
46
Phase 2 Uterine activation and cervical ripening Increase oxytocin receptor degradation and inhibit oxytocin activation at the cell surface Inhibit parturition
Progesterone
47
Phase 2 Uterine activation and cervical ripening Remodeling of the ECm of the uterus, cervix, vagina, breast and pubic symphis as well as promoting cell proliferation and inhibiting apoptosis
Relaxin
48
Phase 2 Uterine activation and cervical ripening Promotes growth of the cervix, vagina, and pubic symphysis and is necessary for breast remodeling for lactation
Relaxin
49
Phase 2 Uterine activation and cervical ripening Also significant more common in pregnancies complicated by hydramnios
Preterm labor
50
Phase 2 Uterine activation and cervical ripening May include activation of cell surface receptors or ion channels, transmission of signals through ECM or release of Autocrine molecules that act directly on myometrium
Mechanotransduction
51
Phase 2 Uterine activation and cervical ripening Ability of the fetus to provide endocrine signals that initiate parturition has been demonstrated in several species.
Fetal endocrine cascades leading to parturition
52
Phase 2 Uterine activation and cervical ripening Synthesized by placenta in relatively large amounts Maternal plasma CRH levels are low in the 1st T and rise from mend gestation to term
Placental CRH production
53
Phase 2 Uterine activation and cervical ripening Only tropic hormone releasing factor to have a specific serum binding protein
CRH
54
Phase 2 Uterine activation and cervical ripening Binds most maternal circulating CRH and this inactivated it
CRH binding protein
55
Phase 2 Uterine activation and cervical ripening CRH Bp levels in both maternal plasma and amniotic fluid decline, leading to markedly increase level of
Bio available CRH
56
Phase 2 Uterine activation and cervical ripening Placental CRH may enhance fetal cortisol production to provide positive feedback so that the placenta produces. Ore CRH
CRH and parturition timing
57
Phase 2 Uterine activation and cervical ripening Some have proposed that the rising levels of CRH at the end of gestation reflects
Fetal placental clock
58
Phase 2 Uterine activation and cervical ripening Produced by the fetal lung is required for lung maturation
Surfactant protein A
59
Phase 2 Uterine activation and cervical ripening Activate fluid macrophage to migrate into the myometrium and induce NF-KB factor that activated inflammatory response
Increased SP-A
60
Phase 2 Uterine activation and cervical ripening Diminished estrogen production
Fetal anomalies and delayed parturition
61
Phase 3 uterine stimulation
Oxytocin and phase 4 parturition
62
Phase 3 uterine stimulation Literally, quick birth, first uterotonin to be implicated in parturition initiation
Oxytocin
63
Phase 3 uterine stimulation Nano peptide synthesized in the magnocellular neurons of the supraoptic and para ventricular neurons
Oxytocin
64
Phase 3 uterine stimulation Pro hormone-> oxytocin during transport
Neurophysin
65
Phase 3 uterine stimulation Role of oxytocin in phase 3 and 4
Increase near the end of gestation Promote prostaglandin release Synthesized directly in decidual and extra embryonic fetal tissues and in the placenta
66
Phase 3 uterine stimulation End of phase 3 of parturition
2nd stage of labor
67
Phase 3 uterine stimulation Early past partum period
Early puerperum
68
Phase 3 uterine stimulation Phase 4 Oxytocin infusions promotes increased levels of mRNAs from myometrial genes that encode proteins essential for uterine involution
Breast feeding
69
Prostaglandin and phase 4 of parturition Levels of prostaglandin or their metabolites in amniotic fluid, maternal plasma, and maternal urine are increased during
Labor
70
Prostaglandin and phase 4 of parturition Treatment of pregnant women with prostaglandin by any route causes
Abortion or labor on all gestational ages
71
Prostaglandin and phase 4 of parturition Inhibitors to pregnant women will delay spontaneous labor onset and sometimes arrest preterm labor
Administration of prostaglandin H synthase type 2
72
Prostaglandin and phase 4 of parturition Prostaglandin synthesis is high and unchanging in the decidua during
Phase 2 and 3 of parturition
73
Prostaglandin and phase 4 of parturition Increased in the decidua at term
PGF2
74
Prostaglandin and phase 4 of parturition Myometrium synthesis PGHS-2 with labor onset but most prostaglandins likely come from the
Decidua
75
Prostaglandin and phase 4 of parturition Also produce prostaglandins
Fetal membrane | Placenta
76
Prostaglandin and phase 4 of parturition Further degrade the ECM weakening of fetal membranes
Increase in cytokines | Prostaglandins
77
Endothelin 1 Is preferentially expressed in smooth muscle and effects an increase in intracellular calcium
Endothelin A receptor
78
Endothelin 1 Evidence of pathologies and aberrant expression.
Premature birth and uterine leiomyomas
79
Angiotensin I There are two G protein linked angiotensin II receptors expressed in the uterus
AT1 | AT2
80
Angiotensin I Non pregnant
AT2
81
Angiotensin I Pregnant
AT1
82
Angiotensin I Evokes contraction
Angiotensin II
83
Maybe another component of the uterotonin system of parturition phase 3
Angiotensin II
84
Highly resistant to penetration leukocytes, microorganism and neoplastic cells
Amnion
85
Constitute a selective filter to prevent fetal particulate bound lung and skin secretions from reaching the maternal compartment
Amnion
86
Amnion Late pregnancy, amniotic prostaglandin biosynthesis is increased and ________ show increased activity too
A2 and PGH-2
87
Primary protective and provides immunological acceptance Relaxation Also enriched with enzymes that inactivate uterotonin a
Chorion laeve
88
Generation of decidual uterotonins that act in a paracrine manner on contagious myometrium Contraction
Decidua
89
Which of the following is/are not related to uterine contraction? ``` A. Prostaglandin B. Estrogen C. Oxytocin D. Angiotensin 2 E. Progesterone F. D and E G. NOTA ```
E. Progesterone
90
Two general contemporaneous theorems concerning labor initiation
Functional loss of pregnancy maintenance factors | Synthesis of factors that induce parturition

Physio OB Midterm (6 decks)

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