Parturition, Lactation, and Neonatal Physiology Flashcards
What is the name of the weak, irregular contractionsthat occur towards the end of pregnancy that are not quite powerful enough to induce labor, and are more though to prep uterus for parturition?
Braxton Hicks Contractions
Administration of nuclear progesterone antagonist would lead to what?
A. Increase in myometrial contractility
B. Increase in estrogen receptor expression
C. Restrict induction of labor
D. All of the above
Increase in myometrial contractility
NOTE: progesterone promots relaxation of the myometrium, and blocks contractions of labor, so administration of an antagonist can be used to induce labor/contractions at any stage in pregnancy
Elevated levels of which of the following is associated with premature birth, even though it plays a role in keeping the uterus in a quiet state during pregnancy?
A. Prostaglandins
B. Oxytocin
C. Estrogen
D. Relaxin
E. Progesterone
Relaxin
NOTE: max plasma concentrations are seen around weeks 38-42, and we think it may soften and help dilate the cervix
Which of the following is the primary stimulus for release of oxytocin?
A. Estrogen and Progesterone secretion
B. Prostaglandins and estrogen promoting formation of gap junctions
C. Estrogen stimulating formation of gap junctions and increasing number of oxytocin receptors
D. Distention of the cervix and initiation of Ferguson Reflex
Distention of the cervix and initiation of Ferguson Reflex
While prostaglandins and estrogen do what options B and C express, it is not the main stimulus according to Dr. Creamer’s slides
Which of the following is true of estrogen in regards to pregnancy?
A. Increases myometrial contractility and cervical dilation
B. Opposes the action of progesterone by increasing responsiveness to oxytocin and prostaglandins
C. Increases release of prostaglandins by fetal membranes
D. All of the above
All of the above
Estrogen stimulates expression of enzyme collagenase to enact what effect?
A. Relax and allow distention of myometrium
B. Dilate the cervix and initiate a wave of contractions
C. Relax and allow distention of the cervix
D. All of the above
Relax and allow distention of the cervix
At what point does estrogen increase the amount of oxytocin receptors in the uterus, that the uterus is no longer insensitive to oxytocin?
A. about 10 weeks gestation
B. about 20 weeks gestation
C. about 30 weeks gestation
D. about 40 weeks gestation
about 30 weeks gestation
What 3 things stimulate prostaglandin synthesis?
Estrogen (fetal membranes)
Oxytocin (uterine cells)
Uterine stretch
What hormone gets released from the placenta and triggers positive feedback cycles as it enters maternal and fetal circulation, leading to events associated with initiation of labor?
A. ACTH
B. CRH
C. TSH
D. GnRH
CRH
By the time the cervix is fully dilated it has drawn up to be just below the _______
A. Sacral Ala
B. Pelvic inlet
C. Ischium
D. Coxxyc
Pelvic Inlet
T/F: The last phase of delivery is expulsion of the placenta, which seperates from the uterus as it contracts and reduces the area in which the placenta can attach
True
NOTE: detaching causes bleeding, but oxytocin release helps constrict uterine blood vessels
All of the following can delay breathing upon birth, EXCEPT which of the following that actually stimulates breathing?
A. Prolonged labor
B. Use of anesthetics during labor
C. Sudden drop in temperature
D. Head trauma
Sudden drop in temperature
- cooling and asphyxiation during birth stim breathing
What are the 2 cardiovascular Right to Left shunts seen in the fetus?
Foramen ovale
Ductus arteriosus
What structure is bypassed when we blood flows through the ductus venosus?
Blood travels from _______ > Ductus Venosus > ________
Liver
Umbilical Vein > Ductus Venosus > Inferior Vena Cava
What structure is bypassed when we blood flows through the foramen ovale?
Blood travels from _______ > Foramen Ovale > ________
Right Ventricle
Right atrium > Foramen Ovale > Left Atrium
What structure is bypassed when we blood flows through the ductus arterosus?
Blood travels from _______ > Ductus Arteriosus > ________
Lungs
Pulmonary artery > Ductus Arteriosus > Aorta
What is the first shunt the blood will pass through when entering fetal circulation from the mother?
A. Ductus Venosus
B. Ductus Arteriosus
C. Foramen ovale
Ductus Venosus
Which of the following accurately describes mammary gland at birth?
A. Intricate duct system with multiple branching alveoli
B. Enterily lactiferous ducts with few alveoli
C. primary mamary cord coming off a mammary bud
D. Lactiferous ducts with branching that has small spheroidal masses
B. Enterily lactiferous ducts with few alveoli
T/F: The contractile myoepithelial cells that move milk from alveoli into the ducts are found between the epithelial cell layer and basement membrane
True
During pregnancy, what 4 hormones lead to full development of breasts?
Very high levels of estrogen and progesterone
Prolactin
hCS (hPL)
What hormone is responsible for promoting contraction of myoepithelial cells and thus milk ejection?
A. mammogenic hormones (estrogen, prolactin)
B. lactogenic hormones (prolactin, hCS/hPL)
C. galactokinetic hormones (oxytocin)
D. galactopoietic hormones (prolactin)
galactokinetic hormones (oxytocin)
What hormone is responsible for maintaining milk production after it has been established?
A. mammogenic hormones (estrogen, prolactin)
B. lactogenic hormones (prolactin, hCS/hPL)
C. galactokinetic hormones (oxytocin)
D. galactopoietic hormones (prolactin)
D. galactopoietic hormones (prolactin)
What are the 5 major pathways of secretion of milk components by alveolar cells?
STL TP
Secretory Pathway
Transcellular endo and exocytosis pathway (proteins)
Lipid pathway
Transcellular salt and water pathway
Paracellular pathway (ions and water)
Suckling, seeing, or hearing an infant activates afferent neural pathway from breast to spinal cord to hypothalamus. Another change that occurs is release of prolactin which stims milk production, Which of the following effects triggers the release of prolactin from lactotrophs?
A. Dopamine release is inhibited
B. Production and release of oxytocin from posterior pituitary
C. Inhibtion of hypothalmus releasing GnRH
Dopamine release is inhibited
- just remember inhibiting dopamine, keeps dopamine from normally inhibiting the lactotroph so that it can release prolactin and stim milk production
In cessation of lactation what system will remain even after full involution completes?
Ductal system
GDM
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