Physio- adaptations to pregnancy Flashcards

1
Q

what are teh blood glucose changes in the mother in pregnancy?

A

decreased blood glucose early, and insulin resistence later

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2
Q

what mediates the blood glucose changes( increased blood glucose on ingestion, and exaggerated insulin response)?

A

human placental lactogen

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3
Q

what does increase in estrogen ( DHEAS) LEAD TO?

A

increase in excitabiluyt ( gap junctions in the myometrium)–> prostaglandin synthesis, increase in oxytocin receptors, increase contraction of the uterus ( increased oxytocin released from pituitary

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4
Q

the release of what hastens the maturation of the respiratoy system?

A

CRH–> ACTH

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5
Q

what is needed to make milk?

A

estrogen and progesterone are needed for prolactin to make milk

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6
Q

what promotes full lobuloalveolar development of the mamarry glands?

A

prolactin from the pituitary

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7
Q

what does prolactin cause after birth?

A

fomration of milk, and secretion into the ducts

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8
Q

what does oxytocin do after birth?

A

contraction of myoepithelial cells, ejection of milk out of the nipple

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9
Q

what si the function of the placenta?

A

gas exchange, nutritional, homeostatic

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10
Q

what is the casue of slower diffusion in the embryo?

A

increase in distance that the gas has to go to diffuse ( 3.5 micrometers vs .6)

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11
Q

what si the net effect of the increased distance for gas exchange, and the difference in change of Pressure?

A

difusion of O2 at the placenta is reduced

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12
Q

what aer teh blood gases of a fetus compared to mom?

A

PaO2 = 35 (HbF high affinity for O2)
PaC02 higher- mom has respiratory alkalosis
ph is a little lower in the fetus ( 7.37)

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13
Q

what do synaptic formations in the brain depend on?

A

genetics and experience

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14
Q

when do movements of the fetus become stereotypical?

A

third trimester

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15
Q

what sit eh process of synapses?

A

too many are formed, thus pruning is needed, and this is done by experience ( occurs late trimester, and after birth)

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16
Q

what happens on EEG in the last trimester?

A

increased voltage

17
Q

what is teh respiratory generator in the fetus?

A

pre-botzinger

18
Q

what aer teh two breathing forms of fetus?

A

paradoxical ( abs out, ribs in)

gentle ( abs and ribs out)- occurs during REM

19
Q

what are the characteristcis of the fetal lungs?

A

high elastin levels= low compliance

20
Q

what is needed for physcial growth of the lungs?

A

IGF-2 and GH

21
Q

do peripheral chemoreceptors effect breathing? are centrl chemo receptors functional?

A

NO, and NO

22
Q

what happens to breathing during times of fetal hypoxia?

A

respiration is supressed

23
Q

what si the action of the mechano receptors on respiration?

A

STRONGLY inhibited- this means anything that increases the work of breathing, will cease breathing

24
Q

what is the initial compliance of the lung at birth?

A

LOW, due to low lung volume

25
what has to happen with the mechano receptors after birth?
must become less inhibitory
26
what is teh oxygenation of the portal vein, and ductus vebnosis? what about the ascending aorta/head?
80% and 65%
27
where is blood preferantially directed to from the inferior vena cava?
heart and head, because it is oxygenated from the placenta
28
where is blood from the superior venacava sent?
to the placenta to get oxygenated
29
what is the cardiovascualr response to stimulus of chemo receptors?
vasoconstrics all but heart, brain and placenta, and also the heart becomes bradycardic
30
what is the fetal GFR?
50 ( about half of the normal adult GFR)
31
what is the result of the fetal inadequate renal function?
loss of Na+, loss of glucose and amino acids, lack of ability to concentrate or dilute the urine
32
why is the GI function of absorption limited in utero?
due to the lack of intestinal flora
33
what is the main function of the liver in utero?
to store glycogen and iron
34
what is the main growth hormone of the fetus?
insulin