Physio- adaptations to pregnancy

Question 1

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

Answer 1

decreased blood glucose early, and insulin resistence later

Question 2

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

Answer 2

human placental lactogen

Question 3

what does increase in estrogen ( DHEAS) LEAD TO?

Answer 3

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

Question 4

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

Answer 4

CRH–> ACTH

Question 5

what is needed to make milk?

Answer 5

estrogen and progesterone are needed for prolactin to make milk

Question 6

what promotes full lobuloalveolar development of the mamarry glands?

Answer 6

prolactin from the pituitary

Question 7

what does prolactin cause after birth?

Answer 7

fomration of milk, and secretion into the ducts

Question 8

what does oxytocin do after birth?

Answer 8

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

Question 9

what si the function of the placenta?

Answer 9

gas exchange, nutritional, homeostatic

Question 10

what is the casue of slower diffusion in the embryo?

Answer 10

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

Question 11

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

Answer 11

difusion of O2 at the placenta is reduced

Question 12

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

Answer 12

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

Question 13

what do synaptic formations in the brain depend on?

Answer 13

genetics and experience

Question 14

when do movements of the fetus become stereotypical?

Answer 14

third trimester

Question 15

what sit eh process of synapses?

Answer 15

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

Question 16

what happens on EEG in the last trimester?

Answer 16

increased voltage

Question 17

what is teh respiratory generator in the fetus?

Answer 17

pre-botzinger

Question 18

what aer teh two breathing forms of fetus?

Answer 18

paradoxical ( abs out, ribs in)

gentle ( abs and ribs out)- occurs during REM

Question 19

what are the characteristcis of the fetal lungs?

Answer 19

high elastin levels= low compliance

Question 20

what is needed for physcial growth of the lungs?

Answer 20

IGF-2 and GH

Question 21

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

Answer 21

NO, and NO

Question 22

what happens to breathing during times of fetal hypoxia?

Answer 22

respiration is supressed

Question 23

what si the action of the mechano receptors on respiration?

Answer 23

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

Question 24

what is the initial compliance of the lung at birth?

Answer 24

LOW, due to low lung volume

Question 25

what has to happen with the mechano receptors after birth?

Answer 25

must become less inhibitory

Question 26

what is teh oxygenation of the portal vein, and ductus vebnosis? what about the ascending aorta/head?

Answer 26

80% and 65%

Question 27

where is blood preferantially directed to from the inferior vena cava?

Answer 27

heart and head, because it is oxygenated from the placenta

Question 28

where is blood from the superior venacava sent?

Answer 28

to the placenta to get oxygenated

Question 29

what is the cardiovascualr response to stimulus of chemo receptors?

Answer 29

vasoconstrics all but heart, brain and placenta, and also the heart becomes bradycardic

Question 30

what is the fetal GFR?

Answer 30

50 ( about half of the normal adult GFR)

Question 31

what is the result of the fetal inadequate renal function?

Answer 31

loss of Na+, loss of glucose and amino acids, lack of ability to concentrate or dilute the urine

Question 32

why is the GI function of absorption limited in utero?

Answer 32

due to the lack of intestinal flora

Question 33

what is the main function of the liver in utero?

Answer 33

to store glycogen and iron

Question 34

what is the main growth hormone of the fetus?

Answer 34

insulin