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4 Pregnant and Nursing Patient > Physiology > Flashcards

Physiology Flashcards

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1
Q

where does fertilisation occur?

A

in the fallopian tubes

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2
Q

After fertilisation a hollow ball of cells forms (?). The inner cell mass becomes the ? and the outer cells (?) allows ? and forms the foetal portions of the ?

A

blastocyst
foetus
trophoblast
implantation
placenta

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3
Q

Implantation of the blastocyst

Blastocyst adheres to ??

???? penetrate the ? carving a whole for the ?

When implantation is finished the blastocyst is completely buried in the ?

?? differentiates into the developing ?

A

endometrial lining

cords of trophoblastic cells
endometrium
blastocyst

endometrium

inner mass
embryo

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4
Q

structures that form the placenta

Finger like projections of ?? form the ?? which protrude into a pool of ??.

??? are broken down by the expanding ? so that ?? oozes through the spaces between the ??.

??? branch off umbilical arteries and project into the ??

Foetal blood is separated from maternal blood by the ?? and thin ?? that forms the placental villi.

Maternal blood enters through the ?? then enters the pool of ?? in the ??

Foetal blood exits through the ?? and the maternal blood exits through the ??

A

chorionic tissue
placental villi
maternal blood

maternal capillary walls
chrorion
maternal blood
placental villi

foetal placental arteries
placental villi

capillary wall
chorionic layer

maternal arterioles
maternal blood
intervillus spaces

umbilical vein
maternal venules

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5
Q

what are the functions of the placenta?

A

Kidneys
Digestive system
Respiratory system
Temporary endocrine gland during pregnancy

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6
Q

why is the placenta a unique endocrine gland?

A

it is a transient tissue and secretion of its hormones is not subject to extrinsic control.

the type and rate of hormonal secretion is dependant on the stage of pregnancy.

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7
Q

During pregnancy ? endocrine glands interact for the development of the ?, coordination of ? and preparing the ?? for after birth

A

3
foetus
birth
mammary glands

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8
Q

name the three placental hormones

A

hCG - human chorionic gonadotropin
oestrogen
progesterone

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9
Q

what does hCG do?

Acts to prolong the lifespan of the ??

Stimulates precursor ? cells in ? foetal ? to produce ?

hCG may trigger ??

A

corpus luteum CL

leydig
male
testes
testosterone

morning sickness

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10
Q

the corpus luteum is maintained by hCG. what does the corpus luteum do?

A

produces oestrogen and progesterone for 10 weeks post implantation

Persistence of oestrogen and progesterone maintains pregnancy

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11
Q

what do pregnancy tests detect?

A

hCG

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12
Q

hCG levels peak after ??, this is then reduced to a low level for the rest of pregnancy

A

60 days

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13
Q

oestrogen

Secreted by ?? in 1st trimester

Secreted by ? in 2nd and 3rd trimester

Synthesis from ?

A

corpus luteum

placenta

cholesterol

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14
Q

roles of oestrogen

Stimulates growth of ? -> uterine musculature needed to expel the foetus in ?

Promotes development of ??? for ? to pass through

A

myometrium
labour

mammary gland ducts
milk

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15
Q

progesterone

Secreted by ?? in 1st trimester

Secreted by ? in 2nd and 3rd trimester

Placenta converts ? into progesterone

A

corpus luteum
placenta
cholesterol

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16
Q

the amount of progesterone produced depends on what?

A

the size of the placenta so in the first 10 weeks the placenta can’t produce enough hence hCG.

The increase in levels of porgesterone over last 7 months reflects placental growth.

17
Q

roles of progesterone

Prevent ? by suppressing ? of uterine ?

Formation of ?? in cervical canal to prevent vaginal components reaching the ?

Stimulates development of ?? in breasts for ?

A

miscarriage
contractions
myometrium

mucus plug
foetus

mammary glands
lactation

18
Q

The gestation (pregnancy) period is ? weeks from conception (? weeks from last menstrual period)

A

38
40

19
Q

remember

Changes that happen to the mother during gestation:

Uterine enlargement

Breast enlargement and develop ability to produce milk (oestrogen and progesterone)

Blood volume increases by 30%

Weight gain

Respiratory activity increases by 20%

Urinary output increases

Increased nutritional requirements for the mother

A
20
Q

Changes during late gestation in preparation for parturition (giving birth)

? contractions in ? -> mild contractions

? of the ? by relaxin

Foetus shifts ? -> ?downwards

Breech birth -> anything other than the ? is at birthing canal

A

braxton-hicks
last trimester

softening
cervix

downwards
head

head

21
Q

Parturition (labour) requires what? 2

A

dilation of cervical canal

contraction of uterine myometrium

22
Q

labour initiation

? cause babies head to put pressure on cervix

? is released and ? which increase contractions

A

contractions

oxytocin
prostaglandins

23
Q

what are the three stages of labour?

A

cervical dilation
delivery of baby
delivery of placenta

24
Q

labour - cervical dilation

Membrane around ?? ruptures releasing ??

Cervix dilates to ?

Can take ? hours

A

amniotic sac
amniotic fluid

10cm

many

25
Q

labour - delivery of baby

Begins once ?? is complete

Baby moves through ? to ?

? receptors trigger contractions of the ?? in time with ??

After birth, ?? is cut freeing the baby from the ?

Takes ? delivery of baby

A

cervical dilation

cervix
vagina

stretch
abdominal wall
uterine contractions

umbilical cord
placenta

30-90minutes

26
Q

labour - delivery of placenta

Second series of ?? to separate the ? from the ?

Placenta expelled out vagina “after birth”

Contractions of ? continue, to ? the uterine blood vessels at the site of placental attachment, to prevent ?

? and ? levels fall after this

A

uterine contractions
placenta
myometrium

myometrium
constrict
haemorrhage

oestrogen
progesterone

27
Q

what is involution and what is it induced by?

A

shrinking of uterus to pregestational size, takes 4-6 weeks

induced by fall in progesterone and oestrogen and oxytocin released in breastfeeding

28
Q

what induces breast development during pregnancy?

A

oestrogen for duct development

progesterone for gland development

prolactin and hCS induce synthesis of enzymes needed to milk production
- During pregnancy high levels of oestrogen and progesterone block prolactin and milk production

29
Q

other than pregnancy what else triggers breast development? how?

A

Suckling
triggers a neuroendocrine reflex that leads to the secretion of prolactin and oxytocin

30
Q

what does prolactin do?

A

milk production

31
Q

what gland secretes prolactin?

A

Anterior pituitary gland

32
Q

what does oxytocin do? 3

A

milk ejection by stimulating contraction of myoepithelial cells

hastens involution

suppress menstrual cycle by inhibiting LH and FSH

33
Q

components of breast milk

Nutrients and water

Immune cells, antibodies and other immunoprotective chemicals

A
34
Q

colostrum

produced in first ? days after delivery

Contains lower levels of ? and ? but higher levels of ??

A

5

fat
lactose
immunoprotective agents

35
Q

how does weaning lead to cessation of breast milk?

A

No suckling so no stimulus for production of prolactin and oxytocin

4 Pregnant and Nursing Patient (3 decks)

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