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Reproduction Key Information > Physiology > Flashcards

Physiology Flashcards

1
Q

what does the zygote divide into?

A

blastocyst which is transported to the uterus

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2
Q

what happens day 3-5 after fertilisation?

A

blastocyst is transported to the uterus

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3
Q

what happens days 5-8 after fertilisation?

A

blastocyst attaches to the lining of the uterus

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4
Q

how does the blastocyst attach to the lining of the uterus?

A

cords of trophoblastic cells penetrate the endometrium

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5
Q

what is the placenta derived from?

A

trophoblast and decidual tissue

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6
Q

role of trophoblast cells

A

invade decidua and break down capillaries to form cavities filled with maternal blood

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7
Q

what separates maternal and foetal blood?

A

thin membrane

AV shunt?

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8
Q

what week are the placenta and heart functional by?

A

week 5

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9
Q

role of hCG

A

prevents degeneration of the corpus luteum

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10
Q

role of human placental lactogen (HCS)

A

produced from week 5
protein formation
decreases insulin sensitivity in mother so more for foetus

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11
Q

role of progesterone in pregnancy

A

develops decidual cells
decreases uterine contraction
prepares lactation

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12
Q

role of oestrogen in pregnancy

A

enlarges uterus
breast development
relaxation of ligaments

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13
Q

what conditions is HCG useful in the diagnosis of?

A

ectopic= static or slow rising
failing pregnancy= falling
viable pregnancy= double or >60% rise

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14
Q

side effects of HCG

A

N&V

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15
Q

what conditions lead to more hCG?

A

multiple pregnancy

molar pregnancy

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16
Q

what week do hCG levels fall?

A

12-14 weeks

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17
Q

what happens when the placenta produces CRH?

A

increases ACTH in mother increasing aldosterone and cortisol

risks hypertension, oedema, GDM

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18
Q

cardiovascular changes in pregnancy?

A

increased CO
increased HR
BP drops in semester 2

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19
Q

why does BP drop in semester 2?

A

uteroplacental circulation expands

PVR decreases

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20
Q

haematological changes in pregnancy

A

plasma volume increased
EPO increases (increased RBC)
Hb decreases

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21
Q

why does Hb decrease?

A

dilution

iron requirements increase

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22
Q

respiratory changes in pregnancy

A

progesterone signals to lower CO2 levels (increase pH
O2 consumption increases
increased RR and TV

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23
Q

urinary changes in pregnancy

A

GFR and RPF increased
increased re-absorption of ions and water
increased UO
postural changes affect renal function

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24
Q

postural changes that affect renal function

A

upright decreases

supine increases

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25
Q

circulatory changes in pregnancy

A

hypercoagulable state

VTE risk

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26
Q

metabolic changes in pregnancy

A

weight gain

21-40 weeks catabolic phase

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27
Q

specific nutritional needs in pregnancy

A 
folic acid
vitamin D
protein
energy
iron 
B-vitamins (erythropoiesis)
28
Q

what hormones induce labour?

A

oestrogen inducing oxytocin receptors

29
Q

what do oestrogen and oxytocin do in labour?

A

stimulates uterus contraction and make prostaglandins

30
Q

three stages of labour

A
  1. cervical dilatation (8-24 hours)
  2. passage of foetus through the birth canal (minutes-120 minutes)
  3. expulsion of placenta and membranes (<10 minutes)
31
Q

active cervical dilatation

A

4-10cm

32
Q

when is stage 2 of labour considered prolonged?

A

3 hours

2 hours in multiparous women

33
Q

when is surgery needed for stage 3 of labour?

A

> 1 hour

34
Q

active management of stage 3?

A

syntometerine or oxytocin

35
Q

what is Bishops score used for?

A

determine whether it is safe to induce labour

36
Q

what is liquor?

A

fluid that surrounds the foetus

37
Q

true labour contractions (compared to Braxton Hicks)

A

under oxytocin
evenly spaced, getting shorter
length of contraction increases
thinning of cervix

38
Q

three reasons why labour may not be progressing?

A
  1. power
  2. passage
  3. passenger
39
Q

pacemaker of uterus smooth muscle contraction

A

fundus the tubal ostia

40
Q

ideal passage pelvic shape

A

gynaecoid

41
Q

what can failure to progress risk?

A

obstructed labour

42
Q

risks in obstructed labour

A

sepsis
AKI
fistula formation
foetal asphyxia

43
Q

signs of obstruction

A 
moulding 
caput (oedema)
anuria
haematuria
vulval oedema
44
Q

what does a partogram assess?

A

assess progress of labour

45
Q

7 cardinal movements of baby in pelvis

A
  1. Engagement
  2. Descent
  3. Flexion
  4. Internal rotation
  5. Crowning and extension
  6. Restitution and external rotation
  7. Expulsion of anterior shoulder first
46
Q

what is crowning?

A

appearance of the foetal head at the introitus

47
Q

actions taken once baby born?

A

delayed clamping

skin-to-skin contact

48
Q

analgesics options in labour

A 
massage 
water immersion
IM opiates
paracetamol/ co-codamol
TENS
entonox (oxygen + NO, gas and air)
diamorphine
epidural (levobupivacaine +/- opiate)
spinal
49
Q

which analgesic can inhibit progress in stage 2?

A

epidural

50
Q

complications with anaesthetics used in labour

A

hypotension
dural puncture
atonic bladder

51
Q

intrapartum foetal assessment

A
  1. foetal heart + maternal pulse
  2. CTG
  3. amniotic fluid
52
Q

what does a CTG show?

A

contraction frequency
decelerations
accelerations
variability

DRCBRAVADO= determine risk contractions baseline rate variability acceleration decelerations overall impression

53
Q

oestrogen in breast feeding

A

grows ductile system

54
Q

progesterone in breast feeding

A

grows lobule-alveolar system

55
Q

role of prolactin in breast feeding

A

stimulates milk production

56
Q

role of oxytocin in breast feeding

A

let-out reflex

57
Q

what is the puerperium?

A

6 week period following birth with tissues returning to non-pregnant state

58
Q

how long does lochia last?

A

discharge containing blood, mucus and endometrial casting lasting around 10-14 days

59
Q

how long does it take BP to return to normal

A

6 weeks

60
Q

placental functions

A 
foetal homeostasis
gas exchange
nutrition/waste transport
acid-base balance
hormone production
transport of IgG
61
Q

three shunts in the foetal circulation

A

ductus venosus
foramen ovale
ductus arteriosus

62
Q

fates of the shunts

A
  1. FO closes (but can persist as PFO)
  2. Ductus arteriosus becomes ligamentum arteriosus (but can persist as PDA)
  3. Ductus venosus becomes ligamentum teres
63
Q

preparations for birth in the 3rd trimester

A 
surfactant production
accumulation of glycogen
brown fat
subcutaneous fat
swallowing amniotic fluid
64
Q

adaptions in first few hours of life

A

thermoregulation
no shivering > breakdown brown fat
ketones as brain fuel

65
Q

when is there a risk of hypothermia in babies?

A

preterm with low brown fat and subcutaneous stores, large SA

66
Q

when is there a risk of hypoglycaemia in babies?

A

increased demand (unwell, hypothermic)
premature
small for dates
maternal diabetes and hyperinsulinaemia

67
Q

why does physiological jaundice happen?

A

breakdown of foetal Hb with immature conjugating pathways causing circulating unconjugated bilirubin

Reproduction Key Information (69 decks)

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