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R & D: Final Exam S'17 > Physiology of Pregnancy > Flashcards

Physiology of Pregnancy Flashcards

1
Q

What affect does Uterine contractions have on arterial flow and venous flow?

A

It attenuates arterial inflow and completely interrupts venous drainage

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2
Q

What is the first hormone produced via the synctiotrophoblasts?

A

hCG

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3
Q

Laboratory assays and OTC pregnancy tests are testing for what subunit of hCG?

A

B-subunit (hormone specific)

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4
Q

What are the endocrine functions of Human Placental Lactogen (hPL)?

A

Protein Anabolic, Lipolytic, & Insulin Antagonist

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5
Q

Which hormone contributes to the diabetogenicity of Pregnancy?

A

Human Placental Lactogen

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6
Q

What is basic mechanism for Progesterone production?

A

It is unregulated; Progesterone is made as much as supplies of cholesterol and enzymes Cholesterole Desmolase & 3B-HSD will allow

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7
Q

What is main hormone of pregnancy?

A

It is etriol

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8
Q

What hormone is secreted from the midluteal phase?

A

Progesterone

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9
Q

What are two effects in regards to both pregnancy and menstruation in terms of Progesterone?

A

1) Pregnancy: Stimulates maternal-to-fetal transfer nutrients
2) Menstruation: Inhibits myometrial contraction and prevents the release of paracrine factors that lead to menstruation

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10
Q

The “Window of Receptivity” as induced by Progesterone expression occurs from days ____ to ____ ?

A

20-24 days

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11
Q

What anatomical structures account for the increased vascularization of the uterine endothelium during implantation?

2) What is the purpose of the increased vascularization to the uterine endothelium?

A

1) Spiral Arteries

2) Increased vascularization to the uterine endothelium allows for increased hCG delivery to “rescue” the Corpus Luteum

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12
Q

What is the role in Progesterone maintaining pregnancy?

A

It reduces uterine contractility and inhibits propagation of contractions

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13
Q

After eight weeks of gestation, what becomes the primary source of estrogens and progesterones?

A

The placenta

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14
Q

What two hormones promote the inactivity of the uterus during pregnancy?

A

Progesterone and Relaxin

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15
Q

What are some common physiological changes with the stages of labor?

A

There are an increase in the number of GAP junctions between myometrial cells & an increase in the number of oxytocin receptors

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16
Q

What is the narrowest part of the pelvis?

A

Ischial Spine

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17
Q

What is defined as 0 station?

A

It is when the baby’s head is even with the ischial spines (mother)

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18
Q

What are two of Estrogens effects in the role of Parturition?

A

1) Increases the degree of uterine contractility

2) Stimulates the synthesis of receptors for Oxytocin in myometrial & decidual tissue

19
Q

The synthesis of Prostaglandins is stimulated via what?

A

1) Estrogen from Arachidonic Acid in Fetal Membranes

2) Oxytocin in uterine cells

20
Q

Which specific prostaglandins increase uterine motility?

A

PGF 2a & PGE2

21
Q

When is the uterus sensitive to both oxytocin & prostaglandins?

A

1) Oxytocin: Uterus remains insensitive to Oxytocin until about 20 weeks of gestation
2) Prostaglandins: Uterus remains susceptible to prostaglandins throughout Pregnancy

22
Q

What is the Ferguson Reflex?

A

It is where the release of Oxytocin is stimluated via stretch of the Cervix

23
Q

What hormonal factors are primary responsible for the initiation of labor and the sustaining of labor?

A

1) Prostaglandins: Stimluate the onset of labor

2) Oxytocin: Stimulates powerful uterine contractions that sustain labor

24
Q

How does Oxytocin stimulate Prostaglandin production?

A

It binds to receptors on decidual cells, thereby stimulating PGF2a production

25
Q

What is the role of Relaxin during labor?

A

It softens and dilates the cervix

26
Q

What is the main product of secretion by the placenta during times of labor?

A

Prostaglandins –> increase the intensity of uterine contractions

27
Q

What are Braxton Hicks contractions?

A

They are weak and slow rhythmic contractions of the uterus during pregnancy

28
Q

What is effacement?

A

It is the process by which the uterus prepares for delivery.

50% Effacement = Patient is half way to being ready for delivery

100% Effacement = Patient’s delivery of the baby is right around the corner

29
Q

At what diameter of the cervix does descent and expulsion take place?

A

10 cm

30
Q

What is the definition of prolonged labor?

Also, what are the subcategories?

A

1) Labor lasting longer than 18-24 hours
2) Latent (early) phase of labor is > 8 hrs

2B) Active Phase of Labor is > 12 hours

31
Q

What is preterm labor defined as?

A

It is labor that begins prior to the 37th week of pregnancy

32
Q

What occurs in a ruptured uterus?

A

The integrity of the myometrial wall is breached; can occur as either traumatic or spontaneous rupture.

Usually occurs during active labor but can occur during late pregnancy

33
Q

What are some definitive characteristics of Preeclampsia?

A

1) It occurs after week 20 during pregnancy
2) Characterized by high blood pressure & signs of damage to other organs, such as the kidney (Proteinuria and edema seen)

34
Q

What is the pathological result seen with mother’s suffering from Preeclampsia?

A

Placenta is abnormal and characterized via poor trophoblast invasion

35
Q

What are Mammogenic hormones?

A

Promoting proliferation of alveolar and duct cells

36
Q

Lactogenic hormones promote what?

A

Milk production by alveolar cells

37
Q

Galactokinetic hormones promote what?

A

Contraction of myoepithelial cells & milk ejection

38
Q

Galactopoietic hormones promote what?

A

Maintain milk production after it has been established

39
Q

What is the primary form of movement of leukocytes in the milk production of the mother?

A

Via the paracellular route

40
Q

What hormone stimulates milk production?

A

PRL (Prolactin); secreted by the anterior pituitary gland

Lesser degree via Human Placental Lactogen

41
Q

PRL (Prolactin) in inhibited via what hormones?

A

It is inhibited via Estrogen and Progesterone

42
Q

What is the most powerful physiological stimulus for PRL release?

A

Suckling; it inhibits hypothalamic dopaminergic neurons

43
Q

What is the effect of Oxytocin on milk production?

A

Contraction of myoepithelial cells surrounding the Alveoli & ducts of the breast; increasing milk ejection

44
Q

In regards to the basis of the lactational amenorrhea; what specific areas of the hypothalamus are inhibited via spinal cord neurons as a result of increased PRL produciton?

A

Increased PRL produciton –> Spinal cord neurons inhibit –> Arcuate and Preoptic area of the Hypothalamus –> causes a fall in GnRH production

R & D: Final Exam S'17 (11 decks)

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