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GIGU Exam 2 > Placenta And Fetal Membranes > Flashcards

Placenta And Fetal Membranes Flashcards

1
Q

4 fetal membranes

A
  1. Chorion
  2. Amnion
  3. Umbilical vehicle
  4. Allantois
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2
Q

2 parts of the placenta

A
  1. FETAL PART : chorionic sac (outermost fetal membrane)

2. MATERNAL PART : from endometrium (most functional part of placenta) = decidua

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3
Q

What connects placenta circulation to fetal circulation

A

Umbilical cord vessels

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4
Q

Site of blood and nutrient exchange from mom and fetus

A

Placenta

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5
Q

Decidua and 3 parts

A

Functional part of endometrium, leaves with baby

  1. Decidua basalis
  2. Decidua Capsularis
  3. Decidua Parietalis
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6
Q

Decidua Basalis

A

Deep to conceptus, where blastocyst implants into endometrium
Maternal part of placenta
BABY + PLACENTA

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7
Q

Decidua Capsularis

A

Superficial and overlies the conceptus

CHORION

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8
Q

Decidua Pareitalis

A

Remaining parts of the decidua

WALLS OF UTERUS

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9
Q

Decidual Reaction

A

Done by the decidua basalis cells that undergo massive lipid and glycogen accumulation and look pale = nutrients for embryo

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10
Q

when do trophoblasts differentiate and to what

A

10th day, as blastocyst is embedded into endometrium

  1. Cytotrophoblast (inner)
  2. Syncytiotrophoblasts (outer)= invades and displaces decidual cells —-> decidua basalis
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11
Q

Lacunae appear

A

In the syncytiotrophoblast

Fill with blood and uterine secretion, forms networks

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12
Q

Primordial Uteroplacental Circulation

A

O2 and nutrients pass to embryo by diffusion through lacunae networks bathing the embryo
(Before any Blood supply network has established)

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13
Q

The Amnion is

A

Thin tough membrane around fetus and amniotic fluid

= will eventually grow to X chronic cavity and line the umbilical cord

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14
Q

Where do amnioblasts come from

A

From the Epiblast

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15
Q

Amniotic Fluid

A

Cushion fetus, reg temp, increases with gestation
(Has aa, carbs, fats, enzymes, Hs., salts, ions, steroids)
Over time GIGU and RESP takes over

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16
Q

How much amniotic fluid at birth

A

700ml-1000ml

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17
Q

Extraembryonic mesoderm (hypoblast) consists of

A
  1. Extraembryonic somatic mesoderm : lines trophoblasts and over amnion
  2. extraembryonic Splanchnic mesoderm : around umbilical vesicle
  3. Extraembryonic Ceolom : around amnion and umbilical vesicle
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18
Q

Chorionic sac 3 components

A

Cytotrophoblasts + Syncytiotrophobalsts + extraembryonic somatic mesoderm

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19
Q

Poly Hydraminos

A

Excessive fluid
CAUSES: CNS + genetic deformities + GI blockage
ABD pain, swelling and bloating,breathlessness, PROM risk, uterus grows too big
*Premature rupture of membranes = PROM

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20
Q

Oligohydramnios

A

Not enough fluid (<400ml),
CAUSES : renal agenesis, pulmonary hypoplasia,
Club foot, maternal HTN

21
Q

Placenta 3 critical components

A

Villous Chorion = fetal part sticking into decidua basalis
Chorionic villi
Decidua basalis = maternal part

22
Q

Cytotrophoblasts do what after implantation to form the placenta at the decidua basalis site

A
  1. It proliferates to make the CHORIONIC PLATE right below the villus chorion (fetal part)
  2. Extends extensions through the syncytiotrophoblasts to attach to decidua basalis = CYTOTROPHOBLASTIC SHELL
  3. Encloses the lacunae networks inside the villus chorion forming the INTERVILLOUS SPACE
23
Q

Intervillous space

A

Forms lacunae network and site of blood with the fetal villi sticking in to it

24
Q

Placental Septa

A

Decidua erosion that happens as the cytotrophocytes that enclose the lancunea network eroded villi by maternal decidua basalis (on either side of villi)
Parts that are not eroded forming the villi = Cotyledons

25
Which weeks do intervillous space of placenta contain maternal blood due to the decidual erosion
Week 11-14 | (In areas that the villous chorion and decidua basalis connect and form openings into each other) * BY spiral arteries
26
Primary Chorionic Villi
When cytotrophoblasts first grow into the syncytiotrophoblasts Week 2 end And then forms small columns (week8) which become SMOOTH and VILLOUS chorion * cytotrophoblasts core and covered by syncytiotrophoblasts
27
The smooth vs villus chorion
the decidua basalis = villous chorion | The decidua Capsularis = smooth chorion (columns degenerate)
28
The Secondary Chorionic Villi
Extraembryonic mesoderm grows into the primary villi (WEEK3) Core : Extraembryonic mesoderm (fetal CT) Covered by cytotrophoblasts and syncytiotrophoblasts
29
Tertiary Chorionic Villi
Some of the Extraembryonic mesoderm have become BVs CORE : Capillaries and CT Then cytotrophoblast layer Then syncytiotrophoblasts layer’ *Late pregnancy = cytotrophoblasts are lost slowly and syncytiotrophoblasts organize into syncytial knots
30
Tertiary Chorionic Villi have 3 types to BV villi inside
all from the villus chorion MAIN STEM VILLI : extend from chorionic plate *BRANCH VILLI : extend from main stem villi to increase SA, (main exchange) ANCHORING VILLI : attach to the maternal tissues on the cytotrophoblastic shell
31
Cotyledons contain
2 or more main stem villi + many branch villi
32
As the the chorionic villi are formed there are some changes happening to the decidua
1. Villous chorion = placenta site Capsularis = smooth chorion 2. Capsularis part bulges into the uterine cavity eventually hitting the other uterine wall 3. Casularis degenerates : Amnion and Chorion fuse = Amniochorionic membrane 4. Amniochorionic membrane fuses with decidua paietalis on opposite wall facing the vagina opening
33
Before 20 week
Syncytiotrophoblasts, cytotrophoblasts, CT in villi, endothelium of fetal capillaries
34
After 20 weeks
Syncytiotrophoblasts, CT in Villi, endothelium of fetal capillaries (Lost cytotrophoblast) - late pregnancy
35
What CANT cross the placenta membrane
Protein Hs. (AP, PP) Bacteria aa like structured drugs (methyldopa)
36
What CAN cross the placental membrane
Nutrients : H2O, glucose, aa, VIT, electrolytes H. : testosterone, progestins, T3/T4 IgG Insulin (some) Waste Drugs + alcohol Infections of : Varicella, rubella, measles, herpes, listeria....
37
What is inside the umbilical cord
Enclosed by amnion and inside is mucous tissue = WHARTON’S JELLY 1. 2 Umbilical A.s (deoxygenated) 2. 1 Umbilical V (80% oxygenated)
38
X Umbilical Artery
By chromosome or fetal anomalies Can impact 3rd stage labor Agenesis or degraded one of A.s, detected before birth
39
Placenta Previa
Placenta implants in lower uterine segment or cervical = 3rd trimester bleeding = high risk if you have had prior placental previa or c-section
40
Placenta Accrete/a
Partial or complete absence of the decidua = villous chorion adheres to myometrium directly = placenta does not separate at birth = sever and life threatening postpartum bleeding
41
Hydatidiform Mole
Replacement of normal villi by dilated or hydropic (edematous) translucent vesicles 1. Partial Mole 2. Complete Mole
42
Partial Mole
Portions of villi are edematous, capillaries can be seen in the villi Fetal tissue can be found Ovum fertilized with 2 sperm (69XXY or 92XXXY)
43
Complete Mole
All villi enlarged, covered with trophoblast invasion No fetal tissue Fertilization of blighted ovum ——> all DNA is paternal (2 sperm or 1 duplicated sperm) (46XY, 46XX)
44
Invasive Mole
Complete mole (which has no genetic info) that penetrates or perforated the uterine wall = hemorrhaging Dx: high hCG Sx: female has + pregnancy test and no fetal tissue in ultrasound Tx: chemotherapy
45
Gestational Choriocarcinoma
Highly invasive tumor from trophoblast cells 50% of molar pregnancies Dx: High hCG with no uterine enlargement Tx: chemotherapy and other agents combined
46
Monozygotic Twins
SAME chorion sac Divides at : 2-8 cell (0-72hr) ——> 2 amnion, 2 chorion * MOST separate placentas Blastocyst (4-8 days) ——> 2 amnion, 1 chorion Implanted (9-12 days) ——> 1 amnion, 1 chorion
47
Most monozygotic twins divide when
from embryoblast at blastocyst (65%) | 35% divide at 2 morula stage - own chorionic and amniotic sacs
48
Dizygotic Twins
From 2 zygotes (2 amnions and 2 chorions) =Fraternal twins Implant separately = 2 chorions, 2 amnions Adjacent Implantatin = 2 amnions, 2 fused chorions, 2 placentas

GIGU Exam 2 (13 decks)

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