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GIGU Final > Placenta and Fetal Membranes > Flashcards

Placenta and Fetal Membranes Flashcards

1
Q

what do the fetal membranes include?

A

chorion, amnion, umbilical vesicle, and the allantois

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2
Q

what is the fetal part of the placenta?

A

the chorionic sac (outermost fetal membrane)

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3
Q

what is the maternal part of the placenta?

A

derivative from endometrium

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4
Q

what connects the placental circulation with the fetal circulation?

A

vessels in the umbilical cord

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5
Q

What is the decidua?

A

the functional layers of the endometrium that separates from the remainder of the uterus after childbirth

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6
Q

what are the three parts of the decidua?

A

decidua basalis, decidua capsularis, decidua parietalis

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7
Q

what area of the decidua forms the maternal part of the placenta?

A

decidua basalis

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8
Q

what can the decidua capsularis be thought of as?

A

the chorion

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9
Q

what can the decidua parietalis be thought of as?

A

“walls” of the uterus

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10
Q

when does implantation typically occur?

A

late 2nd week (~ 10 days post-fertilization)

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11
Q

how do the trophoblast differentiation when implanting?

A

they differentiate into cytotrophblasts and syncytiotrophoblasts

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12
Q

which new layer of the blastocyst is responsible for invading and displacing the decimal cells of the endometrium?

A

the syncytiotrophoblasts

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13
Q

what eventually appears in the syncytiotrophoblast layer that allows for blood and uterine secretions to wash and bathe over the implanting embryo?

A

lacunae

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14
Q

what forms when adjacent lacunae fuse together?

A

lacunar networks

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15
Q

what is the primordial uteroplacental circulation?

A

it is where O2 and nutritive substances pass to the embryo via diffusion through lacunar networks

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16
Q

what is the chorionic sac made up of?

A

extra embryonic somatic mesoderm, cytotrophoblasts, and syncytiotrophoblasts

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17
Q

what is the thin tough membrane that surrounds the embryo/fetus and the amniotic fluid?

A

the amnion

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18
Q

how did the amnion develop?

A

from a population of cells known as amnioblasts (these separate from the epiblast and enclose the amniotic cavity)

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19
Q

what is the umbilical cord covered with?

A

the amnion forms an epithelial covering over the umbilical cord

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20
Q

what is amniotic fluid initially derived from?

A

maternal tissue and interstitial fluid; later fetal urinary, respiratory, and GI systems will also contribute

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21
Q

what is (poly)hydramnios?

A

excessive amniotic fluid; too much produced or not removed effectively

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22
Q

what could cause (poly)hydramnios?

A

genetic and/or CNS anomalies or blockage of the GI tube

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23
Q

what are the clinical signs of (poly)hydramnios?

A

abdominal pain, significant swelling or bloating, and breathlessness

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24
Q

what is a potential risk associated with (poly) hydramnios?

A

PROM (pre-mature rupture of membranes)

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25
Q

what is oligohydramnios?

A

insufficient amniotic fluid

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26
Q

what results from oligohydramnios?

A

renal agenesis, pulmonary hypoplasia, club footing; placental abnormality or maternal high blood pressure

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27
Q

what two things are critical for establishing the placenta?

A

formation of the villous chorion and the chorionic villi from the chorionic sac

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28
Q

where do the cytotrophobasts proliferate?

A

at the chorionic plate

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29
Q

after proliferating at the chorionic plate, what do the cytotrophoblasts do?

A

they extend through the syncytiotrophoblasts to attach to the decidua basalis

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30
Q

when extending through the syncytiotrophoblasts, where is the boundary for where the cytotrophoblasts will stop extending?

A

the cytotrophoblastic shell (surrounding the chorionic sac)

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31
Q

what does the extension of the cytotrophoblast/ cytotrophoblastic shell create and enclose?

A

the intervillous space (created from the lacunar networks)

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32
Q

what does decimal erosion produce?

A

placental septa

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33
Q

what does the placental septa divide the villous chorion into?

A

irregular convex areas known as cotyledons

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34
Q

when do the intervillous spaces start containing maternal blood?

A

11-14th week

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35
Q

when do the cytotrophoblasts grow into the syncytiotrophoblast layer?

A

end of week 2

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36
Q

when do the cytotrophoblasts form syncytial columns? (like little branches all along the chorionic sac)

A

through week 8

37
Q

where would you expect to find the villi with the branches?

A

with the decidua basalis- form bushy area of the chorionic sac, the villous chorion

38
Q

what is the smooth chorion?

A

the villi associated with the decidua capsularis become compressed and then degenerate

39
Q

what is the structure of the primary villi?

A

cytotrophoblastic core covered by syncytiotrophoblasts

40
Q

what is a secondary villi and when do you get it?

A

the extra embryonic mesoderm grows into the primary villi - 3rd week

41
Q

what makes up the secondary villi?

A

extra embryonic mesoderm (core), cytotrophoblasts, and syncytiotrophoblasts

42
Q

how do you get a tertiary villi?

A

the extra embryonic mesoderm differentiates into capillary and blood cells

43
Q

what is the outer layer of the tertiary villi?

A

syncytiotrophoblasts

44
Q

what is the middle layer of the tertiary villi?

A

cytotrophoblasts

45
Q

what is the core of the tertiary villi?

A

capillaries and extra embryonic mesoderm

46
Q

what are the two subpopulations of tertiary chorionic villi?

A

early and late (late tertiary chorionic villi start to lose the cytotrophoblastic layer

47
Q

what is the main stem villi extending from?

A

the chorionic plate

48
Q

what are the branch villi extending from?

A

the main stem villus

49
Q

what is the anchoring villi?

A

villi that attaches to the maternal tissues through the cytotrophoblastic shell

50
Q

what do cotyledons contain?

A

2 main stem villi and multiple branch villi

51
Q

where does the main exchange between mother and fetus occur?

A

via the branch villi

52
Q

what happens to the decidua capsularis are the embryo//fetus grows?

A

the capsularis will degenerate

53
Q

what happens once the capsularis degenerates?

A

the amnion and the chorion will fuse

54
Q

what do you get when you fuse the amnion and the chorion?

A

the amniochorionic membrane

55
Q

what does the amniochorionic membrane fuse with on the opposite wall?

A

the decidua parietalis (it can now span the internal uterine os)

56
Q

what things cannot cross the placenta?

A

protein hormones (pituitary hormones), bacteria, and drugs with amino-acid-like structures

57
Q

what kind of tissue comprises the umbilical cord?

A

mucous tissue (Wharton’s jelly)

58
Q

what are the contents of the umbilical cord?

A

two umbilical arteries and one umbilical vein, allantois

59
Q

what do the umbilical arteries carry?

A

deoxygenated blood

60
Q

what do the umbilical veins carry?

A

oxygenated blood

61
Q

what is one of the most common umbilical cord anomalies?

A

absences of one umbilical artery

62
Q

who is at risk for absence of one umbilical artery?

A

fetuses with chromosomal and fetal anomalies

63
Q

what is the risk of absence of one umbilical artery?

A

it can impact perinatal and 3rd stage labor outcomes

64
Q

what is placenta previa?

A

a condition where the placenta implants in the lower uterine segment or cervix

65
Q

what does placenta previa often lead to?

A

serious 3rd trimester bleeding

66
Q

what is placenta accrete/a?

A

partial or complete absence of the decidua–> so the villous chorion adheres directly to the myometrium

67
Q

what is the result of placenta accrete/a?

A

failure of placental separation at birth

68
Q

what is a hydatidiform mole?

A

a placental anomaly because of faulty fertilization; there is replacement of normal villi by dilated or hydronic (edematous) translucent vesicles

69
Q

what are the two types of hydatidiform moles?

A

partial mole or complete mole

70
Q

which mole does not have any fetal tissue?

A

compete mole

71
Q

what happens in a case of a partial mole?

A

a normal ovum is fertilized with two sperm

72
Q

what would the karyotype of a partial mole be?

A

triploid or tetraploid

73
Q

what happens in a case of a complete mole?

A

there is fertilization of a blighted movum- all DNA is paternal; it is either fertilized by two sperm or there is duplication of a single sperm

74
Q

what would the karytype of a complete mole be?

A

46 XX or 46XY

75
Q

what is gestational trophoblastic disease?

A

a placental anomaly due to issues with invasion

76
Q

what are invasive moles?

A

complete moles that penetrate or perforate the uterine wall

77
Q

how are invasive moles diagnosed?

A

by persistent high blood levels of hCG

78
Q

what are invasive moles responsive to?

A

chemotherapy

79
Q

what is a gestational choriocarcinoma?

A

a highly invasive metastatic tumor that arises from trophoblast cells

80
Q

what do monozygotic twins originate from?

A

one zygote

81
Q

what are the membranes in monozygotic twins dependent upon?

A

timing of the division

82
Q

if there is cleavage in the 2-8 cell stage (0-72 hours), what is the nature of the membranes?

A

diamniotic and dichorionic

83
Q

if there is cleavage in the blastocyst stage (4-8 days) what is the nature of the membranes?

A

diamniotic and monochorionic

84
Q

if there is cleavage in the implanted stage (9-12 days) what is the nature of the membranes?

A

mono amniotic and monochorionic

85
Q

the earlier the split the…?

A

the more separate the membranes and the placenta will be

86
Q

what do dizygotic twins originate from?

A

two zygotes

87
Q

what do you get when you have separate implantation of 2 zygotes?

A

2 chorions and 2 amnions

88
Q

what do you get when you have adjacent implantation of 2 zygotes?

A

2 amnions, 2 fused chorions, and 2 placentas

GIGU Final (15 decks)

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