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Repro > Placenta (Natalia) > Flashcards

Placenta (Natalia) Flashcards

again, sorry for the long ass deck, she has 84 slides and there was no obvious way to pick out the important info

1
Q

inner cell mass of the blastocyst becomes the ____

A

fetus

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2
Q

What is the origin of the placenta?

A

outercell mass of the blastocyst:

  • villous cytotrophoblast cells → syncytiotrophoblast
  • extravillous cytotrophoblast cells → invasive throphoblast
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3
Q

What mediates implantation of the blastocyst?

A

L-selectin system:

The human blastocyst expresses L-selectin, and ‘rolls’ on the endometrial surface. There is a weak interaction between the surface of the blastocyst with glycocalyx (on endometrial surface). This allows for enough time (?) for the hCG secreted from the blastocyst to induce trophin expression on the endometrium. Trophin has a domain that is the ligand for L-selectin. They bind and adhesion can occur.

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4
Q

What changes in the endometrial epithelium does attachment of the blastocyst to the endometrium initiate?

A

decidualisation: increased vascular permeability and secretary action of stromal cells

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5
Q

What signaling interactions occurs from the endometrium to the blastocyt for implantation?

A

progesterone and estrogen from the ovary/CL induces endometrial secretion of EGF and Leukemia inhibiting factor which induces blastocyst expression of MMPs and uPA (plasminogen activator)

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6
Q

does a women have to be pregnant to undergo a decidual reaction

A

NO it happens every menstrual cycle

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7
Q

Is decidualized endometrium suitable for implantation?

A

no, it does not allow trophoblast to be able to implant **this occurs at the end of the menstrual cycle ~day 23

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8
Q

what are the characteristic histo signs of the decidual reaction?

A

prominent spiral arteries

spindle shaped stromal cells → round cells (from Nichols’ lecture)

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9
Q

When in the menstrual cycle does the decidual reaction occur?

A

later part,~ day 23

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10
Q

Why does decidualisation occur?

A

efficient placentation = access to maternal blood
restricts trophoblast invasion
provides nutrients

**this “prepares the uterine lining for the presence of the invasive trophoblast but simultaneously closes the door to implantation”

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11
Q

But how can a nonreceptive decidualized endometrium be returned to a receptive nondecidualized endometrium if no pregnancy occurs?

A

menstruation

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12
Q

Within hours of attachment trophoblast destroys _____

A

epithelial cells

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13
Q

Some trophoblast cells fuse to form _____ others retain cellularity and form _____ .

A

Some trophoblast cells fuse to form syncytiotrophoblasts others retain cellularity and form cytotrophoblast

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14
Q

What invades the decidua to attack blood vessel walls? Why?

A

villi to release nutrients, eventually the villi are invaded by embryonic blood vessels

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15
Q

layer of mononuclear cells that forms new cells form into the syncytiotrophoblast

A

villous cytotrophoblast

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16
Q

What is the major source of placental hormone production, particularly hCG?

A

syncytiotrophoblast

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17
Q

what are the primary chorionic villi? when are they present?

A

villous extensions from cytotrophoblast

end of 2nd week

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18
Q

what are the multinucleated cells that invade the endometrial stroma

A

syncytiotrophoblast

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19
Q

primary chorionic villi originate from

A

cytotrophoblast

known as villous cytotrophoblast when they are present

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20
Q

By nine days the embryo is surrounded by ____

A

two layers of trophoblasts

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21
Q

Describe the trophoblast layers (~day 9)

A

inner mononuclear cytotrophoblast

outer multinucleated syncytiotrophoblast layer

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22
Q

What is the function/purpose of the trophoblast laysers

A

extract nutrients from mother and protects fetus/embryo from maternal immunologic attack

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23
Q

what is a proposed theory for the origination of the deciduation?

A

retrovirus

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24
Q

What mechanisms are present to facilitate immune tolerance of the mother?

A

cytotrophoblasts:
• decrease complement activity
alter Ag presentation (HLA-G)

syncytiotrophoblasts:
• regulate leukocyte traffic by cytokines and chemokines
• releases indolemanine 2,3-dioxygenase

ovaries: secrete progesterone (anti-inflammatory, regulates prostaglandin production)

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25
Q

what promotes angiogenesis in the endometrium surrounding the implanted embryo?

A

trophoblast (both layers) make VEGF

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26
Q

By what week are the anatomical arrangements necessary for physiological exchanges between the mother and her embryo are established

A

3rd

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27
Q

At what week is the complex vascular network established in the placenta (to facilitates maternal-embryonic exchanges of gases, nutrients, and metabolic waste products)?

A

4th

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28
Q

How are secondary chorionic villi formed?

A

made from primary villi that branch and then develop a core of mesenchymal tissue

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29
Q

what do the secondary chorionic villi cover?

A

entire surface of the chorionic sac

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30
Q

what happens as the chorionic sac grows (past the 8th week)?

A

villi assc with the decidua capsularis are compressed → reduced blood supply to them → they degenerate → bald areas/smooth chorion

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31
Q

Decidual vera =

A

decidua capsularis + decidua parietalis

does NOT incule decidua basalias

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32
Q

As the secondary villi disappear, those associated with the ______ rapidly increase in number, branch profusely, and enlarge

A

decidua basalis

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33
Q

As the villi disappear, those associated with the decidua basalis rapidly increase in number, branch profusely, and enlarge → forming the

A

villous chorion

*part of the chorionic sac

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34
Q

During early implantation, the maternal vessels are penetrated and become plugged up with

A

trophoblasts

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35
Q

T or F: you need an embryo present to develop the placenta

A

F: the fetus is a “by product” of the placenta forming

36
Q

the ____ of the spiral arteries decreases to allow more blood to get to the fetus

A

resistance

37
Q

During implantation the trophoblast differentiates into the

A

syncytiotrophoblastand the cytotrophoblast and the embryoblast

38
Q

The______ begins to invade maternal

tissue, making contact with maternal vessels

A

syncytiotrophoblast

39
Q

lacunae develop within the

A

syncytiotrophoblast

40
Q

cytotrophoblastic cones grow into

A

the syncytiotrophoblast mass

41
Q

First fetal capillaries appear within the

A

chorion plate

42
Q

branching of the____ results in a trabecular tree

A

trophoblast

43
Q

The trabecle contain

A

mesenchyme, fetal capillaries, and a single layer of cytotrophoblast cells

44
Q

The _______ is built by a thin syncytiotrophoblast layer

A

barrier to the labyrinth

45
Q

Maternal vessels are opened so that the ______ is filled with maternal blood

A

placental labyrinth

46
Q

Blastocyst implantation occurs around day _____ post-conception

A

6-7

47
Q

Forms a shell that ultimately anchors the conceptus to the endometrium

A

Cytotrophoblast

48
Q

Cavity between the embryoblast and trophoblast forms the_______, lined by a membrane called the

A

primordial amnionic cavity lined by the amnion

49
Q

what cells/tissues constitute the chorion?

A

Trophoblastic layers and extraembryonic somatic mesoderm

50
Q

Basic structure of placenta formed ____ weeks gestation.

A

5

51
Q

maternal and fetal circulations are seperated by

A

syncytiotrophoblast

52
Q

The placenta is responsible for respiration and excretion in the growing fetus. Describe how this is accomplished.

A

Fetal blood flows through the blood vessels of the umbilical cord to the placenta, where fingerlike capillary nets (intermediate and terminal villi) are surrounded by pools of the mother’s blood. Here carbon dioxide and other metabolic wastes diffuse from fetus to mother, and oxygen and nutrients pass from mother to fetus.

53
Q

The definitive placental disc is called the

A

chorion frondosum

54
Q

The _____ contains fetal arteries and veins that connect the umbilical circulation to smaller branches of chorionic arteries and veins

A

chorionic plate (continuous with the bald chorion)

55
Q

What is the inner shell of the conceptus? outer shell?

A 
inner = amnion 
outer = chorion
56
Q

___ is embryologically continuous with the epithelium of the umbilical cord and the baby’s skin

A

amnion

57
Q

is the amnion vascularized?

A

no

58
Q

Wharton’s jelly is

A

the connective tissue of the umbilical cord

59
Q

protects the cord blood vessels from mechanical trauma

A

Wharton’s jelly

60
Q

The maternal portion of the placenta arises from the_____ that is transformed into_____

A

endometrium → decidua

61
Q

What hormone is the major driving force that transforms the endometrium into the decidua?

A

progesterone

62
Q

WHat is the portion of the decidua at the base of the chorion frondosum (the implantation site)?

A

decidua basalis

63
Q

WHat is the origin of the uteroplacental arteries

A

spiral arteries + trophoblast invasion (with remodeling)

64
Q

What causes the uteroplacental arteries to dilate?

A

pressure due to increased uterine blood flow

65
Q

How are the uteroplacental arteries structurally different than other arteries

A

the lack elastic or muscular layers (just fibrous)

66
Q

a predominantly acellular zone that develops at the interface between the chorionic villi and the decidua in the decidua basalis.

A

Nitabuch’s fibrinoid layer

67
Q

The intervillous space can also be thought out as part of the maternal component of the placenta. This space is filled by maternal blood provided by the

A

uteroplacental arteries

68
Q

Fetal nutrient exchange occurs at the interface between the

A

intervillous space and the chorionic villi.

**TERMINAL VILLI

69
Q

What regulates nutrient and gas exchange within the intervillous space

A

blood flow and placenta structure

70
Q

how are Immunoglobulins transferred from maternal circulation to fetal circulation?

A

endocytosis (vesicular transport)

71
Q

how are respiratory gases transferred from maternal circulation to fetal circulation?

A

lipophillic diffusion

72
Q

how are hydrophillic molecules transferred from maternal circulation to fetal circulation?

A

paracellular diffusion (via watter filled channels/pores)

  • ex: Na, Ca, K
  • **larger proteins use transporters
73
Q

Transporters mediating the transfer of amino acids, glucose (GLUTs), and fatty acids (FATPs) are expressed in both plasma membranes (apical and basolateral) of the ______

A

syncytiotrophoblast

74
Q

describe the transfer of lipids from maternal circulation to fetal circulation

A

extracellular lipases release fatty acids from maternal lipoproteins and intracellular binding proteins (FABPs) guide the fatty acids within the cytosol of the syncytiotrophoblast.

75
Q

_____ may interfere with amino acid transport through nutrient signal pathways

A

glc and lipid metabolism

76
Q

what type of FA does the placenta preferentially pick up?

A

long chain poly-unsaturated FA

77
Q

… are predicted to prevent accumulation of xenobiotics in the fetal circulation by limiting their entry into the placenta

A

Maternal facing apical/microvillous membrane ATP-binding cassette (ABC) family of transmembrane transporters

78
Q

Accreta

A

placenta attached to the myometrium

79
Q

Increta

A

placenta invades the myometrium

80
Q

Percreta

A

placenta invades to or through the uterine serosa

81
Q

Absence of the fibrinoid layer between the villi and decidua (Nitabuch’s layer)

A

placenta accreta (leads to the placenta beign directly attached to the myometrium)

82
Q

implantation of the placenta in the lower uterine segment

A

placenta previa

83
Q

complete vs partial vs marginal placenta previa

A

Complete—placenta covers entire internal cervical os
Partial—placenta covers a portion of the os
Marginal—placenta immediately adjacent to internal os

84
Q

separation of a normally-implanted placenta before the birth of the fetus

A

abruption placentae

85
Q

presentation of placental abruption

A

vaginal bleeding, abdominal pain, tender or rigid abdomen, hypercontracile uterine contraction pattern

86
Q

What are risk factors for placental abruption

A 
truama 
maternal HTN 
maternal cocaine use 
maternal cigarette smoking 
sudden uterine decompression

Repro (27 decks)

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