Placental Development - 2/24 Cole

Question 1

What happens in sperm capacitation?

Answer 1

Remove epididymal and seminal glycoproteins
INC membrane permeability to Ca
This maximizes cAMP which increases sperm motility

Question 2

What are the 3 main events in fertilization?

Answer 2

1. Sperm binding to ZP3
2. Acrosome reaction
3. Sperm-egg fusion

Question 3

What enzymes are released during the acrosome reaction?

Answer 3

Neuramidase

Acrosin

Question 4

What prevents polyspermy in fertilization of the egg?

Answer 4

Cortical reaction where proteases are released from cortical granules

Question 5

What is required for sperm to fuse with the egg?

Answer 5

Izumo (CD9)

Question 6

The cortical reaction has what components and what happens in each?

Answer 6

Fast component - change in resting potential of oocyte PM prevents polyspermy

Slow component - release of cortical granules

Question 7

How many cells is a morula?

What does it differentiate into?

Answer 7

8 cells

Blastocyst

Question 8

Layers of blastocyst?

Answer 8

Outer trophoblast

Inner cell mass

Question 9

What is apposition?

Answer 9

Adhesion to endometrium

Question 10

What do trophoblastic and endometrial cells express?

Answer 10

Integrins

Question 11

Cells of the decidual reaction store what?

Under influence of what?

Answer 11

Lipids and glycogen

Progesterone

Question 12

What does the decidual reaction consist of?

Answer 12

Vascular and endematous endometrial stroma
Secretory endometrial glands
Apical microprocesses (pinopodes)

Question 13

What are apical epithelial cellular protrusions of the endometrium called?

Answer 13

Pinopodes

Question 14

What is located between the endometrial cells, which must be reduced to allow synciotrophoblast to get through?

Answer 14

Desmosomes

Question 15

When is uteroplacental circulation established?

Answer 15

When trophoblastic cells are in direct contact with maternal blood

Question 16

What begins the secretion of hCG?

Answer 16

Syncytiotrophoblast

Question 17

What immunosuppressive substance inhibits the activity of NK cells at the implantation cite?

Answer 17

PGs

Question 18

What do infiltrating leukocytes in the endometrial stroma secrete to prevent maternal tissue rejection of the implanting embryo?

Answer 18

IL-2

Question 19

What don’t Syncytiotrophoblastic cells express?

Answer 19

MHC II

Therefore cannot present Ags to CD4 T cells

Question 20

What is a primary villus formed by?

Answer 20

Core of cytotrophoblast covered by multinucleated Syncytiotrophoblast

Question 21

What is a secondary villus formed by?

Answer 21

Inner core of XE mesoderm
Middle cytotrophoblast
Outer Syncytiotrophoblast

Question 22

What is the distinguishing feature of tertiary villi?

Answer 22

Presence of capillaries

Question 23

What are the 2 parts of placenta and where are they from?

Answer 23

Chorion frondosum - embryo

Decidua basalis - mother

Question 24

What are the Fx of the placenta?

Answer 24

Exchange of gases
Transfer of IgG
Rh D antigen isoimmunization
Steroid hormone production

Question 25

What are the 3 components of the maternal Decidua?

Answer 25

Basalis, capsularis, parietalis

Question 26

Where does the implantation site of the blastocyst happen? What part overlays this?

Answer 26

Basalis Capsularis

Question 27

What is the chorionic villus?

Answer 27

Basic structure involved in maternal-fetal exchanges

Question 28

What is the placental barrier composed of?

Answer 28

Syncytiotrophoblast Cytotrophoblast XE mesenchyme Fetal endothelium

Question 29

What is a placental abruption?

Answer 29

Premature separation of normally implanted placenta, hemorrhage into the Decidua basalis, impaired oxygenation of fetus

Question 30

What is placenta previa?

Answer 30

Implantation of placenta over the cervical OS

Question 31

What is placenta accreta? Placenta in increta? Placenta percerta?

Answer 31

Abnormal trophoblastic invasion Into the myometrium Through serosa and surrounding tissues

Question 32

What happens in uterine Atony? What causes it? Tx?

Answer 32

Contractions of the uterine muscles not strong enough -> postpartum bleeding Abnormal labor, enlarged uterus, fibroids (Leiomyomas) Oxytocin

Question 33

What is lithopedion?

Answer 33

Fetal death with ectopic pregnancy Too large to be reabsorbed and it calcifies

Question 34

What are GTD tumors composed of? What is indicitive of GTD? Tx?

Answer 34

Trophoblastic tissue high B-hCG Chemotherapy

Question 35

What is a complete mole karyotype? Presence of fetal tissue? Hydropic villi? Trophoblastic hyperplasia?

Answer 35

46XX or 46XY paternal origin Absent Extensive - look like grapes Extensive w/atypia

Question 36

Partial mole karyotype? Presence of fetal tissue? Hydropic villi? Trophoblastic hyperplasia?

Answer 36

Triploidy or tetraploidy Present bc of maternal chromosomes Limited and focal Focal w/mild atypia

Question 37

What is an invasive mole?

Answer 37

Invasion of myometrium of edematous chorionic villi covered with layers of proliferative trophoblastic cells B-hCG moderately elevated

Question 38

What is choriocarcinoma?

Answer 38

Admixture of malignant cytotrophoblast and Syncytiotrophoblast No villi

Question 39

Where does sperm maturation occur? Sperm capacitation?

Answer 39

Epididymis Female reproductive tract