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ELC Anatomy > Pregnancy and lactation > Flashcards

Pregnancy and lactation Flashcards

1
Q

What is witch’s milk?

A

Milk produced by neonates due to the influence of maternal hormones

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2
Q

How do the breasts differ during the menstrual cycle?

A

May increase in size due to fluid retention at each period

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3
Q

Where are breasts found?

A

Between ribs 2-6 in the anterior chest wall

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4
Q

Where does the nipple lie in the breast?

A

In the centre of the pigmented areola

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5
Q

How does the breast change in puberty?

A

Rudimentary duct system-> branches
20 lobes, each draining into a lactiferous duct to the nipple
Bundles of smooth muscle arise between nipple and areola

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6
Q

How do the breasts change in pregnancy?

A

Breasts grow and become more vascular

Ducts grow and branch and secretory alveoli replace adipose tissue

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7
Q

Describe the blood supply of the breast

A

Branches of internal thoracic artery, lateral thoracic artery and thoraco-acromial artery (from axillary artery) and by intercostal arteries 3-5

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8
Q

Describe the blood supply of the breast

A

Branches of internal thoracic artery, lateral thoracic artery and thoraco-acromial artery (from axillary artery) and by intercostal arteries 3-5

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9
Q

Describe the venous drainage of the breast

A

Superficial venous plexus around areola

Blood drains to axillary vein, internal and lateral thoracic veins and intercostal veins

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10
Q

What is the innervation of the breasts?

A

T4-6

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11
Q

What is the innervation of the breasts?

A

T4-6

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12
Q

What causes the nipple to become erect?

A

Sympathetic innervation of the smooth muscle between nipple and areola

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13
Q

Describe the lymphatic drainage of the breast

A

Interlobular lymph vessels-> subareolar plexus-> axillary/pectoral/parasternal/apical axillary nodes

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14
Q

What are the first secretions of the breast called?

A

Colostrum, rich in protein, IgA,

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15
Q

Function of myoepithelial cells in breast?

A

Contract to move milk out of epithelial cell into lactiferous ducts

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16
Q

What hormones control the development of breasts?

A

Progesterone, oestrogen, prolactin, human placental lactogen (hPL), dopamine (inhib)

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17
Q

Action of oestrogen

A

Needed for development of ducts in puberty and pregnancy

Inhibits milk secretion in pregnancy by stimulating dopamine

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18
Q

Action of progesterone

A

Needed for development of alveoli in puberty and pregnancy

Inhibits milk secretion in pregnancy by ↓prolactin receptors

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19
Q

What are the first secretions of the breast called?

A

Colostrum, rich in protein, IgA, minerals, vitamins

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20
Q

Action of progesterone

A

Needed for development of alveoli in puberty and pregnancy

Inhibits milk secretion in pregnancy by ↓prolactin receptors

21
Q

What is galactopoesis?

A

Maintenance of milk production, needs sustained prolactin levels

22
Q

How is galactopoesis achieved?

A

Needs high sustained prolactin levels

Regular suckling and removal of milk decreases dopamine and increases prolactin and oxytocin

23
Q

How is milk ejection achieved?

A

Suckling or conditioned stimuli causes oxytocin to be released and myoepithelial cells to contract in alveoli

24
Q

What is milk ejection associated with?

A

Afterpains of the uterus contracting (due to oxytocin release)

25
Q

What is the composition of ‘mature’ milk?

A

High in fats, proteins, lactose, essential amino acids

26
Q

What proteins are found in breast milk and how are they secreted?

A

casein, α-lactalbumin and lactoglobulin

secreted from vesicles by merocrine method

27
Q

What proteins are found in breast milk and how are they secreted?

A

casein, α-lactalbumin and lactoglobulin

secreted from vesicles by merocrine method

28
Q

How is fat secreted into breast milk?

A

Fatty acids synthesis in ER, secreted by apocrine method

29
Q

What sugars are found in breast milk and how are they made?

A

Lactose

Made in golgi but dependent on α- lactalbumin to make lactose synthetase complex

30
Q

Why is lactose crucial?

A

Component of myelin and promotes growth of intestinal flora

31
Q

Why is lactose crucial?

A

Component of myelin and promotes growth of intestinal flora

32
Q

When are non-breastfeeding women fertile again?

A

After 4 weeks post partum

33
Q

After loss of suckling stimulus, when does milk production stop?

A

2-3 weeks

34
Q

When do breasts return to normal after stopping breastfeeding?

A

After 3 months

Milk accumulates, ducts swell and compress capillaries. alveoli then dissapear

35
Q

What is galactorrhoea?

A

Milk production in the absence of pregnancy or lactation

36
Q

What is gynecomastia?

A

Male breast development, mild and transient

37
Q

Function of placenta

A

Exchange of fetal CO2 and waste products to be exchanged for O2 and nutrients from maternal blood
Stores nutrients
Produces hormones

38
Q

What part of the embryo forms the placenta?

A

The chorion (and chorionic villi)

39
Q

Name the parts of the maternal endometrium forming the placenta and surrounding structures in pregnancy

A

Decidua basalis, decidua capsularis, decidua parietalis

40
Q

What is the decidua parietalis?

A

Modified endometrium lining the walls of the uterus (not near embryo)

41
Q

Describe the arrangement of the umbilical cord

A

Single umbilical vein containing oxygenated blood, two umbilical arteries from internal iliac artery

42
Q

Describe the arrangement of the umbilical cord

A

Single umbilical vein containing oxygenated blood, two umbilical arteries from internal iliac artery
Outer layer of amnion (Wharton’s jelly)

43
Q

Role of relaxin

A

Hormone which allows pelvis to widen-> pregnancy waddle

44
Q

What happens to the mother’s spine in pregnancy?

A

Increased weight so lumbar lordosis

45
Q

How does the vagina change in pregnancy?

A

Becomes more vascular- has a blue/purple hue
Walls become thicker and softer
Increased sexual sensitivity

46
Q

How does the face change in pregnancy?

A

Increased pigmentation- chloasma (mask of pregnancy)

47
Q

What is a cotyledon?

A

A section of the decidua basalis of the placenta, consists of a main stem of chorionic villus and its branches etc

48
Q

Why might you see scapula winging after breast cancer?

A

Damage to the long thoracic nerve-> serratus anterior not innervated

ELC Anatomy (12 decks)

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