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physio > pregnancy and lactation > Flashcards

pregnancy and lactation Flashcards

1
Q

what is sperms capacitation?

A

occurs when the female genital tract fluids wash away the inhibitory factors and cholesterol plus calcium enterance into the sperm

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2
Q

what is the acrosome reaction?

A

occurs when the proteolytic enzymes and hyaluronidase opens a penetrating pathway in the ovum corona radiate and zona pellucida

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3
Q

what is fertilization?

A

formation of the pronucleuses and their union to form the zygote

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4
Q

What is implantation?

A

the blastocyst implants into the uterine endometrium aided by the action of proteolytic enzymes secreted by the trophoblast cells

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5
Q

What hormones maintain pregnancy for the first trimester until it degenerates at 12 to 17 weeks of gestation?

A

corpus luteum hormones

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6
Q

What ‘takes over’ after the first trimester?

A

the placenta– it secretes relaxin, progesterone, estrogens, human chorionic gonadotropin and human chorionic somatostatin

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7
Q

How long is pregnancy?

A

280 days plus/minus seven days from the last menstrual period

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8
Q

Before implantation, where does the blastocyte obtains its nutrients from?

A

uterine mil secreted by the uterine endometrial glands

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9
Q

Where do nutrients come from after the implantation?

A

the trophoblast cells digest the decidua to provide the nutrients

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10
Q

the trophoblast cells, some of the blastocyst cells and the uterine endometrium cells for the ____.

A

placenta

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11
Q

Trophoblast cells form placental villi into which fetal blood capillaires grow. How does the fetus get blood?

A

fetal blood flows via two umbilical arteries into the villi capillaries then back to the fetus via the umbilical vein

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12
Q

Maternal blood sinuses develop around these placental villi. What is the maternal blood flow track?

A

Maternal blood flow via the uterine arteries into the maternal blood sinuses then back to the mother via the uterine veins.

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13
Q

What is the function of the placenta?

A

allows for diffusion of nutrients from maternal blood into fetal blood and diffusion of excretory products back into maternal blood

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14
Q

What nutrient must use facilitated diffusion to reach the baby via the placenta?

A

glucose by trophoblasts facilitated diffusion

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15
Q

What nutrients/waste move via simple diffusion through the placenta?

A

oxygen, CO2, FA, sodium, potassium, chloride, urea, uric acid, creatinine

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16
Q

The estrogens of the placenta are secreted by what? What are they made from? What do they cause?

A
  • secreted by the syncytial trophoblast cells
  • made from androgenic compounds secreted by the mother and fetus adrenal glands
  • causes enlargement of the maternal uterus, breasts and external genitalia plus relaxation of the pelvic ligaments
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17
Q

The progesterone of the placenta is secreted by what? what effects does it have?

A
  • secreted by the syncytial throphoblast cells
  • causes development of the uterine endometriun, development of the breasts alveoli, & decreases uterine muscles contractility during pregnancy thus preventing spontaneous abortion
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18
Q

Where is human chorionic somatomammotropin secreted from? What is its function?

A
  • secreted by the placenta at about the fifth week of pregnancy
  • decreases glucose utilization by the maternal cells and make it available to the fetus, promotes the release of free fatty acids as an alternative for maternal metabolism, promotes protein tissues formation in the same way as growth hormone
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19
Q

Where is relaxin secreted from and what does it do?

A
  • secreted by the corpus luteum and the placenta
  • suppresses the release of hypothalamic oxytocin and delays the onset of labor contractions, increases the flexibility of the pubic symphysis, softens the cervix for dilation during parturition
20
Q

what are 7 changes that will occur in pregnancy? (all increases)

A

increase in endocrine hormones, basal metabolic rate, food intake and weight, nutrients storage, cardiovascualr functions, respiration, renal functions

21
Q

Amniotic fluid formation is derived from what?

A

fetal renal excretions and the amniotic membrane secretions

22
Q

What is pregnancy-induced hypertension from?

A

excessive sodium and water reabsorption caused by increased adrenal glands secretion of aldosterone

23
Q

What is preeclampsia?

A

hypertension, protein urea and impaired vascular functions with arterial spasms

24
Q

What is eclampsia?

A

extreme degree of preeclampsia with vascualr spasms, seizures and coma

25
Q

Age based terminology for the developing baby

A

blastocyst- less than 2 weeks old
embryo- 2 to 8 weeks old
fetus- 9 weeks to birth
neonate- newborn to 6 weeks old

26
Q

Parturition is preceded by increased uterine excitability and contractibilty caused by what?

A
  • increased estrogens-progesterone secretion ratio
  • increased maternal and fetal oxytocin secretion
  • stretch of the uterine musculature
  • stretch and irritation of the cervix
  • initiation of a positive feedback mechanism
27
Q

What is the positive feedback mechanism of parturition?

A

baby’s head stretches the cervix–> cervical stretch excites fundic contraction–> fundic contraction pushes baby down and stretches the cervix some more–> cycle repeats over and over

28
Q

What causes labor?

A

oxytocin stimulates uterine contractions to cause the forcible expulsion of the fetus in three stages

29
Q

What are the three stages of labor?

A

dialtion- cervix dilates and water breaks
expulsion- baby delivery via the vagina
placental- ejection of the afterbirth

30
Q

What are early labor pains caused by?

A

hypoxia of the uterine muscles transmitted by the hypogastric nerves

31
Q

What are late labor pains caused by?

A

cervical, perineal, and vaginal stretch or tear transmitted by the somatic nerves

32
Q

What is involution (postpartum)?

A

the shrinking of the uterus during the period which is achieved by autolysis of the uterine cells by their own lysosomal enzymes

33
Q

What is lochia (postpartum)?

A

the vaginal discharge produced by this autolysis

34
Q

breast feeding promotes uterine involution because…

A

lactation suppresses estrogen secretion whihc usually keeps the uterus flaccid and it stimulates oxytocin secretion whcih causes uterine myometrium contractions that firm up the uterus

35
Q

What are the milk secreting units in the mammary glands?

A

alveoli

36
Q

suspensory (Cooper’s) ligaments attach the breast tissues to the ___ ____ ___.

A

pectoralis major muscle

37
Q

What is the role of estrogens in development of the breasts?

A
  • stimulates growth of the ductal system
  • increase growth of breast stroma & fat deposition in stroma
  • inhibits actual secretion of milk
38
Q

What is the role of progesterone in the development of the breasts?

A
  • stimulates development of the breats lobule-alveolar system
  • causes budding of more new alveoli
  • stimulates development of the secretory characteristics in the alveoli epithelial cells
  • inhibit the actual secreiton of milk
39
Q

What is the role of prolactin in the development of the breasts?

A
  • stimulates colostrum synthesis during late pregnancy
  • stimulates milk synthesis by the alveoli eptihelial cells soon after birth
  • prolactin surges occur with each nursing
40
Q

What provide nutrients for milk synthesis?

A

growth hormone, cortisol, insulin and parathyroid hormone

41
Q

What is the role of oxytocin in the develpment of the breasts?

A
  • stimulates contraction of the alveoli wall myoepithelial cells
  • milk is squeezed from the alveoli into the lacitferous sinuses and ducts to the nipple during suckling
  • milk ejection can be stimulated or inhibited by psychogenic factors or sympathetic system stimulation
  • powerful positive feedback system
42
Q

What is the positive feedback system of oxytocin and breast feeding?

A

receptors in nipples are stimulated–> impulses propagated to spinal cord–> stimulation of hypothalamic nuclei–> oxytocin released–> milk ejected

43
Q

What is colostrum?

A

fluid synthesized and secreted by the alveoli during the last days of pregnancy and the first days after birht promoted by prolactiin stimulation

44
Q

Colostrum contains….

A

same concentration of proteins and lactose as milk but one-third less fats, contain immunoglobulin (IgA mainly) for the newborn protection

45
Q

What is the lactation cost on the mother?

A

50 g fat, 100 g glucose and 3 g calcium phosphate a day

46
Q

What causes bone decalcification to provide enough calcium and phosphate for the newborn bones calcification?

A

parathyroid hormone

47
Q

Breast feeding suppresses the ovarian cycle via____ by the nipple nerve signals during suckling and the high prolactin levels during lactation.

A

inhibition of gonadotropin releasing hormone

physio (14 decks)

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