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ESA 4 Rev > Repro > Flashcards

Repro Flashcards

1
Q

What are the functions of the pelvic floor?

A

Support pelvic organs
Maintain intra-abdo pressure when coughing, sneezing
Continence
Facilitate childbirth

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2
Q

Which muscles form the lateral walls of the pelvis?

A

Piriformis

Obturator internus

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3
Q

Which muscles form the pelvic diaphragm/floor?

A

Coccygeus

Levator Ani

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4
Q

Which muscles comprise levator ani?

A

Puborectalis
Pubococcygeus
Iliococcygeus

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5
Q

What are the deep perineal muscles?

A

Deep transverse perineal
Compressor urethrae
External urethral sphincter

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6
Q

What are the superficial perineal muscles?

A

Superficial perineal pouch
Superficial transverse perineal
External anal sphincter

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7
Q

Which 2 muscles are in the superficial perineal pouch?

A

Bulbospongiosus

Ischiocavernosus

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8
Q

What is the importance of the perineal body?

A

Attachment point of pelvic floor muscles

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9
Q

How can pelvic floor function be altered during childbirth?

A

levator ani muscles stretched
pudendal n. damage
perineal body disrupted
Iatrogenic - episiotomy

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10
Q

What are the consequences of pelvic floor dysfunction?

A

Prolapse

Incontinence

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11
Q

What are risk factors for prolapse?

A 
Age
Parity
Vaginal delivery
Post-menopause
Obesity - raised intra-abdo pressure
CT disorders
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12
Q

What is episiotomy?

A

Surgical incision medic-laterally during childbirth to prevent uncontrolled perineal tear.

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13
Q

What can PID cause?

A

Endometritis
Salpingitis
Tubo-ovarian abscess

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14
Q

How does tubo-ovarian abscess happen from PID?

A

Adhesions cause blockage in fallopian tubes, fill with exudate.

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15
Q

What are complications of PID?

A

Infertility
Ectopic pregnancy
Fitz- Hugh -Curtis syndrome - RUQ pain, peri-hepatitis after chlamydia PID

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16
Q

What reduces oxytocin function prior to labour?

A

Relaxin
Progesterone
No receptors

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17
Q

How does oestrogen affect myometrium muscle cells?

A

increases gap junctions - excitability

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18
Q

What is the most common cause of PPH?

A

Uterine atony

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19
Q

What is normal length of menstrual cycle?

A

21-35 days

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20
Q

what is the normal position of the uterus?

A

Anteverted and anteflexed

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21
Q

What is menopause?

A

No menstrual periods for 12 months

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22
Q

What are the stages of menopause?

A

Pre-menopause - 40’s, changes in cycles, can still get pregnant
Peri-menopause
Menopause
Post-menopause - after 12 months amenorrhoea

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23
Q

What is pathological menopause?

A

Before 40 years

24
Q

What is used to diagnose menopause?

A

FSH levels high (aromatase enzyme still synthesises oestrogen)

25
Q

Explain risk of endometrial carcinoma at menopause.

A

No progesterone but oestrogen still produced in body.

Unopposed oestrogen - endometrial hyperplasia.

26
Q

What happens to vagina pH at menopause?

A

Increases - less oestrogen means less glycogen

27
Q

Explain the increased CVS risk at menopause?

A

Increase LDL and VLDL, decrease HDL
Increased insulin resistance
Increased BP
Central body fat deposition/weight gain

28
Q

What are the cardinal movements of labour?

A 
Engage
Descend and flex
Internal rotation
Extension x 2
Restitution
Anterior shoulder
Posterior shoulder
29
Q

What hormonal change is repsonsible for the secretion of milk after delivery?

A

Decreased oestrogen and progesterone

30
Q

What does increased fetal HR suggest?

A

Fetal movement

31
Q

What does decreased fetal HR suggest?

A

head compression

umbilical cord compression

32
Q

What is the symphysis-fundal height at 12,16,20 and 36 weeks?

A

12 - pubic symphysis
16 - mid-way to umbilicus
20 - umbilicus
36 - xiphisternum

33
Q

What are causes of oligohydramnios?

A

placental insufficiency
renal impairment
premature membrane rupture

34
Q

What are causes of polyhydramnios?

A

inability to swallow - CNS of tracheoesphageal septum

35
Q

When is surfactant produced?

A

Terminal sac stage - 26 weeks onwards

36
Q

What are the vascular changes that lead to erection?

A

Inhibit sympathetic constriction
Parasympathetic stimulation - dilation
NO released from endothelial cells and nerves (cremasteric)

37
Q

What is MOA of sildenafil?

A

Inhibits phosphodiesterase, increase cGMP to increase NO.

38
Q

What is the order of puberty events in females?

A
  1. Thelarche - breast buds
  2. Pubic hair
  3. Growth spurt
  4. Menarche -periods
39
Q

What is the order of puberty events in males?

A
  1. Testicle enlargement
  2. Pubic hair
  3. Spermatogenesis
  4. Growth spurt
  5. Adult size testicles
40
Q

What influences puberty onset?

A

Photoperiod, leptins

Girls - 47kg weight

41
Q

What is the vagina developed from?

A

Paramesonephric ducts

Urogenital sinus

42
Q

What diffuses by active transport across placenta?

A

Amino acids
Iron
Vitamins

43
Q

What moves by facilitated diffusion across the placenta?

A

Glucose

44
Q

What is the difference between intrauterine device and intrauterine system?

A 
IUD = copper coil
IUS = plastic, progesterone secreting
45
Q

What is the MOA of IUD?

A

Cu is toxic to sperm and ovary
Inflammation in endometrium inhibits implantation
Thickens cervical mucous

46
Q

Does IUD or IUS increase bleeding?

A

IUD - copper coil increases bleeding.

IUS decreases bleeding.

47
Q

What is the MOA of IUS?

A

Prevents implantation

Thickens cervical mucous

48
Q

What are the 2 types of cervical cancer?

A

Squamous cell carcinoma (most common)

Adenocarcinoma

49
Q

What is the cancer marker used for colon cancer?

A

CEA

50
Q

What is the marker used for ovarian cancer?

A

CA-125

51
Q

What is alpha-fetoprotein marker used for?

A

Hepatocellular carcinoma

Germ cells

52
Q

Where does uterine leiomyosarcoma spread to?

A

lungs

53
Q

What marker is used for germ cell tumours?

A

AFP

hCG

54
Q

What is the difference between spermatogenesis and spermiogenesis?

A

Spermatogenesis - spermatogonia to spermatids

Spermiogenesis- spermatids to spermatozoa

55
Q

What is the function of cervical gland, how is it controlled?

A

Secretes mucous

Progesterone - thick, viscous to prevent sperm entry

56
Q

What are the main histological changes in the placenta from the first to the third trimester?

A
  1. Villi increase in SA - primary to tertiary

2. Thinning - decreased diffusion distance.

57
Q

What is a key sign of PCOS?

A

High LH:FSH ratio

ESA 4 Rev (16 decks)

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