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Phys and Pharm > Reproduction - UC > Flashcards

Reproduction - UC Flashcards

1
Q

function of the expanded cumulus cell matrix

A
  • to aid the passage into the fimbria,
  • to protect the zygote
  • to provide an additional barrier to polyspermy
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2
Q

what is polyspermy

A

when more than one sperm reach the egg and all attempt to fertilise

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3
Q

function of the bona pellucida

A
  • to provide a surface receptor for the sperm
  • to prevent polyseprmy
  • to protect pre implantation embryo
  • to prevent the fusion of embryos
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4
Q

what stage is the oocyte at in terms of cell division at the time of ovulation

A

second meiotic devision - just begins after ovulation?

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5
Q

oocyte must have the ability to __________ a sperm nucleus

A

decondense

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6
Q

what other important things must an oocyte have for the development of the early embryo

A

enough proteins, RNA, ribosomes, mitochondria etc

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7
Q

what hormone doe the fallopian tube have high levels of and when?

A

estradiol, at the end of the follicular phase

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8
Q

when is there high levels of contraction in the fallopian tubes?

A

in the luteal phase

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9
Q

when does body temperature rise during the menstrual cycle

A

just a few hours before ovulation

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10
Q

what type of cells are finbriae

A

ciliated columnar cells

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11
Q

most adult male mammals show sexual behaviour when ________________________

A

an attractive and receptive female is present

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12
Q

most female mammals (not primates) show sexual behaviour _________________________

A

only at oestrus when preceptive behaviour may be shown

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13
Q

female primates are sexually receptive at _______

A

all times - potentially

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14
Q

what are the 4 stages (5 in male) in the physiology of sexual intercourse

A
  • arousal (excitement)
  • plateau
  • orgasm
    (- refractory period in males)
  • resolution
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15
Q

what happens in arousal?

A
  • erection due to arteriolar vasodilation, veins constrict, due to parasympathetic non cholinergic NO –> cGMP signal cascade
    this leads to pressurised blood in the corpus cavernous in which stiffens the penis
  • elevation o the penis
  • elevation and swelling of the testis
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16
Q

what happens in plateau stage?

A
  • distension of the penis and testes

- mucus bulbourethral gland secretion (precum) - parasympathetic innervation and from Cowper’s glands

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17
Q

what happens during the orgasm stage?

A
  • there is emission due to the contraction of the vas, seminal vesicles, prostate. there is relaxation of the erethral sphincter guided by sympathetic noradrenergic innervation
  • there is then ejaculation of the semen with rhythmic contraction of the perineal striated muscle and the anal sphincter mediated by the somatic pudendal nerve
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18
Q

what is the refractory period?

A

the refractory period in males is the time where they are unable to get aroused again

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19
Q

what is the resolution phase?

A

the resolution period is when the individual returns to the non aroused state

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20
Q

what is viagra?

A

viagra is sildenafil citrate. it was first made for anti angina purposes

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21
Q

what is the process of a normal erection?

A

cGMP causes the arteries in the corpora cavernous to dilate causing a lot of blood to flow through the penis = making it erect

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22
Q

how does viagra work?

A

Sildenafil is a competitive inhibitor of PDE5 enzyme which is responsible for the breakdown of the cGMP - it is found especially in the penis which means that viagra is a specific drugs

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23
Q

how does female arousal work?

A
  • there is lubrication of the vagina: vascular thickening of the vaginal walls and the labia. cervical mucus
  • expansion of the inner 1/3rd of the vagina and the elevation of the cervic and body of the uterus to accommodate the penis
  • erection of the clitoris - arteriolar vasodilation (parasympathetic non-cholinergic NO)
  • mucus secretion from greater vestibular gland at the opening of the vagina (parasympathetic
  • increased heart rate and blood pressure, depth of breathing, skin flushing, nipple erection and great changes
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24
Q

what happens in the female plateau phase

A
  • continuation in the increase of the features of female arousal
  • orgasmic platform is created in the outer 1/3rd of the vagina
  • continued elevation of the cervix and the body of the uterus
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25
Q

what happens during the female orgasm?

A

contraction of the uterus from the funds to the lower segment

  • minimal relaxation of the external cervcal opening
  • regular contractions of the vaginal orgasmic platform which is the outer 1/3rd od the vagina, external anal and the urethral sphincters
  • variable body wide myotonic contractions at 0.8 second intervals
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26
Q

what happens during the female resolution phase?

A
  • much slower loss of pelvic vasocongestion than in males - maybe a return to the orgasm phase
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27
Q

what is the role of the prostate gland/

A

capacitation of the sperm

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28
Q

what is the role of the seminal vesicle secretions>

A

fructose secretions - fuel for the lill guys

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29
Q

properties of a spermatozoa (7 things)

A
  • haploid DNA
  • strong motility potential
  • receptors for zona pellucid and the egg
  • ability to penetrate cumulus and zona pellucida
  • ability to fuse with egg
  • ability to activate egg
  • be present in large quantities to compensate for wastage
30
Q

what is the capacitation reaction/

A

Immature sperm in the epididymus are galatosyltrasferase modifies to make mature incapacitated seem and in the female genital tract there are then across activated, galatosyltransferase, and increase motility and there is a loss of the cholesterol from the sperm head - to result in capacitated sperm.

this is dependent on the secretions from the seminal vesicles and the prostate

31
Q

what is the chemoattractant used by the egg to attract the sperm to the egg

A
  • progesterone and atrial natriuretic peptide from the cumulus cells
32
Q

what is the function of ANP and progesterone

A

They are secreted by the egg from the cumulus cells to stimulate motility and acrosome reaction. ANP may also attract the sperm

33
Q

how is the sperm recognised

A

sperm is recognised at the bona pellucida

34
Q

what is the function of the zona pellucid (3)

A
  • prevents the ovulated oocyte sticking to the oviduct and the uterine epithelial walls
  • prevents fusion of the oocytes
  • Provides ZP3, the first target for the sperm binding
35
Q

what is the zona reaction

A

prevents polyspermy. Release of cortical granules which hardens the ZP to prevent multiple sperm from trying to fertilise the egg

36
Q

what stage of cell division is started due to the penetration of the sperm into the oocyte

A

second meiotic division

37
Q

FILL IN THE BLANKS:

fertilisation causes _______________ in the zygote. Wave is initiated by ___zeta. A few waves stimulate the ______ _______ _______. Repeated waves stimulate the start of d_______, d_______ etc.

A

fertilisation causes calcium ion transients in the zygote. Wave is initiated by PLCzeta. A few waves stimulate the cortical granule reaction. Repeated waves stimulate the start of development, division etc.

38
Q

where does fertilisation occur

A

ampulla

39
Q

what is the window of attachment for the conceptus before luteal regression

A

7-9 days

luteal regression begins between 12-14 days

40
Q

what is the main hormone secreted at each of these stages:

  • follicular
  • luteal
A
  • oestrogen

- progesterone

41
Q

what is the proliferative phase

A

follicular phase

42
Q

what is the secretory phase

A

luteal phase

43
Q

FILL IN THE BLANKS:

  • estradiol causes the p________ and s_____ a______ development
  • ___________ causes glandular secretions
  • prostaglandins cause a______ s_____ and u______ m_______ c________
A
  • estradiol causes the proliferation and spiral artery development
  • progesterone causes glandular secretions
  • prostaglandins cause arterial spasm and uterine muscular contractions
44
Q

what happens during the proliferative follicular phase

A

there is an expansion of the spiral arteries. Pre receptive phase

45
Q

what happens during the secretory phase

A

this is the receptive phase where the uterine lining would ideally receive the conceptus. In the situation where this does not happen, there is arterial spasm and the shedding of the lining of the uterus and the menstrual phase begins

46
Q

what prevents the shedding of the uterine lining if the conceptus is received

A

human chorionic gonadotrophin secreted by the corpus luteum

47
Q

uterine ________ must be down-regulated for the attachment and _________ to occur. interaction occurs partly through the _______ __________ ___________

A

uterine mucins must be down-regulated for the attachment and implantation to occur. interaction occurs partly through the heparan sulphate proteoglycans

48
Q

hCG blocks cyclicality by maintaining _________ levels and thus blocking the ______ _____________ process

A

hCG blocks cyclicality by maintaining progesterone levels and thus blocking the luteal degeneration process

49
Q

HCG _______ until it reaches a ________ concentration near the end of the first trimester of pregnancy and then decrease to a ___ level thereafter.

Progesterone continues to _________ until it levels off near the ___ of the pregnancy . Early in pregnancy, progesterone is produced by the ____ _____ in the ovary, later production shifts to the _________.

Oestrogen levels increase _____ throughout pregnancy, but they _______ more rapidly as the ___ of the pregnancy approaches. Early in pregnancy, oestrogen is produced only in the _____, later production shifts to the ________.

A

HCG increases until it reaches a maximum concentration near the end of the first trimester of pregnancy and then decrease to a low level thereafter.

Progesterone continues to increase until it levels off near the end of the pregnancy . Early in pregnancy, progesterone is produced by the corpus lute in the ovary, later production shifts to the placenta.

Oestrogen levels increase slowly throughout pregnancy, but they increase more rapidly as the end of the pregnancy approaches. Early in pregnancy, oestrogen is produced only in the ovary, later production shifts to the placenta.

50
Q

Placentation

Although some non-mammalian vertebrates give birth to live offspring, true placentae are found only in ________. The placenta is made of a unique tissue, ________, which forms an intimate relationship with the maternal endometrium.

A

Placentation

Although some non-mammalian vertebrates give birth to live offspring, true placentae are found only in mammals. The placenta is made of a unique tissue, trophoblast, which forms an intimate relationship with the maternal endometrium.

51
Q

Functions of the trophoblast in humans

• P_____ a___ of the conceptus to the u_____
• Invasion of e______ tissue
• Transfer of r________ gases
• Transfer of n_____
• Transfer of w____ p______
• Synthesis of h_______ (as part of maternal-fetal-placental unit) for:
(a) maintenance of p________;
(b) foetal growth control;
(c) influencing maternal m________
(d) foetal growth control;
(e) preparation for p_________;
(f) preparation for l_________
• Synthesis and breakdown of other substances, especially ________
• I________ b________ preventing rejection of the fetal tissue by the maternal i______ s_______

A

Functions of the trophoblast in humans

• Physical attachment of the conceptus to the uterus
• Invasion of endometrial tissue
• Transfer of respiratory gases
• Transfer of nutrients
• Transfer of waste products
• Synthesis of hormones (as part of maternal-fetal-placental unit) for:
(a) maintenance of pregnancy;
(b) fetal growth control;
(c) influencing maternal metabolism
(d) fetal growth control;
(e) preparation for parturition;
(f) preparation for lactation
• Synthesis and breakdown of other substances, especially proteins
• Immunological barrier preventing rejection of the fetal tissue by the maternal immune system

52
Q

Fetal membranes - tissues of fetal origin:

  • Chorion: t_________ plus extra-embryonic m________; this forms the chorionic vesicle, including the p_________
  • Allantois: endoderm lining, mesodermal covering: forms bladder and urachus
  • Yolk sac: haemopoiesis in early pregnancy; development of gut; primordial germ cells
  • Amnion: main source of amniotic fluid in early pregnancy
A

Fetal membranes - tissues of fetal origin:

• Chorion: trophoblast plus extra-embryonic mesoderm; this forms the chorionic vesicle, including the
placenta
• Allantois: endoderm lining, mesodermal covering: forms bladder and urachus
• Yolk sac: haemopoiesis in early pregnancy; development of gut; primordial germ cells
• Amnion: main source of amniotic fluid in early pregnancy

53
Q

Stages in the development of the placenta

  • pre-villous embryo: no villi; cytotrophoblast covered with s___________
  • 1y villi: defined c__________ projections, covered by s_______________
  • 2y villi: m____________ core within the c__________; s_____________ on surface
  • 3y villi: m___________ invaded by fatal b_____ v_______
  • formation of c__________ shell, anchoring villi; substantial b_________ of villi
  • (migration of cytotrophoblast cells to m_______ vessels, g_____, m_______)
  • ‘mature’ villi: very b________; outer syncytiotrophoblast; incomplete cytotrophoblast layer; fetal blood vessels c________ with the s________; loose m_________ containing scattered p________.
A

Stages in the development of the placenta

• previllous embryo: no villi; cytotrophoblast covered with syncytiotrophoblast
• 1y villi: defined cytotrophoblastic projections, covered by syncytiotrophoblast
• 2y villi: mesenchymal core within the cytotrophoblast; syncytiotrophoblast on surface
• 3y villi: mesenchyme invaded by fetal blood vessels
• formation of cytotrophoblastic shell, anchoring villi; substantial branching of villi
• (migration of cytotrophoblast cells to maternal vessels, glands, myometrium)
• ‘mature’ villi: very branched; outer syncytiotrophoblast; incomplete cytotrophoblast layer; fetal blood vessels
contiguous with the syncytiotrophoblast; loose mesenchyme containing scattered phagocytes.

54
Q

Placental blood flow

The placental i_______ s______ receive blood from branches of the umbilical _________ (from internal iliac) carrying ____genated blood. ___genated, nutrient- rich v_____ blood from the p_______ passes via an umbilical _____ (left) to the l_____ (through-passed by the ductus venosus) and from there to the r____ a_______.
• blood enters the intervillous spaces from the spiral arteries
• c_________ flow in the intervillous space ensures maximal transfer
• blood leaves the intervillous spaces via the uterine veins.

Uterine c_________ allow blood to spurt in from the a______, but close venous outflow, causing the low pressure in the intervillous space to rise. When the myometrium relaxes, veins r_____ and intervillous pressure ____.

A

Placental blood flow

The placental intervillous spaces receive blood from branches of the umbilical arteries (from internal iliac) carrying deoxygenated blood. Oxygenated, nutrient- rich venous blood from the placenta passes via an umbilical vein (left) to the liver (through-passed by the ductus venosus) and from there to the right atrium.
• blood enters the intervillous spaces from the spiral arteries
• countercurrent flow in the intervillous space ensures maximal transfer
• blood leaves the intervillous spaces via the uterine veins.

Uterine contractions allow blood to spurt in from the arteries, but close venous outflow, causing the low pressure in the intervillous space to rise. When the myometrium relaxes, veins reopen and intervillous pressure falls.

55
Q

Placental transport: mechanisms
• Simple diffusion: small molecules, ions; unconjugated non-polar molecules: water, electrolytes, urea,
cholesterol, gases
• Carrier mechanisms involving specific receptors on the syncytiotrophoblast brush border:
(a) for large molecules: e.g. immunoglobulins (IgGs which confer passive immunity to the fetus)
(b) to concentrate substances in the fetal circulation: e.g. Fe, Ca, Cu, glucose, vitamin B12, folate,
riboflavin, vitamin C, amino acids, some hormones

NB most proteins are not transported but are synthesized from amino acids by the placenta or fetus.

A

a

56
Q

Hormone production: the maternal-fetal-placental unit
Placental hormonal functions include:

• signalling pregnancy (e.g. _______ to preserve the corpus luteum)
• maintaining pregnancy: (e.g. __________ to maintain uterine quiescence; estradiol for ___________)
• converting maternal metabolism to the pregnant state (e.g. _________________________, aka human
chorionic somatomammotrophin. (similar to GH & PRL). It increases maternal _____ breakdown to provide
the fetus with energy;
• preparing for & initiation of parturition. ______ induces production of contraction-associated proteins by
the m___________, stimulates production of _______ receptors; and increases the __________ of the myometrium. Placental _______ (produced only by primates) appears to act as a signal of readiness for p_________;
• stimulating myometrial contractions and modifying the cervix for parturition. Placental _________ (PGE2 and PGF2) act in this way; (earlier in pregnancy the relaxant prostaglandin ____ predominates).
• preparing for lactation: ________ stimulates development of the _____ system of the mammary gland; ________ causes development of the a_______; ___ has a lactogenic action, developing the secretory potential of the breast ______; however, during pregnancy, production of milk is suppressed by the high levels of _________ and _________.
The cyto- and syncytio-trophoblast synthesize many of the h_________ and ________ peptide hormones.

A

Hormone production: the maternal-fetal-placental unit
Placental hormonal functions include:

• signalling pregnancy (e.g. hCG (human chorionic gonadotrophin) to preserve the corpus luteum)
• maintaining pregnancy: (e.g. progesterone to maintain uterine quiescence; estradiol for uterine growth)
• converting maternal metabolism to the pregnant state (e.g. hPL human placental lactogen, aka human
chorionic somatomammotrophin. (similar to GH & PRL). It increases maternal lipid breakdown to provide
the fetus with energy;
• preparing for & initiation of parturition. Estradiol induces production of contraction-associated proteins by
the myometrium, stimulates production of oxytocin receptors; and increases the excitability of the myometrium. Placental CRH (produced only by primates) appears to act as a signal of readiness for parturition;
• stimulating myometrial contractions and modifying the cervix for parturition. Placental prostaglandins (PGE2 and PGF2) act in this way; (earlier in pregnancy the relaxant prostaglandin PGI2 predominates).
• preparing for lactation: oestradiol stimulates development of the duct system of the mammary gland; progesterone causes development of the alveoli; hPL has a lactogenic action, developing the secretory potential of the breast alveoli; however, during pregnancy, production of milk is suppressed by the high levels of progesterone and oestradiol.
The cyto- and syncytio-trophoblast synthesize many of the hypothalamic and pituitary peptide hormones.

57
Q

Production of estradiol

Although the placenta can produce progesterone from ________, the primate placenta does not have the key enzymes necessary to produce oestradiol from cholesterol (17-hydroxylase; 17-20 lyase). Instead it uses the weak androgen _____ which is synthesized in the fetal adrenal gland. This is converted by the placenta in part to estradiol. However, it is also 16-hydroxylated by the l____, to yield a s_____ which is converted by the placenta to e_____, a weak oestrogen which is the main estrogen secreted in the u____. Some estrone is also formed.

A

Production of estradiol

Although the placenta can produce progesterone from cholesterol, the primate placenta does not have the key enzymes necessary to produce oestradiol from cholesterol (17-hydroxylase; 17-20 lyase). Instead it uses the weak androgen dehydroepiandrosterone (DHEA) which is synthesized in the fetal adrenal gland. This is converted by the placenta in part to estradiol. However, it is also 16-hydroxylated by the liver, to yield a steroid which is converted by the placenta to estriol, a weak oestrogen which is the main estrogen secreted in the urine. Some estrone is also formed.

58
Q

Corpus luteum activity must be maintained in _____ pregnancy to provide _____________

Progesterone is essential for pregnancy (block of the progesterone receptors with RU486 is an effective method of termination). If fertilization occurs, l______ r________ must therefore be prevented until another source of _____________ is available. Within ________ of implantation the blastocyst secretes _____________________ which acts like LH to keep the corpus luteum _____. It also acts locally within the _________ to activate local steroidogenesis. In the human, the placenta takes over progesterone secretion at ____ months, when the ovaries can be removed without causing miscarriage.

A

Corpus luteum activity must be maintained in early pregnancy to provide progesterone

Progesterone is essential for pregnancy (block of the progesterone receptors with RU486 is an effective method of termination). If fertilization occurs, luteal regression must therefore be prevented until another source of progesterone is available. Within hours of implantation the blastocyst secretes human chorionic gonadotrophin (hCG) which acts like LH to keep the corpus luteum active. It also acts locally within the placenta to activate local steroidogenesis. In the human, the placenta takes over progesterone secretion at 3-4 months, when the ovaries can be removed without causing miscarriage.

59
Q

Foetal growth

Foetal growth places considerable nutritional demands on the pregnant mother. _________ stimulates appetite and alters deposition of ___ reserves. Placental __________ assists both fetal and maternal nutrition by altering the mother’s metabolism so that more ___ _____ _______ are available. Epidemiological studies have shown that, provided adequate nutrition is available to the mother, energy balance is maintained to provide a fetus which is appropriate to the mother’s body size. The growth of the fetus is little affected (except for fetal length) by fetal growth hormone; rather it is ______ which is the main determinant of placental and fetal weight.

A

Fatal growth

Fetal growth places considerable nutritional demands on the pregnant mother. Progesterone stimulates appetite and alters deposition of fat reserves. Placental lactogen assists both fetal and maternal nutrition by altering the mother’s metabolism so that more free fatty acids are available. Epidemiological studies have shown that, provided adequate nutrition is available to the mother, energy balance is maintained to provide a fetus which is appropriate to the mother’s body size. The growth of the fetus is little affected (except for fetal length) by fetal growth hormone; rather it is IGF2 which is the main determinant of placental and fetal weight.

60
Q

Fetal malnutrition has serious long-term consequences (see Stress lecture)
It is now clear from the work of David Barker at Southampton and others that poor fetal nutrition can have very long term effects upon aspects of adult pathology such as h___ b_____ p______, d_____ m_______ (Type __) and c_______ h____ d_______. Those born __________ have a reduced life expectancy. This is in part due to long-term programming of the ______________ stress axis, which becomes chronically overactive.

A

Fetal malnutrition has serious long-term consequences (see Stress lecture)
It is now clear from the work of David Barker at Southampton and others that poor fetal nutrition can have very long term effects upon aspects of adult pathology such as high blood pressure, diabetes mellitus (Type II) and coronary heart disease. Those born underweight have a reduced life expectancy. This is in part due to long-term programming of the glucocorticoid stress axis, which becomes chronically overactive.

61
Q

The uterus as a relatively __________ site for development of the conceptus.

When the smooth muscle (_________) of the uterus is stretched one would expect its cells to contract. Expulsive contraction must be prevented until the time of parturition. This is achieved in several ways:
• The uterus grows at the ______ rate as the conceptus, so there is little stretching until the very end of
pregnancy.
• _____________ is essential for uterine quiescence. The increasing levels during pregnancy act in a number of ways: (a) on the muscle cells directly; (b) on chorionic enzymes which prevent the accumulation of activating ____________ from reaching the myometrium; and (c) by reducing the numbers of __________ receptors within the uterine muscle.
• The prostaglandin produced before term is largely _______________ which relaxes smooth muscle
• ___________ (estradiol) is the main hormone causing growth of the uterine muscle. It also stimulates
development of c________ a________ p_______ and oxytocin receptors to prepare the smooth muscle for p____________.

A

The uterus as a relatively quiescent site for development of the conceptus.

When the smooth muscle (myometrium) of the uterus is stretched one would expect its cells to contract. Expulsive contraction must be prevented until the time of parturition. This is achieved in several ways:
• The uterus grows at the same rate as the conceptus, so there is little stretching until the very end of
pregnancy.
• Progesterone is essential for uterine quiescence. The increasing levels during pregnancy act in a number of
ways: (a) on the muscle cells directly; (b) on chorionic enzymes which prevent the accumulation of activating prostaglandins from reaching the myometrium; and (c) by reducing the numbers of oxytocin receptors within
the uterine muscle.
• The prostaglandin produced before term is largely prostaglandin I which relaxes smooth muscle
• Estrogen (estradiol) is the main hormone causing growth of the uterine muscle. It also stimulates
development of contraction-associated proteins and oxytocin receptors to prepare the smooth muscle for parturition.

62
Q

Pregnancy duration and phases
• __ weeks from last menstrual period (__ weeks of actual pregnancy from fertilisation; approximately _ months
• Divided into ____ ‘trimesters’ (3 month periods)

A

Pregnancy duration and phases
• 40 weeks from last menstrual period (38 weeks of actual pregnancy from fertilisation; approximately 9 months
• Divided into three ‘trimesters’ (3 month periods)

63
Q

Approx 12.5Kg
Greatest increase in weight in the 2nd trimester (0.5 Kg/wk)
Due to:
Growth of the conceptus, placenta Enlargement of maternal organs
Maternal storage of fat
Increase in maternal blood and interstitial fluid

A

a

64
Q

Pregnancy requirements

• Fetal _________, provision of oxygen
• Fetal n_______, e________
• Fetal growth, expansion of the uterus
• Fetal development
• Control of _________ blood flow
• _______ partial quiescence during development
• Prevention of maternal _______ _________ of
the fetus
• Control of hormone reaching the fetus
• Fetal control of maternal __________, appetite
for _________
• Placenta production of ___________ to affect
maternal uterus, breast

A

Pregnancy requirements
• Fetal respiration, provision of oxygen
• Fetal nutrition, excretion
• Fetal growth, expansion of the uterus
• Fetal development
• Control of placental blood flow
• Uterine partial quiescence during development
• Prevention of maternal immune rejection of
the fetus
• Control of hormone reaching the fetus
• Fetal control of maternal metabolism, appetite
for nutrition
• Placenta production of estrogens to affect
maternal uterus, breast

65
Q

Phases of foetal nutrition

  1. From the very small amount of _______ proteins within the oocyte
  2. From the secretions of the _______ and the _______ prior to implantation
  3. From digestion of the uterine __________ (specialised endometrium)
  4. From ___________ blood via the ________
A

Phases of foetal nutrition

  1. From the very small amount of yolk proteins within the oocyte
  2. From the secretions of the oviduct and the uterus prior to implantation
  3. From digestion of the uterine decidua (specialised endometrium)
  4. From maternal blood via the placenta
66
Q

Estrogens

Functions of placental steroids
o _________ of uterus and control of function
o Responsible for ________ development with progesterone
o Connective tissue effects to make more pliable
o Causes ______ retention
o Reduces ________ excretion
o ____________

A

Estrogens

Functions of placental steroids
o Growth of uterus and control of function
o Responsible for breast development with progesterone o Connective tissue effects to make more pliable
o Causes water retention
o Reduces sodium excretion
o Vasodilation

67
Q

Progesterone

o ________, constipation
o Reduced ________ and ureter tone (increase micturition)
o Diastolic pressure reduced, vasodilation
o Uterus in partially quiescent state
o Heart burn due to relaxation of cardiac sphincter
o Altered taste, appetite

A

Progesterone

o Nausea, constipation
o Reduced bladder and ureter tone (increase micturition) o Diastolic pressure reduced, vasodilation
o Uterus in partially quiescent state
o Heart burn due to relaxation of cardiac sphincter
o Altered taste, appetite

68
Q

Maternal hormones

Increased size __________ gland, ______ and ________ glands
Increased c______ production
Increased t_______ hormone production (increased total T3 and T4 but free hormone normal)
____________ glands increase size to control plasma calcium homeostasis

A

Maternal hormones

Increased size pituitary gland, thyroid and adrenal glands
Increased cortisol production
Increased thyroid hormone production (increased total T3 and T4 but free hormone normal)
Parathyroid glands increase size to control plasma calcium homeostasis

69
Q

Foetal vascular specialisations

Foetal blood must be able to capture oxygen from ____________ haemoglobin
• Foetal Hb has _________ affinity for oxygen than _____ Hb (declines in postnatal year 1 replaced by adult Hb)
• Foetal cardiac output is proportionally _______ than adult
• Foetal Hb concentration is ___% ______ than adult
• Sporadic uterine contractions during pregnancy
reduce uterine arterial flow but (don’t?) completely block uterine veins so the amount of blood in intervillous spaces ________

A

Fetal vascular specialisations

Fetal blood must be able to capture oxygen from maternal haemoglobin
• Fetal Hb has higher affinity for oxygen than adult Hb (declines in postnatal year 1 replaced by adult Hb)
• Fetal cardiac output is proportionally greater than adult
• Fetal Hb concentration is 50% higher than adult
• Sporadic uterine contractions during pregnancy
reduce uterine arterial flow but (don’t) completely block uterine veins so the amount of blood in intervillous spaces increases

70
Q

Maternal vascular specialisations

• Maternal cardiac output increases by __%
• Maternal plasma volume increases by __%
• Maternal haematocrit increases by __%
• Maternal mean arterial BP __________ in
mid-pregnancy and ____ to non-pregnant
by term
• _____________ role of estrogen and
progesterone
• Increased demand for _____, _______ and
________ to support the expansion of the maternal and fetal vasculatures

A

Maternal vascular specialisations

• Maternal cardiac output increases by 45%
• Maternal plasma volume increases by 50%
• Maternal haematocrit increases by 33%
• Maternal mean arterial BP decreases in
mid-pregnancy and rises to non-pregnant
by term
• Vasodilator role of estrogen and
progesterone
• Increased demand for iron, folate and
protein to support the expansion of the maternal and fetal vasculatures

Phys and Pharm (12 decks)

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