Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Repro / GU > SM_210b: Anatomy and Physiology of Implantation Placentation > Flashcards

SM_210b: Anatomy and Physiology of Implantation Placentation Flashcards

1
Q

Placenta has a ____ circulatory system

A

Placenta has a dual circulatory system (fetal and placental)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Placenta provides ____

A

Placenta provides fetal nourishment from maternal blood without allowing direct mixing with fetal blood

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Describe three compartments of placenta

A

Three compartments of placenta

  • Membranes: maternal + fetal
  • Placental disc: maternal + fetal
  • Umbilical cord: fetal
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Three compartments of placenta are ____, ____, and ____

A

Three compartments of placenta are membranes, placental disc, and umbilical cord

  • Membranes: maternal + fetal
  • Placental disc: maternal + fetal
  • Umbilical cord: fetal
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Membranes of placenta have 3 layers: ____, ____, and ____

A

Membranes of placenta have 3 layers: amnion, chorion, and parietal decidua

  • Amnion: fetal epithelial layer
  • Chorion: fetal mesodermal layer
  • Parietal decidua: maternal layer containing remodeled maternal blood vessels
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Umbilical cord is composed of ____ including ____ and ____ and is cushioned by ____

A

Umbilical cord is composed of 3 vessels including 1 vein and 2 arteries and is cushioned by Wharton’s jelly

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Placental disc components of fetal origin are ____ and ____

A

Placental disc components of fetal origin are chorionic plate (fetal surface) and villous tree

  • Chorionic plate (fetal surface): arborizing fetal vessels
  • Villous tree: fetal vessels surrounded by trophoblasts
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Placental disc components of maternal origin are ____ and ____

A

Placental disc components of maternal origin are basal plate (maternal surface) and intervillous space (maternal blood)

  • Basal plate (maternal surface): decidua (maternal), remodeled vessels (maternal), extravillous trophoblast (fetal), fibrinoid (fetal)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

This is the ___

A

This is the chorionic plate (fetal surface)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Chorionic villi are ____

A

Chorionic villi are embryo derived structures containing fetal blood vessels and surrounded by trophoblast

  • As gestation progresses, villi branch like branches of a tree
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Describe the syncytiotrophoblast

A

Syncytiotrophoblast

  • Outer layer
  • Multinucleated (syncytium)
  • Permeable to oxygen + nutrients
  • Not permeable to blood
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Describe the cytotrophoblast

A

Cytotrophoblast

  • Inner layer
  • Stem cells
  • Continuous -> discontinuous
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Describe the histology

A

Histology of placenta

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Describe remodeled maternal vessels

A

Remodeled maternal vessels lose muscle and become lined by extravillous trophoblast cells to create low resistance vessels that supply blood to the intervillous space

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Normal implantation is into ____

A

Normal implantation is into uterine wall

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Ectopic pregnancy is ____

A

Ectopic pregnancy is implantation outside uterine wall, usually in fallopian tube

  • High risk of rupture and hemorrhage
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Placenta previa is ____

A

Placenta previa is low implantation over the cervical internal os

  • Placenta blocks vaginal delivery
  • Risks: maternal hemorrhage, fetal hypoxic injury
  • Cesarean section
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Normal implantation is into the ____ which separates at birth

A

Normal implantation is into the decidua which separates at birth

  • Without decidua, placenta on myometrium (adherent)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Placenta accreta is ____

A

Placenta accreta is implantation on myometrium

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Placenta increta is ____

A

Placenta increta is invasion into myometrium

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Placenta percreta is ____

A

Placenta percreta is invasion through uterine serosa into adjacent structures

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Describe placenta increta

A

Placenta increta

  • Placenta invades myometrium
  • Often C-section
  • Hysterectomy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

____ placental infections are most common

A

Ascending placental infections are most common

  • Vaginal canal -> amniotic fluid
  • Maternal inflammatory response: chorioamnionitis
  • Fetal inflammatory response: inflammation in umbilical cord and placental vessels
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Hematogenous infection (maternal sepsis) infects ____ and is ____

A

Hematogenous infection (maternal sepsis) infects intervillous spaces and is villitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Ascending placental infections are usually ____ caused by ____ or ____

A

Ascending placental infections are usually bacterial caused by maternal genitourinary flora or maternal gastrointestinal flora

  • Maternal genitourinary flora: Mycoplasmas, Gardnerella
  • Maternal gastrointestinal flora: group B Strep, E. coli, Enterococcus
  • Occassionally: Candida spp, HSV
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Maternal inflammatory response to ascending placental infections is ____ originating from ____

A

Maternal inflammatory response to ascending placental infections is maternal neutrophils (acute inflammatory cells) originating from decidual vessels membrane and basal plate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Three stages of maternal response to ascending placental infections are ____, ____, and ____

A

Three stages of maternal response to ascending placental infections

  • Subchorionitis
  • Chorioamnionitis
  • Necrotizing amnionitis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Fetal inflammatory response to ascending placental infections is ____ originating from ____

A

Fetal inflammatory response to ascending placental infections is fetal neutrophils originating from fetal vessels

  • Fetal vessels are in umbilical cord and on chorionic plate
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Three stages of fetal response to ascending placental infections are ____, ____, and ____

A

Three stages of fetal response to ascending placental infections

  1. Phlebitis (vein)
  2. Arteritis (artery)
  3. Necrotizing funisitis (necrosis in Wharton’s jelly)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Hematogenous placental infections can be caused by ____, ____, or ____

A

Hematogenous placental infections can be caused by bacteria, viruses, or toxoplasmosis

  • Bacteria: syphilis, TB, Listeria
  • Viral: Cytomegalovirus, Rubella
31
Q

Chronic villitis variant of hematogenous placental infection involves ____

A

Chronic villitis variant of hematogenous placental infection involves infiltration of villi by lymphocytes, plasma cells, and / or histiocytes

  • Cytomegalovirus, toxoplasmosis, syphilis
32
Q

Acute villitis variant of hematogenous placental infection involves ____

A

Acute villitis variant of hematogenous placental infection involves infiltration of villi by neutrophils

  • Listeria (abscesses)
  • Sometimes E. coli, TB
33
Q

Maternal vascular malperfusion is ____ that presents with ____ and ____

A

Maternal vascular malperfusion is pathologic changes associated with uteroplacental insufficiency that presents with HTN and preeclampsia

34
Q

In normal placentas, maternal vessels are ____ so they have ____ resistance and ____ flow

A

In normal placentas, maternal vessels are remodeled by trophoblasts so they have low resistance and high flow

35
Q

In maternal vascular malperfusion, maternal vessels ____ so they have ____ resistance and ____ flow

A

In maternal vascular malperfusion, maternal vessels retain their muscular walls so they have high resistance and low flow

36
Q

In maternal vascular malperfusion, decreased maternal blood flow leads to ___

A

In maternal vascular malperfusion, decreased maternal blood flow leads to chronic hypoxia

  • Placenta adapts by increasing villous branching -> smaller terminal villi -> increased surface area for oxygen / nutrient exchange -> accelerated villous maturation
37
Q

In maternal vascular malperfusion, vessel injury consists of ____ and ____

A

In maternal vascular malperfusion, vessel injury consists of replacement of necrotic wall by fibrinoid necrosis and foamy macrophages (atherosis)

38
Q

Damaged placental vessels ____, leading to ____

A

Damaged placental vessels thrombose, leading to placental infarction

39
Q

When placenta infarcts, ___

A

When placenta infarcts, intervillous space collapses and villi die

40
Q

Describe retroplacental hematoma / abruption

A

Retroplacental hematoma / abruption

  • Damaged vessels can rupture -> large retroplacental hematomas -> premature separation of placenta from uterus
41
Q

Women with retroplacental hematoma / abruption usually present with ____

A

Women with retroplacental hematoma / abruption usually present with painful bleeding

(can be life-threatening)

42
Q

Retroplacental hematomas extend into and infarct the ___

A

Retroplacental hematomas extend into and infarct the disc

43
Q

Fetal vascular malperfusion is ____ caused by ____

A

Fetal vascular malperfusion is pathologic changes associated with fetoplacental insufficiency caused by processes that obstruct / compromise blood flow from the fetus to the placenta

44
Q

Fetal vessels are ____, ____, ____, and ____

A

Fetal vessels are umbilical cord, chorionic vessels, stem villous vessels, and villous capillaries

45
Q

____ is sole source of oxygenated / nutrient-rich blood to fetus

A

Umbilical cord is sole source of oxygenated / nutrient-rich blood to fetus

  • Abnormal cords compromise delivery of this blood
46
Q

Normal umbilical cords are inserted ____ on the disc and have ____

A

Normal umbilical cords are inserted centrally / paracentrally on the disc and have loose twists

47
Q

Abnormal cord insertion is ____ and risks ____

A

Abnormal cord insertion is cord inserted into membranes (velamentous insertion) and risks kinks / injury

48
Q

Abnormal cord twisting can lead to ___, ___

A

Abnormal cord twisting can lead to strictures, constricting blood flow

  • Normal cords have 1-3 twists / 10 cm
49
Q

Mechanical obstruction of umbilical cord can be ____ or ____

A

Mechanical obstruction of umbilical cord can be knots or entrapment

  • Neck entrapment (nuchal cord)
  • Body entrapment (body cord)
50
Q

Thrombus formation is governed by ____ which consists of ____, ____, and ____

A

Thrombus formation is governed by Virchow’s triad, which consists of stasis, hypercoagulability, and vascular damage

  • Stasis: cord compression / stricture, heart failure / anomalies, polcythemia
  • Hypercoagulability: thrombophilic disorders, acquired or gentic
  • Vascular damage: infection, meconium, mechanical
51
Q

Pathologic findings of fetal vascular malperfusion are ____ and ____

A

Pathologic findings of fetal vascular malperfusion are thrombosed vessel and apoptosis of fetal vessels (avascular villi)

52
Q

Describe consequences of fetal vascular malperfusion

A

Fetal vascular malperfusion consequences

  • High grade fetal vascular malperfusion can result in fetal neurologic damage (i.e. cerebral palsy)
  • In most severe cases, can result in intrauterine or neonatal fetal demise
53
Q

Dizygous (fraternal) placentas are ___

A

Dizygous (fraternal) placentas are two eggs each fertilized by their own sperm

54
Q

Monozygous (identical) placentas are ____

A

Monozygous (identical) placentas are 1 egg fertilized by 1 sperm

55
Q

Describe chorions in twin placentas

A

Chorions in twin placentas

  • Most twins have 2 chorions (dichorionic): 1/3 monozygous, 2/3 dizygous
  • Monochorionic: nearly always monozygous
56
Q

Describe amnions in twin placentas

A

Amnions in twin placentas

  • Dichorionic always has two amniotic sacs (diamniotic)
  • Monochorionic has one or two (monoamniotic): rarely monochorionic monoamniotic twins can be conjoined
57
Q

All dizoygotic twins are ___ and placental discs can be ___

A

All dizoygotic twins are dichorionic diamniotic and placental discs can be either fused or separate

58
Q

For monozygotic twins, chorionicity and amniocity are dependent on ___

A

For monozygotic twins, chorionicity and amniocity are dependent on when the ovum divides after fertilization

  • < 2 days: dichorionic diamniotic
  • 2-8 days: monochorionic diamniotic
  • > 8 days: monochorionic monoamniotic
59
Q

Dichorionic placenta has a dividing membrane that is ____

A

Dichorionic placenta has a dividing membrane that is thick, obaque, and firmly adhered to the disc because of the intervening chorion

  • Could be either dizygotic or monozygotic
60
Q

Monochorionic placenta has a dividing membrane that is ____

A

Monochorionic placenta has a dividing membrane that is thin, translucent, and not adhered to the disc because no intervening chorion

  • Almost always monzygotic
61
Q

Twin pregnancies are at increased risk of ____

A

Twin pregnancies are at increased risk of developing preterm labor

  • Monochorionic placentas have additional risks: twin twin transfusion and twin reversed arterial perfusion, cord entanglement in monochorionic monoamniotic twins, more congenital malformations
62
Q

Monochorionic twin placenta is almost always ____ and has ____

A

Monochorionic twin placenta is almost always monozygotic and has intertwin vascular connections

63
Q

Problems of intertwin vascular connections are ____ and ____

A

Problems of intertwin vascular connections are twin twin transfusion and twin reversed arterial perfusion

64
Q

Twin twin transfusion syndrome involves ____ and ____

A

Twin twin transfusion syndrome involves anemic donor twin and plethoric recipient twin

65
Q

Twin reversed arterial perfusion involves a ____ and ____

A

Twin reversed arterial perfusion involves a pump twin (hydrops) and acardiac twin

66
Q

Gestational trophoblastic disease involves ____

A

Gestational trophoblastic disease involves proliferative placental tissue tumors that develop from trophoblasts

  • Produce B-hCG (tumor marker)
67
Q

B-hCG is a tumor marker for ____

A

B-hCG is a tumor marker for gestational trophoblastic disease

  • Gestational trophoblastic disease: proliferative placental tissue tumors
68
Q

Gestational trophoblastic disease classificiation includes ____ and ____

A

Gestational trophoblastic disease classificiation includes hydatidiform mole (80%) or choriocarcinoma

  • Hyaditidiform mole: complete or partial
69
Q

Molar pregnancies have ____

A

Molar pregnancies have overrepresentation of paternal chromosomes

70
Q

Describe complete molar pregnancies

A

Complete molar pregnancies

  • Grape-like swollen villi
  • Diffuse trophoblast hyperplasia
  • Cystic swelling of all chorionic villi
71
Q

Describe partial molar pregnancies

A

Partial molar pregnancies

  • Only some villi are edematous and trophoblast hyperplasia only focal
  • Embryo present but often abnormal and rarely visible
72
Q

Compare complete and partial molar pregnancies

A

Complete and partial molar pregnancies

73
Q

Choriocarcinoma is a ____

A

Choriocarcinoma is a pure trophoblast proliferation with NO chorionic villi

  • Highly malignant
  • Rapidly invasive and widely metastasizing (especially to lung, brain, and liver)
  • Responds well to chemotherapy
74
Q

Choriocarcinoma appears as ____ on histology

A

Choriocarcinoma appears as poorly differentiated syncytiotrophoblasts on histology

Repro / GU (46 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions