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Medicine yr1 > UG-fetal period, pregnancy and the breast > Flashcards

UG-fetal period, pregnancy and the breast Flashcards

1
Q

what occurs on week 12 of foetal development (2)?

A
  • Rotation & herniation of the gut is complete large SA

- External genitalia form

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2
Q

what occurs on week 16 of foetal development?

A
  • Kidneys begin to produce urine
  • Fetal skin becomes impermeable
  • Testicles descend (if Y is present)
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3
Q

what occurs on week 17 of foetal development?

A

Sucking reflex observed

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4
Q

what occurs on week 20 of foetal development (4)?

A
  • Max no. oocytes produced (if no Y present)
  • Terminal villi of placenta formed
  • Hair begins to grow
  • Grey matter in brain increases by x4
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5
Q

what occurs on week 21 of foetal development?

A

Nociception (pain detection)

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6
Q

what occurs on week 24 of foetal development?

A

Alveoli begin to develop

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7
Q

what occurs on week 25 of foetal development?

A

-Increase in fetal movements where ‘kicks’ are large limb movements

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8
Q

what occurs on week 28 of foetal development?

A

surfactant produced

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9
Q

what occurs on week 36 of foetal development?

A

renal development complete

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10
Q

which hormones does the placenta produce?

A
  • beta hcG (human chorionic gonadotropin)
  • hPl (human placental lactogen)
  • progesterone and oestrogen (after a certain point)
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11
Q

what are the roles of the placenta?

A
  • produces hormones
  • Acts as a immunological barrier
  • Allows for respiration & excretion of glucose and oxygen
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12
Q

how does the placenta act as an immunological barrier?

A

transferring maternal IgG to the fetus and filters out potentially harmful cytotoxic antibodies

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13
Q

does the placenta continue to develop during foetal development?

A

yes

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14
Q

what gives the placenta its large SA?

A

All the terminal villi (give the placenta a large surface area) will have been formed by 20 weeks.

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15
Q

what event occurs in week 16 that contributes to amniotic fluid?

A
  • Fetal skin becomes impermeable
  • Kidneys produce urine = contributes to amniotic fluid. Fetus will go through cycle of swallowing fluid & producing urine
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16
Q

when does amniotic fluid vol peak?

A

week 30 at 800ml

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17
Q

what happens to amniotic fluid vol at week 40?

A

decreases to 400ml

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18
Q

what are the functions of amniotic fluid?

A
  • Cushion for fetus to be protected from surrounding maternal organs
  • Shock absorber from any sudden movements
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19
Q

during foetal period what do bones mainly remain as?

A

Bones remain mainly as cartilage and ossify later

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20
Q

when do sutures in the skull fuse?

A

childhood

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21
Q

how can you identify the sex of a child on ultrasound?

A
  • Identifying a penis

- girls may also show their labia majora and minora as a 3 line appearance.

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22
Q

when does the brain begin to rapidly increase in size?

A

from 20 weeks

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23
Q

when do lungs develop in the fetal period?

A

lungs are continuously developing even until after birth

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24
Q

where are type 2 pneumocytes found?

A

in lining of alveoli

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25
Q

what is surfactant?

A
  • very important lipoprotein which makes sure the surface tension is low → higher surface tension will increase cohesion inside the alveoli, pulling them closed. .
  • makes it easier for lungs to expand
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26
Q

which structure carries out breathing in the fetal period?

A

the placenta

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27
Q

what is different about fetal haemoglobin?

A

-has higher affinity for oxygen

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28
Q

why is fetal hb different to adult hb?

A

fetal haemoglobin needs to “steal” oxygen away from the mother’s haemoglobin when nearby in the placenta.

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29
Q

how does pulmonary vascular resistance change after birth?

A
  • high in fetus
  • decreases after birth

(pulmonary blood flow increases and o2 exchange can occur in the lungs)

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30
Q

how does systematic vascular resistance change after birth?

A

increase in systemic vascular resistance

this will increase pulmonary blood flow

31
Q

what does the rise in systemic vascular resistance do to the heart?

A

close the foramen ovale & ductus arteriosus naturally

32
Q

why are the foramen ovale & ductus arteriosus open in foetal development?

A

as they bypass undeveloped organs (lungs) = means blood doesn’t flow to organs that haven’t developed yet

33
Q

how is lung fluid cleared?

A
  • During labour, there is a thoracic squeeze = expels fluid and reduces lung volume
  • During baby’s first cry, the lungs will fill with oxygen → this will move the lung fluid out of the lungs so the lungs can fill with oxygen
34
Q

how would you describe foetal growth in the first 20 weeks?

A

linear

35
Q

what is foetal overgrowth?

A

When growth is more than the 95th centile

36
Q

what are some causes of foetal overgrowth?

A

idiopathic, diabetes, fetal overgrowth syndromes

37
Q

what is foetal growth restriction?

A

This is a failure to reach the genetic growth potential

38
Q

what are some causes of foetal growth restriction?

A

placental, infections, genetic/chromosomal

39
Q

what does B-HCG do?

A

maintains the corpus luteum

40
Q

what can B-HCG cause?

A

morning sickness

41
Q

where is progesterone initially produced?

A

corpus luteum

42
Q

what does progesterone do in pregnancy?

A

thickens cervical mucus and maintains uterus lining support pregnancy until pregnancy has implanted

43
Q

where is oestrogen produced initially and what takes over?

A
  • initially-corpus luteum

- placenta takes over

44
Q

what is the role of oestrogen in pregnancy?

A

increases number of oxytocin receptors in uterus, increases vaginal discharge

45
Q

outline the respiratory changes in pregnancy

A
  • decreased residual volume
  • increased tidal vol
  • mild respiratory alkalosis
46
Q

outline the renal changes in pregnancy

A
  • 60% increased blood flow
  • 50% increased GFR
  • glycosuria is normal
  • proteinuria <30mg is normal
47
Q

outline the cardiovascular changes in pregnancy

A
  • increased heart rate (20%) and stroke volume (30%)—>increases cardiac output (40%)
  • increased total blood pressure
  • more RBC but fewer RBC/dl due to peripheral vasodilation
  • increased clotting factors in blood
48
Q

outline the gastrointestinal changes in pregnancy

A
  • delayed gut motility
  • constipation increases
  • increased alkaline phosphatase
49
Q

outline the skeletal changes in pregnancy

A
  • osteopenia (weak bones)

- increased osteoblast activity

50
Q

what is parturition?

A

process of giving birth

51
Q

what is labour?

A

sequence of actions where a baby & afterbirth (placenta) is expelled from the uterus during childbirth

52
Q

how does labour begin?

A
  • Painful uterine contractions = cause is ‘spontaneous’
  • Cervical dilatation
  • The ‘show’= release of mucus plug
  • Rupture of the amniotic sac = water breaking
53
Q

how many stages of labour are there?

A

3

54
Q

what is the first stage of labour?

A

from onset of labour → full dilation

55
Q

what are the 2 phases of the 1st stage of labour?

A
  • Latent: up to 3cm

- Active: 3cm - 10cm dilated

56
Q

what is the 2nd stage of labour?

A

full dilatation → delivery of fetus

57
Q

what is the 3rd stage of labour?

A

birth of fetus → delivery of placenta

58
Q

what is the role of oestrogen in labour?

A

increases oxytocin receptors on uterus, stimulates placenta to release prostaglandins

59
Q

what is the role of oxytocin in labour?

A

stimulates uterine contraction, releases more prostaglandins

60
Q

what is the role of relaxin in labour?

A

made by corpus luteum, increases flexibility of pubic symphysis, dilates (softens) uterine cervix

61
Q

what does a neonatal breast contain?

A

lactiferous ducts but no alveoli

62
Q

what are the characteristics of a breast during puberty?

A
  • Little branching of lactiferous ducts

- Any slight enlargement: reflects growth of fibrous stroma & fat

63
Q

what are the characteristics of a breast post puberty?

A
  • Ducts become branched on stimulation by ovarian oestrogen
  • Ends of branches form alveoli
  • Breast enlargement: due to lipid accumulation by adipocytes
64
Q

what does prolactin stimulate post pregnancy?

A

stimulates milk production

65
Q

what does oxytocin stimulate post pregnancy?

A

stimulates milk ejection

66
Q

what are the characteristics of the breast in pregnancy?

A
  • Breast growth more uniform
  • Increase oestrogen, prolactin & progesterone
  • Size and pigmentation of nipples increase due to increased oestrogen
  • Sebaceous glands produce lubricant
  • Increased vascular branching & dilated veins = increased blood flow
67
Q 
What week does the amniotic fluid peak at?
A-25 weeks
B-27 weeks
C-30 weeks
D-32 weeks
A

C

68
Q 
What week is rotation & herniation of the gut complete?
A-Week 10
B-Week 12
C-Week 15
D-Week 17
A

B

69
Q

Which is Foramen Ovale or Ductus arteriosus
A-Between both atria
B-Between aortic arch & pulmonary artery

A

foramen ovale=A

ductus arteriosus=B

70
Q 
Which of the following liver function tests would be elevated in a healthily pregnant woman?
A-ALT
B-Alkaline phosphatase
C-Albumin 
D-AST
A

B

71
Q 
Which of these is the right renal physiological changes during pregnancy?
A-Decreased blood flow 
B-Decreased GFR
C-Decreased urine frequency
D-Low creatinine levels
A

D

72
Q 
What stage of labour is 3cm - 10cm dilation?
A-Latent first phase
B-Active first phase
C-Second phase
D-Third phase
A

B

73
Q

what is hyperemesis gravidarum?

A
  • extreme morning sickness caused by increased hcG in pregnancy
  • causes severe dehydration
  • treated in hospitals

Medicine yr1 (55 decks)

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