unit 1 Flashcards
ovarian cycle phases
follicular
ovulatory
luteal
follicular phase main hormone
estrogen (increases) and produces LH surge at the end: ovulation
usually 14 days (varies)
Ovulatory phase
mucus
S&S
cervical mucus: thin, watery and alkaline (helps sperm)
SPINBARKHEIT MUCUS
fertile for 24 hrs
midcycle pain/spotting
Luteal Phase
always 14 days (doesn’t vary)
old graafian follicle persists as corpus luteum. which secretes Estrogen and high progesterone to prep. uterus for implantation and preg.
Ovum fertilized-secretes HcG
not fertilized-estrogen and progesterone go down, endometrial lining falls and menses begins
Endometrial cycle phase
Proliferative (cells multiply and form tissue: follicular phase of other)
Secretory (begins with ovulation-lutel phase. endometriu, thickens)
Menstrual phase: at end of luteal phase. vasospasm/ischemia and necrosis if not fertilized.
Pelvic types
Gynecoid (great)
Anthropoid (ok. posterior position. cone head baby)
Platypelloid (narrow from side to side: poor)
Anthroid (heart. poor)
amnion/chorion membranes
inner/outer
amniotic fluid
Cushions
Maintains temperature
Allows movement
Prevents adherence
Olihydramnios/polyhydramnios
2000 ml
poor lung development/due to Gest.diabetes.multifetal
Placenta
sides
Maternal side: from Decidua (protects mother) basilis. ROUGH
Fetal side: from chorionic vili. SMOOTH
Placenta functions
-metabolic: produces glycogen, cholesterol, fatty acids.
-Transfer functions: Gas exchange by diffusion; nutrient transfer across placenta- glucose, electrolytes pass through placenta to nourish the baby; removal of wastes (urea, uric acid, carbon dioxide, billirubin)
-Transfer of Antibodies.
Want women in 9th week of pregnancy to be vaccinated against Pertussis → so baby will get pertussis antibody
Placental endocrine function
secretes: HCG (human chorionic gonadotropin) Estrogen Progesterone Human Placental Lactogen
fertilization (conception)
ovum and sperm unite and form a zygote
baby’s sex is determined at that point
preembryonic period
first 14 days after conception
morula
1.outside cells (throphoblast)
2,Inside cells (blastocysts)
implants into the uterus: nidation (can cause spotting/bleeding a bit, woman thinks is period)
- chorion
- fetus and amnion
Ductus Venosus
Connects umbilical vein to the inferior vena cava.
Forman Ovale:
Opening b/w right & left atrium in heart.
Ductus Arteriosus
Connects pulmonary artery to the aorta
Decidua capsulais
covers the morula (outside of morula; the outer capsule)
Decidua basalis:
underneath/below the morula. Maternal portion of placenta develops from the decidua basalis.
Decidua vera :
the rest of the uterine cavity.
what do they measure with an ultrasound for age
1 trimester
2nd and 3rd
- Crown Rump (head to buttocks)
- Bi-Parietal diameter (head circumference)
and femur leg length
First heart beat detectable
4-5 weeks with transvaginal sonogram/ultrasound
8-12 weeks with a doppler
uterine sizing
bimanual exam one hand on vagina and the other one on uterus to feel for uterus non preg: plum size 6 weeks: egg, pear 8 week: small orange 10 week: large orange
Presumptive signs of preg.
Pt tells you Amenorrhea N/V Urinary frequency Breast and skin changes
Probable signs of preg.
signs that examiner can detect Chadwick's sign Hegar's sign Godell's sign Ballotment Uterine souffle Fetus souffle and enlargement braxton hick contractions
Positive signs (definite)
auscultation of fetal heart sounds
fetal movements detected by examiner
visualization of the embryo or fetus
skin changes during pregnancy
increased pigmentation
linea nigra
strae gravidarum
thicker hair
chloasma (mask of pregnancy)
pruritus (due to gall bladder delayed emptying)
PUPPP (pruritic urticarial papules and plaques in pregnancy) itchy red bumps on abdomen. take oatmeal baths
Musculoskeletal changes
-increased relaxin and progesterone (ligaments more relaxed)
-duck-waddle gait (pubic symphysis widens)
-lumbar lordosis (no heels, do pelvic exercises) goes away
-paresthesias of extremities (put legs up)
-Diasis recti (pt laying down/supine, ask pt to lift shoulders up → may see abdominal muscles separate.)
leg cramps (calcium-phosphorus imbalance) teens
-Round ligament pain (put knees to chest, abd. support)
-varicosities (elevate legs, no constrictive clothing)
-fatigue
Reproductive system changes
-uterus: increases in size (20 weeks: at umbilicus). Hegar
-Cervix: chadwick, godell. mucus plug
-vagina: chadwick, leukorrhea (C&S,wear liner,no douching, hygiene)
braxton hick contractions: not in preterm labor, painless irregular.
-ovulation ceases
-breast enlarge, sensitive, montgomery glands, darker, colostrum
Cardiovascular system changes
- heart pushed upward to left. increased muscle. abn sounds
- blood volume increases: diluted blood (less clots)
- HR Accelerates by 10-15 bpm
- clotting factors increase (fibrinogen) (walk postpartum)
- BP decreases 1st and 2nd trimester. Nrmal in 3rd
- vena cava syndrome
- physiological anemia and leukocytosis