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Maternal Newborn 211 > Week 02 > Flashcards

Week 02 Flashcards

Prenatal Physiology

1
Q

sexual maturation is determined at

A

conception

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2
Q

the male embryo produces which hormone

A

testosterone

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3
Q

the female embryo produces which hormone

A

estrogen and progesterone

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4
Q

primary female sex hormone

A

estrogen

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5
Q

estrogen

A
  • primary female sex hormone
  • presents in high levels in women of childbearing age
  • development of the secondary characteristics
  • regulates the menstrual cycle by proliferation of the endometrial lining
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6
Q

progesterone

A
  • decreases uterine motility and contractility
  • prepares the uterus for implantation after fertilization
  • during pregnancy readies the breast for lactation
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7
Q

gonadotropin-releasing hormone (GnRH)

A

hypothalamus

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8
Q

FSH

A
  • anterior pituitary gland
  • stimulation of corpus luteum, the follicle, ovum, and sac to mature
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9
Q

LH

A
  • anterior pituitary gland
    causes the release of ovum
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10
Q

estrogen

A
  • corpus lutem degenerates decreasing estrogen and progesterone levels
  • if pregnancy occurs, the corpus luteum continues to produce these hormones supporting the pregnancy
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11
Q

female ovulation

A

14 days before the menstrual period, mature ovum is released

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12
Q

male eajculation

A

35-200 million sperm suspended in seminal fluid

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13
Q

fertilization

A
  • occurs in the distal third of the fallopian tube
  • 2 to 3 day window every month that pregnancy can occur
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14
Q

implantation

A
  • upper third portion of the uterus
  • where implantation occurs is where the placenta develops
  • if lower, it can cover the cervix
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15
Q

genome

A

genetic makeup

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16
Q

total chromosomes

A

46

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17
Q

chromosomes from mother, father

A

23, 23

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18
Q

father

A

XX

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19
Q

mother

A

XY

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20
Q

autosomal dominant

A

only 1 copy of the gene is needed, infant has a 50% chance of having the disorder

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21
Q

autosomal recessive

A

both parents have a copy of the gene, the infant needs 2 copies, the infant has a 25% chance of having the disorder

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22
Q

signs of pregnancy: presumptive phase (i think)

A

breast changes, N/V, amenorrhea, increased urination, fatigue, uterine enlargement, quickening, skin changes

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23
Q

signs of pregnancy: probable phase (i have proof)

A

positive pregnancy test, abdominal enlargement, Chadwick’s sign (blush colored cervix), Goodall’s sign (softening of the cervix), Hagar’s sign (softening of the lower uterus), Braxton Hicks

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24
Q

signs of pregnancy: positive phase (the MD confirmed)

A

FHR heard separate from maternal HR, fetal movement felt by the examiner, ultrasound

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25
Q

Chadwick’s sign

A

blush colored cervix

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26
Q

Goodall’s sign

A

softening of the cervix

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27
Q

Hagar’s sign

A

softening of the lower uterus

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28
Q

1st trimester duration

A

weeks 1-13

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29
Q

2nd trimester duration

A

weeks 14-27

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30
Q

3rd trimester duration

A

weeks 28-40

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31
Q

postpartum duration

A
  • 6 weeks following delivery
  • sometimes called the 4th trimester
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32
Q

pre embryonic stage duration

A

conception - weeks 1 & 2

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33
Q

embryonic stage duration

A

weeks 2 - 8

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34
Q

fetal stage duration

A

weeks 8 - birth

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35
Q

pre embryonic process

A

zygote > morula > blastocyte > implantation > placenta formation

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36
Q

week 03

A
  • missed period
  • divided up into the 3 layers
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37
Q

week 04

A
  • neural tube closes
  • heart begins beating
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38
Q

week 08

A
  • organogenesis
  • most organ systems have developed with minimal function
  • heartbeat detected on vaginal ultrasound
  • arm and leg buds are present and finger ridges begin to appear
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39
Q

weeks 12 - 13

A
  • end of 1st trimester
  • ultrasound detects FHR, spontaneous movement, sex
  • urine production
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40
Q

week 16

A
  • FHR can be obtained via stethoscope
  • swallowing reflex is present
  • fetal skeleton can be seen on x-ray
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41
Q

week 20

A
  • fetal movement felt by mother (quickening)
  • rule out anomalies scan
  • vernix & lanugo present
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42
Q

weeks 24 - 27

A
  • end of 2nd trimester
  • age of viability
  • fingernails are present
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43
Q

week 28

A
  • surfactant
  • quality viability
  • eyes can open
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44
Q

week 32

A
  • subcutaneous fat
  • responds to outside noise
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45
Q

week 36

A
  • vertex position (head down)
  • increase in subcutaneous fat
  • vernix thickens
  • lanugo disappears
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46
Q

week 40

A
  • active fetal movement
  • conversion of fetal HBG to newborn HBG
  • due date
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47
Q

germ layers

A

ectoderm, mesoderm, endoderm

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48
Q

ectoderm

A

brain and spinal cord, peripheral nervous system, pituitary gland, sensory epithelium (eyes, nose, ears), epidermis, hair and nails, subcutaneous glands, mammary glands, tooth enamel

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49
Q

mesoderm

A

cartilage and bone, connective and muscle tissue, heart and blood vessels, lymphatic system, spleen, kidneys, adrenal cortex, reproductive system, lining membranes

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50
Q

endoderm

A

lining of GI and respiratory tract, tonsils, thyroid, parathyroid, thymus, liver, pancreas, lining of bladder, and urethra, lining of ear canal

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51
Q

monozygotic pregnancy

A
  • identical
  • single ovum and sperm
  • one placenta and chorion
  • two amnions and umbilical cords
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52
Q

dizygotic pregnancy

A
  • fraternal
    -2 sperate ovum and sperm
  • 2 placentas, chorions, amnions, umbilical cords
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53
Q

functions of the placenta

A

chorionic villi, oxygen, nutrients, hormones, immune system, waste removal

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54
Q

human chorionic gonadotropin (HcG)

A

thickens the lining of the uterus

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55
Q

human placental lactogen (HPL)

A

regulates glucose

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56
Q

estrogen

A

triggers organ development

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57
Q

progesterone

A

suppresses maternal immunity

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58
Q

relaxin

A

(ovaries help) allow ligaments and collagen to relax

59
Q

prolactin

A

keeps corpus luteum active (progesterone production)

60
Q

functions of the umbilical cord

A
  • formed from amnion
  • lifeline between mother and fetus
  • AVA
  • Wharton jelly
  • 22 in long, 1 in wide
61
Q

AVA

A
  • 2 arteries: carries deoxygenated blood
  • 1 vein: carries oxygenated blood
62
Q

functions of amniotic fluid

A
  • maintains fetal temp
  • permits symmetric growth and development
  • cushions and prevents cord compression
  • promotes fetal movement
63
Q

infertility: male factors

A
  • sperm count
  • erection
  • ejaculation
  • seminal fluid
64
Q

infertility: female factors

A
  • endometriosis
  • ovulation disorders
  • tubal occlusions
  • cervical abnormalities
65
Q

infertility: other factors

A
  • infections
  • environmental agents
66
Q

how to improve probability of conception

A
  • Intercourse should happen every other day
  • Eat healthy, no alcohol
  • Maintain a healthy weight
  • Stay lying down after intercourse
  • Don’t shower after intercourse
  • No douching (ever)
67
Q

infertility treatments: surgery

A
  • laparoscopic
  • hysteroscopic
  • tubal
68
Q

infertility treatments: therapeutic insemination

A

places sperm at the cervical OS

69
Q

infertility treatments: intauterine insemination (IUI)

A

sperm is placed in the uterus

70
Q

infertility treatments: in-vitro fertilization (IVF)

A
  • Sperm and egg are combined outside of the body
  • The fertilized egg is implanted inside the uterus
71
Q

infertility treatments: surrogate parenting

A
  • preserved/ donated egg or sperm
72
Q

infertility treatments: other

A
  • surgery (reversal of sterilization)
  • medications (clomid; induced ovulation)
73
Q

teratogens

A

drugs, alcohol, tobacco, environmental, hyperthermia, infections, ionizing radiation

74
Q

T.O.R.C.H infections

A
  • T: toxoplasmosis
  • O: other
  • R: rubella
  • C: cytomegalovirus
  • H: HSV
75
Q

toxoplasmosis

A
  • Harmful throughout pregnancy
  • Found in cat litter and undercooked deli meats
  • Miscarriage, hydrocephaly, microcephaly, chronic retinitis, seizures
76
Q

other

A

HIV, syphilis, Hep B, Zinka, GBS< and Hep C

77
Q

rubella

A
  • Mother is tested during pregnancy for immunity
  • Mother cannot get pregnant for 4 weeks after vaccination
  • Miscarriage, IUGR, cataracts, congenital anomalies, intellectual development disability, death
78
Q

cytomegalovovirus

A
  • Common virus, blueberry rash
  • Hemolytic anemia, jaundice hydrocephaly, microcephaly, pneumonitis, intellectual disabilities, cerebral palsy, deafness
79
Q

HSV

A
  • Can be passed to infant at delivery
  • Miscarriage, preterm birth, stillbirth, transplacental infection (rare), IUGR, intellectual/ developmental disabilities, microcephaly, seizures, coma
80
Q

pharmacologic agents: category A

81
Q

pharmacologic agents: category B

A

no risk in animals

82
Q

pharmacologic agents: category C

A

adverse effects in animals

83
Q

pharmacologic agents: category D

A

evidence of human risk, benefits may outweigh risk

84
Q

pharmacologic agents: category X

A

never to be used in pregnancy

85
Q

physiological changes: uterus

A
  • Week 12: above symphysis pubis
  • Week 20: reach umbilicus
  • Week 36: touches the xiphoid process
86
Q

physiological changes: ovarian

A
  • Ovulation
  • Amenorrhea
87
Q

physiological changes: cervical

A
  • Increased vascularity
  • Mucous plug
  • Goodell sign
88
Q

physiological changes: vaginal

A
  • Increased vascularity, Chadwick’s sign
  • Increase in vaginal secretions, Increased acidity
89
Q

physiological changes: integumentary

A
  • Striae
  • Linea nigra
  • Chloasma
90
Q

physiological changes: breast

A
  • Size increase, Areola darkens
  • Week 16: colostrum can be expelled
91
Q

physiological changes: cardiovascular

A
  • Weeks 16-18: blood volume increases 30%-50%
  • Pseudomamma
  • Cardiac output increases
  • Heart rate increases by 10 BPM
  • Fibrinogen increases by 50 %
92
Q

physiological changes: respiratory

A
  • Congestion
  • SOA
  • Increased RR
  • Diminished lung sounds
93
Q

physiological changes: renal

A
  • Increased urine output
  • Increased frequency
  • Urinary tract infection
  • Kidney stones and hydronephrosis
  • Urine stays longer increasing risk for pyelonephritis
94
Q

physiological changes: skeletal

A
  • Calcium, phosphorus
  • Pelvic ligaments joints
  • Relaxin
95
Q

physiological changes: gastrointestinal

A
  • Early n/v, later decreased gastric motility
  • Constipation, heart burn, flatulence, fluid retention
96
Q

physiological changes: vascular

A
  • Vasoconstriction
  • Nasal stuffiness, gum swelling
  • Spider veins
97
Q

fetal circulation

A

Blood bypasses the liver > inferior vena cava > right atrium > left atrium > aorta > head and lower body

98
Q

ductus venous

A
  • Oxygen rich blood from the umbilical vein is shunted past the liver
  • To the inferior vena cava
99
Q

foramen ovale

A
  • Diverts blood from the right atrium
  • Into the left atrium
  • Bypasses the lungs
100
Q

ductus arteriosus

A
  • Diverts blood from the pulmonary artery
  • By connecting the pulmonary artery to the aorta
  • Bypassing the lungs
  • Oxygen rich blood goes to the head
  • Mixed blood goes to the lower body
101
Q

What determines sexual maturation?

A

Determined at conception

102
Q

What hormone does a male embryo produce?

A

Testosterone

103
Q

What hormones do female embryos produce?

A

Estrogen and progesterone

104
Q

What is the primary female sex hormone?

105
Q

What are the functions of estrogen?

A
  • Development of secondary sex characteristics
  • Regulates the menstrual cycle by proliferation of the endometrial lining
106
Q

What is the function of progesterone?

A
  • Decreases uterine motility and contractility
  • Prepares the uterus for implantation after fertilization
  • Readies the breast for lactation during pregnancy
107
Q

What hormone is released from the hypothalamus?

A

Gonadotropin-Releasing Hormone (GnRH)

108
Q

What does FSH stimulate?

A
  • Corpus luteum
  • Follicle
  • Ovum
  • Sac to mature
109
Q

What is the role of LH?

A

Causes the release of ovum

110
Q

What happens to estrogen levels if pregnancy occurs?

A

The corpus luteum continues to produce estrogen and progesterone

111
Q

When does female ovulation occur?

A

14 days before menstrual period

112
Q

What is the sperm count in male ejaculation?

A

35-200 million sperm

113
Q

Where does fertilization occur?

A

In the distal third of the fallopian tube

114
Q

What is the significance of implantation?

A

Occurs in the upper third portion of the uterus where the placenta develops

115
Q

How many chromosomes are in the human genome?

A

46 chromosomes

116
Q

What is the difference between genotype and phenotype?

A
  • Genotype: all the information inside the DNA
  • Phenotype: what is expressed
117
Q

What does an autosomal dominant disorder require?

A

Only 1 copy of the gene

118
Q

What is needed for an autosomal recessive disorder to manifest?

A

Both parents must have a copy of the gene, and the infant needs 2 copies

119
Q

What are presumptive signs of pregnancy?

A
  • Breast changes
  • Nausea/Vomiting
  • Amenorrhea
  • Increased urination
  • Fatigue
  • Uterine enlargement
  • Quickening
  • Skin changes
120
Q

What are probable signs of pregnancy?

A
  • Positive pregnancy test
  • Abdominal enlargement
  • Chadwick’s sign
  • Goodell’s sign
  • Hegar’s sign
  • Braxton Hicks
121
Q

What confirms a positive sign of pregnancy?

A
  • FHR heard separate from maternal HR
  • Fetal movement felt by examiner
  • Ultrasound
122
Q

What is the duration of a typical pregnancy?

123
Q

What are the three trimesters of pregnancy?

A
  • First trimester: weeks 1-13
  • Second trimester: weeks 14-27
  • Third trimester: weeks 28-40
124
Q

What is the embryonic period’s duration?

125
Q

What happens during organogenesis?

A

Differentiated/specialized body cells develop

126
Q

What are the three germ layers and their derivatives?

A
  • Ectoderm: brain, spinal cord, skin
  • Mesoderm: muscle, bone, heart
  • Endoderm: lining of GI tract, respiratory tract
127
Q

What is the longest period of pregnancy called?

A

Fetal period

128
Q

What defines a monozygotic pregnancy?

A

Identical twins from one ovum and one sperm

129
Q

What defines a dizygotic pregnancy?

A

Fraternal twins from two separate ova and two separate sperm

130
Q

What is the function of the placenta?

A
  • Provides oxygen
  • Nutrients
  • Hormones
  • Immune system support
  • Waste removal
131
Q

What hormone thickens the lining of the uterus?

A

Human Chorionic Gonadotropin (HCG)

132
Q

What does Human placental lactogen (HPL) regulate?

133
Q

What is the structure of the umbilical cord?

A

AVA: one vein and two arteries

134
Q

What does the amniotic fluid do?

A
  • Maintains fetal temperature
  • Permits symmetric growth and development
  • Cushions and prevents cord compression
  • Promotes fetal movement
135
Q

What are male factors contributing to infertility?

A
  • Sperm count
  • Erection
  • Ejaculation
  • Seminal fluid
136
Q

What are female factors contributing to infertility?

A
  • Endometriosis
  • Ovulation disorders
  • Tubal occlusions
  • Cervical abnormalities
137
Q

What are some treatments for infertility?

A
  • Surgery
  • Therapeutic insemination
  • Intrauterine Insemination (IUI)
  • In vitro fertilization (IVF)
138
Q

What are teratogens?

A

Substances that can cause developmental abnormalities in a fetus

139
Q

What are the TORCH infections?

A
  • Toxoplasmosis
  • Other (HIV, syphilis, etc.)
  • Rubella
  • Cytomegalovirus
  • Herpes Simplex Virus (HSV)
140
Q

What is the classification of pharmacologic agents in pregnancy?

A
  • Category A: safest
  • Category B: no risk in animals
  • Category C: adverse effects in animals
  • Category D: evidence of human risk
  • Category X: never to be used
141
Q

What physiologic change occurs in the uterus by week 12?

A

Above symphysis pubis

142
Q

What is the role of the ductus venosus?

A

Shunts oxygen-rich blood from the umbilical vein past the liver to the inferior vena cava

143
Q

What is the function of the foramen ovale?

A

Diverts blood from the right atrium into the left atrium, bypassing the lungs

144
Q

What does the ductus arteriosus connect?

A

The pulmonary artery to the aorta, bypassing the lungs

Maternal Newborn 211 (5 decks)

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