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Bioscience for Midwifery > Week 2 > Flashcards

Week 2 Flashcards

1
Q

What does Oestrogen do in pregnancy?

A

Growth and development of breasts;
Hyperplasia of the endometrium - building up the lining of the uterus;
Hypertrophy of the uterus - growth in size;
Increased vascularisation of the uterus;
Promotes growth of myometrial muscle;
Increases blood flow.

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2
Q

What is the role of progesterone in pregnancy?

A

Relaxes smooth muscle;
Reduces uterine muscle excitability, to prevent uterine contraction;
Suppresses immune system;
Relaxation of blood vessels.

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3
Q

What is the role of Human Chorionic Gonadotropin (hCG)?

A

Maintains the corpus luteum so that it continues to produce Oestrogen and Progesterone until the placenta takes over at 3 months.

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4
Q

Which hormone is detected by pregnancy tests?

A

Human Chorionic Gonadotropin (hCG).

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5
Q

What is the role of Human Placental Lactogen (hPL)?

A

It facilitates growth, changing maternal metabolism to maximise the nutrients available to the fetus in utero.

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6
Q

What is the function of the Corpus Luteum?

A

Maintain the endometrium for implantation and embryonic development;
Suppress ovulation;
Achieves this through release of Oestrogen and Progesterone.

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7
Q

Which hormone is released 5 days after fertilisation?

A

Human Chorionic Gonadotropin (hCG).

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8
Q

The corpus luteum produces which hormones?

A

Oestrogen and Progesterone

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9
Q

Oestrogen and progesterone are supress what during pregnancy?

A

Production of Follicle Stimulating Hormone (FSH) and Lutenising Hormone (LH) and therefore Ovulation and Menstruation.

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10
Q

When does the placenta take over from the corpus luteum in producing Oestrogen and Progesterone?

A

At around 3 months.

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11
Q

What occurs during Lactogenesis?

A

Initiation of production of colostrum and milk.

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12
Q

When are the three phases of breast development during the lifespan of the woman?

A

Inutero; first two years of life, and puberty.

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13
Q

When does the primitive milk streak develop?

A

During embryogenesis - 4th week after fertilisation.

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14
Q

When does the mammary ridge develop?

A

During embryogenesis - 5th week after fertilsation.

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15
Q

How is the immune system impacted by pregnancy?

A

White blood cells increase in number and responsiveness;
Phagocytic activity is supressed (phagocytes attach to foriegn bodies such as bacteria and break them down);
Prostaglandins supress NK cell activity (cells that respond to viral infection.

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16
Q

How is the cardiovascular system impacted by pregnancy?

A

The heart is displaced upward by the diaphragm;
The heart enlarges and cardiac volume increases by 10-20%;
Cardiac output increases;
Heart rate increases from the 4th week;
Increase in plasma volume and red cell mass, but relativity of increases results in dilute of Hb resulting in anaemia;
Diastolic BP decreases in 1st/2nd trimester, returning to normal in 3rd trimester (drop is due to decrease in total peripheral resistance thanks to progesterone);
Little to no change to systolic BP.

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17
Q

How is the respiratory system impacted by pregnancy?

A

Diaphragm moves upward;
No change to lung capacity due to increase in diameters of the thoracic cavity;
Tidal volume increases with an offset in residual volume;
02 consumption increases to accomodate the needs of the growing fetus.

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18
Q

How is the renal system impacted by pregnancy?

A

Kidneys enlarge by 1 - 1.5cm;
Increased blood flow to the kidneys;
Progestoerone dilates the calycesm pelves and ureters (slower passage of urine);
Bladder is displaced up and forward, with reduced capacity meaning frequent urination;
Glomerular filtration increases by about 50%;
Reabsorption of electrolytes is increased as activity of the renin-angiotensis-aldosterone system increases (due to in increased progesterone/oestrogen).

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19
Q

How is the gastrointestinal system impacted by pregnancy?

A

Displaced by the uterus;
Tone and motility decreased due to progesterone - decreased peristalsis (symptoms include constipation, haemorrhoids, nausea and vomiting and indigestion);
Liver - size and blood volume unchanged;
Gall bladder - increased risk of gall stones; hypotonic, distended, slow emptying;
NVP;
Indigestion due to pressure of uterus and relaxation of sphincters.

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20
Q

What is a teratogen?

A

Any agent that can disturb the development of an embryo or fetus. Examples include alcohol, medication, cigarettes, bacteria/viruses.

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21
Q

What is the corona radiata?

A

Outer layer of the oocyte after released from the ovary.

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22
Q

What is the zona pellucida?

A

The inner layer of the oocyte, inside the corona radiata.

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23
Q

What is the “acrosome reaction”?

A

Where the acrosome of the sperm releases digestive enzymes after the sperm has attached to receptors on the surface of the zona pellucida. This is stimulated by progesterone.

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24
Q

What is the cell called immediately after fertilisation?

A

Zygote.

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25
Q

What is meant by cleavage?

A

The repeated mitotic divisions of the zygote.

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26
Q

What is a morula?

A

This is the developed zygote at day 4 - 5 that enters the uterus for implantation.

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27
Q

What are the cells of the zygote called?

A

Blastomeres

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28
Q

How is the blastocyst cavity formed?

A

Once the morula enters the uterus, uterine secretions pass through the zona pellucida creating a fluid filled space called the blastocyst cavity.

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29
Q

When the zona pellucida disintergrates, what is the fertilised ovum called?

A

Blastocyst

30
Q

When does implantation normally occur?

A

Day 6.

31
Q

What is gastrulation?

A

The reorganisation of cells of the bilaminar disc to form the trilaminar disc.

32
Q

What are the three primary germ layers?

A

Ectoderm, mesoderm and endoderm.

33
Q

What is the embryo called after gastrulation?

A

The gastrula.

34
Q

The trophoblast differentiates into ?

A

Syncytiotrophoblast (maternal side); and

Cytotrophoblast (fetal side).

35
Q

What does the syncytiotrophoblast do?

A

releases enzymes that break down maternal tissue to allow implantation.

36
Q

What is the endometrium referred to as after implantation?

A

The decidua.

37
Q

What is the decidua basalis?

A

The region beneath the site of implantation.

38
Q

What is the decidua capsularis?

A

Area covering implantation site.

39
Q

What is the decidua parietalis?

A

The remaining uterine lining excluding the decidua basalis and the decidua capsularis.

40
Q

When is the embryonic period?

A

Weeks 3 - 8.

41
Q

What is the embryo known as after week 8?

A

Fetus.

42
Q

When does the neural tube close?

A

Week 4.

43
Q

Which hormone is secreted by the trophoblast?

A

Human Chorionic Gonadotropin (hCG).

44
Q

When is hCG detectable in blood and urine?

A

Blood: 7 days after fertilisation;
Urine: 26 - 29 days after fertilisation.

45
Q

Which hormone is secreted by the syncytiotrophoblast?

A

Human Placental Lactogen (hPL) and progesterone.

46
Q

When does the synthesis of hPL begin?

A

5 - 10 days after implantation.

47
Q

What are the three main metabolic changes facilitated by hPL?

A
  1. Reduces maternal utilisation of glucose by reducing the response to insulin (an insulin antagonist). This raises the maternal BGL making more available to the fetus;
  2. Mobilises maternal lipid stores, releasing fatty acids for use by the mother, reserving glucose for the fetus;
  3. Accelerates amino acid transfer to the fetus.
48
Q

What is the common precursor for production of steroids such as oestrogen and progesterone?

A

Cholesterol.

49
Q

What are the three types of oestrogen?

A
  1. Oestriol: the weaker form, and the most common. It increases most significantly during pregnancy.
  2. beta oestradtiol;
  3. Oestrone.
50
Q

What pregnancy symptoms are associated with the progesterone-induced relaxation of smooth muscle?

A
  • Oesophageal reflux (heartburn) due to relaxation of oesophageal sphincter;
  • NVP;
  • UTIs which increase due to stasis of urine caused by relaxation of the smooth muscle in the ureters and bladder;
  • varicose veins and haemorrhoids due to dilation of the veins in the legs and rectal region;
  • postural hypotension due to venous pooling resulting from reduced peripheral resistance in blood vessels in the lower limbs.
51
Q

What neurohormones does the placenta produce?

A

Corticotrophic-releasing hormone (CRH);
Thyrotrophin-releasing hormone (TRH);
Adrenocorticotrophic hormone (ACTH);
Beta endorphin.

52
Q

True or False: The release of cortisol by the adrenal glands increases two to three times during pregnancy?

A

TRUE

53
Q

True or False: Glucocorticoids such as cortisol stimulate the release of glucose stores into the plasma.

A

TRUE

54
Q

What is the operculum and what is it’s function?

A

The mucous plug of the cervix, that prevents ascending infection.

55
Q

What is Jacquemier’s sign?

A

A bluish-purplish colour in the vagina/cervix that occurs due to the increased blood supply in the region during pregnancy. This is related to the increase in oestrogen.

56
Q

What is Osiander’s sign?

A

The pulsation of the uterine arteries that can be palpated in the lateral fornices of the vagina.

57
Q

What is leucorrhoea?

A

A whitsh/yellowish discharge from the vagina caused by an increase in shedding of superficial mucosal cells.

58
Q

What causes haemodilution?

A

Blood volume increases during pregnancy. However, the plasma increases as a faster rate than the cellular components, resulting in lower haemoglobin per blood volume.

59
Q

What stimulates erythropoeisis?

A

The production of red blood cells is stimluated by increased O2 demand and increased metabolism.

60
Q

True or False: Haemodilution decreases blood viscosity, which decreases the workload on the heart.

A

TRUE

61
Q

What are the impacts on the musculoskeletal system during pregnancy?

A

Symphysis pubis, sacroiliac and sacrococcygeal joints soften and facilitate widening of the pelvis;
Relaxation of ligaments due to relaxin and oestrogen.

62
Q

Which hormone is stimulated during pregnancy and results in deeper pigmentation of the skin?

A

Melanocyte-stimulating hormone.

63
Q

Name four hormones of pregnancy.

A

hPL;
hCG;
Oestrogen;
Progesterone.

64
Q

Which is the main hormone produced by the placenta?

A

Human Placental Lactogen (hPL)

65
Q

Which hormones are produced by the corpus luteum?

A

Oestrogen & Progesterone.

66
Q

Name three signs of early pregnancy.

A
  1. Amenorrhoea;
  2. Increased urination;
  3. Breast tenderness;
  4. hCG detected in urine.
67
Q

How much does cardiac output increase by during pregnancy?

A

30 - 50%

68
Q

True or False: Blood volume increases in pregnancy to accomodate the growing the fetus.

A

True

69
Q

True or False: Lung capacity increases during pregnancy.

A

False - Tidal volume increaes, with an offseting decrease to residual volume.

70
Q

True or False: Respiratory rate decreases during pregnancy

A

False

71
Q

True or False: The bladder is displaced up and forward with reduced capacity.

A

True.

Bioscience for Midwifery (4 decks)

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