Woman in Labor (1): 4 P's Flashcards
1
Q
What are the 4 P’s?
A
- Passage
- Passenger
- Powers
- Psyche
2
Q
is the series of events by which uterine contractions and
abdominal pressure expel a fetus and placenta from the uterus.
A
LABOR
3
Q
It cause progressive dilatation of the cervix and create sufficient muscular uterine force to allow a baby to be pushed out into the extrauterine world.
A
REGULAR CONTRACTIONS
4
Q
Who is the main passenger of labor?
A
FETUS
5
Q
A woman’s psychological state which may either encourage or inhibit labor.
A
PSYCHE
6
Q
It is the most important body part during labor
A
HEAD
7
Q
The cranium is composed of _____ bones
A
EIGHT
8
Q
Bones of cranium
A
1 Frontal Bone
2 Parietal Bone
2 Temporal
1 Occipital
1 Sphenoid
1 Ethmoid
9
Q
the uppermost portion of
the skull
A
CRANIUM
10
Q
They are the most important fetal skull
bones because they form the presenting part when the fetus is in cephalic
presentation.
A
FRONTAL, PARIETAL, OCCIPITAL
11
Q
The fetal skull is not yet completely ossified at birth and
its bones are joined only by membranes so that spaces
actually exist between them.
These spaces are called ____
A
SUTURE LINES
12
Q
Types of suture lines
A
SAGITTAL
FRONTAL
CORONAL
LAMBDOIDAL
13
Q
Suture line located between 2 parietal bones
A
SAGGITAL SUTURE
14
Q
Suture line located between two frontal bones
A
FRONTAL SUTURE
15
Q
Suture line located between frontal and parietal bones
A
CORONAL SUTURE
16
Q
Suture line located between parietal and occipital bones
A
LAMBDOIDAL SUTURE
17
Q
The suture lines are important because
they allow the skull bones to overlap,
called ________
A
MOLDING
18
Q
These are membrane covered spaces located between the intersections of suture lines.
A
FONTANELS
19
Q
A type of fontanel that is formed by the intersection of the sagittal, frontal and coronal sutures. Diamond shaped and closes between 12 to 18 months of age.
A
ANTERIOR FONTANEL OR BREGMA
20
Q
Fontanel that is formed by the
intersection of sagittal and lambdoidal sutures. It is triangular in shape and closes by 2 to 3 months of age.
A
POSTERIOR FONTANEL OR LAMBDA
21
Q
The area between the two fontanelles is
called _____
A
VERTEX
22
Q
The area over the frontal bone is
called the ________
A
SINCIPUT
23
Q
The area over the occipital bone is called the _____
A
OCCIPUT
24
Q
It helps determine the position and presentation of the fetus
A
LOCATION OF FONTANELS
25
Is a part of the fetal body that enters the true pelvis first and which is also the first part to come out during delivery.
PRESENTING PART
26
The presentation of the fetus is determined by ____
FETAL LIE & ATTITUDE
27
Types of fetal presentation
1. Cephalic
2. Breech
3. Shoulder
4. Compound
28
The head comes out first during delivery
CEPHALIC PRESENTATION
29
Occurs when the head is completely flexed so that the chin touches the chest. It is the most ideal type of
presentation.
VERTEX PRESENTATION
30
Occurs when the head is partially flexed and the anterior fontanel is the presenting part. Also called military position because it gives the
appearance of a military person at attention.
SINCIPUT PRSENTATION
31
Occurs when the head is extended or bent backward causing the
occipitomental diameter (13.5 cm) to be presented for delivery
BROW PRESENTATION
32
Occurs when the head is sharply extended causing the occiput to
come in contact with the back of the fetus.
FACE PRESENTATION
33
Occurs when head is hyperextended
with the chin as the presenting part.
CHIN PRESENTATION
34
Types of cephalic presentation
VERTEX
SINCIPUT
BROW
FACE
CHIN
35
The feet or buttocks come out first during delivery.
BREECH PRESENTATION
36
Types of breech presentation
FRANK
COMPLETE
FOOTLING
37
The fetus has the thighs tightly flexed on the abdomen; both the buttocks and the tightly flexed feet present to the cervix.
COMPLETE BREECH
38
Attitude is moderate because the hips are flexed, but the knees are extended to rest on the chest. The buttocks alone present to the cervix.
FRANK BREECH
39
Neither the thighs nor lower legs are flexed. One foot is presented (dangling)
FOOTLING BREECH
40
The presenting part is usually one of the shoulders (acromion process)
SHOULDER PRESENTATION
41
This presentation occurs when there is prolapsed of the fetal
hand alongside the vertex, breech or shoulder.
COMPOUND
42
It is the relationship between the long (cephalocaudal) axis of the fetal body and the long (cephalocaudal) axis of a woman’s body
FETAL LIE
43
Refers to the relationship of the long axis of the fetus to the long axis of the mother.
FETAL LIE
44
Types of fetal lie
LONGITUDINAL
TRANSVERSE
OBLIQUE
45
The long axis of the fetus is parallel to the long axis of the
mother, meaning, the fetus is lying lengthwise in the
mother's abdomen
LONGITUDINAL LIE
46
The long axis of the fetus forms a right angle with the
long axis of the mother, which means that the fetus is
lying crosswise in the mother's abdomen.
TRANSVERSE LIE
47
This lie is the most unstable. The fetus assuming this lie usually rotates to transverse or longitudinal lie in the course of labor.
OBLIQUE LIE
48
It refers to the degree of flexion of the fetal body, head and extremities,
FETAL ATTITUDE
49
In terms of fetal attitude (flexion), describe the following:
Cephalic Presentation
1. Vertex
2. Brow
3. Sinciput
4. Face
5. Chin
1. complete
2. moderate
3. moderate
4. poor
5. very poor
50
This flexion allows the smallest anteroposterior diameter of the head to enter the pelvis
COMPLETE FLEXION
51
It refers to the relationship of the presenting part to one of the quadrants of the mother's pelvis.
FETAL POSITION
52
Most ideal fetal position
ROA or LOA
53
Presentation Fetal Points of direction or
Denominator
1. Vertex /Occiput
2. Face and chin / Mentum
3. Breech / Sacrum
4. Shoulder / Scapula
54
The pelvis is divided into several areas in order to locate accurately the position of the presenting part.
These areas are known as the ____
4 Quadrants of the maternal pelvis
55
When fetal denominator faces the anterior left side of the mother's pelvis
Left Anterior Quadrant:
56
When fetal denominator faces the left posterior side of the mother's pelvis.
Left Posterior Quadrant
57
When fetal denominator faces the right anterior side of the mother's pelvis.
Right Anterior Quadrant
58
When fetal denominator faces the right posterior side of the mother's pelvis.
Right Posterior
58
When fetal denominator faces the right side of the mother's pelvis
Right Transverse
59
When fetal denominator faces the left side of the mother's pelvis
Left Transverse
60
These are the different movements or positional changes that the fetus
makes during the first and second stage of labor in order to pass
successfully through the irregular shape of the birth canal.
MECHANISMS OF LABOR
60
This is also known as cardinal movements of labor
MECHANISMS OF LABOR
61
When the greatest transverse diameter of the head in the vertex passes thru the pelvic inlet
ENGAGEMENT
61
What are the cardinal movements of labor
1. Engagement
2. Descent
3. Flexion
4. Internal rotation
5. Extension
6. Restitution
7. Expulsion
62
downward movement of the fetal head until it is within the pelvic inlet. Occurs
intermittently with contractions and is brought about the pressure of the amniotic fluid,
DESCENT
62
The rotation of the fetal head until the longest diameter of the fetal head match the longest diameter of maternal pelvic
INTERNAL ROTATION
62
As the fetal head moves deeper into the pelvis, it meets resistance from the cervix, pelvic floor or walls of the pelvis.
FLEXION
62
Once crowning has occurred, the fetal head need only to extend to be born.
EXTENSION
63
The return of the head to its original position
RESTITUTION
64
When the head is born, the shoulder and the rest of the body follow without much difficulty. The anterior shoulder is born first followed by the posterior shoulder.
EXPULSION
65
is the relationship of the presenting part of the fetus to an imaginary line drawn at the level of the ischial spines of the mother.
It describes the degree of advancement
STATION
66
When the presenting part is above the ischial spines, it is at ______
MINUS STATION
67
occurs when the sagittal suture does not lie exactly midway between the sacral promontory and the
symphysis pubis but is deflected posteriorly or anteriorly.
ASSYNCLITISM
67
_____ is when the presenting part is at
the level of ischial spines.
ZERO STATION
68
When assynclitism is deflected posteriorly toward the sacral
promontory,
Anterior Assynclitism or Naegele's Obliquity
69
When assynclitism is deflected anteriorly toward the symphysis pubis
it is called _____
Posterior Assynclitism or Litzman's Obliquity
70
Molding is the overlapping of the cranial bones that occur during labor.
MOLDING
70
Passageway of Labor:
1. Hard passage: bony pelvis
2. Soft passage: Lower uterine
segment, cervix , vagina , pelvic floor
and perineum
71
The male-type pelvis has a heart shaped inlet
ANDROID
71
Type of pelvis most ideal for childbirth
GYNECOID
71
Types of pelvis
1. Gynecoid
2. Android
3. Anthropoid
4. Platypelloid
72
Ape-like pelvis
ANTHROPOID
72
flat pelvis and most shallow pelvic type.
PLATYPELLOID
72
The true and false pelvis is separated by an imaginary line, called _____
LINEA TERMINALIS
72
The pelvis is divided into 2 parts:
TRUE PELVIS
FALSE PELVIS
72
It is the upper flaring portion, the ilia.
Its functions are to provide support to the uterus during pregnancy and to direct the fetus to the true pelvis
during labor.
FALSE PELVIS
73
It forms the passageway of the fetus during labor.
It has a wider transverse diameter and appears heart shaped
when viewed from the top.
TRUE PELVIS
74
The most important forces during the
first stage of labor are the ____
UTERINE CONTRACTIONS
74
Muscular contractions which lead to dilation and effacement in the First Stage of Labor
INVOLUNTARY UTERINE CONTACTIONS
75
Characterized by alternating periods of contraction and relaxation.
INTERMITTENT
75
Abdominal muscles assist in the Second
Stage of Labor with pushing. Increase intra-abdominal pressure to aid in expulsive forces
VOLUNTARY UTERINE CONTRACTIONS
75
* The time when contraction is starting and intensity is building up.
* This is the longest phase.
INCREMENT
76
Phases of Uterine Contractions
1. Increment or crescendo
2. Acme or Apex
3. Decrement or decrescendo
77
The time when muscles start to relax.
DECREMENT
77
The lower passive portion of the uterus contains less muscle fiber and is therefore not as contractile as the
upper portion.
LOWER SEGMENT
77
Peak of contraction
APEX
78
This is the active part of the uterus found at the fundal area that contracts with great force.
UPPER SEGMENT
79
This refers to the permanent shortening of the muscles fibers of
the uterus that occurs with each contraction.
RETRACTION
80
refers to the strength of uterine contractions.
INTENSITY
81
Classification of Intensity:
Slightly tense fundus that is easy to indent with fingertips. Consistency of fundus is likened to the tip of the nose.
MILD CONTRACTIONS
81
Classification of Intensity:
Firm fundus that is difficult to indent with fingertips. Consistency of fundus is likened to the earlobe.
MODERATE CONTRACTIONS
82
Classification of Intensity:
Rigid board like fundus that is almost
impossible to indent with fingertips.
Consistency of fundus is likened to the
forehead.
STRONG CONTRACTIONS
83
refers to the rate at which contractions are occurring. It is measured from the
beginning of a contraction to the beginning of the next contraction.
FREQUENCY
83
Refers to length of contraction
DURATION
84
It refers to the time that lapse between two uterine contractions.
INTERVAL
