MATERNAL PHYSIOLOGY Flashcards

1
Q

Early changes are due in part to the:

A
  1. metabolic demands brought on by the fetus, placenta and uterus
  2. increasing levels of pregnancy hormones particularly those of progesterone and estrogen
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2
Q

Late changes (starting mid-trimester) are:

A
  1. anatomical in nature

2. caused by mechanical pressure from the expanding uterus

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3
Q

In the nonpregnant woman, the uterus is an almost-solid structure weighing about _____ and with a cavity of _____ or less.

A

70 g

10 mL

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4
Q

By the end of pregnancy, the uterus has achieved a capacity that is _____________ times greater than in the nonpregnant state.

A

500 to 1000

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5
Q

___________ is mainly stretching & marked hypertrophy of muscle cells

A

Uterine enlargement

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6
Q

Uterus weight increases from _____ to _____ at term.

A

70 gm - 1100 gm

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7
Q

Volume of cavity is 10ml or less in non-pregnant women and increases to ______ in pregnant women

A

5-20 liters

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8
Q

For the first few weeks, the uterus maintains its original pear shape, but as pregnancy advances, the corpus and fundus assume a more globular form becoming almost spherical by _______.

A

12 weeks

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9
Q

Subsequently, the organ increases more rapidly in length than in width and assumes an _______.

A

ovoid shape

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10
Q

With ascent of the uterus from the pelvis, it usually undergoes rotation to the ______.

A

right

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11
Q

This ________ likely is caused by the rectosigmoid on the left side of the pelvis.

A

dextrorotation

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12
Q

As early as _____ after conception, the cervix begins to undergo pronounced softening and cyanosis.

A

1 month

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13
Q

Due to increased vascularity and edema of the entire cervix, together with hypertrophy and hyperplasia of the cervical glands the endocervical mucosal cells produce copious amounts of a tenacious ____ that obstruct the cervical canal soon after conception.

A

mucus

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14
Q

May act as an immunological barrier to protect the uterine contents against infection from the vagina.

A

Mucus plug

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15
Q

Rich in cytokines & immunoglobulins

A

Mucus plug

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16
Q

The major component of the cervix is ________ although it contains a small amount of smooth muscle.

A

connective tissue

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17
Q

Rearrangement of this collagen-rich connective tissue is necessary for diverse functions such as:

A
  1. maintenance of a pregnancy to term
  2. dilatation to aid delivery
  3. repair following parturition so that a successful pregnancy can be repeated
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18
Q

Pregnancy is associated with both endocervical gland _________ and ________ appearance.

A

hyperplasia and hypersecretory

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19
Q

Endocervical gland hyperplasia and hypersecretory appearance

A

Arias- Stella Reaction

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20
Q

_______ ceases during pregnancy, and the maturation of new follicles is suspended.

A

Ovulation

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21
Q

Ordinarily, only a single _______ can be found in pregnant women.

A

corpus luteum

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22
Q

This functions maximally during the first 6 to 7 weeks of pregnancy in progesterone production.

A

corpus luteum

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23
Q

During pregnancy, increased vascularity and hyperemia develop in the skin and muscles of the ________ and _______ with softening of the underlying abundant connective tissue.

A

perineum and vulva

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24
Q

The pH is acidic, varying from _____ due to increased production of lactic acid from glycogen in the vaginal epithelium by the action of Lactobacillus acidophilus.

A

3.5 to 6

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25
Q

Increased vascularity prominently affects the vagina and results in the violet color characteristic of ________.

A

Chadwick sign

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26
Q

HYPERPIGMENTATION

A
  1. Chloasma or Melasma Gravidarum (Mask of Pregnancy)

2. Linea Nigra

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27
Q

VASCULAR CHANGES

A
  1. Angiomas (vascular or spider)

2. Palmar erythema

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28
Q

Due to hyperestrogenemia

A

Palmar erythema

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29
Q

BREASTS

A
  • tenderness
    - increase in size
    - veins more visible
    - larger, deeply pigmented, more erectile nipples
    - colostrum expression
    - broader pigmented areola
    - elevation of the glands of Montgomery
30
Q

In response to the rapidly growing fetus and placenta and their increasing demands, pregnant women undergo metabolic changes that are numerous and intense. Metabolic rate increased by _____ percent compared with that of the nonpregnant state.

A

10 to 20

31
Q

Average weight gain is _________.

A

12.5 kg or 27.5 lbs

32
Q

Is due to the accumulation of fluid, which may amount to a liter or so, which is caused by increased venous pressure below the level of the uterus as a consequence of partial vena cava occlusion

A
  • increase water retention
    • pitting edema of ankles and legs at the end of the day

(WATER METABOLISM)

33
Q

The products of conception, the uterus, and maternal blood are relatively rich in _______.

A

protein

34
Q

By term, the fetus and placenta together weigh about ______ kg and contain approximately _____ of protein.

A

4 kg

500 grams

35
Q

CARBOHYDRATE METABOLISM

A
  • mild fasting hypoglycemia

- post-prandial hyperglycemia & hyperinsulinemia

36
Q

FAT METABOLISM

A
  • increased lipids
    - increased lipoproteins and
    - increased apolipoproteins
37
Q

Hypervolemia associated with normal pregnancy averages ___ to ____ percent above the non-pregnant.

A

40 to 45

38
Q

Blood volume after ____ weeks begin to increase at ________, most rapid in _______ & slower rate in ________.

A

32 to 34
1st trimester
2nd trimester
3rd trimester

39
Q

Hg & Ht concentration _________.

A

slightly decreased

40
Q

Blood viscosity __________.

A

decreased

41
Q

Markedly _______ WBC during labor and early puerperium ( 25,000/uL).

A

elevated

42
Q

__________ platelet count.

A

Decreased (hemodilution & platelet consumption)

43
Q

Heart is displaced to the _________ and ________.

A

left and upward

44
Q

Results to _____ axis deviation on ECG

A

left

45
Q

Cardiac output is _______.

A

increased

46
Q

Resting pulse rate increases about _________.

A

10 beats/minute

47
Q

_______ peripheral vascular resistance.

A

Decreased

48
Q

Blood pressure falls during ______ and returns to normal then.

A

2nd trimester

49
Q

The _________ is essentially unchanged.

A

respiratory rate

50
Q

___________ and __________ increase significantly as pregnancy advances.

A

Tidal volume and resting minute ventilation

51
Q

The increase in minute ventilation is caused by several factors including enhanced respiratory drive primarily due to the stimulatory effects of _________, ____ expiratory reserve volume, and compensated _____________.

A

progesterone, low, respiratory alkalosis

52
Q

The functional residual capacity and the residual volume are decreased as a consequence of the elevated __________.

A

diaphragm

53
Q

Diaphragm rises _____ from the non-pregnant woman.

A

4 cm

54
Q

Primarily as a consequence of this elevated GFR, approximately 60 percent of women report ____________ during pregnancy.

A

urinary frequency

55
Q

Kidneys increased in size _____ & weight

A

(1.5 cm)

56
Q

Dilatation of ______.

A

ureters

57
Q

Elevated Glomerular Filtration Rate (GFR) about _____.

A

50%

58
Q

Renal plasma flow increases by ______ in early pregnancy & decreases during the late pregnancy.

A

75%

59
Q

_________ is common during pregnancy and is most likely caused by reflux of acidic secretions into the lower esophagus.

A

Pyrosis (heartburn)

60
Q

___________ are common during pregnancy caused by constipation and elevated pressure in veins below the level of the enlarged uterus.

A

Hemorrhoids

61
Q

________ impairs gallbladder contraction by inhibiting cholecystokinin-mediated smooth muscle stimulation.

A

Progesterone

62
Q

Are displaced by the enlarging uterus.

A

Stomach and intestines

63
Q

Hepatic blood flow _______.

A

increases

64
Q

Physiological changes of pregnancy cause the thyroid gland to increase production of thyroid hormones by ______% to meet maternal and fetal needs.

A

40 to 100 percent

65
Q

Maternal plasma levels of ______ increase markedly during normal pregnancy and concentrations are usually ____ fold greater at term —about __________ — compared with nonpregnant women.

A

prolactin, 10, 150 ng/mL

66
Q

Pituitary gland enlarges by _______.

A

135%

67
Q

Thyroid hormone ________.

A

increases

68
Q

Parathyroid hormone plasma concentrations ________.

A

increases

69
Q

Decreased motility due to influence of _________.

A

progesterone

70
Q

___________ is very common

A

Lower extremity edema