Harvluck B11 W2 Flashcards

1
Q

Supplies blood to medial aspect of breast

A

Internal thoracic artery- branch of subclavian artery

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2
Q

Functions of the pelvis?

A

Locomotion, thermoregulation, labour

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3
Q

Android pelvis

A

Heart shaped inlet which is more common in taller and Afro-Carribean women. Increases risk of failure of rotation and deep transverse arrest.

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4
Q

Platypelloid pelvis

A

Wide inlet which makes it difficult for the head to engage.

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5
Q

Anthropoid pelvis

A

AP diameter is wider than transverse diameter. Increased risk of breech position

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6
Q

Epithelia lining breast ducts

A

Stratified squamous epithelia

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7
Q

Liver analytes in jaundice

A

Bilirubin, alkaline phosphatase, aspartate. Normal prothrombin time.

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8
Q

What is the shortest stage of labour?

A

3rd stage which is 20 minutes.

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9
Q

Complications of prolonged labour?

A

Incontinence, sepsis and prolapse

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10
Q

How does feedback inhibitor of prolactin work?

A

Distorts shape of mammary alveoli and suppresses secretion of prolactin.

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11
Q

Effect of oestrogen on mammogenesis

A

Stimulates mammary duct development and collection of fat in the collective tissue

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12
Q

Effect of progesterone on mammogenesis

A

In the second trimester, increases the volume of breast tissue. It causes the lobes and alveoli to grow and widening of the ducts.

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13
Q

Effect of oestrogen and progesterone on mammogenesis

A

Proliferation of the lactocytes/secretory tissues

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14
Q

Hormones for mammary gland growth and differentiation

A

LH, somatomammatrophin, oestrogen, progesterone, prolactin

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15
Q

What promotes mammary growth in pregnancy?

A

Growth hormone and adrenocorticotropic hormone.

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16
Q

Changes to the breast in pregnancy?

A

Alveolar cell differentiation, lobule formation, hypertrophy of ductar-lobular-alveolar system

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17
Q

Hormones important for breast development in puberty?

A

Oestrogen
Growth hormone

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18
Q

How are the alveoli formed?

A

From the epithelia of the milk hills.

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19
Q

What is the impact of epidurals?

A

Loss of motility such as bladder control, low blood pressure and slower breathing.

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20
Q

Source of progesterone production in pregnancy?

A

Placenta, myometrium and placental membranes.

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21
Q

Let-down reflex

A

Milk at ph7.0 is ejected first due to stimulation of mechanoreceptors which induces oxytocin release before prolactin, releasing milk already present.

22
Q

What inhibits the let-down reflex?

A

Oestorgen, relaxin and prostaglandins.
Pain, embarassment and alcohol intake inhibits this.

23
Q

What stimulates prolactin release?

A

Vasoactive intestinal protein and oxytocin which inhibit dopamine release.

24
Q

Where is prolactin released?

A

Decidual cells
Anterior pituitary gland

25
Q

What is important in cervical effacement?

A

Oestrogen, relaxin and prostaglandins.

26
Q

Which hormone is only present in the serum during pregnancy?

A

Human placental lactogen/somatomammatropin which is involved in areola growth.

27
Q

Composition of colostrum

A

Contains more immunogoblins and fat soluble vitamins than normal breast milk but less water soluble vitamins, fat and sugar.

28
Q

Treatment of infective mastitis

A

Analgesia, increased fluid, frequent breast feeding and antibiotics

29
Q

Treatment of non-infective mastitis

A

Massaging breasts, analgesics, bra fitting

30
Q

Normal foetal heart rate

A

100-160bpm

31
Q

What determines the size of the birth canal?

A

Size of pelvic inlet

32
Q

Conditions screened for in newborn neonatal screening?

A

Sickle cell disease
Cystic fibrosis
Hypothyrodisim
Phenylketonuria
Acyl coA dehydrogenase
Maple syrup urine disease
Isovaleric acidaemia
Glutaric aciduria type 1
Homocystinuria

33
Q

Location of oxytocin production

A

Posterior pituitary gland

34
Q

Latent labour

A

Slow cervical dilatation until it reaches 4cm

35
Q

How does oxytocin cause uterine contractions?

A

Lowers threshold for action potentials to increase the frequency of contractions via the Ferguson reflex. Afferent impulses from the cervix and vagina creates positive feedback loop for release.

36
Q

Role of oestrogen in labour

A

Increases expression of oxytocin receptors and excitability of smooth muscle

37
Q

What is a major component of breast milk?

A

Water

38
Q

Major cause of infective mastitis?

A

Staphylcoccus aureus
-poor management of mastitis leads to breast abscess

39
Q

Passenger in labour

A

Portion of the skull which first descends into pelvis, where foetal bones can be overlapped to reduce diameter

40
Q

What increases myometrial excitability in labour?

A

CRH + Oestrogen (which increases oxytocin receptor expression)
Prostaglandin; increases muscle contractiliy

41
Q

Hormones which induce labour

A

Cortisol, vasopressin, oxytocin, prostaglandin, uterine distention

42
Q

Hormones which prevent labour

A

Adrenaline, relaxi, progesterone
Cervical ripening: reduced collagen and glcosaminoglycans that causes thinning

43
Q

Analgesics in labour

A

Simple oral
Transcutaneous electrical stimulation
Systemic opiates
Epidural

44
Q

Effect of systemic opiates in labour

A

Pain relief and slows breathing however it can lead to foetal respiratory distress

45
Q

Preventable causes of labour death

A

Severe bleeding, infection, pre-eclampsia

46
Q

Delivery of foetus in labour

A

Foetus reaches perineum and extends the head. It rotates to assist with shoulder delivery that comes out from under the pubic symphysis.

47
Q

Which position does the foetus engage with the pelvis?

A

Occipital-transverse.

48
Q

Cardinal movements of labour

A

Movements of the foetus to fit the pelvis
-engagement, descent, flexion, internal rotation, extension, external rotation, and expulsion

49
Q

Partogram

A

Chart which measures cervical dilation

50
Q

Contractility

A

Ability for uterus to contract in co-ordination.

51
Q

Entonox

A

Mixture of NO2 and O2 which is a fast acting pain relief in labour that can cause nausea