2-24-16-Fertilization, Implantation, Placental Development (Cole) Flashcards

1
Q

What are 3 main events in fertilization?

A
  • Acrosome rxn
  • Sperm binding to ZP3
  • Sperm-egg fusion
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2
Q

During the acrosome rxn, the outer membrane of the sperm binds to the ___ receptor which allows for the acrosome rxn or the release of enzymes from the acrosomal space of the sperm to break down the ___

A

ZP3

Zona pellucida

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3
Q

This process prevents polyspermy which is an egg to be fertilized by more than 1 sperm

A

Cortical rxn

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4
Q

The immunoglobulin superfamily protein __ is required for sperm to fuse with eggs, as is the protein CD9 (egg)

A

Izumo

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5
Q

A mutation in __ creates the inability for the sperm to fuse to the egg and undergo the acrosome rxn

A

Izumo

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6
Q

The __ component in the cortical rxn is a change in resting potential of the oocyte plasma membrane that prevents further binding of sperm

A

Fast

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7
Q

The __ component of the cortical rxn is the release of cortical granules containing enzymes (into PVS) that destroy sperm receptors

A

Slow

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8
Q

The morula differentiates into the ___

A

Blastocyst

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9
Q

The blastocyst hatches from its zona pellucida at ___ days

A

6-7

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10
Q

Implantation of the blastocyst into the luminal epithelium of the endometrium is mediated by penetrating __ cells

A

Trophoblastic

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11
Q

Uterine receptivity and the decidual rxn corresponds to days ___ of a regular 28-day cycle

A

20-24

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12
Q

During blastocyst implantation, differentiated ___ cells invade part of the myometrium (interstitial invasion)

A reduction in the number of ___ in the epithelial cells factilitates embryo penetration

___ are apical epithelial cellular protrusions of the endometrium

A

Syncytiotrophoblastic

Desmosomes

Pinopodes

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13
Q

Invasion of the endometrium and the inner third of the myometrium is determined by the action of secretory proteolytic enzymes released by the ___

___ erode the branches of the spiral uterine arteries to form spaces or lacunae of maternal blood within the syncytiotrophoblast mass

A

Syncytiotrophoblast

Proteases

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14
Q

___ initiates the primitive uteroplacental circulation and represents the starting point of the future intervillous space

A

Endovascular invasion

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15
Q

___ is established when trophoblastic cells are in direct contact with maternal blood

A

Uteroplacental circulation

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16
Q

The ___ begins the secretion of hCG into the maternal lacunae. The secretion of estrogens and progesterone by the __ is now under the control of hCG

A

Syncytiotrophoblast

Corpus luteum

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17
Q

During implantation, the ___ provides an immune-protective environment for the development of the embryo.

Production of immunosuppressive substances, mainly ___, inhibit the activation of NK cells at the implantation site

___ cells do not express MHC II and cannot present ags to maternal CD4+ T cells

A

Decidua

Prostaglandins

Syncytiotrophoblast

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18
Q

At the end of the 2nd week, cytotrophoblastic cells proliferate and extend into the syncytiotrophoblast mass, forming the ___

A

Primary villi

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19
Q

Early in the 3rd week, the extraembryonic mesoderm extends into the primary villi to form the ___.

In a cross section, a ___ is formed by a core of extraembryonic mesoderm surrounded by a middle cytotrophoblast layer and an outer layer of syncytiotrophoblast

A

Secondary villi

Secondary villi

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20
Q

Cells of the XE mesoderm differentiate into capillary and blood cells, forming the ___

A

Tertiary villi

The difference between secondary and tertiary villi is the presence of capillaries in tertiary villi

21
Q

___ protects the fetus, provides for nutrition, respiration, excretion and hormone protection during development. It is a temporary organ with embryonic (chorionic frondosum) and maternal (decidua basalis) components

A

The placenta

22
Q

Maternal Abs, mainly ___, are taken up by the syncytiotrophoblast and then transported to fetal capillaries for passive immunity. The larger ___ molecules do not cross the placental barrier

A

IgG

IgM

23
Q

Maternal Abs against the __ ag cause hemolytic disease (erythroblastosis fetalis)

A

D

24
Q

In erythroblastosis fetalis, the fetus will be Rh___ and the mother will be Rh___

A

Fetus=Rh-positive

Mother=Rh-negative–> mom lacks the D ag

25
Q

After a Rh negative mother gives birth to the first child who is Rh positive, describe what happens in a subsequent pregnancy if mother is not treated?

A

In a subsequent pregnancy, Abs to the D ag (IgG) cross the placenta and cause hemolysis of fetal RBCs

26
Q

The fetoplacental unit produces ___ hormones

A

Steroid

27
Q

The decidua ___ is the portion underlying the implantation site and forms the maternal part of the placenta

A

Basalis

28
Q

The decidua ___ is the portion overlying the impanted embryo and separating it from the uterine cavity

A

Capsularis

29
Q

The decidua ___ is the remainder of the endometrium

A

Parietalis

30
Q

___ is the chorionic plate and villi derived from the cytotrophoblastic shell

A

Chorionic frondosum

31
Q

The ___ is the basic structure involved in maternal-fetal exchanges

A

Chorionic villus

Each villus has a core of mesenchyma connective tissue and fetal BVs (arterioles and capillaries)

32
Q

___ is the premature separation of the normally implanted placenta

A

Placental abruption

33
Q

During a placental abruption, hemorrhage into the __ leads to premature placental separation and bleeding. Also, separation of the placenta from the uterus impairs ___ of the fetus

A

Decidua basalis

Oxygenation

34
Q

This abnormality of placental implantation is an impantation of the placenta over the cervical os

A

Placenta previa

35
Q

This abnormality of placental implanatation is an abnormal trophoblastic invasion into the myometrium

A

Placenta accreta

36
Q

This placental implantation abnormality is when chorionic villi invade into the myometrium

A

Placenta increta

37
Q

This placental implantation abnormality is when chorionic villi invade through the serosa and into the surrounding tissues

A

Placenta percerta

38
Q

In ___, the contractions of the uterine muscles are not strong enough and postpartum bleeding occurs

A

Uterine atony

39
Q

What are some predisposing factors of uterine atony?

A
  • abnormal labor
  • substantial enlargement of the uterus
  • uterine fibroids (leiomyomas)
40
Q

IV infusion of __ stimulates uterine contractions and decreases the possibility of uterine atony

A

Oxytocin

41
Q

What is one significant risk factor for placental calcification?

A

Smoking

42
Q

___ are a group of neoplasms, both benign and malignant, that arises from fetal tissue invading the maternal host.

A

Gestational trophoblastic disease–> tumors composed of trophoblastic tissue

43
Q

Malignant Gestational Trophoblastic Disease is diagnosed on the basis of elevated tumor markers, primarily ___

A

Beta-hCG

44
Q

The karyotype of this GTD is 46 XX (>90% paternal origin) or 46XY (paternal origin), has extensive hydropic villi, absent fetal tissue, and extensive trophoblastic hyperplasia with significant atypia

A

Complete mole

45
Q

The karyotype of this GTD is triploidy (>90%) or tetraploidy, maternal chromosomes are present and there is fetal tissue, has limited and focal hydropic villi, and focal with mild atypia trophoblastic hyperplasia

A

Partial mole

46
Q

This malignant GTD is an invasion into myometrium of edematous chorionic villi covered with layers of proliferative trophoblastic cells, beta-hCG is moderately elevated

A

Invasive mole

47
Q

___ is an admixture of malignant cytotrophoblast and syncytiotrophoblast, with no villi

A

Choriocarcinoma

48
Q

Fertilization must be preceded by:

A
  • sperm maturation (epididymis)
  • sperm capacitation (female repro tract)–> physiological changes necessary to penetrate the egg: removal of some epididymal and seminal glycoproteins, increase in membrane permeability to Ca which Ca influx maximizes cAMP and increases sperm motility