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Block 11: Ellen > L2:physiology of pregnancy > Flashcards

L2:physiology of pregnancy Flashcards

1
Q

weeks of trimester 1 (T1)

A

1-12

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2
Q

weeks of trimester 2 (T2)

A

13-26

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3
Q

weeks of trimester 3 (T3)

A

27-40

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4
Q

4 parts of T1 for foetus

A

fertilisation
implantation
initial development
placentation

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5
Q

5 parts of T2 for foetus

A 
nervous system 
hair 
spine straightens 
pain 
proportions change
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6
Q

5 changes to mother in T2

A 
placental growth 
uterus rises 
hypervolemia 
cardiac remodelling 
breast remodelling
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7
Q

5 changes to foetus in T3

A 
growth 
fat deposition 
brain growth 
lung development 
blood cells
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8
Q

4 changes to mother in T3

A

braxton hicks
tiredness
restricted breathing
lactation

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9
Q

overall what happens to mother heart rate

A

increases

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10
Q

overall change to mothers blood pressure

A

doesn’t

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11
Q

overall change to mothers blood volume

A

increases

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12
Q

what happens to mother haematocrit

A

decreases

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13
Q

pattern of foetal heart rate change

A

dramatically increases in 1st trimester then plateaus

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14
Q

official start of pregnancy=

A

last menstrual period

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15
Q

when is conception in pregnancy

A

3 weeks

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16
Q

when is implantation in pregnancy

A

4 wks

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17
Q

other name for luteal phase

A

secretory phase

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18
Q

what does the blastocyst need to do before implantation

A

hatch from zona pellucida

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19
Q

3 factors of uterine epithelia

A

tight inter-cellular gap junctions
villi
glycocalyx

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20
Q

what in the uterine epithelia attracts the embryo

A

glycocalyx

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21
Q

what breaks down the zona pellucida

A

protease

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22
Q

what breaks down the glycocalyx

A

blastocyst signals uterine epithelium to break it down

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23
Q

what cells of the blastocyst integrate with the cell lining the uterus epithelia

A

trophoblasts

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24
Q

3 changes in the uterine epithelium the interaction between trophoblasts and uterine epithelium causes

A

migration of nuclei to basal compartment
changes in structure of stromal cells
start of decidualisation

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25
Q

what causes decidualisation

A

trophoblasts invade into primary decidua and produce protease and destroy these cells

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26
Q

an important cytokine involved in decidualisation

A

leukaemia inhibiting factor

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27
Q

what 2 cells do trophoblasts differentiate into after implantation

A

syncytial trophoblasts

cytotrophoblasts

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28
Q

outer layer of trophoblast=

A

syncytial trophoblasts

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29
Q

what are syncytial trophoblasts

A

multicellular –> big nucleated structure

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30
Q

what are cytotrophoblasts

A

single cellular inner layer

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31
Q

where does embryo development happen

A

in uterine wall itself

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32
Q

what forms in the cytoplasm of the syncytial trophoblasts

A

trophoblastic lacunae

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33
Q

what do trophoblastic lacunae contain/ do

A

nutrients for support (histotroph)

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34
Q

what rescues the corpus luteum

A

hCG

35
Q

6 things progesterone leads to in early pregnancy

A 
suppression of menses 
tender/ enlarged breasts 
fatigue 
urinary frequency 
nausea/ vomiting 
constipation
36
Q

2 things pluriblast divide into

A

epiblast

hypoblast

37
Q

epiblast –>

A

ectoderm

38
Q

hypoblast –>

A

endoderm

39
Q

what forms inbetween ectoderm and endoderm

A

mesoderm

40
Q

amnion=

A

ectoderm and mesoderm

41
Q

chorion=

A

trophoblast and mesoderm

42
Q

yolk sac=

A

endoderm and mesoderm

43
Q

what overtakes histotrophic support

A

haematrophic support

44
Q

how does the embryo switch to haematrophic support

A

prompting remodelling of uterine spiral arteries

45
Q

why do spiral arteries need remodelling

A

they have high blood pressure which can damage the embryo

46
Q

what cells grow into the maternal spiral arteries

A

syncytial and cytotrophoblasts

47
Q

what happens when the syncytial and cytotrophoblasts grow into the spiral arteries

A

leads to widening so blood can pool

48
Q

how does the embryo access pool of blood

A

uses vili

49
Q

what forms the embryo vili

A

syncytial trophoblasts

50
Q

when does haematrophic support happen

A

around 5 weeks post conception

51
Q

what happens at the same time of haematrophic support

A

foetal circulation system begins to develop

52
Q

what is a primary vili

A

solid trophoblast

53
Q

what is a secondary vili

A

invasion of mesoderm within trophoblast

54
Q

what is a tertiary vili

A

foetal blood vessels penetrate vili

55
Q

vili at week 9=

A

tertiary vili stem lengthen forming mesenchymal vili

56
Q

vili at week 16

A

terminal extensions reach maximal length

57
Q

vili at week 32

A

mature intermediate tertiary vili produce secondary branches = terminal vili

58
Q

what is the umbilical cord

A

coiling of 2 veins around artery which feeds into villous tree

59
Q

4 things transported in the placenta

A

respiratory gases
glucose
free fatty acids
lipids

60
Q

how is glucose transported into foetus

A

via GLUT and oxidised in placenta

61
Q

can foetus do gluconeogenesis

A

NO

62
Q

what does the placenta express for lipid delivery

A

lipoprotein lipase

63
Q

peak of hCG conc

A

3 weeks

64
Q

2 things oestrogen’s do

A

relaxation of pelvic ligaments and increase elasticity of pubic synthesis

65
Q

what is needed for oestrogen synthesis

A

foetal and placental cooperation

66
Q

what can indicate placental function

A

progesterone

67
Q

3 roles of progesterone

A

causes decidualization
increase oviductal/ uterine secretions
reduce uterine contractions

68
Q

when is somato mammotropin secreted from

A

week 5

69
Q

what is hypervolemia

A

too much fluid in blood –> maternal glow

70
Q

effect of oestrogen in trimester 2

A
  • increasing angiogenesis (via NO increase)

- act on hepatic system increasing ang2, renal absorption and aldosterone

71
Q

effects of progesterone in trimester 2

A
  • increases vasodilation, decreases peripheral resistance

- increases aldosterone levels

72
Q

downside of progesterone in trimester 2

A

oedema

73
Q

what does HR and stroke volume increase by in T2

A

HR 20% SV 20%

74
Q

increase in heart size=

A

12%

75
Q

what does breathing become in T2

A

thoracic

76
Q

what happens to sensitivity to chemoreceptors in T2

A

lowered (–> deeper breathing)

77
Q

what in the lungs stays to same

A

vital capacity

78
Q

why does vital capacity stay the same

A

lose residual volume

79
Q

what happens to the kidneys in T2

A

enlarge

80
Q

enlarged kidneys causes (3)

A

increase waste excretion
increase Na+ absorption
increase blood flow

81
Q

what is pregnant urine richer in

A

glucose and AA

82
Q

what happens to the fetus at the end of pregnancy

A

engages

83
Q

average weight gain in pregnancy =

A

24lb

84
Q

what urine related pathology are you at higher risk of in pregnancy

A

UTIs

Block 11: Ellen (7 decks)

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