Chap 3 - Prenatal, Birth & Neonatal

Question 1

What are the different parts of the male reproductive system and what are their utility?

Answer 1

• Scrotum: sac under the penis that contains the testicles and the epididymis
• Testicles: produce the sperm and are important in the production of testosterone
• Seminal vesicles: located at the base of the bladder, produces thick fluid that nourishes the sperm
• Prostate gland: walnut sized; also produces fluid that nourishes the sperm
• Vas deferens: tube through which the sperm is transported
• Epididymis: next to each testicle; where the sperm can be stored and then shipped for future use
• Urethra: tube that carries the sperm out of the penis
• Penis: shaft and the gland; delivers the sperms as it goes through the urethra to enter the female

Question 2

What are the different parts of the female reproductive system and what are their utility?

Answer 2

• Uterus: consists of the endometrium and the cervix
• Endometrium: inner layer of the uterus, which thickens over weeks and is shed out of vagina in the menstruations
• Cervix: neck of the uterus (lower part); connects uterus to vagina
• Fallopian tubes: very fine tube that connect the ovaries and the uterus
• Ovaries: contain the ova
• Vagina: muscular organ that allows for sexual intercourse and birth

Question 3

What are the two main parts of the uterus?

Answer 3

The endometrium and the cervix

Question 4

What is a cephalocaudal development?

Answer 4

It is development or growth starting from the head (cephalo) to the tail (caudal)

Question 5

What is a proximodistal development?

Answer 5

It is development that starts from the middle to the outside

Question 6

What is meant by “mass to specific sequence”?

Answer 6

The idea that large structures appear before the finer details (i.e. you need the fingers before you have finger nails)

Question 7

How many trimesters are there in a pregnancy? What are they?

Answer 7

1. Germinal Stage
2. Embryonic Stage
3. Fetal Stage

Question 8

What is another name for the geminal stage? What are the two main events in this period? How long does it last?

Answer 8

• Period of Zygote
• Fertilization and Implantation
• first two weeks of pregnancy

Question 9

Explain what is going on in the germinal stage.

Answer 9

First off, there is the union of the sex cells (ovum and sperm), which is called fertilization. Fertilization occurs in the fallopian tubes. Afterwards comes the implantation, in which the blastocyst (200-300 human cells) adheres to the wall of the uterus, meaning that the fertilized ovum travels down the fallopian tube and sticks to the wall of the uterus.

Question 10

What are the genetics behind the process of fertilization in the germinal stage?

Answer 10

23 pairs of chromosomes are passed down to the zygote (half coming from mom, half from dad). Chromosomes store genes that contain all DNA blueprint.

Question 11

What is called the map of all chromosomes?

Answer 11

Karyotype

Question 12

What is another name for the embryonic stage? What are the 3 main layers developed in this period? How long does it last?

Answer 12

• The period of Embryo
• Ectoderm, Mesoderm, Endoderm
• week 3 to week 8

Question 13

What is the ectoderm? Why is it important?

Answer 13

Refers to the external layer
It is important because it continues to develop and give rise to the nervous system (brain, spinal cord, PNS), and the skin of the body.

Question 14

What is the mesoderm? Why is it important?

Answer 14

Refers to the middle layer
Important since it gives rise to the muscles, the skeleton, the circulatory system (heart, lungs), and internal organs (kidneys, gut).

Question 15

What is the endoderm? Why is it important?

Answer 15

Refers to the internal layer

Important since it gives rise to the digestive system, the glands (thyroid (hormonal growth)), and urinary tract .

Question 16

What important part develops around the 19th day of pregnancy? What does it consist of?

Answer 16

The neural groove, which is the precursor of the embryo’s nervous system

Question 17

What important part develops around the 21st-23rd day of pregnancy? What does it consist of?

Answer 17

The neural tube, which splits into the rostral portion (the brain), and the caudal version, being the spinal cord and the PNS

Question 18

What important part develops around the 29th day of pregnancy?

Answer 18

Genital organs are forming, brain development (neurons), you can start eating a heart beat, can see body parts developing into limbs

Question 19

What important part develops throughout the 30-60 days of pregnancy?

Answer 19

Brain region differentiation, meaning that you can start to see different brain regions, such as the limbic, the hypothalamus, the forebrain, midbrain, hindbrain. This also meant that functioning gets more sophisticated.
Autonomic functions such as blood pressure and motor control also emerge

Question 20

What is another name for the fetal stage? ? How long does it last?

Answer 20

The period of the fetus

Lasts from week 9 to birth

Question 21

What are five parts that protect the fetus? How do they work?

Answer 21

1. Amniotic sac with amniotic fluid: protects and nourishes the fetus (maintains constant temperature)
2. Umbilical cord: connects the fetus to the placenta and allows for exchange
3. Placenta: flat organ that contribute to the exchange of nutrients, oxygen, and waste (nourishes the fetus and takes away the wastes)
4. Lanugo: fuzzy hair that covers the body of the fetus as it helps the vernix to stick to the skin
5. Vernix: cheese-like substance covering the fetus body and protect the skin, since the skin is in constant contact with the fluid

Question 22

What important part develops throughout the 3rd-4th months of pregnancy?

Answer 22

Head grows slowly, hair develops, cartilage is being replaced by bones

Question 23

What important part develops throughout the 5th-7th months of pregnancy?

Answer 23

Quickening: baby movements are felt by mom

Lanugo and vernix develop

Question 24

What important part develops throughout the 8th-9th months of pregnancy?

Answer 24

Organism is slowly preparing for birth, significant weight gain, fetus rotates, head pointed down

Question 25

What is a teratogen? What are common consequences of teratogens?

Answer 25

An agent causing damage during prenatal period. Common consequences include lowered birth weight and premature birth

Question 26

What are examples of things that the mother may intake that prevent healthy pregnancies?

Answer 26

Drugs, alcohol, tobacco, medication

Question 27

What is the danger behind drug intake during pregnancy? How can we take care of the issue?

Answer 27

The baby can be born addicted since the substances passed through the mom's fluid to the fetus. Hence, the baby is born with an addiction and a dependence, but the drug is no longer available to the baby, which leads to the neonatal abstinence syndrome. The baby is affected by symptoms of withdrawal, including irritability, tremors, sweating. The baby must then be weed off the drug (comforting baby in warm blanket, special formula, intravenous fluid)

Question 28

What is the danger behind alcohol intake during pregnancy?

Answer 28

If alcohol consumption is excessive throughout the whole pregnancy, baby may develop the fetal alcohol syndrome, which leads to defect such as having a flat face, lowered birth weight and height, poor coordination, etc.

Question 29

What is the danger behind thalidomide intake during pregnancy?

Answer 29

Thalidomide is a frug that was previously used to relieve pregnancy nausea, but scientific then found that it lead to phocomelia, which is accompanied by serious malformations of the limbs, deformed heart and eyes. Thalidomide is no longer used for pregnant women, but can be used for the immune system.

Question 30

What is the danger behind tobacco intake during pregnancy?

Answer 30

Consumption of tobacco may lead to increased risk of being born much smaller, much less health, with a lowered head circumference, and tend to spend much LESS time in the womb.

Question 31

What is another teratogen linked to the mother's mental state? To what may this teratogen lead?

Answer 31

Maternal distress. The earlier the stress, the more dangerous it can be for the development of the infant. Maternal distress may translate in psychosocial maladjustments (socio-emotional distress).

Question 32

What is another teratogen linked to the mother's physical disease? To what may this teratogen lead?

Answer 32

Maternal infectious diseases, such as herpes or vitamin deficiency (or any nutrient). This can lead to shorter prenatal development, miscarriage, and lower birth rate.

Question 33

What 5 genetic disorders act as teratogens?

Answer 33

Gene mutations. 1. Down syndrome: mutation on autosome 2. Patau syndrome: trisomy 13; affects brain development, vision deficit, cleft lip 3. Edward's syndrome: trisomy 18; leads to internal problems (heart & kidney defects), affects survival rate, many children don't live up till their first birthday 4. Turner's syndrome: female missing sex chromosome, shorter stature, facial features, hormonal deficiencies (fertility reduced) 5. Kleinfelter syndrome: more subtle, XXY, affect boys, increased height and more acne than usual

Question 34

What is another teratogen linked to the environment?

Answer 34

Environment radiation, such as pollution, toxins --> very serious repercussions on parents and children

Question 35

What is the use of prenatal tests?

Answer 35

They are used to detect problems or abnormalities in the development of the fetus

Question 36

What are the different prenatal tests?

Answer 36

1. Ultrasound 2. Alpha-fetoprotein test 3. Chorionic villus sampling (CVS) 4. Amniocentesis

Question 37

How does the ultrasound work? What is its utility? What can be detected in each trimester?

Answer 37

It is a high-frequency sound wave that is used to image the baby development and the health of the mom (reproductive system). It permits to see more details over time. First trimester: can see age of baby, heart beat, ectopic pregnancies (in fallopian tube) Second trimester: see the continuation of growth Last trimester: position of the baby in the womb

Question 38

How does the alpha-fetoprotein test work? What is its utility? When is it recommended to do it? Is it well-recommended?

Answer 38

It is a blood test that is given to the mother, which can assess the degree of visibility. Looks at the AFP levels. If the levels are high, it means that there is problems in the neural tube. If the levels are low, it means that there could be chromosome abnormalities. It is only recommended starting in the 2nd trimester. It gives a lot of details, but it may be invasive.

Question 39

How does the Chorionic Villus Sampling (CVS) work? What is meant by chorionic villus? Is it recommended? What are the risk? To whom is it really not recommended?

Answer 39

Chorionic villus is another word for placental tissue. The idea is to sample placental tissue to detect any abnormality. It is gives a lot of detail, but it is not necessarily recommended since it could be invasive. It can be performed earlier (around the 10th week). There is a risk of leaking amniotic fluid, but can rarely lead to miscarriage. Highly not recommended to mothers suffering from infectious disease because of cross-contamination.

Question 40

How does amniocentesis work?

Answer 40

The idea is to sample amniotic fluid since it contains the fetal tissue. It can be performed at the 15th week and further in pregnancy. The aim is to detect abnormalities in the development (neural tube, chromosome deficiency). The risks are similar as CVS.

Question 41

How does pregnancy affect both parents?

Answer 41

Both parents experience strong emotions about this life-changing event; and other concerns (such as financials, dynamic of the relationship) may increase the distress. Social support is the key.

Question 42

Outside of the womb, what happens in the first trimester?

Answer 42

Headaches, fatigue, morning sickness. | Miscarriages are more prevalent at that time (spontaneous abortion).

Question 43

Outside of the womb, what happens in the second trimester?

Answer 43

Mother feeling better physically, maternity clothes become a must, first baby's movement are felt by the mom, feelings of attachment become stronger

Question 44

Outside of the womb, what happens in the third trimester?

Answer 44

Physical and emotional symptoms, leg cramps and backaches, insomnia, unpleasant irregular uterine contractions, anxious anticipation

Question 45

What are the three stages of childbirth?

Answer 45

1. Dilation and effacement of the cervix (longest stage; 12-14h) --> dilation caused by the contractions 2. Delivery of the baby (contractions have reached their peak, cervix is fully dilated 3. Expulsion of the placenta (very quick)

Question 46

What are the threats during childbirth?

Answer 46

1. Cervix is not fully dilated, which complicates the delivery 2. Breech position, meaning that the baby is turned so that the buttocks or feet would be delivered first, which is dangerous 3. Anoxia, meaning that there is inadequate oxygen supply during labor and delivery (wrapping umbilical cord around baby's neck)

Question 47

What are the medical interventions for threats during childbirth?

Answer 47

1. Episiotomy; surgical procedure in which an incision is done between the vagina and anus; the idea is to enlarge the opening for the baby to pass through 2. Epidural; injection of a pain killer in the epidural space (outer part of the spinal cord) that cause a loss of sensation anywhere near the spinal cord 3. Cesarean (C-section); used to manually remove the baby; incision on mom's lower belly 4. Isolette at the NICU; plexy glass closure to protect the pre-term baby to make sure it gets everything it needs

Question 48

What is the APGAR scale? What does each letter stand for?

Answer 48

``` A: activity (muscle tone) P: pulse (heart rate) G: grimace (reflex response) A: appearance (color of skin) R: respiration ```