Exam 1 Flashcards
(100 cards)
1
Q
When does reproductive development begin?
A
at the moment of conception
2
Q
How is sex determined?
A
at moment of conception by the chromosome information supplied by the ovum and sperm
3
Q
What is a gonad?
A
a body organ that produces the cells necessary for reproduction (ovary and testes)
4
Q
How do you determine chromosomal sex of baby?
A
Father’s sperm carries X&Y chromosome therefore an XX is a girl and an XY is a boy
5
Q
For how long are male and female reproductive systems similar in gestation?
A
Until about 6 weeks gestation
6
Q
When are the external sex structures complete in the womb?
A
at 12th week however the clitoris is still very prominent and can be confused as a penis
7
Q
What do both ovaries and testes do?
A
secrete their primary hormones
8
Q
T/F An ovary has all the eggs it will ever have when the girl is born?
A
True
9
Q
When and what happens when a female reaches puberty
A
at 8-13 years, the hypothalamus secretes GnRH which stimulates FSH and LH in the anterior pituitary that secrete both estrogen and progesterone and also help create secondary sex characteristics
10
Q
What are some examples of female changes
A
breast changes body contours body hair skeletal growth reproductive organs menarche
11
Q
What causes skeletal growth
A
the response to estrogen - typically one year after breast development
12
Q
What is menarche?
A
first menses (can take up to 3 years for the period to normalize)
13
Q
T/F Can ovulation occur prior to the first menstrual period?
A
Yes
14
Q
What does estrogen do?
A
helps us heal
makes things tougher
helps us stretch
plumps everything up
15
Q
Where is the area where most women tear?
A
The perineum
16
Q
Primary Amenorrhea
A
delayed onset of 1st menstrual period
17
Q
When do we begin to worry about primary amenorrhea?
A
if it has not occurred within 2 years of breast dev, by age 16, or if more than 1 yr older when mother/sister received their menarche
18
Q
Secondary Amenorrhea
A
absence of menses of at least 3 cycles after an established 6 months of regular cycles
19
Q
What is number one reason for secondary amenorrhea?
A
Pregnancy
20
Q
What are other reasons for secondary amenorrhea?
A
pregnancy thyroid problem eating disorder (we need endogenous fat to have a period) competitive athlete anatomical problem
21
Q
What is the cervix?
A
The opening to the uterus
22
Q
What is the vagina?
A
The tube that opens to the cervix (8-10 cm) has multiple folds, rugae, muscular layers
23
Q
What is the uterus?
A
A hollow thick-walled muscular organ
Houses/nourishes fetus
Contracts rhythmically during labor to expel fetus
Each month, it prepares for pregnancy whether concpetion occurs or not
24
Q
What are the divisions of the uterus?
A
Corpus- body
Isthmus
Cervix- neck that is 2-3cm long (has internal os which is what dilates and opens and also the external os)
25
What are the layers of the uterus?
Perimetrium
Myometrium - muscle
Endometrium - inner layer that contains basal and functional layer
26
What are the 4 divisions of the fallopian tubes
Interstitial- within uterine wall, runs into uterine cavity
Isthmus- narrow part adjacent to uterus
Ampulla - WHERE CONCEPTION TAKES PLACE
Infundibulum - wide funnel-shaped end that contains fimbria (finger-like projections)
27
Explain ovaries
they produce sex hormones of estrogen and progesterone
we have 5-7 million in utero
by age 22 only 300,000 left
28
What are the phases of the ovarian cycle?
Follicular, Ovulatory, Luteal
29
What happens in the follicular phase?
maturing under influence of FSH
begins 1st day of menstration
decrease in estrogen/progesterone secretion by ovary
stimulates secretion of FSH/LH and maturing of ovarian follicles
1 follicle matures and secretes estrogen
30
What happens in the ovulatory phase?
Middle of 28 day cycle/2 days before ovulation
LH rises sharply for 24 hours
fall in estrogen and rise in progesterone
stimulates final maturation and release of ovum
follicle ruptures and ovum is released
31
What happens in the luteal phase
remaining cells of old follicle persist for 12 days (corpus luteum)
secretes estrogen and large amounts of progesterone
preparing endometrium for fertilized ovum
if fertilized, it will secrete hCG
if not, FSH and LH fall and corpus luteum regresses
Menstruation then occurs
32
What does the corpus luteum need in order to not miscarry?
hCG is secreted by corpus luteum no matter where in the uterus and that then secretes progesterone which is needed in order to not miscarry
33
What should the hCG do every 48 hrs?
Double
34
What are the phases of the endometrial cycle?
Menstrual, Proliferate, and Secretory
35
What happens in the menstrual phase?
Days 1-5, endometrium becomes ischemic and necrotic
36
What happens in the proliferate phase?
Days 6-13, first half of ovarian cycle, ovum matures and is released, this is the build up for a child
37
What happens in the secretory phase?
Dyas 14-28, second half of ovarian cycle, endometrium continues to thicken, get juicy, secrete nutrients, etc, uterus is preparing to receive a fertilized egg
38
What is meiosis?
where we take 22 chromosomes from each parent and then one sex chromosome from each parent
39
What happens when the hCG begins to decline?
Most likely pregnancy is not viable
40
What happens when the hCG increases but doesn't double
Most likely an ectopic pregnancy
41
What what week will the female fetus have all the ova she will ever have?
30 weeks gestation
42
What does conception require?
It requires timing of ovulation and ejaculation
ova lives and has 24hr for fertilization
sperm can live for 1-2 days
43
What is a spontaneous abortion?
hCG declines and then creates a miscarriage
44
What is a missed abortion?
fetus dies in utero and must be removed
45
When does implantation happen?
between the 6th and 10th day (endometrium is in the secretory phase and the zygote is secreting hCG leaving the corpus luteum to secrete estrogen and progesterone for 6-7 weeks)
46
What implantation bleeding?
chorionic villi embed in the endometrium now called the decidua basalis (right around when woman is expecting her next period)
chorionic villi become fetal side of placenta
decidua basalis becomes maternal side of placenta
47
What happens in the embryonic period?
(between the 3rd and 8th week) - the organs are vulnerable to teratogens and all major organ systems are in place by the 8th week
48
What is quickening?
felt during the fetal period where slight fluttering of movements of the fetus felt by a woman usually between 16-20 weeks of gestation and sooner when a woman has had a baby before
49
What is vernix caseosa and what does it do?
is the cheese like secretion that covers and protects fetus from amniotic fluid (that is very acidic and mostly made up of fetal urine)
50
What is lanugo and what does it do?
fine, down hair, all over the body of the fetus that diminishes when the fetus reaches term, protects from amniotic fluid
51
Where is the brown fat deposited?
behind the neck, back of sternum, around the kidneys to keep the fetus warm
52
What does the amniotic fluid do?
```
cushions fetus against impact
provides stable temperature
allows for symmetric development
keeps membranes from adhering to fetus
allows room and buoyancy for fetal movements
```
53
What is amnion?
inner membrane (as opposed to the outer chorion) that is where the amniotic fluid is that is made up of fetal urine and fluid from maternal blood (should have around 500-100ml at term)
54
How many blood vessels are in the umbilical cord?
2 arteries and 1 vein on the fetal side of the placenta that is cushioned by wharton's jelly
55
How many shunts does the fetus have?
3 shunts
56
What are some presumptive signs of pregnancy?
```
amenorrhea
fatigue, N/V
urinary frequency
breast changes (Montgomery's glands enlarge and areolas darken)
quickening
uterine enlargement
```
57
What are probable signs of pregnancy?
abdominal enlargement
hegars sign (softening/compressibility of lower uterus)
chadwick's sign- deepened violet/blue of cervix/vaginal mucosa
goodells sign- softening of cervical tip
ballottement- rebound of unengaged fetus
braxton hicks contractions- false contractions
positive pregnancy test
fetal outline felt by examiner
58
What are some positive signs of pregnancy?
fetal heart sounds
visualization of fetus by ultrasound
fetal movement
59
What is Nageles rule?
first day of woman's last period, subtract 3 months, add 7 days, change the year
60
How do you measure the fundal height?
cm from symphysis pubis to top of uterine fundus (between 18-30 weeks of gestation)
61
What is gravidity?
Number of pregnancies
62
What is parity?
number of pregnancies that reached 20 weeks (not number of fetuses and does not matter if fetus was born still born or alive)
63
What is viability?
the point in time when an infant has the capacity to survive outside of the uterus
most of the time from 22 to 25 weeks
64
GTPAL
```
Gravidity
Term births > 37 weeks
Preterm births <37 weeks
Abortions/miscarrages
Living children
```
65
Why does the baby need folic acid?
To help the baby's spine form
66
VDRL/RPR
this is syphillis
67
When would you vaccinate?
after the pregnancy because a live virus can not be given to a pregnant women and they cannot get pregnant for 28 days
68
How can you get toxoplasmosis?
gardening
cat/bird feces
raw meat
69
When can you see the heart beat? When can you hear the heartbeat?
6 weeks
| 10 weeks
70
What hepatitis b are you testing for?
The hep B antigen (antibody would be that you have had the vaccine)
71
How are the trimesters broken up in pregnancy?
1st is 1-12
2nd is 13-27
3rd is 28-40
72
What is EDC?
estimated date of confinement
73
Explain uterine growth in pregnancy at 12, 20, 36, and 40 weeks gestation
12- just about symphysis pubis
20- located at the umbilicus
36- extends to xiphoid process
40- fetal head descends to pelvis (lightening)
74
How long can it take for you to have your baby once you pass your mucous plug?
can take up to two weeks to have a baby
75
What is lucorrhea?
Increased vaginal discharge
| More lactovacilli
76
When does placenta take over estrogen and progesterone secretion?
at about 16 weeks
77
What are the cardiovascular changes in pregnancy?
- heart is pushed up and to the left
- blood VOLUME increases by 30% and peaks at 28-32 weeks
- plasma VOLUME increases but not RBCs = psuedoanemia
- cardiac output is increased
78
What are some S/S of Vena Caval Syndrome (supine hypotensive syndrome)?
```
get dizzy
shaky
done feel good
hypertensive
sweating
```
MOVE THEM ON THEIR LEFT SIDE
79
What happens to blood components during pregnancy?
fibrinogen level increases 50%
clotting factors 7, 8, 9, 10 increase to fight major bleeding
WBC increase to protect
blood lipids rise
80
How does the respiratory system change in pregnancy?
increased O2 consumption
| lung vol is decreased (might look like a pulmonary emboli but it's not)
81
How doe the GI system change during pregnancy?
mouth- more gum bleeding, salivation
esophagus- heartburn d/t increased sphincter tone
stomach/sml intestine- decreased gastric mobility leads to nausea
lrg intestine- constipation
GB- increased risk of stones
Liver- altered function
82
What are some changes in the skin seen in pregnancy?
```
warmer and sweat more
cholasma (mask of pregnancy)
linea negra
areola darkens
spider nevi
palmer erythem (red hands)
striae gravidarum- stretch marks THAT DONT GO AWAY
```
83
How does the musculoskeletal system change?
relaxin hormone is released causing the mother to waddle in 2nd and 3rd trimester
also abdominal wall - diastases recti muscles separate for room for the fetus
84
What 2 hormones are released by endocrine system in particular?
prolactin- by anterior pituitary which promotes milk production
oxytocin- by posterior pituitary which
stimulates milk ejection after birth
stimulates contractions
keeps uterus contracted after birth so you dont hemorrhage
85
Changes in pregnancy at certain weeks
```
9-12= N/V which will decrease at 12
13-16= Gestation, quickening, urinary frequency decreases
17-20= HB detected, Braxton Hicks, increased skin pigmentation, colostrium maybe
21-24= relaxin, vericose veins and increased UTI risk
25-28= greatest weight gain, lowest hgb, lordosis
29-32= heart burn, braxton hicks, waddline
33-36= dyspnea, thoracix breathing, varicosities, pedal/ankle edema, lightening, more urinary frequency
37-40= mom is uncomfortable and ready for birth
```
86
When and what do you do for the GCT test?
glucose challenge test at 28 weeks
drink 50g of glucola wait an hour - greater than 140
12 hour fast
then another 100gm of glucola (OGTT)
if two are elevated then have automatic gestational diabetes
87
When does the Group Strep B sampling take place?
at 35-37 weeks
88
When and how often should you visit the doctor during pregnancy
first 28 weeks = every 4 weeks
29-36 = every 2-3 weeks
37 weeks on = weekly
89
What types of ultrasounds at each trimester?
1st= transvaginal
| 2nd and 3rd = transabdominal
90
What is involved in 1st trimester screening?
sequential screening - 2 part process
1st test done at 11-13
2nd test done at 15-18
^^ measures proteins made by developing placenta
Nuchal Translucency Ultrasound at 11-13 to confirm dates and measure nuchal fold (if thickened- early indicator of down syndrome)
if at increased risk, go to further testing CVS, or amnio
91
What is involved in 2nd trimester screening?
measuring 4 protines of HCG, unconjugated estriol, AFP, and inhibin A. 78-85% of neural tube defects can be detected from Quad screen at 16-18 weeks.
Down Syndrome = low AFP, high HCG, low estriol
measuring her odds
92
Later in pregnancy, how many fetal movements should be in an hour?
10 fetal movements
93
What does NST tell us?
if adequate fetal oxygenation
| FHR SHOULD increase with fetal movement
94
What is considered a reactive NST?
an acceleration in fetal HR of 15 beats/min or more above baseline for at least 15 sec
need 2 accelerations in 20 min
95
What does a Biophysical Profile test for?
```
fetal breathing movements
gross fetal movements
fetal muscle tone
amniotic fluid vol
and fetal reactivity
```
each a score max of 2
96
What does oligohydramnios indicate?
low amniotic fluid, chronic fetal hypoxia, could indicate a kidney issue
97
Contraction Stress Test
determines uteroplacental dysfunction
dilute infusion of oxytocin, given to establish 3 uterine contractions in 10 min
```
Postive CST (BAD)
Negative CST (GOOD)
```
98
How is normal labor defined?
progressive cervical effacement and dilation resulting from regular uterine contractions that occur at least every 5 min and last 30-60 sec
99
What is the frequency vs duration of contractions?
Frequency is beginning to beginning
| Duration is the length of one contraction
100
What is cephalopelvicdisproportion?
baby isnt fitting, will most likely have to do a C section the next time
