Fertilization And Implantation Flashcards

(117 cards)

1
Q

Where does fertilization occur?

A

At the ampulla of the uterine tube.

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2
Q

Mention the phases of fertilization and explain.

A

1.Penetration of corona radiata.
2.Penetration of zona pellucida
(Acrosomal And cortical reactions)
3. Fusion of sperm and oocyte.

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3
Q

What’s the male pronucleus and female pronucleus contribution in forming a zygote a functional-zygote?

A

Female pronucleus- mitochondrion but loses it’s centrioles

Male pronucleus loses its mitochondrion and tail but presents sperm centrioles pair necessary for microtubule organizing centers.

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4
Q

What is syngamy?

A

A complete successful fusion of the male and female pronucleus to form a functional zygote.

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5
Q

When cell division occurs through the cytoplasm of the cell it known as?

A

Holoblast.

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6
Q

cleavage results in ………..formation.

A

Blastula formation.

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7
Q

What is a morula?

A

A blastula with 16-32 blastomeres

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8
Q

Blastocyst forms when?

A

When fluid fills the morula and creates a blastocyst cavity and an inner cell mass.

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9
Q

What becomes the inner cell mass?

A

Embryo (embryoblast)

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10
Q

Blastomeres are totipotent up to the 8 cell stage. Explain.

A

Each blastomeres can differentiate into every cell within the organism. Including extra embryonic tissues. Each can form an embryo by itself.

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11
Q

The inner cell mass can be referred to as embryoblast. They are known to be pluripotent. Meaning?

A

A stem cell that can be differentiated into ectoderm mesoderm and endoderm.

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12
Q

What becomes the fetal part of placenta?

A

The outer cell mass of the blastocyst.

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13
Q

Zona pellucida degenerates by

A

Day 4 after conception. It must degenerate before implantation can occur.

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14
Q

Ectopic pregnancy is also know as

A

Extrauterine pregnancy

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15
Q

State the function of synciotrophoblast?

A

It produces HCG
HPL
Leptin
Also maintains the corpus luteum to continue progesterone production.

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16
Q

What results in ectopic pregnancy ?

mention 4 causes.

A

Delay in transport

  1. Salpingitis
  2. scar tissue from salpingectomy
  3. Endometriosis
  4. pelvic inflammatory disease.
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17
Q

Mention 5 signs and symptoms of EP.

A

Palpable Adnexal mass

Unilateral pelvic pain

High HCG levels than normal in normal pregnancy.

Abnormal uterine bleeding

Anaemia In ruptured EP.

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18
Q

Mention 4types of EP?

A
Tubal
Abdominal 
Ovarian
Cervical 
Interstitial ectopic pregnancy
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19
Q

What are the differential diagnoses of ectopic pregnancy?

A

Appendicitis
Intrauterine pregnancy abortion
Bleeding Corpus luteum

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20
Q

A neoplasm of germ cells (male pregnancy) is referred to as?

A

Testicular teratocarcinoma

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21
Q

High level of alpha fetoprotein in male signifies ?

A

TTC

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22
Q

At what time does the blastocyst implant and where?

A

7days after fertilization and at the superior posterior wall of the uterus.

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23
Q

HCG is produced by?

A

Syncytiotrophoblast.

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24
Q

When is HCG assayed in maternal blood and urine?

A

8days in blood

10days In urine after conception

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25
low HCG in pregnancy indicates
Ectopic pregnancy | Abortion
26
High HCG indicates
Hydatidiform mole Gestational trophoblastic neoplasm Multiple pregnancy
27
During week 1-6 HCG levels will
Increase by 70% every 48hours
28
What produces the HPL? And state the main function of HPL
Placenta | and it responsible for lipolysis which results in an increase in serum fatty acid levels in mother.
29
When is HPL assayed in pregnancy?
6weeks in maternal blood
30
When does HPL disappear in maternal blood ?
At birth or after delivery of fetus.
31
What produces prolactin during pregnancy?
Maternal adenohypophysis fetal adenohypophysis Desidual layer of uterine wall
32
Prolactin is available in
Maternal blood and amniotic fluid through out pregnancy.
33
What is the level of prolactin in maternal blood during pregnancy?
100ng/mL ( normal is 8-24ng/mL)
34
Progesterone during pregnancy is produced by
Corpus luteum until 8weeks | Then placenta throughout
35
Mention 3 other functions of progesterone
Maintains the functional layer of endometrium Precursor for synthesis of corticosteroids and mineralocorticosteroids By the fetal adrenal cortex Precursor for testosterone production by the fetal testis.
36
Which of the following is the weakest and most available of the steroid hormones produced in pregnancy? Estriol estradiol and estrone.
Estriol | Can be assayed in maternal blood (high in morning)
37
Significant amount of estriol is produced at
3month of pregnancy (early 2nd trimester)
38
What is the clinical significance of maternal estriol levels?
Determines the reliable index of fetal placental function because its production depends on a functional placenta fetal adrenal cortex and fetal liver
39
Outline the steps involved in estriol production?
LDL from maternal liver is converted into pregnenolone by placenta Then into pregnenolone sulphate This is then converted by the fetal adrenal cortex into DHEA- SO4 DHEA-SO4 to estradiol and estrone by placenta DHEA-SO4 is converted into 16alpha -hydroxy- 16alpha -hydroxy DHEA-SO4 is converted by fetal liver Into estriol by placenta.
40
Is the placenta fetal or maternal?
The placenta functions as a fetomaternal organ with two components: the fetal placenta (Chorion frondosum), which develops from the same blastocyst that forms the fetus, and the maternal placenta (Decidua basalis), which develops from the maternal uterine tissue.
41
State the functions of the placenta. Endocrine barrier waste removal gaseous exchange and immunity
Produces HCG, hpl etc Chorionic villi has a membrane that separate maternal blood from fetal blood preventing bacteria and large molecules from the crossing Allows immunoglobulin G to cross for fetal immunity Fetal wastes are excreted across the placenta where they are excreted by mother via kidney. It also allow for gaseous exchange and nutrient from mother through the chorionic villi.
42
At what gestation is the fundus palpated at the pubic symphysis?
1st trimester 12weeks
43
When is Doppler fetal heart rate audible ?
12weeks 1st trimester.
44
Second trimester begins and end @
Begins at end of first trimester and | Ends at 40weeks of LMP.
45
When can amniocentesis be performed ?
14 to 18 weeks
46
Uterine fundus is palpable between pubic symphysis and umbilicus at?
16weeks
47
Quickening in a 1st time pregnant woman is at?
18-20weeks
48
The fetal heart sound can be heard on fetoscope at?
17-20weeks
49
Sex determination is at ?
18weeks
50
Fundus is palpable at the umbilical region at?
20weeks
51
When is the fetal lung capable of respiration?
25-27weeks
52
At second trimester, what is the ideal weight of the fetus?
1kg/ 1000g
53
3rd trimester ends at ?
40weeks.
54
Outline the important events at the end of third trimester.
Pupillary reflex to light Lightening (head descent) Rupture of amniotic membrane Labor within 24hours of rupture
55
What is the ideal weight of the fetus in the 3rd trimester?
3300g/ 3.3kg
56
Mention 4 prenatal diagnostic tests.
USG AMNIOCENTESIS CHORIONIC VILLI BIOPSY PERCUTANEUS UMBILICAL BLOOD SAMPLE
57
Mention 5 indications for USG?
``` To determine fetal growth Fetal lie Placenta placing Congenital abnormalities Diagnose multiple pregnancy Guide needle for amniocentesis ```
58
Anechoic means?
Tissues with no sound during USG. eg bladder brain cavities and amniotic fluid.
59
Echogenic refers to
Tissues with high capacity to reflect sound.
60
Indications for amniocentesis
35years old pregnant woman History of neural defect History of paternal or maternal translocations History of chromosomal anomaly
61
Mention 4 investigations performed with amniotic fluid?
Alpha fetoprotein assay for neural defects Spectrophotometer assay for bilirubin for haemolytic dxs Lecithin sphingomyelin ratio and phosphatidylglycerol for fetal lung maturity DNA analysis for karyotyping.
62
What is the normal fetal heart rate?
120-160bpm
63
Fetal hypoxia is measured by changes in fetal HR/fetal scalp capillary pH. True or false?
True
64
Normal Fetal scalp capillary pH is
7.25-7.35
65
FSCph of 7.20 indicates
Fetal hypoxia
66
Pueperium extends from delivery to?
4-6weeks
67
Mention 4 important events of pueperium?
Involution of uterus Pain due to uterine contraction Discharge of lochia Return of menses 6-8weeks Return of ovulation 2-4 weeks postpartum in a non lactating mother. Lactating Mother’s ovulation returns after 10weeks. NB: birth control only last for 6weeks
68
Small for date fetus body weight is generally defined as
10th percentile of body weight at gestational age.
69
The epiblast and hypoblast are made of which epithelial tissues?
Epiblast columnar epithelium | Hypoblast cuboidal epithelium
70
When the hypoblast migrated to line the line the inner part of the cytotrophoblast what is formed?
Exocoelomic membrane
71
The exocoelomic membrane is also known as the ?
Primitive yolk sac
72
When is the definite primitive yolk sac formed ?
It is formed when the exocoelomic membrane pinches off the extra embryonic mesoderm forming an exocoelomic cyst
73
The prochordal plate is formed from?
The fusion of the epiblast and hypoblast which is now columnar epithelium
74
In which of these two undergoes mitosis? Syncytiotrophoblast and cytotrophoblast
Cytotrophoblast
75
Which is multinucleated syncytiotrophoblast or cytotrophoblast?
Syncytiotrophoblast
76
How is the lacuna network formed?
It is formed as the syncytiotrophoblast continues to burrow into the decidua basalis Eroding maternal blood vessels and glands creating spaces within which fuse to form the new maternal blood vessel.
77
The uteroplacental circulation depends on which mode of transport of nutrients to the embryoblast?
Diffusion
78
Uteroplacenta circulation is established at which gestation?
12-13th day
79
What develops as the primary chorionic villi?
Cytotrophoblast
80
When is the blastocyst completely implanted into the endometrium?
12days after fertilation
81
The extra embryonic mesoderm develops from proliferation of ?
Epiblast
82
What forms the exocoelomic membrane
Hypoblast And cytotrophoblast
83
The extra embryonic mesoderm is found between the?
Exocoelomic membrane and cytotrophoblast
84
Large spaces that develop within the extra embryonic mesoderm are referred to as the
Extra embryonic coelom
85
What becomes of the extra embryonic coelom?
It separates the extra embryonic mesoderm into extra embryonic somatic mesoderm and extra embryonic visceral mesoderm forming a chorionic cavity
86
Where is the extra embryonic somatic mesoderm and extra embryonic visceral mesoderm located?
EESM is attached to the inner lining of the trophoblast | The EEVM covers the yolk sac
87
A portion of the extra embryonic mesoderm suspending the conceptus to the chorion is know as
Connecting stalk
88
Mention the structures that make the chorion
Syncytiotrophoblast cytotrophoblast and the extra embryonic somatic mesoderm
89
Mention 4xtics of a complete hydatidiform mole
1. No fetal tissue present( snow storm on USG) . A single sperm or two fertilizes an egg with no maternal pronucleus teduplicating to producing 46XXX,46XXY 46XYY chromosomes .2 requires chemotherapy after D/C 4. The is 2% chance of choriocarcinoma
90
A gestational trophoblastic disease which grows into a mass in the uterus that has swollen chorionic villi growing into clusters that resemble grapes. Are known as?
Hydatidiform mole
91
In rare cases a hydatidiform mole co-exists in the uterus with a normal, viable fetus this indicates
Twin pregnancy
92
A partial mole is formed?
partial moles are triploid (three chromosome sets). The nucleus contains one maternal set of genes and two paternal sets. The mechanism is usually the reduplication of the paternal haploid set from a single sperm, but may also be the consequence of dispermic (two sperm) fertilization of the egg.[10]
93
metastatic moles (cancer) may require chemotherapy and often responds to
Methotrexate. Contraceptive pills can be used to prevent pregnancy for at least half a year with frequent monitoring of HCG Levels.
94
Why tremors in hydatidiform mole?
HCG mimics TSH which overstimulates the thyroids causing hyperthyroidism resulting in tremors.
95
Mention 5 signs and symptoms of hydatidiform moles.
``` Amenorrhea High HCG levels Signs of early pregnancy like hyperemesis gravidarium, tremor, etc Positive pregnancy test Preeclampsia at 1st trimester Painless vaginal bleeding ```
96
Alpha fetoprotein antigen is associated to which kind of tumor?
Hepatocellular carcinoma Germ cell neoplasm Yolk sack tumor of testicles and ovaries
97
Alpha-1-antitrypsin(AAT)
Hepatocellular carcinoma Germ cell neoplasm Yolk sac sinus tumors of testicles and ovary
98
Colorectal cancer, pancreatic cancer , breast cancer and small cancer of the lungs
Carcino embryonic antigen(CEA) | Poor prognosis if elevated preoperatively
99
Multiple myeloma | Light chains in urine(bence jones protein)
Beta2-microglobullin | Excellent prognostic factor.
100
Hodgkin disease (antigen)
Lactate dehydrogenase (LDH)
101
Prostate cancer antigen
Prostate specific antigen (PSA)
102
The pharyngeal arch is composed of mesoderm and neural crest cells as well as cartilages aortic arches ectoderm and endoderm mention 2 cartilages of the 1st pharyngeal arch
Meckels cartilages ossifies into the malleus Incus
103
Derivatives of the 2nd pharyngeal arch cartilages?
``` Reicherts cartilage Remember LUSSS Lesser horn of hyoid bone. Upper body of hyoid bone Stapes Styloid process Stylohyoid ```
104
3rd pharyngeal arch cartilage derivatives include?
Greater horn of hyoid bone | Lower body of the hyoid bone.
105
The 1st pharyngeal arch is also know as
Mandibular arch
106
2nd pharyngeal arch is also know as
Hyoid arch
107
Derivatives of the 4/6pharyngeal arches includes
``` Thyroid cartilages Arytenoid cartilages Cuniform cartilages Corniculate cartilage Cricoid cartilage RememberTACCC ```
108
Ligaments of the 1st pharyngeal arch consists of
Spenomandibular ligament
109
Mesodermal layers of the 1st pharyngeal arch gives rise to
The muscles of mastication which includes Masseters, temporalis , medial and lateral pterygoid muscles Tensor tympani Tensor palatine Anterior belly of digastric muscle
110
2nd pharyngeal arch muscle derivatives includes
``` Muscles of facial expression which includes Occipitofrontalis Temporauricular Obicularis oris levator labii superioris Depressor labii inferioris Depressor angular oris Procerus Resorius Buccinator Platysma Nasalis Posterior belly of digastric muscle Stylohoid Stapedius ```
111
3rd pharyngeal arch muscle derivatives include
Stylopharyngeus muscles
112
Levator palatini Cricothyroid muscle Constrictors of the pharynx are derivatives of which pharyngeal arch?
4th
113
``` Intrinsic muscles of the larynx Cricoarytenoid posterior lateral Cricothyroid Vocalis Transverse and oblique arytenoid muscles belongs to ```
6th pharyngeal arch
114
All arteries during embryonic development arises from the aortic arch name them according to its arch
Pharyngeal arch 1 maxillary artery 2stapedial artery 3common carotid artery 4part of aortic arch and proximal part of right subclavian 6. Pulmonary artery and ductus arteriosum
115
Nerve innervations of the pharyngeal arch
``` Pharyngeal arch 1. Trigeminal nerve ( v2 mandibular/ v3 maxillary) 2. Facial nerve 3. Glossopharyngeal nerve 4 vagus superior laryngeal n 6. Vagus nerve(inferior laryngeal nerve) ```
116
Anterior 2/3 of tongue Eustachian tube Tympanic membrane (inner lining) Middle ear are derivatives of which pharyngeal pouch?
1st pharyngeal pouch( endodermal layer)
117
Posterior 1/3 of tongue Palatine tonsils are derivatives of? Name innervations.
2nd pharyngeal pouch and innervated