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Y4R2 - Obstetrics I 🀰 > L1: Physiology of Pregnancy > Flashcards

L1: Physiology of Pregnancy Flashcards

(172 cards)

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1
Q

Phases of Early developed pregnancy

A
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2
Q

Def of Fertilization

A
  • Union of male gamete (mature capacitated sperm) +
    female gamete (mature ovum) to form zygote.
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3
Q

Site of Fertilization

A

Ampulla of tube

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4
Q

Time of Fertilization

A

24 hours after ovulation.

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5
Q

Fertilizable Life Span of Ovum

A

12 - 36 hours

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6
Q

Fertilizable Life Span of Sperm

A

24-72 hours.

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7
Q

Oocyte journey During Fertilization

A
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7
Q

Sperms journey During Fertilization

A
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8
Q

Factors helping in ascending of sperms in female genital tract

A
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9
Q

Def of Sperm Capacitation

A
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10
Q

Method of Sperm Capacitation

A
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11
Q

Acrosomal Reaction

A
  • Removal of decapacitating factors & activation of acrosomal
    enzymes (neuroamidase, hyaluronidase & acrosin enzymes).
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12
Q

How is acrosomal Cap lost?

A
  • May be attributed to proteolytic enzymes in estrogen dominant uterus.
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12
Q

Events occuring when sperm reach ovum

A
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13
Q

Events occuring when sperm reach ovum

  • Sperms start to release …..
A
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14
Q

Events occuring when sperm reach ovum

  • Sperms start to release ….. to penetrate corona radiata
A

Neuroamidase

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15
Q

Events occuring when sperm reach ovum

  • Sperms start to release ….. to penetrate Zona pellucida
A

Hyaluronidase

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16
Q

Events occuring when sperm reach ovum

  • Stimulation of Zona Pellucida receptor site
A
  • Allowing penetration of zona by 1 sperm only
  • Many sperms can penetrate corona radiata & participate in weakening of zona pellucida but only 1 sperm can penetrate zona).
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17
Q

Events occuring when sperm reach ovum

  • Reblocking of Zona Pellucida Receptor Site
A

to prevent further sperms entrance.

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18
Q

Events occuring when sperm reach ovum

  • Completion of 2nd Meiotic Division
A

(which was arrested in metaphase) β†’ formation
of mature ovum & 2nd polar body.

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19
Q

Events occuring when sperm reach ovum

  • Penetration of Oocyte Membrane
A
  • Penetration of oocyte membrane (by acrosin) & only head & midpiece of sperm enter ovum.
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20
Q

Results of Fertilization

A
  • Union of female pronucleus (contains 22 + X chromosomes) with male pronucleus (contains 22 + X or Y chromosomes) to form zygote (l-cell stage) which contains 46 chromosomes then zygote undergoes cleavage
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21
Q

Steps of Morula Formation

A
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22
Q

When does Morula reach the uterine cavity?

A

at 3rd - 4th post-fertilization day.

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23
what is the morula?
16-cell stage
24
Blastocyst Formation
25
Def of **Decidua**
Thickened vascular endometrium prepared for implantation (endometrium of pregnancy)
26
Layers of **Decidua**
27
Factors maintaning **Decidua**
28
Functions of **Decidua**
29
Def of **Implantation**
- Embedding of blastocyst in decidua - (so, pregnancy is defined as implantation of blastocyst in decidua).
30
Normal Sites of **Implantation**
In Upper uterine segment UUS (60% posteriorly & 40% anteriorly).
31
Abnormal Sites of **Implantation**
- In Lower Uterine Segment LUS (placenta previa). - Outside normal uterine cavity (ectopic pregnancy)
32
Time of **Implantation**
6th - 7th post fertilization day (one week post fertilization).
33
Mechanism of **Implantation**
34
Main Steps of **Implantation**
35
Differentiation of **Decidua**
36
Decidua Basalis - Site - Formed of - Function
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Decidua Capsularis - Site - Formed of - Function
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Decidua Parietalis (Vera) - Site - Formed of - Function
39
Origin of **Trophoblasts**
Outer cell mass of blastocyst.
40
layers of **Trophoblasts**
41
Types of **Chorionic Villi**
42
Formation of **1ry Villi**
43
Components of **1ry Villi**
44
Foemation of **2ry Villi**
45
Components of **2ry Villi**
46
Formation of **3ry Villi**
47
Components of **3ry Villi**
48
Intervillous Space (Choriodecidual Space)
49
Functional Types of Villi
All are anchoring but not all are nutritive. βœ“ Anchoring For supporting embryo. βœ“ Nutritive For nutrition via choriodecidual space.
50
Fate of Chorionic Villi
- **Villi related to decidua basalis:** Form chorion frondosum (shares e decidua basalis in formation of placenta). - **Villi related to decidua capsularis:** Form chorion leave (forms outer layer of fetal membranes).
51
Origin of Embryo
From inner cell mass of blastocyst.
52
Def of **Placenta**
Unit of connection ( ) fetus & uterus ( mother)
53
Development of **Placenta**
Decidua basalis (maternal part) + Chorion frondosum (fetal part).
54
Anatomy of **Placenta**
55
Shape of **Placenta**
at full term, disc shaped or ovoid (circular cake - Discoid)
56
Diameter of **Placenta**
15-20 cm.
57
Thickness of **Placenta**
2 inch in center & thinner inch at periphery (1/2 inch)???
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Weight of **Placenta**
300- 500 gm (at full term).
58
Color of **Placenta**
Dark red (due to maternal blood in intervillous space)
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Surfaces of **Placenta**
60
Attachment of **Placenta**
61
Function of **Placenta**
- Respiratory function - Nutritive function - Secretory function - Excretory function - Hemopoietic function - Mechanical function
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Function of **Placenta** - Respiratory
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Function of **Placenta** - Nutritive
Transport of glucose, lipids, proteins, vitamins & minerals.
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Function of **Placenta** - Secretory
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Function of **Placenta** - Secretory (Hormones)
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Function of **Placenta** - Secretory (Enzymes)
67
Function of **Placenta** - Secretory (Placental Proteins)
68
Function of **Placenta** - Excretory
Placenta acts as a kidney for fetus.
69
Function of **Placenta** - Hemopoietic
Production of fetal Hb.
70
Function of **Placenta** - Mechanical
Fixation of fetus to mother.
71
Def of **Placental Barrier**
- It is formed of layers of tertiary chorionic villi which separate maternal & fetal blood. - It prevents mixing of both maternal & fetal blood and allow exchange of gases.
72
Thickness of **Placental Barrier**
73
Layers of **Placental Barrier**
74
Functions of **Placental Barrier**
75
Mechansim of transport in **Placental Barrier**
76
Examples of Placental Hormones
- HCG - HPL - Progesterone - Estrogen - Prolactin - PGs - Relaxin
77
Chemical Nature of **HCG**
Glycoprotein hormone formed of 2 subunits: 1. a-subunit: Similar to all anterior pituitary gonadotropins. 2. b-subunit: Specific to HCG.
78
Source of **HCG**
Syncytiotrophoblast
79
Half Life of **HCG**
30-40 hours.
80
Levels of **HCG**
81
Actions of **HCG**
82
Clinical Uses of **HCG**
 Diagnosis of early pregnancy.  Diagnosis of ectopic pregnancy.  Tumor marker in HCG secreting tumors  Induction of ovulation.  Diagnosis & follow up of GTD.  Treatment of LPD
83
Source of **HPL**
Syncytiotrophoblast
83
Chemical Nature of **HPL**
Large protein hormone structurally similar to prolactin.
84
Levels of **HPL**
85
Actions of **HPL**
- Somatotropic (growth). - Lactogenic (milk formation). - Erythropoietic
86
Clinical Uses of **HPL**
- Used as a placental function test (if its level is < 4 Β΅g/ml in 3rd trimester β†’ fetal risk).
87
Chemical Nature of **Estrogen**
Steroids (18c)
88
Source of **Estrogen**
Fetoplacental (90%) & maternal (10%).
89
Types of **Estrogen**
All types are produced during pregnancy, but main type is E3.
90
levels of **Estrogen**
Urinary E3 level is 30-35 mg\day at term.
91
Actions of **Estrogen**
92
Clinical Uses of **Estrogen**
- Indicator for fetal wellbeing (if urinary E3 level is < 4 mg/dl β†’ fetal risk). - Marker for some congenital anomalies (as anencephaly)
93
Chemical Nature of **Progesterone**
Steroids (21C)
94
Source of **Progesterone**
Corpus luteum then placenta
95
Levels of **Progesterone**
96
Actions of **Progesterone**
 Prepare endometrium for implantation.  Maintains decidua.  Inhibits uterine activity throughout pregnancy.  May have role in pelvic relaxation.
97
Clinical Uses of **Progesterone**
Given in cases of threatened abortion
98
Chemical Nature of **Relaxin**
..
99
Source of **Relaxin**
..
100
Levels of **Relaxin**
101
Types of Abnormalities of Placenta
Notes
102
Abnormalities of Placenta - Abnormal Size & Weight
Increased or Decreased
103
Abnormalities of Placenta - Abnormal Size & Weight (Increased)
In multifetal pregnancy, Rh isoimmunization & DM.
104
Abnormalities of Placenta - Abnormal Size & Weight (Decreased)
In HTN, heart diseases & IUGR.
105
Abnormalities of Placenta - Abnormal Shape
- Placenta membranacea (diffuse placenta) - Bilobate or multilobate placenta - Bipartite & multipartite placenta - Succenturiate placenta: (Accessory loop) - Circumvallate placenta - Placenta fenestrata - Placenta annularis
106
Abnormalities of Placenta - Abnormal Shape (Placenta Membranacea - Diffuse Placenta)
- Thin & large placenta (occurs in cases of ↓↓ blood flow β†’ placenta accommodates by ↑↑ its size to get more blood)
107
Abnormalities of Placenta - Abnormal Shape (Bilobate or Multilobate Placenta)
Placenta is made of 2 or more lobes connected by placental tissue.
108
Abnormalities of Placenta - Abnormal Shape (Bipartite & Multipartite Placenta)
Placenta is made of 2 separate parts almost equal in size connected by membranes.
109
Abnormalities of Placenta - Abnormal Shape (Succenturiate Placenta)
Placenta is made of 2 separate unequal parts (large part & small accessory part) connected by membranes.
110
Abnormalities of Placenta - Abnormal Shape (Circumvallate Placenta)
- Thick Whitish ring (composed of decidua) is seen around edge of placenta on its fetal surface.
111
Abnormalities of Placenta - Abnormal Shape (Placenta Fenestrata)
- Gap is seen in placenta covered by membranes giving appearance of window (the placenta is empty eccentrically).
112
Abnormalities of Placenta - Abnormal Shape (placenta Annularis)
Absent central part of placenta
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Abnormalities of Placenta - Abnormal Site of Implantation
➲Placenta previa: In the lower uterine segment ➲ Ectopic pregnancy: In the tube, in the cervix and in the peritoneum. ➲ Transverse lie: In the fundu
114
Abnormalities of Placenta - Abnormal Adhesions
115
Diseases of Placenta
116
Another Name of Umbilical Cord
Funis
117
Def of **Umbilical Cord**
Vascular cord connecting fetus to placenta.
118
Development of **Umbilical Cord**
From connecting stalk & mesoderm.
119
Anatomy of **Umbilical Cord**
120
Length of **Umbilical Cord**
50 cm
121
Diameter of **Umbilical Cord**
1-2 cm
122
Shape of **Umbilical Cord**
Thick, soft & tortuous.
123
Attachment of **Umbilical Cord**
- Fetus: At umbilicus. - Placenta: Eccentric (70%) or centric (30%).
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Structure of **Umbilical Cord**
125
Function of **Umbilical Cord**
- Carries fetal blood to & from placenta.
126
Abnormalities of **Umbilical Cord**
- Abnormal length - Abnormal insertion into placenta - Abnormalities of blood vessels - Knots
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Abnormalities of **Umbilical Cord** - Abnormal Lenghts
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Abnormalities of **Umbilical Cord** - Abnormal Insertion
129
Abnormalities of **Umbilical Cord** - Abnormal Blood Vessels
- Single umbilical artery: Most common vascular anomaly. - 2 umbilical veins.
130
Abnormalities of **Umbilical Cord** - Knots
131
Abnormalities of **Umbilical Cord** - Other Abnormalities (Diseases)
132
Examples of Fetal Membranes
Chorion & Amnion
133
Characters of **Chorion**
134
Characters of **Amnion**
135
Abnormalities of **Fetal Membranes**
136
Another Name of Amniotic Fluid
Liquor Amnii
136
Definition of Amniotic Fluid
Watery Fluid Enclosed in Amniotic Cavity
137
Volume of **Amniotic Fluid**
138
Color of Amniotic Fluid
Pale Yellow
139
Shape of Amniotic Fluid
Clear & becomes opaque at term due to - Presence of Fetal epithelial cells, lanugo Hair & vernix caseosa
140
pH of **Amniotic Fluid**
Slightly Alkaline (pH = 7-7.5)
141
Composition of Amniotic Fluid
142
Sources of **Amniotic Fluid**
143
Sources of **Amniotic Fluid** - Fetal Source
144
Sources of **Amniotic Fluid** - Maternal Souce
145
Main source of AF - In early Pregnancy
Transudation from Maternal Circulation **Througth The placenta**
146
Main source of AF - In mid Pregnancy
Transudation from fetal circulation **Throught non-keratinized skin**
147
Main source of AF - In Late Pregnancy
Fetal Urine
148
Circulation of **Amniotic Fluid**
149
Functions of **Amniotic Fluid**
150
Functions of **Amniotic Fluid** - During Pregnancy
151
Functions of **Amniotic Fluid** - During Labor
152
Clinical Importance of **Amniotic Fluid**
Amniocentesis
153
Abnormalities of **Amniotic Fluid**
- In Volume or Color
154
Abnormalities of **Amniotic Fluid** - Abnormal Volume
- Polyhydraminous - Oligohydraminous
155
Abnormalities of **Amniotic Fluid** - Yellowish Green Af
D2 Meconium D2 fetal distress
156
Abnormalities of **Amniotic Fluid** - Golden Yellow AF
D2 excess bilirubin
157
AFI
158
Def of ****Amniocentesis****
Aspiration of an amount of AF for Dx & TTT
159
Indications of **Amniocentesis**
160
Dx Uses of **Amniocentesis**
161
Therapeutic Uses of **Amniocentesis**
162
Timing of **Amniocentesis**
163
Early **Amniocentesis**
164
2nd Trimester **Amniocentesis**
165
Technique of **Amniocentesis**
166
Complications of **Amniocentesis**
167
done
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Y4R2 - Obstetrics I 🀰 (59 decks)

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