Maternal prelim Flashcards
1
Q
(first 2 weeks, beginning with fertilization)
A
Pre-embryonic
2
Q
(weeks 3 through 8)
A
Embryonic
3
Q
(from week 8 through birth)
A
Fetal
4
Q
From ovulation to fertilization
A
Ovum
5
Q
From fertilization to implantation
A
Zygote
6
Q
From implantation to 5–8 weeks
A
Embryo
7
Q
From 5–8 weeks until term
A
Fetus
8
Q
Developing embryo and placental structures throughout pregnancy
A
Conceptus
9
Q
(also referred to as conception and impregnation)
A
Fertilization
10
Q
is the union of an ovum
and a spermatozoon.
A
Fertilization
11
Q
where fertilization usually occurs
A
in the outer third of a fallopian tube, termed
the ampullar portion.
12
Q
after penetration of the ovum, the chromosomal material of the ovum
and spermatozoon fuse to form a
A
zygote.
13
Q
ring of mucopolysaccharide fluid
A
(the zona pellucida)
14
Q
circle of
cells
A
(the corona radiata).
15
Q
is released by the spermatozoa and
dissolves the layer of cells protecting the ovum.
A
Hyaluronidase (a proteolytic enzyme)
16
Q
The cells in the outer ring are
A
trophoblast cells.
17
Q
contact between the growing structure and the uterine
endometrium, occurs approximately 8 to 10 days after fertilization.
A
Implantation,
18
Q
Once implanted, the zygote is called an
A
embryo.
19
Q
grows from a few identifiable trophoblastic cells at the beginning of pregnancy to
an organ 15 to 20 cm in diameter and 2 to 3 cm in depth,
A
The placenta
20
Q
“hormone of women,”
A
Estrogen
21
Q
“hormone that maintains pregnancy.”
A
progesterone
22
Q
is produced as a second product of the syncytial cells of the
placenta.
A
Estrogen
23
Q
is a hormone with both growth-promoting and lactogenic
A
Human Placental Lactogen
24
Q
It is produced by the placenta beginning as early as the sixth week of
pregnancy,
A
Human Placental Lactogen
25
is a dual-walled sac with the chorion as the outmost part
amniotic
membrane
26
The chorionic villi on the medial surface of the trophoblast gradually thin
until they become the
chorionic membrane,
27
it produces a phospholipid that initiates the formation of prostaglandins,
which may be the trigger that initiates labor.
(the amniotic
membrane)
28
fetus is unable to swallow
(esophageal atresia or
anencephaly
29
excessive amniotic fluid
hydramnios
30
may also
occur in women with diabetes because hyperglycemia causes excessive fluid shifts into
the amniotic space
hydramnios
31
a reduction in the amount of amniotic fluid.
oligohydramnios
32
may also
occur in women with diabetes
Hydramnios
33
to shield the fetus against pressure
or a blow to the mother’s abdomen.
amniotic fluid
34
is formed from the fetal membranes, the amnion and chorion, and provides a circulatory pathway that connects the embryo to the chorionic villi of the
placenta.
umbilical cord
35
(carrying blood from the placental villi to
the fetus)
umbilical cord vein
36
(carrying blood from the fetus back to the placental villi).
umbilical cord two arteries
37
The walls of the umbilical cord arteries are lined with
smooth muscle.
38
During the first 4 days of life, zygote cells are termed
totipotent stem cells,
39
become specific body cells, such as nerve, brain, or skin cells,
pluripotent stem cells.
40
In yet another few days, the cells grow so specific they are
termed
multipotent,
41
As soon as conception has taken place, development proceeds in a
cephalocaudal
(head-to-tail) direction;
42
the blastocyst already has differentiated to a point at
which three separate layers of these cells are present:
the ectoderm, the endoderm, and
the mesoderm
43
Central nervous system (brain and spinal cord)
Peripheral nervous system
Skin, hair, nails, and tooth enamel
Sense organs
Mucous membranes of the anus, mouth, and nose
Mammary glands
Ectoderm
44
Supporting structures of the body (connective tissue, bones, cartilage,
muscle, ligaments, and tendons)
Upper portion of the urinary system (kidneys and ureters)
Reproductive system
Heart, lymph, and circulatory systems and blood cells
Mesoderm
45
Lining of pericardial, pleura, and peritoneal cavities
Lining of the gastrointestinal tract, respiratory tract, tonsils,
parathyroid, thyroid, and thymus glands
Lower urinary system (bladder and urethra)
Endoderm
46
All organ systems are complete, at least in a rudimentary form, at ___ gestation
8 weeks (the end of the embryonic period).
47
the growing structure is most vulnerable to invasion by teratogens
organogenesis (organ
formation),
48
one of the first systems to become functional in
intrauterine life.
cardiovascular system
49
forms as early as the
16th day of life and beats as early as the 24th day.
cardiovascular system
50
sympathetic
nervous system matures,
28th week of pregnancy,
51
consistent heart rate of fetus
110 to
160 beats/min
52
This blood enters
the fetus through the
umbilical vein
53
umbilical vein (which is still called a vein because?
because the direction of the blood is toward the fetal heart).
54
Specialized structures present in the fetus then shunt blood flow to first supply the most
important organs of the body:
the liver, heart, kidneys, and brain.
55
Blood flows from the
umbilical vein to the
ductus venosus,
56
an accessory vessel that discharges oxygenated
blood into the fetal liver, and then connects to the fetal inferior vena cava so oxygenated
blood is directed to the right side of the heart.
ductus venosus,
57
an opening in the atrial septum called the
foramen
ovale.
58
the larger portion of even this blood is shunted away from the lungs through
an additional structure,
ductus arteriosus,
59
As the majority of blood cells in the aorta become deoxygenated, blood is
transported from the
descending aorta through the umbilical arteries
60
umbilical arteries which are called
arteries because?
they carry blood away from the fetal heart
61
At birth, an infant’s oxygen saturation level is to and pulse rate
95% to 100% and 80 to
140 beats/min.
62
At the third week of intrauterine life, exist as a single
tube.
respiratory and digestive tracts
63
Spontaneous respiratory practice movements begin as early as
3 months gestation
64
a phospholipid substance, is formed and excreted by the alveolar
cells of the lungs beginning at approximately the 24th week of pregnancy.
Surfactant,
65
Surfactant has two components:
lecithin and sphingomyelin.
66
Early in the formation
of surfactant, is the chief component.
sphingomyelin
67
At approximately 35 weeks, there
is a surge in the production of
lecithin,
68
ratio of lecithin and sphingomyelin
2:1.
69
an analysis of the lecithin/sphingomyelin (L/S)
ratio in surfactant is a
primary test of fetal maturity.
amniocentesis technique,
70
(a thickened portion of the ectoderm)
A neural plate
71
any intestine remains outside the abdomen in the base of the cord, a congenital
anomaly, termed
omphalocele, will be present at birth.
72
occurs when the original midline fusion that occurred at the early cell stage is
incomplete
gastroschisis,
73
a collection of cellular wastes, bile, fats, mucoproteins,
mucopolysaccharides, and portions of the vernix caseosa
Meconium,
74
Sucking and swallowing reflexes are not mature
until the fetus is approximately
32 weeks gestation, or weighs 1,500 g.
75
is synthesized by the action of bacteria in the intestines,
vitamin K,
76
The ability of the gastrointestinal tract to secrete enzymes essential for carbohydrate
and protein digestion is mature at
36 weeks.
77
is active throughout intrauterine life, functioning as a filter between the
incoming blood and the fetal circulation and as a deposit site for fetal stores such as iron
and glycogen.
The liver
78
two
serious problems that can occur in the first 24 hours after birth
hypoglycemia and
hyperbilirubinemia
79
Ossification of this cartilage into bone begins at about the
12th week
80
A fetus can be seen to move on
ultrasonography as early as the
11th week,
81
fetal movement
quickening
82
mother usually does not feel
this movement (quickening) until
16 to 20 weeks of gestation.
83
this is
revealed at birth by the persistent drainage of a clear, acid–pH fluid (urine) from the
umbilicus
patent urachus),
84
soft downy hairs that serve as insulation to preserve warmth in utero
(lanugo)
85
important for lubrication and for keeping the
skin from macerating in utero.
vernix caseosa,
86
take place about 2 weeks after the
last menstrual period
ovulation and fertilization
87
In lunar months, a total
pregnancy is
10 months
88
The length of the embryo is about 0.75 cm; weight is about 400 mg.
* The spinal cord is formed and fused at the midpoint.
* The head is large in proportion and represents about one third of the entire
structure.
* The rudimentary heart appears as a prominent bulge on the anterior surface.
* Arms and legs are bud-like structures; rudimentary eyes, ears, and nose are
discernible.
End of Fourth Gestational Week
89
* The length of the fetus is about 2.5 cm (1 in.); weight is about 20 g.
* Organogenesis is complete.
* The heart, with a septum and valves, beats rhythmically.
* Facial features are definitely discernible; arms and legs have developed.
* External genitalia are forming, but sex is not yet distinguishable by simple
observation.
* The abdomen bulges forward because the fetal intestine is growing so rapidly.
* A sonogram shows a gestational sac, which is diagnostic of pregnancy
End of Eighth Gestational Week
90
The length of the fetus is 7 to 8 cm; weight is about 45 g.
* Nail beds are forming on fingers and toes.
* Spontaneous movements are possible, although they are usually too faint to be
felt by the mother.
* Some reflexes, such as the Babinski reflex, are present.
* Bone ossification centers begin to form.
* Tooth buds are present.
* Sex is distinguishable on outward appearance.
* Urine secretion begins but may not yet be evident in amniotic fluid.
* The heartbeat is audible through Doppler technology.
End of 12th Gestational Week (First Trimester)
91
The length of the fetus is 10 to 17 cm; weight is 55 to 120 g.
* Fetal heart sounds are audible by an ordinary stethoscope.
* Lanugo is well formed.
* Both the liver and pancreas are functioning.
* The fetus actively swallows amniotic fluid, demonstrating an intact but
uncoordinated swallowing reflex; urine is present in amniotic fluid.
* Sex can be determined by ultrasonography.
End of 16th Gestational Week
92
The length of the fetus is 25 cm; weight is 223 g.
* Spontaneous fetal movements can be sensed by the mother.
* Antibody production is possible.
* Hair, including eyebrows, forms on the head; vernix caseosa begins to cover the
skin.
* Meconium is present in the upper intestine.
* Brown fat, a special fat that aids in temperature regulation, begins to form behind
the kidneys, sternum, and posterior neck.
* Passive antibody transfer from mother to fetus begins.
* Definite sleeping and activity patterns are distinguishable as the fetus develops
biorhythms that will guide sleep/wake patterns throughout life.
End of 20th Gestational Week
93
The length of the fetus is 28 to 36 cm; weight is 550 g.
* Meconium is present as far as the rectum.
* Active production of lung surfactant begins.
* Eyelids, previously fused since the 12th week, now open; pupils react to light.
* Hearing can be demonstrated by response to sudden sound.
* When fetuses reach 24 weeks, or 500 to 600 g, they have achieved a practical
low-end age of viability if they are cared for after birth in a modern intensive care
nursery.
End of 24th Gestational Week (Second Trimester)
94
The length of the fetus is 35 to 38 cm; weight is 1,200 g.
* Lung alveoli are almost mature; surfactant can be demonstrated in amniotic fluid.
* Testes begin to descend into the scrotal sac from the lower abdominal cavity.
* The blood vessels of the retina are formed but thin and extremely susceptible to
damage from high oxygen concentrations (an important consideration when
caring for preterm infants who need oxygen).
End of 28th Gestational Week
95
The length of the fetus is 38 to 43 cm; weight is 1,600 g.
* Subcutaneous fat begins to be deposited (the former stringy, “little old man”
appearance is lost).
* Fetus responds by movement to sounds outside the mother’s body.
* An active Moro reflex is present.
* Iron stores, which provide iron for the time during which the neonate will ingest
only breast milk after birth, are beginning to be built.
* Fingernails reach the end of fingertips.
End of 32nd Gestational Week
96
The length of the fetus is 42 to 48 cm; weight is 1,800 to 2,700 g (5 to 6 lb).
* Body stores of glycogen, iron, carbohydrate, and calcium are deposited.
* Additional amounts of subcutaneous fat are deposited.
* Sole of the foot has only one or two crisscross creases compared with a full
crisscross pattern evident at term.
* Amount of lanugo begins to diminish.
* Most fetuses turn into a vertex (head down) presentation during this month.
End of 36th Gestational Week
97
The length of the fetus is 48 to 52 cm (crown to rump, 35 to 37 cm); weight is
3,000 g (7 to 7.5 lb).
* Fetus kicks actively, sometimes hard enough to cause the mother considerable
discomfort.
* Fetal hemoglobin begins its conversion to adult hemoglobin.
* Vernix caseosa starts to decrease after the infant reaches 37 weeks gestation and
may be more apparent in the creases than the covering of the body as the infant
approaches 40 weeks or more gestational age.
* Fingernails extend over the fingertips.
* Creases on the soles of the feet cover at least two thirds of the surface.
End of 40th Gestational Week (Third Trimester)
98
Softening of the cervix
Goodell’s sign
99
Softening of the lower
uterine segment
Hegar’s sign
100
refers to an assessment of fetal well-being and assesses
the fetal heart rate for a normal baseline rate.
“rhythm strip testing”
101
measures the response of the fetal heart rate to fetal movement.
nonstress test
102
The sound frequencies that bounce back from the fetus can be displayed on an
oscilloscope screen
103
feelings less than pleasure
and closer to anxiety
ambivalence.
104
These
symptoms apparently result from stress, anxiety, and empathy for the pregnant woman.
The phenomenon is common enough that it has been given a name:
couvade syndrome
105
Color change of the
sign vagina from pink to
violet
Chadwick’s sign
106
Stretch marks form on
abdomen
Striae
gravidarum
107
Periodic uterine
tightening occurs
Braxton Hicks
contractions
108
This settling of the fetus into the midpelvis is termed
lightening
109
(a woman who has had one or
more children).
multipara
110
fetus rebounds against the examiner’s
hand when pushed gently upwards
ballottement
111
forms to seal out bacteria and help prevent
infection in the fetus and membranes.
operculum,
112
a bacteria that grows freely in the
increased glycogen environment, which increases the lactic acid content of secretions.
Lactobacillus acidophilus,
113
The
sebaceous glands of the areola
(Montgomery’s tubercles),
114
keep the nipple
supple and help to prevent nipples from cracking and drying during lactation, enlarge
and become protuberant.
(Montgomery’s tubercles),
115
can cause rupture and
atrophy of small segments of the connective layer of the skin, leading to streaks
(striae
gravidarum)
116
the abdominal wall has difficulty stretching enough to accommodate the
growing fetus, causing the rectus muscles underneath the skin to actually separate,
diastasis.
117
A narrow, brown line
(linea nigra)
118
Darkened or reddened areas may appear on the face
as well, particularly on the cheeks and across the nose.
melasma
119
The number of pregnancies that have reached viability, regardless of
whether the infants were born alive
Para
120
A woman who is or has been pregnant
Gravida
121
A woman who is pregnant for the first time
Primigravida
122
A woman who has given birth to one child past age of viability
Primipara
123
A woman who has been pregnant previously
Multigravida
124
A woman who has carried five or more pregnancies to viability
Grand
multipara
125
A woman who has carried two or more pregnancies to viability
Multipara
126
A woman who has never been and is not currently pregnant
Nulligravida
127
(a metal or plastic instrument with movable flat blades;
speculum
128
Each maturing oocyte is contained within a sac called the
graafian follicle
129
Ovulation occurs approx. ___ days before next menstrual
period would begin
14
130
which maintains high estrogen and
progesterone secretion for final preparation of the uterine
lining for a fertilized ovum.
CORPUS
LUTEUM
131
The collapsed follicle is transformed into the
CORPUS
LUTEUM
132
Nourishes and
Protects the sperm from acidic environment of the vagina
seminal fluid
133
sperm undergo changes that
enable one to penetrate the protective layers surrounding the
ovum, a process called
capacitation.
134
a glycoprotein coat and seminal
proteins are removed from the acrosome
CAPACITATION
135
sperm that reach the ovum release
Hyaluronidase
Acrosin
136
12-14 days after fertilization
zygote
137
flow of w whitish,
yellowish, or greenish discharge from the vagina of the
female that may be normal or that may be a sign of
infection)
leukorrhea
138
Earliest test possible on fetal cells alternative to
amniocentesis to diagnose fetal karyotype and genetic
anomalies
CHORIONIC VILLI SAMPLING
139
To detect certain birth defects
Used to determine fatal maturity and detect certain birth
defects such as down syndrome, spinal bifida, hemolytic
disease of the newborn, sex and chromosomal
abnormalities
AMNIOCENTESIS
140
records fetal movements
Tocodynamometer
141
is a glycoprotein produced by fetal yolk sac,
GIT, and liver
Alpha-fetoprotein
142
Evaluates fetal response to stress of labor; performed after
28 weeks
Can be done either thru nipple stimulation or oxytocin
stimulation
CONTRACTION STRESS TEST
143
FUNIC SOUFFLE
o Caused by blood rushing through the umbilical arteries;
synchronous with the FHR
144
UTERINE SOUFFLE
o Caused by the sound of blood passing through the uterine
vessels; synchronous with the maternal pulse
145
Transducer on abdomen transmit sound waves that show
fetal image on screen
ULTRASONOGRAPHY
