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GIGU Final > Placenta and Fetal Membranes > Flashcards

Placenta and Fetal Membranes Flashcards

1
Q

What makes up the fetal and maternal part of the placenta?

A
  • Fetal: choroinic sac (outermost fetal layer)
  • Maternal: derived from endometrium
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2
Q

What is the Decidua & its layers?

A

The functional layer of the endometrium that separates from the rest of uterus after birth

  • Decidua basalis
  • Decidua capsularis
  • Decidua parietalis
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3
Q

Describe the decidua basalis?

A
  • Behind the implantation site and contributes to maternal part of the placenta
  • Baby/Placenta
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4
Q

Decidua capsularis?

A
  • Superficial and overlies conceptus
  • Capsularis=Chorion
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5
Q

Decidua Parietalis?

A
  • emaining parts of the decidua
  • Walls of uterus
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6
Q

Late in the second week, around ten days post fertilization, what will the trophoblast differentiate into?

A
  1. Cytotrophoblast: the inner layer
  2. Syncytiotrophoblast: outer layer invades and displaces decidual cells of the endometrium
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7
Q

What layer do lacunae appear in and what is their significance?

A
  • Appears in the syncytiotrophoblast and fills with blood and uterine secretions
  • Networks of lacunae alllows for diffusion of oxygen and nutrients to embryo
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8
Q

What is Primordial uteroplacental circulation?

A

Oxygen and nutritive substances pass to embryo through diffusion in the lacunar networks

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9
Q

What makes up the Chorionic sac?

A
  • Extraembryonic somatic mesoderm + Cytotrophoblast + Syncytiotrophoblast
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10
Q

Where is Extraembryonic somatic mesoderm found?

A
  • lining the trophoblast and covering the amnion

Also one of the three components making the chorionic sac

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11
Q

Where is extraembryonic splanchnic mesoderm found?

A

Surrounding the umbilical vesicle

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12
Q

What is the extraembryonic coelom?

A

A fluid filled cavity surrounding the amnion and umbilical vesicle

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13
Q

What is the amnion & how does it form?

A
  • Amniotic sac
  • Thin tough membrane surrounding the embryo with amniotic fluid
  • Amnioblasts separate from epiblast and enclose the developing amniotic cavity
  • The amnion eventurally obliterates the choroinic cavity and forms epithelial covering of umbilical cord
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14
Q

What makes up the amniotic fluid?

A

Made of organic compounds such as proteins carbs fats enzymes hormones and inorganic salts ions glycophospholipids and steroid hormones

  • Initally made from maternal tissue and interstitial fluid
  • Fetal urinary, respiratory, & GI systems begin to contribute
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15
Q

What is PolyHydramnios?

A

Excessive amniotic fluid either due to being overproduced or not removed correctly

  • Genetic and CNS anomalies or blockage of GI tube
  • Clinical signs in mother include abdomen pain, swelling or bloating & SOA
  • Uterus can grow to large PROM risk
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16
Q

What is Oligohydramnios?

A
  • Insufficient amniotic fluid less t han 400 mL
  • Anoalies with fetal development such as club foot renal agenesis, pulmonary hypoplasia
  • Placental abnormality or maternal HBP
  • decrease fluid doesn’t allow enough cushion for fetus movement
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17
Q

What happens to cytotrophoblasts of the chorionic sac when they proliferate at the chorionic plate?

A
  1. They extend through the syncytiotrophoblasts to attach to the decidua basalis
  2. Forming the cytotrophoblastic shell surrounding the chorionic sac
  3. Creating and enclosing the intervillious space
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18
Q

What area of the placenta contains maternal blood at weeks 11-14?

A

Intervillous space

19
Q

What does decidual erosion produce?

A

Produces placental septa dividing the villous chorion into irregular convex areas called Cotyledons

20
Q

What two parts of the placenta fuse allowing the chorionic villi to span into the intervillous space exposing them to maternal blood?

A

Villous chorion from the fetal side and decidua basalis from the maternal side

21
Q

What are primary chorionic villi?

A
  • Cytotrophoblasts that grow into the syncytiotrophoblast layer at end of week 2
  • Forms syncytial columns through week 8
22
Q

What happens to villi associated with decidua capsularis?

A

They become compressed and degenerate leaving a smooth chorion behind

23
Q

What happens to villi that are associated with decidua basalis?

A

They branch profusely and form bushy area of the chorionic sac

called villlous chorion

24
Q

What is the main difference between primary and secondary villi?

A

It has a core of extraembryonic mesoderm

25
Q

What are tertiary villi?

A
  • Extraembryonic mesoderm differentiating into capillary and blood cells
  • Capillaries and CT core
  • Cytotrophoblast layer in the middle
  • Syncytiotrophoblast layer is the outside
  • Capillaries are the hallmark for Tertiary villi
26
Q

What are main stem vlli?

A

Directly attached to and extending from chorionic plate

27
Q

What are branched villi?

A

Extend from main tem villus increasing surface area

28
Q

What are anchoring villi?

A

VIlli attached to maternal tissues through the cytotrophoblatic shell

29
Q

What makes up a Cotyledon?

A

2+ main stem villi and multiple branched villi

30
Q

What type of villi is the main exchange between mother & fetus

A

Branched villi

31
Q

What four changes occur in the decidua as fetus grows?

A
  1. Villous chorion forms at the placental site remaining capsularis forms smooth chorion
  2. Embryo grows and the decidua capsularis bulges into the uterine cavity
  3. Capsularis will degenerate
  4. Amniochorionic membrane fuses with decidua parietalis on the opposite wall
32
Q

What makes up the amniochorionic membrane?

A

Amnion and Chorion fuse

33
Q

What substances can cross the placenta?

A
  • Nutrients such as water glucose electrolytes AA vitamins
  • Steroid hormones
  • IgG and insulin (small amounts)
  • Waste products
  • Drugs
  • Infectious agents (virus)
34
Q

What does not cross the placenta?

A
  • Protein hormones (pituitary)
  • Bacteria
  • Drugs with amino acid structures
35
Q

What makes up the umbilical cord?

A
  • Whartons jelly
  • Two umbilical arteries (deox fetal blood)
  • One umbilical vein (80% ox fetal blood)
  • Allantois proper
36
Q

What is placenta previa?

A
  • Placenta implants in the lower uterine segment or even the cervix, it can lead to serious 3rd trimester bleeding
  • Most common type of abnormal placentation
  • Predisposing factors are prior placenta previa and hisotry of previous cesarean section
37
Q

What is placenta accreta?

A
  • Partial or complete absence of decidua, the villous chorion adheres direcctly to myometrium
  • Failure of placental separation at birth
  • This can cause severe life threatening post partum bleeding
38
Q

What is hydatidiform mole?

A

Replacement of normal villi by dilated or hydropic translucent vesicles

  • Partial mole: portion of villi are edematous caps can be seen in villi
    • Fetal tissue commonly found
    • Normal ovum fertilized with two sperm
    • Triploid (69,XXY), Tetraploid (92, XXXY)
  • Complete mole: All/most of the villi are enlarged covered with trophoblast invasion
    • NO fetal tissue
    • Fertilization of blighted ovum, all DNA is paternal
    • Fertilized by two sperm, duplication of siingle sperm
    • 46 XX 46XY
39
Q

What is invasive mole?

A
  • Complete mole that penetrates or perforates uterine wall
  • Diagnosed by persistent high blood levels of hCG, but no pregnancy
  • Trophoblast deeply invades the uterine wall and can cause hemorrhaging
  • Responsive to chemotherapy
40
Q

What is gestational choriocarcinoma?

A
  • Highly invasive metastatic turmor arising from trophoblast cells
  • Observed in 50% of patients with molar pregnancies
  • Increasing hCG titer w/no uterine elnargement
  • Treatment with combined chemo agents
41
Q

Describe Dizygotic twins?

A
  • Originates from two zygotes, Fraternal twins
  • 2 chorion and 2 amnions
42
Q

Describe Monozygoitc twins?

A
  • Originate from one zygote
  • Membranes in these twins depend on the timing of the division
    • Earlier the splt the more separate the membranes and placentas will be
43
Q

What tissue from implanting embryos directly interfaces with endometrial CT?

  • Corona Radiata
  • Trophoblast
  • Extraembryonic somatic mesoderm
  • Syncytiotrophoblast
  • Epiblast

(Dr. Anderson)

A

Syncytiotrophoblast

GIGU Final (12 decks)

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