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OB-GYN > Placenta & Immunology > Flashcards

Placenta & Immunology Flashcards

(67 cards)

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1
Q

The infant is dependent on the placenta for what functions?

A

Pulmonary, Hepatic, Renal

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2
Q

Maternal blood spurts from the __________ into the placental intervillous space and bathes the outer syncytiotrophoblasts

A

uteroplacental vessels

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3
Q

True or False: Fetal and maternal blood are not mixed in this hemochorial placenta

A

True

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4
Q

Where does the human placental formation begin?

A

Trophectoderm aka Morula

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5
Q

What is the invasive fxn of the trophoblast?

A

promotes implantation

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6
Q

What is the endocrine fxn of the trophoblast?

A

Endocrine function: maternal physiological adaptations, pregnancy maintenance

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7
Q

8th day after fertilization, what cells are formed on the outside. These are multinucleated

A

Syncitiotrophoblast

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8
Q

8th day after fertilization, what cells are formed on the inside. These are Germinal cells for syncytium and there is a well-demarcated cell border, single nucleus, undergoes DNA synthesis and mitosis

A

Cytotrophoblast

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9
Q

After implantation, trophoblasts differentiate further along two main pathways. What are these 2?

A

Villous Trophoblast & Exravillous Trophoblast

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10
Q

What is the function of Villous trophoblast?

A

It gives rise to CHORIONIC VILLI, which primarily transports oxgen, nutrients and other compounds bet mother and baby

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11
Q

The extravillous trophoblast is further differentiated into what? (2)?

A

Interstitial Trophoblast & Endovascular Trophoblast

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12
Q

Fxn of Interstitial Trophoblast

A

invade decidua and penetrate myometrium to form PLACENTAL BED GIANT CELLS. They also surround spiral arteries

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13
Q

Fxn of Endovascual Trophoblast

A

penetrate spiral artery LUMEN. Converts it from narrow-lumen, muscular spiral arteries into DILATED, LOW-RESISTANCE UTEROPLACENTAL VESSELS

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14
Q

by the 10th day… Blastocyst becomes totally encased within the _________

A

Endometrium.

Embryo enlarges -> more maternal decidua basalis is invaded by syncytiotrophoblast

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15
Q

by the 12th day… syncitiotrophoblast is permeated by a system of intercommunicatiing channels called ______

A

Trophoblastic Lacunae

It is filled with Maternal Blood

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16
Q

What does the extravillous cytotrophoblast give rise to?

A

Solid Primary Villi = Cytotrophoblast (Langhan’s Cell) Core + Syncitiotrophoblast Cover

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17
Q

Trophoblast-lined labyrinthine channels form….

A

Intervillous space

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18
Q

the solid cellular columns form the…

A

Primary Villous Stalks

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19
Q

At 8-10 weeks, this is formed via fusion of amnionic and primary chorionic plate mesenchyme

A

chorionic plate formed

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20
Q

Once angiogenesis begins in the mesenchymal cores, what are formed?

A

Tertiary Villi

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21
Q

At what day does the maternal blood enter the intervillous space?

A

day 15

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22
Q

At the 17th day, fetal blood vessels are _____ & placental circulation is _________

A

Functional & established

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23
Q

What is the contact between the trophoblast & maternal blood

A

Hemochorial Placenta

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24
Q

Hemochorial Placenta can be subdivided into:

A

Hemodichorial and Hemomonochorial.

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25
In early pregnancy,villi are distributed _______ of the chorionic membrane
over the entire PERIPHERY
26
What is the fetal component of the placenta?
Chorion Frondosum or Leafy Chorion
27
Which part of the chorion becomes the avascular fetal membrane that abuts the decidua parietalis?
Chorion Laeve or Smooth Chorion
28
This is composed of cytotrophoblasts and fetal mesodermal mesenchyme that survives in a relatively low-oxygen atmosphere
Smooth Chorion
29
During first half of pregnancy, these accumulate in the decidua and are found in direct contact w/ trophoblasts. They lack cytotoxic fxns and are able to dampen inflammatory TH17 cells
Decidual Natural Killer Cells
30
These cells play a regulatory role in inhibiting NK cell killing during pregnancy
Decidual Macrophages
31
These promote decidual invasion toward spiral arteries
IL-8 & interferon-inducible protein 10
32
When is the trophoblast highly invasive?
First trimester
33
Invasive trophoblasts secrete _______ that digest ECM and activate proteinases already present in the endometrium
Proteolytic enzymes
34
This appears to be critical for human trophoblst invasion
MMP-9
35
During this time, there is limited invasiveness of trophoblasts
Late Pregnancy
36
This promotes invasion into the endometrium
Insulin-like growth factor II
37
secreted by decidual cells which blocks the autocrine loop
Insulin-like factor binding protein type 4
38
Truncal/main stem villi = lobule/cotyledon
Functional Unit
39
``` The ff are functions of this type of cell found during placental maturation: Phagocytic Immunosuppressive Produces cytokines Regulates trophoblast function ```
Hofbauer cells
40
Which MHC/s are absent from villous trophoblasts?
I & II
41
Normal implantation depends on....
controlled trophoblastic invasion of maternal EM-decidua and spiral arteries
42
This regulate trophoblast invasion
Uterine Natural Killer Cells
43
Tough, pliable, tenacious membrane | Provides tensile strength of fetal membranes
Amnion
44
Amnion is first identified during...
7th or 8th day
45
the tensile strength of the amnion is due to....
Cross-linked interstitial collagens I (tensile strength) & III (+ tissue extensibility)
46
Until when does the amniotic fluid increase?
increases until 34 weeks, then declines
47
True or false: As pregnancy advances: Yolk sac becomesl larger Pedicle grows shorter Expanding amnion fuses with chorion laeve Covers the placental disc and lateral surface of the body stalk  UMBILICAL CORD/FUNIS
FALSE As pregnancy advances: Yolk sac becomesl SMALLER Pedicle grows LONGER Expanding amnion fuses with chorion laeve Covers the placental disc and lateral surface of the body stalk  UMBILICAL CORD/FUNIS
48
most common vascular anomaly in the absence of 1 artery
Meckel Diverticulum
49
2 routes of blood flow
Ductus venosus | Hepatic circulation
50
Umbilical arteries are obliterated and become....
Medial umbilical ligaments
51
This hormone is almost exclusively synthesized in the placenta. May be elevated in fetal kidney & malignant tumors
HCG
52
Peak of HCG
Complete molecule peaks at 8-10 weeks
53
Give the fxns of HCG
Rescue & maintenance of corpus luteum Stimulation of fetal testicular testosterone secretion Leydig cell replication: sexual differentiation Stimulate maternal thyroid gland Promotion of relaxin Regulates expansion of uterine NK cells
54
low plasma HCG indicates...
Early pregnancy wastage (abortion), ectopic pregnancy
55
elevated plasma HCG indicates...
Multifetal pregnancy, erythroblastosis fetalis, GTD
56
Proportional to placental mass Synthesis is stimulated by insulin and insulin-like growth factor-1 Inhibition is by PGE2 and PGF2a
Human Placental Lactogen
57
Actions of hPL
Promotes maternal lipolysis Inhibits leptin secretion by term trophoblasts Inc maternal β-cell proliferation Potent angiogenic hormone
58
This persists after fetal demise
Placental Progesterone
59
principal precursor for placental estradiol synthesis
DHEA-S
60
most impt source of placental estrogen precursors
Fetal Adrenal Glands
61
source of 90% of placental estriol precursors
fetus
62
85-90% of progesterone and estrogen formed in
Syncitiotrophoblast
63
Fetal glands take up lipoproteins as a source of cholesterol.
(LDL>HDL>VLDL)
64
in Anencephaly there is high levels of
Fetal Adrenal Steroid Precursor
65
Used to assess level of serum estriol
maternal serum triple or quadruple screening test
66
what do you check in triple screen
alpha-fetoprotein (AFP), human chorionic gonadotropin (hCG), unconjugated estriol
67
what is added to the triple screen to be quad?
Inhibin A

OB-GYN (4 decks)

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