Test 5 Reproduction revealed

Question 1

The vessels in the umbilical cord are named according to their relationship to the?

Answer 1

Fetal Heart
(artery away from fetal heart)
(vein towards the fetal heart)

Question 2

Umbelical cord has how many veins?
Arteries?
Arteries are oxygenated or deoxygenated?

Answer 2

1
2
deoxygenated (away from fetal heart, towards chorion frondosum)

Question 3

How many layers separate the fetal and maternal blood?

Answer 3

Two
Syncytiotrophoblast
Fetal capillary endothelium

Question 4

Three roles of the placenta:

Answer 4

• Provide conduit for waste disposal and nutrient delivery
• High protein production and metabolic processing (which helps protect the fetus, like the liver filters nutrients/toxins from the GI)
• Endocrine function

Question 5

Hormones produced by the placenta:

Answer 5

All of these have human in front of it:
Chorionic gonadotropin
Growth hormone-variant (also called placental growth hormone)
chorionic somatomammotroppin (also called placental lactogen)

Question 6

human chorionic gonnadotroppin function:

Answer 6

LH like effect, maintains the corpus luteum.

May suppress maternal immune system.

Question 7

Human Growth Hormone-Variant function:

- Other name:

Answer 7

works like maternal growth hormone. Stimulates lipolysis for nutrient generation for fetus.
- Other name:
placental growth hormone

Question 8

chorionic Somatomammotroppin function:

- other name:

Answer 8

Supplements growth hormone. Mobilizes metabolism. No effect on lactation yet seen.
- other name:
human placental lactogen

Question 9

What two hormones from the placenta produce a diabetes like effect:
- Why?

Answer 9

Human Growth Hormone-VariantHuman Growth Hormone-Variant
chorionic Somatomammotroppin
- Why?
mobilize sugar, which the placenta/fetus runs off of

Question 10

Maternal pancreatic beta cells proliferate to prevent:

Answer 10

gestational diabetes

Question 11

How much estrogen comparatively is produced by the placenta by 6 weeks?
Why?

Answer 11

100x as much

To help maintain the placenta once the corpus luteum tags out

Question 12

Ratio shift for estrogen/progesterone during pregnancy:

Why?

Answer 12

100:1 ratio of estrogen/progesterone at beginning
1:1 ratio at the end
Progesterone helps:
- Calm uterine contractions
- maintain the placenta

Question 13

Fetal-placental unit:

Answer 13

Maternal cholesterol -> placenta -> progesterone -> fetus -> androgens -> placenta -> estrogens

Question 14

Estriol:

- Define:

Answer 14

Estriol is a weak estrogen

Question 15

What hormone in the urine can be used to approximate health of the placenta?

Answer 15

Estriol

Question 16

Which two agents can be used to induce labor?

Answer 16

Oxytocin

Prostaglandins (prostaglandin F2alpha and prostaglandin prostaglandin E2)

Question 17

What hormone in the first semester promotes the decidual reaction:

Answer 17

relaxin

Question 18

Relaxin in animals:

Answer 18

Promotes softening of the pubic symphysis prior to parturition

Question 19

Oxytocin effect on the uterus:

- Alternative means to produce oxytocin?

Answer 19

it causes it to contract (how it stimulates birth)
- Alternative means to produce oxytocin?
Give baby to the mother to suckle -> induces oxytocin -> uterus contracts -> reduces blood loss

Question 20

Light somewhat irregular 20 - 30 second uterine contractions occurring every 20 minutes throughout much of pregnancy are called:

Answer 20

Braxton Hicks contractions

Question 21

Braxton Hicks contractions:

• When can you start feeling them?
• function:
• How do they differ from true labor?

Answer 21

• When can you start feeling them?
  mid pregnancy, though some women never notice
• function:
  Tone the uterus
• How do they differ from true labor?
  True labor contractions last longer 40 seconds

Question 22

Positive feedback in labor:

Answer 22

Stretching of cervix -> more oxytocin released by pituitary -> stronger uterine contractions -> more Stretching of cervix -> more oxytocin released by pituitary -> etc.

Question 23

Oxytocin:

• Stimulates the uterus how?
• Brand name:

Answer 23

- Stimulates the uterus how?
Directly stimulates uterus
Stimulates the uterus through prostaglandin
- Brand name:
Pitocin

Question 24

Labor induction can use:

Answer 24

Injection of pitocin

Insertion of a suppository of prostaglandins into the vagina

Question 25

Bloody show:

Answer 25

Expulsion of a protective mucous plug from the cervical canal

Question 26

Head of the baby should be orientated towards:

Answer 26

The cervix | looking towards mother's back (the floor)

Question 27

First stage labor:

Answer 27

- cervix must thin out (effacement) - Cervix must then dilate - Amniotic sack is normally ruptured (water breaks)

Question 28

When does the first stage of labor end?

Answer 28

When the cervix is dilated to 10 cm

Question 29

En-caul birth:

Answer 29

Baby born within the amniotic sack

Question 30

Second stage maneuver:

Answer 30

Contractions every 1-2 minutes Women often perform valsalva's maneuver As the fetus enters the vagina, the desire to push increases

Question 31

Advantages of squatting birth:

Answer 31

Widens the pelvic space Helps mother apply force downward (with abdominals) Gravity helps) Less tearing of the perineum (region around genital and anus)

Question 32

An incision to widen the vaginal opening and hasten delivery: - Is called: - Should be used?

Answer 32

- Is called: episiotomy - Should be used? Rarely

Question 33

Why is the babies head guided down and turned to one side?

Answer 33

So one shoulder can exit at a time, reduces the chance they get caught

Question 34

Why can the babies head mold to be cone shaped?

Answer 34

Because the bones are meant to move to allow the head to exit more easily

Question 35

When is the umbilical cord cut?

Answer 35

After the baby is breathing normally. This allows babies to still oxygen from their mothers

Question 36

Third stage of labor:

Answer 36

Separation and delivery of the placenta

Question 37

Breech birth:

Answer 37

Baby comes out butt first

Question 38

Cesarean section:

Answer 38

30% of births are done this way Baby removed from abdomen Mostly driven by concern for liability

Question 39

Vernix Caseosa:

Answer 39

Protective white cheese-like substance produced by fetal skin to protect it.

Question 40

Meconium:

Answer 40

Found inside the intestines of the fetus. Expelled after birth. Breast feeding helps to remove meconium, which has bilirubin

Question 41

Effect of maternal hormone on sex characterizing traits and reproductive functions of babies:

Answer 41

Babies will sometimes have enlarged breasts, which produce milk Female babies will sometimes have a mini period due before hormone levels drop

Question 42

Structure of mammary gland (flow chart of milk flow):

Answer 42

Lobe (of lobules (of glandular alveoli)) -> excrete milk which flows -> secondary tubules -> mammary ducts -> ampulla (lumen of the lactiferous ducts) -> lactiferous ducts -> out of the nipple

Question 43

What determines the size and shape of a woman's breast? | Is this related to milk production?

Answer 43

Adipose tissue. | No, not really

Question 44

Estrogen and mammary gland development:

Answer 44

Proliferation of tubules and ducts

Question 45

Progesterone and mammary gland development:

Answer 45

Development of mammary alveoli

Question 46

What causes the hypothalamus to excrete prolactin inhibiting hormone:

Answer 46

High levels of estrogen.

Question 47

Prolactin inhibiting hormone: - Turns out to be: - Effect:

Answer 47

- Turns out to be: Dopamine - Effect: Inhibits anterior pituitary from excreting prolactin

Question 48

What causes milk to start being produced?

Answer 48

The placenta is excreted (which produces estrogen) -> blood estrogen drops -> PIH levels drop -> prolactin from anterior pituitary -> milk protein production

Question 49

How long is the milk supply delayed?

Answer 49

2 - 3 days of delay.

Question 50

What can be done to prevent a women from creating breast milk after pregnancy?

Answer 50

Exogenous estrogen | Bromocriptine (dopamine agonist)

Question 51

Suckling effect on prolactin:

Answer 51

Neuro endocrine reflex. Sensory stimuli from suckling -> inhibits release of PIH -> more prolactin May also increase prolactin releasing hormone levels.

Question 52

Milk letdown (ejection) reflex:

Answer 52

Neuro endocrine reflex. | Sensory stimuli from suckling -> oxytocin produced -> release of milk

Question 53

Conditional reflex milk let down reflex explain:

Answer 53

Milk letdown reflex is initially triggered only by suckling, but can later be triggered by a bay crying, or seeing a baby.

Question 54

What can suppress the milk let down reflex?

Answer 54

Fight or flight reflex

Question 55

IgG gains entry to the fetus how? | IgG provides what?

Answer 55

Transplacental crossing | Passive immunity

Question 56

Passive immunity from milk:

Answer 56

Predominately IgA, some IgG. Protects the intestinal tract.

Question 57

Breast feeding contraception: - Define: - Most effective when:

Answer 57

``` - Define: Inhibits secretion of gonadatropins, which stops ovulating - Most effective when: mother has low calorie intake Baby is fed frequently ```