The Puerperium & Lactation Flashcards

(71 cards)

1
Q

What is the puerperium

A

The period after parturition when the reproductive tract returns to its non pregnant condition

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2
Q

2 reasons for the puerperium period

A
  1. Repair of damaged reproductive tissues

2. Resumption of ovarian cyclicity

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3
Q

Puerperium length varies among __

A

species

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4
Q

Uterine Involution (repair) 4 main parts

A
  1. Reduction in size of uterus (tissue) and volume of uterus (space occupied)
  2. Discharge of fluid
  3. Sloughing of endometrial tissue
  4. Postpartum bacterial contamination
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5
Q

How does the uterus reduce in size during uterine involution

A

Strong contractions of myometrium after parturition and the uterus undergoes atrophy

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6
Q

What do strong contractions of myometrium after parturition do?

A
  1. facilitates discharge of fluids and tissue debris
  2. Compress uterine vasculature
  3. Reduces uterine size overall
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7
Q

Compressing uterine vasculature also reduces __

A

hemorrhage

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8
Q

When the uterus undergoes atrophy, it also ___

A

reduces uterine size

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9
Q

Uterine involution 2: Discharge of fluid

Lochia is blood-tinged fluid containing remnants of ___ ___ and ____

A

Lochia is blood-tinged fluid containing remnants of fetal placenta and endometrial tissue that is dying off at this time

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10
Q

Caruncles

A

Provide maternal contribution to placenta

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11
Q

In cattle and sheep, how does sloughing of endometrial tissue happen?

A

Vasal constriction of caruncles

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12
Q

what happens with nasal constriction of caruncles?

A

Causes necrosis of caruncular tissue

Sloughs off uterine length

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13
Q

What happens when uterine length sloughs off?

A

endometrial epithelium undergoes repair

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14
Q

Uterine involution 4: Postpartum bacterial contamination is a ____ ____ ____

A

natural defense mechanism

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15
Q

3 natural defense mechanisms of postpartum bacterial contamination

A
  1. Discharge of lochia
  2. Phagocytosis due to estradiol at parturition
  3. Return to ovarian cyclicity
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16
Q

What does discharge of lochia do?

A

washes out the tract

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17
Q

What does phagocytosis due to estradiol at parturition do?

A

recruits leukocytes

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18
Q

What does return to ovarian cyclicity do?

A

increased estradiol levels

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19
Q

What are some causes of infection under postpartum bacterial contamination?

A
  1. retained fetal membranes
  2. dystocia
  3. weak myometrial contractions
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20
Q

How could weak myometrial contractions cause infection in postpartum bacterial contamination?

A

Cleans uterus more slowly

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21
Q

What are some effects from infection after postpartum bacterial contamination?

A
  1. Prolonged uterine involution to occur
  2. Prolong period of puerperium
  3. Delay subsequent pregnancy
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22
Q

What is the biggest management issue from effects of infection?

A

Delaying subsequent pregnancy

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23
Q

What is mammogenesis?

A

Mammary gland development

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24
Q

What happens in prenatal life during mammogenesis?

A
  1. Formation of mammary ridges

2. Mammary ridge to gland transition

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25
The formation of mammary ridges happens during prenatal life, what are the characteristics of it (2)
1. Two lateral lines on ventral surface of fetus | 2. Thickened layer/ridges of epidermis
26
What does the number and location of final mammary glands depend on?
species
27
3 parts to mammary ridge to gland transition
1. Formation of primary mammary bud 2. Secondary mammary bud 3. Canalization
28
Mammary ridge to gland transition: | 1. Formation of primary bud: what does this do?
Pushes into underlying dermis
29
Mammary ridge to gland transition: | 2. What happens with the secondary mammary bud?
1. forms protrusions away from primary bud | 2. Lengthen and branch during remainder of embryonic development
30
Mammary ridge to gland transition: | 3. What happens under canalization?
formation of ducts in center of each bud
31
2 parts to postnatal life
1. Birth to puberty | 2. Puberty to pregnancy
32
What happens to mammary glands in birth to puberty?
Isometric growth: mammary gland grows in proportion to body (other tissues)
33
What happens to mammary glands in puberty to pregnancy?
Allosteric growth: Mammary gland grows faster than other tissues
34
____ induced growth also happens from puberty to pregnancy
hormone
35
What are the key hormones produced from puberty to pregnancy?
1. Estradiol 2. Progesterone 3. Prolactin and growth hormone
36
What does estradiol do during puberty to pregnancy?
Ducts branch and diameter increases
37
What begins to form from progesterone in postnatal life?
Alveoli begins to form
38
What do the alveoli form from in postnatal life?
Form from terminal portion of each ductal branch
39
What do prolactin and growth hormone contribute to in postnatal life?
Contribute to duct development
40
During pregnancy, what development occurs in the last trimester?
Final alveolar development occurs in last trimester of pregnancy
41
What are lobule-alveolar structures?
The alveoli-functional unit of mammary gland (where the milk is actually made)
42
What is a lobule?
groups of alveoli
43
What is the lobe?
Groups of lobules that empty into common duct
44
2 things milk production can do
1. Hormone control | 2. Immunoprotection
45
What hormones stimulate milk synthesis and increase just prior to parturition?
1. prolactin 2. adrenal cortical hormones 3. placental lactogen
46
What kind of immunity does milk secretion give to the offspring?
Passive immunity: offspring receiving immunity through mother being exposed to disease and developing immune response to pass to offspring
47
What is colostrum?
first postpartum milk secretion
48
Colostrum contains ___ which provides neonate with ____ to common pathogens
- antibodies | - immunity
49
Colostrum contains __ __ __ which promote __-__ growth/health of offspring?
- various growth hormones | - long-term
50
What is involution?
The reduced suckling frequency as neonate grows
51
Involution causes __ __ which causes a ___ ___ ___ in the mammary gland telling ___ ___ to stop working?
Pressure atrophy which causes a build of pressure in mammary gland and causes secretory cells to stop working
52
What cells invade mammary tissue causing it to recover and develop into new secretory tissue
immune cells
53
Involution also causes __ to remain quiescent until next pregnancy
alveoli remain quiescent until next pregnancy
54
What hormones restimulate milk secretion?
1. prolactin 2. adrenal cortical hormones 3. placental lactogen
55
Most milk is stored in alveoli lumen and nearby ducts. What causes milk retention?
The small diameter of ducts creates resistance to fluid flow
56
Milk ejection (letdown): transfer of milk from __ and __ __ to __ __, __, and __/__
transfer of milk from alveoli and alveolar ducts to mammary ducts, cisterns and teat/nipples
57
3 steps in neuroendocrine reflex
1. Tactile stimulation activates sensory neurons in teat/nipple 2. Signal causes oxytocin to be release from post pituitary 3. Oxytocin binds receptors on myoepithelial cells
58
Entrainment
allows other signals to elicit same response
59
Tactile stimulation activates sensory neurons in teat/nipple causing __
entrainment
60
Examples of entrainment
baby crying, sight/sound of milking parlor
61
Oxytocin binds receptors on myoepithelial cells causing __ cells to surround each alveoli
contractile
62
oxytocin causes __ forces __ into __
contractions which forces milk into ducts
63
What substances does milk of dam include?
1. hormones 2. Alcohol, drugs, etc (many substances found in dam's blood)
64
What hormones is found in the milk?
Growth hormone (BST)
65
What kind of hormone is a growth hormone?
protein hormone
66
What does bovine somatotropin hormone (BST) do?
Used to increase milk production in dairy cattle
67
What urban myth surrounds BST?
1. BST is a large protein that is digested in the gut before it is absorbed 2. If absorbed whole, it cannot activate the human growth hormone receptor due to species specificity
68
Potential use of lactating animals as pharmaceutical "bioreactors": transgenic animals can secrete proteins into milk which capitalizes on
animal's body to produce desired substance in large quantities
69
The desired substance of animal's body is
secreted into milk and harvested
70
The production of protein via pharmaceutical "bioreactors" is
non-invasive, large-scale
71
Human antithrombin is an FDA-approved
pharmaceutical "bioreactor" which treats rare clotting disorder