Week 02 Flashcards
Prenatal Physiology (144 cards)
1
Q
sexual maturation is determined at
A
conception
2
Q
the male embryo produces which hormone
A
testosterone
3
Q
the female embryo produces which hormone
A
estrogen and progesterone
4
Q
primary female sex hormone
A
estrogen
5
Q
estrogen
A
- primary female sex hormone
- presents in high levels in women of childbearing age
- development of the secondary characteristics
- regulates the menstrual cycle by proliferation of the endometrial lining
6
Q
progesterone
A
- decreases uterine motility and contractility
- prepares the uterus for implantation after fertilization
- during pregnancy readies the breast for lactation
7
Q
gonadotropin-releasing hormone (GnRH)
A
hypothalamus
8
Q
FSH
A
- anterior pituitary gland
- stimulation of corpus luteum, the follicle, ovum, and sac to mature
9
Q
LH
A
- anterior pituitary gland
causes the release of ovum
10
Q
estrogen
A
- corpus lutem degenerates decreasing estrogen and progesterone levels
- if pregnancy occurs, the corpus luteum continues to produce these hormones supporting the pregnancy
11
Q
female ovulation
A
14 days before the menstrual period, mature ovum is released
12
Q
male eajculation
A
35-200 million sperm suspended in seminal fluid
13
Q
fertilization
A
- occurs in the distal third of the fallopian tube
- 2 to 3 day window every month that pregnancy can occur
14
Q
implantation
A
- upper third portion of the uterus
- where implantation occurs is where the placenta develops
- if lower, it can cover the cervix
15
Q
genome
A
genetic makeup
16
Q
total chromosomes
A
46
17
Q
chromosomes from mother, father
A
23, 23
18
Q
father
A
XX
19
Q
mother
A
XY
20
Q
autosomal dominant
A
only 1 copy of the gene is needed, infant has a 50% chance of having the disorder
21
Q
autosomal recessive
A
both parents have a copy of the gene, the infant needs 2 copies, the infant has a 25% chance of having the disorder
22
Q
signs of pregnancy: presumptive phase (i think)
A
breast changes, N/V, amenorrhea, increased urination, fatigue, uterine enlargement, quickening, skin changes
23
Q
signs of pregnancy: probable phase (i have proof)
A
positive pregnancy test, abdominal enlargement, Chadwick’s sign (blush colored cervix), Goodall’s sign (softening of the cervix), Hagar’s sign (softening of the lower uterus), Braxton Hicks
24
Q
signs of pregnancy: positive phase (the MD confirmed)
A
FHR heard separate from maternal HR, fetal movement felt by the examiner, ultrasound
25
Chadwick's sign
blush colored cervix
26
Goodall's sign
softening of the cervix
27
Hagar's sign
softening of the lower uterus
28
1st trimester duration
weeks 1-13
29
2nd trimester duration
weeks 14-27
30
3rd trimester duration
weeks 28-40
31
postpartum duration
- 6 weeks following delivery
- sometimes called the 4th trimester
32
pre embryonic stage duration
conception - weeks 1 & 2
33
embryonic stage duration
weeks 2 - 8
34
fetal stage duration
weeks 8 - birth
35
pre embryonic process
zygote > morula > blastocyte > implantation > placenta formation
36
week 03
- missed period
- divided up into the 3 layers
37
week 04
- neural tube closes
- heart begins beating
38
week 08
- organogenesis
- most organ systems have developed with minimal function
- heartbeat detected on vaginal ultrasound
- arm and leg buds are present and finger ridges begin to appear
39
weeks 12 - 13
- end of 1st trimester
- ultrasound detects FHR, spontaneous movement, sex
- urine production
40
week 16
- FHR can be obtained via stethoscope
- swallowing reflex is present
- fetal skeleton can be seen on x-ray
41
week 20
- fetal movement felt by mother (quickening)
- rule out anomalies scan
- vernix & lanugo present
42
weeks 24 - 27
- end of 2nd trimester
- age of viability
- fingernails are present
43
week 28
- surfactant
- quality viability
- eyes can open
44
week 32
- subcutaneous fat
- responds to outside noise
45
week 36
- vertex position (head down)
- increase in subcutaneous fat
- vernix thickens
- lanugo disappears
46
week 40
- active fetal movement
- conversion of fetal HBG to newborn HBG
- due date
47
germ layers
ectoderm, mesoderm, endoderm
48
ectoderm
brain and spinal cord, peripheral nervous system, pituitary gland, sensory epithelium (eyes, nose, ears), epidermis, hair and nails, subcutaneous glands, mammary glands, tooth enamel
49
mesoderm
cartilage and bone, connective and muscle tissue, heart and blood vessels, lymphatic system, spleen, kidneys, adrenal cortex, reproductive system, lining membranes
50
endoderm
lining of GI and respiratory tract, tonsils, thyroid, parathyroid, thymus, liver, pancreas, lining of bladder, and urethra, lining of ear canal
51
monozygotic pregnancy
- identical
- single ovum and sperm
- one placenta and chorion
- two amnions and umbilical cords
52
dizygotic pregnancy
- fraternal
-2 sperate ovum and sperm
- 2 placentas, chorions, amnions, umbilical cords
53
functions of the placenta
chorionic villi, oxygen, nutrients, hormones, immune system, waste removal
54
human chorionic gonadotropin (HcG)
thickens the lining of the uterus
55
human placental lactogen (HPL)
regulates glucose
56
estrogen
triggers organ development
57
progesterone
suppresses maternal immunity
58
relaxin
(ovaries help) allow ligaments and collagen to relax
59
prolactin
keeps corpus luteum active (progesterone production)
60
functions of the umbilical cord
- formed from amnion
- lifeline between mother and fetus
- AVA
- Wharton jelly
- 22 in long, 1 in wide
61
AVA
- 2 arteries: carries deoxygenated blood
- 1 vein: carries oxygenated blood
62
functions of amniotic fluid
- maintains fetal temp
- permits symmetric growth and development
- cushions and prevents cord compression
- promotes fetal movement
63
infertility: male factors
- sperm count
- erection
- ejaculation
- seminal fluid
64
infertility: female factors
- endometriosis
- ovulation disorders
- tubal occlusions
- cervical abnormalities
65
infertility: other factors
- infections
- environmental agents
66
how to improve probability of conception
- Intercourse should happen every other day
- Eat healthy, no alcohol
- Maintain a healthy weight
- Stay lying down after intercourse
- Don’t shower after intercourse
- No douching (ever)
67
infertility treatments: surgery
- laparoscopic
- hysteroscopic
- tubal
68
infertility treatments: therapeutic insemination
places sperm at the cervical OS
69
infertility treatments: intauterine insemination (IUI)
sperm is placed in the uterus
70
infertility treatments: in-vitro fertilization (IVF)
- Sperm and egg are combined outside of the body
- The fertilized egg is implanted inside the uterus
71
infertility treatments: surrogate parenting
- preserved/ donated egg or sperm
72
infertility treatments: other
- surgery (reversal of sterilization)
- medications (clomid; induced ovulation)
73
teratogens
drugs, alcohol, tobacco, environmental, hyperthermia, infections, ionizing radiation
74
T.O.R.C.H infections
- T: toxoplasmosis
- O: other
- R: rubella
- C: cytomegalovirus
- H: HSV
75
toxoplasmosis
- Harmful throughout pregnancy
- Found in cat litter and undercooked deli meats
- Miscarriage, hydrocephaly, microcephaly, chronic retinitis, seizures
76
other
HIV, syphilis, Hep B, Zinka, GBS< and Hep C
77
rubella
- Mother is tested during pregnancy for immunity
- Mother cannot get pregnant for 4 weeks after vaccination
- Miscarriage, IUGR, cataracts, congenital anomalies, intellectual development disability, death
78
cytomegalovovirus
- Common virus, blueberry rash
- Hemolytic anemia, jaundice hydrocephaly, microcephaly, pneumonitis, intellectual disabilities, cerebral palsy, deafness
79
HSV
- Can be passed to infant at delivery
- Miscarriage, preterm birth, stillbirth, transplacental infection (rare), IUGR, intellectual/ developmental disabilities, microcephaly, seizures, coma
80
pharmacologic agents: category A
Safest
81
pharmacologic agents: category B
no risk in animals
82
pharmacologic agents: category C
adverse effects in animals
83
pharmacologic agents: category D
evidence of human risk, benefits may outweigh risk
84
pharmacologic agents: category X
never to be used in pregnancy
85
physiological changes: uterus
- Week 12: above symphysis pubis
- Week 20: reach umbilicus
- Week 36: touches the xiphoid process
86
physiological changes: ovarian
- Ovulation
- Amenorrhea
87
physiological changes: cervical
- Increased vascularity
- Mucous plug
- Goodell sign
88
physiological changes: vaginal
- Increased vascularity, Chadwick’s sign
- Increase in vaginal secretions, Increased acidity
89
physiological changes: integumentary
- Striae
- Linea nigra
- Chloasma
90
physiological changes: breast
- Size increase, Areola darkens
- Week 16: colostrum can be expelled
91
physiological changes: cardiovascular
- Weeks 16-18: blood volume increases 30%-50%
- Pseudomamma
- Cardiac output increases
- Heart rate increases by 10 BPM
- Fibrinogen increases by 50 %
92
physiological changes: respiratory
- Congestion
- SOA
- Increased RR
- Diminished lung sounds
93
physiological changes: renal
- Increased urine output
- Increased frequency
- Urinary tract infection
- Kidney stones and hydronephrosis
- Urine stays longer increasing risk for pyelonephritis
94
physiological changes: skeletal
- Calcium, phosphorus
- Pelvic ligaments joints
- Relaxin
95
physiological changes: gastrointestinal
- Early n/v, later decreased gastric motility
- Constipation, heart burn, flatulence, fluid retention
96
physiological changes: vascular
- Vasoconstriction
- Nasal stuffiness, gum swelling
- Spider veins
97
fetal circulation
Blood bypasses the liver > inferior vena cava > right atrium > left atrium > aorta > head and lower body
98
ductus venous
- Oxygen rich blood from the umbilical vein is shunted past the liver
- To the inferior vena cava
99
foramen ovale
- Diverts blood from the right atrium
- Into the left atrium
- Bypasses the lungs
100
ductus arteriosus
- Diverts blood from the pulmonary artery
- By connecting the pulmonary artery to the aorta
- Bypassing the lungs
- Oxygen rich blood goes to the head
- Mixed blood goes to the lower body
101
What determines sexual maturation?
Determined at conception
102
What hormone does a male embryo produce?
Testosterone
103
What hormones do female embryos produce?
Estrogen and progesterone
104
What is the primary female sex hormone?
Estrogen
105
What are the functions of estrogen?
* Development of secondary sex characteristics
* Regulates the menstrual cycle by proliferation of the endometrial lining
106
What is the function of progesterone?
* Decreases uterine motility and contractility
* Prepares the uterus for implantation after fertilization
* Readies the breast for lactation during pregnancy
107
What hormone is released from the hypothalamus?
Gonadotropin-Releasing Hormone (GnRH)
108
What does FSH stimulate?
* Corpus luteum
* Follicle
* Ovum
* Sac to mature
109
What is the role of LH?
Causes the release of ovum
110
What happens to estrogen levels if pregnancy occurs?
The corpus luteum continues to produce estrogen and progesterone
111
When does female ovulation occur?
14 days before menstrual period
112
What is the sperm count in male ejaculation?
35-200 million sperm
113
Where does fertilization occur?
In the distal third of the fallopian tube
114
What is the significance of implantation?
Occurs in the upper third portion of the uterus where the placenta develops
115
How many chromosomes are in the human genome?
46 chromosomes
116
What is the difference between genotype and phenotype?
* Genotype: all the information inside the DNA
* Phenotype: what is expressed
117
What does an autosomal dominant disorder require?
Only 1 copy of the gene
118
What is needed for an autosomal recessive disorder to manifest?
Both parents must have a copy of the gene, and the infant needs 2 copies
119
What are presumptive signs of pregnancy?
* Breast changes
* Nausea/Vomiting
* Amenorrhea
* Increased urination
* Fatigue
* Uterine enlargement
* Quickening
* Skin changes
120
What are probable signs of pregnancy?
* Positive pregnancy test
* Abdominal enlargement
* Chadwick’s sign
* Goodell’s sign
* Hegar’s sign
* Braxton Hicks
121
What confirms a positive sign of pregnancy?
* FHR heard separate from maternal HR
* Fetal movement felt by examiner
* Ultrasound
122
What is the duration of a typical pregnancy?
40 weeks
123
What are the three trimesters of pregnancy?
* First trimester: weeks 1-13
* Second trimester: weeks 14-27
* Third trimester: weeks 28-40
124
What is the embryonic period's duration?
Weeks 3-8
125
What happens during organogenesis?
Differentiated/specialized body cells develop
126
What are the three germ layers and their derivatives?
* Ectoderm: brain, spinal cord, skin
* Mesoderm: muscle, bone, heart
* Endoderm: lining of GI tract, respiratory tract
127
What is the longest period of pregnancy called?
Fetal period
128
What defines a monozygotic pregnancy?
Identical twins from one ovum and one sperm
129
What defines a dizygotic pregnancy?
Fraternal twins from two separate ova and two separate sperm
130
What is the function of the placenta?
* Provides oxygen
* Nutrients
* Hormones
* Immune system support
* Waste removal
131
What hormone thickens the lining of the uterus?
Human Chorionic Gonadotropin (HCG)
132
What does Human placental lactogen (HPL) regulate?
Glucose
133
What is the structure of the umbilical cord?
AVA: one vein and two arteries
134
What does the amniotic fluid do?
* Maintains fetal temperature
* Permits symmetric growth and development
* Cushions and prevents cord compression
* Promotes fetal movement
135
What are male factors contributing to infertility?
* Sperm count
* Erection
* Ejaculation
* Seminal fluid
136
What are female factors contributing to infertility?
* Endometriosis
* Ovulation disorders
* Tubal occlusions
* Cervical abnormalities
137
What are some treatments for infertility?
* Surgery
* Therapeutic insemination
* Intrauterine Insemination (IUI)
* In vitro fertilization (IVF)
138
What are teratogens?
Substances that can cause developmental abnormalities in a fetus
139
What are the TORCH infections?
* Toxoplasmosis
* Other (HIV, syphilis, etc.)
* Rubella
* Cytomegalovirus
* Herpes Simplex Virus (HSV)
140
What is the classification of pharmacologic agents in pregnancy?
* Category A: safest
* Category B: no risk in animals
* Category C: adverse effects in animals
* Category D: evidence of human risk
* Category X: never to be used
141
What physiologic change occurs in the uterus by week 12?
Above symphysis pubis
142
What is the role of the ductus venosus?
Shunts oxygen-rich blood from the umbilical vein past the liver to the inferior vena cava
143
What is the function of the foramen ovale?
Diverts blood from the right atrium into the left atrium, bypassing the lungs
144
What does the ductus arteriosus connect?
The pulmonary artery to the aorta, bypassing the lungs
