Week 1 Flashcards
1
Q
What does pelvic girdle not include?
A
Coccyx
2
Q
What is each hip bone a fusion between?
A
- Ilium
- Ischium
- Pubis
3
Q
What muscle attaches to iliac fossa?
A
Iliacus
4
Q
What is part of both ischium and pubis?
A
Ischiopubic ramus
5
Q
What part of ischium to yo sit on?
A
Ischial tuberosity
6
Q
What attaches at pubic tubercle?
A
Inguinal ligament
7
Q
What type of joint is pubic symphysis?
A
Secondary Cartilaginous
8
Q
What does the inguinal ligament attach between?
A
ASIS and pubic tubercle
9
Q
On vaginal examination what can be felt at 4 and 8 o clock positions?
A
Ischial spines
10
Q
What ligament attaches between sacrum and iscjhial spine?
A
Sacrospinous ligament
11
Q
What does sacrotuberous ligament attach to?
A
Sacrum and ischial tuberosity
12
Q
What ligaments ensure the inferior part of sacrum is not pushed superiorly when weight is suddenly transferred vertically through the vertebral column (jumping/late pregnancy)?
A
Sacrotuberous ligament
Sacrospinous ligament
13
Q
At what point in pregnancy do sacrospinous and sacrotuberous ligaments relax?
A
Later pregnancy
14
Q
What do the sacrospinous ligament and sacrotuberous ligament form?
A
Lesser and greater sciatic foramen
15
Q
What is a straddle injury?
A
Fracture of all four pubic rami
16
Q
What is at risk of damage in trauma to bony pelvis?
A
Common iliac artery + common iliac vein
17
Q
What diamteres of the female pelvis are larger than the males both at pelvic inlet and outlet?
A
AP
Transverse diamters
18
Q
Is the subpubic angle or pubic arch in female wider than male?
A
Yes
19
Q
What can be said about the pelvic cavity in a female?
A
Shallower
20
Q
What is the vertex (fetal skul0?
A
Area of foetal skull: oiutlined by anterior and posterior fontanelles and the parietal eminences
21
Q
What is longer - occipitofrontal diamter or biparietal diamter in foetal skull?
A
Occipitofrontal - foetal head longer than it is wide
22
Q
At the pelvic inlet what diamter is wider- AP or transverse?
A
Transverse - foetus enters pelvic cavity facing either right or left
23
Q
What is the distance of the foetal head from ichial spine referred to as?
A
Station - negative number means head is superor to spines, positive number means head is inferior
24
Q
When descending through the pelvic cavity what should be said about foetal head?
A
Rotate
Flexed position
25
At the pelvic outlet the AP diamter is wider than transverse diameter so baby should ideally leave cavity in what position?
Occipitoanterior OA position and head in extension
26
What is the term for any treatment in which involves gametes outside the body?
Assisted conception treatment ACT
27
What is the biggest cause of infertility?
Male factor
28
What is the alcohol limit for treatment ACT?
limit up to 4 units a week
29
What blood borne viruses are screened for in ACT?
Hep B/C
| HIV
30
How do you assess ovarian reserve?
Antral follicle count or AMH
31
a simple procedure that uses a syringe to place semen into a woman's vagina to assist her in getting pregnant?
Donor insemination
32
a fertility treatment that involves placing sperm inside a woman's uterus to facilitate fertilization. The goal of IUI is to increase the number of sperm that reach the fallopian tubes and subsequently increase the chance of fertilization?
Intra-uterine Insemination
33
During what, are mature eggs are collected (retrieved) from your ovaries and fertilized by sperm in a lab
IVF
34
An in vitro fertilization procedure in which a single sperm is injected directly into an egg?Defective sperm function remains the single most important cause of human infertility.
Intracytoplasmic sperm injection ICSI
35
What fertility treatment can be used for unexplained infertility, mild or moderate endometriosis and mild male factor infertility?
Intra Uterine Insemination
36
What fertility treatment is indicated in unexplained greater than 2 years duration, pelvic disease including tubual disease, anovulatory infertility, male factor infertility and pre-implantation genetic diagnosis?
IVF
37
What is given as an injection to reduce cancellation from ovulation and allows precise timing of oocyte recovery by using HCG trigger?
Down regulation using synthetic gonadotrophin releasing hormone agonist
38
Name three side effects of synthetic gonadotrophin releasing hormone?
Hot flushes and mood swings
Nasal irritation
Headaches
39
What does injection of gonadotrophin hormone with (FSH or LH) cause?
Ovarain stimulation including Foolicular development
40
Name some side effects of ovarian stimulation?
Mild allergic reactions
| Ovarian Hyperstimulation Syndrome
41
What four things are looked for in assessment of sperm?
1. Volume
2. Density
3. Motility
4. Progression
42
What state of human embryo implants?
Blastocyst
43
How many embryos are normally transferred?
1 - then luteal support (progesterone) is given.
44
What fertility treatment is indicated in severe male factor ifertility, previous failed IVF and preimplantation genetic diagnosis?
Intra cytoplasmic sperm injection (ICSI)
45
Name a complication of assisted reproduction techniques?
Ovarian hyperstimulation syndrome
46
Abdominal pain/bloating
Nausea/diarrhoea
Breathlessness
OHSS
47
If a patient gets OHSS after embryo transfer how is it treated?
1. Antithrombotic - TED stockings and fragmin
48
Is multiple pregnancy common in IVF?
Yes
49
What involves downregulation, ovarian stimulation, oocyte retrieval, embryo transfer and luteal support?
IVF
50
What is the highly vascular region of the ovary?
Medulla
51
What arteries enter the hilum of the ovary from the braod ligament and supply blood to the organ?
Helicine arteries
52
Where is the common site for ovarian cancer?
Simple cuboidal epithelium
53
Underneath the ovary's simple cuboidal epithelium, what is the dense connective tissue called?
tunica albuginea
54
Early in embryonic development (around week 6) germ cells from the yolk sac invade the ovaries and proliferate by mitosis to form what?
OOgonia
55
What do oogonia undergo development and division via meiosis to form?
Mature oocytes or ova
56
What is the term for the development of oocytes, the female germ cells, from oogonia?
Oogenesis
57
What is folliculogenesis?
Growth of follicle, which consists of the oocyte and any associated support cells
58
What is the name of the process that is loss of oogonia and oocytes?
Atresia
59
Before birth, meiosis begins in the oocyte, but halts at what phase?
Prophase I
60
What happens if the oocyte fails to associate with pregranulosa cells (follicel cells)?
It dies
61
Initially the pregranulosa cells in a primoirdial follicle are squamous but what happens to them when follicle enters growth phase?
They become cuboidal
62
In a primary follicle, stromal cells associate with the outside of the follicle and go on to from what?
Theca
63
What special layer forms between the oocyte and the granulosa cells in a primary follicle?
Zona pellucida
64
The theca interna secretes oestrogen precurosrs which are converted to oestrogen by what?
Granulosa cells
65
In follicular development a space called the antrum forms and enlarges in the granulosa layer to form what?
Secondary follicle
66
What are the very largest antral follicles called?
Graafian follicles
67
One day before ovulation (release of oocyte from follicle) what happens to the largest Graafian follicle?
It completes meiosis 1 and produces one cell called a secondary oocyte
68
Once the secondary oocyte begins second phase of meiosis where does it stop/
Metaphase II
69
After ovulation what happens to the follicle?
It turns into corpus luteum with the theca and granulosa cells secreting oestrogen and progesterone
70
If no implantation occurs what happens to corpus luteum?
Becomes corpus albicans
71
If implantation occurs what does the placenta secrete to prevent degeneration of corpus luteum?
HCG - maintains progesterone levels
72
Where does fertilisation usually occur in uterine tube?
Ampulla
73
What part of uterine tube has folded mucosa and lined by simple columnar epithelium with ciliated cells and secretory cells?
Ampulla
74
What part of uterine tube has epithelium lining mostly secretory with few ciliated cells?
Isthmus
75
What are the three layers of uterus?
1. Endometrium
2. Myometrium
3. Perimetrium
76
What are the two layers of the endometrium and which one sheds?
Stratum Functionalis - sheds
| Stratum Basalis
77
What phase of the uterus involves glands becoming coiled with corkscrew appearance and secreting glycogen?
Secretory phase
78
During what phase do arterioles in the functionalis undergo constriction, depriving the tissue of blood and causing ischemia, with resultant tissue breakdown, leakage of blood and tissue sloughing?
Menstrual phase
79
On the cervix vaginal surface it has stratified squamous epithelium - what covers the transitioning?
Simple columnar epithelium
80
What zone does cervical cancer most frequently occur in?
Transition zone
81
Four layers of vagina?
1. Non-keratinised stratified squamous epithelium
2. Lamina propria
3. Fibromuscular layer
4. Adventitia
82
What prevents growth of pathogenic bacteria in vagina?
Commensal bacteria metabolising glycogen to lactic acid
83
Keratinized epithelium extends into the opening of the vagina to the level of the hymen, where there is a transition to non-keratinized stratified squamous epithelium?
Labia minora
84
Contains two tubes of erectile vascular tissue (corpora cavernosa), covered by a fibrocollagenous sheath covered by skin with rich innervation and a thin epidermis.
Clitoris
85
In relation to issues specfiic to infertiltiy, what is there a right for?
To procreate
86
In law, how long is embryo research permitted up to?
14 days (when primitive streak appears), but abortion permissible up to 24 weeks
87
Name a few guidelines for NHS funded fertiltiy treatment in Scotland?
1. Unexplained infertility of at least 2 years
2. Female partner under age of 40
3. Female BMI between 18.5 and 30
4. Both partners non smoking
5. Both partners abstain from illegal substances
6. Neither partner should drink before treatment
7. Not have a genetic child
88
Give 5 examples of code of practice from Human Fertilisation and Embryology Authority?
1. Right to people getting proper consideration of their request
2. Concerns for welfare of child
3. Pleimplantation tissue typing
4. Sex selection for medical conditions
5. Embryo with 2 genetic mother for mitochondrial disease
89
What are the four ethical values
1. Autonomy - right to desicion
2. Beneficence - best interset
3. Non maleficence - do no harm
4. Justice - fairness and equality
90
When discussing reproductive ethics what 4 considerations must be made?
1. Is it legal?
2. Is it practical?
3. Do we have all appropriate information?
4. Is treatment ethical for all involved (principles)
