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NURS ADN004 Maternity > Week 1 Chapters 3 and 10 > Flashcards

Week 1 Chapters 3 and 10 Flashcards

1
Q

Antepartum Nursing includes

A

Presentation 1

A and P of the Reproductive System

Menstrual Cycle

Genetics

Fetal Development

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2
Q

Pelvis includes

A

Bones :
- Inominate Bones: ilium, ischium, pubic bone
- Sacrum
- Coccyx

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3
Q

Bony Structures of the Female Reproductive System includes

A

Sacral Promontory
Ischial Spines
Symphasis Pubis
Linea Terminalis
Ischial Tuberosities
Pubic Arch

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4
Q

Pelvic Divisions Include

A

Inlet

Mid Pelvis

Outlet

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5
Q

Bordered by linea terminalis and upper third of sacrum

A

Inlet

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6
Q

Bordered by upper third of sacrum and ischial spines

A

Mid Pelvis

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7
Q

Bordered by ischial spine, coccyx and ischial tuberosities

A

Outlet

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8
Q

True Pelvis includes

A

Midplane and Outlet

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9
Q

False Pelvis Includes

A

Inlet

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10
Q

Female Pelvic Type

A

Gynecoid

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11
Q

Male Pelvic type

A

Android

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12
Q

Widest in posterior aspect of pelvic types

A

Anthropoid

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13
Q

Flat and shallow pelvic type

A

Platypelloid

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14
Q

External Female Genetalia Includes

A

Differences related to age, number of pregnancies, race and heredity

Mons Pubis
Labia Majora and Minora
Clitoris
Vaginal Vestibule
Perineum

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15
Q

External genetalia expands how far to get the baby out?

A

13.5 inches

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16
Q

Muscular area between fourchette and anus

A

Perineum

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17
Q

Composed of glandular tissue, fatty and connective

Increases with size with puberty, pregnancy, and lactation

A

Breast

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18
Q

Supported by suspensory Coopers Ligament

Contains Nipple and Areola

A

Breast

Nipple is erectile tissue with numerous openings
Very sensitive
Areola contains smooth muscle fibers and sebaceous glands to lubricate the nipple

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19
Q

Abundant Vascular Supply
Structures
Organs for sexual arousal
Lactation

A

Breast

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20
Q

Muscular organ that is thick walled and hollow in non pregnant state

A

Uterus

Becomes thin walled sac late in pregnancy

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21
Q

Components of Uterus includes

A

Fundus
Corpus
Cervix

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22
Q

Outer layer of the Uterus

A

Serosal layer outer layer: Peritoneum

Muscle layer is myometrium - composed of smooth muscle fibers

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23
Q

Muscle fibers of Uterus include

A

Longitudinal

Interlacing Figure Eight

Circular Fibers

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24
Q

Outer Muscle layer
thick fibers located in the fundus
Function is that of expulsion

A

Longitudinal

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25
Q

Middle muscle layer
Located around capillaries and arterioles, function is that of hemostasis

A

Figure Eight

Interlacing

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26
Q

Located near the cervix
Inner layer of fibers
Weak fibers
Function close to cervical anal

A

Circular Fibers

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27
Q

Involuntary muscle that can even function with spinal damage

A

Uterus

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28
Q

Triple Gradient Theory

A

How the uterine functions

Contractions are stronger in the upper parts of the uterus than lower parts

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29
Q

When upper portion of uterus becomes thicker and shorter what does it promote?

A

Promotes the descent of the fetus toward lower uterine segment

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30
Q

Mucosal layer of uterus in non pregnant women

A

Endometrium

Pregnant called Decidua

Has the ability to proliferate and slough in response to hormone levels

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31
Q

The uterus is suspended in the pelvis by

A

10 ligaments

Types include broad, round, ovarian, and uterosacral

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32
Q

Located at the terminal end of the uterus

Elastic characteristic which allows effacement and dilation during labor

A

Cervix

Secretes fluid - Bacteriostatic quality and enhances spermatozoa motility and survival

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33
Q

Musculo-membranous tube

Female organ copulation
Birth Canal

A

Vagina

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34
Q

Capable of great distention from rugae (foldings)
Few Nerve Endings

A

Vagina

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35
Q

Formed from sloughed epithelial cells containing glycogen which interact with bacteria in the vagina

A

Vaginal Discharge

Doderiens Bacilli- Produces lactic acid

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36
Q

This contributes to self cleaning abilities of the vagina

A

Lactic Acid

Acidic pH which protects the vagina from infection

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36
Q

Uterus is an essential organ

A

FALSE

Mom goes top physiological crisis, blood and oxygen will be shunted away from the uterus and the fetus

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37
Q

Tubular structures located either side of the uterus; arising from the fundal portion of the uterus

A

Fallopian Tubes

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38
Q

Propel fertilized ovum to the uterus
Nourish the fertilized ovum during transport

A

Functions of the Fallopian Tubes

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39
Q

Composed of smooth muscle
Has peristaltic motion
Three components
- Isthmus
- Ampulla- Site of fertilization
- infundibulum

A

Characteristics of Fallopian Tubes

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40
Q

Ovoid organs adjacent to fallopian tubes and uterus

A

Ovaries

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41
Q

Characteristics of Ovaries

A

Ova are formed in the fetal state

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42
Q

Mature and release an ovum for fertilization each menstrual cycle

A

Ovaries Functions

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43
Q

Female infant is born with all the ova she will ever produce

A

False

Current info contradicts this theory

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44
Q

Expulsion of inner uterine occurring monthly

Marks the beginning and end of each menstrual cycle

A

Menstruation

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45
Q

Establishment of menstruation in females

A

Menarche

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46
Q

Frequency variable of menstrual cycles

A

21to36 days

average of 28 days

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47
Q

GnRH
FSH and LH
Estrogen
Progesterone

A

Hormone

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48
Q

Hormone Sequence

A

Hypothalamus
GnRH
Pituitary
Stimulates LH and FSH
Hits Ovaries
Then OVULATION

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49
Q

Timing of Menstrual Cycle based on

A

28 day cycle

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50
Q

Ovarian Phase

A

Day 1-13
Follicular Phase
- Development of the follicle from FSH
-Developing follicle secreted increasing amounts of Estrogen

Day 14 Ovulation
- Release of mature ovum

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51
Q

Luteal Phase includes days

A

15-28

Formation of the corpus luteum

Corpus luteum secretes progesterone and some estrogen

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52
Q

When does corpus luteum degeneration begins

A

Day 22

and essentially complete by day 26-28 if no intervening factor

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53
Q

Uterine Phase day 1-5

A

Menses

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54
Q

Uterine Phase days 6-14

A

Proliferative Phase

Changes of endometrium due to Estrogen

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55
Q

Uterine Phase 15- 28

A

Secretory Phase

Changes in endometrium due to progesterone

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56
Q

Increased Endometrium lining
Hypertrophy of endometrial secreting gland
Vasodilation of endometrial arterioles

A

Proliferative Stage

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57
Q

Extensive increase in endometrial lining
Secretion of Endometrial glands
Continued elongation and corkscrew
development of endometrial arteriole

A

Secretory Stage Changes

58
Q

Ovarian Cycle Includes

A

Follicular Phase
Ovulation
Luteal Phase

59
Q

Day 1 to Ovulation approximately 10to14 days

A

Follicular Phase

60
Q

Day 14 to 28th day cycle

A

Ovulation Day

61
Q

Day 15 to 28th day of Menstrual Cycle

A

Luteal Phase

62
Q

The endometrial cycle includes

A

Proliferative phase
Secretory phase
Ischemic phase
Menstrual phase

63
Q

Produced in the gonads, pituitary gland, placenta, corpus luteum and other organs

A

Inhibin

64
Q

FSH stimulates the secretion of ___________ from the granulosa cells of the ovarian follicles in the ovaries

A

Inhibin

65
Q

Inhibin suppresses______.

A

FSH

66
Q

Low levels of estrogen and progesterone acts on__________.

A

Menses

Then sends message to hypothalamus to produce GnRH

GnRH stimulates Anterior Pituitary to secrete FSH

Then stimulates ovary to begin follicular development

Follicles secrete levels of Estrogen

Graafian Follicle Dominant follicle produces increased levels of estrogen Estriodiol

67
Q

Increased estrogen causes endometrium to change leading to what?

A

FSH decreases due to negative feedback caused by increased estrogen

Increases in estrogen also causes LH to increase from the Anterior Pituitary - Prostaglandins also increase)

68
Q

Day 14 Ovulation leads to

A

Corpus Luteum develops with increase estrogen and progesterone

LH decreases

Corpus Luteum will regress if no fertilization in day21-28

Estrogen and progesterone drop

Menses Occurs

Cycle begins again

69
Q

Summary of Menstrual Cycle Hormones

A

LH rises produces estrogen
Estrogen produced by follicle estrogen levels rise inhibiting output of LH
Ovulation occurs after LH surge, damages estrogen and declines
Establishes Corpus Luteum produces estrogen and progesterone
Estrogen and Progesterone rises and suppress LH
Lack LH degenerates corpus luteum
Cessation of the corpus luteum means decline in estrogen and progesterone
Decline of ovarian hormones ends negative effect on secretion of LH
LH secreted and menstrual begins again

70
Q

Mother contributes 2

A

X chromosomes

71
Q

Father contributes

A

X and Y chromosome

Father responsible for determining sex of fetus

72
Q

Each sex cell contains how many chromosomes

A

22 and 1 sex chromosome

73
Q

Total of how many chromosomes

A

44 plus 2 sex chromosomes = 46
either XX
or XY

74
Q

Male sex cell is

A

SpermatozoanF

75
Q

emale sex cell is

A

Ovum

76
Q

When does ovulation take place?

A

day 14

77
Q

Mature ovum is released by

A

Follicle and swept into the fallopian tube

78
Q

Ovum is propelled into?

A

Ampullar portion

and awaits the spermatozoa

Ovum only viable for 24 hours !

79
Q

What is released into the vagina during process of fertilization?

A

Coitus
Spermatozoa

80
Q

How many sperm cells make it to fallopian tube?

A

50-100

Survive in female reproductive tract for 2-3 days

81
Q

Capacitation

A

Makes the spermatozoan capable of fertilization takes place

During fertilization journey

82
Q

Only one spermatozoa penetrates ovum

A

TRUE

After penetration a biochemical reaction occurs which make the cell membrane impervious to penetration of more spermatozoa

83
Q

Where does fertilization or conception take place

A

The ampulla

Now fertilized ovum contains all genetic material to form fetus and now called zygote

84
Q

Ovum transport slowly towards the uterus and will take

A

3-4 days

85
Q

What aids ovum transport?`

A

Peristaltic activity of fallopian tubes and cilia on the inner aspect of the tubes

86
Q

How is the Ovum nourished?

A

By the secreting glands in the fallopian tube

87
Q

The fertilized ovum is protected and nourished by what two layers?

A

Zona Pellucida
Corona Radiata

88
Q

First weeks of human development

A

Implantation 6 days

Blastocyte 4 days

Morula - 3days
Clevage - 1 day

(Reverse ordered)

Then Fertilization

Follicular development, ovulation, fertilization, and transport to uterus where implantation occurs

89
Q

Cell division takes place when?

A

24 hours after fertilization

Cells duplicated not overall size

Then continues at 22 hr intervals

90
Q

By time fertilized ovum reaches uterus entrance is at

A

16 cell stage called morula

91
Q

Zygote floats in uterus for another 3-4 days and during this time the cells have

A

Differentiated

92
Q

Entire structure then assumes form called

A

Blastocyte

93
Q

Outer ring of cells are called

A

Trophoblastic cells and will become the fetal membranes and placenta

94
Q

Inner clump of cells are called

A

Embryoblast and will become the fetus

95
Q

What do trophoblastic cells secrete

A

HCG

HCG will prolong the viability of the corpus luteum it will continue to secrete progesterone and estrogen for about 8-11 weeks

96
Q

Rapid Cell Division that leads to multicellular embryo

A

Cleavage

Zygote-Eight Cell Stage-Blastula- Blastocoel- Gastrulation- Gastrula

97
Q

When does implantation take place on

A

About day 22-23 or 7-10 days after ovulation

98
Q

Zygote simply buries itself in the uterine endometrium which is now called the

A

Decidua

99
Q

Trophoblastic cells also contain a substance that can erode some of the superficial endometrial tissue

A

True

100
Q

Why is it important for the zygote to burrow deeply?

A

Tap into the maternal vascular system for a nourishment source

101
Q

Trophoblastic cells will develop what?

A

Chorionic Villi

Project deep into the decidua and open the ends of the maternal arterioles

102
Q

Implantation process allows for what?

A

pooling of maternal blood which facilitates oxygen and nutrient transport to the embryo and exchange of waste products

Rudimentary form of the placenta

103
Q

Fertilized ovum, zygote

A

Conception to Implantation

104
Q

Implantation to 8 weeks after fertilization

A

Embryo

105
Q

8 weeks to birth

A

Fetus

106
Q

Development of major organ system is essentially complete by end of embryo stage

A

Organogenesis

Susceptibility to teratogens is greatest at this time

107
Q

Term used to describe the ability of the fetus to survive outside of the uterus

A

Viability

Viable will be 22-24 weeks

108
Q

Maturation takes place in an orderly and predictable manner

A

True

Maturation is cephalocaudal

109
Q

Skin, nails, nervous system, tooth enamel what germ layer?

A

Ectoderm

110
Q

Connective Tissue, teeth, muscles and blood vessels develop from what layer?

A

Mesoderm

111
Q

Epithelial lining of GI and respiratory tract, endocrine glands, auditory canals developed from what layer?

A

Entoderm

112
Q

First system to develop is

A

Cardiovascular System

113
Q

When is functional heart beating by?

A

3 weeks post conception

Heart developmentally complete by end of 8 weeks

Early development due to need for nourishment system and waste removal system

Fetal Circulation System

114
Q

Placenta is formed by

A

Embryonic and uterine tissues

115
Q

Factors that facilitate fetal oxygenation

A

FHR 110-160

Fetal hemoglobin carries more o2 per molecule and forms tighter bond than hemoglobin

Hemoglobin and HCT values are HIGHER

116
Q

When does the respiratory system develop?

A

Week 4

117
Q

Larynx, trachea, and bronchi and lung buds develop from what weeks?

A

4-17 weeks

118
Q

Vascular structures and primitive alveoli form at what weeks?

A

16-24 weeks

119
Q

Weeks 24-40 of the respiratory system what develops?

A

Maturation and increased number of alveoli; secretion of surfactant

120
Q

The phospholipid is secreted by

A

Surfactant

Alveolar cells

Peak production at 35 weeks

Purpose is to minimize surface tension to keep alveoli partially open on exhalation

121
Q

What are the components of surfactant ?

A

Lecithin Sphingomyelin and Phosphogycerlolipid

122
Q

How can adequate amounts of surfactant be tested by?

A

Amniotic Fluid

These tests should be LS ratio 2:1 and PG level (positive)

123
Q

Which system is very sensitive to oxygen levels?

A

Neurological System

124
Q

Brain development during pregnancy by cellular hyperplasia and continues after birth

A

True

125
Q

Neural Crest evolves into the

A

PNS develop by 4 weeks

126
Q

Neural tube evolves into the

A

CNS

127
Q

Sensory development documented response to

A

Painful stimuli
well developed sense of hearing
Taste buds developed; distinguish sweet vs sour

128
Q

When do digestive enzymes develop?

A

Third Trimester

129
Q

Rudimentary system by 4 weeks

A

GI System

130
Q

Fetal stool that develops during third trimester but normally remains in gut until after birth

A

Meconium

131
Q

Kidneys are formed by____________`

A

2-3 weeks

Functional by 10 weeks

Kidneys are still immature at birth unable to concentrate urine

132
Q

Average is about 1 liter at term
Volume changes constantly
Electrolyte similar to blood
Also contains shed fetal cells
Sterile Fluid

A

Amniotic Fluid

133
Q

Placenta forms from

A

Trophoblastic Cells

134
Q

What creates a larger surface area for pooling of maternal blood, which facilitates nutrient/ waste transfer

A

Branching of Villi

135
Q

Embryo/ Fetus is totally dependent on

A

Maternal Vascular system to meet nutrient and oxygen needs

136
Q

Branching of villi forms what?

A

Cotyledons

137
Q

Maternal side rough and bright red is known as

A

Duncan

138
Q

Fetal side that is grey and shiny in appearance

A

Schultz

139
Q

When is placenta functional by

A

End of third week

Continues to grow in size and function until 40 weeks

140
Q

Name the Three Shunts during Fetal Life

A

Ductus Venosus

Ductus Arteriosus

Foramen Ovale

141
Q

Connects the umbilical vein to the inferior vena cava and bypasses the liver

A

Ductus Venosus

142
Q

Connects the main pulmonary artery to the aorta and bypasses the lungs

A

Ductus Arteriosus

143
Q

Anatomic opening between the right and left atrium and bypasses right ventricle

A

Foramen Ovale

NURS ADN004 Maternity (11 decks)

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