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
2
Q
Pelvis includes
A
Bones :
- Inominate Bones: ilium, ischium, pubic bone
- Sacrum
- Coccyx
3
Q
Bony Structures of the Female Reproductive System includes
A
Sacral Promontory
Ischial Spines
Symphasis Pubis
Linea Terminalis
Ischial Tuberosities
Pubic Arch
4
Q
Pelvic Divisions Include
A
Inlet
Mid Pelvis
Outlet
5
Q
Bordered by linea terminalis and upper third of sacrum
A
Inlet
6
Q
Bordered by upper third of sacrum and ischial spines
A
Mid Pelvis
7
Q
Bordered by ischial spine, coccyx and ischial tuberosities
A
Outlet
8
Q
True Pelvis includes
A
Midplane and Outlet
9
Q
False Pelvis Includes
A
Inlet
10
Q
Female Pelvic Type
A
Gynecoid
11
Q
Male Pelvic type
A
Android
12
Q
Widest in posterior aspect of pelvic types
A
Anthropoid
13
Q
Flat and shallow pelvic type
A
Platypelloid
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
15
Q
External genetalia expands how far to get the baby out?
A
13.5 inches
16
Q
Muscular area between fourchette and anus
A
Perineum
17
Q
Composed of glandular tissue, fatty and connective
Increases with size with puberty, pregnancy, and lactation
A
Breast
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
19
Q
Abundant Vascular Supply
Structures
Organs for sexual arousal
Lactation
A
Breast
20
Q
Muscular organ that is thick walled and hollow in non pregnant state
A
Uterus
Becomes thin walled sac late in pregnancy
21
Q
Components of Uterus includes
A
Fundus
Corpus
Cervix
22
Q
Outer layer of the Uterus
A
Serosal layer outer layer: Peritoneum
Muscle layer is myometrium - composed of smooth muscle fibers
23
Q
Muscle fibers of Uterus include
A
Longitudinal
Interlacing Figure Eight
Circular Fibers
24
Q
Outer Muscle layer
thick fibers located in the fundus
Function is that of expulsion
A
Longitudinal
25
Middle muscle layer
Located around capillaries and arterioles, function is that of hemostasis
Figure Eight
Interlacing
26
Located near the cervix
Inner layer of fibers
Weak fibers
Function close to cervical anal
Circular Fibers
27
Involuntary muscle that can even function with spinal damage
Uterus
28
Triple Gradient Theory
How the uterine functions
Contractions are stronger in the upper parts of the uterus than lower parts
29
When upper portion of uterus becomes thicker and shorter what does it promote?
Promotes the descent of the fetus toward lower uterine segment
30
Mucosal layer of uterus in non pregnant women
Endometrium
Pregnant called Decidua
Has the ability to proliferate and slough in response to hormone levels
31
The uterus is suspended in the pelvis by
10 ligaments
Types include broad, round, ovarian, and uterosacral
32
Located at the terminal end of the uterus
Elastic characteristic which allows effacement and dilation during labor
Cervix
Secretes fluid - Bacteriostatic quality and enhances spermatozoa motility and survival
33
Musculo-membranous tube
Female organ copulation
Birth Canal
Vagina
34
Capable of great distention from rugae (foldings)
Few Nerve Endings
Vagina
35
Formed from sloughed epithelial cells containing glycogen which interact with bacteria in the vagina
Vaginal Discharge
Doderiens Bacilli- Produces lactic acid
36
This contributes to self cleaning abilities of the vagina
Lactic Acid
Acidic pH which protects the vagina from infection
36
Uterus is an essential organ
FALSE
Mom goes top physiological crisis, blood and oxygen will be shunted away from the uterus and the fetus
37
Tubular structures located either side of the uterus; arising from the fundal portion of the uterus
Fallopian Tubes
38
Propel fertilized ovum to the uterus
Nourish the fertilized ovum during transport
Functions of the Fallopian Tubes
39
Composed of smooth muscle
Has peristaltic motion
Three components
- Isthmus
- Ampulla- Site of fertilization
- infundibulum
Characteristics of Fallopian Tubes
40
Ovoid organs adjacent to fallopian tubes and uterus
Ovaries
41
Characteristics of Ovaries
Ova are formed in the fetal state
42
Mature and release an ovum for fertilization each menstrual cycle
Ovaries Functions
43
Female infant is born with all the ova she will ever produce
False
Current info contradicts this theory
44
Expulsion of inner uterine occurring monthly
Marks the beginning and end of each menstrual cycle
Menstruation
45
Establishment of menstruation in females
Menarche
46
Frequency variable of menstrual cycles
21to36 days
average of 28 days
47
GnRH
FSH and LH
Estrogen
Progesterone
Hormone
48
Hormone Sequence
Hypothalamus
GnRH
Pituitary
Stimulates LH and FSH
Hits Ovaries
Then OVULATION
49
Timing of Menstrual Cycle based on
28 day cycle
50
Ovarian Phase
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
51
Luteal Phase includes days
15-28
Formation of the corpus luteum
Corpus luteum secretes progesterone and some estrogen
52
When does corpus luteum degeneration begins
Day 22
and essentially complete by day 26-28 if no intervening factor
53
Uterine Phase day 1-5
Menses
54
Uterine Phase days 6-14
Proliferative Phase
Changes of endometrium due to Estrogen
55
Uterine Phase 15- 28
Secretory Phase
Changes in endometrium due to progesterone
56
Increased Endometrium lining
Hypertrophy of endometrial secreting gland
Vasodilation of endometrial arterioles
Proliferative Stage
57
Extensive increase in endometrial lining
Secretion of Endometrial glands
Continued elongation and corkscrew
development of endometrial arteriole
Secretory Stage Changes
58
Ovarian Cycle Includes
Follicular Phase
Ovulation
Luteal Phase
59
Day 1 to Ovulation approximately 10to14 days
Follicular Phase
60
Day 14 to 28th day cycle
Ovulation Day
61
Day 15 to 28th day of Menstrual Cycle
Luteal Phase
62
The endometrial cycle includes
Proliferative phase
Secretory phase
Ischemic phase
Menstrual phase
63
Produced in the gonads, pituitary gland, placenta, corpus luteum and other organs
Inhibin
64
FSH stimulates the secretion of ___________ from the granulosa cells of the ovarian follicles in the ovaries
Inhibin
65
Inhibin suppresses______.
FSH
66
Low levels of estrogen and progesterone acts on__________.
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
Increased estrogen causes endometrium to change leading to what?
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
Day 14 Ovulation leads to
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
Summary of Menstrual Cycle Hormones
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
Mother contributes 2
X chromosomes
71
Father contributes
X and Y chromosome
Father responsible for determining sex of fetus
72
Each sex cell contains how many chromosomes
22 and 1 sex chromosome
73
Total of how many chromosomes
44 plus 2 sex chromosomes = 46
either XX
or XY
74
Male sex cell is
SpermatozoanF
75
emale sex cell is
Ovum
76
When does ovulation take place?
day 14
77
Mature ovum is released by
Follicle and swept into the fallopian tube
78
Ovum is propelled into?
Ampullar portion
and awaits the spermatozoa
Ovum only viable for 24 hours !
79
What is released into the vagina during process of fertilization?
Coitus
Spermatozoa
80
How many sperm cells make it to fallopian tube?
50-100
Survive in female reproductive tract for 2-3 days
81
Capacitation
Makes the spermatozoan capable of fertilization takes place
During fertilization journey
82
Only one spermatozoa penetrates ovum
TRUE
After penetration a biochemical reaction occurs which make the cell membrane impervious to penetration of more spermatozoa
83
Where does fertilization or conception take place
The ampulla
Now fertilized ovum contains all genetic material to form fetus and now called zygote
84
Ovum transport slowly towards the uterus and will take
3-4 days
85
What aids ovum transport?`
Peristaltic activity of fallopian tubes and cilia on the inner aspect of the tubes
86
How is the Ovum nourished?
By the secreting glands in the fallopian tube
87
The fertilized ovum is protected and nourished by what two layers?
Zona Pellucida
Corona Radiata
88
First weeks of human development
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
Cell division takes place when?
24 hours after fertilization
Cells duplicated not overall size
Then continues at 22 hr intervals
90
By time fertilized ovum reaches uterus entrance is at
16 cell stage called morula
91
Zygote floats in uterus for another 3-4 days and during this time the cells have
Differentiated
92
Entire structure then assumes form called
Blastocyte
93
Outer ring of cells are called
Trophoblastic cells and will become the fetal membranes and placenta
94
Inner clump of cells are called
Embryoblast and will become the fetus
95
What do trophoblastic cells secrete
HCG
HCG will prolong the viability of the corpus luteum it will continue to secrete progesterone and estrogen for about 8-11 weeks
96
Rapid Cell Division that leads to multicellular embryo
Cleavage
Zygote-Eight Cell Stage-Blastula- Blastocoel- Gastrulation- Gastrula
97
When does implantation take place on
About day 22-23 or 7-10 days after ovulation
98
Zygote simply buries itself in the uterine endometrium which is now called the
Decidua
99
Trophoblastic cells also contain a substance that can erode some of the superficial endometrial tissue
True
100
Why is it important for the zygote to burrow deeply?
Tap into the maternal vascular system for a nourishment source
101
Trophoblastic cells will develop what?
Chorionic Villi
Project deep into the decidua and open the ends of the maternal arterioles
102
Implantation process allows for what?
pooling of maternal blood which facilitates oxygen and nutrient transport to the embryo and exchange of waste products
Rudimentary form of the placenta
103
Fertilized ovum, zygote
Conception to Implantation
104
Implantation to 8 weeks after fertilization
Embryo
105
8 weeks to birth
Fetus
106
Development of major organ system is essentially complete by end of embryo stage
Organogenesis
Susceptibility to teratogens is greatest at this time
107
Term used to describe the ability of the fetus to survive outside of the uterus
Viability
Viable will be 22-24 weeks
108
Maturation takes place in an orderly and predictable manner
True
Maturation is cephalocaudal
109
Skin, nails, nervous system, tooth enamel what germ layer?
Ectoderm
110
Connective Tissue, teeth, muscles and blood vessels develop from what layer?
Mesoderm
111
Epithelial lining of GI and respiratory tract, endocrine glands, auditory canals developed from what layer?
Entoderm
112
First system to develop is
Cardiovascular System
113
When is functional heart beating by?
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
Placenta is formed by
Embryonic and uterine tissues
115
Factors that facilitate fetal oxygenation
FHR 110-160
Fetal hemoglobin carries more o2 per molecule and forms tighter bond than hemoglobin
Hemoglobin and HCT values are HIGHER
116
When does the respiratory system develop?
Week 4
117
Larynx, trachea, and bronchi and lung buds develop from what weeks?
4-17 weeks
118
Vascular structures and primitive alveoli form at what weeks?
16-24 weeks
119
Weeks 24-40 of the respiratory system what develops?
Maturation and increased number of alveoli; secretion of surfactant
120
The phospholipid is secreted by
Surfactant
Alveolar cells
Peak production at 35 weeks
Purpose is to minimize surface tension to keep alveoli partially open on exhalation
121
What are the components of surfactant ?
Lecithin Sphingomyelin and Phosphogycerlolipid
122
How can adequate amounts of surfactant be tested by?
Amniotic Fluid
These tests should be LS ratio 2:1 and PG level (positive)
123
Which system is very sensitive to oxygen levels?
Neurological System
124
Brain development during pregnancy by cellular hyperplasia and continues after birth
True
125
Neural Crest evolves into the
PNS develop by 4 weeks
126
Neural tube evolves into the
CNS
127
Sensory development documented response to
Painful stimuli
well developed sense of hearing
Taste buds developed; distinguish sweet vs sour
128
When do digestive enzymes develop?
Third Trimester
129
Rudimentary system by 4 weeks
GI System
130
Fetal stool that develops during third trimester but normally remains in gut until after birth
Meconium
131
Kidneys are formed by____________`
2-3 weeks
Functional by 10 weeks
Kidneys are still immature at birth unable to concentrate urine
132
Average is about 1 liter at term
Volume changes constantly
Electrolyte similar to blood
Also contains shed fetal cells
Sterile Fluid
Amniotic Fluid
133
Placenta forms from
Trophoblastic Cells
134
What creates a larger surface area for pooling of maternal blood, which facilitates nutrient/ waste transfer
Branching of Villi
135
Embryo/ Fetus is totally dependent on
Maternal Vascular system to meet nutrient and oxygen needs
136
Branching of villi forms what?
Cotyledons
137
Maternal side rough and bright red is known as
Duncan
138
Fetal side that is grey and shiny in appearance
Schultz
139
When is placenta functional by
End of third week
Continues to grow in size and function until 40 weeks
140
Name the Three Shunts during Fetal Life
Ductus Venosus
Ductus Arteriosus
Foramen Ovale
141
Connects the umbilical vein to the inferior vena cava and bypasses the liver
Ductus Venosus
142
Connects the main pulmonary artery to the aorta and bypasses the lungs
Ductus Arteriosus
143
Anatomic opening between the right and left atrium and bypasses right ventricle
Foramen Ovale
