Maternal Newborn - Test 2 Chapter 13

Front 1

-the stage of the embryo lasts from day ___ until approx. ____ weeks after conception, when the embryo measures:

Back 1

-the stage of the embryo lasts from day 15 until approx. 8

measures 3 cm from crown to rump (head to butt)

Front 2

-why is the embryonic stage is the most critical time in the development?

Back 2

the development of the organ systems and the main external features

Front 3

what are teratogens


what areas are at risk of problems caused by teratogens?

Back 3

teratogens (substances or exposure that cause abnormal development)

-developing areas with rapid cell division are the most vulnerable to malformation caused by envt

Front 4

-at the end of the ____ week, all organ systems and external structures are present and the embryo is unmistakably human

Back 4

8th

Front 5

Membranes

-at the time of implantation, ___ fetal membranes that will surround the developing embryo begin to form

Back 5

2

Front 6

Membranes

-the _______develops from the trophoblast and contains the chorionic villi on its surface.

Back 6

chorion


the villi increase in size and complexity as the vascular processes develop into the placenta

Front 7

Membranes

-what becomes the covering of the fetal side of the placenta and contains major umbilical blood vessels as they branch out over the surface of the placenta

Back 7

chorion

Front 8

Membranes

-the inner cell membrane _____ develops from the interior cells of the blastocyst

Back 8

(amnion)

Front 9

Membranes

-the cavity that develops b/w the inner cell mass and the outer layer of cells is the :

Back 9

amniotic cavity

Front 10

Membranes

-the developing embryo draws the ______ around itself, forming a fluid-filled sac

Back 10

amnion

Front 11

Membranes

-________becomes the covering of the umbilical cord and covers the chorion on the fetal surface of the placenta

Back 11

amnion

Front 12

amniotic fluid

-derives its fluid by

Back 12

diffusion from the maternal blood

Front 13

amniotic fluid

-the amount of fluid (increases or deccreases) weekly and 800-1200 ml of transparent liquid is normally present at term

Back 13

increases

Front 14

amniotic fluid

does the volume stay the same or change?

Back 14

-the volume of the amniotic fluid changes all the time

(fetus swallows fluid, fluid flows in and out of lungs, and the fetus urinates into the fluid thereby increasing the volume)

Front 15

amniotic fluid
-what are the functions: (7)

Back 15

1- helps maintain constant body temp,
2- source of oral fluid
3- cushions the fetus from trauma,
4- allows freedom of movement for musculoskeletal development,
5- fluid keeps the embryo from tangling with the membranes
6- facilitating growth
7-a repository for waste,

Front 16

-what is important to assess fetal well-being

Back 16

volume of amniotic fluid

Front 17

amniotic fluid

oligohydramnios
-how much fluid is it?
-associated with?

Back 17

-having less than 300 ml of amniotic fluid (oligohydramnios)

is associated with renal abnormalities

Front 18

amnitoic fluid

hydramnios
-how much fluid is it?
-associated with?

Back 18

-having more than 2 L of amniotic fluid (hydramnios)


is associated with GI and other malformations

Front 19

yolk sac

-aids in transferring :

Back 19

- maternal nutrients and oxygen which have diffused through the chorion to the embryo

-blood vessels form to aid transport

Front 20

-blood cells and plasma are manufactured in the ______ during the 2 and 3 weeks while circulation is being established and is forming blood cells

Back 20

yolk sac

Front 21

yolk sac

-at the end of the ____ week, the heart begins to beat and circulate blood

Back 21

3rd

Front 22

-the folding of the embryo during the 4th week results in incorporation of part of the yolk sac into the embryos body as the

Back 22

digestive system

Front 23

-during the 5th week the embryo has curved inward, bringing the connecting stalk to the ventricle side of the embryo. the connecting stalk becomes compressed from both sides by the amnion and forms the :

Back 23

umbilical cord

Front 24

umbilical cord

-composed of how many arteries and how many veins?

what does the artery do?
what does the vein do?

Back 24

-2 arteries carry blood from the embryo to the chorionic villi and 1 vein returns blood to the embryo

Front 25

umbilical cord

-at ____, the cord is 2 cm in diameter an ranges from 30-90 cm long

Back 25

-at term, the cord is 2 cm in diameter an ranges from 30-90 cm long

Front 26

umbilical cord

-connective tissue called Wharton’s jelly, does what? (2)

Back 26

prevents compression of the blood vessels and ensures continued nourishment of the embryo/fetus

Front 27

umbilical cord

-when the cord is wrapped around the fetal neck, it’s called

Back 27

nuchal cord

Front 28

Placenta
-begins to form when?

-the structure of the placenta is complete by the ___ week

Back 28

at implantation

12th

Front 29

Placenta
-the maternal-placental-embryonic circulation is in place by day ____, when the embryonic heart starts beating

Back 29

17

Front 30

Placenta
-by the end of the ____ week, embryonic blood is circulating between the embryo and the chorionic villi

Back 30

3rd

Front 31

Placenta
-what happens to the waste products and carbon dioxide?

Back 31

diffuse into the maternal blood

Front 32

-the placenta functions as a means of

Back 32

metabolic exchange

Front 33

-early functions of the placenta is an

Back 33

endocrine gland that produces 4 hormones necessary to maintain the pregnancy and support the embryo and fetus

Front 34

what is the basis for pregnancy tests??

when can it be detected in maternal serum??

Back 34

-the human chorionic gonadotropin (hCG)


can be detected in the maternal serum by 8-10 days after conception,

Front 35

-the hCG ensures the continued supply of _______ and _______ needed to maintain the pregnancy

Back 35

estrogen and progesterone

Front 36

-miscarriage occurs if:

Back 36

the corpus luteum (which produces progesterone) stops functioning before the placenta is producing sufficient estrogen and progesterone

Front 37

-another protein hormone produced by the placenta is the human chorionic somatomammotropin (hCS)
-what does it stimulate?
-what does it increase? (3)

Back 37

-stimulates maternal metabolism to supply nutrients needed for fetal growth

-increase the resistance to insulin,
facilitates glucose transport across the placental membranes

stimulates breast develop to prepare for lactation

Front 38

-metabolic functions of the placenta are (4)

Back 38

respiration,
nutrition,
excretion,
storage.

Front 39

-(4) things are stored in the placenta for ready access to meet fetal needs

Back 39

-carbs, proteins, calcium, iron

Front 40

-what 6 things pass from maternal blood supply across the placental membrane into the fetal blood, supplying nutrition

Back 40

water,
inorganic salts,
carbs,
proteins,
fats,
vitamins

Front 41

-braxton hicks contractions enhance what?

aiding what?

Back 41

the movement of blood through the spaces

aiding placental circulation

Front 42

-prolonged or too-short intervals b/w contractions during labor result in what?

Back 42

reduce blood flow to the placenta

Front 43

Hematopoietic System

-hematopoiesis, the formation of blood, occurs in the yolk sac beginning in the ___ week

Back 43

3rd

Front 44

Hematopoietic System
-antigenic factors that determine blood type are present in the _______soon after the ______

Back 44

erythrocytes , 6th week


-the Rh negative woman is at risk for isoimmunization in any pregnancy that lasts longer than 6 weeks


Giving these Rh antibodies to an Rh-negative pregnant woman prevents her immune system from producing its own Rh antibodies, which would attack her Rh-positive fetus's red blood cells.

Front 45

the placenta also functions as lungs for the fetus: how?

Back 45

oxygen diffuses from the maternal blood across the placental membrane into the fetal blood, and carbon dioxide diffuses in the opposite direction

Front 46

GI system
when does the digestive system form?

Back 46

-during the 4th week,

Front 47

GI system
--fetus swallows amniotic fluid beginning in the ___ month

Back 47

5th

-gastric emptying and intestinal peristalsis occur

Front 48

GI system
-as the fetus nears term, fetal waste products accumulate where?

Back 48

in the intestines as dark green to black tarry meconium

Front 49

GI system

-the failure to pass meconium after birth may indicated ___ somewhere in the digestive tract

Back 49

atresia

Front 50

-by week 9, the fetus synthesizes ________ for storage in the liver

Back 50

glycogen

Front 51

-between 26-30 weeks, the fetus begins to do what to prepare for extrauterine cold stress

Back 51

to lay down stores of brown fat in

Front 52

-ineffective thermoregulation in the neonate requires (2) things

Back 52

increased metabolism and adequate oxygenation

Front 53

-the GI system is matured by ____ wks

Back 53

36

Front 54

digestive enzymes (except pancreatic amylase and lipase) are present in sufficient quantity to facilitate _____

Back 54

digestion

Front 55

-the neonate can’t digest what 2 things efficiently?

Back 55

starches or fat efficiently

Front 56

Hepatic system
--bile begins to form by the ______ week

Back 56

12th

Front 57

Hepatic system
-glycogen is stored in the fetal liver beginning at week ____

what is glycogen??

Back 57

9 or 10

-glycogen is the major source of energy for the fetus and neonate

Front 58

Hepatic system
-____is also stored in the fetal liver.

Back 58

iron

if the maternal intake is sufficient, the fetus can store enough iron to last for 5 months after birth-

Front 59

Hepatic system

-what cannot be synthesized in the fetal liver because of the lack of vitamin k synthesis is sterile in the fetal gut

Back 59

coagulation factors

Front 60

Respiratory system
--the development of the respiratory tract begins in week ___

Back 60

4

Front 61

Respiratory system
-after ___ weeks, sufficient surfactant is present in developed alveoli to provide infants with survival

Back 61

32

Front 62

Respiratory system
- What 2 conditions can retard fetal lung maturity

Back 62

gestational diabetes
chronic glomerulonephritis

Front 63

Respiratory system
--fetal respiratory movements have been seen on ultrasound by wk 11 (they aid in development of the chest wall muscles and regulate lung fluid volume)
- the fetal lungs produce ____ that does what?

Back 63

fluid
-expands the air spaces in the lungs. the fluid drains into the amniotic fluid or is swallowed by the fetus

Front 64

-before birth, secretion of lung fluid (increases or decreases)
- what does the vaginal birth process to do fluid??

-infants of cesarean births do not benefit from this squeezing process, thus they may have more respiratory difficulty at birth

Back 64

decreases

the normal birth process squeezes out aprrox. 1/3 of the fluid.

Front 65

Sensory awareness
--purposeful movements of the fetus have been demonstrated in response to

Back 65

a firm touch on the moms abdomen

Front 66

Sensory awareness
--b/c it can feel touch, the fetus requires ______when invasive procedures are done

Back 66

anesthesia

Front 67

Sensory awareness
--fetuses respond to sound by

Back 67

24 wks

Front 68

Sensory awareness
-different types of music can evoke different movements
-moms voice can do what?

-what does acoustic stimulation do?

Back 68

(infant can be soothed by mothers voice),

acoustic stimulation can be used to evoke a fetal heart response

Front 69

-hearing is fully developed at birth

true or false

Back 69

true

Front 70

-the fetus is able to distinguish taste
-how do we know this??

Back 70

-by the 5th month, when the fetus is swallowing amniotic fluid, a sweetener added to the fluid causes the fetus to swallow faster

Front 71

-does a fetus able to distinguish temperature?

how do we know this??

Back 71

-fetus reacts to temperature changes.

a cold solution placed in amniotic fluid can cause fetal hiccups

Front 72

-can fetus see?

how do we prove this?

Back 72

–a bright light shone on the mother’s abdomen in late pregnancy causes abrupt fetal movements

Front 73

Multifetal pregnancy

-incidence of twinning is 1 in 43 pregnancies

Back 73

-incidence of twinning is 1 in 43 pregnancies

Front 74

Multifetal pregnancy (Dizygotic or Monozygotic)

-when 2 mature ova are produced in 1 ovarian cycle

Back 74

Dizygotic twins

Front 75

Multifetal pregnancy (Dizygotic or Monozygotic)

identical twins

Back 75

Monozygotic twins

Front 76

Multifetal pregnancy (Dizygotic or Monozygotic)

may be the same sex or different sex

Back 76

Dizygotic twins

Front 77

Multifetal pregnancy (Dizygotic or Monozygotic)

-there is always 2 amnions, two chorions, 2 placentas

Back 77

Dizygotic twins

Front 78

Multifetal pregnancy (Dizygotic or Monozygotic)

develop from 1 fertilized ovum and then divides

Back 78

Monozygotic

Front 79

Multifetal pregnancy (Dizygotic or Monozygotic)

-fraternal

Back 79

Dizygotic twins

Front 80

Multifetal pregnancy (Dizygotic or Monozygotic)

same sex and have the same genotype

Back 80

Monozygotic

Front 81

Multifetal pregnancy (Dizygotic or Monozygotic)

occurs more often in African American women

Back 81

Dizygotic twins

Front 82

Multifetal pregnancy (Dizygotic or Monozygotic)

most of the time there are 2 embryos, 2 amnions, 1 chorion, 1 placenta

Back 82

Monozygotic

Front 83

Multifetal pregnancy (Dizygotic or Monozygotic)

1 in 250 births

Back 83

Monozygotic

Front 84

what is "Zona reaction"

Back 84

when the first of the 10 million sperm gets through, it seals up, and nobody else can get int. if more than 1 sperm gets in, you have chromosomal problems

Front 85

Pregnant for 40 weeks from when?

Back 85

last menstrual period
LMP

Front 86

Intrauterine development 3 stages

Back 86

Ovum -conception-day 14 the egg that is dividing

Embryo –day 15-8 weeks post conception many woman don’t know they are pregnant
Most critical time in development of organs and main external features
Vulnerable to teratogens (things that can cause birth defects, ex: radiation, drugs)

Fetus -9 weeks until delivery

Front 87

–smaller, carry deoxygenated poor blood (takes the bad stuff away)


carries oxygenated blood

Back 87

artery


vein

Front 88

Some babies have thick cords take forever to dry and fall off… normal size cord fries an falls off within ____weeks

Back 88

2

Front 89

Placenta
-Circulation is in place by day ___ when heart begins to beat

Back 89

17

Front 90

Human chorionic gonadotropin (hCG)
-what is a reassuring sign that it’s a good pregnancy


-if not doubling appropriately or falling off, think what??

-if the levels are tripling or quadrupling, think??

-as it doubles, it can cause:

Back 90

should double appropriately every 2-3 days in the beginning of the pregnancy


that the pregnancy won’t make it..


-if it’s tripling or quadrupling, think multiples


-as this doubles, it can cause the morning sickness

Front 91

Human chorionic somatomammotropin (hCS)

3 functions:

Pregnant mom is resistant to her own insulin.
Insulin = growth for baby

Back 91

Increases resistance to insulin,

facilitates glucose transport across placental membrane,

stimulates breast development in mom

Front 92

what does the mom lying on her back cause:

Back 92

the weight of the pregnancy is going to stop flood from returning to the vena cava ..blood supply decreases to baby

Front 93

Hematopoietic System -

baby makes their own blood. Baby is not always the same as mom.

(true or false)

Back 93

true

Front 94

Hematopoietic System

Begins in ___week,

-Rh concerns
If mom is rh – and baby is rh +, what will the mom do?

Back 94

6th

the mom will see it as a foreign tissue and destroy it

Front 95

Coagulation factors cannot be synthesized in the liver because of lack of Vitamin K synthesis in the sterile gut

Back 95

Vit is made in the gut, it’s not making any vitamin k. we need vit k to go to the liver to help coagulation factors

Front 96

what organs are the last thing to fully develop.

Back 96

lungs

Front 97

true or false

-when the baby is stressed, the lungs mature faster

Back 97

true

Front 98

what can accelerate fetal lung maturity (4 things)

Back 98

Maternal hypertension, placenta dysfunction, infection,
corticosteroid use

–can add to the lungs maturing faster than they would have

Front 99

what can delay fetal lung maturity: 2

Back 99

Gestational diabete

chronic glomerulonephritis

Front 100

Neurologic System
-folic acid is very important for what?

Back 100

the spine to close…folic acid before pregnant!


Open neural tube closes, 1st cranial, then caudal –want it to closing as it should be (8 weeks is usually done), spinabifida is when it’s not closed

Front 101

Quickening,-1st felt movement, is felt earlier by primes or multips?

Back 101

multips feel it earlier (they know what they are feeling)

Front 102

Rods and cones by ___month,

-fetus can see when they put lights in, the babies look away

Back 102

7th

Front 103

Neurologic insult such as ____________________
can result in cerebral palsy, Neuromuscular impairment, mental retardation, and learning disabilities

Back 103

chronic poor nutrition, hypoxia,
drugs,
toxins
trauma

Front 104

Endocrien system
-infant of diabetic mother, baby going to be hyperglycemic or hypoglycemic?

Back 104

Hypoglycemia in IDDM

Babies have own endocrine system, baby makes own insulin – moms insulin doesn’t cross placenta

Front 105

Reproductive System

Distinguishing characteristics appear around ___week
-

Back 105

9th

Front 106

Reproductive System
-Pseudomenstruation?
-witch’s milk?

Back 106

from moms hormones, baby girls can have bleeding around vagina, its temporary and it will stop.

Witch’s milk – milk coming from nipples of boys and girls, its from moms hormones and very temporary

Front 107

T or F
-Females born with all eggs in ovaries –she doesn’t make anymore after birth

Back 107

true

Front 108

Sutures allow skull to mold/move, enabling head to

Back 108

pass through birth canal

Front 109

Integumentary System
-Vernix caseosa

Back 109

(creases, white lotioning stuff, doesn’t cause any harm, protects them),

thick at 24 weeks, scant at term

Front 110

Immunologic System
-who is mature?

Back 110

-all are immature

Front 111

Monozygotic / Dizygotic

u cant have a boy and a girl, 2 girls or 2 boys

Back 111

Monozygotic

Front 112

Monozygotic / Dizygotic

2 eggs get fertilized, 2 differ babies, can have boy and girl

Back 112

Dizygotic twins (aka fraternal

Front 113

Monozygotic / Dizygotic

1 egg

Back 113

Monozygotic

Front 114

Monozygotic / Dizygotic

Depending on when division occurs
1 or 2 amnions, 1 or 2 placentas, 1 or 2 chorions (sac around amniotic sac)

Back 114

Monozygotic

Front 115

Inadequate maternal nutrition

Back 115

LBW infants, susceptible to infection

Affects brain development,-learning disabilities