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44 Cards in this Set
- Front
- Back
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What are the 5 primary hormones effected by pregnancy
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HCG
Estrogen Progesterone HPL Relaxin |
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What are the cases/effects of Estrogen during pregnancy
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Secreted: Corpus luteum (placenta @ 7wks)
Effects:stimulates breast developement and ducts in breast tissue. Pigmentation of skin (linea nigra), diffuse fluid retention. |
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What are the cases/effects of Progesterone during pregnancy
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Secreted: Corpus luteum (placenta @ 10-12wks)
Effects: decrease ctx, stim developement of breast acini and lobules. Slow GI tract, chnages in CHO metab. |
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What are the cases/effects of HPL during pregnancy
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Secreted: by syncytiotrophoblats
Effects: Mat. meta; increased free fatty acids, decreased glucose (promote fetal growth). Changes in CHO metab may lead to gest.dm |
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What are the cases/effects of HCG during pregnancy
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Secreted: trophoblasts
Effects: stimulates CL to produce estrogen and progesterone. N/V preg +preg test |
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What are the cases/effects of Relaxin during pregnancy
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Secreted: by CL
Effects: decreased uterine axtivity, remodels collagen, soften p.joints/abdomen (make room for fetus). Striae of breasts, gait changes |
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Changes in uterus duing pregnancy
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-Increased size (hypertropy/hyperplasia)-
*Cause: Increased estrogen, later due to grwth of fetus -Myometrical hypertrophy (later thinning)- *Causes: estrogen *Result: Fetus palpable |
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Changes in cervix during pregnancy
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(1)Inc production of cervical mucus
*Causes: estrogen stimulates glands to increase production *Result: seals of uterine cavity (2)Goodall's(softening) *Causes: increased vascularization, engorgement of BVs (3)Chadwick's (cyanosis) *Causes: increased vascularization, engorgement of BVs |
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Changes to vagina during pregnancy
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(1)Increased vascularity and distendability
(2)Estrogen causes thickening of mucosa (3)Increase vaginal pH (yeast infect) |
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Results and effects of increased uterine size during pregnancy.
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(1)Increased femoral venous pressure: edema below uterus
(2)C-V: displacement of heart up and to the left (3)Resp: increase O2 consumption (15-20%), TV, diaphram up, ribs out, SOB (4)GI: Heartburn (5)UT: pressure on bladder |
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Effects of Pregnancy on CV system
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(1)Blood volume: increase by 45% by end, nurished fetus and placenta. Can result in anemia, decreased systemic vasc. & pulm. resistance and increased CO.
(2)CO increases 30-50% by 26 wks (3)RBC(by 30%), WBC (@5-12k) production. Increase O2 delivery, protect infection. (4)Fibrin/Fibrinogen: inc by 40-50%. Prevent hemorrhage @ del, inc risk of clot. (5)Increased bllod flow to uterus and kidney. (6)HR increase 10-15bpm |
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Effects of pregnancy on the urinary tract
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Increased tubular reabsorption (partly compensates for GFR)
Urinary: increased RPF & GFR. Alt norm level of Ureters and Pelvis dilate b/c hormones and pressure on uterus and kidneys |
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What are the PRESUMPTIVE(subjective)signs and symptoms of pregnancy.
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-absense of menses
-N&V -Urinary freq -Breast tenderness, discoloration, discharge -"quickening" -Pigmentation of the skin (mask and belly line) |
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What are the PROBABLE(Possible, objective) signs and symptoms of pregnancy.
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-Enlargement of abdomen
-Changes in size, shape, consistency of uterus -Fetal outlines distinguished by abdominal palp -Braxton hicks contractions +Pregnancy test +Goodell's (soft cervix) +Hegar's (soft isthmus) +Chadwick's (cyanosis) |
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What are the POSITIVES(diagnostic)signs and symptoms of pregnancy.
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-Fetal heart sounds
-Doppler 10-14 wks -Fetoscope 18-20 wks -Fetal movement felt by examiner -Ultrasound |
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Define
(a) abortion (b) Gravida (c) Partity (d) Nulligravida/nullipara (e) Primigravida/Primipara (f) Multigravida/Multipara (g) Term (h) Post/term (i) Viability |
(a) <20 wks or <500g
(b) # of preganancies (c) # of preg carried past 20wks (d) never been pregnant/ never carried to viable age (e) 1st preg/ 1st preg to 20wks (f) 2+ pregnancy, 2+ viable pregnancy (g) 38-42 wks (h) +42 wks (i)Ability to survivr outside the uterus |
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What are Macdonald's measurements (on the back)
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-12wks: fundus @ symphysis
-16wks: 1/2 b/t symphysis & unbilicus -20wks: @ umbilicus -22-24wks: dist cm from syphysis and fundus. |
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Psychological changes during pregnancy
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-1st trimester: acceptance of preg, incorp to part of self, ambilvalence normal.
-2nd trimester: acceptance of preg/fetus by self/others. Relationship w/mother/fam. -3rd trimester: separation fetus-self, prep for birth, fam change. -L&D: safe passage for self/babe |
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What are the common lab tests that are run during pregnancy:
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-CBC
-Rubella screen -Varicella screen -VDRL: Veneral Disease Research Lab -GDM: if BMI>30 @16-20wks repeat 26-28wks -Chlamydia -Gonorrhea culture -Pap smear: HPV -Glucose. Glucola 26-28wks -Rh factor -HIV testing -GBS 36-37wks Triple/Quad test 15-18 wks -Alpha-fetoprotein (AFP)testing: High inc risk neural tube defect. Low indicates downs -HCG -Inibin A -Estriol -Multiple marker test: AFP hCG, estriol; Quad screen: AFP, hCG, estiol plus inhibin A TORCH: Toxoplasmosis, Other, Rubella, Cytomegalovirus and Herpes |
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Nutrional needs of pregnant women
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FIRST TRIMESTER
-eat what stays down -may increase CHO -cut out substances 2nd/3rd TRIMESTER -quality/quantity -Protein +30% -Caloties: +300 -Fe: +100% (30mg) -Folic acid: 50% (600mcg)4g w/hx -H2O sol vita 10-20% |
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Weight gain benchmarks during pregnancy
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-25-35 lbs during preg
-1st tri 3-5lbs -Gain 10lbs in 1st 20wks -2nd&3rd trimester 1/2-1lbs/wk Fetus 2x's wt from 32-40wks, 1/2lbs/wk last week. |
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What the danger signs in each trimester
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1st:
-Severe vomitting -Fever >24hrs/ >101 -Buring in urination -Ab cramping/bleeding 2nd and 3rd: -change in fetal movements -Watery discharge/ROM -Sudden inc sweat (HTN) -Pain/bleeding |
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What is a typical follow-up visit scedule
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-Q4 wks <28s
-Q2 wks 28-36wks -Q week 36-41wks |
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What are typical lab values for a pregnant women
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-HGB: 10-14
-HCT: 32-42 -WBCs 5-15 -Fibrinigen: 400 |
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What are the external structures of the female reproductive system
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-Mons pubis
-Labia majora/minora -Clitoris -Vestibular glands -Vaginal vestibule -Vaginal orifice -Urethral opening |
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What are the internal structures of the female reproductive system
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-Vagina
-Uterus -Uterine tubes -Ovaries |
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What are the 4 pairs of ligaments that support the uterus
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-Cardinal
-Uterosacral -Round -Broad |
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What are the bones of the pelvis
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(1) innominate bones (ilium, ischium, pubis)
(2)Sacrum (3)Coccyx |
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What is the dividing line between true and false pelvis
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The Inlet (false below/true above)
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Effects of Estrogen/Progesterone on the breasts
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ESTROGEN
-Stimulate growth by inducing fat deposition -Increase elasticity -Growth of the ductile system -Inc vascularization of breast tissue PROGESTERONE -Maturation of mammary gland tissue |
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Identify structures of the breast
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mammary glands- lobes- lobules- acini (secrete milk/colostrum)
-Lactiferous sinuses serve as milk reseviors connect to the nipples |
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Normal timing on mensturation
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-Onset: 13 yrs
-Uterine bleeding: 14 days post ovulation -Length of cycle: 28 days -Duration of flow: 3-6 days -Blood loss: 20-80ml |
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Phases of endometrical cycle
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(1)Menstrual phase: shedding of functional 2/3 of endometrium
(2)Proliferation phase: period of rapid grwth (5th day- ovulation). Depends on estrogen stimulation from ovarian follicles. Estrogen peaks (3)Secretory phase: day of ovulation- 3 days b/f next period. Large amts of progesterone are produced. By the end of this phase endometrial lining fullly formed. (4)Ischemic phase: if ovulation has not occured blood supply cut off and necrosis occurs. |
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Timing of Ovulation and implantation
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OVULATION: around 14th day of endometrial cycle
IMPLANTATION: 7-10 days after ovulation |
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Define fertilization, implantation and conception
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FERTILIZATION: union of egg and sperm, usually occurring in the ampulla of the fallopian tube.
IMPLANTATION: zona pellucida degenerated, trophoblast attactes to uterine wall (6-10 days post conception) usually in anterior/posterior region of fungus. CONCEPTION: |
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Calculating fetal age.
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BASIC: 40 weeks (280 days) from the LMP, or 38 weeks (266 days) from the date of fertilization.
Naegele's rule: LMP + 7days - 3months + 1yr |
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Define Gametogenesis, Oogenesis, spermatogenesis
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GAMETOGENESIS: production of gametes
SERMATOGENESIS: in male production of 4 mature gamates OOGENESIS: in female the production of one mature ovum and 3 polar bodies |
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Mitotic vs Meiotic cellular division
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MITOSIS: results in 2 dipliod cells
MEIOSIS: results in 4 hapliod cells (gametes) |
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Define Mendelian inheritance in relation to single-gene and multifactoral inheritance.
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Multifactorial inheritance:
combination of genetic and environmental factors Single-Gene inheritance: when one gene controls a trait, disorder or defect. |
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What are the terms used to describe abnormalities of chromosomal number
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(1) polyploidy, exact multiple of a chromosomal set
(2) Aneuploidy: not all the chromosomes are duplicate |
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What does G_P_tpal represent
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G- gravida
P- paragravida t- term p- premature a- abortion l- living children |
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What are other physiological changes that occur during pregnancy
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Neurological: carpal tunnel syndrome (edema to peripheral nerves)
Gallbladder: distend, tockening of bile, slight hypercholesterolemia from increase progesterone. |
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List five factors affecting progress in labor
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(1)Passageway
(2)Passenger (3)Postition (4)Power (5)Psycological response |
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List 4 pelvic shapes
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(1)Gynecoid
(2)Android (3)Anthropoid (4)Platypelloid |
