Medical 2-22-Labor And Birth

Front 1

Define molding?

Back 1

cranial bones overlap under pressure of powers of labor and demands of unyielding pelvis

Front 2

Define sutures of fetal skull?

Back 2

membranous spaces between cranial bones

Front 3

Define fontanelles?

Back 3

intersections of cranial sutures

Front 4

Define frontal (mitotic) suture?

Back 4

located between two frontal bones; becomes anterior continuation of sagittal suture

Front 5

Define sagittal suture?

Back 5

located between parietal bones; divides the skull into left and right halves; runs anteroposteriorly, connecting the two fontanelles

Front 6

Define coronal sutures?

Back 6

located between frontal and parietal bones; extend transversely left and right from anterior fontanelle (bregma)

Front 7

Define lambdoidal suture?

Back 7

located between two parietal bones and occipital bone; extends transversely left and right from posterior fontanelle

Front 8

Define mentum?

Back 8

fetal chin

Front 9

Define sinciput?

Back 9

anterior area known as the brow

Front 10

Define vertex?

Back 10

area between anterior and posterior fontanelles

Front 11

Define occiput?

Back 11

areas of fetal skull occupied by occipital bone, beneath posterior fontanelle

Front 12

Define fetal attitude?

Back 12

relation of the fetal parts to one another

normal:
moderate flexion of head, flexion of arms onto chest, and flexion of legs onto abdomen

Front 13

Changes in fetal attitude, esp. head, cause fetus to what?

Back 13

present larger diameters of fetal head to maternal pelvis...this contributes to a longer, more difficult labor

Front 14

Define fetal lie?

Back 14

refers to relationship of cephalocaudal axis (spinal column) of fetus to cephalocaudal axis of woman

Front 15

Define longitudinal lie?

Back 15

occurs when the cephalocaudal axis of fetus is parallel to woman's spine

Front 16

Define transverse lie?

Back 16

occurs when the cephalocaudal axis of fetal spine is at right angles to woman's spine

Front 17

Why does transverse lie complicate delivery?

Back 17

there is shoulder presentation

Front 18

Define fetal presentation?

Back 18

determined by fetal lie and by body part of fetus that enters maternal pelvis first

Front 19

Define presenting part?

Back 19

first part of fetus to descend into pelvis
may be cephalic, breech,
or shoulder

Front 20

Define malpresentations?

Back 20

breech and shoulder presentations which are considered difficult during labor and do not proceed as normal

Front 21

The most common presentation is?

Back 21

cephalic
97% rate

Front 22

Define vertex presentation of cephalic?

Back 22

most common type
fetal head is completely flexed onto chest
smallest diameter of head first

Front 23

Define military presentation of cephalic?

Back 23

head is neithe flexed nor extended
occipitofrontal diameter first
top of head first

Front 24

Define brow presentation of cephalic?

Back 24

head is partially extended
occipitomental diameter, the largest anteroposterior diameter is first

Front 25

Define face presentation of cephalic?

Back 25

head is hyperextended
submentobregmatic diameter presents
face is presentingn part

Front 26

Define breech?

Back 26

presenting part is lower extremities or buttocks
3% chance in term births
classified according to attitude of hips and knees
sacrum is landmark
butt and feet first

Front 27

Define frank breech?

Back 27

fetal hips are flexed, knees
extended
butt first

Front 28

Define footling breech?

Back 28

hips and legs extended
feet first
single footling - one foot first
double footling - both feet first

Front 29

Define shoulder presentation?

Back 29

shoulder first
transverse lie
acromion process of scapula is landmark

Front 30

Define engagement?

Back 30

presenting part occurring when the largest diameter of presenting part reaches or passes through the pelvic inlet

Front 31

Define station?

Back 31

refers to the relationship of the presenting part to an imaginary line drawn between the ischial spines of the maternal pelvis

Front 32

Define fetal position?

Back 32

refers to relationship of landmark on the presenting fetal part to the anterior, posterior, or sides

Front 33

What influences labor and birth?

Back 33

fetal position

Front 34

The most common fetal position is?

Back 34

occiput anterior

Front 35

Define frequency?

Back 35

refers to time between beginningn of one contraction and beginning of next contraction

Front 36

Define primary force?

Back 36

uterine muscular contractions, which cause the changes of the first stage of labor
complete effacement and dilatation of the cervix

Front 37

Define secondary force?

Back 37

use of abdominal muscles to push during second stage of labor
adds to primary power after full dilatation

Front 38

Contractions have what 3 phases?

Back 38

increment - building up
acme - peak
decrement - letting up

Front 39

Why is relaxation between contractions important?

Back 39

restores uteroplacental circulation, which is important to fetal oxygenation and adequate circulation in uterine blood vessels
respite for woman
uterine muscles relax

Front 40

Define duration?

Back 40

measured from beginning of contraction to completeion of contraction
beginning? 30-40 seconds
later? 30-90 seconds

Front 41

Define intensity?

Back 41

refers to strength of uterine contraction during acme
estimated by palpating...nurse can give subjective mild, moderate, or strong by judging amount of indentability of uterine wall during acme...indented easily? mild...can't indent? strong..
contraction, but it may be measured directly with an IUC attached to monitor

Front 42

Describe measurements of intensity when using an IUC?

Back 42

resting tonus (between contractions): 10-12 mmHg
acme early labor: 25-40 mmHg
acme active labor: 50-70 mmHg
transition: 80-100 mmHg
second stage pushing: 100mmHg

Front 43

At the beginning of labor, contractions are usually____, of _____ duration, and relatively ______

Back 43

mild
short
infrequent

Front 44

As labor progresses, duration and intensity _______, and frequency is every _____ to ______ minutes.

Back 44

increase
2 to 3

Front 45

What hormone stimulates uterine muscle contractions to permit softening, stretching, and eventual thinning of cervix.

Back 45

estrogen

Front 46

Define physiologic retraction ring.

Back 46

the division of the uterus into two portions during true labor...upper portion which is contractile gets thicker as labor advances....lower portion, including lower uterine segment and cervix, is passive...lower portion thins out

Front 47

Define effacement?

Back 47

taking up of internal os and cervical canal into uterine side walls

Front 48

Define brachystasis?

Back 48

uterine muscle remains shorter and thicker and does not return to its original length

Front 49

How does cervical dilatation occur?

Back 49

as uterus elongates, longitudinal muscle fibers are pulled upward over presenting part...as well as hydrostatic pressure of fetal membranes

Front 50

Define fetal axis pressure?

Back 50

pressure exerted by fetus as the uterus elongates and pushes fetus down

Front 51

Define lightening?

Back 51

effects that occur when fetus begins to settle into pelvic inlet (engagement)..
eases mother's breathing

symptoms:
leg cramps or pains
increased pelvic pressure
increased venous stasis
leading to edema
increased urinary frequency
increased vaginal secretions

Front 52

Define Braxton Hicks contractions?

Back 52

prior to labor
irregular intermittent contractions...
"drawing" sensation
false labor

Front 53

Define ripening?
Goodell's sign?

Back 53

softening of cervix
under influence of hormonal factors

Front 54

Define bloody show?

Back 54

resulting pink-tinged secretions from expelling of mucus plug...
usually means labor will begin within 24 to 48 hours...
vaginal exam blood-tinged discharge may be confused with bloody show

Front 55

Define mucus plug?

Back 55

a barrier in cervical canal..
cervical secretions accumulate in cervical canal

Front 56

How is mucus plug expelled?

Back 56

softening and effacement of cervix

Front 57

Define rupture of membranes (ROM)?

Back 57

12% of women
80% will experience spontaneous labor within 24 hours...otherwise, labor may be induced to avoid infection if baby near term

Front 58

Define spontaneous rupture of membranes?
SROM

Back 58

generally occurs at height of an intense contraction with a gush of fluid out of vagina...
at risk for prolapsed cord if engagement (descent) hasn't occurrred

Front 59

What is prolapsed cord?

Back 59

cord is expelled with fluid before baby...mother should be checked...sometimes amniotic fluid mistaken for urine

Front 60

What is amniotomy or artificial rupture of membranes?

Back 60

rupture of membranes with amniohook

Front 61

Signs of onset of labor might include?

Back 61

lightening
Braxton Hicks
cervical changes-ripening
bloody show
ROM SROM

unknown causes:
sudden energy
weight loss 1 to 3 lbs
increased backache and
sacroiliac pressure
diarrhea
indigestion
nausea
vomiting

Front 62

Define crowning?

Back 62

occurs when fetal head is encircled by external opening of vagina (introitus) and means birth is imminent

Front 63

Define cardinal movements?

Back 63

for fetus to pass through birth canal, fetal head and body must adjust to maternal pelvis by certain positional changes
also called mechanisms of labor

Front 64

List cardinal movements?

Back 64

descent
flexion
internal rotation
extension
restitution
external rotation
expulsion