Module 4

Front 1

where is the secondary yolk sac located?

Back 1

in the chorionic cavity(exocolomic)

Front 2

what length of time is the embryonic period? what is it also known as?

Back 2

5-10 weeks gestational age

Front 3

what does the developing follicle produce?

Back 3

estrogen

Front 4

what day does ovulation occur? What causes it?

Back 4

day 14; a surge in LH

Front 5

what is the fate of the corpus luteum if pregancy doesn't occur?

Back 5

it involutes, regresses, and becomes the corpus albicans

Front 6

what is the predominant hormone secreted by the corpus luteum

Back 6

progesterone

Front 7

why doesn't the corpus luteum involute during pregnancy?

Back 7

becuase it is needed to maintiain pregnancy and is still producing progesterone

Front 8

what happens to the endometrium after ovulation? What hormone influences this?

Back 8

it becomes soft, thick, and edematous; progesterone

Front 9

What is decidual reaction?

Back 9

with pregnancy, the hormonal response produces a hypertrophic endometrium regardless of implantation site. the endometrial change is termed decidual reaction.

Front 10

what day of the menstral cycle does fertilization occur?

Back 10

day 15

Front 11

when the mature ovum and sperm unite, what do they form? where?

Back 11

the zygote; in the outer 3rd of the fallopian tube

Front 12

what is the difference btw morola and blastocyst?

Back 12

morola's outside rim is the zona palucida, and the blastocyst's outside rim is the trophoblast

Front 13

what burrows into the endometrium to begin implantation?

Back 13

the blastocyst

Front 14

what are the primary germ cell layers produced from the baliaminar disk during gestation

Back 14

ectoderm, endoderm, and mesoderm

Front 15

what is neuralation?

Back 15

the formation of the neural plate, and its closure to form the neural tube.

Front 16

what 3 embryonic processes occur within week 5?

Back 16

gastrolation, neuralation, primitive heart transformation

Front 17

when do nearly all congenital malformations except abnormalities occur?

Back 17

during the embryonic period

Front 18

when does crown rump length double?

Back 18

btw 11-14 weeks

Front 19

what day does the implantation of the blastocyst occur? where?

Back 19

day 5-7; occurs in the decidua(posterior wall of the fundus)

Front 20

what is the endometrium deep to the implanted conceptus?

Back 20

deciduas basalis

Front 21

what are FSH and LH released from?

Back 21

anterior pituitary

Front 22

what are the 3 ovarian phases?

Back 22

follicular, ovulation, luteal

Front 23

what are the menstral phases?

Back 23

proliferative, ovulatory, secertory, menstration

Front 24

what is the intradecidual sign?

Back 24

when the sac is completely embedded within the thickened decidua, and the sac doesn't disform the cavity

Front 25

are there echos produced from the decidual layer?

Back 25

yes

Front 26

what is the cherio shaped object?

Back 26

yolk sac

Front 27

if the amnion is not seen, is the pregnancy lost?

Back 27

no

Front 28

allantoic duct?

Back 28

allontois is an elongated duct that contriubtes to the development of the umbilical cord and placenta during the first trimester

Front 29

amniotic cavity

Back 29

area enclosed by the amnion that contains the amniotic fluid and the fetus

Front 30

blastocyst

Back 30

an eartly stage of embryonic development that consists of outer trophoblast and inner ebryoblast

Front 31

chorion

Back 31

embryonic membrane that formes the outermost covering around the developing fetis and contributes to the development of the placent

Front 32

chorionic cavity

Back 32

area enclosed by the chorion(thin membrane), and contains yolk sac. It becomes increasingly smaller as amniotic cavity enlarges.

Front 33

chorion frondosum

Back 33

portion of the chorion that develops into the fetal portion of the placenta

Front 34

chorion laeve

Back 34

the future chorionic membrane referred to as the smooth chorion

Front 35

chorionic plate

Back 35

part of the chorionic membrane that covers the placenta

Front 36

chorionic villi

Back 36

projections that extend from the outer surface of the chorion and help attach the ambryo to the uterine wall

Front 37

estrogen

Back 37

hormone secreted by the ovary and during pregnanacy by the placenta

Front 38

exocoelomc membrane

Back 38

(heusers mambrane)-encloses cavity called the primitive or primary yolk sac

Front 39

progesterone

Back 39

hormone produced by the corpus luteum in the 2nd half of the menstral cycle that modifies the endometrium in preparation for implantation of the fertilized egg

Front 40

trophoblast

Back 40

the outer cells of a blastocyst that lep to form the placenta and other embryonic membranes

Front 41

vitelline duct?

Back 41

"yolk stalk"-connects the yolk sac to the embryonic midgut

Front 42

when do the amnion and chorion usually fuse?

Back 42

16 weeks

Front 43

what part of the cycle is mensus?

Back 43

1-5 days

Front 44

what is normal physiology of the menstral cycle controlled by?

Back 44

the hypothalamic pituitary ovarian axis

Front 45

when does the hypothalamus become active? what does it produce?

Back 45

before puberty; produces FSHRF, and LFRF which stimulate the anterior pituitary to produce hormones

Front 46

where is the anterior pituitary located? what does it produce?

Back 46

located at the base of the brain, and it produces FSH, and LH

Front 47

what controls the amount of FSH and LH produced by the anterior pituitary?

Back 47

ovarian secretion of estrogen and progesterone

Front 48

how do estrogen and progesterone levels affect FSH and LH levels?

Back 48

less estrogen/progesterone=higher FSH and LH

Front 49

What does FSH stimulate the follicels to do?

Back 49

secrete estrogen

Front 50

what causes the stratum functionalis to be shed?

Back 50

a decrease in progesterone cuases release of prostaglandins which cause spiral arteries to constrict which results in oxygen deprevation to the stratum functionalis

Front 51

explain how each phase of the menstral cycle relates to the days of the menstral cycle?

Back 51

mensus-1-5
proliferative-6-14
ovlatory-14
secretory-14-28

Front 52

what hormone is inreased during the proliferation phase of the menstral cycle?

Back 52

estrogen, and to a much lesser extent, progesterone

Front 53

what hormone is released during the secretory phase of the mestral cycle?

Back 53

progesterone, and estrogen to a much lesser extent

Front 54

perimenopause

Back 54

the period leading up to the cessation of menstration(when cycles become irregular)

Front 55

describe how the phases of the ovarian cycle corrispond to the days/

Back 55

follicular-1-13
ovulatory-14
luteual-15-28

Front 56

low levels of what cuase the endometrium to be shed?

Back 56

estrogen, estradiol, and progesterone

Front 57

what hormone do follicles produced? what happens as a result of this?

Back 57

estrogen, which causes the pituitary to release LH

Front 58

when is the dominant follicle chosen?

Back 58

day 9

Front 59

what causes the endometrium to thicken?

Back 59

estradiol is secreted by the ovaries.

Front 60

what is the primary oocyte surrounded by?

Back 60

the zona pellucida, and corona radiata

Front 61

what is the ovum called once it is released?

Back 61

secondary oocyte

Front 62

what phase does estradial peak?

Back 62

during ovalatory phase

Front 63

what is mittelschmerz?

Back 63

dulpain felt on the side of the pelvis where ovulation occurs.

Front 64

what is the corpus hemorrhagicum?

Back 64

ruptured, involuted follicle.

Front 65

what sonographic findings occur when ovulation occurs?

Back 65

-decrease in folliclar size
-free fluid in the cul-de-sac

Front 66

what happens to LH and FSH during the luteal phase?

Back 66

they decrease

Front 67

what does the corpus luteum secreate?

Back 67

progesterone, and estadial to a lesser extent

Front 68

what happens if the egg is not fertilized?

Back 68

the corpus luteum regresses, and progesterone is no longer prodcued

Front 69

what maintins the copus luteum intil the growing fetus can produce its own hormones?

Back 69

hCG

Front 70

explain oogenesis?

Back 70

females are born with approximately 2million oocyctes, and one is ovulated/cycle. Meisois cuases the cell to divide, so the diploid is now a haploid number.

Front 71

when does fertilization take place compared to ovulation

Back 71

24 hours after ovultion

Front 72

what is mitosis

Back 72

cell didvision that begins 24-30 hours after fertilixation which results in 2 cells, then, 4 etc.

Front 73

what is cleavage?

Back 73

cell division resulting in smaller and smaller cells that occurs in the fallopian tube

Front 74

what is a blastomere?

Back 74

cells enclosed in the zona pellucida of the original egg cell that undergo rapid cell dicision to form the 16 cell morula

Front 75

what is the morula protected by?

Back 75

zona pellucida

Front 76

what is the stage after the morula? explain it?

Back 76

blastocysts stage which contains trophoblastic cells ad and innner cell mass that fors the embryo. Once fluid passes into the morula, it is termed a blastocyst

Front 77

what is the outer layer of cells of the blastocyst?

Back 77

trophoblast

Front 78

what does the trophoblast become?

Back 78

the chorion, and the fetal contribuation to the placenta

Front 79

what does the inner cell mass become?

Back 79

embryo, amnion, cord, and secondary yolk sac

Front 80

when does the blastocyst enter the uterus?

Back 80

5 days post fertilization

Front 81

what happens after the blastocyst enters the uterus?

Back 81

zona pellucida degenerates

Front 82

when the blastocyst is in the uterus, where does it recieve its nutrients fro?

Back 82

the secretions of the endometrial glands

Front 83

what day does the blastocyst attac to the wall?

Back 83

day 6(post fertilization)

Front 84

what completes the period of clevage?

Back 84

implantation

Front 85

what are the 2 layers of the trophoblast?

Back 85

cytotrophoblast-inner layer
sycytotrophoblast-outer layer

Front 86

what does the cytotrophoblast form?

Back 86

rhe corion

Front 87

lacunae spaces

Back 87

when the syncytiotrophoblst invades the endometrium and lacunae become filled with blood from ruptured vessels.

Front 88

at 4 weeks, what do laculnae spaces fuse into?

Back 88

lacunar network which acts as an early placental circulatory system

Front 89

what do the lacunae enlarge to become?

Back 89

the intervillous spaces of the developing placenta

Front 90

what is the function of the trophoblast?

Back 90

the production of hCG to extend the life of the corpus luteum.

Front 91

what happens to the zona pellucida during implantation?

Back 91

it disappears and the

Front 92

what do the trophoblastic cells do during implantation?

Back 92

trophoblastic cells invade the endometrial mucosa of the uterus and maternal capillaries to produce primitive blood supply.

Front 93

what do trophoblastic cells form with the completionof implantation?

Back 93

the primary villi which relsut in the development of the early gestational sac

Front 94

what is an ectopic preganancy?

Back 94

implantation where there is no endometrail lining.

Front 95

what does the inner cell mass become?

Back 95

embryic disc

Front 96

what are the initail layers of the embryonic disk?

Back 96

the endoderm, and ectoderm which are joined by the mesoderm

Front 97

what are the ferm layers resopnsible for?

Back 97

forming all the body organs

Front 98

what happens to the embryonic disk during the 4th week?

Back 98

it becomes attached to the develoing placenta by a connecting stalk.

Front 99

what happens to the inner cell mass by day 11?

Back 99

it becomes the bilaminar embryonic disk.

Front 100

how does the bilaminar convert to the trilaminar?

Back 100

by gastrulation

Front 101

what forms during gastrulation?

Back 101

primitive streak and notochord

Front 102

what develops from the primitive streak?

Back 102

mesenchyme develops from the primitive streak, and aforms the connective tissue of the glandular stroma

Front 103

what is another name for the chorionic cavity?

Back 103

extraembryonic coelum

Front 104

when does the chorionic cavity expand and the primary yolk sac regress into the secondary yolk sac?

Back 104

days 11-14 post fertilization

Front 105

when is the gestational sac detectable with an endovaginal probe? What size is it?

Back 105

5 weeks menstal age-2mm

Front 106

when does the allantios form?

Back 106

during the 3rd week

Front 107

what is the allantois?

Back 107

a tube that forms from the early yolk sac into the connecting stalk of the embryo.

Front 108

what are the functions of the allantois?

Back 108

-formation of blood cells
-gives rise to the umbilical arteris and veins

Front 109

whe does the yolk sac appear?

Back 109

during the 4th week, and is attached to the embryonic disk

Front 110

what are the functions of the yolk sac?

Back 110

-forms blood vessels
-gives rise to cells that become sex cells
-supplies nutrition to the fetal pole

Front 111

what does the yolk sac help with the formation of?

Back 111

-embryonic sac
-umbilical cord

Front 112

what are 2 ways to define the age of pregnancy?

Back 112

-conceptual age-time since fertilization of ovum
-menstral/gestational age-time since start of last period

Front 113

what is the decidua? what does it do/

Back 113

endometrial lining; prepares itself for pregnancy

Front 114

what is the decidual recation?

Back 114

the hypertriphic change in the endometrium due to the endometrial response to fertilization.

Front 115

will the endometrium still appear thick on ultrasound if there is an ectopic pregnancy?

Back 115

yes

Front 116

what are the 3 layers of the deciduized endometrium?

Back 116

-Decidua capsularis-surrounds blastocyst and eventually fuses with the deciua arietalis
-decidua parietalis(vera)-lines the rest of the endometrial cavity which is not implanted by the blastocyst
-decidua basalis-area that the blastocyst attaches to the uterus ad goes on to contribute to the maternal portion of the placenta.

Front 117

what is the double decidual sac sign?

Back 117

observed sonographically at a very early gestation. interface btw decidua capsularis and decidua paretalis before they fuse. It is useful for viable gestation. (only visible in 50% of pregnancies)

Front 118

what are sonographic features of an early gestational sac?

Back 118

-round or ovoid
-fundal portion of uterus
-smooth/echogenic wall-3mm or more
-internal landmarks:
)10mm yolk sac
)16mm embryo EV
)25mm embryo transabdominal
-gestational sac-1mm/day growth
-amniotic cavity
-chorionic cavity

Front 119

what is the first indicator of a potentially viable pregnancy?

Back 119

secondary yolk sac

Front 120

what are the earliest sonographic indications of pregnancy?

Back 120

-arcuate arteries more evident on myometrium
-thick echogenic endometrium
-gestational sac surounded by echogenic rim

Front 121

what is the embryonic portion of the placenta composed of?

Back 121

chorion and it's villi

Front 122

what is the maternal portion of the placenta composed of?

Back 122

the area of the uterine wall(decidua basalis) to which the villi are attached

Front 123

while the placenta is forming from the chorion, what happens to the amnion?

Back 123

it develops around the embryo

Front 124

what is the chorionic plate?

Back 124

the fusion of the amnion and chorion on the fetal side of the placenta

Front 125

when can the placenta be seen sonographically?

Back 125

as early as 8 weeks, but usally 12 weeks

Front 126

what may be seen post ovulation on U/S?

Back 126

fluid in the cul-de-sac

Front 127

is a hemorrhagic cysts benigh? why do they develop?

Back 127

yesas a result of rupture of blood vessels into the cystic cavity.

Front 128

how may hemorragic cysts appear on U/S?

Back 128

cystic, with septations, internal debris, fibrin strands, solid component, or other appearances

Front 129

what can be performed to differential a hemorragic cyst from other pathologies?

Back 129

a serial scan

Front 130

what happens to a hemorragic cysts within 7-10 days?

Back 130

the internal appearance will have altered, or it will decrease in size.

Front 131

What are some characteristics of a follicular cyst?

Back 131

-unilateral average-2cm
-usually spontaneously regress by resorption or rupture.
-assymptomatic
-sonographically simple cyst

Front 132

what are some characteristics of a corpus luteum cyst?

Back 132

-post ovulatory
-less than 2.5 cm
-usually regress

Front 133

what is a functional cyst?

Back 133

part of the normal female cycle:
-corpus luteum cysts
-follicular cyst
-hemorrhagic cyst
-theca lutien cyst(influenced by hormones)

Front 134

what is the most critical stage of development for a fetus?

Back 134

embryonic period(6-10 days)

Front 135

what happens to the early cell mass within the gestational sac?

Back 135

it matures into the bilainar embrynic disc, amnion, and primary yolk sac

Front 136

how is the secondary yolk sac formed?

Back 136

during 23 day of menstral age, the primary yok sac is pinched off by extra embryonic coelum forming the secondary yolk sac.

Front 137

how does the yolk sac appear sonographically?

Back 137

appears as a focal echogenic rig 4mm in diameter

Front 138

what is the double bleb sign?

Back 138

early amniotic sac and yolk sac with the developing embryo btw them

Front 139

what happens to the chorioamniotic space when the amniotic sac grows?

Back 139

the sac expands causing the space to go away, and the chorion and amnion fuse.

Front 140

when does the embryonic heart begin?

Back 140

5 weeks LMP