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68 Cards in this Set
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- Back
- 3rd side (hint)
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After ovulation, fimbriae of the fallopian tube sweep egg into outer third of tube where this takes place. Mature sperm swim up the uterus to fallopian tube and try to do this to the egg. If this doesn't happen the ovum dies in 24-48 hrs. It takes 1000's of sperm to break through outer layer of ovum but only 1 enters. A physiologic barrier prevents remaining sperms from entering egg. Once this happens to the ovum, the sex of the egg is determined.
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Fertilization
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After ovulation_________ sweep egg into the outer third of the tube where fertilization takes place.
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fimbriae of the fallopian tube
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swims up the uterus to the fallopian tube to try to fertilize the egg.
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Mature sperm
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If it doesn't happen, the ovum dies in 24-48 hours
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It takes 1000's of sperm to break through the outer layer of theovum, but only how many will enter?
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1
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What prevents the remaining sperm from entering the egg?
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A physiological barrier
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Once ovum is fertilized the sex of the _______ (fertilized egg is determined.
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Zygote
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What is the Zygotic stage of conception?
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2 weeks, but the stage is considered 8 weeks, then it is a fetus for the remaining 32 weeks. Embryonic stage is considered 3-8 weeks. fetal stage is week 8-40
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Zygotic stage of conception consists of...
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1. Rapid growth and development
2. Cell division takes place and forms a mullberry like structure called a morula and the number of cells increase size and stay the same. 3. Stays in the tube for 3 days then travels to the uterus and is retained for approximately 4 days prior to implantation in uterus at day 7. |
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Outer layer and nourishes inner layer
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Trophoblast
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Embryonic stage is...
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week 3-8
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What happens in the embryonic stage of development?
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Tissues and organs are differentiated. End of circulation stage which is established and begins to function.
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What forms all major fetal organs?
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Germ layers
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Inner layers that form bladder and urethral lining, urethra lining, respiraatory tract, liver and pancreas...
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Endoderm
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Middle layer forms connective tissue, bones, muscles, kidneys, ureters, reproductive system, heart, circulatory system and the heart begins to pump.
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Mesoderm
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Outer layer that forms nervous system, skin,eyes,ears, hair follicles, nasal cavity, mammary glands (neural tube is formed)
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Ectoderm
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Needs to be taken by the Mother to provide good nutrition, prevent Spina Bifida and neural tube defects...
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Folic Acid
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Inner most membrane of placenta which contains amniotic fluid and developing fetus (fluid is clear and is 98% water, also called bag of waters) 500-1000 cc
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Amnion
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Outer most membrane , thick layer with finger like projections.
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Chorion
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In the chorion is embedded into the decidua and develop into the placenta
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Chorionic villi
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Hormone of pregnancy that is given off chorionic villi into blood and eventually into the urine. It denotes a positive pregnancy test...
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Chorionic Gonadotropin
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Can prevent neural tube defects such as spina bifida. Women need to have good nutrition and take this supplement before they even become pregnant...
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Folic acid
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Functions as a temporary organ of the woman for the developing fetus for respiration, nutrition, and excretion and endocrine gland. It is an organ of transfer and exchange between the mother and fetus. Responsible for metabolism and transfer of nutrients and wastes between woman and embryo. It secretes various hormones of pregnancy. One is HCG or Human Chorionic Gonadotropin which is detectable in maternal blood as soon as implantation occurs-79 days after fertilization. It is the basis for most pregnancy tests. it is functional by the 12th week of pregnancy. Maternal and fetal blood do not mix. At term is oval 6-8 inches in diameter, 1 inch thick & weighs 1/6 as much as the fetus.
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Placenta
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Lifeline between placenta and fetus. Contains 3 vessels (one large vein, and 2 arteries)and is 18-20 inches long.
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Umbilical cord see hint
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One large vein brings oxegenated blood and nutrients to the fetus. 2 arteries returns non-oxygenated blood, c02 & other fetal wastes to the placenta. Wharton's jelly is a gelatinous material surrounding the 3 vessels to prevent kinking, twisting and collapsing.
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Gelatinous material surrounding the 3 umbilical vessels to prevent kinking, twisting and collapsing
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Wharton's Jelly
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Weeks 9-40. Final stage of intrauterine growth. Emryo is now called this. Quickening (fetal movement) is felt during this period about 18 weeks...
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Fetal Stage
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Lungs do not function, so receive 02 from placenta. fetus must have special structures to bypass immature lungs and shunt blood around the lungs. During intrauterine life, circulation of blood to lungs is for nourishment, not oxygenation. Circulation is accomplished by 6 structures:
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Fetal Circulation
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What six structures accompany fetal circulation....
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1.Two umbilical arteries
2.Placenta 3. Umbilical vein 4. Ductus Veinosis 5. Foramen Ovale 6. Ductus Arteriosus |
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Carries fetal blood to the placenta...
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Two umbilical arteries
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Exchange site for oxygen and othergases
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Placenta
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Returns oxygenated blood from the placenta through the umbilicus to the inferior vena cava & shunts small amount of blood to liver underside of the liver where it gives off two or three branches and continues to the ductuus veinosis.
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Umbilical vein
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Continuation of the umbilical vein which drains into the inferior vena cava, bypassing th liver. (Then emptys into the right atrium)
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Ductus Veinosis
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Opening in the septum (middle of heart) etween the right and left atria. Allows blood to bypass the lung.
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Foramen Ovale
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Shunts blood away from the lung. Small vessel between the pulmonary artery and the aorta & sent to 2 umbilical arteries to be resupplied with 02 from the placenta...
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Ductus Arteriosis
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What are the three germ layers?
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Endoderm, Mesoderm and Ectoderm
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What are the advantages of spinal/epidural anesthesia?
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Doesn't cross he placenta, Mother is awake, reduces post op pain, reduces preterm vomiting.
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Why is general anesthesia sometimes chosen?
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Baby is in distress, emergency
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What preparations are done pior to the induction of anesthesia and why?
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skin prep, bladder drainage, draping and glove. This is all done to keep everything sterile.
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I&D (Incision and delivery time) should be how many minutes?
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5-7 minutes
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What are the two possible incisions for a C-Section?
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1. Lower transverse ncision and
2. midline |
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What are the two uterine incisions that can be used? How is the uterus opened? Which one is the most common?
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Low transverse incision is the most common. The use of a listner scissors
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Where should the scalpel be placed when the surgeon is done using it?
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On the back table
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At what point is the baby's airway suctioned?
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as soon as the head is delivered
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At what point is the cord clamped?
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after delivery
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What drug is given to enhance uterine contraction and slow bleeding?
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Oxytocin
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Why is it that when the placenta is delivered at the last stage of labor is it inspected thoroughly?
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So as not to leave remnants in the uterus
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Why is the fundus massaged after delivery?
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To prevent hemmorrhage from relaxation. (It is massaged until it is hard.)see hint
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Oxytocin may have to be given to help with uterine hmostasis to prevent hemmorrhage.
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When is a sponge count done post C Section?
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as the uterus is closed and again as the abdomen is closed
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When is a tubal ligation (tubes tied)performed during C-Section?
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Prior to closure of the abdomen
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What is the wound classified as post C-section?
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Clean contaminated because of entrance into the reproductive tract
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What are some possible complications status post delivery?
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Bleeding
Infection Injury to adjacent organs C-Section weakens musculature and may result in future C-Section |
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When are apgar scores performed and when is intervention needed on a baby?
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Done at 1 & 5 minutes
A score under 7 needs intervention. 10 is perfect. see hint |
Abe and Beau's scores were both 9 @ 1 minute and 10 @ 5 minutes because there feet were slightly blue.
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What is the prophylactic antibiotic ointment put in the baby's eyes after delivery for?
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to prevent gonococcus (gonorrhea) and chlamydia conjunctivitis(eye infection)
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What are identified after delivery?
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Footprints of baby. Mom's index finger. ID bands are placed on mom's wrist and ankles of the infant.
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What is done after the initial assessment and ID post delivery?
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Infant is placed with Mom and may be put to the breast for the first time
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May be a scheduled case or an emergency. An emergency delivery occurs very quickly. If a general anesthetic is given, time is extremely critical to prevent fetal anesthesia and to correct the condition that warranted the emergency. In an emergency, you will not be able to do a complete set up. After you are gowned and gloved, there are several instruments that are critical to do delivering the baby.
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C-Section see hint for materials used
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laparotomy Drape
Scalpel Lap sponges Clamps 4-6 (Peans or long Carmalts) Metzenbaum scissors Bladder retractor (delee or the bladder blade from a balfour retractor) Hemostats such as Kelly or Crile clamps. Lister bandage scissors Suction tubing Bulb syringe (to suction nose and mouth) |
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Why is the mother placed supine with the riht side slightly elevated?
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To displace the uterus and prevent aortocaval compression
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What happens during the first stage of labor?
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Effacement, dilation
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Cervix thins out
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Effacement of cervix
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Cervix expands to 10 cm
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dilation of cervix
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How long does labor last for a Primipara(first time mom)
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8-12 hours
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How long does labor last for a multipara(more than the first time mom)?
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6-8 hours
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What happens during the second stage of labor?
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expulsion stage. begins with full dilation of the cervix and ends with the birth of the infant. Mother bears down to aid in expulsion of infant.
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What happens duing the third stage of labor?
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Placenta detaches and is expelled. Is painless and occurs within 5-15 minutes after birth. Pitocin adminitered sometimes to keep the uterus contracted.
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What type of anesthesia is used for a vaginal delivery?
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Epidural, Pudental, Local infiltration.
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administered during 1st and 2nd stage of labor. Extends from the umbilicus to the toes for analgesia for delivery and repair of episiotomy...
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Epidural
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Administered during the second stage of labor to numb the perineum for birth & repair of the episiotomy, lacerations, or forceps delivery...
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Pudental
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Injection of anesthetic into superficial tissues & nerves of perineum to numb area for repairs of lacerations and episiotomies.
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Local infilatration
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What is done in the immediate care of the newborn?
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Once the infant is dryed it is wrapped in sterile blankets and placed in a radiant warmer and wiped dry. A pediatrician checks the infant. The infant is covered in vernix caseosa (lotion like substance on baby's skin). The umbilical stump is also checked for 1 vein and two arteries (abscence of artery is associated with heart and kidney anomalies)
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