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PMS FINAL: Maternal and Fetal Physiology
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Agriculture
Kindergarten
08/23/2010

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Cards

Term

These symptoms are associated with that trimester of pregnancy?

  • Your period stops.
  • Your breasts may become larger and more tender.
  • Your nipples may stick out more.
  • You may need to urinate more often.
  • You may feel very tired.
  • You may feel nauseated and even vomit.
  • You may crave certain foods or lose your appetite.
  • You may have heartburn or indigestion.
  • You may be constipated.
  • You may gain or lose a few pounds.

 

Definition
First trimester
Term

These symptoms are associated with what trimester?

 

  • Your appetite increases and nausea and fatigue may ease.
  • Your abdomen begins to expand. By the end of this trimester, the top of your uterus will be near your rib cage.
  • The skin on your abdomen and breasts stretches and may feel tight and itchy. You may see stretch marks.
  • Your abdomen may ache on one side or the other, as the ligaments that support your uterus are stretched.

 

Definition
Second
Term

Thes sxs are assoc with what trimester?

 

  • A dark line, the linea nigra, may appear down the middle of your stomach from your navel to your pubic hair.
  • You may get brown patches (chloasma, or the "mask of pregnancy") on your face.
  • Your areolas, the darker skin around your nipples, may darken.
  • Your feet and ankles may swell.
  • You may feel your uterus in your lower abdomen.

 

Definition
second
Term

These symptoms are associated with that trimester?

 

  • You can feel the baby's movements strongly.
  • You may be short of breath.
  • You need to urinate more often as the baby drops and puts extra pressure on your bladder.
  • Colostrum—a yellow, watery pre-milk—may leak from your nipples.
  • Your navel may stick out.
  • You may have contractions (abdominal tightening or pain). These can signal false or real labor

 

Definition
Third semester
Term

When does this occur: (ie. what month)

  • The fertilized egg attaches to the lining of the uterus. Some of these cells will grow into a baby. Other cells will form the placenta.
  • Arms and legs begin to form.
  • Brain and spinal cord begin to form.
  • Heart and lungs begin to develop. The heart begins to beat near the end of this month

 

Definition

First month

 

(1/2 inch, less than 1 ounce)

Term

At what time would you describe the embryo as the size of a pinhead. It would be during this time that the embryo is in a protective shell of special cells in the uterus wall.

 

(ie. weeks fertilization vs weeks menstruation)

Definition

two weeks fertilization

 

4 weeks menstruation

Term

When is the embryo and first nerve cells formed?

 

(ie weeks fertilization vs menstrual)

Definition

3 weeks fertilization

 

5 weeks menstrual

Term

During this many weeks:

 

a blood vessel forms which will later develop into the heart and circulatory system. It begins to pump blood. At about the same time, a ridge of tissue forms down the length of the mbryo. That tissue will later dvelop into the brain and psinal cord. Arm and leg buds are present.

Definition

4 weeks fertilization

 

6 weeks menstrual

Term

What month does this occur:

 

  • Eyelids form, but remain closed.
  • The inner ear begins to develop.
  • Bones appear.
  • Ankles, wrists, fingers, and toes form.
  • The genitals begin to develop.
  • By the end of the month, all major organs and body systems have begun to develop.

 

Definition

second month

 

(1 inch, less than 1 oz)

Term

6 weeks fertilization and or 8 weeks menstrual.

 

What starts to appear?

 

What is starting to form?

Definition

Cells of the embryo continue to multiply and start to form the brain.

 

At the other end is a tail bud which will become the end of the spine.

 

Fingers and otes are starting to appear.

 

Cells which also are multiplying in other parts of the embryo are starting to form the eyes, ears, jaws, lungs, stomach, intestines and liver

Term
At what stage is the embryo considered a fetus?
Definition
8 weeks fertilization/ 10 weeks menstrual
Term

At what weeks, can you start to identify eyes, ears, arms and legs?

 

What is now developing at this time as well?

Definition

8 weeks fertilization/ 10 weeks menstrual

 

muscles and skeleton are developing

Term

At how many months does this occur?

 

  • Twenty buds for future teeth appear.
  • All internal parts are formed, but are not fully developed.
  • Fingers and toes continue to grow. Soft nails begin to form.
  • Bones and muscles begin to grow.
  • The intestines begin to form.
  • The backbone is soft and can flex.
  • The skin is almost transparent.
  • The hands are more developed than the feet.
  • The arms are longer than the legs.

 

Definition

Third month

 

3.5 in, just more than 1 oz

Term

At how many weeks have all major external body features appeared?

 

What else is unique about this time period?

Definition

10 weeks fertilization

 

fingers and toes are distinct and have nails

Term

Teh eyes are beginning to grow toward the forn tof the head and 20 buds are present for baby teeth. There are eyelids and the nose is developing a bridge.

 

How many weeks?

Definition

12 weeks fertilization

14 weeks menstrual

Term

What month is this:

 

  • Eyebrows, eyelashes, and fingernails form.
  • Arms and legs can flex.
  • External sex organs are formed.
  • The skin is wrinkled and the body is covered with a waxy coating (vernix) and fine hair (lanugo).
  • The placenta is fully formed.
  • The outer ear begins to develop.
  • The fetus can swallow and hear.
  • The neck is formed.
  • Kidneys are functioning and begin to produce urine.

 

Definition
Fourth month
Term

When does fine, downy hair as well as scalp hair appear on fetus?

 

Respiratory movements occur, but the lungs have not developed enough to permit survival.

Definition

18 weeks

 

20 weeks menstrual

Term
When can you start to feel the fetus move?
Definition

18 weeks fertilization

 

20 weeks menstrual

Term

What month does this describe?

 

  • The sucking reflex develops. If the hand floats to the mouth, the fetus may suck his or her thumb.
  • He or she is more active. You may be able to feel him or her move.
  • The fetus sleeps and wakes regularly.
  • Nails grow to the tips of the fingers.
  • In girls, all her eggs have formed in the ovaries.
  • In boys, the testicles begin to descend from the abdomen into the scrotum

 

Definition
Fifth Month
Term

At what many weeks does the fetus become more active (ie. turning side to side)??

 

kidneys are starting to work and the air sacs of the lungs are starting to develop.

Definition
20 weeks fertilization and 22 weeks menstrual
Term

What month does this describe?

 

  • 12 inches, 1–1 1/2 pounds
  • Real hair begins to grow.
  • The brain is rapidly developing.
  • The eyes begin to open.
  • Finger and toe prints can be seen.
  • The lungs are fully formed, but not yet functioning.

 

Definition
Sixth month
Term

What month does this describe?

 

  • 14 inches, 2–2 1/2 pounds
  • The eyes can open and close and sense changes in light.
  • Lanugo begins to disappear.
  • The fetus kicks and stretches.
  • The fetus can make grasping motions and responds to sound.

 

Definition
7th month
Term

What month does this describe?

 

  • With its major development finished, the fetus gains weight very quickly.
  • Bones harden, but the skull remains soft and flexible for delivery.
  • The different regions of the brain are forming.
  • Taste buds develop and the fetus can taste sweet and sour.
  • The fetus may now hiccup.

 

Definition
8th month
Term

What month does this describe?

  • The fetus usually turns into a head-down position for birth.
  • The skin is less wrinkled.
  • The lungs mature and are ready to function on their own.
  • Sleeping patterns develop.
  • The fetus will gain about 1/2 pound per week this month.

 

Definition
Ninth month
Term
When a woman becomes pregnant-what changes take place to cervix?
Definition
Becomes cyanotic and soft secondary to increase vascularity and hyperplasia
Term
What happens to the cervical glands during pregnancy?
Definition

initially in a non prego glands occupy small fraction o fcervix.

 

In prego: glands occupy half of the cerviz, producing more mucous of more tenacious consistency

Term
Why does the cervix look like a  honey comb during pregnancy?
Definition
secondary decreased stroma
Term
How long is the presence of the corpus luteum during prengancy mandatory?
Definition
first 6-7 weeks
Term

What color does the vagina become during pregnancy? why?

 

why increased thickness of mucosa?

Definition

Color: due to hyperemic state

 

Increased thickness of mucosa: to allow increased distensibility

Term
What causes the increased pigmentation in prego women?
Definition
increased prigmentation in linea nigra and chloasm due to increased melanocyte stimulating hormone
Term

Chloasm

 

What is another name for it?

 

What is it?

Definition

Melasma

 

tan or dark skin discoloration

Term
Who gets vascular angiomas?
Definition

2/3 of white women

 

10% African American

Term

What happens to the breasts during pregnancy?

 

(ie nipples, alveoli)

Definition

nipples: larger, more pigmented

 

alveolar growth

Term
What happens to RBCs during pregnancy?
Definition
RBC increase due to increase in maternal plasma erythropoetin
Term
What causes the physiologic anemia in pregos?
Definition
an increase in the plasma componenet is greater than in the RBC component
Term
What happens to BP during prego?
Definition

small decrease in systolic

 

large decrease in diastolic

Term

What is the non prego state/size of uterus?

 

What is prego state/size of the uterus?

Definition

non-prego: 70 gm

 

prego: increases to 1100 gm; cavity enlarges to hold an avg of 5000 mL

Term

In the first 3 months, the uterus grows is response to ______ and _______.

 

Thereafter it grows in response to ________

Definition

In the first 3 months, the uterus grows is response to estrogen and progesterone.

 

Thereafter it grows in response to products of conception.

Term
What causes the physiologic anemia of pregnancy?
Definition

an increase in the plasma component is GREATER than in RBC component.

 

*RBC increase due to increase in maternal plasma erythropoeitin

Term
Blood volume in preg lady increases up to __ weeks and the plateaus.
Definition
32
Term
In what position will BP be the highest? (referring to 3 positions)
Definition

sitting>left lateral>supine

 

due to vena caval compression, decreased venous return

Term
What happens to systolic and diastolic BP in pregnant woman?
Definition

small decrease in systolic BP

 

LARGE decrease in diasolic

 

*becomes more pronounced mid pregnancy

Term

Why is venous pressure increased with lower extremities in pregnant woman?

 

what is the effect of this?

Definition

BECAUSE OF GROWING FETUS

-no valves btw inf vena cava and femoral blood vessels

-cause stasis and varicosities

-edema secondary to elevated pressure and decreased oncotic pressure

Term
What type of murmur is common in prego lady?
Definition
systolic ejection murmur
Term
The heart is displaced how in pregnancy?
Definition
displaced anteriorly and upward
Term
Cardiac output in the pregnant lady is dependant on two factors.
Definition

stroke volume AND heart rate

 

stroke volume makes the greater contribution initially but at the end of pregnancy CO is secondary to HR

Term
What body region receives the larges increase in cardiac output in prego lady?
Definition

uterus

 

then renal blood flow

 

**brain and liver do not see increase in blood flow-remain constant

Term
Prego lady will notice decrease in total lung capacity due to what?
Definition

due to decreased residual volume

 

-due to elevation of diaphragm and decreased chest wall stiffness which reduces trapped air volume

 

-tidal volume is increased, probably mediated by progesterone

Term
How is airway function measured? (3)
Definition

airflow

diffusion capacity

ventilation

Term
What causes dilation of entire collecting system right>left?
Definition

partial ureteral obstruction at the pelvic brim by growing uterus

 

-growing uterus is dextro-rotated

-relaxation effect of progesterone

-increased volume of urine-changes persist up to 3 months postpartum

Term
what hormone causes sensation of SOB in pregnancy?
Definition
progesterone
Term
What causes respiratory alkalosis in pregnancy?
Definition
increased ventilation
Term

Diffusion capacity in normal pregnancy:

 

explain what happens in early pregnancy vs at 24 weeks

Definition

diffusion capacity increased in early pregnancy due to increased pulmonary blood flow

 

Diffusion capacity decreased at 24 weeks due to decreased hemoglobin concentration

Term

What do you expect levels to be for BUN, Cr in pregnancy?

 

why?

Definition
decreased by GFR is increased
Term
Why do women have glucosuria and proteinuria during pregnancy?
Definition
due to increased GFR which overwhelms capacity for reabsorption
Term

Explain why pregnant woman is predisposed to UTI?

 

(domino effect of events going on....hint: start with her breathing...)

Definition

pt has increased breathing so more alkaline

therefore, kidneys choose to NOT absorb more bicarb which causes urine to be more alkalotic which is the perfect environment for bacteria; hence UTI infection (also bacteria love glucose)

Term

Uric acid in pregnancy

 

where is it filtered?

where is it absorbed?

Where is it excreted?

Definition

where is it filtered? glomerulus

where is it absorbed? proximal convoluted tubules

Where is it excreted? distal tubules

Term
Why is it important for the kidneys regulate Na during pregnancy?
Definition

Na needed to expand intravascular and extravascular compartments

 

increased GFR, increases tubular absorption of Na, prevents Na depletion

Term
Prego women are resistant to ___ loss
Definition
K
Term

Oropharyngeal:

 

why do gums become edematous and bleed more during pregnancy?

Definition
secondary to increased blood flow and increased mucopolysaccharides
Term

Esophagus:

 

why is their lower esophageal spincter pressure during pregnancy?

Definition

with increased gestational age due to increased progesterone.

 

will return to normal 1-7 weeks post partum

Term

Stomach in pregnancy:

 

what is the result of progesterone?

Definition

decreased motility and tone--therefore always have a full stomach

 

gastric acid secretion is decreased

Term
Why do the powers to be make a prego woman have decreased  motility in small intestine and large intestine?
Definition
allows for increased absorption of Fe and Ca and H20
Term
What are two consequences of decreased motility of small and large intestine?
Definition

constipation

 

hemorrhoids due to increased venous pressure

Term
Why is prego lady more prone to gallstones?
Definition
increased gallbladder volume dilutes bile and decreases its solubility of cholesterol. Bile becomes more dilute and cholesterol is therefore less soluble so the number of stones increases. Cholesterol then precipitates to form crystals and stones
Term

Liver and pregnancy:

 

what happens to liver proteins?

 

fibrinogen synthesis

Definition
both are increased
Term
Why an increased MCV in pregnancy?
Definition
due to increased number of reticulocytes
Term

What happens to the following levels during pregnancy:

 

serum Fe

Total Fe binding capacity

Ferritin

Definition

serum Fe: decreases

Total Fe binding capacity: increase

Ferritin: normal

Term
What happens to WBC and coagulation factors during pregnancy?
Definition

WBC-total count as well as % of neutrophils increased due to estrogen

total lymphocyte count decreased

 

Coag factors: all but factor XI and XIII increased (reason why increased clotting activity in pregos)

uterine contractions cause hemostasis

Term

You will see an increased T4 value, but not free T4 in pregnancy.

 

Why?

Definition

due to increased production of thryoid binding globulin

T3 uptake decreased

Term
What is the most important hormone responsible for the increased use of lipids for maternal caloric needs?
Definition
chorionic somatroptropen/ aka human placental lactogen
Term
braxton hicks
Definition
false contractions
Term

What month do these happen?

 

bones appear

ankles, wrists, fingers and toes form

genitals BEGIN to develop

 

at the end of this month, all major organs and body systems have begun to develop!!!!!!!

Definition
second month
Term

what month?

 

twenty buds for future teeth appear

Definition
third month
Term

What month?

 

all internal parts are formed, but are not fully developed!

 

intestines begin to form

 

arms are longer than legs

Definition
third month
Term

At what month can arms and legs flex?

 

external organs are formed

 

kidneys are functioning and begin to produce urine?

Definition
fourth month
Term
At what month is the placenta full formed?
Definition
fourth month
Term

When does the sucking reflex develop?

 

What month?

Definition

fifth month

 

think fifth month--could view the thumb as the fifth digit..

Term

What month:

 

in boys, testicles begin to descend from the abdomen into the scrotum.

 

in girls, all her eggs have formed in the ovaries.

Definition
fifth month
Term

When do eyes beging to be open?

 

when do fingers and toe prints come into view?

 

this is also when lungs are fully developed!!!

Definition
sixth month
Term

Be nice to the baby: this is when the eyes open and close and are sensitive to changes in light.

 

baby becomes a soccer player and starts kicking you! fetus makes grasping motions and responds to sound

Definition
seventh month
Term

When do taste buds develop and the fetus can taste sweet and sour?

 

development finished now maturation and wt gain from this point on.

Definition
eighth month
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