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OB Exam 1
OB chapter 10
| Question | Answer |
|---|---|
| process of fertilization | a sperm cell merges with an egg cell to combine their genetic material and form a single-celled zygote |
| what is decided at fertilization | gender |
| where does fertilization take place | fallopian tube |
| a zygote is | sperm + egg |
| the zygote goes through replication | aka cleavage which happens on day 1 |
| cleavage is | when egg and sperm meet and divide in half until 16 cells |
| the 16 cells from cleavage are called | morula cells which travel through fallopian tubes to the uterus and this occurs on day 3 |
| once the morula cells travel to the uterus, what forms? | a blastocyst |
| a blastocyst is | when a cavity forms in ball of cells and this occurs on day 4 |
| blastocysts give rise to | fetus and amniotic membrane |
| the outer part of the blastocyst is called | trophoblasts |
| blastocysts do what? | soak up lining of uterus when most supportive (uterine blood) |
| on day 6, what happens? | implantation |
| what does an unhealthy sperm look like? | large head and sharp tail, don't move and die in birth canal |
| ovary appearance | bumpy and small |
| oocyte is a | mature follicle |
| stages of human development | preembryonic, embryonic, fetal |
| preembryonic | conception to day 14 (2 weeks) mother may experience spotting due to blastocysts in uterine lining |
| embryonic | day 15 to 8 weeks after conception this stage gives rise to various functions |
| fetal | 9 weeks until end of pregnancy fetus have big heads, tiny hands and feet |
| embryonic stage has 3 layers called | embryo layers |
| when do the embryo layers form | within the first 8 weeks |
| 3 embryo layers | ectoderm, mesoderm, endoderm |
| ectoderm is responsible for | CNS, special senses, skin and glands |
| mesoderm is responsible for | skeletal, urinary, circulatory and repro organs |
| endoderm is responsible for | forming respiratory systems, liver, pancreas and digestive system |
| the embryonic stage also has | development of supporting structures |
| the supporting structures the embryonic stage forms are | amniotic fluid, umbilical cord and placenta |
| amniotic fluid has many functions | maintains body temp, source of oral fluid and a repository for urine, promotes muscle development, cushions against trauma, weightless state which allows symmetrical development, antibacterial factors in fluid, facilitates normal lung development |
| alterations in amniotic fluid | polyhydramnios, oligohydramnios |
| polyhydramnios | too much fluid - you can feel excess AF >2000 ml or 2L GI malformations cord entanglement - twist around and knot difficulty monitoring FHR labor complications |
| polyhydramnios causes more | bleeding!! |
| oligohydramnios | too little fluid <300 ml renal abnormalities asymmetric growth and development - head and tail impacted cord compression - when there are contractions there is more pressure on the cord bc not enough fluid to buffer |
| umbilical cord | the babys lifeline!! |
| umbilical cord consists of | 1 vein to bring O2, 2 arteries to carry out waste and CO2 "AVA" |
| umbilical cord feature that prevents compression | wharton jelly |
| size of umbilical cord | 22 in long and 1 in wide |
| umbilical cord should be | centrally inserted on placenta so that there is equal pressure across the placenta |
| anything that affects moms O2, | impacts the fetus!! |
| placenta functions | endocrine, metabolic, circulation |
| endocrine placenta functions | Hormones provide ”direction” to mother’s physiology to prioritize supply of nutrients and oxygen needed for fetal growth (respiratory and nutrition |
| metabolic placenta functions | waste remover (excretory) high demand for glucose |
| circulation placenta functions | interface between mom and fetus via active transport |
| fetal side of placenta | railroad, glistening, not dry smooth and shiny |
| maternal side of placenta | red and rough attached to mothers uterus |
| where does placenta lie | on top of uterine lining, so not a good sign if stuck |
| placenta endocrine function: hormones | hCG, hPL, progesterone, estrogen |
| since one cell layer separates maternal and fetal blood, what can happen | Breaks occasionally occur in this membrane Mixing of maternal / fetal blood Problematic for Rh- mothers |
| placental function is dependent on maternal circulation | as uterus enlarges, it presses on inferior vena cava which means no blood to head or heart and can make mom hypotensive when they stand so should lay on side |
| embryonic stage - teratogen exposure | exposure to teratogens is especially dangerous because the major organs and body structures are forming |
| Teratogens are | substances or environmental exposures that can cause birth defects |
| harmful teratogens to embryonic stage | viruses: flu or rubella alcohol certain prescription drugs (antidepressants) nicotine radiation |
| fetal stage circulation | opposite of adult circulation, vein delivers increased O2, arteries deliver unoxygenized blood |
| blood travels through 3 shunts in fetal body | ductus venosus, foramen ovale, ductus arteriosus |
| ductus venosus (liver bypass) | connects umbilical vein to IVC liver processes nutrient rich blood |
| foramen avale (RV bypass) | opening between the right and left atrium to bypass ventricle |
| ductus arteriosus (lung bypass) | connects pulmonary artery to aorta bypass pulmonary circulation |
| where is surfactant | lamalar bodies |
| fetal stage: respiratory system | surfactant: used to determine fetal lung maturity, prevents alveoli from closing |
| fetal stage: respiratory system L/S ratio | diagnostic marker 2:1 = mature to support themselves |
| fetal stage: neurologic system | Spinal cord develops from neural tube (ectoderm) Chronic poor nutrition, hypoxia, drugs, or environmental toxins can damage CNS Neural tube defects due to folic acid deficiency |
| genotype | genetic makeup of an individual when discussing a specific gene pair |
| phenotype | observable expression of an individuals genotype |
| chromosomal abnormalities | Major cause of reproductive loss (e.g., miscarriage), congenital problems, & gyn disorders Monosomic individuals - 45 chromosomes Trisomic individuals - 47 chromosomes |
| who should genetic counseling be offered to | everyone! |
| genetic testing allows for | earlier diagnoses & molecular biology and genomics advancements allow us to better understand diseases |
| factors that affect decision making | social norms socioeconomic status cultural, ethnic, and religious differences finding screening scary or stressful access to healthcare resources |
| timeline of genetic testing | carrier screening, transvaginal US, non invasive pregnancy testing, chorionic villus sampling, aminocentesis, anatomy scan (transabdominal US) |
| NIPT | cfDNA - cell free DNA screening checks fetal chromosomes for specific conditions |
| chorionic villus sampling | 10-13 weeks |
| amniocentesis | 15-20 weeks |
| anatomy scan (transabdominal US) | 20+ weeks |
| maternal serum tests | proteins and hormones in maternal serum combined with multiple steps to create models and risk scores detection rate is lower false positive rate is higher |
| cfDNA screening taking over maternal serum tests | fragments of placental DNA in maternal bloodstream can be performed early (10 weeks) detection rate is higher false positive rate is lower |
| types of genetic problems | chromosomal abnormalities unifactorial inheritance multifactorial inheritance gene mutations - 3 mechanisms |
| chromosomal abnormalities | Major cause of miscarriage, congenital problems, & gyn disorders |
| unifactorial inheritance | Single-gene disorders have much higher incidence than chromosomal abnormalities |
| multifactorial inheritance | Multifactorial inheritance causes most common congenital malformations |
| gene mutations - 3 mechanisms | 1.environment changes genes (e.g., UV) 2.chance - norm metabolic processes damage DNA 3.inherit - mutated genes from parents (5-10% of all cancers) |
| karyotypes | Cells from any replicating body tissue can be used (except RBCs, nerve cells, and muscle cells) Used to provide a pictorial analysis of number, form, and size of chromosomes |
| monosomies | missing the 2nd chromosome 23 Turner Syndrome - X associated with infertility on female side |
| trisomies | extra chromosome on 13 (patau), 18 (edwards), 21(down) |
| translocation example | cri du chat |
| autosomal dominant | A single gene can produce the phenotype one partner affected = new child has 50% chance |
| x linked inheritance | Associated with altered genes present on the X chromosome. Can be either dominant or recessive |
| autosomal recessive | Two copies of the abnormal gene in a homozygous state are needed to produce the phenotype both partners are carriers = new child has 25% chance |
| multifactorial inheritance | Caused by polygenic and environmental factors |
| x linked recessive | dad normal, mom carrier males are normally more likely to be affected |
| x linked dominant | dad normal, mom affected 50% chance for kids, equal chance male and female kids |
| risk factors suggesting genetic testing | maternal age >35 consanguinity or inscest paternal age >40 family hx of genetic conditions 2 or mo previous miscarriages previous child with congenital abnormalities teratogen exposure previous child with developmental/intellectual delays |
| nurses' role in genetic testing | create a pedigree from family hx develop plan of care that incorporates genetic assessment info assess knowledge, perception, and responses to genetic information facilitate referrals for specialized genetic services ***provide emotional support! |
Created by:
leh195