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Martin's Notes

Trophoblast What surrounds the embryo in the 1st trimester?
Cytotrophoblast What is the inner layer of the trophoblast?
Syncytiotrophoblast What is the outer layer of the trophoblast?
Decidua Another term for gravid endometrium?
Decidua Basalis This decidual layer occurs between the blastocyst and myometrium.
Decidua Basalis This thick decidual layer is found at the implantation site.
Decidua Capsularis This thin decidual layer overlies the gestational sac facing the UT cavity.
Decidua Parietalis This decidual layer is also known as Decidua Vera.
Decidua Parietalis This decidual layer surrounds the remaining endometrium, and lies opposite of the implanted ovum.
Smooth Chorion This is also known as Chorion laeve.
Smooth Chorion This consists of degenerating villi and lies opposite of implantation site.
Chorion Frondosum This is also known as the definitive placenta.
Chorion Frondosum This is the portion of the chorion at the implantation site and invades the decidua basalis for embryo nutrition. Seen sonographically as a hyperechoic focal thickening.
Chorion Frondosum This structure of 1st trimester/placental development is seen by 12 weeks sonographically.
Chorionic Villi These are the functioning units of the placenta; vascular projections from the chorion.
centrally Where does the cord insert on the placents?
Maternal, Fetal What are two portions of the placenta?
Basal plate The maternal aspect of the placenta is called what?
Chorionic plate The fetal aspect of the placenta is called what?
Basal plate This is divided into cotyledons.
Chorionic plate This aspect of the placenta is covered by amniotic membrane.
Intervillous space What space lies between the chorionic villi and acts as reservoirs for transfer of gases and nutrients?
Spiral arteries Oxygenated maternal blood enters the placenta through what arteries?
Hemoglobin Which is NOT associated with the placenta and 1st trimester bleeding? Subchorionic bleed, hemoglobin, hemorrhage, hematoma
Subchorionic bleed Defined as the chorionic membrane stripped from the endometrium with elevation of the chorionic membrane.
2-4 Normal placenta is usually _____ cm thick.
4 cm, 24 Placenta thickness > _____ before _____ weeks is abnormal.
Retroplacental damage (correct answer would be Intraplacental) All of the following are causes of placenta thickening EXCEPT: Retroplacental damage/hemorrhage, chorioangioma, fetal hydrops?
5 Placenta thickness @ _____ in the 3rd trimester is considered abnormal.
1.5 Thin placenta is </= _____ cm
Diabetes Inspidus (correct answer would be Diabetes Mellitus) All are causes of thin placenta EXCEPT: IUGR, Diabetes Insipidus, Intrauterine infection
Placental substance Placental tissue aka?
12-13 Placenta is homogenous & hyperechoic by _______ week.
12-13 Placenta intervillous blood flow can be demonstrated by _______ week.
2-3 trimesters Placenta is homogenous-heterogenous in _________.
Venous lakes Another name for placenta lakes?
5 Venous lakes are seen in ____% of pregnancies.
base The placenta demonstrates a clear separation from myometrium at the ______.
Retroplacental complex This structure of placenta is seen by 14-15 week.
Retroplacental complex This structure at the base of the placenta is composed of decidua, myometrium, and UT vessels.
edges The marginal sinus of the placenta can be found at the ______.
Marginal sinus This is defined as the area where intervillous blood drains into the maternal venous circulation.
Marginal sinus Do not mistake this portion of the placenta for separation/abruption.
3 Which trimester does the placenta exhibit high vascularity?
Placental migration This is defined as the uterus expanding and displacing placenta away from the cervix.
Metabolism All are FUNCTIONS of the placenta except? Respiration, Nutrition, Excretion, Metabolism, Protection, Storage, Hormone production
Respiration This function of placenta diffuses maternal blood across placental membrane into fetal blood.
Nutrition This function of placenta supplies carbs, fat, protein from maternal blood.
Excretion This function of placenta carries fetal waste away.
Protection This function of placenta guards against microorganisms.
Storage This function of placenta holds carbs, proteins, calcium, and iron for release into fetal circulation.
Hormone production This function of placenta creates hCG, estrogen, progesterone.
Vitamin A All are stored by the placenta for later fetal circulation use EXCEPT: Carbs, Protein, Vitamin A, Calcium, Iron
Grade 0 This placenta grade is defined as a smooth chorionic plate.
Grade 1 This placenta grade contains small, randomly dispersed intraplacental calcs.
Grade 2 This placenta grade displays calcification of the basilar plate. The chorionic plate displays comma-like densities.
Grade 3 This placenta grade divides the placenta into segments.
Diabetes Mellitus Advanced maturation of the placenta before expected is associated with all of the following EXCEPT: Htn, Diabetes Mellitus, IUGR, Smokin, Multiples
Circumvallate placenta Which placental variant is associated with PROM, PTL, hemorrhage, and abruption?
Circumvallate placenta Which placental variant can appear as linear and confused with uterine synechiae or amniotic bands?
Succenturiate placenta Which placental variant is seen as two unequally sized lobes connected by vascular bands?
Chorioangioma Most common benign tumor of the placenta (1%)
Complete hydatidiform mole Which molar pregnancy has a "snowstorm" appearance?
Partial mole Which molar pregnancy has placenta with a triploid karyotype fetus?
Placental Infarction This is a focal lesion caused by ischemic necrosis due to interruption of maternal blood supply.
Placental Infarction The sono appearance of this is small or large, anechoic/hypo, and absent blood flow.
Abnormal Adherence This is a deficiency of decidua during implantation and may cause the placental villi to adhere to myometrium.
Previous trisomic pregnancy Predisposing factors for Abnormal adherence are all EXCEPT: Previous trisomic pregnancy, previous c-section, previous placenta previa, previous myomectomy surgery/ut scarring, AMA
Placenta Accreta This type of abnormal adherence has a growth of chorionic villi to surface of, but not into the myometrium.
Placenta Increta This type of abnormal adherence has a growth of chorionic villi into the myometrium.
Placenta Percreta This type of abnormal adherence has a growth of chorionic villi through the myometrium and can perforate the uterine serosa as well as invade other organs.
MRI Which imaging modality is best for diagnosis of Placenta accreta, increta, or percreta?
Placenta Previa Clinical signs of this: painless, bright red vaginal bleeding in 3rd trimester
Nulliparity (correct would be multiparity) All are predisposing factors of Placenta Previa EXCEPT: AMA, smoking, nulliparity, prior c-sec/UT surgery, abortion
Vasa Previa The risks of this condition are: hemorrhage or hypoxia
Abruptio Placentae Placental abruption is also called:
Placental Abruption Clinical signs of this are PTL, vaginal bleedings, UT pain, fetal distress, and shock.
Placental Abruption Risk factors of this are htn, trauma, fibroids, previa
Retroplacental Abruption This type of abruption is associated with a high pressure bleed.
Marginal Abruption This type of abruption is associated with a low pressure bleed.
Retroplacental Abruption This type of abruption is due to a rupture of spiral arteries.
Marginal Abruption This type of abruption is due to tears in marginal veins.
5 Umbilical cord forms during the first ___ weeks of gestation.
2 Normal diameter of umbilical cord is < ___ cm.
40 Umbilical cord develops appx ____ spiral turns as it elongates.
Short cord This condition is associated with CNS abnormalities, aneuploidy, and extreme IUGR.
Long cord This condition is associated with conditions that compromise cord flow.
False knots (correct would be True knots) Long umbilical cord is associated with all of the following EXCEPT: Excessive coiling, false knots, multiple loops of nuchal cord, cord prolapse
25 Nuchal cord entanglement around neck occurs in about ____% of deliveries.
1 True knots occur in ___% of singletons.
False knot This type of knot is a folded knot; not knotted (haha).
Umbilical Vein Thrombosis This is caused by FBS or intrauterine transfusion.
SUA/Bivascular cord This is associated with autosomal trisomy, renal abnormalities, cardiac abnormalities.
Umbilical Cord Cyst This type of cyst may be associated with aneuploidy or GI or GU anomalies.
Omphalomesenteric & allantoic duct cysts These cysts are located toward the fetal end of the umbilical cord.
Body Stalk Anomaly This condition is lethal and the umbilical cord is absent or rudimentary. The fetus is "tethered" to placenta.
Battledore Placenta This cord condition has a cord insert @ margin of the placental.
Velamentous CI This cord condition has a cord attachment to membranes instead of placenta.
3.0, 30 UA Doppler: S/D ratio > _____ after _____ weeks is abnormal.
Created by: 1319517318