Study Guide Questions–Week 1 1. What is the purpose of the figure 8 pattern of muscle fibers in the body of the uterus and how does this affect blood flow to the baby before birth? a. The purpose of the figure 8 pattern of muscle fibers in the body of the uterus, is to provide hemostasis after birth of baby and placenta; blood vessels which perfused the placenta are clamped off by these vessels when uterus contracts. b. Due to the figure 8 pattern of the uterus, before birth, blood flow to the placenta is significantly reduced during contractions of the uterus: this decreases blood flow the placenta and the baby 2. When is the best time for a woman to conduct a breast self-exam? a. In the shower, 5-7 days post menstrual cycle 3. Compare puberty/menarche and climacteric/menopause. a. Puberty and climacteric are transitional periods preceding the beginning and end of reproductive yea b. Menarche is a woman’s first period c. Menopause is woman’s last period after not having one for a year 4. What health risks increase after menopause? a. Osteoporosis, CAD, UTI 5. What is the function of HCG in early pregnancy? a. HCG is secreted by the zygote which helps maintain he corpus luteum that secretes progesterone and estrogen until he placenta is made and can produce hormones. 6. Which endometrial phase is ideal from implantation of a zygote? a. Secretory phase- endometrium is thick and vascular 7. Which 2 endometrial phases occur during the ovarian follicular phase? During the luteal phase? a. Menstruation and proliferation occur during follicular phase b. Secretory and ischemic occur during the luteal phase 8. When does ovulation occur in relationship to menstruation? a. Ovulation occurs 14 days before the next menstrual cycle 9. If a woman has a 30-day menstrual cycle, how long is the follicular phase of the ovarian cycle? The luteal phase? a. The follicular phase is varying during the 30 days and could be 16 days long or could be 14-15. b. The luteal phase is ALWAYS 14 days long 10. Identify physiologic indicators of ovulation. a. Basal body temp increases by at least one degree b. Increase of cervical secretions to egg white consistency c. Cervical opening dilates d. Pelvic pain sometimes unilaterally e. 11. Define spinnbarkeit and mittelschmerz. a. Spinnbarkeit= egg-white consistency during ovulation b. Mittelschemerz= sharp unilateral abdominal or pelvic pain during ovulation 12. Identify 2 functions of the ovary. a. Hormone production b. ovulation 13. Which hormone causes relaxation of smooth muscles, preventing uterine contractions and therefore maintaining the pregnancy? a. progesterone 14. Explain points the patient should consider when choosing a contraceptive method. a. Contraindications and side effects including woman's medical conditions and other medications - Reliability - Ease of use - Relative cost - Protection from sexually transmitted infections - Woman's comfort with proper use of method - Partner's agreement with and willingness to use method - Cultural and religious implications 15. Contrast the duration of fertility of the ova and sperm. a. Ova= 12-24 hours after ovulation b. Sperm= 4-48 hrs. remains fertile in female body 16. Differentiate zygote, embryo, and fetus. a. Zygote- From conception until complete implantation in the wall of the uterus (about day 14 by the time implantation is complete) b. Embryo- from complete implantation to 8 weeks after conception c. Fetus- 8 weeks after conception until birth 17. Differentiate the major organs or tissues arising from each of the three primary germ layers a. Ectoderm: skin, nervous system, hair, lenses of eyes b. Mesoderm: skeleton, muscles, connective tissue, blood vessels kidneys c. Endoderm: GI tract, lungs, bladder, liver, pancreas, thymus 18. What are the functions of the amniotic fluid? a. Maintains appropriate temp for the baby b. Provides cushion against traumatic forces 19. What are the sources of amniotic fluid? a. Fluid from the mother’s reproductive tract, GI and respiratory system produce fluid b. After 9-11 weeks it is mainly fetal urine 20. Describe the structure and function of the umbilical cord. a. Has 3 umbilical blood vessels:2 arteries and 1 vein b. Blood vessels are surrounded by a gelatinous membrane called Wharton’s jelly and covered with a membrane c. Spiral shaped 21. What tissue develops into the fetal side of the placenta? The maternal side? a. The outer cell mass, or trophoblast develops into the chorionic villi which form the fetal side of the placenta b. The functional layer of the endometrium, the inner layer of the uterus, develops into the maternal side of the placenta 22. Describe the four (4) functions of the placenta. a. Endocrine Function of the placenta- the placenta produces human chorionic gonadotropin (hCG), human placental lactogen (hPL), estrogen, and progesterone b. Metabolic- Function of the placenta- the placenta provides glycogen, fatty acids, cholesterol, and enzymes to nourish the developing embryo; especially during early pregnancy before the transport function is well developed c. Transport- Function of the placenta- the placenta transports gases, nutrients, and waste products across from mother to fetus and fetus to mother d. Immunological- Function of the placenta- the mother's immune system is slightly depressed during pregnancy; placenta is also involved in preventing mother's body from rejecting the baby's foreign DNA 23. Where does the exchange of nutrients (including oxygen) and waste products between the mother and fetus occur? a. The exchange of nutrients and waste products occurs in the intervillous space and chorionic villi of the placenta 24. Identify the 3 shunts in fetal circulation, including their names, locations, and purpose. a. Ductus Venous shunt in fetal circulation- located between the umbilical vein and the inferior vena cava; bypasses the fetal liver to deliver highly oxygenated blood to the fetal heart b. Foramen ovale shunt in fetal circulation- located between the right atrium and left atrium; shunts oxygenated blood from the right side of the fetal heart to the left side, bypassing the fetal lungs c. Ductus arteriosus Shunt in fetal circulation- located between the pulmonary trunk and the arch of the aorta; shunts mixed oxygenated/deoxygenated blood from the right ventricle to the descending aorta, bypassing the fetal lungs 25. When does the baby’s heart begin to beat? When is it completely developed? a. AROUND 17 DAYS OR 3 WEEKS AFTER CONCEPTION BUT IS NOT DEVELOPED COMPLETELY UNTIL ABOUT 8 WEEKS 26. Describe the general order of fetal development. a. The fetus develops in a cephalocaudal manner, meaning the head and upper body develop sooner than the lower body 27. What is an L/S ratio? What is its significance? a. Measure of lecithin in relation to sphingomyelin Determines fetal lung maturity 2:1 considered mature Occurs in middle of third trimester 28. At what conceptual age can the baby hear? See? a. Hear-24 weeks b. See-24-26 weeks 29. When do the fetal kidneys function? a. At birth but they are fully developed in utero 30. What is vernix caseosa? When is it most abundant? a. Protects fetal skin- cells of the superficial layer are sloughed and become mixed with sebaceous secretions to form white, cheesy vernix 31. What is lanugo? When is it most abundant? a. Super fine hair that the fetus starts developing at 12 weeks. Their whole body is covered by 20 weeks gestation and is usually gone by birth. 32. Define teratogen a. Something that produces permanent abnormal development or physiology 4 different kinds 33. Explain the principles of teratology. a. Dose dependent- how much was the baby exposed to b. Duration of exposure- how long was the teratogen present c. All or none- if the mom’s body is exposed to a teratogen between conception and implantation, then typically the pregnancy will either be lost, or not affected at all. d. Host- there is no known reason why a specific baby is affected and others are not. e. Drug interaction- prescription, OTC, or illegal drugs mom took f. Critical periods for certain effects: each major organ has different critical periods that are highly sensitive or less sensitive. 34. What are the presumptive signs of pregnancy? a. The presumptive signs and symptoms are things that the woman experiences. They are subjective. They may be symptoms of pregnancy, but they could also have other causes. Symptoms in this category include: b. Changes in the breast. The breast may feel heavy, tingly, and may be very sensitive to touch. Many women experience these changes during their menstrual cycle, shortly before their period. When the woman is pregnant, the symptoms continue longer than they usually would with her menstrual cycle. However, these changes can be caused by hormonal fluctuations not related to pregnancy. c. Nausea and vomiting is a common complaint of early pregnancy. Nausea and vomiting, especially in the morning, is a frequent complaint of women who think they may be pregnant. There are numerous possible causes of nausea and vomiting. d. Urinary frequency is common in early pregnancy but could also be a symptom of urinary tract infection or another issue. e. Fatigue is noticeable during early pregnancy, but once again, it can have many other causes. f. The woman’s perception of fetal movement. This is called quickening. When the fetus moves, the mother may feel a fluttering sensation in her abdomen. However, this sensation is similar to the feeling of gas moving through the intestines. g. AMENORRHEA 35. What are the probable signs of pregnancy? a. Abdominal enlargement b. Chadwick’s sign c. Goodells sign d. Hagar’s sign e. Positive serum or urine pregnancy test f. Braxton hicks contractions g. Ballottement 36. What are the positive signs of pregnancy? a. b. c. d. Visualization of pregnancy on a sonogram Auscultation of the babys heart rate Palpation of fetal movement by an examiner Visualization of fetal movement by an examiner through the mothers abdomen 37. Describe the following signs of pregnancy: a. Goodell’s sign: softening in the cervix b. Chadwick’s sign: bluish discoloration of the vagina and the cervix c. Hegar’s sign: a softening of the isthmus or neck of the cervix 38. What is the recommended intake of folate (folic acid) for a woman of childbearing age before conception and during pregnancy? a. b. c. d. First trimester- 400 mcg Second trimester- 400mcg Third trimester- 400 mcg Lactating-500 mcg 39. Why is fish and seafood recommended in the diet? a. They provide sources of DHA and AA which is good for fetal development and neurological function. It also reduces preterm births. 40. What types of fish should be avoided by pregnant women and why? a. Avoid raw and undercooked fish like sushi b. Shark, swordfish, king mackerel, tilefish- too much mercury can harm nervous system development 41. Is it safe for pregnant women to eat fish caught in local rivers, streams and lakes? a. No, there may be other chemicals in the fish and pregnant women are more susceptible to illness 42. What is pica? a. Pica is a craving, chewing, or consuming of substances that lack nutritional values. Examples- ice, clay, cornstarch 43. What physical condition may be associated with pica, and should be evaluated in women with pica? How is it evaluated? 44. What foods are considered unsafe during pregnancy? Why? a. b. c. d. e. Unpasteurized milk and foods Hot dogs, luncheon meats, cold cuts Refrigerated pate and meat spreads Refrigerated smoked seafood Raw and undercooked seafood, eggs, and meat 45. What types of food are restricted in a vegan vegetarian diet? a. Animal products 46. What types of food are restricted in a lacto-vegetarian diet? a. No animal products except dairy, but it cannot be mixed with other meat products. 47. What types of food are restricted in a lacto-ovo-vegetarian diet? a. Dairy products and eggs can be consumed, but not any other animal product. 48. What is a good source of calcium for a vegetarian? a. b. c. d. e. Fish eaten with bones (sardines/salmon) Legumes Collard greens Kale Turnip greens 49. What nutrient, when consumed with iron, increases the body’s absorption of iron and what is a good source of this nutrient? a. Vitamin c 50. What methods and tools are used to assess the nutritional status of a pregnant woman? a. Height, WEIGHT, BMI, PHYSICAL ASSESSMENT, LAB RESULTS, PSYCHOSOCIAL, DEMOGRAPHIC, ECONOMIC 51. What are physical symptoms of malnutrition other than BMI? a. Cracked lips b. Dry brittle hair c. glossitis 52. Why is it important to assess the woman’s oral health? a. A pregnant woman needs to be able to eat, and if there are dental carries and periodontitis it can affect this.
