197 terms

Exam 1

STUDY
PLAY

Terms in this set (...)

mom dad and kids - less and less frequent due to census
Nuclear Family
both parents work (some work at home) juggle child care
Dual-career/ Dual-earner family
choose to not have children
Child-free Family
multiple generations in close prox in helping w/ family tasks.
Extended Family
nuclear families sharing social support, chores, goods & services--more family in close prox like aunts and uncles. Facetime makes it easier.
Extended Kin Network
step family and spend time w/ 2 households. Parents divorce but still help other parent out and have positive relationship. *ideal world for divorced families
binuclear families
Family consisting of two heterosexual adults living together and sharing responsibilities economic and childrearing. Not legally married.
Nonmartial Heterosexual Cohabitating Family
two parents of the same sex rather than two parents of opposite sex
Gay and/or Lesbian Family
Characteristics of Healthy Families
-Communicate openly
-Are flexible in role assignment
-Adults agree on basic principles/rules of parenting
-Adapt to changes in family routine with new baby
-Volunteer assistance with parenting tasks
Factors That Affect Family Functioning- High Risk Families
-Inadequate resources
-Inadequate support of family members
-Unexpected problems with infant at birth
-Unhealthy habits i.e. smoking
-Immaturity in decision making
family interview focus on family assessment
-Identifying data
-Developmental family stage and history
-Environmental data
-Family structure
-Family functions
-Family coping
"beliefs, values, attitudes, and practices that are accepted by a population, community, or an individual"
Culture
how many years does it take something to go from evidence into practice?
17 years
what joint allows coccyx to move back during labor
Sacrococcygeal joint
what supports the pelvic organs
pelvic floor
the upper portion above the pelvic brim is called
false pelvis
lower bony canal from brim to outlet is called
true pelvis
relaxation of the pelvic floor sometimes occurs due to
multiple vaginal deliveries or due to anesthesia during labor.
importance reference points in OB
pubic arch and the ischial spines
imaginary line forming the lower border of what we call the false pelvis
linea terminalis
bony limit of the birth canal
true pelvis
most favorable pelvis shape for childbirth
Gynecoid
what female pelvis shape is similar to the male type
Android
upper 2/3 musculature of the breast is called
greater pectoral
low 1/3 musculature of the breast is called
anterior serrates
fibrous tissues that support the breasts
Coopers ligaments
how many granular lobes do the breasts have
15-20 glandular lobes
what secretes colostrum and milk
Acini
the nipple is constructed of
papilla surrounded by areola
which breast is bigger
left
structure of the breast
glandular lobes, adipose tissues, and fibrous connective tissue
another name for pailliae
Tubercles of Montgomery
normal brest changes
1) change in size and nodularity due to cyclic ovarian hormones (sweeping, tender, discomfort)
2) lympathics
best time to do a breast self exam
right after menses
overlies the symphysis pubis
Mons pubis
extend back from mons pubis
Labia majora -btw its highly vascular
visible when majora separated
Labia minora
loose skin covering clitoris
prepuce
composed of sensory nerve endings
clitoris
anterior edge of perineum
Fourchette
almond-shaped area containing openings to urethra, Skene's glands, vagina, hymen, and Bartholin glands
Vestibule
skin-covered muscular area from lower vagina to the anus. Can become torn during childbirth
Perineum
secretions from the vagina are
slight acidic (4-5)
Rugaed fibromuscular tubular canal between
bladder and rectum. Few sensory nerve endings
Vagina
the vagina has how many fornices
4
name the 2 layers of smooth muscle in the vagina
outer longitudinal and inner circular
vaginal walls are composed of thick folds which are called
rugae
pH in vagina is regulated by
lactobacillus ( gram + bacteria thats part of natural flora)
upper triangular "body" of the uterus
corpus
dome of the corpus. Thickest part, where the tubes enter and contx. start in the uterus
fundus
lower cylindrical portion of the uterus usually 2.5cm
cervix
lower constricted portion of corpus, just above the cervix in the uterus
isthmus
most cervical cancer begins at the
squamocolumnar junction
what system allows the uterus to do stimulation, vasoconstriction and muscular contractions
Sympathetic nervous system
what system inhibits muscular contractions
Parasympathetic
Pain comes from
stretching or ischemia to a part.
highly vascular lining. Produces prostaglandins. Is shed during menstruation
Endometrium
layers of smooth muscles of the uterine wall
Myometrium
portion of the fallopian tubes nearest the uterus, where lumen is smallest is called
Interstitial
middle portion, slightly wider lumen of the fallopian tubes
Isthmus
curved area. Fertilization site of the fallopian tubes
ampulla
one of the
Scarring and/or blocking of the fallopian tubes
Produces mature ova and hormones and is Almond shaped, glandular, pitted, scarred.
ovaries
3 cylindric layers: 2 corpus cavernosa, 1 corpus spongiosum containing the urethra. Covered by loose skin and fascia.
shaft of penis
End of penis. Sensitive nerve endings. Urethral meatus at tip. Covered by prepuce.
glans of penis
scrotrum function
to protect the testes and keeps them at a temperature conducive to spermatozoa production
structure of penis
connective tissue and smooth muscle. Rugaed skin can contract or expand according to temp. 2 compartments each with one teste. Lt. Spermatic cord grows longer - Lt. Scrotal sac hangs lower.
testes function
spermatogenesis and hormone production
testes structure
lobes made up of lobules of coiled seminiferous tubules
males duct system function
transports sperm and semen
structure of the duct systems is
1) seminiferous tubules, vas deferens, ejactulatory duct
male accessory structures function
generate sperm transport medium
male accessory structures are
seminal vesicles, prostate gland, and cowper glands
- lobes on either side of prostate.
seminal vesicles
prostate secretes
alkaline fibrinolysin
either side of urethra
coopers glands
GnRh is secreted by the
Hypothalamus
GnRh stimulate the anterior pituitary to
release FSH and interstitial-cell-stimulating hormones
FSH stimulates production of
spermatocytes in the seminiferous tubules
ICSH stimulates
Leydig's cells to synthesize testosterone from cholesterol
. The sperm consists of
1) the head cell nucleus with chromosomes
2) middle and tail which propels and rotates sperm forward
how long can sperm live in the uterus
3 days
Both spermatogenesis and sperm are adversely affected by
hot external environment and limitation on the mobility of the testes.
Immature spermatozoa are called
sperm/ spermatids
head cell nucleus with chromosomes and covered by an enzyme to penetrate ovum are called
sperm
ejaculate volume is around
3-5 ml
how much sperm per ml
60-120 M.
Ovarian and menstrual cycle are controlled by
relative hormone proportions
secreted by the ovaries Development of female secondary sex characteristics
estrogen
secreted by corpus luteum Allows pregnancy to be maintained
Progesterone
secreted by endometrium Essential for ovulation
Prostaglandin
the periodic uterine bleeding that begins approximately 14 days after ovulation
menstruation
menstruation
-endometrial cycle
-hypothalamic-pituitary cycle
-ovarian cycle
Oxygenated fatty acids produced in most organs of the body that very concentrated in menstrual blood
Prostaglandins
Prostaglandins affect
smooth muscle contractility, ovulation, menstruation, abortion, onset of labor
Corpus luteum does not decline into the corpus albicans but continues to secrete progesterone to maintain pregnancy until 11th week
ovaries effects on conception on menstrual cycle
what secretes enough progesterone to maintain pregnancy until the placenta operates
corpus luteum
uterus effects on conception on menstrual cycle
Fertilized egg implants in uterus and begins to secrete HCG to maintain the corpus luteum. Endometrium continues to develop. The placenta produces hCG, hPL, estrogen and progesterone.
inner layer of embryonic embrace that contains amniotic fluid and forms from ectoderm
amnion
outer layer of embryonic membrane containing chorionic villi and can be used for genetic testing
chorion
helps to dispose of secretions from the kidneys and the respiratory tract, allows the fetus to move around, protect the fetus from external forces and keeps the temperature normal.
amniotic fluid
Protects fetus from injury
Maintains even fetal body temperature
Fluid for fetus to drink and "breathe"
Allows fetal movement for muscular skeletal development
Prevents pressure on umbilical cord
Provides oral fluids and repository for waste
amniotic fluid function
Three shunts bypass fetal liver & lungs
-Ductus Venosus (Umbilical vein/Inferior V.C.)
-Foramen Ovale (Rt. Atrium/Lt. Atrium)
-Ductus Arteriosus (Pulmonary Artery to Aorta)
Cephalocaudal means
brain before lungs
Proximodistal
arms before fingers
Differentiation means
organs formed
when does GI tract begin to form
4 weeks
when do dumb buds appears
4 weeks
when is the neural tube closed by
4 weeks
when does the brain differentiate
4 weeks
First 2 weeks after conception
is termed
pre-embryonic
3rd to 8th week after conception is termed
embryonic
9 weeks-40 weeks after conception is termed
fetal
liver starts functioning when
at 2-3 weeks
tubular heart beats at
28 days
cranial nerves present at
5 weeks
eye lid, palate,tongue and diapharm form at what week
week 7
when do arms and legs move
week 7
heart development is complete by
8 weeks
when does fetus resemble human being
8 weeks
weight at 8 weeks is
2 grams
fetal heartbeats are detected at
7 weeks
trachea, bronchi, and lung buds are present at
6 weeks
heartbeat can be heard with doppler at
8-12 weeks
finger and toenails form at
9 weeks
bladder form sac formed at
10 weeks
sucking motions begin at
13-16 weeks
swallowing amniotic fluid and producing meconium in intestinal tract is at
12 weeks
fetal fender is apparent externally at and is determined by
12 weeks ; 16 weeks
fetal heart tones are audible with fetoscope at
18 weeks
surfactant production begins at
20 weeks
fetus brain will look like mature brain at
24 weeks
respiratory movements may occur; nostril reopen, and alveoli appear in the lungs and begin production of surfactant gas exchange
24 weeks
lecithin-sphingomyelin ratio approaches 2:1 at
38 weeks
hazards to fetal developlment
teratogens, tissues most vulnerable during embryonic stage, critical time is 16-56th day, and most women don't know they preggers
its important implantation occurs high in the uterus because
is implantation occurs in the lower portion, the growing placenta may obstruct the cervix. && rich blood supply.
when does implantation occur?
near time of the next expected menstrual period .. its like "spotting"
how much extra does a women need to eat during pregnancy
a woman only has to add 300 kcal/day during pregnancy
what do all women of childbearing age need to take
0.4-mg supplement of folic acid daily.
maternal weight gains for a normal weight woman are
11.5-16 kg OR 25-35 lb
what foods should preggers women avoid
eating fish that contain high levels of mercury such as swordfish, shark, tilefish, or king mackerel and limit their intake of fish that are lower in mercury.
what does folic acid do
prevent neural tube defects and spina bifida
1st trimester is
conception to 13 weeks
2nd trimester is
14 weeks to 26 weeks
3rd trimester is
26 weeks to 40 weeks
gravida means
number of pregnancies
para means
any births after 20 weeks gestation
GTPAL
gravida
term >37 weeks
preterm 20-37 weeks
abortion <20 weeks
living
early term
37 weeks to 28 6/7
full term
39 weeks to 40 6/7
late term
41 weeks to 41 6/7
postterm
42 weeks and beyond
menstrual cycle: follicular phase:
1st day of menstruation through day 12-14.
menstrual cycle: ovulatory phase:
peak of estrogen levels to release of egg from mature graafian follicle (i.e. ovulation). LH surge 12-36 hours before ovulation. Basis for tests to tell when woman is ovulating.
menstrual cycle:
after ovulation; about 14 days. High progesterone; low estrogen. Days 15-28 in 28-day cycle.
Review uterine/ menstrual cycle (p. 39): mensstual phase; proliferative phase; secretory phase; ischemic phase
nageles rule
1st day of last menstrual period. subtract 3 months, add 7 days, correct year
1st trimester physiologic changes in uterus
-Prepregnant weight: 1.8-2.5 ounces
-Growth due to hyperplasia & hypertrophy
-Muscle fibers increase length & width
By 12 weeks: palpable above symphysis (top of pubic bone)
-Contractions infrequent (may be sign of impending abortion)
-Blood flow to myometrium & endometrium
Feed placenta, BF O2 to baby
-Amenorrhea
chadwicks sign
cervix turns bluish color-slightly grey, due to increased estrogen levels
goodells sign
softening of cervix -> probable sign of pregnancy
development of mucus plug
in middle of cervix. prevents anything getting to baby. happens in 1st trimester
vagina and vulva changes in 1st trimester
vaginal walls appear bluish and increased vaginal discharge, increased lactic acid & decreased pH levels, and pelvic congestion due to increased blood flow
changes in ovaries in the first trimester
secrete progesterone to help maintain pregnancy until placenta fully developed
changes in the breasts in the first trimester
changes from estrogen and progesterone and may increase in size and tenderness
changes in thyroid during the first trimester
may feel palpable smooth and full
1st trimester common discomforts
N/V, urinary frequency, fatigue, mild vaginal discharge, pain, tingling in breasts, and mood swings
why do women have N/V in first trimester
elevated HCG and progesterone levels
1st trimester DANGER signs
vaginal bleeding, abdominal cramping, and severe and or prolonged vomiting
abdominal cramping in 1st trimester are signs of___ and treatments are__
1) miscarriage
2) bedrest, ultrasound, observe
severe and or prolonged vomitting indicates __ tx is
1) hypermeisis gravidarum
2) tx: rehydrate and observe
1st trimester prenatal tests: ultrasonography:
-Confirm pregnancy
-Verify location of pregnancy uterine or atopic
-Determine gestational age
-Determine # of fetuses
-Confirm fetal viability
-Heart beating
-Determine position of uterus, cervix & placenta
1st trimester prenatal tests: Chorionic villus sampling
-Purpose: early diagnosis of fetal genetic makeup
-Performed 10-12 week gestation
-0.5-1.0% chance of pregnancy loss
-More expensive than amniocentesis
2nd trimester: uterus & ovaries changes
-16 weeks: midway between symphysis pubis & umbilicus
-20 weeks (mid-point): fundus at umbilicus
-May feel contractions (report to HCP)
-Blood flow to placenta increases
-Progesterone now secreted by placenta
-Fetal movement felt by HCP
-Fetal HR heard by HCP
-Fetus seen on ultrasound
when is progesterone secreted by placenta
2nd trimester
2nd trimester breast and nipple changes
-Continue to become larger
-Increasing vascularity
-Nipples larger & more erect
-Areolae larger & more pigmented
-Colostrum may be present
2nd trimester skin changes
1)"mask of pregnancy" -> chloasma
2) linea nigra
3) striae (stretch marks)
2nd trimester Cardiovascular system changes
-may hear split S1
-may hear systolic murmur -> Due to increased blood volume
2nd trimester common discomforts
-gum hypertrophy and bleeding (indication of pre term labor!)
-nasal congestion and nosebleeds
-hyperpigmentation of skin
danger signs in second trimester
-Vaginal bleeding
-Burning or painful urination UTI
-Fever infection
-Decreased or absent fetal movement SHOULD be moving ie kicks
-Nausea/ vomiting
-Abdominal cramping
-Swelling of face or fingers, headaches, -epigastric pain pre-clampsia call clinic or go in if one or more occurs
signs and symptoms of preterm labor in 2nd trimester
-Uterine contractions or cramping
(Or baby feels like its in a "ball")
-Low back pain
-Pelvic pressure
-Increased vaginal discharge or bleeding
-Frequency or burning with urination
ultrasound in the second trimester
helps guide needle for amniocentesis, discover anomalies, get visualization of fetus
amniocentesis in second trismester
-Identify fetal chromosome abnormalities
-Evaluate status of Rh-sensitized fetus
Alpha-fetoprotein Screening -> maternal serum and amniotic fluid looks at
done if at risk for birth defect and esophageal defects
Percutaneous umbilical blood sampling (PUBS) is done to
help Manage Rh disease, Diagnose clotting or acid-base problems, to see if May be life-threatening to fetus i.e. twin taking too much blood
3rd trimester uterus changes
-Weight about 2.2 pounds (1 kilogram)
-36 weeks: fundus is at xiphoid process
-40 weeks: fetal head into pelvic cavity
"lightening"
-Occurs 2-3 weeks before labor in nulliparas
-"Braxton-Hicks" contractions
-Blood flow to placenta increase
-Progesterone secreted by placenta
3rd trimester breast and nipple changes
-Continue to become larger
-Appearance may continue to change
-Colostrum can often be expressed
3rd trimester Musculoskeletal system changes
Diffuse, bilateral pitting edema , Torsion of spine
abdominal changes in 3rd trimester
Diastasis recti
means separation of rectus muscles
3rd trimester cardiovascular changes
heart pushed upward and to left, blood volume increased (45% by 32nd week), physiologic anemia (normal)
3rd trimester physiologic changes
Dyspnea bc diaphragm pushed up
Leg & feet cramps
GI problems (DEF at end)
Pedal edema +1
Fatigue
Braxton-Hicks contractions
danger signs in 3rd trimester
Visual disturbances (double vision)
Headache (pounding)
Hand & facial edema
Fever
Vaginal bleeding
Abdominal pain (constant); uterine contractions before 36 wks
Rupture of membranes - water breaking
Decreased or lack of fetal movement
3rd trimester fetal surveillance
1) non stress test
2) Vibroacoustic stimulation test
3)contraction stress test
Gestational hypertension
>140/90 before pregnancy and after 20 weeks returns to previous normal blood pressure, proteinuria NOT present
Preeclampsia
>140/90 AFTER 20 weeks WITH proteinuria
Eclampsia
>140/90 AFTER 20 weeks WITH proteinuria, and seizures
normal pregnant changes
Increase blood volume, plasma volume, physiologic anemia
Decrease peripheral resistance and BP
Increase cardiac output
Increased O2 consumption
Increased clotting factors
Increased renal plasma flow and GFR
Generalized Vasospasm
-Constriction and dilation/arterial system
-Endothelial cellular damage/platelets
risk factors for hypertension in pregnancy
-First pregnancy, >35 or <20
-Hx of hypertension, preeclamipsia
-Obese prior to pregnancy
-Multifetal gestation
-Positive angiotensin gene T235
-Hx of diabetes, renal disease
-Hx of autoimmune disorders