NUR 220 unit 1 pt 2

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ilwimmer
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167138
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NUR 220 unit 1 pt 2
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2012-08-27 12:29:58
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NUR 220 unit 1 pt 2
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  1. the pH of the vagina from infancy to puberty and after menopause is
    7.4 ( neutral)
  2. Each third of the vagina is supplied by a distinct vascular and lymphatic pattern.
  3. Vaginal lymphatics drain to what 4 nodal areas ? ( vaginal infections follow these routes )
    • external and internal illiac nodes
    • hypgastric nodes
    • inguinal glands
    • rectovaginal septum ( the posterior wall drains here )
  4. venous anastomeses make it possible for pelvic embolism or carcinoma to bypass the heart and lungs and lodge in the brain, spine or other remote parts of the body
  5. Lower third of the vagina is innervated by the _______ _____ and has very little somatic sensation
    Pudendal nerve


    ** vaginal sensation and pain during coitus and during the second stage of labor is thereby minimized***
  6. What are the 3 functions of the vagina?
    • passageway:
    •        *sperm during coitus and fetus during birth
    • passageway:
    •        *for menstrual flow from the uterine endometrium --> outside the body
    • Protection:
    •        * trauma from sexual intercourse
    •        * infection of the uterus, ovaries and pelvis from pathogenic organisms
  7. The uterus is located:
    center of the pelvic cavity between the base of the bladder and the rectum and above the vagina.  it is level with , or slightly below the brim of the pelvis with teh external opening of the cervix about the level of the ischial spines
  8. The average measurements of a mature womans uterus is:
    • weight:  40 -70 grams
    • length :  6 - 8 cm
  9. name 2 uterine malformations that are associated with habitual abortion:
    • Bicornuate uterus ( 2 horned)
    • uterus didelphys ( double uterus)
  10. the urinary and reproductive systems develop from the same urogenital fold in the embryo, so anomalies in one system are typically accompanied by problmes in the other
  11. Name the 4 pairs of ligaments that support the uterus
    • cardinal
    • uterosacral
    • round
    • broad
  12. name the 2 major parts of the uterus
    • Corpus (  Fundus = top , isthmus = bottom)
    • Cervix
  13. The corpus of the uterus is made of mostly _______ muscle ( or _________)
    smooth , myometrium
  14. The female reproductive cycle is composed of 2 different, interplaying cycles which are the ________ _________ and the _________ _________.
    Ovarian cycle and menstrual cycle
  15. The ovaries secrete what 3 hormones ?? and are sensitive to what 2 hormones ??
    Secrete: Estrogen, progesterone,testosterone

    Sensitive to : FSH and LH
  16. The uterus is sensitive to what 2 hormones ?
    Estrogen and progesterone
  17. Estrogens control what 5 things and assist in what other 2 processes.
    • development of secondary sex characteristics
    • breast development
    • hair growth
    • widening of hips
    • deposits of tissue ( fat ) into butt and mons pubis

    Assists in maturation of the ovarian follicles , and cause the endometrial mucosa to proliferate following menstruation
  18. Estrogen is highest in concentration during the proliferative (estrogenic  ) phase of the MENSTRUAL cycle
  19. Estrogens cause the uterus to increase in size and weight due to the increase in : glycogen, amino acids, electrolytes and water  as well as blood supply
  20. Under the influence of estrogens:
     **Uterus and fallopian tubes have increased myometrial contractility
    *** Uterus becomes more sensitive to oxytocin
  21. Estrogen:

    INHIBITS FSH production
    STIMULATES LH production
  22. Estrogens can decrease the excitability of the hypothalamus --> increase in sexual desire
  23. Progesterone is secreted by the corpeus luteum and is considered the "hormone of pregnancy " because it inhibits uterine contractions and relaxes smooth muscle ( allowing pregnancy to be maintained)
  24. During pregnancy, the major source of progesterone secretion is the placenta
  25. progesterone inhibits action of prolactin --> preventing lactation while pregnant
  26. progesterone influences:

    Vaginal epithelium to proliferate
    cervix to secrete thick, viscous mucus
    development of lobules and alveoli in breast ( lactation support )
    Rise in temperature during ovulation
  27. Prostaglandins : Oxygenated acids produced by endometrium

    PGE  - relaxes smooth muscle
    PGF  - vasoconstrictor and increased contractility of muscles and arteries
  28. Prostaglandin production INCREASES during follicular maturation ( 1st part of ovarian cycle with FSH from ant. pituitary) under the influence of gonadotropins

    Re: critical to follicle rupture

    Follicular swelling and increased contractility of smooth muscle of theca layer of the mature follicle is caused by PGF
  29. During late secretory phase ( last part of luteal phase when the endometrium is thickest ) the PG's ( PGF  in particular) are high because they cause vasoconstriction, limiting blood loss during the coming menstrual phase and start the ischemic phase , cutting of supply since no implantation occured
  30. Pregnancy is counted as 280 days ( 40 weeks) from day 1 of last period.
  31. The fertilization age ( postconception age ) is about 2 weeks less than the 40 weeks.
  32. preembryonic stage is the 14 days from fertilization of the ovum.
  33. Embryo stage starts at day 15 from the 1st day of last period and continues until appx 8 weeks
  34. AT 2 -3  weeks:  2 mm ( Crown to rump)

    neural tube forms
    beginnig of blood circulation
    tubular heart begins to form
    liver begins to function
    kidney formation starts
    thyroid tissue appears
  35. Week 4  = 4 - 6 mm 

    Anterior portion of neural tube closes to form brain
    posterior portion of neural tube closes to form spinal cord
    limb buds form
    tubular heart beats at appx 28 days
    primitive red blood cells circulate
    formation of oral cavity ( primitve jaw present)
    division of esophagus and trachea begins
    stomach forms
  36. week 5  = 8 mm

    C-shaped body with rudimentary tail
    Brain is differentiated and cranial nerves are present
    muscles have innervation
    atrial division in heart has occured
  37. Week 6 = 12 mm

    primitive skeletal shape forms
    ossification of skull and jaw begins
    chambers of heart are present
    groups of blood cells can be identified
    oral and nasal cavities formed/ upper lip formed
    liver begins to form red blood cells
    trachea , bronchi and lung buds present
    formation of external, middle and inner ear continues
    embryonic sex glands appear
  38. week 7 = 18 mm

    Head is rounded and nearly erect
    eyes have shifted to a more forward position
    fetal heartbeat can be detected
    tongue separates, palate folds , GI tract and stomach take on final form
    separation of bladder and urethra from rectum
    diaphragm separates abdominal and thoracic cavities
    optic nerve formed, lens thickens , eyelids appear
    differentiation begins into ovaries or testes
  39. week 8 = 2.5 - 3 cm wt. 2 g

    digits are formed
    cartilaginous bones start to ossify
    fetal movement is possible
    heart development is essentially complete
    rectal passage opens with perforation to anal membrane
    2 circuits for fetal circulation
    heartbeat can be heard with doppler at 8-12 weeks
  40. 9 -12 weeks  , 5- 8 cm / 14 - 45 g

    face is well-formed
    tooth buds visible
    urogential tract completes development
    kidneys produce urine
    spontaneous movement can occur
    fetal tones can be heard by doppler ( 120- 160 bpm)
  41. age 13 - 16 weeks  =9 cm/ 55-60g-   13.5 cm / 200 g

    fetus can swallow amniotic fluid, make sucking motions and produce meconium
    teeth beginning to form
    differentiation of hard/soft palate
    development of gastric/intestinal glands/muconium in intestines
    kidneys assume typical shape and organization
    appearnce of scalp hair/lanugo on body
    skin transparent with visible blood vessels
    eyes/ears/nose are formed
    sex determination is possible
  42. 20 weeks   = 19 cm / 435-465 g

    lanugo covers entire body
    subcutaneous brown fat ( rich blood supply)
    hair on head /eyelashes,eyebrows
    nails present on toes/fingers
    muscles well developed
    mother may feel quickening ( fetal movement)
    heartbeat audible through fetoscope
  43. 24 weeks = 28 cm / 780 g ( 1 lb 10 oz )

    hair is getting long
    eyes are stucturally complete and will open soon
    fetus has grasp reflex
    skin on body is reddish and wrinkled with little body fat
    footprints/fingerprints developing
    vernix caseosa covers body (protective cheesecake)
  44. 25 - 28 weeks = 14 - 15 inches long/ 2 lb 10 oz - 2lb 12oz

    nervous system complete enough to control body systems
    eyelids open / close by neural control
    lungs are immature, but capable of gas exchange
    if born at this time, will require extensive care to survive and minimize handicap
  45. 29 - 32 weeks  12 - 17 inches   / 3 - 4 lbs

    CNS can direct rhythmic breathing
    lungs not yet mature
    bones are developed but soft/flexible
    fetus starts to store iron, calcium and phosphorus
  46. 35-36 weeks 17- 19 inch/ 5 -7 lbs

    deposits of fat
    lanugo starts to disappear
    baby shows spontaneous waking at night
  47. 38 - 40 weeks  = 19 - 21 inches/ 6 - 8 lbs

    skin is smooth/polished look
    lanugo only present on arms/shoulders
    body fills entire uterus
    baby gets antibodies from mother
  48. potential teratogen malformation

    3 weeks = abscence of limbs ( ectromelia)
    4 weeks = abdominal herniation into umbilical cord
                     trachea/esophogus fistula
    5 weeks = eyes .
                     facial clefts
    6 weeks = aortic abnormalities
    7 weeks = cleft palate
                     mixed sexual characteristics
    8 weeks = digital stunting ( shortness of fingers/toes)
                     persistent opening in atrial septum
  49. spinnbarkheit
    • change in cervical mucous elasticity
    • decreased viscosity/increased length
  50. trisomies = extra chromosome

    down syndrome is most common
  51. Trisomy 21 = Down syndrome

    Trisomy 18 = severe mental hypotonia , heart defects , renal defects , drooping eyes , low set ears

    Trisomy 13 = seizures, severe mental hypotonia , polydactly (extra fingers) kidney ddefects, microcephaly,, heart defects
  52. monosomy is usually incompatible with life
  53. mosaicism = individual with 2 different cell lines
    most common in sex chromosome and found in down syndrome

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