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(4) Reproductive System - Sessions > (8.1) Implantation > Flashcards

(8.1) Implantation Flashcards

1
Q

Describe the process of implantation.

A
  • 4th week: Blastocyst enters uterine cavity -> Trophoblasts (outer Syncitiotrophoblast + inner Cytotrophoblast) invade uterine endothelium
  • 10th week: complete interstitial implantation (foetal vessels project villi into mesenchyme)
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2
Q

Suggest things that are transported across Placenta, how are they each transported?

A
  • Passive Diffusion: gases, water, electrolytes, urine, uric acid
  • Facilitated Diffusion: glucose
  • Active Transport: amino acid, iron, vitamins
  • Teratogens: alcohol, smoking, therapeutic drugs (e.g. Thalidomide, Wafarin)
  • Infectious pathogens: Varicella zoster, Rubella, Cytomegalovirus, Treponema pallidum, Toxoplasma gondii
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3
Q

What are Teratogens? List some examples of them.

A
  • Substances transport across Placenta -> Foetal damage
  • Alcohol
  • Maternal smoking
  • Wafarin
  • Thalidomide
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4
Q

What are the aims of implantation?

A
  • Anchor Placenta
  • Establish maternal blood flow within Placenta
  • Establish exchange unit via foetal vessels projecting like villi into Placenta
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5
Q

Describe the structure of Placenta.

A
  • Chorion Frodosum forms the foetal portion
  • Ducidua Basalis forms the maternal portion
  • Chorionic and Ducidual Plates mark the boarder and the forms the Intervillous spaces in between, which is filled with maternal blood
  • Ducidual Septae separate Placenta into Cotyledons
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6
Q

Describe the arrangement of foetal blood vessels within Placenta.

A
  • Spiral arteries remodel -> low resistance -> high blood flow & pressure -> force oxygenated blood filling Intervillous spaces
  • 2 x Umbilical veins -> OXYGENATED blood from Intervillous spaces to baby
  • 1 x Umbilical artery -> DE-oxygenated blood from baby to mom
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7
Q

Describe the histology changes and roles during implantation.

A
  • Dicidualisation - Ducidual cells -> Placenta: balance invasive force from Trophoblasts
  • Spiral arteries remodel -> low resistance -> meet high blood flow demands
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8
Q

Describe the difference between First Trimester Placenta and Term Placenta.

A
  • First Trimester Placenta: thick

- Term Placenta: loss of Syncitiotrophoblasts

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9
Q

What do Ducidual Septae separate Placenta into?

A

Cotyledons

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10
Q

Describe the space between Chorionic and Ducidual Plates.

A
  • Intervillous spaces

- Filled with maternal blood from remodelled Spiral arteries

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11
Q

What structure is the foetal portion of Placenta derived from?

A

Chorion Frodosum

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12
Q

What structure is the maternal portion of Placenta derived from?

A

Ducidua Basalis

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13
Q

How is the trimester of pregnancy divided?

A
  • 1st: week 1 - 12
  • 2nd: week 13 - 28
  • 3rd: week 29 - 40
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14
Q

What is Ducidualisation? How is it initiated? What is the aim of this and what happens if it fails?

A
  • Ducidual cells -> Placenta
  • Stimulated by Progesterone (from Corpus Luteum first 2 months -> Placenta)
  • Balance invasion force of Trophoblasts
  • Failure -> harmorrhage
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15
Q

Suggest three locations that Ectopic Pregnancy may take place?

A
  • Fallopian Tube - most common
  • Peritoneal cavity
  • Ovary
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16
Q

What is it called when the Blastocyst is implanted at lower portion of Uterine? How is it managed?

A
  • Placenta Praevia

- C-section delivery

17
Q

What is tested in the urine during Antenatal Screening? Why is it tested?

A
  • Protein

- High protein levels indicates Pre-Eclampsia

18
Q

Describe the endocrine function of Placenta.

A
  • Progesterone (takes over Corpus Luteum in week 2)
  • Oestrogen
  • Human Chorionic Gonadotrophin
  • Human Chorionic Somatotrophin
  • Human Chorionic Corticotrophin
19
Q

What produce Human Chorionic Gonadotropin? What is its function?

A
  • Syncitiotrophoblasts

- In the first 2 weeks to maintain Corpus Luteum -> production of Progesterone -> enriches Uterine vasculatures

20
Q

What is the role of Human Chorionic Somatotropin?

A

Interferes maternal metabolism -> Increase Glucose availability

21
Q

What other substances except from hormones does the Placenta produce?

A
  • Glycogen
  • Cholesterol
  • Fatty acids
22
Q

What is tested during hormonal pregnancy test?

A
  • Human Chorionic Gonadotrophin
  • In maternal urine
  • During first 2 months of pregnancy
23
Q

How does the foetus receive passive immunity?

A
  • Foetus makes its own components of complement in late T1
  • Receptor Mediated Pinocytosis
  • IgG transported from mom to foetus in Week 14
24
Q

Describe the endocrine function of Placenta.

A
  • Progesterone (takes over Corpus Luteum in week 2)
  • Oestrogen
  • Human Chorionic Gonadotrophin
  • Human Chorionic Somatotrophin
  • Human Chorionic Corticotrophin
  • Human Chorionic Thyrotrophin
25
Q

What is the role of Human Chorionic Somatotropin?

A

Reduce Insulin sensitivity of mother -> Increase Glucose availability

26
Q

What substances except from hormones does the Placenta produce?

A
  • Glycogen
  • Cholesterol
  • Fatty acids
27
Q

What are the main functions of the Placenta?

A
  • Metabolic: synthesis of Glycogen & Cholesterol & Fatty acids
  • Endocrine: hCH, hCS, hCC, hCT, Progesterone, Oestrogen
  • Transport: water, nutrients, IgG
28
Q

Describe how the maternal blood flood is established to the foetus?

A
  • Invasion of Syncitiotrophoblasts -> Lacunae
  • Lacunae enlarges -> Primary Villi = including both types of Trophoblasts
  • Continuous development of these projections -> Secondary Villi = Mesenchyme core
  • Tertiary Villi = Foetal vessels
29
Q

Suggest three infectious agents which across the Placenta.

A
  • Rubella
  • Varicella zoster
  • Cytomegalovirus
30
Q

What is Haemolytic Disease of the newborn?

A
  • Mother = Rhesus -ve
  • Foetus = Rhesus +ve
  • IgG across placenta -> destroy foetal RBCs
31
Q

What is thought to be the underlying pathology of Pre-eclampsia?

A

Inadequate modification of vessel walls during invasion

32
Q

How does Pre-eclampsia manifest?

A
  • Increased blood pressure (V. important)
  • Proteinuria (V. important)
  • Pitting oedema
  • Headache/blurred vision
  • Liver distension (RUQ pain)
  • Oligouria - kidney fucked

(4) Reproductive System - Sessions (16 decks)

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