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Questions and Answers
What type of pelvis is considered most favourable for delivery?
What structure fills the pelvic floor providing support for pelvic and abdominal organs?
At birth, what are the membranous lines that separate the bones of the fetal skull called?
Which part comprises the external structures collectively known as the vulva?
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What are the internal organs that are concerned with fertilization and development of the fetus?
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Which landmark is formed where the sutures of the fetal skull meet?
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What is the role of the gynaecoid pelvis regarding childbirth?
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In which cycle are minor discomforts experienced with menstruation?
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What is the primary role of the acrosome in spermatozoa?
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What environmental condition is essential for optimal spermatogenesis?
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How long does it take for sperm to mature after production begins?
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Which gland is responsible for secreting an alkaline fluid to neutralize acidic vaginal secretions?
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What is the approximate number of sperm per milliliter of semen?
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What are seminiferous tubules responsible for?
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What anatomical part stores mature sperm until ejaculation?
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What effect does wearing tight clothing have on sperm production?
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What occurs immediately after the trophoblast touches the uterine wall?
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By what day after ovulation is the blastocyst typically embedded within the endometrium?
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What transformation occurs to the endometrium after fertilization?
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Which hormone is responsible for increasing endometrial thickness during early pregnancy?
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What is the main function of the functional layer of the decidua?
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Which layer of the decidua remains unchanged and helps regenerate the endometrium after delivery?
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Which engaging diameter is associated with face presentation?
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What type of glands are primarily found in the functional layer of the decidua?
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What is the circumference measurement for brow presentation?
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What is one of the main reasons that understanding fetal skull measurements is important for midwives?
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Which layer of the fetal scalp is primarily involved in the formation of caput succedaneum?
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The area underneath the developing ovum in the decidua is known as what?
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What is the largest engaging diameter in brow presentation?
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What is a characteristic of the fetal skull during delivery?
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Which intracranial structure is particularly at risk during an abnormal delivery?
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In terms of dimensions, how does the fetal head compare to the fetal body?
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What triggers the rupture of the follicle during the menstrual cycle?
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How does rising estrogen levels impact cervical mucus as ovulation approaches?
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Which phase of the menstrual cycle directly follows ovulation?
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What happens to the corpus luteum if the ovum is not fertilized within 48 hours?
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During which phase is the endometrium primarily under the influence of follicle-stimulating hormone (FSH)?
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What is the primary role of progesterone following fertilization?
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What occurs during the regenerative stage of the menstrual cycle?
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How thick does the endometrial lining become during the secretory phase?
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Study Notes
Engaging Diameters
- Occipito frontal diameter: 11.5cm
- Biparietal diameter: 9.5cm
- Bitemporal diameter: 8.2cm
- Occipito frontal circumference: 35cm
Face Presentation
- Head is completely extended
- Engaging diameter: sub-mento bregmatic 9.5cm
- Bitemporal: 8.2cm
- Sub-mento vertical: 11.5cm
- Sub-mento vertical will descend the vaginal orifice
Brow Presentation
- Partially extended head
- Most unfavorable presentation
- Normal delivery is rarely possible unless attitude changes
- Engaging diameter: mento vertical 13.5cm
- Bitemporal: 8.2cm
- Mento vertical circumference: 38cm
Importance of the Fetal Skull
- Contains the delicate brain
- 95% of babies present by head
- Sound knowledge of fetal diameter and measurement minimizes problems during labor and delivery
- Diagnosis of abnormalities, presentation, and position
- Recognizing disproportion between the fetal head and pelvis
- Delivery with minimal injuries to the mother and baby
- Head is the most difficult part to be delivered, whether first or last
- Adaptation between the head and pelvis is necessary
The Scalp
- Consists of 5 layers:
- Skin
- Subcutaneous tissue containing blood vessels and hair follicles
- Tendon – Galea
- Loose layer of alveolar tissue
- Pericranium
- Caput succedaneum is formed in the subcutaneous tissue
- Cephalhaematoma is limited to the layer over the bones where it is attached to the edge of the bone
Intracranial Membranes and Sinuses
- Delicate membranous structure liable to damage especially during abnormal molding
- Structures include:
- Folds of Dura matter
- Venous sinuses
Pelvis
- Divided into false pelvis (no significance to midwifery) and true pelvis (important landmarks)
- Gynecoid pelvis is the most favorable type for delivery
- Pelvic floor is filled with muscles forming a sling, supporting pelvic and abdominal organs
Fetal Skull Development
- Membranous lines known as sutures separate bones at birth
- Fontanelles formed at suture intersections, serving as important landmarks in midwifery
- Explains why the gynaecoid pelvis is well suited for childbearing
- Describe the changes in the uterus during puerperium
Female Reproductive System
- Structures:
- Vulva
- Vagina
- Uterus
- Fallopian tubes
- Ovaries
- Structures work together for fertilization and fetal development
Menstrual Cycle
- Phases:
- Ovarian Cycle:
- Follicular phase: follicle development leading to ovulation on day 14
- Luteal phase: ruptured follicle forms corpus luteum (yellow body), producing progesterone
- Ovarian Cycle:
- Uterine Cycle/Menstrual Cycle:
- Proliferative Phase:
- Repair of endometrium
- Endometrium ready to receive ovum
- Ripening of graafian follicles
- Oestrogen secretion by ripe follicles
- Secretory Phase:
- Thickening of endometrium
- Increase in vascularity
- Endometrium ready for fertilized ovum
- Proliferative Phase:
- Ovulation:
- Rupture of graafian follicle on day 14
- Release of ovum
- Oestrogen peak inhibits FSH production
- Cervix mucus becomes thin, clear, and elastic
Menopause
- End of menstrual cycle
- Decrease in ovarian function
- Decline in oestrogen and progesterone levels
- Symptoms include hot flashes, vaginal dryness, and mood swings
Male Reproductive System
- Parts:
- External: penis and scrotum
- Internal: testes, epididymis, vas deferens, seminal vesicles, prostate gland, Cowper's glands
- Testes:
- Contain seminiferous tubules where spermatogenesis (sperm production) occurs
- Produce testosterone
- Epididymis:
- Maturation of sperm
- Sperm storage
- Seminal fluids:
- Provide nutrition and aid sperm motility
Spermatogenesis
- Production of sperm starts at puberty and continues throughout life
- Takes place in seminiferous tubules
- Matured sperm stored in the epididymis
- Temperature regulation is critical for sperm production
Sperm
- 0.05mm long, visible under a microscope
- Head, body, and a tail for motility
- Acrosome contains enzymes to dissolve the ovum covering for penetration
Placenta
- Formed after implantation of the blastocyst
- Trophoblast burrows into the endometrium
- Decidua formation
- Chorionic villi develop for exchange of oxygen, nutrients, and waste products
- Placenta is responsible for hormone production
Decidua
- Formed from the endometrium after fertilization
- Three layers:
- Basal layer
- Functional layer
- Compact layer
- Supports the developing embryo and provides nutrients
- Sheds after delivery
Fetal Development
- Stages:
- Germinal stage: first 2 weeks after conception
- Embryonic stage: weeks 3-8, major organs develop
- Fetal stage: week 9 to birth, organs mature and grow
- Embryo is attached to the placenta by the umbilical cord
- Amniotic sac surrounds the embryo
- Fetal membranes are important for protective support, waste removal and nutrient exchange
Labor and Delivery
- Stages:
- First stage: dilation of the cervix
- Second stage: expulsion of the fetus
- Third stage: delivery of the placenta
- Engagement: descent of the fetal head into the pelvis
- Descent: further movement of the fetal head
- Flexion: head flexes to present the smaller diameter
- Internal rotation: head rotates to fit the pelvic outlet
- Extension: head extends as it emerges from the vaginal opening
- External rotation: shoulders rotate to fit the outlet
- Expulsion: delivery of the fetus
Postpartum Period
- Recovery period after delivery
- Involution of uterus back to its normal size
- Lochia discharge
- Physical and emotional adjustments
- Breastfeeding
Midwife's Role's
- Care for women throughout pregnancy, labor, and postpartum
- Provide education, counseling, and support
- Assist with childbirth and newborn care
- Monitor the mother and baby for complications
- Promote healthy pregnancy outcomes
Important Considerations
- Fetal lie, presentation, and position
- Fetal well-being monitoring
- Maternal health and safety
- Pain management
- Complications of labor and delivery
- Postpartum care
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Description
This quiz covers essential measurements and presentations of the fetal skull during delivery, including occipito frontal and biparietal diameters. Knowing these details is crucial for diagnosing abnormalities and ensuring safe labor and delivery. Test your understanding of engaging diameters, fetal presentations, and their significance.
