Questions and Answers
What is a common emotional response experienced during pregnancy that can involve mixed feelings about the pregnancy?
Which trimester is primarily focused on accepting the pregnancy?
What is a common activity associated with the third trimester in preparation for the baby's arrival?
Which term describes the act of preparing the home and selecting a name for the baby?
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Which of the following is NOT typically associated with the emotional responses during pregnancy?
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Which germ layer is responsible for forming the linings of the gastrointestinal tract and respiratory tract?
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What is the role of the mesoderm during development?
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At what week does the heart begin to beat during fetal development?
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Which fetal circulation shunt directs blood away from the liver?
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What structures are responsible for shunting blood to supply important organs in the fetus?
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What psychological condition is associated with body image and boundary issues related to narcissism and introversion?
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What physiological change typically occurs in the uterus during pregnancy regarding its size?
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Which of the following describes somatic symptoms that the father may experience due to Couvade syndrome?
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In what way may sexual desire change during pregnancy?
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What are the local changes that occur in the body during pregnancy?
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What is the average weight range for a baby at full term (week 40)?
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What major physiological change occurs as a baby takes its first breaths of air?
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Which condition does not affect the fetus during pregnancy?
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What is a characteristic of monozygotic twins?
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Which statement accurately describes the appearance of a fetus in week 36 of pregnancy?
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What common psychological problem might expectant mothers face?
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How many creases are typically found on the soles of a fetus's feet at full term?
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What psychological change relates to the belief that pregnancy will stretch a woman's abdomen and breasts permanently?
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What is the primary reason for the increase in uterine blood flow at the end of pregnancy?
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Which sign indicates softening of the cervix during pregnancy?
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What is a probable sign of pregnancy that is determined through a bimanual examination?
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What occurs to the diaphragm as pregnancy progresses?
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Which of the following is true about Braxton Hicks contractions?
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What is the primary purpose of the operculum during pregnancy?
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What change in vaginal secretions occurs during pregnancy?
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Which hormonal change is directly linked to the softening of pelvic ligaments and joints during pregnancy?
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What is a possible effect of supine hypotension syndrome during pregnancy?
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What is the expected increase in blood volume during pregnancy?
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Which mouth-related change is a common symptom during pregnancy?
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What anatomical change occurs to the umbilicus around the 28th week of pregnancy?
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What percentage of women may experience nausea and vomiting during early pregnancy?
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What is a psychological change that can be seen during pregnancy?
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Study Notes
Germ Layers
- Entoderm: Forms linings of pericardial, pleural, and peritoneal cavities, gastrointestinal tract, respiratory tract, tonsils, thyroid, thymus, parathyroid glands, and lower urinary system.
- Mesoderm: Develops supporting structures of the body including dentin of teeth, upper portion of the urinary system, reproductive system, heart, circulatory system, blood cells, and lymph vessels.
- Ectoderm: Forms central nervous system (CNS), peripheral nervous system (PNS), skin, hair, nails, sebaceous glands, sense organs, mucous membranes of anus, mouth, nose, tooth enamel, and mammary glands.
- Blastocyst: Provides baseline for all organ systems by 8 weeks during organogenesis.
- Rubella infection can impact the development of organ systems.
Cardiovascular System Development
- Day 16: Formation of a single heart tube.
- Day 24: Initiation of heart beating.
- Week 6-7: Development of septum and valves.
- Week 11: Electrocardiogram (ECG) can be performed; accuracy improves by week 20.
- Week 10-12: Doppler ultrasound assessment of heart activity.
- Week 20: Stethoscope can be used to listen for fetal heart sounds.
Fetal vs. Extrauterine Circulation
- Fetal oxygen exchange occurs via the placenta, not the lungs.
- Blood bypasses the lungs in utero, directly supplying lung tissue.
- Specialized structures (shunts) direct blood flow to essential organs:
- Ductus venosus: Shunts blood to liver.
- Foramen Ovale: Directs blood from right to left side of the heart.
- Survival rate for fetuses is over 95%, with signs of vitality including Moro reflex and fingernail growth.
Fetal Development Milestones
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Week 36:
- Length: 42-48 cm; Weight: 1800-2700 g (5-6 lb).
- Body stores of glycogen, iron, carbohydrates, and calcium increase; fat deposition noted; lanugo decreases.
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Weeks 38-40:
- Length: 48-52 cm; Weight: approximately 3000 g (7-7.5 lbs).
- Full-term characteristics include mature lungs, absence of lanugo, mature hair, placental detachment, and initiation of breathing.
Twin Development
- Monozygotic Twins: Arise from a single fertilized egg; share one placenta and two amnions.
- Dizygotic (Fraternal) Twins: Result from two separate fertilized eggs; each has a separate placenta and amniotic sac.
Psychological Changes During Pregnancy
- Pregnancy Duration: 9 months allows the fetus and family ample time to prepare.
- Superstitions: Common beliefs regarding pregnancy can impact emotional responses, though they do not affect fetal health.
- Common Psychological Problems: Concerns about career impact, body changes, financial burdens, and perceived time consumption associated with children.
Nursing Responsibilities
- Assist in stress coping mechanisms; ensure women feel secure and supported through prenatal interactions.
- Encourage expression of feelings and promote positive beliefs about having a baby.
Psychological Tasks in Trimesters
- 1st Trimester: Acceptance of pregnancy; dealing with ambivalence.
- 2nd Trimester: Acceptance of the baby; engaging in anticipatory behaviors like shopping for baby supplies.
- 3rd Trimester: Preparing for birth and the arrival of the baby.
Emotional Responses to Pregnancy
- Possible feelings of ambivalence, grief, and narcissism; mood changes due to hormonal fluctuations.
- Consideration of the father’s emotional experience (Couvade syndrome), reflecting pregnancy symptoms.
- Sexual desire changes and adjustments to the family dynamic as older siblings prepare for the new baby.
Physiological Changes of Pregnancy
- Local Changes: Alterations in uterus, cervix, vagina, ovaries, and breasts.
- Systemic Changes: Affect integumentary, respiratory, circulatory, gastrointestinal, urinary, skeletal, endocrine systems, including weight fluctuations and temperature changes.
Uterine Changes
- Significant increase in uterine size:
- Length expands from 6.5 to 32 cm.
- Weight increases from 50 to 1000 g.
- Early thickness of the uterine wall is 1-2 cm, thinning to 0.5 cm towards the end of pregnancy.
- Uterus can hold over 7 lbs and approximately 1000 ml of amniotic fluid.### Uterine Changes
- Vascularity and dilation of blood vessels increase significantly during pregnancy, expanding from 15-20 ml/min to 500-750 ml/min by term.
- Decidua development is essential for embryo implantation and support.
- Uterine size increases, displacing intestines and elevating the diaphragm and liver, leading to pressure on the stomach and bladder.
- "Lightening" refers to the fetus settling lower in the pelvis, typically occurring two weeks before term for primigravidas.
- Hegar’s sign presents as softening of the lower uterine segment, detectable at six weeks.
- Ballottement, felt between 16-20 weeks, involves the fetus bouncing in amniotic fluid during a bimanual exam.
- Braxton Hicks contractions, or "practice" contractions, occur as early as the second trimester, becoming more pronounced in the last month.
Cervical Changes
- Cervix exhibits increased vascularity, appearing violet due to blood flow.
- Goodell's sign pinpoint's the cervix's softening early in pregnancy.
- Operculum, a mucus plug, forms to protect the uterus from infection.
Vaginal Changes
- Leukorrhea (white discharge) from increased vaginal epithelial activity is a presumptive sign.
- Chadwick’s sign indicates a color change in the vaginal wall, shifting to a deep violet hue due to vascularity.
- Vaginal pH decreases from >7 to 4-5, enhancing resistance to bacterial infections, but can predispose to Candida infections.
Ovarian Changes
- The placenta becomes the key hormonal organ, halting FSH and LH production, thus preventing ovulation.
Breast Changes
- Tenderness and fullness noted by the 6th week due to rising estrogen levels, with breast size increasing from tissue hyperplasia.
- Areola darkens, increasing in diameter from 1.5 inches to 2-3 inches.
- Montgomery's tubercles secrete lubrication for nipple protection.
- Colostrum can be expelled by the 16th week, containing high protein.
Integumentary System
- Striae gravidarum appear as pink or reddish streaks that fade to silvery-white.
- Linea nigra develops, a brown line extending from umbilicus to pubis.
- Melasma (mask of pregnancy) presents as darkened facial regions due to hormonal changes.
Respiratory System
- Increased nasal congestion attributed to elevated estrogen levels is common.
- Uterine enlargement pushes the diaphragm, potentially causing shortness of breath, especially late in pregnancy.
Temperature Changes
- Early pregnancy brings an elevation in body temperature, influenced by progesterone, with a decrease noted around the 16th week as the placenta assumes hormonal duties.
Cardiovascular System
- Blood volume increases by 30-50% to ensure adequate placental nutrient exchange.
- Cardiac output rises by 25-50%, with a heart rate increase of approximately 10 bpm.
- Edema commonly occurs due to pressure on lower extremity veins from the expanding uterus.
Gastrointestinal System
- Increased pressure from the growing uterus results in slower gastrointestinal motility, precipitating heartburn and constipation.
- Morning sickness affects about 50% of women due to rising hormone levels.
- Hemorrhoids and gum hypertrophy can occur due to increased blood flow and pressure.
Urinary System
- Fluid retention increases by 7.5L to support blood volume for placental exchange.
- Urinary output rises 60-80%, with initial frequency peaking in the first trimester due to pressure but easing in the second.
Skeletal System
- Increased calcium and phosphorus demand supports fetal skeletal development.
- Softening of pelvic ligaments aids fetal passage while leading to lordosis, which can cause back pain.
Endocrine System
- Placenta acts as an endocrine organ, producing estrogen, progesterone, and other hormones to maintain pregnancy.
- Thyroid glands enlarge to boost metabolic rates and prevent goiter.
Immune System
- Immunologic changes reduce rejection of the fetus while increasing white blood cell count for infection protection.
Weight Changes
- Total weight gain throughout pregnancy ranges from 25-35 lbs, from various sources including the fetus, placenta, fluid, and increased blood volume.
Signs of Pregnancy
- Presumptive signs include subjective symptoms such as nausea and breast changes, while probable signs are detectable by an examiner (e.g., Hegar's sign).
- Positive signs provide definitive evidence of pregnancy, including fetal heart sounds and visualization via ultrasound.
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Description
This quiz explores the origin and development of organ systems, focusing on the three germ layers: entoderm, mesoderm, and ectoderm. Each layer's contributions to various body structures and systems are examined in detail. Test your knowledge on how these layers shape the human body during development.
