Phys 83 Flashcards

While still in the ovary, the ovum is in the:
A. Primary oocyte
B. Secondary oocyte
C. Mature ovum
D. Zygote

Shortly before release from the follicle, the primary oocyte nucleus undergoes ___ and expels ___:
A. Mitosis; second polar body
B. Mitosis; first polar body
C. Meiosis; second polar body
D. Meiosis; first polar body

After the first polar body is expelled, the oocyte becomes a:
A. Primary oocyte
B. Secondary oocyte
C. Mature ovum
D. Zygote

The chromosomes of the secondary oocyte are:
A. Unpaired
B. Paired
C. Bivalent
D. Tetrad

Once 23 unpaired chromosomes are present, the oocyte is:
A. Implanted in endometrium
B. Arrested in meiosis I
C. Ovulated into abdominal cavity
D. Transformed into trophoblast

Granulosa cells attached to the ovum constitute the:
A. Zona pellucida
B. Corona radiata
C. Trophoblast layer
D. Cryptoid surface

The inner surfaces of the fimbriae are lined with:
A. Squamous epithelium
B. Cuboidal epithelium
C. Transitional epithelium
D. Ciliated epithelium

The fimbrial cilia are activated by ovarian:
A. Progesterone
B. FSH
C. LH
D. Estrogen

Transport of sperm is aided by uterine and tubal contractions stimulated by:
A. Prostaglandins and oxytocin
B. Estrogen and progesterone
C. FSH and LH
D. Histamine and bradykinin

After penetrating granulosa layers, sperm must bind to and penetrate the:
A. Corona radiata
B. Zona pellucida
C. Uterine milk
D. Male pronucleus

Once a sperm enters the ovum, the oocyte will:
A. Arrest permanently
B. Degenerate immediately
C. Form mature ovum plus second polar body
D. Expel first polar body

On entering the ovum, the fertilizing sperm’s head swells to form a:
A. Male pronucleus
B. Zona pellucida
C. Corona radiata
D. Trophoblast cell

The 23 unpaired chromosomes of male and female pronuclei align to re-form:
A. 23 chromosomes
B. Triploid complement
C. 46 chromosomes
D. Tetraploid complement

A fertilized ovum is called a:
A. Morula
B. Zygote
C. Blastocyst
D. Trophoblast

Mature sperm carrying X versus Y chromosomes are distributed:
A. Mostly X
B. Mostly Y
C. All X
D. Half X, half Y

After fertilization, additional time required for tubal transport into the uterus is usually:
A. 3–5 days
B. 1–2 days
C. 7–10 days
D. 10–14 days

Fallopian tubes are lined with a rugged structure that impedes ovum passage despite fluid current:
A. Smooth mucosa
B. Cryptoid surface
C. Squamous plaque
D. Endometrial villi

For about the first 3 days after ovulation, which structure remains spastically contracted?
A. Infundibulum
B. Ampulla
C. Isthmus
D. Uterine cavity

Delayed transport through the fallopian tube allows:
A. Immediate implantation
B. Completion of meiosis I
C. Zona pellucida formation
D. Several stages of cell division

The dividing ovum (per these notes) is called a:
A. Zygote
B. Blastocyst
C. Primary oocyte
D. Secondary oocyte

The developing blastocyst remains in the uterine cavity for an additional:
A. 1–3 days
B. 3–5 days
C. 7–9 days
D. 10–12 days

Before implantation, blastocyst nutrition comes from uterine endometrial secretions called:
A. Amniotic fluid
B. Placental blood
C. Yolk secretions
D. Uterine milk

Implantation results from the action of cells developing over the blastocyst surface called:
A. Granulosa cells
B. Ciliated epithelium
C. Trophoblast cells
D. Theca interna

In early implantation, which cells secrete proteolytic enzymes that liquefy adjacent endometrium?
A. Decidual cells
B. Endometrial glands
C. Granulosa cells
D. Trophoblast cells

The term for the embryo plus associated membranes is:
A. Zygote
B. Conceptus
C. Morula
D. Blastocyst

Continued progesterone secretion causes endometrial cells to:
A. Swell further
B. Shed superficially
C. Undergo necrosis
D. Become ciliated

After swelling and nutrient storage, endometrial cells become:
A. Theca cells
B. Cytotrophoblast
C. Decidual cells
D. Syncytiotrophoblast

As trophoblast invades decidua, released nutrients are used by the:
A. Embryo
B. Ovary
C. Uterus
D. Placenta

Placental nutrition becomes available after about the:
A. 8th day
B. 12th day
C. 16th day
D. 28th day

Around 21 days after fertilization, blood begins to be pumped by the:
A. Maternal heart
B. Placenta
C. Decidua
D. Embryonic heart

Maternal blood surrounding trophoblastic cords is supplied by:
A. Umbilical arteries
B. Blood sinuses
C. Villi capillaries
D. Uterine veins

Which sequence correctly describes fetal blood flow through the placenta?
A. Two umbilical arteries → chorionic villi → one umbilical vein
B. One umbilical vein → chorionic villi → two umbilical arteries
C. Two umbilical veins → chorionic villi → one umbilical artery
D. One umbilical artery → chorionic villi → two umbilical veins

Maternal placental blood flow follows:
A. Uterine arteries → intervillous sinuses → uterine veins
B. Uterine veins → intervillous sinuses → uterine arteries
C. Umbilical vein → intervillous sinuses → uterine veins
D. Chorionic villi capillaries → uterine arteries → uterine veins

Most nutrient transfer across placental membrane occurs by:
A. Primary active transport
B. Secondary active transport
C. Pinocytosis
D. Diffusion

The placenta’s major diffusion role includes transfer of:
A. Fetus → mother oxygen
B. Mother → fetus oxygen
C. Mother → fetus antibodies
D. Fetus → mother glucose

The placenta also supports diffusion of fetal:
A. Estrogens to mother
B. Progesterone to fetus
C. Excretory products to mother
D. hCG to maternal liver

Placental permeability increases later in pregnancy mainly because:
A. Membrane thins, area expands
B. Membrane thickens, area shrinks
C. Maternal sinuses collapse
D. Villi capillaries regress

The predominant hemoglobin type in fetal blood is:
A. Fetal hemoglobin
B. Adult hemoglobin
C. Methemoglobin
D. Myoglobin

The principle that Hb carries more O₂ at low PCO₂ is the:
A. Root effect
B. Chloride shift
C. Haldane effect
D. Bohr effect

Loss of CO₂ makes fetal blood more:
A. Acidic
B. Alkaline
C. Hypotonic
D. Hypercapnic

The only route for fetal CO₂ excretion is through the:
A. Fetal kidneys
B. Fetal lungs
C. Placenta
D. Amniotic fluid

Glucose supply to trophoblast cells occurs via:
A. Simple diffusion
B. Facilitated diffusion
C. Primary active transport
D. Endocytosis

The placenta forms especially large quantities of:
A. FSH, LH, prolactin, ADH
B. Insulin, glucagon, GH, TSH
C. Cortisol, aldosterone, renin, ANP
D. hCG, estrogens, progesterone, hCS

In a nonpregnant woman, menstruation usually occurs about ___ days after ovulation:
A. 7
B. 10
C. 14
D. 21

Sloughing of the endometrium in early pregnancy is prevented mainly by:
A. Progesterone
B. Human chorionic gonadotropin
C. Estrogen
D. Relaxin

Glycoprotein that prevents corpus luteum involution is:
A. Human placental lactogen
B. Progesterone
C. Estrogen
D. Human chorionic gonadotropin

If the corpus luteum is removed before ~7 weeks, what usually occurs?
A. Spontaneous abortion
B. Preterm labor
C. Normal gestation
D. Placental abruption

hCG stimulates fetal testes via ___ cells to produce testosterone:
A. Sertoli
B. Leydig
C. Decidual
D. Germ

Placenta, like the corpus luteum, secretes:
A. Prolactin and oxytocin
B. Estrogen and progesterone
C. hCG and aldosterone
D. Thyroxine and cortisol

Placental cells that secrete estrogen/progesterone are:
A. Syncytial trophoblast cells
B. Cytotrophoblast cells
C. Decidual cells
D. Granulosa cells

Placental estrogen is synthesized mostly from adrenal:
A. Cholesterol directly
B. Androgenic steroid compounds
C. Amino acid precursors
D. Fatty acid substrates

Key estrogen precursors provided by maternal and fetal adrenals include:
A. Cortisol and corticosterone
B. DHEA and 16-OH DHEA
C. Testosterone and estradiol
D. Aldosterone and renin

Late pregnancy pelvic ligament changes are mainly:
A. Increased ligament calcification
B. Decreased ligament elasticity
C. Relaxation of pelvic ligaments
D. Fibrosis of pelvic ligaments

Marked breast ductal growth in pregnancy is most linked to high:
A. Estrogens
B. Progesterone
C. Aldosterone
D. Glucocorticoids

Enlargement of maternal external genitalia during pregnancy is driven mainly by:
A. Estrogens
B. hCG
C. Thyroxine
D. Aldosterone

Progesterone promotes pregnancy by decreasing:
A. Mammary ductal growth
B. Maternal thyroid size
C. Contractility of pregnant uterus
D. Placental diffusion capacity

Progesterone supports the uterine lining by causing development of:
A. Granulosa cells
B. Decidual cells
C. Blood sinuses
D. Syncytial cords

Hormone contributing to conceptus development even before implantation:
A. Estrogen
B. Progesterone
C. hCS
D. Aldosterone

Progesterone helps estrogen prepare the mother’s breasts for:
A. Lactation
B. Parturition
C. Ovulation
D. Menstruation

Hormone increasing progressively in proportion to placental weight:
A. hCG
B. Human chorionic somatomammotropin
C. Progesterone
D. Thyroxine

Human chorionic somatomammotropin acts as a general:
A. Gonadotropin hormone
B. Mineralocorticoid hormone
C. Metabolic hormone
D. Antidiuretic hormone

During pregnancy, which gland enlarges ≥50% and increases corticotropin, thyrotropin, prolactin?
A. Posterior pituitary
B. Adrenal medulla
C. Thyroid gland
D. Anterior pituitary

Rate of adrenocortical secretion moderately increased in pregnancy:
A. Glucocorticoids
B. Mineralocorticoids
C. Catecholamines
D. Androgens

Pregnant women usually have about a twofold increase in:
A. Cortisol
B. Thyroxine
C. Aldosterone
D. Prolactin

The aldosterone rise in pregnancy can lead to:
A. Hyperthyroidism
B. Hypotension
C. Pregnancy-induced hypertension
D. Spontaneous abortion

Thyroid gland typically doubles in size, increasing production of:
A. Thyroxine
B. Progesterone
C. Aldosterone
D. hCG

Parathyroid enlargement in pregnancy occurs because of mother’s:
A. Sleep deprivation
B. Diet
C. Placental weight
D. Uterine growth

Parathyroid-related adaptation may maintain normal Ca²⁺ by:
A. Calcium absorption from maternal bones
B. Renal calcium overexcretion
C. Reduced intestinal absorption
D. Decreased bone remodeling

Average maternal weight gain during pregnancy is about:
A. 25–35 lb
B. 10–15 lb
C. 40–50 lb
D. 55–65 lb

Beyond nutrition, milk also provides newborn:
A. Increased fetal hemoglobin
B. Higher aldosterone secretion
C. Placental oxygen diffusion
D. Protection against infection

Colostrum is characterized by:
A. Mostly fat, minimal protein
B. Mostly fat, minimal lactose
C. Protein lactose, almost no fat
D. No protein, high fat

Despite breast development, estrogen/progesterone inhibit:
A. Ductal system growth
B. Actual milk secretion
C. Prolactin release
D. Oxytocin receptor formation

Hormones important for breast ductal growth include:
A. Oxytocin, ADH, estrogen, cortisol, TSH
B. Progesterone, FSH, LH, oxytocin, insulin
C. hCG, hCS, prolactin, oxytocin, estrogen
D. Estrogen, GH, prolactin, glucocorticoids, insulin

Postpartum vaginal discharge from placental-site autolysis is:
A. Lochia
B. Amniotic fluid
C. Colostrum
D. Mucus plug

Labor pain signals reach CNS primarily via:
A. Visceral afferents
B. Autonomic efferents
C. Somatic nerves
D. Lymphatic channels

After birth, continued uterine contraction causes placental:
A. Trophoblast proliferation
B. Decidual cell swelling
C. Oxytocin receptor loss
D. Shearing effect separates placenta

Begins with the onset of regular uterine contractions and ends when the cervix is fully dilated to 10 centimeters

A. Third stage of labor
B. Second stage of labor
C. First stage of labor
D. Fourth stage of labor

Begins when your cervix is fully dilated (10 centimeters) and ends with the birth of your baby

A. First stage of labor
B. Second stage of labor
C. Third stage of labor
D. Latent phase only

First major obstruction to fetal expulsion is:
A. Uterine cervix
B. Pelvic inlet
C. Pubic symphysis
D. Placenta

Buttocks/feet-first entry into birth canal is:
A. Vertex presentation
B. Shoulder presentation
C. Occiput posterior
D. Breech presentation

Intermittent labor contractions are beneficial because:
A. Fetal lungs need rest periods
B. Placental flow could stop
C. Oxytocin must be metabolized
D. Cervix must scar between waves

Labor contraction waves typically go from the:
A. Fundus, spreading downward
B. Cervix, spreading upward
C. Isthmus, spreading outward
D. Cervix, spreading downward

Another positive feedback mechanism is:
A. Cervical stretch lowers oxytocin
B. Uterus relaxation increases dilation
C. Cervix stretch releases oxytocin
D. Oxytocin blocks pituitary output

Positive feedback during labor includes:
A. Fundus stretch stops contractions
B. Oxytocin inhibits cervical stretch
C. Cervix relaxes uterine body
D. Cervix stretch amplifies contractions

Strong forces producing final parturition are:
A. Braxton Hicks contractions
B. Labor contractions
C. Postpartum afterpains
D. Cervical ripening waves

Weak, slow rhythmic uterine contractions are:
A. Labor contractions
B. Afterpains
C. Braxton Hicks contractions
D. Tetanic contractions

Cervical stretching can increase oxytocin via:
A. Cervix stretch triggers oxytocin reflex
B. Placental diffusion increases oxytocin
C. Fetal kidneys secrete oxytocin
D. Maternal liver activates oxytocin

Supporting evidence for oxytocin in labor reduction:
A. Labor ends after hypophysectomy
B. Labor prolonged after hypophysectomy
C. Hypophysectomy prevents implantation
D. Hypophysectomy increases progesterone

Another pro-oxytocin change near term is:
A. Lower oxytocin secretion rate
B. Lower oxytocin receptor density
C. Reduced cervical stretch reflex
D. Oxytocin secretion rate rises

Evidence oxytocin matters near term includes:
A. More uterine oxytocin receptors
B. Fewer uterine oxytocin receptors
C. Fewer uterine gap junctions
D. Lower uterine excitability

Near term, which ratio rises?
A. Progesterone-to-estrogen ratio
B. Oxytocin-to-prostaglandin ratio
C. Estrogen-to-progesterone ratio
D. Insulin-to-glucagon ratio

Hormones that increase uterine contractility via gap junctions:
A. Prolactin
B. Estrogens
C. Aldosterone
D. Relaxin

Hormone that inhibits uterine contractility during pregnancy:
A. Estrogens
B. Oxytocin
C. Prostaglandins
D. Progesterone

Two major drivers of parturition contractions are:
A. Fetal cortisol, uterine ischemia
B. Cervical dilation, membrane rupture
C. Hormonal excitability, mechanical changes
D. Oxytocin burst, uterine atony

Severe pregnancy hypertension is acutely treated with rapid:
A. Vasodilating agents
B. Loop diuretics
C. Beta blockers
D. Magnesium sulfate

Preeclampsia plus clonic seizures/coma is:
A. Placental abruption
B. Eclampsia
C. Amniotic embolism
D. Postpartum endometritis

Late-pregnancy hypertension with heavy proteinuria is:
A. HELLP syndrome
B. Gestational diabetes
C. Placenta previa
D. Preeclampsia

After ejaculation, sperm normally travel toward which region of the fallopian tube?

A. Cervix

B. Uterine cavity

C. Ampulla

D. Ovary

Fertilization most commonly occurs in which part of the fallopian tube?

A. Ampulla

B. Isthmus

C. Uterine cavity

D. Cervix

Opening of the fallopian tube isthmus is primarily mediated by which hormone?

A. Estrogen

B. FSH

C. Oxytocin

D. Progesterone

Implantation of the blastocyst normally occurs approximately how many days after ovulation?

A. 1–3 days

B. 5–7 days

C. 8–10 days

D. 13–17 days

Fetal capillaries of the placenta develop from which structures?

A. Placental villi

B. Maternal sinuses

C. Decidual cells

D. Endometrial glands

Compared with maternal hemoglobin, fetal hemoglobin demonstrates which oxygen-dissociation curve shift?

A. Rightward

B. No shift

C. Downward

D. Leftward

Compared with maternal blood, fetal blood normally contains what hemoglobin concentration?

A. Lower hemoglobin concentration

B. Higher hemoglobin concentration

C. Equal hemoglobin concentration

D. No circulating hemoglobin

Which combination allows adequate fetal oxygen delivery despite low fetal PO2?

A. HbA, low hemoglobin, chloride shift

B. Myoglobin, low PCO2, Haldane effect

C. HbF, more hemoglobin, Bohr effect

D. HbA, more hemoglobin, Root effect

Compared with maternal blood, fetal blood normally contains what CO2 concentration?

A. Higher

B. Lower

C. Equal

D. Absent

Placental glucose transport to fetal blood occurs by which mechanism?

A. Simple diffusion by endometrium

B. Active transport by decidua

C. Pinocytosis by villi

D. Facilitated diffusion by trophoblast

Which group contains common fetal wastes transferred to maternal blood?

A. Ammonia, lactate, bilirubin

B. Urea, uric acid, creatinine

C. Ketones, albumin, insulin

D. Sodium, chloride, calcium

Which cells secrete human chorionic gonadotropin during early pregnancy?

A. Trophoblast cells

B. Decidual cells

C. Granulosa cells

D. Theca cells

Human chorionic gonadotropin reaches its maximum concentration at approximately which gestational age?

A. 5–7 weeks

B. 13–17 weeks

C. 10–12 weeks

D. 20–24 weeks

In addition to preventing involution, hCG directly promotes which change?

A. Endometrial shedding

B. Corpus luteum growth

C. Follicular atresia

D. Cervical dilation

The corpus luteum normally involutes at approximately which gestational age?

A. 5–7 weeks

B. 8–10 weeks

C. 20–24 weeks

D. 13–17 weeks

DHEA and 16-hydroxy-DHEA used for placental estrogen synthesis are formed in which tissue?

A. Placental trophoblast

B. Maternal ovaries

C. Maternal adrenal glands

D. Maternal pituitary

Placental trophoblast converts weak androgen precursors into which hormones?

A. Estradiol, estrone, estriol

B. Cortisol, aldosterone, estradiol

C. Progesterone, testosterone, estrone

D. Estriol, cortisol, progesterone

Estrogens primarily exert which type of effect on maternal reproductive organs?

A. Secretory

B. Inhibitory

C. Atrophic

D. Proliferative

High estrogen concentrations during pregnancy directly promote which maternal change?

A. Uterine involution

B. Enlargement of uterus

C. Reduced breast growth

D. Decreased genital growth

Progesterone increases fallopian tube secretions primarily to accomplish what?

A. Trigger ovulation

B. Increase cervical dilation

C. Nourish the morula

D. Promote menstruation

Human chorionic somatomammotropin begins placental secretion at approximately what gestational age?

A. 5 weeks

B. 10 weeks

C. 20 weeks

D. 30 weeks

Human chorionic somatomammotropin has a growth-hormone-like effect that primarily stimulates what?

A. Uterine contractions

B. Corpus luteum regression

C. Cervical dilation

D. Tissue growth

Which maternal metabolic effects are produced by human chorionic somatomammotropin?

A. Higher insulin sensitivity; fat storage

B. Lower insulin sensitivity; fatty acid release

C. Lower glucose; reduced fatty acids

D. Higher insulin sensitivity; less lipolysis

Which gonadotropin pattern normally occurs during pregnancy?

A. LH rises, FSH rises

B. LH rises, FSH falls

C. LH decreases, FSH decrease

D. LH falls, FSH rises

Which hormone pair normally increases during pregnancy?

A. PTH and relaxin

B. LH and FSH

C. FSH and progesterone

D. LH and prolactin

How does basal metabolic rate normally change during pregnancy?

A. Decreases markedly

B. Increases

C. Remains unchanged

D. Becomes negligible

During which trimester does the greatest amount of fetal growth occur?

A. First trimester

B. Second trimester

C. Peripartum period

D. Third trimester

Which nutrients become especially important during the final months of pregnancy?

A. Sodium, potassium, chloride

B. Zinc, copper, magnesium

C. Calcium, phosphate, iron

D. Iodine, selenium, fluoride

Inadequate maternal iron intake during pregnancy can lead to which anemia?

A. Hypochromic anemia

B. Hemolytic anemia

C. Aplastic anemia

D. Megaloblastic anemia

According to these pregnancy notes, supplementation with which vitamin helps prevent hemorrhage?

A. Vitamin A

B. Vitamin K

C. Vitamin C

D. Vitamin D

How does placental blood flow change during the last month of pregnancy?

A. Stops

B. Decreases

C. Remains unchanged

D. Increases

Which pair of maternal physiologic changes occurs near term?

A. Blood volume and ventilation decrease

B. Blood volume falls; ventilation rises

C. Blood volume and ventilation increase

D. Blood volume rises; ventilation falls

How does maternal urine formation generally change during pregnancy?

A. Increases

B. Decreases

C. Stops

D. Remains fixed

What is the fluid surrounding the fetus within the uterus called?

A. Colostrum

B. Lochia

C. Uterine milk

D. Amniotic fluid

Which placental abnormality can contribute to development of preeclampsia?

A. Excess placental oxygen delivery

B. Insufficient placental blood supply

C. Increased fetal urine production

D. Excess progesterone secretion

Failure to remodel which maternal vessels is associated with preeclampsia?

A. Umbilical arteries

B. Uterine veins

C. Maternal spiral arteries

D. Ovarian veins

Which inflammatory mediators are linked to preeclampsia in these notes?

A. TNF-alpha and IL-6

B. IL-2 and IFN-gamma

C. IL-4 and IL-10

D. Histamine and serotonin

Which two circulating proteins are increased in women with preeclampsia?

A. Albumin and transferrin

B. Renin and angiotensinogen

C. Fibrinogen and plasminogen

D. sFlt-1 and soluble endoglin

Which mechanical change can itself help trigger parturition?

A. Cervical shortening

B. Uterine smooth-muscle stretch

C. Reduced uterine blood flow

D. Placental villous regression

Contraction of which muscles adds major force during fetal expulsion?

A. Pelvic floor muscles

B. Diaphragmatic muscles

C. Abdominal muscles

D. Gluteal muscles

How does contraction frequency change as labor progresses?

A. Increases

B. Decreases

C. Remains constant

D. Stops intermittently

In the positive-feedback cycle of labor, cervical stretch directly promotes what next response?

A. Uterine relaxation

B. Placental separation

C. Progesterone secretion

D. Fundic contractions intensify

What process normally occurs to the uterus after parturition?

A. Hypertrophy

B. Hyperplasia

C. Involution

D. Calcification

Besides prolactin, which hormones are required for adequate milk secretion?

A. GH, cortisol, PTH, insulin

B. FSH, LH, ACTH, ADH

C. Estrogen, oxytocin, renin, TSH

D. Aldosterone, glucagon, hCG, thyroxine

Which hypothalamic substance acts as prolactin-inhibitory hormone?

A. Oxytocin

B. Prolactin

C. Serotonin

D. Dopamine

What normally happens to ovulation immediately after childbirth?

A. Resumes immediately

B. Does not resume immediately

C. Permanently stops

D. Becomes continuously active

Which hormone causes milk ejection from mammary alveoli into ducts?

A. Prolactin

B. Estrogen

C. Oxytocin

D. Progesterone

Suckling one breast can cause bilateral milk flow. What is this process called?

A. Milk let-down

B. Colostrum formation

C. Mammary involution

D. Lactational amenorrhea

Which neural condition can inhibit milk ejection?

A. Reduced parasympathetic activity

B. Increased vagal tone

C. Reduced sensory input

D. Excess sympathetic outflow