MIDWIFERY ANATOMY AND PHYSIOLOGY YEAR 1 FINAL
EXAM QUESTIONS AND ANSWERS SURE A+
✔✔What is the valsalva manoeuvre? - ✔✔Breath holding and attempting to exhale
against closed airways (used in directed pushing).
✔✔Immediately after birth, where can the uterus be palpated? - ✔✔Midway between
the umbilicus and the symphysis pubis.
✔✔What 3 things should you look for, when checking the placenta? - ✔✔That there are
two membranes and they are intact.
That all of the cotyledons fit together and form a complete circle.
That there are 2 umbilical arteries and 1 umbilical vein.
✔✔What is hypovolaemia? - ✔✔A decrease in blood volume. It can lead to
hypovolaemic shock, as severe blood/fluid loss prevents the heart from pumping
enough blood around the body.
✔✔During the follicular phase of the ovarian cycle, what hormones are released and
from where? - ✔✔GnRH - from the hypothalamus
FSH and LH - from the anterior pituitary gland
✔✔Name 5 functions of the placenta (think SERPENT). - ✔✔Storage
Endocrine
Respiration
Protection
Excretion
Nutrition
Transfer of substances
✔✔What is the name of the ridge that develops between the lower and upper uterine
segment? - ✔✔The retraction ring
NOT Bandls ring - this occurs in mechanically obstructed labour and the retraction ring
becomes visible above the symphysis pubis - now referred to as Bandls ring.
Associated with fetal compromise.
,✔✔What is thought to cause the onset of labour? (Four hormones/gases) -
✔✔Oestrogen - stimulates the placenta to release prostaglandin
Progesterone - metabolises to oestrogen increasing uterine sensitivity to prostaglandins
causing myometrial contractions
Nitric oxide - produced by the placenta, causes smooth muscle relaxation
Corticotrophin-releasing hormone - stimulates the placenta to produce prostaglandins
✔✔Name some external signs of full dilation. - ✔✔Expulsive pushing
Rupture of forewaters (not always)
Dilation and gaping of anus
Anal cleft line/purple line
Rhomboid of Michaelis
Show/fresh blood
Appearance of presenting part
Change in woman's behaviour
✔✔The process that leads to the inclusion of the cervical canal into the lower uterine
segment is called? - ✔✔Effacement
✔✔Pain in labour is caused by? - ✔✔Ischemia of the uterus and pressure of fetal parts.
✔✔What are the 4 main joints in the pelvis? - ✔✔Symphysis pubis joint
Sacroiliac joints x2
Sacrococcygeal joint
✔✔Name the 3 innominate bones of the pelvis. - ✔✔Ilium
Ischium
Pubis
, ✔✔What is the difference between caput and moulding? - ✔✔Caput - swelling on the
baby's head
Moulding - change in shape of the baby's head where the bones move over each other
to allow passage through the birth canal
✔✔The placenta and chorion are derived from which part of the blastocyst? - ✔✔The
trophoblast
✔✔How might an epidural affect the normal mechanisms of labour? - ✔✔An epidural
causes the pelvic floor to relax which causes a delay in rotation of the head.
✔✔What observations should be taken in labour and how often? - ✔✔Pulse - hourly
Contractions - every 30 mins
VE - 4 hourly
Temperature - 4 hourly
BP - 4 hourly
Fluid balance - all fluids given and all urine output, as and when
Auscultation of fetal heart - every 15 minutes for 1 full minute in the first stage and every
5 minutes in the second stage
✔✔What is the physiological importance of resting between contractions? - ✔✔Allows
perfusion of the placenta and fetal recovery.
✔✔Name and detail the 4 ways in which a newborn baby may lose heat. -
✔✔Evaporation - if left wet
Convection - from a cool/draughty environment
Conduction - if in contact with a cold surface/object
Radiation - if left uncovered near cold windows or walls
✔✔Name the 5 superficial muscles of the perineal floor. - ✔✔Membranous sphincter of
the urethra
Ischiocavernosus muscle
Bulbocavernosus muscle (bulbospongiosus)
EXAM QUESTIONS AND ANSWERS SURE A+
✔✔What is the valsalva manoeuvre? - ✔✔Breath holding and attempting to exhale
against closed airways (used in directed pushing).
✔✔Immediately after birth, where can the uterus be palpated? - ✔✔Midway between
the umbilicus and the symphysis pubis.
✔✔What 3 things should you look for, when checking the placenta? - ✔✔That there are
two membranes and they are intact.
That all of the cotyledons fit together and form a complete circle.
That there are 2 umbilical arteries and 1 umbilical vein.
✔✔What is hypovolaemia? - ✔✔A decrease in blood volume. It can lead to
hypovolaemic shock, as severe blood/fluid loss prevents the heart from pumping
enough blood around the body.
✔✔During the follicular phase of the ovarian cycle, what hormones are released and
from where? - ✔✔GnRH - from the hypothalamus
FSH and LH - from the anterior pituitary gland
✔✔Name 5 functions of the placenta (think SERPENT). - ✔✔Storage
Endocrine
Respiration
Protection
Excretion
Nutrition
Transfer of substances
✔✔What is the name of the ridge that develops between the lower and upper uterine
segment? - ✔✔The retraction ring
NOT Bandls ring - this occurs in mechanically obstructed labour and the retraction ring
becomes visible above the symphysis pubis - now referred to as Bandls ring.
Associated with fetal compromise.
,✔✔What is thought to cause the onset of labour? (Four hormones/gases) -
✔✔Oestrogen - stimulates the placenta to release prostaglandin
Progesterone - metabolises to oestrogen increasing uterine sensitivity to prostaglandins
causing myometrial contractions
Nitric oxide - produced by the placenta, causes smooth muscle relaxation
Corticotrophin-releasing hormone - stimulates the placenta to produce prostaglandins
✔✔Name some external signs of full dilation. - ✔✔Expulsive pushing
Rupture of forewaters (not always)
Dilation and gaping of anus
Anal cleft line/purple line
Rhomboid of Michaelis
Show/fresh blood
Appearance of presenting part
Change in woman's behaviour
✔✔The process that leads to the inclusion of the cervical canal into the lower uterine
segment is called? - ✔✔Effacement
✔✔Pain in labour is caused by? - ✔✔Ischemia of the uterus and pressure of fetal parts.
✔✔What are the 4 main joints in the pelvis? - ✔✔Symphysis pubis joint
Sacroiliac joints x2
Sacrococcygeal joint
✔✔Name the 3 innominate bones of the pelvis. - ✔✔Ilium
Ischium
Pubis
, ✔✔What is the difference between caput and moulding? - ✔✔Caput - swelling on the
baby's head
Moulding - change in shape of the baby's head where the bones move over each other
to allow passage through the birth canal
✔✔The placenta and chorion are derived from which part of the blastocyst? - ✔✔The
trophoblast
✔✔How might an epidural affect the normal mechanisms of labour? - ✔✔An epidural
causes the pelvic floor to relax which causes a delay in rotation of the head.
✔✔What observations should be taken in labour and how often? - ✔✔Pulse - hourly
Contractions - every 30 mins
VE - 4 hourly
Temperature - 4 hourly
BP - 4 hourly
Fluid balance - all fluids given and all urine output, as and when
Auscultation of fetal heart - every 15 minutes for 1 full minute in the first stage and every
5 minutes in the second stage
✔✔What is the physiological importance of resting between contractions? - ✔✔Allows
perfusion of the placenta and fetal recovery.
✔✔Name and detail the 4 ways in which a newborn baby may lose heat. -
✔✔Evaporation - if left wet
Convection - from a cool/draughty environment
Conduction - if in contact with a cold surface/object
Radiation - if left uncovered near cold windows or walls
✔✔Name the 5 superficial muscles of the perineal floor. - ✔✔Membranous sphincter of
the urethra
Ischiocavernosus muscle
Bulbocavernosus muscle (bulbospongiosus)
