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Exam (elaborations)

NM704 Exam 1 QUESTIONS WITH 100% CORRECT ANSWERS| LATEST UPDATE 100% VERIFIED

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NM704 Exam 1 QUESTIONS WITH 100% CORRECT ANSWERS| LATEST UPDATE 100% VERIFIED

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NM704 Exam 1 QUESTIONS WITH 100% CORRECT ANSWERS| LATEST UPDATE 100% VERIFIED



Explain the way in which asynclitism can assist or impede labor progress. Can be mechanical
advantage w/ bosses entering pelvis one at a time. Diam approx 8.75 - can enable a larger head
to pass through inlet. If marked or persistent, may prevent normal internal rotation



Define and understand the cephalic prominence. For dx attitude. Flexion: occiput higher
than sinciput, therefore front of head is prominent. CP and back on opposite side; Extension:
Back of head prominent. CP and back on same side; CP not palp: military. Oxorn pp.72-74



Know the mechanisms of labor for birth in the occiput anterior position: engagement, descent,
flexion, internal rotation, extension, restitution, external rotation. Engagement: ROT or LOT
position; Descent: occurs throughout; Flexion: suboccipitobregmatic diameter presenting;
Internal rotation: 45 LOA or ROA, 90 LOT or ROT, 135 LOP or ROP to OA; Extension: birth of
head by extension; Restitution: 45 to LOA or ROA; External rotation: 45 to LOT or ROT



Know the mechanisms of labor for birth in the occiput posterior position: engagement, descent,
flexion, internal rotation, flexion then extension, restitution, external rotation. Engagement:
Right or left oblique diameter; Descent: occurs throughout; Flexion: usually less completely
flexed; Internal rotation: 45 LOP or ROP to OP; Flexion then extension: Birth of head by first
flexion and then extension; Restitution: 45 to LOP to ROP; External rotation: 45 LOT to ROT



Understand long arc versus short arc rotation with an occiput posterior position. Long arc:
long arc rotation of 135 to a direct OA position; Short arc: occurs in a LOP or ROP, internal
rotation through a short arc of 45 to a direct OP position in the anteroposterior diameter of the
maternal pelvis



Analyze the way in which engagement allows the fetus to negotiate the three planes of the
maternal pelvis. Figure out where in the pelvis each mechanism occurs, and what each one
accomplishes. Must like it sounds, this involves the head becoming 'engaged' in the pelvis;
This is the point at which the head enters the true pelvis

, Analyze the way in which descent allows the fetus to negotiate the three planes of the maternal
pelvis. Figure out where in the pelvis each mechanism occurs, and what each one accomplishes.
Must occur throughout labor; due to downward pressure of contractions, maternal effort,
and a little by gravity



Analyze the way in which flexion allows the fetus to negotiate the three planes of the maternal
pelvis. Figure out where in the pelvis each mechanism occurs, and what each one accomplishes.
Usually takes place at inlet. Essential to continuing descent; allows for the
suboccipitobregmatic diameter to present rather than larger diameters, so that a smaller
diameter is trying to pass through the pelvis; in OP babies this flexion is less complete, so the
diameter is larger than in OA babies. Resistance from below increases flexion.



Analyze the way in which the internal rotation allows the fetus to negotiate the three planes of
the maternal pelvis. Figure out where in the pelvis each mechanism occurs, and what each one
accomplishes. Lines the AP of the fetal head with the AP of the pelvis in the mid-plane,
where the AP diameter is the largest diameter. This lines up the ovals and puts the fetal head
into a position that can more easily pass through the mid-plane. Shoulders do not rotate
internally at this time.



Analyze the way in which extension allows the fetus to negotiate the three planes of the
maternal pelvis. Figure out where in the pelvis each mechanism occurs, and what each one
accomplishes. Required for the delivery of the fetal head; the pelvic changes shape in this
area in such a way that the head must move down to just above the tip of the sacrum, then
forward, up, and outward to the vaginal opening. This is how the fetal head negotiates the
curve of Carus. In OP births, flexion must first occur for the fetal head to negotiate the change
in pelvic shape & Curve of Carus, and is completed with extension.



Analyze the way in which restitution allows the fetus to negotiate the three planes of the
maternal pelvis. Figure out where in the pelvis each mechanism occurs, and what each one
accomplishes. This lines the head up with the rest of the body

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