Midwifery Anatomy and Physiology Year One Detailed Exam 2025

What are the 3 phases of the first stage of labour? - Correct Ans-Latent phase - 0-4cm, irregular contractions, cervical canal shortens (3cm to less than 0.5cm). Active phase - 4-8cm, regular contractions 2-5 mins apart and lasting over 60 seconds, cervix is mid to anterior/soft, effaced. Transitional - 8-10cm, can be brief lull in contractions, change in woman's behaviour. Where does fertilisation usually occur? - Correct Ans-Ampulla of the uterine tube. What is the dosage of diamorphine and how is it given? - Correct Ans-5-10mg (dependent on patient size), 4 hourly and IM. What is Pica? - Correct Ans-Craving of non-food items such as clay, soap, coal, etc. When should the nuchal translucency scan take place and what is it for? - Correct Ans Between 11+2 and 14+1 weeks. It checks the fluid at the back of the baby's neck and is an indicator for Down's syndrome. What is tachysystole? - Correct Ans-More than 5 contractions in 10 minutes in spontaneous labour. What is tachycardia? - Correct Ans-A maternal pulse rate of over 100bpm. Name 5 non-pharmacological methods of pain relief. - Correct Ans-Water Distraction techniques TENS machine Position Massage Hypnotherapy Aromatherapy Acupuncture Breathing techniques What changes occur in the maternal respiratory system during pregnancy? - Correct Ans-Oxygen consumption increases by up to 20-30% Rib cage expands Midwifery Midwifery Tidal volume increases by up to 30-40% Name 3 types of abnormal placenta. - Correct Ans-Battledore insertion - cord inserted on the edge Velementous insertion - cord inserted through the membranes, some distance from the placenta Succenturiate lobe - a lobe which is separated from the main body but connected by the placental blood vessels Circumuallate - opaque ring Bipartite - two separate lobes and a bifurcated cord The zygote undergoes mitotic cellular division (clevage), resulting in the formation of smaller cells. What is the zygote called at each of these changes (day 1, day 3 and day 4)? - Correct Ans-Day 1 - blastomere Day 3 - morula Day 4 - blastocyst There are 3 primary germ layers that are the main embryonic tissues, from which structures and organs develop. What are they and what develops from them? - Correct Ans-Ectoderm - epidermis layer of skin, hair, nails and the nervous system Mesoderm - muscle, skeleton, dermis of skin, connective tissue, urogenital gland, blood vessels, blood and lymph cells Endoderm - epithelial lining of the digestive, respiratory and urinary systems and glandular organs, such as the liver and the pancreas What is the dosage of meptid and how should it be given? - Correct Ans-75-150mg, 2-4 hourly and IM. What is haemoglobin broken down into? - Correct Ans-Iron - which produces more red blood cells Globin - a protein used in the body Un-conjugated bilirubin - toxic, fat-soluble, not easily excreted in bile/urine, causes yellow discolouration of skin and deposits in the brain Sensory receptors that respond to pain are called? - Correct Ans-Nocioceptors Midwifery Midwifery What should you look for when performing a vaginal examination. - Correct Ans-Labia - varicosities, oedema, warts, sores, etc Perineum - scars, epis, FGM, etc Vaginal orifice - discharge, show, liquor, bleeding etc Liquor - clear, bloodstained, offensive smell, mec etc Rectum - loaded, or not (can impede descent) Cervix - position, consistency, presenting part, effacement and dilation Membranes - intact or not Position of presenting part Caput or moulding Station What is fetal axis pressure? - Correct Ans-The force of a contraction, transmitted down the upper pole of the fetus and down the long axis, onto the presenting part. Does the pH of blood increase or decrease during pregnancy? - Correct Ans-Increases - due to an increased respiration rate (more oxygen and less CO2). What are the names of the 5 temporary structures in the fetal circulation, prior to birth? - Correct Ans-Ductus venosus - connects the umbilical vein to the inferior vena cava Foramen ovale - opening between the left and right atria Ductus arteriosus - leads from bifurcation of the pulmonary artery to the descending aorta. Umbilical arteries - branch from the internal iliac arteries and carry deoxygenated blood from the placenta to the heart. Umbilical vein - carries oxygenated blood back to the fetus. Bypasses the liver and connects to the IVC. What changes/symptoms occur, relating to the gastrointestinal system, during pregnancy? - Correct Ans-Bleeding and tender gums Increased acidity of saliva Midwifery Midwifery Possible nausea, vomiting and heartburn, due to the relaxing effects of progesterone Enlargement of the gall bladder - which also empties more slowly Increased flatulence - due to pressure of the uterus on the bowel Constipation - the uterus mechanically limits colonic emptying What is the valsalva manoeuvre? - Correct Ans-Breath holding and attempting to exhale against closed airways (used in directed pushing). Immediately after birth, where can the uterus be palpated? - Correct Ans-Midway between the umbilicus and the symphysis pubis. What 3 things should you look for, when checking the placenta? - Correct Ans-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? - Correct Ans-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? - Correct Ans-GnRH - from the hypothalamus FSH and LH - from the anterior pituitary gland Name 5 functions of the placenta (think SERPENT). - Correct Ans-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? - Correct Ans-The retraction ring Midwifery Midwifery 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) - Correct Ans 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, cau