NM704 Exam 1 QUESTIONS 100% Verified Questions &
Answers
Q: Explain the way in which asynclitism can assist or impede labor progress.
Answer:
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
Q: Define and understand the cephalic prominence.
Answer:
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
Q: Know the mechanisms of labor for birth in the occiput anterior position: engagement, descent, flexion, internal
rotation, extension, restitution, external rotation.
Answer:
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
Q: Know the mechanisms of labor for birth in the occiput posterior position: engagement, descent, flexion, internal
rotation, flexion then extension, restitution, external rotation.
Answer:
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
Q: Understand long arc versus short arc rotation with an occiput posterior position.
Answer:
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
Q: 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.
Answer:
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
Q: 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.
Answer:
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.
Q: 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.
Answer:
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.
Q: 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.
Answer:
This lines the head up with the rest of the body
Q: Analyze the way in which external 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.
Answer:
Shoulders rotate so that the longest diameter (shoulder to shoulder) of the baby lines up with the longest diameter (AP) of
the pelvic mid-plane, allowing for passage of the shoulders to complete delivery of the baby.
Q: Define molding.
Answer:
involves entire skull, with overlapping in one area being counterbalanced by movement elsewhere
Q: Define caput succedaneum.
Answer:
edematous swelling over the most dependent portion of the presenting fetal head
Q: Know the etiology, clinical findings, and clinical significance of molding.
Answer:
Etiology: Creates harmony between the base and the vertex of the skull and prevents destructive tension and possible
rupture of the cranial membrane. Clinical findings: elongation of the skull
Q: Know the etiology, clinical findings, and clinical significance of caput succedaneum.
Answer:
Answers
Q: Explain the way in which asynclitism can assist or impede labor progress.
Answer:
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
Q: Define and understand the cephalic prominence.
Answer:
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
Q: Know the mechanisms of labor for birth in the occiput anterior position: engagement, descent, flexion, internal
rotation, extension, restitution, external rotation.
Answer:
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
Q: Know the mechanisms of labor for birth in the occiput posterior position: engagement, descent, flexion, internal
rotation, flexion then extension, restitution, external rotation.
Answer:
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
Q: Understand long arc versus short arc rotation with an occiput posterior position.
Answer:
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
Q: 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.
Answer:
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
Q: 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.
Answer:
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.
Q: 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.
Answer:
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.
Q: 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.
Answer:
This lines the head up with the rest of the body
Q: Analyze the way in which external 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.
Answer:
Shoulders rotate so that the longest diameter (shoulder to shoulder) of the baby lines up with the longest diameter (AP) of
the pelvic mid-plane, allowing for passage of the shoulders to complete delivery of the baby.
Q: Define molding.
Answer:
involves entire skull, with overlapping in one area being counterbalanced by movement elsewhere
Q: Define caput succedaneum.
Answer:
edematous swelling over the most dependent portion of the presenting fetal head
Q: Know the etiology, clinical findings, and clinical significance of molding.
Answer:
Etiology: Creates harmony between the base and the vertex of the skull and prevents destructive tension and possible
rupture of the cranial membrane. Clinical findings: elongation of the skull
Q: Know the etiology, clinical findings, and clinical significance of caput succedaneum.
Answer:
