MIDWIFERY - ANATOMY AND PHYSIOLOGY - YEAR 1

What are the 3 phases of the first stage of labour? - 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? - ANS-Ampulla of the uterine tube. What is the dosage of diamorphine and how is it given? - ANS-5-10mg (dependent on patient size), 4 hourly and IM. What is Pica? - 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? - 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? - ANS-More than 5 contractions in 10 minutes in spontaneous labour. What is tachycardia? - ANS-A maternal pulse rate of over 100bpm. Name 5 non-pharmacological methods of pain relief. - ANS-Water Distraction techniques TENS machine Position Massage Hypnotherapy Aromatherapy Acupuncture Breathing techniques What changes occur in the maternal respiratory system during pregnancy? - ANS-Oxygen consumption increases by up to 20-30% Rib cage expands Tidal volume increases by up to 30-40% Name 3 types of abnormal placenta. - 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)? - 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? - 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? - ANS-75-150mg, 2-4 hourly and IM. What is haemoglobin broken down into? - 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? - ANS-Nocioceptors What should you look for when performing a vaginal examination. - 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