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Exam (elaborations)

NM704 Exam 1 – Questions With Verified Solutions

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NM704 Exam 1 – Questions With Verified Solutions

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NM704 Exam 1 – Questions With Verified Solutions

Cervix Changes for Onset and Progress of Labor Right Ans - Remodeling,
increased cervical discharge, passage of the cervical mucous plug, vaginal
spotting, and eventually dilation.

Cervical Remodeling Right Ans - 4 Phases: ripening, softening, dilation,
repair

Cervical Effacement Right Ans - Thinning of the cervix as it becomes
shorter and softer

Progesterone in Labor Right Ans - Central hormone leading to uterine
quiescence (inactivity or dormancy). When progesterone dominates, labor
onset is prevented. It has no relationship to the progress of labor

Estrogen in Labor Right Ans - The placenta is the main source of its
biosynthesis in pregnancy. It plays a central role in the activation of labor
(phase 1). Facilitates labor initiation and causes uterine myometrial cells to
express receptors for prostaglandins and oxytocin, as well as gap junctions. It
has no relationship to the progression of labor

Prostaglandins in Labor Right Ans - Stimulate contractions, the formation
of gap junctions and increase myometrial sensitivity to oxytocin. For labor
progression, they promote decreased collagen content in the cervix, leading to
cervical softening and effacement. they're produced by the uterine decidua

Oxytocin in Labor Right Ans - It doesn't increase before labor starts, but
uterine sensitivity to oxytocin increases in late pregnancy because of a 100-
200-fold increase in the concentration of receptors for it in the myometrium.
Receptor increase, not an increased production, is what influences the
strength and frequency of contractions in active labor. As labor progresses,
there's an increase in the pulsatile release of this, resulting in stronger uterine
contractions. It also leads to the production of prostaglandins by the uterine
decidua.

Gap Junctions in Labor Right Ans - Allow for communication between
muscle fibers, which allows for the effective coordination of contractions.
They are needed for both the onset of labor and the effective progress of labor.

, They're transmembrane proteins that create a pore used for said
communication

Myometrium Right Ans - Smooth muscle with four layers, each of which
produce a distinct response to substances that inhibit or promote
contractions. Inner circular layer runs in a spiral perpendicularly, the middle
layer has blood vessels that pass through the muscle fibers, and the two outer
laters run parallel to the long axis of the uterus.

Where is the uterine muscle thickest in labor? Right Ans - The fundus

Where does the uterus thin during labor? Right Ans - Toward the lower
uterine segment in the isthmus, forming a tube through which the fetus
passes.

Phase 0 of Labor Right Ans - Quiescence

Involves progesterone, nitric oxide, relaxin, and prostacyclin to maintain
minimal contractility. Nitric oxide and relaxin increase the intracellular
concentrations of substances that inhibit intracellular release of calcium,
which causes contractions.

Phase 1 of Labor Right Ans - Activation

Involves estrogen and prostaglandins. Under the influence of estrogen and the
inflammatory cascade, uterine myometrial cells express receptors for
prostaglandins and oxytocin and develop gap junction between myometrial
cells. Action potentials initiate contractions through these gap junctions.
Prostaglandins also facilitate contractions, increase myometrial sensitivity to
oxytocin, and stimulate the formation of gap junctions

Phase 2 of Labor Right Ans - Stimulation/Progression

Involves oxytocin and prostaglandins. They increasingly influence myometrial
activity. The amnion, chorion, and decidua produce prostaglandins, in part by
the upregulation of COX-2 enzymes, working to affect nearby tissues to
promote uterine contractions. Inflammatory cytokines and oxytocin also
stimulate prostaglandin production

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