Labor and Delivery (exam 1) Questions And Answers

-birth passage (passageway) -fetus (passenger) -relationship between the passage and fetus (proportion, fetus size or position) -physiologic forces of labor (powers) -psychological factors (psyche)ANS - what are the critical factors in labor? fetal presentationANS - -the manner in which the fetus appears to the examiner during delivery -head first or butt first? fetal attitudeANS - -how well flexed or extended the fetus is -ideally, well flexed -the relationship of body parts of the fetus -cephalic -breech -shoulderANS - what are the three fetal presentations? cephalicANS - the fetus is head first breechANS - the fetus is butt first breech and shoulderANS - what two fetal positions are an indication for c-section? -vertex or occiput -sinciput -brow -facialANS - what are the 4 types of cephalic presentation? vertex/cephalic presentationANS - -crown of the head is the presenting part of the fetus -***most commonly seen presentation and what we want to see -fetal head is completely flexed and the fetal chin is flexed to the chest sinciput presentationANS - -fetal head is partially flexed -top of head is the presenting part of the fetus brow presentationANS - the eyebrow or forehead is the presenting part of the fetus facial presentationANS - -the head is hyperextended -the face is the presenting part of the fetus -cephalic/vertex -well flexed is the most ideal for vaginal deliveryANS - what is the most ideal type of cephalic presentation? right occiput anterior (ROA)ANS - what is the most common type of fetal presentation? right occiput anterior (ROA)ANS - -the crown of the fetus's head is to the right and forward of the mother's pelvis -when the baby is delivered, we should see the back of the baby's head frank breechANS - breech presentation where the buttocks is the presenting part footling breechANS - breech presentation where the feet are the presenting part shoulder/transverse/lie presentationANS - -presentation where the fetus is laying across the mother's abdomen -the presenting part of the fetus is the shoulder flexedANS - what fetal attitude is ideal? -face: bones well fused -base of skull: 2 temporal bones well fused -vault: **not fused** held together by suturesANS - what are the 3 major parts of the fetal head? suturesANS - the membranous spaces between cranial bones fontanelsANS - -intersections of cranial sutures that can mold -anterior is diamond shaped -posterior is triangle shaped -anterior is open longer than the posterior -during the delivery process of a vaginal delivery, the sutures can override themselves to make the head a little smaller through the birthing process -as the brain grows, these allow for the skull to grow with the brainANS - what is the purpose of sutures and the vault on the fetal head? -size of the maternal pelvis -shape of the maternal pelvis -ability of the cervix to dilate and effaceANS - what is included in a birth passageway? gynecoidANS - what is the ideal shape of the maternal pelvis? effacementANS - the gradual thinning, shortening and drawing up of the cervix measure in percentage from 0 to 100% dilationANS - the gradual opening of the cervix measured in centimeters from closed to 10 cm cervical effacement and dilationANS - what are the two things that can be measured to determine labor? fetal axis pressure: as the uterus contracts, it puts pressure on the cervixANS - what causes dilation of the cervix? with a manual examANS - how is dilation of the cervix assessed? 10 cm dilatedANS - what does a "complete" dilation mean? thick cervixANS - 0% effaced paper thin cervixANS - 100% effaced engagementANS - (relationship of presenting part to the pelvis) -the largest diameter of the presenting part passes through the pelvic inlet (BPD) stationANS - (relationship of presenting part to the pelvis) -the relationship of the presenting part to the ischial spines -how far up or down the fetus is zero stationANS - the presenting part is at the ischial spines