l & D 2
Terms
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- what muscles are the powers of labor?
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uterine
abdominal - The uterus is divided into what 2 segments?
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Upper active segment - Fundus
Lower passive segment - Corpus - What kind of muscle cells make up the fundus?
- longitudinal muscle cells which contract, relax, and retract.
- What is retraction?
- muscle is minutely shorter after each contraction. Only muscle in the body that retracts.
- What happens to the fundus with each contraction?
- Fundus gets shorter and thicker which pushes baby down.
- The presenting part becomes a what?
- dilating force - causes thinning or effacing.
- What are the muscles of the fundus like during gestation?
- relaxed
- What are the muscle cells of the Corpus like?
- Circular fibers that relax and stretch (get thinner) during labor. Allows the baby to be pushed through fundus into corpus.
- What are these muscles like during gestation?
- These muscles are contracted so baby not expelled.
- What happens if the corpus obstructs decent of baby?
- It becomes a pathological retraction ring or Bandle's Retraction Ring.
- What complication can happen of corpus obstructs decent of baby?
- Lower segment could rupture because upper still pushing and lower still thinning. Not as much of a problem for baby.
- What is the biggest obstruction?
- Large baby.
- What is meant by antagonistic response of uterine muscles?
- They reverse roles from gestation to labor.
- What is a physiological or Braun's retraction ring?
- Where long uterine fibers meet circular corpus fibers.
- What is brachystasis?
- Phenomena of retraction. Long fibers of fundus retract and get shorter and thicker. Space decreases in uterus.
- what happens physically during labor involving miometrial activity?
- As cervix stretches and opens (dilates and effaces) miometrial activity is increasing. Contractions = miometrial activity.
- Fergason's reflex?
- Whole process of labor is increased with contractions and increased miometrial activity.
- Uterine contractions are intermittent. How long should rest period between contractions be?
- at least 1 minute.
- Are contractions voluntary or involuntary?
- involuntary
- What 4 factors is labor dependant on?
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4 P's:
Passenger (baby)
Pelvis (passage)
Powers (uterine muscles, contractions)
Psychi (frame of mind) - What characteristics of the passenger (baby) effects the progress of labor?
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Size of baby:
small - speeds up possibly
Way presenting - dilating force. - What shape pelvis (passage) is best?
- gynecoid
- What should happen with uterine muscles/contractions during labor (Powers)
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Contractions should get longer, closer together.
Ability to push affected by abdominal muscles. - How can psychi affect labor?
- If fearful - tense - effects progress.
- How much above the baseline is a normal contraction?
- 35-60 (50-75 with 15 baseline)
- A woman can feel intensity of contraction when it is how far above baseline.
- 25 mmhg above
- How far above baseline can false labor pains be?
- 40
- What is fundal dominance?
- contraction begins high on fundus and radiates down on uterine body. Felt as back pain.
- What controls contractions?
- Pacemaker - by R fallopian tube - enters fundus - dominant pacemaker.
- What happens with cervical effacement and dilatation?
- as uterus elongates with every contaction and horizontal diameter decreases (gets long and narrow)
- What causes cervical effacement and dilitation?
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Fetal axis pressure
Hydrostatic pressure of BOW
Lower segment pulled up over the presenting part. - What happens to cause fetal axis pressure?
- fundus pushes on upper pole and lower pole (head) and becomes a dilating force.
- How does hydrostatic pressure of BOW affect effacement and dilitation?
- before ruptured, is a dilitating force.
- When might the doctor leave the BOW intact?
- with a preemie to be cushion for fragile head.