Ob Placenta And Umbilical Cord

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Ob Placenta And Umbilical Cord - Quiz

Questions and Answers
  • 1. 

    Fetal portion of the placenta is formed from

    • A.

      Chorion frondosum

    • B.

      Decidua basalis

    • C.

      Decidua vera

    • D.

      Yolk sac

    Correct Answer
    A. Chorion frondosum
    Explanation
    The fetal portion of the placenta is formed from the chorion frondosum. The chorion frondosum is the part of the chorion that contains the chorionic villi, which are finger-like projections that extend into the maternal blood sinuses. These villi are responsible for the exchange of nutrients, gases, and waste products between the mother and the fetus. The chorion frondosum is in direct contact with the decidua basalis, which is the maternal portion of the placenta. The decidua vera, on the other hand, is the non-placental portion of the uterine lining. The yolk sac, although involved in early embryonic development, does not contribute to the formation of the placenta.

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  • 2. 

    Placenta weighs ____ grams at term.

    • A.

      500

    • B.

      600

    • C.

      800

    • D.

      950

    Correct Answer
    B. 600
    Explanation
    The placenta is an organ that develops during pregnancy and provides oxygen and nutrients to the fetus. At term, which is around 37 to 40 weeks of pregnancy, the average weight of the placenta is approximately 600 grams. This weight can vary, but 600 grams is a commonly accepted average weight for a term placenta.

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  • 3. 

    What covers the placental surface?

    • A.

      Decidua capsularis

    • B.

      Amniotic membrane

    • C.

      Chorionic villi

    • D.

      Glisson's capsule

    Correct Answer
    B. Amniotic membrane
    Explanation
    The amniotic membrane covers the placental surface. It is a thin, transparent membrane that surrounds the fetus and is filled with amniotic fluid. The amniotic membrane plays a crucial role in protecting and cushioning the developing fetus, as well as providing a barrier against infections. It also helps in the exchange of nutrients and waste between the mother and the fetus.

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  • 4. 

    Check all that are true about placenta

    • A.

      Maternal and fetal blood mix in the placenta

    • B.

      Site of exchange of gas and nutrients between mom and fetus

    • C.

      Fetal portion is 1/5 of total placental weight

    • D.

      Can overcompensate for inadequacies

    • E.

      Maternal portion formed from decidua basalis

    • F.

      Produces hormones to maintain pregnancy

    • G.

      Composed of fibrous connective tissue

    • H.

      Highly vascular structure

    Correct Answer(s)
    B. Site of exchange of gas and nutrients between mom and fetus
    D. Can overcompensate for inadequacies
    E. Maternal portion formed from decidua basalis
    F. Produces hormones to maintain pregnancy
    H. Highly vascular structure
    Explanation
    The placenta is the site of exchange of gas and nutrients between the mother and fetus. It is also capable of overcompensating for any inadequacies in nutrient or gas exchange. The maternal portion of the placenta is formed from decidua basalis, a layer of the uterine lining. The placenta also produces hormones, such as progesterone, to maintain pregnancy. Additionally, the placenta is a highly vascular structure, meaning it has a rich blood supply.

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  • 5. 

    Maternal and fetal portions of placenta are equal.

    • A.

      True

    • B.

      False

    Correct Answer
    B. False
    Explanation
    Materal part is less than 1/5 of placental weight.

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  • 6. 

    Placental migration

    • A.

      Movement of placenta in relation to internal os of cervix

    • B.

      As uterus grows, the placenta changes positions

    • C.

      Apparent change in position of placenta

    • D.

      Placenta covering the cervix

    • E.

      All of the above

    Correct Answer
    C. Apparent change in position of placenta
    Explanation
    The correct answer is "apparent change in position of placenta." This means that as the uterus grows, the placenta may appear to change positions. It is important to note that the actual position of the placenta does not change, but due to the growth of the uterus, it may seem like the placenta has moved. This phenomenon is known as placental migration.

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  • 7. 

    Cystic areas visualized in placenta may indicate

    • A.

      Large fetal vessels

    • B.

      Fibrin deposits

    • C.

      Placental lakes

    • D.

      All of the above

    Correct Answer
    D. All of the above
    Explanation
    Cystic areas visualized in the placenta can indicate large fetal vessels, fibrin deposits, or placental lakes. Large fetal vessels refer to abnormally dilated blood vessels in the placenta, which can be a sign of certain fetal abnormalities. Fibrin deposits are abnormal accumulations of a protein called fibrin, which can indicate inflammation or blood clotting issues in the placenta. Placental lakes are spaces filled with maternal blood, which can be a normal finding but can also indicate placental abnormalities. Therefore, the presence of cystic areas in the placenta can suggest any of these three conditions.

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  • 8. 

    What is the thickness of placenta after the 6th month?

    • A.

      ~12mm

    • B.

      ~15mm

    • C.

      ~16mm

    • D.

      ~18mm

    • E.

      ~21mm

    Correct Answer
    B. ~15mm
    Explanation
    After the 6th month, the placenta typically has a thickness of around 15mm.

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  • 9. 

    Based on these findings, what grade would you give the placenta?Indentations in chorionic plate with calcium deposits dispersed throughout placental tissue. Regular basal plate.

    • A.

      Grade 0

    • B.

      Grade 1

    • C.

      Grade 2

    • D.

      Grade 3

    Correct Answer
    B. Grade 1
    Explanation
    The given findings indicate indentations in the chorionic plate with dispersed calcium deposits throughout the placental tissue, along with a regular basal plate. These characteristics are consistent with Grade 1 placenta.

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  • 10. 

    Grade 2 of the placenta is approximately how many weeks?

    • A.

      34

    • B.

      36

    • C.

      38

    • D.

      28

    Correct Answer
    B. 36
    Explanation
    Grade 2 of the placenta is approximately 36 weeks. This suggests that the placenta is functioning at a moderate level, which is typical for a pregnancy around the 36-week mark. The grading system for the placenta assesses its maturity and function, with higher grades indicating more advanced development. Therefore, a grade 2 placenta at this stage of pregnancy is considered normal and healthy.

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  • 11. 

    Grade 3 placenta

    • A.

      Linear densities extend to basal plate

    • B.

      Linear densities extend from chorionic plate but not reaching basal plate

    • C.

      Smooth without echogenic densities

    • D.

      Homogeneous placental tissue

    Correct Answer
    A. Linear densities extend to basal plate
    Explanation
    Linear densities extending to the basal plate indicate that there are areas of increased density or calcifications present in the placenta. This can be a sign of aging or degeneration of the placenta. The basal plate is the part of the placenta that attaches to the uterine wall, so the presence of linear densities reaching this area may suggest potential issues with the attachment or function of the placenta.

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  • 12. 

    What is the hypoechoic area beneath chorionic plate?

    • A.

      Venous lake

    • B.

      Fibrin deposit

    • C.

      Placenta previa

    • D.

      Large fetal vessels

    • E.

      Hematoma

    • F.

      Either B or E

    • G.

      Either A or B

    Correct Answer
    F. Either B or E
    Explanation
    The hypoechoic area beneath the chorionic plate can be either a fibrin deposit or a hematoma. Fibrin deposits are commonly seen in the placenta and are characterized by a hypoechoic appearance. Hematomas, on the other hand, are collections of blood that can also appear hypoechoic. Therefore, the correct answer is either B (fibrin deposit) or E (hematoma).

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  • 13. 

    How do you distinguish a fibrin deposit from a placenatl lake?

    • A.

      Placental lake will be hypoechoic

    • B.

      Impossible to distinguish

    • C.

      Placental lake will have slow blood flow

    • D.

      Fibrin deposit will be hyperechoic

    Correct Answer
    C. Placental lake will have slow blood flow
    Explanation
    The correct answer is "placental lake will have slow blood flow". This is because a placental lake refers to a pool of maternal blood within the placenta, which typically has slow or stagnant blood flow. On the other hand, a fibrin deposit refers to the accumulation of fibrin, a protein involved in blood clotting, which would not affect blood flow. Therefore, by assessing the blood flow within the area, one can distinguish between a placental lake and a fibrin deposit.

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  • 14. 

    Placenta Previa

    • A.

      Associated with placentomegaly

    • B.

      Best seen with an overfilled bladder

    • C.

      Placenta implants over or near internal os of cervix

    • D.

      All of the above

    Correct Answer
    C. Placenta implants over or near internal os of cervix
    Explanation
    Placenta previa is a condition in which the placenta implants over or near the internal os of the cervix. This can cause complications during pregnancy and delivery. Placentomegaly refers to an enlarged placenta, but it is not necessarily associated with placenta previa. Having an overfilled bladder is not related to placenta previa either. Therefore, the correct answer is that placenta previa is associated with the placenta implanting over or near the internal os of the cervix.

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  • 15. 

    Risk factors for placenta previa

    • A.

      Multiparity

    • B.

      Advanced maternal age

    • C.

      Prior cesarean sections

    • D.

      All of the above

    • E.

      A and C

    Correct Answer
    D. All of the above
    Explanation
    Placenta previa is a condition where the placenta partially or completely covers the cervix, which can lead to complications during pregnancy. The risk factors mentioned in the options, including multiparity (having multiple pregnancies), advanced maternal age, and prior cesarean sections, are all known to increase the likelihood of developing placenta previa. Therefore, all of the above options are correct as they are recognized risk factors for placenta previa.

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  • 16. 

    What is not a risk factor of placenta previa?

    • A.

      Premature delivery

    • B.

      Life-threatening maternal hemorrhage

    • C.

      Increased risk of placenta accreta

    • D.

      Increased risk of intraplacental lesions

    Correct Answer
    D. Increased risk of intraplacental lesions
    Explanation
    Placenta previa is a condition where the placenta partially or completely covers the cervix. It can lead to complications during pregnancy and childbirth. Premature delivery is a risk factor for placenta previa, as it increases the chances of the placenta not moving away from the cervix as the uterus grows. Life-threatening maternal hemorrhage is also a risk factor, as the placenta can detach from the uterus and cause severe bleeding. Increased risk of placenta accreta is another risk factor, where the placenta attaches too deeply into the uterine wall. However, increased risk of intraplacental lesions is not a recognized risk factor for placenta previa.

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  • 17. 

    What is the most common cause of painless 2nd and 3d timester bleeding?

    • A.

      Placenta previa

    • B.

      Placenta accreta

    • C.

      Succenturiate placenta

    • D.

      Circumvallate placeta

    Correct Answer
    A. Placenta previa
    Explanation
    Placenta previa is the most common cause of painless 2nd and 3rd trimester bleeding. This condition occurs when the placenta partially or completely covers the cervix, leading to bleeding as the cervix begins to thin and dilate during pregnancy. Placenta accreta, succenturiate placenta, and circumvallate placenta are all different placental abnormalities, but they are not typically associated with painless bleeding.

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  • 18. 

    Newly formed vessels between placenta and bladder wall indicate

    • A.

      Placenta accreta

    • B.

      Complete placenta previa

    • C.

      Placenta percreta

    • D.

      Venous lakes

    • E.

      Succenturiate placenta

    • F.

      Partial placenta previa

    Correct Answer
    C. Placenta percreta
    Explanation
    Placenta percreta is a condition where the placenta grows too deeply into the uterine wall and can even penetrate through it. The presence of newly formed vessels between the placenta and the bladder wall suggests that the placenta has invaded the bladder, which is a characteristic feature of placenta percreta. Placenta accreta, on the other hand, refers to the abnormal attachment of the placenta to the uterine wall, while placenta previa involves the placenta partially or completely covering the cervix. Venous lakes are dilated blood vessels within the placenta, and succenturiate placenta refers to the presence of additional lobes of placental tissue. Therefore, the correct answer is placenta percreta.

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  • 19. 

    Attachment of placental membranes more towards the center (fetal portion) rather than to the placental margin

    • A.

      Circumvallate placenta

    • B.

      Placenta previa

    • C.

      Placenta accreta

    • D.

      Succenturiate placenta

    Correct Answer
    A. Circumvallate placenta
    Explanation
    Circumvallate placenta is the correct answer because it is a condition where the placental membranes attach more towards the center (fetal portion) rather than to the placental margin. In this condition, the placenta appears raised and thickened at the edges, forming a ring-like structure. This abnormal attachment can lead to complications during pregnancy, such as bleeding and restricted fetal growth. Placenta previa refers to a condition where the placenta partially or completely covers the cervix, placenta accreta is when the placenta attaches too deeply into the uterine wall, and succenturiate placenta is when there are additional lobes or smaller accessory placental masses.

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  • 20. 

    Infarcts and necrosis are complications of what abnormality?

    • A.

      Placenta previa

    • B.

      Succenturiate placenta

    • C.

      Circumvallate placenta

    • D.

      Placenta accreta

    Correct Answer
    B. Succenturiate placenta
    Explanation
    Infarcts and necrosis are complications that can occur in the placenta. Succenturiate placenta is a condition where there is an additional lobe or lobes of placental tissue separate from the main body of the placenta. This abnormality can lead to inadequate blood supply and oxygenation, resulting in infarcts and necrosis.

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  • 21. 

    External abruptio placenta may not always be seen on ultrasound.

    • A.

      True

    • B.

      False

    Correct Answer
    A. True
    Explanation
    if no blood remains within retroplacental space

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  • 22. 

    A woman with painful vaginal bleeding comes in for an ultrasound. She is experiencing spasms in her uterus. On the ultrasound you visualize elevation of placenta from uterine wall. What is your diagnosis?

    • A.

      Concealed abruptio placenta

    • B.

      External abruptio placenta

    • C.

      Partial or complete placenta previa

    • D.

      Subchorionic hemorrhage

    • E.

      Placenta percreta

    Correct Answer
    B. External abruptio placenta
    Explanation
    The correct diagnosis in this case is external abruptio placenta. This is indicated by the painful vaginal bleeding, spasms in the uterus, and visualization of elevation of the placenta from the uterine wall on ultrasound. External abruptio placenta refers to the separation of the placenta from the uterine wall before delivery, leading to bleeding and potentially compromising the health of the fetus and mother.

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  • 23. 

    Umbilical vein carries

    • A.

      Oxygenated blood from placenta to fetus

    • B.

      Deoxygenated blood from fetus to placenta

    • C.

      Deoxygenated blood from placenta to fetus

    • D.

      Oxygenated blood from fetus to placenta

    Correct Answer
    A. Oxygenated blood from placenta to fetus
    Explanation
    The umbilical vein carries oxygenated blood from the placenta to the fetus. This is because the placenta acts as a site for gas exchange, where oxygen from the mother's blood diffuses into the fetal blood, and carbon dioxide from the fetal blood diffuses into the mother's blood. The umbilical vein is responsible for transporting the oxygen-rich blood to the fetus, providing it with the necessary oxygen for its development and growth.

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  • 24. 

    Umbilical arteries carry

    • A.

      Oxygenated blood

    • B.

      Deoxygenated blood

    • C.

      Both

    Correct Answer
    B. Deoxygenated blood
    Explanation
    Umbilical arteries carry deoxygenated blood. During fetal development, these arteries are responsible for carrying blood from the fetus to the placenta. The blood in the umbilical arteries is low in oxygen and high in carbon dioxide, as it has already been used by the fetus. This deoxygenated blood is then transported to the placenta where it can be replenished with oxygen and nutrients before being returned to the fetus through the umbilical vein.

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  • 25. 

    Check all that apply to umbilical cord

    • A.

      Averate length 55 cm

    • B.

      Transports blood between fetus and fetal portion of placenta

    • C.

      2 arteries, 1 vein

    • D.

      Forms during first 2 weeks of gestation

    • E.

      Outer portion of cord is surrounded by Wharton's jelly

    • F.

      2 veins, 1 artery

    • G.

      Amnion covers umbilical cord

    Correct Answer(s)
    A. Averate length 55 cm
    B. Transports blood between fetus and fetal portion of placenta
    C. 2 arteries, 1 vein
    G. Amnion covers umbilical cord
    Explanation
    The umbilical cord is a flexible cord-like structure that connects the fetus to the placenta during pregnancy. It serves as the lifeline for the fetus, transporting oxygen and nutrients from the mother's bloodstream to the fetus and removing waste products. The cord is composed of two arteries and one vein, which carry deoxygenated blood and oxygenated blood respectively. The average length of the umbilical cord is approximately 55 cm. The outer portion of the cord is surrounded by a gelatinous substance called Wharton's jelly, which provides protection and support. Additionally, the amnion, a thin membrane, covers the umbilical cord.

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