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Fertilization and Implantation, Fetal Environment > Maternal Newborn

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Total Questions : 5

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Question 1:

Which of the following best describes the function of the trophoblast?

A. It forms the embryonic heart and neural tube. B. It produces the early amniotic fluid. C. It invades maternal tissue during implantation. D. It contributes to fetal limb formation.

Answer and Explanation

Choice A:

The embryonic heart and neural tube are derived from the mesoderm and ectoderm of the embryonic disc, not the trophoblast. These structures originate from the inner cell mass during gastrulation, not the trophoblastic layer.

Choice B:

Amniotic fluid is initially produced by the amniotic membrane and later by fetal urine. The trophoblast contributes to chorionic membrane formation but not directly to early amniotic fluid production.

Choice C:

The trophoblast invades maternal endometrial tissue during implantation to establish uteroplacental circulation. This invasion allows the embryo to embed securely into the uterus and initiate formation of the placenta through chorionic villi development. This invasion is essential for successful pregnancy continuation.

Choice D:

Limb formation is controlled by the embryonic mesoderm, specifically the lateral plate mesoderm and apical ectodermal ridge. The trophoblast plays no role in morphogenesis of limbs.

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Question 2:

In reviewing the mechanism of trophoblast invasion. Which of the following enzymes is released by syncytiotrophoblasts?

A. Collagenase and aldolase B. Acrosin and amylase C. Matrix metalloproteinases and hyaluronidase D. Protease inhibitors and histidine kinase

Answer and Explanation

Choice A:

Collagenase is a type of MMP but aldolase is a glycolytic enzyme, not involved in tissue invasion. Syncytiotrophoblasts do not secrete aldolase as part of the implantation process.

Choice B:

Acrosin and amylase are secreted by the sperm. Acrosin facilitates penetration of the zona pellucida during fertilization. Amylase digests carbohydrates and is not involved in implantation or ECM degradation.

Choice C:

Matrix metalloproteinases and hyaluronidase are secreted by syncytiotrophoblasts to degrade collagen, fibronectin, laminin, and hyaluronic acid in the maternal endometrium. This degradation enables proper trophoblastic invasion, anchoring of the blastocyst, and remodeling of maternal spiral arteries.

Choice D:

Protease inhibitors oppose proteolytic activity and would hinder trophoblast invasion. Histidine kinase is part of bacterial two-component regulatory systems and has no role in mammalian implantation.

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Question 3:

A nurse is educating a group of students on decidualization. Which of the following regions gives rise to the maternal part of the placenta?

A. Decidua capsularis B. Decidua basalis C. Decidua parietalis D. Endometrial myometrium

Answer and Explanation

Choice A:

Decidua capsularis is the thin layer of endometrium that overlies the implanted embryo. It does not contribute to placental structure but instead stretches as the gestational sac expands, eventually fusing with the parietalis.

Choice B:

Decidua basalis lies directly beneath the implanted embryo and is the site of trophoblast invasion. It contains maternal blood vessels and stromal cells that become part of the placental intervillous space. It forms the maternal contribution to the placenta.

Choice C:

Decidua parietalis lines the remaining endometrial surface not directly involved in implantation. It plays no structural role in placental formation and becomes compressed as the gestational sac enlarges.

Choice D:

The endometrial myometrium is the muscular layer beneath the endometrium. It does not undergo decidualization and has no direct role in placental formation. It provides contractile support during labor but is not part of the placenta.

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Question 4:

A nurse is teaching about factors that hinder sperm transport. Which of the following would likely impair sperm progression?
Select all that apply

A. Acidic vaginal pH B. Thick cervical mucus during ovulation C. Uterine contractions post-intercourse D. Blockage of cervical crypts E. Decreased sperm motility

Answer and Explanation

Choice A:

Acidic vaginal pH (below 7.0) reduces sperm viability. Normal vaginal pH is approximately 3.8–4.5, but semen buffers it temporarily. Persistently acidic conditions damage sperm membranes and impair motility, hindering progression through the cervix.

Choice B:

Thick cervical mucus does not occur during ovulation. Under the influence of estrogen, cervical mucus becomes thin, watery, and stretchable (spinnbarkeit), which facilitates sperm penetration. Thick mucus is seen in the luteal phase due to progesterone dominance and is not a feature of ovulation.

Choice C:

Uterine contractions post-intercourse aid sperm transport by creating suction-like currents that move sperm toward the uterine tubes. Oxytocin and prostaglandins in semen stimulate these contractions, enhancing fertility rather than hindering it.

Choice D:

Blockage of cervical crypts prevents storage and guidance of sperm through the cervical canal. These crypts secrete mucus and facilitate sperm transport toward the uterus. Obstruction disrupts this path and impairs sperm ascent.

Choice E:

Decreased sperm motility, defined as <40% total motility or <32% progressive motility per WHO criteria, prevents effective movement through cervical mucus and uterine cavity, reducing chances of fertilization.

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Question 5:

Which of the following are correct pairings of decidua regions with their descriptions?
Select all that apply

A. Decidua basalis – maternal placenta site B. Decidua capsularis – covers implanted embryo C. Decidua parietalis – lines rest of uterus D. Decidua spongiosa – underlies fallopian tubes E. Decidua amnion – lines chorionic villi

Answer and Explanation

Choice A:

Decidua basalis is the region directly beneath the implanted blastocyst and forms the maternal part of the placenta. It interacts with trophoblasts and contributes to the intervillous space and placental bed.

Choice B:

Decidua capsularis is the part of the endometrium that overlies and encloses the implanted embryo. It stretches as the embryo grows and later fuses with the decidua parietalis.

Choice C:

Decidua parietalis lines the remaining uterine cavity not occupied by the embryo. By the end of the first trimester, it fuses with the expanding decidua capsularis as the chorionic sac fills the uterine space.

Choice D:

Decidua spongiosa is not a recognized anatomical subdivision of the decidua. The term "spongiosa" typically refers to histologic zones in the endometrium or myometrium but not a decidual region associated with implantation or placental function.

Choice E:

Decidua amnion is not a valid anatomical term. The amnion is a fetal membrane derived from epiblast cells and does not originate from decidual tissue. Chorionic villi are surrounded by the chorion and bathed in maternal blood, not lined by a so-called "decidua amnion".

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