Cervical incompetence → M/C cause of 2nd trimester loss → Painless, sudden dilatation of internal OS → Sudden rupture of membrane & expulsion of fetus. Etiology: Congenital Acquired- → Forcible Dilatation of cervix → Cervix Surgery
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Cerebral blood supply Normal Cerebral Blood Flow = 750 mL/min (Or) 55 mL/100g/min Note: Flow is ½ of liver blood flow Brain O2 consumption = 46 mL/min (20% total body O2 consumption) → Blood supply in Grey matter > White matter. → Brain HIGHLY SENSITIVE to HYPOXIA, Hippocampus is the most sensitive. Munro Kellie Doctrine:
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Regulation of cerebral blood flow Major Regulating factors – Blood pressure, PCO2 & Temperature. The mechanism involved in each one of the factors are: 1.Blood pressure Fluctuation Bt. 65 – 140 mm Hg NO CHANGE in blood flow AUTOREGULATION 2. PCO2 ↑ PCO2 -↑ Blood Flow 3. Temperature On ↓ Body Temp. by 1° C
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Indications for cerclage 1. History based indication- → RPL of 2nd trimester (≥2) → H/O PTL (Preterm Labor) 2. USG based indication → Length of cervix < 2.5cm + pt. giving H/O ≥ 1 second trimester abortion 3. Emergency Cerclage/ Rescue Cerclage → Cervix has begun dilating then do cervical cerclage. In this remember: –
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Contraindications for cerclage → Cervical dilatation ≥ 4 cm → Ruptured membranes → Presence of gross anomaly of fetus → Vaginal bleeding Present → Pelvic infection +nt. → Placenta Previa- relative contraindication
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Cells of CNS The cells present in CNS are: Neurons Glial cells 1.Neurons: Neurons are- Unipolar-Seen in invertebrates Pseudo unipolar-Seen in dorsal root ganglion Bipolar-Seen in Retina & nose Multipolar-Seen in Spinal motor neurons 2.Glial cells: They are- Macroglial cells-Astrocyte, Oligodendrocyte, Schwann cell Microglial cells-Phagocytic cells
Causes of Intrauterine growth restriction Maternal Causes: • PIH • Placental insufficiency • Chronic renal disease • Heart disease (NYHA 3 & 4) • Connective tissue disorders • Infections • Diabetes with vasculopathy • Diabetes with PIH Placental Causes: • Placental insufficiency • Abnormal placentation • Calcification in placenta Fetal Causes: • Chromosomal abnormality •
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Causes of isolated spontaneous abortion The causes for isolated spontaneous abortion in 1st & 2nd trimester include: Chromosomal abnormalities: 1.Aneuploidy M/C 2.Trisomy – 2nd best answer 3.Monosomy X (20%)- 3rd 4.Trisomy 16 (16%) Germ plasm defects Fetal causes • Weather it is first or second trimester the m/c cause is chromosomal abnormality. The frequency of
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Cardiac Muscle-Unique features 1. Gap junctions → SINGLE NUCLEUS CENTRALLY placed – Seen in Intercalated disc region. → Protein subunit – CONNEXONS – 6 subunits of “Connexin” functions: → Gap junctions causes “SYNCHRONIZED CONTRACTION” / “SYNCYTIAL CONTRACTION”. → Entire cardiac muscle unit contracts as single unit – FUCNTIONAL SYNCYTIUM. 2. Elasticity → Cardiac muscle ELASTICITY
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Cardiac muscle v/s Skeletal muscle Properties Cardiac muscle Skeletal muscle Muscle action INVOLUNTARY – Regulated by pacemaker (SA node) Voluntary Tetany CAN’T BE tetanized CAN BE tetanized Functional unit Sarcomere (Actin, Myosin, Tropomyosin, Troponin C etc.,) Sarcomere (Actin, Myosin, Tropomyosin, Troponin C etc.,)
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