Exam

Name___________________________________

SHORT ANSWER. Write the word or phrase that best completes each statement or answers the question.

Figure 28.1

Using Figure 28.1, match the following:

1) Liver. 1)

2) Esophagus. 2)

3) Trachea. 3)

4) Stomach. 4)

5) Pancreas. 5)

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Figure 28.2

Using Figure 28.2, match the following:

6) Protective water-filled embryonic sac surrounding the embryo. 6)

7) Extraembryonic membrane that develops from the trophoblast and some extraembryonic 7)
mesoderm, and forms part of the placenta.

8) Site of early blood cell production, and forms part of the gut (digestive tube). 8)

9) The part of the endometrium destined to be a part of the placenta. 9)

10) The part of the endometrium that surrounds the uterine cavity face of the implanted 10)
embryo.

MATCHING. Choose the item in column 2 that best matches each item in column 1.

Match the following:

11) Leads to the development of a morula A) Cleavage

11)
and then a blastocyst.
B) Implantation
12) Embedding of the blastocyst in the
12)
uterine wall.

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 13) Leads to the formation of the first cell A) Fertilization
13)
of the new individual.
B) Gastrulation
14) Leads to the establishment of the three
14)
primary germ layers. C) Capacitation

15) Leads to enhancement of sperm

15)
motility and increasing membrane
fragility to enable enzyme release
from acrosomes.

Match the following:

16) Forms the mother's part of the A) Trophoblast

16)
placenta.
B) Decidua capsularis
17) Becomes the embryonic disc.
17)
C) Decidua basalis
18) A solid sphere of undifferentiated
18)
cells. D) Inner cell mass

19) Forms the chorion. E) Morula 19)

20) Surrounds the uterine cavity face of

20)
the implanted embryo.

TRUE/FALSE. Write 'T' if the statement is true and 'F' if the statement is false.

21) True fertilization occurs when the sperm's membrane binds to the oocyte's sperm-binding 21)
receptors.

22) The period from fertilization through week eight is called the embryonic period. 22)

23) Fertilization occurs while the egg is still in the ovarian follicle. 23)

24) Freshly deposited sperm are not immediately capable of penetrating an oocyte. 24)

25) By 72 hours after fertilization, the egg has divided into more than 160 cells and is called the 25)
morula.

26) Implantation begins six to seven days after ovulation. 26)

27) A pregnancy test involves antibodies that detect growth hormone (GH) levels in a woman's blood 27)
or urine.

28) By the end of the embryonic period, at 8 weeks, all the adult organ systems are recognizable. 28)

29) Of the three germ layers, the mesoderm forms the most body parts. 29)

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 30) A pregnant woman urinates more often than usual because the uterus compresses the bladder, her 30)
metabolic rate and blood volume are increased, and she must also dispose of fetal metabolic
wastes.

31) The "fluid-filled, hollow ball of cells" stage of development is the blastocyst. 31)

32) The embryonic period lasts until the end of the eighth week. 32)

33) The embryo is directly enclosed in and protected by the amnion. 33)

34) In fetal circulation, one way in which blood bypasses the nonfunctional lungs is by way of the 34)
foramen ovale.

35) An episiotomy is an incision made to widen the vaginal orifice, aiding fetal expulsion. 35)

36) Humans do not have a yolk sac associated with embryonic development. 36)

37) Human placental lactogen initiates labor. 37)

38) Premature infants often need to be placed on a ventilator because their undeveloped lungs 38)
produce excess surfactant.

39) A blastocyst is a hollow ball of cells, while the morula is a solid ball of cells. 39)

40) A zygote is usually formed within the uterus. 40)

41) Acrosomal enzymes trigger exocytosis of cortical granules in the cortical reaction. 41)

MULTIPLE CHOICE. Choose the one alternative that best completes the statement or answers the question.

42) What destroys the zona pellucida sperm-binding receptors? 42)

A) the process of capacitation B) human placental lactogen
C) zonal inhibiting proteins D) the acrosomal reaction

43) The result of polyspermy in humans is ________. 43)

A) interruption of meiosis B) mitotic insufficiency
C) multiple births D) a nonfunctional zygote

44) It is impossible for sperm to be functional (able to fertilize the egg) until after ________. 44)
A) they have been stored in the uterus for several days
B) they undergo capacitation
C) the tail disappears
D) they become spermatids

45) Milk ejection (the letdown reflex) is stimulated by which of the following hormones associated 45)
with pregnancy?
A) inhibin B) prolactin C) oxytocin D) gonadotropin

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46) The corpus luteum prevents loss of the implanted embryo through menstruation by secreting 46)
________.
A) follicle-stimulating hormone B) human chorionic gonadotropin
C) estrogens and progesterone D) luteinizing hormone

47) The placenta, a vitally important metabolic organ, is made up of a contribution from mother and 47)
fetus. Which portion is from the fetus?
A) yolk sac B) chorion C) amnion D) umbilicus

48) Relaxin is a hormone produced by the placenta and ovaries. The function of this hormone is to 48)
________.
A) ensure the implantation of the blastula B) prevent morning sickness
C) relax the pubic symphysis D) block the pain of childbirth

49) Which embryonic structure produces human chorionic gonadotropin (hCG)? 49)
A) the cytotrophoblast B) the epiblast
C) the hypoblast D) the syncytiotrophoblast

50) The neonatal period refers to ________. 50)

A) the last trimester of pregnancy B) the first year after birth
C) the first trimester of pregnancy D) the first month after birth

51) The most common assisted reproductive technology process used by couples having difficulty 51)
conceiving is _______.
A) in vitro fertilization B) cloning of parent stem cells
C) artificial insemination D) hormone therapy

52) Which hormone maintains the viability of the corpus luteum? 52)
A) estrogen B) human placental lactogen
C) human chorionic gonadotropin D) progesterone

53) Which of the following events does NOT occur during the first 8 weeks of development? 53)
A) presence of all body systems
B) beginning of ossification
C) formation of a functional cardiovascular system
D) myelination of the spinal cord

54) Which of the following is NOT a correct matching of a fetal structure with what it becomes at 54)
birth?
A) ductus arteriosus–ligamentum teres
B) foramen ovale–fossa ovalis
C) ductus venosus–ligamentum venosum
D) umbilical arteries–medial umbilical ligaments

55) Which body system of a pregnant woman undergoes the most dramatic physiological changes 55)
during pregnancy?
A) cardiovascular system B) urinary system
C) respiratory system D) digestive system

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56) Thalidomide was once used to treat intense nausea and morning sickness in pregnant women. 56)
Unfortunately, if administered at certain points during gestation it resulted in limb malformation.
This drug is an example of a(n) ________.
A) neurotoxin B) teratogen
C) carcinogen D) endocrine disruptor

57) The correct sequence of preembryonic structures is ________. 57)

A) blastocyst, morula, zygote B) zygote, morula, blastocyst
C) morula, zygote, blastocyst D) zygote, blastocyst, morula

58) Which of the following is NOT assessed as part of the Apgar score? 58)
A) muscle tone B) heart rate C) respiration D) temperature

59) Prior to the let-down reflex, the mammary glands secrete a yellowish fluid called ________ that 59)
has less lactose than milk and almost no fat.
A) prolactin B) colostrum C) bilirubin D) meconium

60) How long is the secondary oocyte viable and capable of being fertilized after it is ovulated? 60)
A) 12-24 hours B) 36-72 hours C) 24-36 hours D) a full week

61) Select the correct statement about fertilization. 61)

A) Once inside the uterus, most sperm cells are protected and remain viable.
B) If estrogen is present, the pathway through the cervical opening is blocked from sperm entry.
C) Millions of sperm cells are destroyed by the vagina's acidic environment.
D) Both spermatozoa and the ovulated secondary oocyte remain viable for about 72 hours in the
female reproductive tract.

62) Shortly after implantation, ________. 62)

A) the embryo gastrulates (within 3 days)
B) maternal blood sinuses bathe the inner cell mass
C) the trophoblast forms two distinct layers
D) myometrial cells cover and seal off the blastocyst

63) Gastrulation begins when a groove with raised edges called the ________ appears on the dorsal 63)
surface of the embryonic disc.
A) primitive streak B) placenta
C) spinal cord D) notochord

64) Muscle tissue is formed by the ________. 64)

A) endoderm B) epiderm C) mesoderm D) ectoderm

65) Neural tissue is formed by the ________. 65)

A) epiderm B) mesoderm C) ectoderm D) endoderm

66) The trophoblast is mostly responsible for forming the ________. 66)
A) lining of the endometrium B) placental tissue
C) archenteron D) allantois

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67) The cardiovascular system of a newborn must be adjusted after the infant takes its first breath. 67)
Which of the following is also true?
A) The ductus venosus is disconnected at the severing of the umbilical cord and all visceral
blood goes into the vena cava.
B) The urinary system is activated at birth.
C) The foramen ovale between the atria of the fetal heart closes at the moment of birth.
D) The ductus arteriosus constricts and is converted to the ligamentum arteriosum.

68) Sperm move to the uterine tube through uterine contractions and the energy of their own flagella. 68)
What other factor is involved in sperm movement?
A) reverse peristalsis of the uterus and uterine tubes
B) the increased temperature in the vagina, which stimulates sperm motility
C) the cilia on the apex of the cells lining the endometrium
D) hormonal attraction to the ova

69) At which stage of labor is the "afterbirth" expelled? 69)

A) placental B) dystocia C) full dilation D) expulsion

70) Which hormone is NOT produced by the placenta? 70)

A) human placental lactogen B) oxytocin
C) relaxin D) human chorionic gonadotropin

71) During which stage of labor is the fetus delivered? 71)

A) placental stage B) expulsion stage C) gastrula stage D) dilation stage

72) Implantation of the blastocyst is the result of all of the following EXCEPT ________. 72)
A) adherence of the trophoblast cells to the endometrium
B) digestive enzymes and growth factors produced by the trophoblast cells
C) phagocytosis by the trophoblast cells
D) settling of the blastocyst onto the prepared uterine lining

73) The presence of endoderm, ectoderm, and mesoderm is first seen in the ________ stage. 73)
A) gastrula B) morula C) blastocyst D) fetal

74) Which of the following is true in reference to what may pass through the placental barriers? 74)
A) nutrients and respiratory gases only
B) hormones, blood cells, and nutrients
C) respiratory gases, hormones, nutrients, and blood cells
D) nutrients, respiratory gases, wastes, and alcohol

75) Drinking alcohol during pregnancy is ________. 75)

A) not significantly harmful, since alcohol does not cross the placenta
B) associated with microencephaly and intellectual disorders of the fetus
C) beneficial to the fetus, as it stimulates cardiovascular development
D) only harmful to the fetus if the mother drinks hard liquor

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76) Derivatives of the mesoderm include ________. 76)
A) epithelium of the digestive tract
B) glandular derivatives of the digestive tract
C) all nervous tissue
D) vertebrae and ribs

77) Derivatives of the endoderm include ________. 77)

A) heart and blood vessels B) brain and spinal cord
C) kidneys and gonads D) epithelial lining of the respiratory tract

78) Which of the choices below occurs if implantation is successful? 78)

A) The corpus luteum is maintained until the placenta takes over its hormone-producing
functions.
B) Increased levels of FSH will be produced.
C) The ovarian cycle begins.
D) The corpus luteum degenerates and becomes the corpus albicans.

79) Select the correct statement about the special fetal blood vessels. 79)
A) The fossa ovalis becomes the foramen ovale.
B) The distal parts of the umbilical arteries form the superior vesical arteries.
C) The umbilical vein becomes the ligamentum teres.
D) The hepatic portal vein forms from the umbilical artery.

80) The decidua basalis is ________. 80)

A) not a maternal contribution to the placenta
B) the tissue that surrounds the uterine cavity face of the implanted embryo
C) the part of the endometrium that lies beneath the embryo
D) destined to remain in the uterus after the birth of the infant

81) At what point is meiosis II completed for the female gamete? 81)
A) ovulation B) puberty C) implantation D) fertilization

82) A urine test reveals a positive result for human chorionic gonadotropin (hCG). This indicates 82)
________ was successful.
A) gastrulation B) fertilization C) ovulation D) implantation

83) The first major event in organogenesis is ________. 83)

A) myelination B) ossification C) gastrulation D) neurulation

84) As pregnancy continues, the increasing bulkiness of the anterior abdomen changes the woman's 84)
center of gravity, possibly causing an accentuated lumbar curvature called ________.
A) kyphosis B) hunchback C) lordosis D) scoliosis

85) Which of the following would be the best method for delaying the onset of labor? 85)
A) giving the mother antiprostaglandin drugs
B) giving the mother prostaglandins
C) giving the mother anti progesterone drugs
D) giving the mother oxytocin

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 86) Which of the following refers to the transfer of sperm and harvested oocytes together into the 86)
woman's uterine tubes in the hopes that fertilization will take place there?
A) in vitro fertilization (IVF) B) gamete intrafallopian transfer (GIFT)
C) rhythm method D) zygote intrafallopian transfer (ZIFT)

87) In the block to polyspermy, entry of the sperm's contents causes ________ levels in the oocyte's 87)
cytoplasm to rise, triggering the cortical reaction.
A) sodium ion B) calcium ion C) ATP D) phosphate ion

88) Which method of contraception is most reliable? 88)

A) vasectomy B) cervical cap
C) rhythm method D) morning-after pills

89) Cells of the ________ gather around the notochord and neural tube and produce the vertebra and 89)
rib at their associated level.
A) dermatome B) intermediate mesoderm
C) myotome D) sclerotome

90) A friend confides that she desires to have children but is having trouble conceiving. Which of the 90)
following is true regarding implantation?
A) In cases where implantation fails to occur, a nonreceptive uterus becomes receptive once
again.
B) An estimated 60% of implanted embryos later miscarry due to genetic defects of the embryo.
C) It is estimated that a minimum of two-thirds of all zygotes formed fail to implant by the end
of the first week or spontaneously abort.
D) Detection of human chorionic gonadotropin (hCG) in blood or urine indicates failure of the
blastocyst to implant.

91) Human chorionic gonadotropin (hCG) is at its highest levels ________. 91)
A) just before birth
B) about 2 months after implantation during the 8 th gestational week
C) after copulation but before implantation
D) at about the midpoint of pregnancy

SHORT ANSWER. Write the word or phrase that best completes each statement or answers the question.

92) Explain what triggers a baby's first breath. 92)

93) At what time in the pregnancy is the placenta fully prepared to fulfill the needs of the 93)
developing fetus?

94) Briefly describe the events leading to the implantation of the blastocyst in the uterus, 94)
including how it is nourished.

95) How are the metabolic needs of the implanted embryo provided for? 95)

96) Describe the events of the oocyte from sperm penetration to first cleavage. 96)

97) Define Braxton Hicks contractions. 97)

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 98) List four factors that help to precipitate parturition (birth). 98)

99) Briefly describe the physiological changes occurring in the mother during pregnancy. 99)

100) Describe the events allowing monospermy. 100)

101) When do we begin to call the developing individual a fetus rather than an embryo? Why? 101)

102) A couple interested in conceiving has been carefully charting her menstrual cycles for 102)
many months. Relative to ovulation, what window of time does coitus need to occur in
order to achieve fertilization?

ESSAY. Write your answer in the space provided or on a separate sheet of paper.

103) A 30-year-old woman is admitted to the emergency room. Her husband, who rode in the ambulance with her,
said that she had suddenly complained of severe pain in the right iliac region of her abdomen and then had
collapsed. Upon examination, she was shown to have signs of internal hemorrhage and her abdominal muscles
were rigid. Her menstrual history revealed that she had missed her last menstrual period. A diagnosis of
ruptured tubal, or ectopic, pregnancy was made and surgery scheduled. What is an ectopic pregnancy, and
why is it problematic?

104) Mrs. Phang, eight months pregnant with her first child, makes an appointment with her obstetrician to
investigate the cause of vaginal bleeding. Because it is actually more "spotting" than frank bleeding, and
painless, she is becoming worried. Ultrasound visualization of her abdomen shows that the placenta is formed
across the internal os of the cervix, and she is ordered to her bed for the remainder of the pregnancy. What
name is given to Mrs. Phang's condition? Why is it an extremely serious condition? Why was she ordered to
have complete bed rest for the remainder of her pregnancy?

105) A mother who has been nursing her infant for over seven months is beginning to have problems throughout
the day with nausea. Is there a connection?

106) A 28-year-old woman has been in the first stage of labor for several hours. Her uterine contractions are weak,
and her labor is not progressing normally. Because the woman insists upon a vaginal delivery, the physician
orders that pitocin (a synthetic oxytocin) be infused. What will be the effect of pitocin? What is the normal
mechanism by which oxytocin acts to promote birth?

107) A 19-year-old, single, sexually active college student, who has not used birth control on a regular basis, is in
her first trimester of pregnancy. She is at the OB/GYN clinic for her first prenatal visit. In assessing her
nutrition, the doctor discovers that the patient drinks heavily on a regular basis. She also states she does not
like milk. What information will the doctor give the patient regarding nutrition?

108) The lactation nurse visits a first-time mother six hours after her delivery of a healthy 8 -pound boy. The patient
is giving the baby boy a bottle of sugar water. She tells the lactation nurse that she does not seem to be
producing milk. What should the nurse say to the patient?

109) The patient is in her first trimester of pregnancy. She complains of feeling nauseated and has vomited on
occasion. She tells the nurse that she did not have this with her first pregnancy. She asks the nurse, "What is
causing this and when will it end?" How should the nurse respond?

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Answer Key
Testname: UNTITLED28

1) D
2) A
3) B
4) C
5) E
6) C
7) B
8) D
9) A
10) E
11) A
12) B
13) A
14) B
15) C
16) C
17) D
18) E
19) A
20) B
21) FALSE
22) TRUE
23) FALSE
24) TRUE
25) FALSE
26) TRUE
27) FALSE
28) TRUE
29) TRUE
30) TRUE
31) TRUE
32) TRUE
33) TRUE
34) TRUE
35) TRUE
36) FALSE
37) FALSE
38) FALSE
39) TRUE
40) FALSE
41) FALSE
42) C
43) D
44) B
45) C
46) C
47) B
48) C
49) D
50) D
11
Answer Key
Testname: UNTITLED28

51) A
52) C
53) D
54) A
55) A
56) B
57) B
58) D
59) B
60) A
61) C
62) C
63) A
64) C
65) C
66) B
67) D
68) A
69) A
70) B
71) B
72) C
73) A
74) D
75) B
76) D
77) D
78) A
79) C
80) C
81) D
82) D
83) D
84) C
85) A
86) B
87) B
88) A
89) D
90) C
91) B
92) A buildup of carbon dioxide in the baby's blood once the carbon dioxide is not being removed by the placenta causes
central acidosis. This excites respiratory control centers in the baby's brain and triggers the first inspiration.
93) The placenta is fully formed and functional as a nutritive, respiratory, excretory, and endocrine organ by the end of
the third month of pregnancy.
94) The blastocyst floats freely in the uterine cavity for two to three days, during which time it is nourished by uterine
secretions. Six to seven days after ovulation, implantation begins. The trophoblast determines the readiness of the
endometrium for implantation. If the mucosa is prepared for implantation, the blastocyst becomes embedded high in
the uterus.

12
Answer Key
Testname: UNTITLED28

95) Initially, the implanted embryo obtains nutrition by digesting the endometrial cells, but by the second month, the
placenta is providing all the nourishment and oxygen the embryo requires. The placenta is also responsible for
disposing of embryonic metabolic wastes.
96) After sperm penetration, the secondary oocyte completes meiosis II and releases the second polar body. The two
nuclei swell into pronuclei and join each other to form a zygote. The cell then undergoes its first mitosis and cell
division to form two daughter cells.
97) Braxton Hicks contractions are the weak, irregular uterine contractions resulting from the increase in estrogen
production. Estrogen causes oxytocin receptors to form on the myometrial cells of the uterus and antagonizes
progesterone's quieting influence on the uterine muscle. As a result, the myometrium becomes increasingly irritable,
resulting in weak, irregular contractions.
98) Four factors that help to precipitate parturition include: (1) estrogens peak to their highest levels in the mother's blood,
causing irregular uterine contractions due to oxytocin and negation of progesterone's influence on the uterine muscle;
(2) prostaglandins are stimulated by the increase in oxytocin to act as uterine muscle stimulants; (3) increasing
emotional and physical stressors activate the mother's hypothalamus, which signals oxytocin release; and (4) certain
cells of the fetus begin to produce oxytocin, which in turn acts on the placenta, stimulating production and release of
prostaglandins.
99) Many women suffer nausea until their systems become adjusted to elevated levels of hCG, estrogens and
progesterone. Heartburn is common due to displacement of the esophagus and crowding of the stomach by the
growing fetus in the uterus. Additional wastes from fetal metabolism cause the production of more urine. Due to
pressure on the bladder by the uterus, urination is more frequent. Tidal volume increases during pregnancy, as does
respiratory rate. Residual volume decreases and many women exhibit dyspnea (difficult breathing). Total body water
rises, acting as a safeguard against blood loss during birth. Blood volume increases, blood pressure and pulse rise, and
cardiac output increases.
100) A sperm entering the secondary oocyte causes ionic calcium to be released into the oocyte cytoplasm, activating the
oocyte and preparing it for the second meiotic division. This also causes the cortical granules to spill their contents
into the extracellular space beneath the zona pellucida. Enzymes from the cortical granules destroy sperm receptors,
preventing further sperm entry. This spilled material binds with water, and as it swells, detaches all sperm still in
contact with the oocyte membrane.
101) We begin to call the developing individual a fetus at the beginning of the ninth week. It is at this point that all body
systems are present as a result of organogenesis, at least in a rudimentary form.
102) The oocyte is viable for 12 to 24 hours after it is cast out of the ovary. Most sperm retain their fertilizing power for 24
to 48 hours after ejaculation. Consequently, for successful fertilization to occur, coitus must occur no more than two
days before ovulation and no later than 24 hours after.
103) An ectopic pregnancy occurs when the embryo implants in any site other than the uterus. In a tubal pregnancy the
embryo implants in the uterine tube. When the swelling uterine tube is unable to accommodate growth, it ruptures. It
is highly vascular leading to severe bleeding upon rupturing.
104) Mrs. Phang's condition is called placenta previa. It is an extremely serious condition because as the uterus and cervix
stretch, tearing of the placenta may occur. The placenta is covering over the cervix preventing any possibility to
deliver vaginally. Furthermore, if the placenta is located inferior to the fetus and separates, the placenta will be
expelled before the fetus, who isn't yet in a location to breathe. Given the length of time needed for fetal expulsion, the
fetus will suffocate and die. She was ordered to have complete bed rest to keep physical activity at a minimum so that
the placenta would not tear away. Vaginal delivery is not an option and the doctor will have to perform a cesarean
section before going into labor.
105) The mother was not taking birth control pills because she assumed that she could not get pregnant while nursing.
Under normal conditions that would be true, but after a few months some women do begin to ovulate again. This
mother is probably pregnant again.
106) Pitocin will act on the placenta, stimulating production and release of prostaglandins. The pitocin and prostaglandins
are powerful uterine muscle stimulants. Oxytocin normally causes frequent and vigorous contractions of the uterine
wall. In a positive feedback loop, greater distension of the cervix causes the release of more oxytocin from the mother's
hypothalamus, which causes greater contractile force, and so on.
13
Answer Key
Testname: UNTITLED28

107) Because many potentially harmful substances can cross placental barriers and enter the fetal blood, the doctor
instructs the patient to not drink alcohol. The nurse should warn the patient that alcohol can cause serious permanent
damage to the fetus. The doctor prescribes the patient to take prenatal multivitamins containing folic acid to reduce
the risk of birth defects. If the patient's caloric intake is marginal, she should increase her daily calorie intake by 300
calories to sustain proper fetal growth.
108) The nurse should explain that she won't produce true milk until two to three days later. During this delay, colostrum
is produced that contains protein, vitamin A, and minerals and is rich in antibodies that are necessary for the baby.
The nurse should explain that continual milk production depends on mechanical stimulation of the nipples, normally
provided by the sucking infant. Before attempting to nurse, the mother should massage her breasts and "roll" the
nipples to start the stimulatory effects herself. Furthermore, until the baby is able to nurse sufficiently,
supplementation should be given only after the baby has nursed for 5-10 minutes on a side, not before. Babies prefer
the ease of sucking through bottle nipples more than breast nipples if they are allowed.
109) The nurse should explain that nausea is a common occurrence during the first trimester of pregnancy, believed to be
related to elevated levels of hCG, progesterone and estrogens, and that the nausea should end once her body adjusts
to the increased hormone levels. Over 50% of pregnancies are accompanied by nausea and vomiting, at least to a
slight degree. But she should report any weight loss, since if she loses >5% of her body weight, the condition of
hyperemesis gravidarum should be considered, which can lead to electrolyte imbalances, miscarriage, and even death.

14