CPM CPM Anatomy and Physiology for Midwifery 2 — Questions and Answers
Question 1: Which fetal presentation is described when the occiput is directed toward the maternal left anterior quadrant?
- Right occiput posterior (ROP)
- Left occiput anterior (LOA) (Correct answer)
- Left occiput posterior (LOP)
- Right occiput anterior (ROA)
Correct answer: Left occiput anterior (LOA)
LOA (left occiput anterior) means the occiput of the fetus is toward the mother's left side and anteriorly, which is the most common and favorable position for labor.
Question 2: What physiological change to the cardiovascular system occurs during the second trimester of pregnancy?
- Cardiac output decreases by 20%
- Blood pressure rises above pre-pregnancy levels
- Cardiac output increases by 30–50% (Correct answer)
- Heart rate decreases to below 60 bpm
Correct answer: Cardiac output increases by 30–50%
Cardiac output increases by 30–50% during pregnancy, peaking in the second trimester due to increased stroke volume and heart rate to meet the demands of the uteroplacental circulation.
Question 3: What is the purpose of the foramen ovale in fetal circulation?
- Allows blood to bypass the fetal liver
- Allows oxygenated blood to pass from the right atrium to the left atrium, bypassing the lungs (Correct answer)
- Connects the pulmonary artery to the aorta
- Transports nutrients from the placenta to the fetus
Correct answer: Allows oxygenated blood to pass from the right atrium to the left atrium, bypassing the lungs
The foramen ovale is an opening in the atrial septum that shunts oxygenated blood from the right atrium directly to the left atrium, bypassing the non-functional fetal lungs.
Question 4: Which muscle forms the pelvic floor and is most commonly damaged during vaginal birth?
- Piriformis muscle
- Levator ani muscle group (Correct answer)
- External anal sphincter alone
- Obturator internus
Correct answer: Levator ani muscle group
The levator ani, comprising the pubococcygeus, puborectalis, and iliococcygeus, forms the main pelvic floor support and is the muscle most frequently stretched or torn during vaginal delivery.
Question 5: During normal pregnancy, which renal change is expected and does NOT indicate pathology?
- Decreased glomerular filtration rate
- Glycosuria in the absence of hyperglycemia (Correct answer)
- Rising serum creatinine above 1.2 mg/dL
- Oliguria of less than 30 mL/hr
Correct answer: Glycosuria in the absence of hyperglycemia
GFR increases by up to 50% in pregnancy, increasing the filtered glucose load beyond tubular reabsorption capacity, causing glycosuria even with normal blood glucose.
Question 6: What anatomical structure separates the true pelvis from the false pelvis?
- The ischial spines
- The pelvic brim (linea terminalis) (Correct answer)
- The sacral promontory alone
- The pubic symphysis
Correct answer: The pelvic brim (linea terminalis)
The pelvic brim, or linea terminalis, is the boundary formed by the pubic crest, iliopectineal line, arcuate line, and sacral promontory that divides the greater (false) pelvis from the lesser (true) pelvis.
CPM CPM Anatomy and Physiology for Midwifery 2
Which fetal presentation is described when the occiput is directed toward the maternal left anterior quadrant?