all right welcome everybody to our last lecture can you believe that it's May first and this is the last day of me teaching you new stuff so yeah you made it to the end congratulations and I know you're tired I'm tired the world is tired we just want to be back to normal again so I applaud you for just hanging in there and sticking it out and so we'll make sure everything goes well for you for the last week of school the the test six is open now so you can take it anytime between now and Monday by 11:59 not at 11:59 because though you'll be in there for a minute and it'll kick you out so that's in there I will get extra credit in the case studies they're all gonna be Kovan 19 case studies because they've been kicking those suckers out every week now in my case study clearinghouse thing so we'll do that and then well this Monday and Wednesday we'll review for the final we won't have class on Tuesday and then my name Wednesday we'll just take our regular time to interview for the final I'll have the final on Thursday I've got to pick the time because we have to do it at a time so clear your Thursday right now as much as you can and then we'll figure out what what we'll do beyond that so anyway just know that Thursday morning we'll have a have your final you know it's just like being in the or maybe anyway I was gonna say maybe we just do it Wednesday at 9:00 because then some of you have it at 10:00 but anyway we'll figure it out I'll give you plenty of time heads up time at what time it'll be but for right now clear your Thursday okay and so let me know if you're gonna have any serious conflicts with that in an email Olivia says we should do it Wednesday I think we should do it Wednesday too but well what um I don't have Wi-Fi at my house and I'm actually going down to my in-laws house to do my finals because I've been using my grandparents house okay their Wi-Fi is really slow and every time I take test it like kicks me out because I said they don't have your Wi-Fi okay so many problems but we have to leave on Wednesday but I could figure something out if we have to take your Thursday but if I could take it Wednesday that would be great okay well we'll we'll we'll talk Olivia okay I mean if and here might be what we could do with you is just we could zoom just the two of us and you could take your final and then and then it that way so whatever works okay I'll let you know okay okay and that was it okay all right so let's go ahead and finish this off and be done so what I want to do right now is go back in the notes to gastrulation and figure out oh yeah how many times have I done this I'm still going I don't know what I'm doing all right so there we go all right so gastrulation again is the process where that primitive inner cell mass so the two laminar or the bilaminar disk where you add just that the blue and the green the epiblast and the hyper blast are gonna turn into the three germ layers so we call it a try laminar disk and our try laminar embryo and now try laminar disc is actually what it's called and at that point you then have these three germ layers so germ layers why do we call them germ layers and have anything to do with germs it has everything to do with germinate so these are the layers from which all of our body structures are going to germinate that's why we call them germ layers and and that's why we call you know cells that that are gametes are germline because that's what's inherited and then the next organism the offspring are gonna grow from from that zygote that came from the germline cells so case you hear that that's what they're referring to all right so we have endoderm mesoderm and ectoderm so endoderm remember is on the very inside so that's gonna be all the epithelial lining of digestive respiratory or genital systems we saw that any glands that happen to branch off of those four systems I guess you can say are gonna come well yeah sorry thinking beyond so yeah are gonna come from just because I was thinking like Bobo urethra glands I'm no vesicle yeah those are gonna come off of there too serious transcribing everything I'm saying all right okay so yeah that's all under mesoderm then is gonna be everything in the middle so all our skeleton all our muscles kidneys intermediate mesoderm reproductive organs except that well part of the vagina the bottom third of the vagina is gonna come from endoderm but the army was gonna come from ectoderm the rest of its gonna come front that's attached to the uterus is gonna come from the Chloe well actually that's endoderm so that's gonna come from the cloaca sorry I'm just thinking out loud beyond what you're gonna need to know so reproductive organs mesoderm because we're gonna see that today in just a minute circulatory system definitely your heart and all of your blood vessels dermis of your skin dentin them your teeth it's all gonna come from Musa derm yes serous membrane so all of your epicardium I mean the epicardium pleura pericardium peritoneum all of that smooth my soul so skeletal muscle cardiac muscle smooth muscle all of its going to come from user and then ectoderm is of course your superficial stuff so the epidermis of your skin that epithelium out there stratified squamous nervous tissue so remember your complete CNS so brain spinal cord nur a peripheral nervous system as well the nerves as they go out because they're gonna go out in the somites and go out to your tissues sense organs I'm just I think oh I don't have a soda this morning dang it yeah just just we'll just lump it together I just wanted to tell you everything in MLM see ya lens the eye more than to the lens that I all of your eye you guys I know the book the book that we are using where I got the notes from says lens of the eye but actually all of your eye you have surface ectoderm you have neural ectoderm that come together and make your eye so all of your eye that's a sense organ I don't know I broke it out like that because I hadn't taken the class yet okay so then this just shows gastrulation here's endoderm so everything that's all the glands so we have parathyroid thymus thyroid liver pancreas gallbladder okay all of that alright so what we want to do now right here is go into how do you make a male or a female so at what's happening embryonic lee to develop into a male or female we're gonna start out with well we're gonna start at conception with you being a male or female okay so you are either an XY which would make you a male or you would be an xx which would make you a female now beyond that there are some non disjunctions that can happen so you could be an xx axiom met a female you could be an X X Y could be a client there's mail you could have it XO you could be a Turner syndrome female I had a student I didn't even know and she said she goes miss G I have Turner syndrome and I went here kidding me now that explains everything small stature a lot of times they have mental retardation but she was smart she's really smart so she didn't have that but she only got one X chromosome so so anatomically it it made total sense to me after she told me she goes oh yeah I've turned her like you just okay just at the end of this end of the year oh by the way of course you don't tell everybody stuff like that but anyway so she only got one X chromosome because nondisjunction happened in the sperm so the two WA are the two x's that the dad her father had to give stayed in one sperm and then she ended then it ended up with a sperm without an X chromosome in it and she got that one so obviously they survived and in fact I saw her this morning and but she won't she didn't progress reproductively so she can't have children but she's fine that she does I know always adopt she's I don't care where the baby came from I don't have to have it she's I just want it so she's really cute it has a good mindset with you know the cards that she was dealt all right so so my point is we are male or female and and then how do we develop those differences because when we you know obviously you you go to find out the sex of your baby go get the ultrasound you know and all the gender-reveal party things and all the you know the trend today and and but you can't just go as soon as you find out that you're pregnant and go and have an ultrasound and see because nothing's showing up because males and females look identical to one another up until a certain stage of development and so what are those structures that's we're gonna look at what are the structures that are gonna give rise to male or female based on what happens with sexual development and of course weird things can happen and we'll get into that so there's always problems that can happen but you know most of the time you're gonna get X X X Y and then develop fully into a reproductively capable male or female alright so in our notes here let me show you a picture okay so it's a whole lot easier then to go back to the notes because like I don't even know what you're talking about alright so if we take a look at here we have yellow and pink in this red so the the this this Mezen F Rose okay so this here and then we have our gonna garage and then we have our metal now Fross this is all going to come from intermediate Musil dirt and so music and then the rest of it are gonna come as branches off of this urogenital sinus which is going to end up as the cloaca and we're gonna have two sets of ducts we're gonna have new Larian ducts or Parham Asenath nefra ducts parametric means it's outside of the Mezen F Rose right here this is not really a kidney because the met enough Rossa is going to be the kidney but this is this is a stage of development that is going to disappear after a while where you have the mesenteric ducts the wolffian ducts which are actually attached to the Mezen arrows so parametric outside of the Mezen arrows and then the mezzo nefra ducts which are attached to the Mezen F ROS itself now I don't like to call them that because it's so hard to remember param S&F written as an effort because they're so close but mule Aryan and wolffian are much different so I am absolutely going to go with these people names I'm alright with that so the mule Arian duck right here these pink ones so remember at five to six weeks you have both sets of ducks you know the pink ducks and the tan color ducks and pink ducks the mullerian ducks are going to develop into the female duct system okay so that would be uterine tubes and uterus and if and then the wolffian ducts are the tan ones would develop into the male ductwork so the epididymis the ductus deferens seminal vesicles that would be that would come from the wolffian ducts okay so how do we remember then eulerian is female and wolfy and is male because women are mules and men are wolves and you know that's just how I remember yep we're stubborn and you guys are tough and aggressive I don't know we want to put that but that's how I remember okay so girls are mules and boys are wolves so you have both ductwork at five to six weeks so how are you gonna decide well which one should I develop I'm not going to develop both of them so I need to pick one of these and so how do we pick one well let's go back here so we have mezzo nefra can pair our wolffian and Eulerian ducts and undifferentiated gonads we have these go now the ridges don't know by looking what they are but if we looked at the cells sure they would have X Y or X X depending on what you are oh I'm going the wrong way okay so now here's the difference in presence of testosterone produced by the testes of the male the wolffian ducts develop into the epididymis and the ductus deferens the genital tubercle becomes the penis labial scrotal swelling's become the scrotum and testes descend down into the scrotum AM H stands for anti-mullerian hormone is secreted by the testes and eulerian ducts degenerate so let's go back to the picture and see what is going on here so here we are we've got both steps we have the potential to become a male and a female at the same time but that's not going to happen so what's the what's the special ingredient that determines if we're going to be a male or female it the production of testosterone by the testes here the gonna know rich so let's go over to seven or eight weeks so right around seven weeks of development six to seven weeks or development these testes if they are XY are going to start secreting testosterone because there's an there's a crumb or there's a gene on the on the y chromosome called the sex the srg sry gene or the sex related Y gene and that is the trigger that's the gene that codes for the production of testosterone so as that test in a lot of other stuff too but as that testosterone starts to be secreted then the wolffian ducts will proceed in their development so in the presence of testosterone secreted by the testes baring XY chromosomes and that sry gene on the Y chromosome that STR the the testosterone will make the wolffian ducts grow and they'll also secrete a mhm anti-mullerian hormone so a mhm will inhibit so notice right here it says parametric ducts degenerate so it's going to inhibit the progression or the development differentiation whatever word you want to use of the parametric ducts so you'll never get uterine tubes you'll never get fimbriae you'll never get a uterus because AMH is inhibiting that so testosterone stimulates the wolffian ducts and then and they'll plug in see notice they're not plugged into the into the testes so in the testes you'll have the seminiferous tubules and then these efferent decals will plug into a little spot called the Reedy testes that I didn't teach you but they'll come together and then and then the sperm will be able to go through the efferent duct she was into the epididymis through epididymis through the depth is deferens and then notice that the little seminal vesicle sprouts off of off of there now prostate gland is actually going to come from the endoderm that's here so this is this is a meso derm here that will then plug into the end ermm of the urinary bladder and the urethra and so we have the urogenital sinus becoming the urethra and then we're gonna sprout off the bubble urethral gland and the prostate gland from the endoderm that's here then by birth you can see that the testes have curved around and then descended down into the scrotum and then we'll talk we'll look at the external genitalia here in just a minute then we have what happens if you are not a male and you do not have the sry gene then you don't have testosterone so in the absence of testosterone you mullerian ducts no the the wolffian ducts are gonna degenerate okay so we have the degenerating wolffian ducts no testosterone so we're just gonna keep on going being a girl because that's what our floor plan was originally is to develop in the tube develop to become a female in the absence of testosterone so here's the uterine tube paramedic so the new Larry index may become the uterine tube now here's what's cool is that the two uterine tubes are gonna come together and fuse to form the uterus now we have female humans sorry humans have a a white no have a u-shaped uterus like this but a lot of mammals have a more Y shaped uterus so there's gonna be still a solar a split down the middle like the outer straw line like this and then the vagina down here okay and so it's shaped more like a Y so let's take guinea pigs I used to raise guinea pigs and here's what happens with with guinea pig pregnancy is that you're gonna get implantation implantation along one side of the uterus and down the other side of the uterus and there it's gonna be along the abdomen of the mummy so once those babies are moving around inside the mummy you can see on either side of her baby's moving you know in us you just see the baby moving in the middle but in guinea pigs you know all mammals really well essential mammals because they have that Y shaped uterus then except primates then there you can see the babies up and down the side of the mummy before she has babies and the last mommy that I was that I had that was pregnant was so sad she was supposed to have her babies you could see him in there and then we got up the next morning and she died she couldn't I guess she couldn't give birth and she died and none of the babies were born either and I was heartbroken absolutely heartbroken and so I then that was 23 years ago and I haven't raised a guinea pig since then because it just was too tough on me but anyway here you can see that mesoderm makes that first third of the uterus and then the endoderm is gonna plug in from the outside okay with the cloaca and the bladder and the urethra and so those are all gonna plug up in there and then and then give you an outlet to the outside so here we are at birth there's everything and then there's that dividing line so the bottom half bottom two-thirds of the vagina comes from endoderm not ectoderm I misspoke and because I was like no wait that comes from the cloaca so endoderm and then the bladder and the urethra also come from endoderm too because you get another little split between here and here and then the rest of its gonna come from from music okay so let's go back gee-ya what is it that happens then when you have those cases where they are born with both things is it not that because you're not gonna be completely true you're not gonna be completely both you are so you'll so you could have testes that didn't descend and a uterus uh-huh and and that's because you didn't have testosterone or you didn't have receptors to testosterone okay is typically and then they can still check the chromosomes and absolutely when you are and then recreate it that way absolutely and you know we've failed a lot of people historically because we looked at and you know sometimes that the fetal adrenal gland is gonna make androgens so it can mate it's gonna make some testosterone and if you have an extra sensitive you're still a girl but you have too many testosterone receptors and you get too sensitive to that testosterone secretion when you're born you may have an enlarged clitoris and they look at and go oh you know you just have a low baby penis but you're still a boy and then we raise you to puberty as a boy but you're really a female or vice versa and said why don't they do the chromosomal testing when they're first born to figure that about to not have all that confusion I would think now that they would do that more in the case of looking at external genitalia and seeing some some you know indiscriminant stuff any question I'm I would think they would do that today but you know what we've done until today we just go hmm and so anyway in Python because regular dumb all right so let's just look at these notes and we'll go into the external genitalia and see the different development the different developments based on presence of testosterone or the absence of it so if testosterone was not present due to the ovaries of the female she's not going to have an A Y chromosome and she's not going to have sry gene then the mullerian ducts continue to develop into the oviducts uterine tubes and uterus the wolffian ducts degenerate the clitoris becomes from the genital tubercle and the labia Scrolls well no labial scrotal swelling become the labia majora all right let's look at on the outside so here we are at five weeks we don't know what you're going to be from the outside we can't tell all you have is this genital tubercle and you have these urethra folds and these labial scrotal swelling Zanden anus and a urethral groove okay so this is we can build a boy from this we can build a girl from this okay so let's go build a boy so in the presence of testosterone the genital tubercle will enlarge and become the glans penis and the erectile tissue that's here in the genital tubercle will become the corpora cavernosa and the corpus spongiosum and that will elongate not a super lot but it'll elongate then these two urethra folds right here are going to come together to enclose the urethra as the penis lengthens and so this will fold up and it'll actually fold up from the bottom and come up to the top and then and so that this raphe right here this line is this is the suture so to speak it's the sealed up to urethra folds right here that runs along the back of the penis then on the outside we have the labial scrotal swelling x' which will become the scrotum and so as they enlarge then the testes are gonna swing down into them and then that will you know because they're here on the outside and so the testes will just descend down into the into the scrotum and it's really important like I've said before that you palpate the scrotum to make sure that the testes have descended when your baby's born because we got to pull him down if they haven't come down yet to make sure that they don't become sterile because in that in that too warm of a body temperature they they will become not functional anymore okay so that's what's gonna happen if you're a boy if you don't have testosterone the glans clitoris is gonna still well the genital tubercle become the glans clitoris but it's gonna remain tiny there's still a reptile tissue in there but but you know not anything like what you find in the penis then the urethra folds are going to remain open and those will be the labia minora so the folds that don't have hair on them okay better that are there in the perineum and so the urethral opening of course is going to be right in there then the labia majora on the outside are going to be the or the labial square swellings will become the labia majora in in female okay and then that will enclose the vestibule well actually the labia minora will enclose the vestibule and then you've got the urethral opening right there and then you have the vaginal orifice right now our Yuri through orifice surrounded by the labia minora and then the labia majora on the outside so you can see that females don't deviate from this floorplan very much at all it's the male's that really deviate now just one before I go to the next picture just one little thing I want to show you or I want to tell you about as this is zipping up and and that's how my professor describes he goes yeah they're the urethral folds it doesn't zip up from the bottom and they and they do so it just goes full like what's the word I want what did I use before they just seal together that's not the word I use anyway so they just huh okay teacher well there was somebody said before that in the other part but anyway so they just come together and they'll seal up but sometimes they don't seal up all the way right here at the end and you'll get what's known as hypospadias where there's an opening for the urethra and instead of coming out at the end of the penis that the urine comes out here in the back and so we just have to replumb it so that the tube urethral oh you know that comes out through the end of the penis and not here in the back and uh I guess one of my students last year she goes oh my little boy had hypospadias and I'm like oh well there you go so it is rather common that this doesn't zip up all the way to the top okay so anyway in case you run across that ever and you're like all right so let's see what's happening with those testes so here is the the test is we have this ligament it's actually the round ligament in a female but it becomes a goober nak ulam in a male so it pulls the testes down into the scrotum and then it anchors them so at the end by full descent into the into the scrotum the Guru nach ulam should hang on to it and keep it from retracting back up into the body however sometimes it doesn't and then that can go back up into your body I had I have a friend who has twin boys and they were getting uh they were in middle school I think it wasn't they were wanting to play soccer and and so they they had they went in for their preschool like before school not not like four-year-old so their before school physical and and the doctor had palpated it and and went oh okay and so he had to go in and have that tacked down again because his one of his testes was moving back up okay so there's that all right so does anybody have any questions then on sex development you okay great all right fetal circulation we already did this in labs so we can go through this really quickly so remember that there is one umbilical vein two umbilical arteries umbilical vein is going to go from the placenta back to the fetus but it's gonna carry all of the oxygenated blood in the nutrient-rich blood that just came from exchange with the with the placenta and that the umbilical vein will hook into the inferior vena cava by way of the ductus venosus okay so I'll show you a picture again so I'm bilkul vein so the pathway of the blood then would be placenta umbilical vein ductus venosus inferior vena cava remember there's an opening between the left and right atria called the foramen ovale and so that's going to shunt the blood from the right atrium to the left atrium so we can get it we can bypass pulmonary circulation and get it right into systemic circulation since there's no need really to carry blood to the lungs and then the actual major bypass is the ductus arteriosus that's gonna carry the blood so once it's left them right atrium if it doesn't go through the foramen ovale it's gonna go down into the right ventricle up the pulmonary trunk but I don't want it to go to the lungs and so it will bypass the lungs again through the ductus arteriosus that links the pulmonary trunk to the aorta so remember a ductus venosus goes from umbilical vein to vena cava ductus arteriosus goes from pulmonary artery pulmonary trunk to aorta so that's how I always can remember them and then the umbilical arteries will carry the deoxygenated waste Laden blood to the placenta from the common iliac arteries if you want to know where those come from so if we take a look at this picture again let's start here at the placenta so this one big red umbilical vein will then carry the blood through the umbilicus okay up here now we're gonna get to the ductus venosus because we're underneath the liver so normally blood you know venous blood goes through the paddock I mean digestion blood goes through paddock portal vein and and then into the liver and then into intervenor kaiba but that's that right there that's that paddock portal thing so we're even bypassing that we're gonna go up here now we're gonna start to go into the liver but we're going to bypass the liver and we're going to ducked right into the inferior vena cava blood will then come into the right atrium we got to place two choices we can go down into the right ventricle or we can cut through to the other side through the foramen ovale over to the left side and then go down to left ventricle in out the aorta but if we stay if we go right atrium right ventricle then we're gonna go up through the pulmonary trunk and then we're gonna go from the pulmonary trunk to the aorta and then out through the body but notice there is some blood that goes to the lungs because you do want blood to go to lungs obviously it's living tissue and so it needs a blood supply plus we've got to keep that pulmonary circulation going so we're gonna have you know pulmonary arteries capillaries pulmonary veins just for practice so no exchange will be going on but we'll still have that pulmonary circuit there that we just want to you know keep open so that so they the lungs will be ready to go when when the fetus is born okay so then what's the fate so once you don't have a frame of value anymore which is gonna close as soon as the pressure here when we taking our breath and we're using our lungs now and that pulmonary blood is coming back is through the pulmonary vein and into the into the left atrium that's gonna close the foramen ovale just sticks the tube because there's two sides they just stick right together again and then the openings plug up and and then and then you're good to go then you're not a you're not a blue baby and then the ductus venosus is going to turn into the ligamentum venosum and then the ductus arteriosus will turn into the ligamentum arteriole so there's ligament - Marty Rio some is this little connection here between the pulmonary trunk in the aorta and then here's ligamentum venosum it's just this ligament and you can see that under the in the cadaver it's just connective tissue that's there same with this one this ligamentum Terry's that used to be the umbilical vane you can see that too in the cadaver okay so there's fuel circulation alright so now we need to see well what's happening with the mommy so before conception she's gonna have this tiny little uterus about the size of small pear and then four months it's gonna get bigger in seven months it's gonna get even bigger and nine months you know she doesn't have room for that so that's why it has to bulge out because there's just there's just no room well it's definitely not me I remember I my head resident when I lived on campus at BYU when she got pregnant she was super tall she's like six feet and she and her husband are both super tall and she's when she was pregnant she didn't even show for like forever because she was so tall she'd such a long torso she had plenty of room to put a baby I have no torso so my babies all stick way out in front of me when I'm pregnant okay so we're gonna have a baby right now and then we'll be done so how are we gonna start having a baby Kate so this is just all I have three children I've never been in labor on my own before and I delivered c-sections with all three of them so I am quite not the authority on this but theoretically I know how this works but practically I don't even know because my babies don't ever want to leave so they just like being in there all right so here's what happens is that the fetal adrenal gland is gonna be releasing cortisol that cortisol is going to this is you know late in your pregnancy not right as you're going into labor but near the end of your pregnancy estrogen is going to be secreted that stimulates the cells in your myometrium so the smooth muscle layer of your of your of your uterus is going needs to have some oxytocin receptors because the oxytocin remember is what stimulates uterine contractions so we need to have receptors for the oxytocin when the oxytocin starts getting me and to antagonize progesterone so as that process is happening then we get Brexton Hicks contractions not everybody gets Braxton Hicks I used to get I had him I don't remember him with Amy but I remember him with Cameron and Missy Missy I had him a lot and and I could just feel my my whole abdomen tightening up my uterus tightening up and everything and it would make me flush because it was like pushing him on my blood up to my face it was really wearing my students would be all and you're having a contraction aren't you like yeah yeah thanks for asking thanks for noticing all right so certain cells of the fetus stiffen liver whatever I don't remember let's see it's gonna produce the oxytocin well actually hypothalamus has got to produce the oxytocin but this is baby oxytocin its own oxytocin is gonna cause the placenta to release prostaglandins okay so prostaglandins are heavily involved in inflammation and so they're gonna trigger instead of histamine this time they're gonna trigger inflammation and then this oxytocin always is positive feedback you guys so once we get even if we get baby oxytocin being produced and that's gonna go into the moms bloodstream it's gonna go up to her hypothalamus and it's gonna say hey look this baby wants to be born so let's help it get out and so then the hypothalamus will start producing its own oxytocin and again we've got positive feedback going on so mom's hype my mom's oxytocin goes down to the uterus uterus starts to contract those contractions go back to her hypothalamus and say look we really need to get the baby out of here and so we get more oxytocin more contractions more oxytocin more contractions than so finally the baby is born and that's the way it's supposed to work does not work in me even on pitocin with my first child with Cameron they I was a week late I was probably more in a week late because I was huge and now I supposed to he was supposed to be born in in December and here it is January and I'm still not having a baby and so they said okay we're gonna induce you so I went in on his birthday and they hooked me up at 6:30 in the morning to the pitocin IV and a very short time later I started having contractions and but they were super intense there was no gradual you know warming up process it's just like kicking in and going crazy and I'm like holy crap what is this by 5:30 that night I still hadn't dilated beyond a three and had and a faced and so they're like we got to get him out of there because every time I had a contraction his heart rate would drop so um so we just went ahead and did an emergency c-section and and finally got him out of there so this is what's supposed to happen is that you're supposed to have the dilation and effacement stage where the where the uterus is I mean the cervix is gonna dial eight to 10 centimeters that's four inches across and the wall is gonna thin to paper-thin at 100% of Faceman initial contractions can be somewhere between 15 and 30 minutes apart the pushing of the baby's head down on the cervix is the stimulus for softening and thinning it my kids never dropped my son when he even after being induced for 11 hours well 12 by the time I was getting ready to have the baby the doctor said his head still was not in the birth canal that it was still up above my pelvic outlet so above my pubic symphysis he was his head was still there right where where he made the incision he says I've never done an easier c-section after after induction because my baby didn't go anywhere so the next stage is the expulsion stage so full dilation to delivery two or three minutes between the contractions so you're fully dilated and then the baby comes out and all of these times are all dependent on the girl and the baby and who knows what so we can't put time lengths on them we just put okay here's the major event and then after that then the placenta must be delivered within 30 minutes after birth so if we take a look at this estrogen and juice is the oxytocin receptors and then pushing down on the head the oxytocin from the baby from the fetus and the mother's posterior pituitary stimulates uterus contract streaming expla sento to make prostaglandins stimulate more vigorous contractions all of this is positive feedback let's get that baby out of there and then here is delivery so this is the optimum wave to be delivered we want to go head first because your head is the widest diameter you can see how your shoulders kind of fold up like that so your head is the largest thing you're gonna deliver because you don't deliver shoulders out sideways unless you're a big giant baby and bad stuff happens okay so there's those all right the last thing we want to look at because we want to deliver a baby today is the Apgar score so the Apgar score is our assessment of the newborn we take it at five minutes or at one minute and five minutes after birth and we assess these five signs so we look at for the heart rate in the newborn and respiration color muscle tone and reflexes and it's a zero to two scale zero means it's absent one means it's there but is not optimum two is its optimum and then an Apgar score of eight to ten is a healthy baby so when Cameron was born he didn't breathe and he was absolutely purple so he had zero for respiration he had zero for color so right there he's got a six at best and I don't know what the rest of it was I just know that two weeks after he was born I got a call from the health department and and asking me how my baby was doing and I'm like well he's just fine so apparently the hospital with in Utah in st. George reports low Apgar scores to the Health Department so that they can check up on the baby after and the mom after the baby goes home so I thought that was really nice okay and then last in here I just could these are different means of birth control right here and you can look at that and I'm gonna go into that because I want to have a baby I really want to deliver this baby so here are two ways of doing prenatal testing both of them run some risks this is amniocentesis where we draw off some a meiotic fluid but we don't want to poke the baby and then we do chorionic villus sampling where we where we extract part of the chorionic villi and then what we do is is produce a karyotype so that we can check okay so this is what the old way so took a long time to grow those cells out and then and then do the karyotype on them to see are there any chromosomal abnormalities so I'm sure it's much easier for us today so Nicole this is probably why we didn't you know just do that as a standard procedure after a baby's born if we if we question you know the gender of the baby okay so I'm so excited about this okay we're gonna have a baby so I think I'm gonna get anyone here alright so here is our uterus alright so here's the uterus here's the vagina here's well actually this is urethral opening but we'll pretend this is the cervix so you can see our cervix it's pretty thick right there at the bottom right it's not very thin so how can you get a baby out of there so first of all we need to impregnate her which does look all right so here's our baby and we're gonna I gotta watch what I'm doing I can't watch you guys so we're gonna impregnate her okay all right so now she's pregnant all right so here's the baby well actually here's her uterus there's a baby in there all right so now we're gonna grow the baby oh dang it I just tore her uterus I tore her vagina let me try that again these balloons aren't as good as the ones we have in yay and I used to have super good da ones and then I then they got old and and my uterus would pop every time I tried to deliver the baby all right oh I had these on my desk the other day just you know in a bag and in the box and mr. Burke comes in he goes calm you're gonna have a baby like I'm so happy that you knew I was gonna have a baby okay so everything's intact now all right so now okay now we're waiting for the baby to descend okay so I don't know if you can pray can't see in here the baby's head right here is right up against the cervix so now what we're gonna do is start contracting the uterus and as the as the uterus contracts watch what's happening to the cervix down here get a little closer so we're gonna contract from the top so you can see it shortening it doesn't really short but oh come on it works way better with the ei ones but I'm kind of nervous cuz it didn't work so great oh there we go we're almost ready alright so the moms having all these contractions just she's in labor for hours and look at look at our cervix almost ready I want to go to okay there we go look we're crowning there you can see the baby's head so now we're gonna talk push mom push mom oh that wasn't that dramatic sometimes the stronger the balloon the better are delivering the baby comes shooting out of there but that's what happens that is legit delivery so her contract the those uterine contractions from the top I'm just gonna keep pushing and pushing pushing and that's gonna thin out and a face the cervix so that the baby can come out of there alright so there it is friends whoo I got one more minute to spare alright so does anybody have any questions on anything no I was super cool though that wasn't that neat I did not come up with that that was actually a woman I think she was in Wisconsin or somewhere she was head of the health department someplace and she was showing you know I think it was part of sex ed or something like that but showing you know this is what happens when you have a baby and and I was like holy grab I need to do that so nobody cool yeah Kayden cases a boy or girl um I don't know you guys decide that's what got born it's a pin so it's a penis so it's a boy okay there we go it's the little star oh happy boy we will name him Kayden alright okay so there is no there is no Kahoot for this sorry so just remember you're going through male and female reproductive system and the growth in development notes and then on Monday we will meet and we will review for the final oh I'm gonna put the extra credit in I'm gonna put the final review note thing and so bring that and we'll go over that and then we'll Kahoot as well and we'll pray Kahoot on Wednesday so we'll go over any questions that you might have so take a look after you take this weekend's test pull out the study guide for the final and and highlight any concepts that you really need me to go over again cuz I don't want to I'm not gonna do a whole semester in a review that's you know way too much stuff so let's just pick out those things that we really need to to know more stuff so you guys need to let me know what you want to go over then we'll Kahoot on Wednesday and then take our tests on Thursday all right I am gonna work on the lab practical grades and doing those things I haven't even looked at them yet so I'm gonna look at them right now okay um other than that I guess that's it so again thank you so much for for being such a great class and in having the opportunity to teach you and and I you know I just hope great and wonderful things for you but I'll tell you that in the final again that's when I'll cry so okay have a good weekend bye