The mechanism of labor known as cardinal movements of labor are the positional changes that the fetus goes through to best navigate the birth process. These cardinal movements are:

a. Engagement, Descent, Flexion, Extension, Internal rotation, External rotation, Expulsion
b. Engagement, Descent, Flexion, Internal rotation, Extension, External rotation, Expulsion
c. Engagement, Flexion, Internal rotation, Extension, External rotation, Descent, Expulsion
d. Engagement, Flexion, Internal rotation, Extension, External rotation, Flexion, Expulsion


ANS: b
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a. The order of the cardinal movements is incorrect.
b. Engagement occurs when the greatest diameter of the fetal head passes through the pelvic inlet. Engagement can occur late in pregnancy or early in labor. Descent is the movement of the fetus through the birth canal during the first and second stages of labor. Flexion is when the chin of the fetus moves toward the fetal chest. Flexion occurs when the descending head meets resistance from maternal tissues. This movement results in the smallest fetal diameter to the maternal pelvic dimensions. It typically occurs early in labor. Internal rotation is the movement, the rotation of the fetal head, that aligns the long axis of the fetal head with the long axis of the maternal pelvis. It occurs mainly during the second stage of labor. Extension is the movement facilitated by resistance of the pelvic floor, causing the presenting part to pivot beneath the pubic symphysis and the head to be delivered. This occurs during the second stage of labor. External rotation is when the sagittal suture moves to a transverse diameter and the shoulders align in the anteroposterior diameter. The sagittal suture maintains alignment with the fetal trunk as the trunk navigates through the pelvis. Expulsion is the movement that occurs when the shoulders and remainder of the body are delivered.
c. The order of the cardinal movements is incorrect.
d. The order of the cardinal movements is incorrect.

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