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Pediatrics Exam 1

Respiratory Exam on Pediatrics

Fetal Shunts Ductus Arteriosus, Ductus Venousus, Foramen Ovale
Ductus Arteriousus Joins pulmonary artery and aorta, Protects lungs against circulatory overload (bypasses lungs. 10% of blood perfuses the lungs), Allows right ventricle to strengthen, High pulmonary vascular resistance, low pulmonary blood flow
Ductus Venousus Lays in abdominal cavity, Connects umbilical vein to inferior vena cava, 50% of blood flows to liver, Rest goes into IVC, Carries mostly highly oxygenated blood
Foramen Ovale One way flap between right and left atria, Relieves high pressures of right atrium, Shunts highly oxygenated blood from right to left atrium, After birth, pressure in left atrium increases, closing the flap
Twins Full term 36 weeks, Can be fraternal or identical, 1 of 100 births, most common, Females more healthy
Identical multiples One fertilized egg splits, Same gender only, Shared genetic makeup, Higher mortality rate due to shared placenta, Different amniotic sacs
Fraternal multiples More than one egg fertilized and attached to uterus, Not genetically identical, Can be any mix of boys/girls, Separate placentas
Triplets 1 in 535 births, Higher rate w/ fertility drugs, Can be fraternal or identical or combination
Quadruplets Can be fraternal or identical (very rare) or combination, Super quads= 2 sets of identical twins
Term Lengths Single: 40 weeks, Twins: 36, Triplets: 32-34, Quads: 29-32
Licithin-Sphingomyelin ratio >2.0= mature, 1.5-2.0= transitional, <1.5= immature
Alcohol Abuse Most common, Increased prematurity & SIDS, low birth weight
Heroin Abuse Decreased surfactant production, Tachypnea, . Microcephaly (decreased brain mass), Fetal hypoxia, Low birth weight, Higher risk of meconium issues, breech, or transverse position, placenta abruption, post partum bleeding, and SIDS
Methamphetamines Lethargic newborn, Poor feeding- sucking instinct diminished, Decreased body weight, length, and head circumference, Glassy eyed baby, Stares a lot
Cocaine Low birth weight, Hypothermia, Baby shakes, cries, irritable, sweats, Increases risk of prematurity, SIDS, ICH, heart defects
Marijuana Shorter gestation, Dysfunctional labor, Increased meconium issues, Impaired fetal growth, Increased eye problems, “cat-like” cry
Cigarette Doubles the risk of SIDS, More prone to placenta previa, Results in IUGR, low birth weight, and fetal hypoxemia
Pressure needed for 1st breath -20 to -40 cmH2O
Vertex Anterior Normal head down, facing mom’s back, Allows smallest part of head to come out 1st
Vertex Posterior Head down, facing mom’s front, Forehead is 1st, so labor and delivery can be more painful
Breech Butt first, sitting upright
Transverse Laying sideways over cervix
Footling breech Foot comes out 1st
Stages of lung growth Embryonal, Pseudoglandular, Canalicular, Saccular, Alveolar
Embryonal Stage day 26-day 52, development of trachea and major bronchi
Pseudoglandular Stage Day52-week 16, Development of remaining conducting airways
Canalicular Stage Week 17-Week 26, Vascular bed and framework or respiratory acini
Saccular Stage Week 26-Week 36, Increased complexity of saccules
Alveolar Stage Week 36 on, Development of alveoli
Created by: geko546