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Pediatrics Exam 1
Respiratory Exam on Pediatrics
Question | Answer |
---|---|
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 |