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Neo Unit 1-4

spc

QuestionAnswer
What are the fetal germ layers? Ectoderm, Mesoderm, Endoderm
The ectoderm is the outside layer and creates? Hair, epidermis, nails, CNS system
The mesoderm is the middle layer and makes? dermis, muscle, bone, C/V system, PLEURAE
The endoderm is the innermost layer and makes the? respiratory system, liver, gut, epithelium
The mesoderm and the endoderm both make the? respiratory system, the mesoderm makes the pleurae(musculature), the endoderm makes the parenchyma(functional units)
A full term baby is between? 37-42 weeks
The embryonic stage is the first 6 weeks? primitive lung bud forms at 24 days
The pseudoglandular phase is 7-16 weeks? conducting airways are developed
The canalicular pahse is 17-26 weeks? pulmonary capillaries develop
The saccular phase is 27 weeks to post term? definitive alveolar epithelium is established, type 1 and 2 cells
The conducting airways? sequestrian of the conducting airways is completed by the end of the 16th week of gestation
The respiratory bronchioles develop? between week 16 to 2 months post term
At full term there are about 24 million developed alveoli, they keep developing until? 8 years of age
Fetal lung fluid is secreted into the amniotic fluid, therefore? an amniocentesis can be done to analyze lung fluid
Lung maturity can be assessed by comparing the level of? lecithin to the sphingomyelin, L/S ratio
Lecithin is short for dipalmitoyl lecithin, it is mature surfactant. Levels rise as the? fetal lung matures and type 2 cells proliferate. Surfactant is made by type 2 cells
Sphingomyelin, which is a sphingolipid remains? fairly stable through out gestation
The L/S ratio increases as the fetal lung matures, a ratio of 2:1 can? sustain extra uterine life
What are other markers of fetal development? ultrasound, alpha fetoprotein, bilirubin, creatinine, shake test
The diaphragm develops from a ventral mesodermal fold (septum transversum) this is done by? the end of the 7th week of gestation
The cilia appear between 10-13 weeks, goblet cells appear at? 13 weeks
Cartilage is well established by ? 24 weeks
Smooth muscle is poorly developed in the newborn? begins to dramatically develop after 3 years of age
Lymphatics appear at 20 weeks and are well developed at? birth
Connective tissue develops from mesoderm? collagen, and elastic tissue
Collagen makes the large airways and is? well developed at birth
Elastic tissue makes the acinus and is poorly developed at birth? continues to develop through adolecense
The placental gas exchange is enhanced by? maternal-fetal 02 gradient (90-100 VS 30mmhg) , fetal HB has a decreased P50 so that 2,3 DPG does not bind with it, Maternal HB has an increase P50 to increase 2,3 DPG levels
Arterial uterine gas tensions? 02 90-100mmhg C02 30mmhg progesterone
Venous uterine gas tensions? 02 30mmhg C02 45mmhg
Arterial umbilical tensions? 02 30mmhg C02 40mmhg
Venous umbilical gas tensions? 02 15mmhg C02 55mmhg
Fetal circulation traces from the? umbilical vein (only 1) to the umbilical arteries (there are 2)
The lungs are bypassed with fetal circulation because they are filled with fluid. 02 is brought to the fetus by blood circulation from the mother. The lungs are bypassed by? the ductus venosus, foramen ovale, and the ductus arteriosus. Objective is to bypass the lungs and get the blood to the aorta to be pused out the fetus's body
The ductus venosus communicates the? umbilical vein with the IVC
The foramen ovale communicate the? fetal atria
The ductus arteriosus communicate the? pulmonary artery with the descending aorta
The umbilical cord is made of? whartons jelly, surround the arteries and vein to stabilize and prevent kinking or occlusion of blood flow
The umbilical arteries return blood? to the placenta, away from fetus
The umbilical vein delivers blood? to the fetus
The amnion is the sac that surround the fetus and is filled with? 500-1500ml of amniotic fluid
Excessive amniotic fluid >2L is called? polyhydramnios
Decreased amniotic fluid <500ml is called? oligohydramnios
Disorders that can cause excessive amniotic fluid are? hydrocephalus, spina bifida, esophageal atresia, pyloric stenosis, and major complications like PROM during delivery
Disorders that can cause decreased amniotic fluid are? renal dysplasia, urethral stenosis, and major complications like asphyxia due to cord compression and lung hypoplasia
How does closure of the ductus venosus happen at birth? The umbilical cord is clamped, the umbilical vein has no flow and collapses, the ductus venosus then collapses and becomes the ligamentum teres
Closure of the foramen ovale? Rt atrial pressure decreases from decreased IVC flow cause by umbilical clamping, the Lt atrial pressure increases from increased pulmonary blood flow
Closure of the ductus arteriosus? Increased Pa02 that decreases the synthesis of PGE1, indomethacin inhibits the synthesis of PGE1. PGE1 causes ductal dilatation in utero.
Loss of Fetal Lung Fluid =Gain Air. 1/3 is squeezed out w/ vaginal delivery. 1/3 is drained by the lymphatics. Some is eliminated via swallowing & coughing
INCREASE PaO2 = INCREASE pH = decreased PVR
INITIATION OF RESPIRATION? BIRTH ASPHYXIA - PRIMARY STIMULUS. COLD ENVIRONMENT NOISY ENVIRONMENT TRANSPULMONARY PRESSURES OF -40 to -60 mmHg are witnessed.
Newborn >2500 grams blood pressure? SYSTOLIC: 55-65 mmHg DIASTOLIC: 30-40 mmHg MEAN: 40-50 mmHg
A blood gas five hours post delivery should be? pH: 7.35 PaCO2: 35 mmHg PaO2: 70 mmHg
Norms for a full term baby? VT: 5ml/Kg f: 30-40/minute FRC: 20-30ml/Kg
CCW (THORAX): HIGH due to: Incomplete bone & muscle development.
SPECIFIC CL = ADULT CL NEWBORN = 75 ml/cmH2O/L ADULT = 80 ml/cmH2O/L
SPECIFIC Raw = < 0.6 cmH2O/l/sec/L
The peripheral chemoreceptors are sensitive too? low Pa02
Central chemoreceptors are sensitive too? PaC02 and PH
Hering-Breuer inflation reflex is to prevent over distension of the lung? causes shorter exhalation when lung is under inflated
The Gasp Reflex? A reflex augmentation of the newborn’s first breath with a subtle “breath stack”. Helps establish the newborn’s FRC.
J receptors are Sensory nerve endings within the alveolar walls in juxtaposition to pulmonary capillaries, they are Triggered with? Pulmonary edema, pulmonary emboli, pneumonia, barotrauma, etc May cause dyspnea and increased RR
Propriocepters are Responsible for stabilizing the chest wall during non-REM sleep. During REM sleep? they are disengaged & the chest wall becomes unstable. Thus, paradoxical movement of the chest & abdomen is seen.
Common patterns? periodic breathing and recurrent apnea
Periodic breathing is Most common in SGA < 2 Kg preemie? . Onset is after 1st week of extrauterine life. Periods of apnea last up to 10 seconds. Innocuous
Recurrent apnea? Serious apneic spells that last more than 20 seconds. Oxygen saturation drops significantly. Bradycardia is noted.
Recurrent apnea factors? PREMATURITY SEPSIS INTRACRANIAL HEMORRHAGE
True alveoli appear around weeks? 32-34
The combination of L/S ratio and testing for PG is called the? lung profile
Created by: juialynn92