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Cardiovascular Week 6 2016/17 > 2: Foetal circulation and adaptation at birth > Flashcards

2: Foetal circulation and adaptation at birth Flashcards

1
Q

The ___ is responsible for fetal ___.

A

placenta , homeostasis

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2
Q

What maintains the patency of the ductus arteriosus when a baby is in utero?

A

Prostaglandin E2

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3
Q

What is the site of gas exchange, nutrition, waste excretion and homeostasis in a foetus?

A

Placenta

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4
Q

In a foetus, the lungs are ___-filled and ___.

A

fluid-filled , unexpanded

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5
Q

The umbilical arteries come off the ___ arteries and supply the placenta with oxygen.

Blood from the placenta returns to the foetus by the ___ ___.

A

iliac

umbilical veins

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6
Q

In a foetus, there are three ___ which do not appear in adults.

A

shunts

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7
Q

What is the ductus venosus?

A

Connects umbilical vein to the IVC

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8
Q

What is the foramen ovale?

A

Opening in atrial septum which connects the right atrium to left atrium

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9
Q

What is the ductus arteriosus?

A

Connects pulmonary bifurcation to the descending aorta

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10
Q

Name the three shunts found in the foetal circulation.

A

Ductus venosus

Foramen ovale

Ductus arteriosus

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11
Q

The ductus venosus carries the majority of placental blood straight into the ____, bypassing the ___ circulation.

A

IVC

portal

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12
Q

The foramen ovale allows blood to flow from the ___ atrium to the ___ atrium.

A

right → left

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13
Q

On which side of the heart is the foramen ovale’s membrane flap found?

A

Left side

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14
Q

At the pulmonary bifurcation in a foetus, there are three possible pathways - name them and give their relative resistances.

A

Left pulmonary artery - high resistance

Right pulmonary artery - high resistance

Ductus arteriosus - low resistance

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15
Q

The majority of oxygenated blood goes via the low-resistance ___ ___ to join the descending aorta.

A

ductus arteriosus

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16
Q

Patency of the ductus arteriosus is maintained by ___ __.

A

Prostaglandin E2

17
Q

Where is Prostaglandin E2 produced?

A

Placenta

18
Q

Why are pregnant women advised not to take steroids?

A

Steroids interfere with Prostaglandin E2 which maintains the patency of the ductus arteriosus in their foetus

19
Q

In the first few minutes following birth, a baby undergoes many ___.

A

adaptations

20
Q

Following birth, a baby ___ their lungs and ___.

A

inflates , cries

21
Q

Following birth, a baby turns from ___ to ___.

A

blue , pink

22
Q

Following birth, the umbilical cord is ___.

A

cut

23
Q

Following birth:

pulmonary vascular resistance (increases / decreases)

systemic vascular resistance (increases / decreases)

A

Pulmonary resistance decreases

Systemic resistance increases

24
Q

Why does pulmonary resistance decrease following birth?

A

Baby starts to breath - lungs physically expand

Greater concentration of circulating oxygen - V/Q match, vasodilation

25
Q

Why does systemic resistance increase following birth?

A

Umbilical cord is clamped and cut - all blood now part of the systemic circulation of the newborn

26
Q

In a foetus, when the pressure of the __ atrium exceeds that of the ___ atrium, the ___ ___ closes.

A

left > right , closes

27
Q

Following birth, the foramen ovale ___.

A

closes

28
Q

Why does the ductus arteriosus constrict following birth?

A

Increased pO2

Placenta removed so Prostaglandin E2 no longer produced

Reduced blood flow because pulmonary arteries are in use

29
Q

Once the ductus arteriosus has completely closed, what is it called?

A

Ligamentum arteriosum

30
Q

Some congenital heart diseases cause ___-dependent circulation.

A

duct

31
Q

Give an example of a congenital heart disease in which the patency of the ductus arteriosus is vital to maintain life.

A

Interruption of the aortic arch

32
Q

What is given to maintain the patency of the ductus arteriosus while treatment for a duct-dependent circulation is figured out?

A

IV prostaglandin E2

33
Q

Pulmonary resistance reaches normal levels by ___ months.

A

2-3 months

34
Q

If a baby’s pulmonary resistance doesn’t decrease following birth, what disease do they have?

A

Persistent pulmonary hypertension of the newborn

35
Q

Persistent pulmonary hypertension is more likely to occur in ___ babies.

A

sick

36
Q

Persistent pulmonary hypertension can be caused by patent ___.

A

ducts / shunts

see Slide 23 for illustration

37
Q

If a baby has persistent pulmonary hypertension, comparing the O2 sats of the ___ and the ___ can help you confirm a ___-related cause.

A

hand , foot , duct

38
Q

Babies with PPHN will tend to be ___.

A

blue

39
Q

What can be inhaled to reduced pulmonary resistance? How?

A

Nitric oxide - potent vasodilator

Cardiovascular Week 6 2016/17 (6 decks)

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