Chapter 15 - Phys + Behavioral Responses of Neonates (resp, cardiovasc, therm) Flashcards
neonatal period
from time when umbilical is cut to 28 days
-adjustment fr intrauterine to extra uterine
most critical + dynamic changes
resp + cardiovasc systems
resp changes is initiated by…
- compression of thorax> forces amni fluid fr lungs
- lung expansion
- incr in alveolar o2 concentratn
- vasodilatn of pulmo vessels
___ + ___ stimuli are primary factors that initiate resp. secondary stimuli, _____, such as ______ also aid
mechanical + chemical stimuli
> sensory stimuli> temp change, sound, light, rouch
surfactant is responsible for…
functional residual capacity
2 factors that negatively affect resp transition
- decr surfactnt r/t immature lungs
- persistent hypoxemia + acidosis> leads to constriction
mechanical stimuli of resp:
Delivery of FACE>
loss of amnio fluid fr lungs>
entry of air into alveoli to replace amnio fluid>
lung fluid is reabsorbed (lymph systm)/neonate crying incr intrathoracic pos pressure>
alveoli remains open
mechanical stimuli of resp:
Delivery of CHEST>
expansion of chest>neg pressure> passive inspiration> first breath>
entry of air into alveoli to replace amnio fluid>
lung fluid is reabsorbed (lymph systm)/neonate crying incr intrathoracic pos pressure>
alveoli remains open
chemical stimuli of resp
stop of placental BF> decr o2> mild hypoxia> incr co2> decr pH (acid)> stim of resp center in medula> stim of respirations
flow of initiation of resp affects pulmo circ + gas exchange (starts w first breath)
first breath> incr alv PaO2> decr arterial pH> dilatn of pulmo arteries> decr pulmo vasc resistnc> incr BF thru pulmo vessels> incr o2/co2 exchnage
signs of fetal resp distress
- cyanosis
- abnormal resp pattern
- retraction of chest wall
- grunting
- flaring of nostrils
- hypotonia
ductus venosus connects the…
umbilical vein to inferior vena cava
ductus venosus closes…
day 3
-becomes a ligament
blood flow thru ductus venosus stops…
once cord is clamped
foramen oval connects…
right + left atrium
foramen oval closes when…
when left atrial pressure is higher than the right
-incr PaO2> decr pulmo pressure> incr pulmo BF> incr lft atrium pressure> closure of foramen ovale
___ can cause the foramen oval to reopen
signifiant neonatal hypoxia
ductus arteriosus connects the…
pulmo artery w descending aorta
ductus arteriosus closure occurs when…
pulmo vasc resistance is less than system vasc resistance> left to right shunt> closure
-usually 15 hr after birth
ductus arteriosus WONT close if…
lungs fail to expand or if PaO2 levels drop