chapter 5 Flashcards
presence of either moderate variability or fetal heart accelerations predicts the absence of metabolic acidema though the lack thereof does _______ confirm its presence.
presence of either moderate variability or fetal heart accelerations predicts the absence of metabolic acidema though the lack thereof does NOT confirm the presence
of metabolic acidema.
this category of tracing has a normal baseline rate of 110-160, moderate variability and on variable, prolonged or late deceleration’s : Category ____
this category of tracing has a normal baseline rate of 110-160, moderate variability and on variable, prolonged or late deceleration’s : Category I
This category of tracing has at least one of the following:
absent variability with recurrent late deceleration’s, absent variability with recurrent variable deceleration’s, absent variability with bradycardia for at least 10 min, sinusoidal pattern for at least 20 min. category _____
This category of tracing has at least one of the following:
absent variability with recurrent late deceleration’s, absent variability with recurrent variable deceleration’s, absent variability with bradycardia for at least 10 min, sinusoidal pattern for at least 20 min. Category III
patterns that do not fit in either category I or category III are category ____tracings
patterns that do not fit in either category I or category III are category II tracings
normal uterine cxt patterns are defined as 5 or less in 10 min averaged over ____minutes. ____________ is more than five cxt averaged over 30 min
normal uterine cxt patterns are defined as 5 or less in 10 min averaged over 30 minutes. TACHYSYSTOLE is more than five cxt averaged over 30 min
In addition of uterine cxt the five components of a FHR tracing include \_\_\_\_\_\_\_\_\_rate variability accelerations deceleration's changes or trends over time
In addition of uterine cxt the five components of a FHR tracing include BASELINE rate variability accelerations decelerations changes or trends over time
the baseline rate is defined as the approximate mean FHR rounded to increments of ____ bpm during a 10 min segment excluding accelerations, deceleration’s, periods differing 25 beats or more and periods of marked variability. there is a 2 minute minimum for identifiable baseline though it need not be continuous.
the baseline rate is defined as the approximate mean FHR rounded to increments of 5 BPM during a 10 min segment excluding accelerations, deceleration’s, periods differing 25 beats or more, and periods of marked variability. there is a 2 minute minimum for identifiable baseline though it need not be continuous.
if the baseline during any 10 minute segment is determined to be indeterminate it may be necessary to refer to previous _____ min segments for the determination of baseline.
if the baseline during any 10 minute segment is determined to be indeterminate it may be necessary to refer to previous 10 min segments for the determination of baseline.
baseline fetal heart rate is regulated by intrinsic cardiac pacemakes (SA and AV nodes) and conduction pathways, autonomic innervation (sympathetic and parasympathetic) humoral factors( catecholamines) extrinsic factors (medications) and local factors (calcium and potassium. sympathetic innervation and plasma catecholamines ___________ baseline FHR and parasympathetic innervation ______ FHR.
baseline fetal heart rate is regulated by intrinsic cardiac pacemakes (SA and AV nodes) and conduction pathways, autonomic innervation (sympathetic and parasympathetic) humoral factors( catecholamines) extrinsic factors (medications) and local factors (calcium and potassium. sympathetic innervation and plasma catecholamines increase baseline FHR and parasympathetic innervation decrease FHR.
Autonomic input regulates the FHR in response to flucuations in PO2 and PCOc by __________ and flucuations of blood pressure by ___________
Autonomic input regulates the FHR in response to flucuations in PO2 and PCOc by CHEMORECEPTORS and flucuations of blood pressure by BARORECEPTORS.
Conditions that are potentially associated with fetal \_\_\_\_\_\_\_\_\_\_\_\_\_ include: maternal fever infections medictions sympatheomimetics parasympatholytics caffeine thophylline cocaine methamphetamine fetal anemia maternal hyperthyroidsm arrhythmia sinus tachycardia supraventricular tachycarida atrial fibrilation atrial flutter ventricular arrhythmia metabolic acidemia.
Conditions that are potentially associated with fetal TACHYCARIDA include: maternal fever infections medictions sympatheomimetics parasympatholytics caffeine thophylline cocaine methamphetamine fetal anemia maternal hyperthyroidsm arrhythmia sinus tachycardia supraventricular tachycarida atrial fibrilation atrial flutter ventricular arrhythmia metabolic acidemia.
Conditions that are potentially associated with fetal \_\_\_\_\_\_\_\_\_\_ include: medications sympatholytics cardiac conduction abnormalities heart block heterotaxy syndrome structural cardiac defects viral infections sjogrens antibodies fetal heart failure maternal hypoglycemia maternal hypothermia interruption of fetal oxygenation
Conditions that are potentially associated with fetal BRADYCARIDA include: medications sympatholytics cardiac conduction abnormalities heart block heterotaxy syndrome structural cardiac defects viral infections sjogrens antibodies fetal heart failure maternal hypoglycemia maternal hypothermia interruption of fetal oxygenation
_______________is defined as fluctuations in baseline FHR that are irregular in amplitude and frequency. it is quantitated in beats per minute and is measured from peak to the trough in beats per minute
VARIABILITY is defined as fluctuations in baseline FHR that are irregualr in amplitude and frequency. it is quantitated in beats per minute and is measured from peak to the trough in beats per minute
there is no distinction between short term and long term variability because in actual practice they are ________ determined as a unit
there is no distinction between short term and long term variability because in actual practice they are VISUALLLY determined as a unit
__________ variability. absent amplitude range
__________ variability: amplitude detectable but less than or equal to 5 bpm
__________ variability amplitude 6-25 bpm
__________ variability amplitude more than 25
a sinusodial pattern is one in which there is a smooth sine wave like undulating pattern in fhr baseline with a cycle frequency of __-___ per minute lasting 20 min
ABSENT: variability. absent amplitude range
MINIMAL variability: amplitude detectable but less than or equal to 5 bpm
MODERATE variability amplitude 6-25 bpm
MARKED variability amplitude more than 25
a sinusodial pattern is one in which there is a smooth sine wave like undulating pattern in fhr baseline with a cycle frequency of 3-5 PER MINUTE lasting 20 min
In the 2008 NICHD consensus report states unequivocally that moderate variability reliably predicts the absence of _________ academia that the time that it is observed.
however the converse is not true the minimal or absent variability __________ confirm the presence of fetal metabolic academia.
In the 2008 NICHD consensus report states unequivocally that moderate variability reliably predicts the absence of METABOLIC academia that the time that it is observed.
however the converse is not true the minimal or absent variability CANNOT confirm the presence of fetal metabolic academia.
chemoreceptors and baroreceptors are located in the _________ arch and the ______ arteries
chemoreceptors and baroreceptors are located in the AORTIC arch and the CAROTID arteries
classically the sinusodial pattern is related to severed fetal _______ - variations of the pattern have also been seen with chorioamniotis, fetal sepsis or administration of narcotic analgesics.
classically the sinusodial pattern is related to severed fetal ANEMIA - variations of the pattern have also been seen with chorioamniotis, fetal sepsis or administration of narcotic analgesics.
Acceleration is an abrupt onset to peak less than ____ seconds increase of fetal heart rate above baseline lasting for ___ sec 32-42 weeks and ___ sec for less than 32 weeks. it lasts less than __ min. if lasting 2-10 min considered a __________ acceleration
Acceleration is an abrupt onset to peak less than 15 seconds increase of fetal heart rate above baseline lasting for 15 sec 32-42 weeks and 10 sec for less than 32 weeks. it lasts less than 2 min. if lasting 2-10 min considered a PROLONGED acceleration
Deceleration’s that occur with at least 50% of uterine cxt in a 20 min period are considered _________ deceleration’s occurring with fewer than 50% of cxt are defined as ______
Deceleration’s that occur with at least 50% of uterine cxt in a 20 min period are considered reccurent deceleration’s occurring with fewer than 50% of cxt are defined as intermittent.
___________ deceleration’s are defined as a gradual (onset to nadir equal or greater than 30 sec) decrease in FHR from the baseline and subsequent return to baseline associated with uterine cxt. in most cases the onset nadir and recovery of the deceleration’s occur at the same time as the beginning peak and end of cxt.
EARLY deceleration’s are defined as a gradual (onset to nadir equal or greater than 30 sec) decrease in FHR from the baseline and subsequent return to baseline associated with uterine cxt. in most cases the onset nadir and recovery of the deceleration’s occur at the same time as the beginning peak and end of cxt.
Transient fetal __________ compression
leads to
Altered _____________ pressure and or cerebral blood flow
leads to
Reflex \_\_\_\_\_\_\_\_\_\_\_\_\_\_ outflow
leads to
Gradual \_\_\_\_\_\_\_\_\_\_\_of FHR
leads to
Early deceleration
Transient fetal HEAD compression
leads to
Altered INTRACRANIAL pressure and or cerebral blood flow
leads to
Reflex PARASYMPATETIC outflow
leads to
Gradual SLOWING of FHR
leads to
Early deceleration
A _______________ deceleration is a reflex fetal responses to transient hypoxemia during a uterine cxt this can result from any interruption anywhere along the oxygen pathway.
A LATE deceleration is a reflex fetal responses to transient hypoxemia during a uterine cxt this can result from any interruption anywhere along the oxygen pathway.
Pathophyisiology of the Late Deceleration:
uterine contractions impedes maternal perfusion of the placental _______________ space
leads to
transient fetal hypoxemia
leads to
_____________ stimulation
leads to
reflex _________ outflow
leads to
peripheral vasoconstriction preferentially shunting oxygenated blood away from the peripheral tissues and toward the central vital organs, the brain, heart and adrenal glands
leads to
increase in fetal peripheral resistance and __________ ___________
leads to
______________ stimulation
leads to
gradual slowing of the fhr
Pathophyisiology of the Late Deceleration:
uterine contractions impedes maternal perfusion of the placental INTERVILLIOUS space
leads to
transient fetal hypoxemia
leads to
CHEMORECEPTOR stimulation
leads to
reflex SYMPATETIC outflow
leads to
peripheral vasoconstriction preferentially shunting oxygenated blood away from the peripheral tissues and toward the central vital organs, the brain, heart and adrenal glands
leads to
increase in fetal peripheral resistance and BLOOD PRESSURE
leads to
BAROCEPTOR stimulation
leads to
gradual slowing of the fhr
