Exam 2 Peds - Summary Set Flashcards
the most common congenital condition in peds is
congenital heart disease (CHD)
when completing a physical exam for cardiac assessment, you should start with ___, then ___, then ___
inspection; auscultation; palpation
nail clubbing is a sign of advanced ____
CHD
the function of the placenta is ___
to provide gas exchange
the ____ connects the two atrium in a fetal heart
patent foramen ovale (PFO)
___ provides lower limb perfusion in the fetus
ductus arteriosus
____ bypasses the lungs
ductus arteriosus
in fetal circulation, the ___ are very vasoconstricted
lungs
4 respiratory changes happen with baby’s first breath:
(1) pulmonary alveoli open up
(2) decrease in pulmonary resistance
(3) lungs expand
(4) increase in pulmonary blood flow
circulatory changes that occur with birth are ___ and ___
systemic circulation is established; fetal shunts close
why might you not hear murmurs immediately after birht?
Because the pulmonary vascular resistance is still high
which valve is on the Right side of the heart?
Tricuspid
which valve is on the Left side of the heart?
Bicuspid / mitral
name the 4 steps in the cardiac conduction system
(1) SA node
(2) AV node
(3) Bundle of His
(4) Purkinje fibers
at which phase of the cardiac cycle are the coronary arteries perfused?
Diastole
name the 4 types of acyanotic cardiac defects with increased pulmonary blood flow
(1) Patent Ductus Arteriosus (PDA)
(2) Atrial Septal Defect (ASD)
(3) Ventricular Septal Defect (VSD)
(4) AVSD
____ cardiac defects are associated with pink and left-to-right shunts
acyanotic
in ____, it begins to constrict 10-15 hours after birth
patent ductus arteriosus
what are two reasons the ductus arteriosus doesn’t close in PDA?
(1) prematurity
(2) hypoxia
we can treat premature infants with PDA with what 4 things?
(1) fluid restriction
(2) diuretics
(3) digoxin
(4) indomethacin
we can treat larger children with PDA with what?
coil occlusion / surgical correction
PDA is a major risk factor for ___
stroke
how do you repair PDA?
Cath lab repair or OR repair
___ is a hold in the wall separating the atrium
atrial septal defect (ASD)
why does ASD cause an increased workload on the right heart?
because ASD causes a left-to-right shunt
how do you repair an ASD?
(1) small shunts don’t require therapy / watch to resolve on own
(2) surgical closure / patch closure
(3) secundum ASD - transcatheter device therapy
___ is a hole between the ventricles
ventricular septal defect (VSD)
what two factors determine the magnitude of VSD?
(1) size of the defect
(2) pressure in the lungs and body
both ___ and ___ will increase workload on the right side of the heart
ASD, VSD
how do you repair a VSD?
(1) incision in the R atrium
(2) patch closure
what should you monitor for post-op for VSD repair?
(1) arrhythmias
(2) pulmonary hypertension
(3) low CO syndrome
(4) residual VSD
___ is a narrowing of the aorta that hinders blood flow
coarctation of the aorta (COA)
COA at birth can present as
cardiac collapse
COA as a teenager can present as ___
very high BP!
the overall goal of COA is ___
to prevent end organ damage
the pressures before the narrowing in COA will be ____
high
the pressures after the narrowing in COA will be ____
low
the two types of COA repair are
(1) transcatheter dilation
(2) surgical repair
the most common type of transcatheter dilation for COA is
balloon angioplasty
the two risks associated with balloon angioplasty are ___ and ___
aortic rupture; re-coarctation as the child gets older
the two types of surgical repair for COA are:
(1) left subclavian patch angioplasty
(2) synthetic patch angioplasty
3 post-op complications for a surgical repair of COA are:
(1) hypertension
(2) postcoarctectomy syndrome
(3) spinal cord hypoperfusion
which cardiac defects are cyanotic with increased pulmonary vascularity?
(1) D-Transposition of the Great Vessels (D-TGV)
(2) Total anomalous pulmonary venous return
(3) Truncus arteriosus
in ____ the aorta rises from the R ventricle with no opportunity for blood to be oxygenated in the lungs
D-Transposition of the Great Vessels
what does the child with D-TGV require?
intracardiac mixing to survive
