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Nur 943 OB > Exam 3 Neonatal Congenital Defects > Flashcards

Exam 3 Neonatal Congenital Defects Flashcards

1
Q

Failure of the nasal bone or membranous portion of nasopharynx to undergo regression during development

A

What is Choanal Atresia and Stenosis?

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2
Q

Key Sign of Choanal Atresia

A

Cyanosis at rest that resolves with crying or oral airway

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3
Q

5 conditions associated with laryngeal and tracheal obstruction

A 
Webs
Subglottic Stenosis
Subglottic hemangioma
Esophageal Atresia
Tracheoesophageal Fistula
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4
Q

What up wit Webs?

A

Webs- can be laryngeal or tracheal, can produce incomplete fibrous membrane that can obstruct the airway.

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5
Q

Sx of Esophageal Atresia

A

Excessive Secretions
Regurg
Respiratory distress worsened with feeding
Recurrent Pneumonia

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6
Q

Most common form of Tracheoesophageal fistula

A

Esophagus ends in blind pouch with distal end connected to trachea just above the Corina.

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7
Q

Anatomic Defect of the diaphragm allowing intrusions of abdominal contents into the thoracic cavity

A

What is Congenital Diaphragmatic Hernia

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8
Q

Sx of Congenital Diaphragmatic Hernia

A

Dyspnea, Tachypnea, Cyanosis, Absence of breath sounds on affected side, and severe retractions.
Also- Barrel chest and scaphoid abd

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9
Q

CD Hernia Surgery is usually performed on day ____

A

4

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10
Q

Avoid these during CDH sugery

A

N20 (Increases GI tissue and impairs ventilation)
Hypoxia
Hypothermia
Acidosis (increases PVR)

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11
Q

Two types of emergency GI surgical conditions

A

1- those that are obstructive

2-those that compromise intestinal blood supply

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12
Q

2 types of obstructive GI lesions

A

Congenital and Aquired

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13
Q

Describe Congenital Obstructive GI lesions

A

Abnormal increase in maternal weight
polyhydramnios
fetal size > normal for gestational age
fetal abdominal distention

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14
Q

Describe Acquired congenital obstructive GI lesions

A

after birth have vomiting
abdominal distention
late passage of meconium

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15
Q

Hypertrophy of Muscularis Layer of Pyloris

Vomiting starts at 2-6 weeks of life

A

What is Hypertrophic Pyloric Stenosis

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16
Q

What is associated with Necrotizing Entercolitis

A 
Birth Asphyxia
Hypotension
Recurrent Apnea
Intestinal Ischemia
Umbilical Vessel Cannulation
Respiratory Distress Syndrome
PDA
Systemic Infections

Often have metabolic and hematologic abnormalities, hyperglycemia, thrombocytopenia, coagulopaty, and anemia.

17
Q

Defects in abd wall occurring during gestation, usually at the umbilicus

A

Omphalocele and Gastrochisis

18
Q

Omphacele

A

Herniated viscera emerge at umbilicus d/t failure of gut to move from yok sac into abdominal cavity.
Covered by membranous Sac.
Associated with other anomalies (gender, cardiac, GU and metabolic

19
Q

Gastrochisis

A

Due to occulsion omphalomesenteric artery during gestation. Herniated viscera and intestines are periumbilical and usually on right side.
Intestines exposed to air- leads to inflammation, edema and dilated abnormal bowel

20
Q

Failure of gut migration from yolk sac into abdomen
Located within umbilical cord
Associated with Beckwith-Weidemann Syndrome (marcroglossia, gigantism, hypoglycemia, hyperviscosity) CHD, Extrophy of blader

A

Omphalocele

21
Q

Occusion of omphalomesenteric artery
Location- Periumbilical
Associated with exposed gut, inflammation, edema, dilation and foreshortened.

A

Gastroschisis

22
Q

Anesthetic Implications with Omphalocele and Gastrochisis

A

Severe dehydration and massive fluid loss from exposed viscera
Gastrochisis lose more fluid
Potential for sepsis, hypothermia and postop vent.
May need Stage closures. (staging)

23
Q

Due to abnormal migration or incomplete rotation of intestines from yolk sac back into abdomen

A

What is Malrotation and Midgut Volvulus?

24
Q

Malrotation and Midgut Volvulus

If occurs DURING Development _____ may be formed

A

Atretic Segments

25
Q

Malrotation and Midgut Volvulus

If occurs AFTER Development _____ may occur

A

bowel necrosis

26
Q

Malrotation and Midgut Volvulus

Sx?

A

Bilious Emesis, Tender and Distended Abd, Abd pain
If Bloody Stools Present- OMINOUS SIGN
Neonatal Emergency- SURGERY ASAP

27
Q

What is the most common CNS Defect?

A

Myelomeningocele

28
Q

Myelomeningocele AKA

A

Spina Bifida

29
Q

What is Myelomeningocele

A

Failure of neural tube to close leading to herniation of spinal cord and meninges through defect in spinal column

30
Q

Meningocele contains only

A

meninges

31
Q

Myelomeningocele contains ____ and ____

A

meningies and neural elements

32
Q

Myelomeningocele is urgent surgery and will need to occur within _____

A

24 hours

33
Q

Myelomeningocele usually occurs without other anomalies, but may have _______malformation, where hind brain is displaced downward into foramen magnum causing hydrocephalus

A

Arnold-Chiara malformation

May need VP shunt

Nur 943 OB (11 decks)

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