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Reproduction > Fetal and neonatal physiology > Flashcards

Fetal and neonatal physiology Flashcards

1
Q

how do you calculate gestational age

A

fertilization age + 2 weeks

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2
Q

growth: hyperplasia and hypertrophy

A

hyperplasia: increase in cell number
hypertrophy: increase in cell size

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3
Q

___ is primary form of placental growth

A

hypertorphy

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4
Q

intrauterine growth restriction

A
  • abnormality of fetal growth and development
  • decreased placental reserve caused by insult
  • mothers who smoke during pregnancy have small palcentas
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5
Q

what does the fetus use as its major energy source?

A

glucose

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6
Q

glucocorticoids do what to fetal liver

A

promote storage of glucose as glycogen

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7
Q

Insulin on fetal growth

A

causes glucose to be stored as glycogen,
uptake of aa’s
-lipogenesis

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8
Q

GH (postnatally)

A

binds GH receptors on liver causes production of somatomedin or IGF-1
-minimal effect on fetal growth bc fetal liver has few GH receptors

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9
Q

IGF-1 and IGF-2

A

mitogenic peptides, important for fetal growth

amt correlates with birth weight

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10
Q

thyroid hormones and fetal growth

A

most T4 in fetus is maternal (before second trimester)

  • fetal TSH and T4 begin to increase in 2nd trimester
  • hypothyroidism has adverse effects on fetal growth
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11
Q

when does the fetal heart begin to beat at how fast

A
  • 4th week after fertilization

- 65 bpm, goes to 140 bpm just before birth

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12
Q

when do nucleated RBCs form in fetus and where

A

3rd week, yolk sac and mesothelium of placenta

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13
Q

when do non-nucleated RBCs form and where

A

4th-5th weeks, by fetal mesenchymal and endothelial cells of fetal blood vessels

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14
Q

what takes over blood cell formation at 6 weeks

A

liver

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15
Q

at 12 weeks the ___ and ___ start forming RBCs

A

spleen and lymphoid tissue

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16
Q

from 3rd month on _____ becomes principal source of RBCs

A

bone marrow

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17
Q

fetal erythrocytes and reticulocytes

A

fraction of erythrocytes that are reticulocytes is high in young fetus but decreases at term
-fetal erythrocytes live 80 days as compared to adult being 120

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18
Q

development of NS

A

by 3rd and 4th month after pregnacny most reflexes present

-cerebral cortex development continues after birth

19
Q

fetal metabolism and iron

A

by week 12 gestation iron accumulates rapidly and 1/3 is stored in liver, available to use for Hb for months after birth

20
Q

development of kidneys: when does urine excretion begin

A

2nd trimester and accounts for 70-80% of amniotic fluid

-renal control stystems don’t fully develop until few months after birth

21
Q

what stimulates breathing at birth

A
  • asphyxiation during birth

- sudden drop in ambient temp and cooling of skin

22
Q

what can cause delayed breathing at birth

A

use of general anesthesia during delivery
prolonged labor
head trauma of infant during birth: depressed respiratory center

23
Q

causes of hypoxia during delivery

A

CAPE

compression of umbillical cord, anesthesia (excessive, which depresses oxygen of even her blood), premature separation of placenta, excessive uterine contractions

24
Q

how much negative inspiratory pressure is needed to overcome surface tension and open alveoli for 1st time

A

over 25mmHg

  • air in lungs remains almost exactly zero until negative pressure reaches -40
  • once gets to -60 then 40 mL of air comes into lungs
25
Q

how much positive pressure does it take to deflate lungs on first breath

A

+40

26
Q

is more or less effort required after first breath and when does breathing become completely normal

A

less, after 40 minutes

27
Q

surfacant fnct and made by what

A

secreted by type II alveolar epithelial cells

  • mainly phospholipid (phosphatidylcholine)
  • syn begin last trimester
  • harder to close aveoli with surfacant once open
28
Q

Respiratory distress syndrome common in what and due to what

A

common in premature infants and infants born to diabetic mothers
-failure to secrete adequate amounts of surfactant resulting in collapsed alveoli and develop of pulmonary edem

29
Q

4 unique shunts of fetal circulation

A

placenta
ductus venosus
foramen ovale
ductus arteriosus

30
Q

placenta shunt

A

shunts blood away from lower trunk and lowers effective blood flow to all abdominal viscera including kidneys

31
Q

blood from the umbilical vein returns ___ blood back to fetus from placenta and enters ___

A

oxygenated, ductus venosus

32
Q

ductus venosus blood flow

A

blood from umbilical vein to the IVC, bypassing the liver

33
Q

foramen ovale

-right to left shunt

A

blood goes from right atria to left atria

-of 69% combined CO that enters RA through IVC, 27% shunts into LA

34
Q

formaen ovale blood that isn’t shunted to LA

A

rest of combined cardiac output that enters RA from IVC joins poor oxygenated blood from SVC and coronary vessels

  • none of this shunts to LA
  • instead goes through tricuspid to RV so PO2 here is lower than in LV
  • blood from right ventricle then enters trunk of pulmonary artery
35
Q

ductus arteriosus

A

directs blood from pulmonary artery to the aorta

  • contains SM in vessel wall
    • pateny of vessel is due to active relaxation of SM from PGE2
36
Q

at birth there is a ____ pulmonary and ___ systemic vascular resistance

A

decreased pulm: due to lung expansion, vasodilation from prostaglandins
increased systemic: loss of blood flow from placenta increases this
-increases pressure in aorta, LA, and LV

37
Q

what causes the foramen ovale to close

A

reversal of pressure gradient pushes valve on left side shut on septum which eventually seals
-due to increased venouse return to LA and elevated LA pressure

38
Q

ductus arteriosus closing

A

now aortic pressure excedes pulmonary a pressure so blood flow reverses from aorta to pulmonary a

  • high oxygen content from aorta causes vasoconstriction of DA
  • also falling levels of prostaglandins cause closure
39
Q

patent ductus arteriosus

A

ductus arteriosus remains open which allows O2 rich blood from aorta to mix with O2 poor blood in pulmonary a
-strain on heart and increase BP in lung arteries

40
Q

ductus venosus closing

A

after birth blood flow through umbilical vein stops but portal blood flow still goes through

  • muscle wall of ductus venosus contracts strongly and closes
  • increase in portal venous pressure forces venous blood flow through liver sinuses
41
Q 
neonate: 
HR
BP
RR
metab
A

HR: 100-150 bpm (even higher in prematures)
BP: 70/50 first day, 90/60 few months, 115/70 adolescence
RR: 40
metab: 2X adult

42
Q

special feature of kidney neonate

A
  • high fluid tunrover
  • rapid acid formation, only concentrates urine/plasma 1.5X compared to 3-4X of adult
  • problems with acidosis and dehydration
43
Q

neonate phys and body temp

A

body temp falls easily

44
Q

nutritional needs neonate

A
  • calcium and vitamin D: bone ossification
  • iron: for RBCs, withou = anemia
  • vitamin C: not stored in enough quantitiy in fetal tissue
    • can be provided in breast milk

Reproduction (15 decks)

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