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FHB Exam 1 - Cardiovascular Physiology > Fetal Circulation > Flashcards

Fetal Circulation Flashcards

1
Q

The placenta is composed of a maternal & fetal component. What is the fetal component derived from? The maternal?

A
  1. Chorionic Sac

2. Endometrium

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2
Q

What is the function of the placenta?

A
  1. Gas exchange
  2. Nutrients
  3. Removal of wastes
  4. hormones & Immunologic exchange
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3
Q

How does oxygenated fetal blood enter the fetus? How does this deoxygenated blood then LEAVE the fetus?

A

Umbilical VEINS

Umbilical Arteries

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4
Q

What does the ostium premium form from? The foramen scandium?

A
  1. Inerior extension of septum premium

2. Fenestrations in the septum premium form Foramen Secundun

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5
Q

What does foramen ovale connect?

A

Right Atrium to Left Atrium

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6
Q

What is the flow of blood from the Fetal Branch Villi to the Aorta? (9)

A
  1. Fetal Branch Villi
  2. Umbilical Vein
  3. Ductus Venosus
  4. IVC
  5. Right Atrium
  6. Foramen Ovale
  7. Left Atrium
  8. Left Ventricle
  9. AORTA
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7
Q

Because the lung has high pressures and is collapsed in the fetus, where is blood shunted as it enters as it travels from the right atrium –> right ventricle –> pulmonary artery?

A

Ductus Arteriosus!

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8
Q

What structure connects the umbilical vein to the IVC?

A

Ductus Venosus

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9
Q

Uterine contractions that clamp the cord and decrease pressure in the umbilical vein, and thus decrease pressure where? (forming a pressure gradient in the heart)

A

Right Atrium

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10
Q

What is the result of clamping the Umbilical Artery? Where does pressure increase?

A

Increase Systemic Vascular resistance, increasing pressure in the LEFT ATRIUM

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11
Q

What is the main result of clamping both the umbilical vein & the umbilical artery?

A

DECREASEs flow across foramen ovale

- increasing pressure in Left Atrium forces this SHUT
septum primum presses against septum scandium

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12
Q

What happens to pulmonary resistance as the first breath is taken (and alveoli & capillaries expand)?

A

Pulmonary Resistance DROPS

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13
Q

Decrease in pulmonary resistance causes flow from right ventricle to pulmonary and increases pressure in the LEFT Atrium. What is the result?

A

Further facilitates closure of FORAMEN OVALE

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14
Q

What does Bradykinin do?

A

Causes close of Ductus Arteriosus

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15
Q

What are the remnants of the following:

  1. Umbilical Artery
  2. Umbilical Vein
  3. Ductus Arteriosus
  4. Ductus Venosis
A
  1. Medial Umbilical Ligament
  2. Ligamentum Teres
  3. Ligamentum Arteriosum
  4. Ligamentum Venosus
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16
Q

Describe the structure of Fetal & Adult Hemoglobin.

A
  1. Fetal = 2 alpha & 2 gamma

2. Adult = 2 alpha & 2 BETA

17
Q

What has a higher affinity for oxygen HbF or HbA? Which direction is the oxygen dissociation curve shifted?

A
  1. HBF!

2. Shifted LEFT! (fetus wants to hold on to oxygen)

18
Q

What is the effect of 2,3 DPG on HbF? on HbA?

A
  1. NO affect on fetal

2. HbA –> curve shifts RIGHT (decreases binding affinity)

19
Q

Up until 30 weeks of gestation, where does fetal hematopoiesis occur? Where is it after this?

A
  1. Fetal Liver & Spleen

2. Bone Marrow!

20
Q

As fetal hemoglobin shifts to adult hemoglobin, how is the oxygen dissociation curve changed?

A

SHIFTS RIGHT

2,3 - DPG

21
Q

What is the function of 2,3-DPG? Is the affect the same in fetal and adult hemoglobin?

A

2,3-diphosphoglycerate lowers the affinity of Hb for oxygen by binding to and stabilising deoxyhemoglobin.

The gamma chains of HbF allow less 2,3-DPG binding. Therefore, HbF has a higher O2 affinity/ decreased unloading in the presence of 2,3-DPG than HbA

22
Q

What are the 5 cyanotic lesions?

A

Cyanotic lesions (“5-Ts”):

Transposition of the Great Vessels
Truncus Arteriosis
Total Anomalous Pulmonary Venous Return
Tricuspid Atresia
Tetrology of Fallot
23
Q

How does the pressure change in the right ventricle as the umbilical vein is clamped?

A

Decreased pressure in right ventricle from clamping the umbilical vein.

24
Q

What are the pressure changes regarding Dustus Arteriosus?

A

Increased SVR secondary to crying, moving, and clamping the umbilical arteries.
Decreased PVR secondary to opening of the lungs.
Reversal of flow in the ductus arteriosus.

FHB Exam 1 - Cardiovascular Physiology (26 decks)

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