FETAL DEVELOPMENT Flashcards
1
Q
When do centers of ossification appear?
A
12 wks
2
Q
When do skin and nails develop?
A
12 weeks
3
Q
When are fingers and toes differentiated?
A
12 weeks
4
Q
When do eye movements begin?
A
16 weeks
5
Q
When does midbrain maturation begin?
A
16 weeks
6
Q
When do eyes open?
A
26 weeks
7
Q
When does subcutaneous fat deposit?
A
36 weeks
8
Q
When does vernix caseosa form over skin?.
A
28 weeks
9
Q
When does vaginal canalization begin?
A
16 weeks
10
Q
When does testes descend?
A
20 weeks
11
Q
When does canalicular development complete?
A
24 weeks
12
Q
When is the fetal liver and spleen the sites of hematopoiesis
A
28 weeks
13
Q
When does type ii pneumocytes begin to secrete surfactant?
A
24 weeks
14
Q
When does downy lanugo cover the body?
A
20 weeks
15
Q
When does fetal uterus form?
A
16 weeks
16
Q
When do fingers and toes differentiate?
A
12 weeks
17
Q
When is the bone marrow the major site of hematopoeisis?
A
28 weeks
18
Q
What significant fetal changes occur during 36 weeks?
A
Subcutaneous fat deposition
Body becomes rotund
Face becomes fuller
19
Q
What significant fetal changes occur during 28 weeks?
A
Vernix caseosa
Bone marrow for hematopoiesis
20
Q
What significant fetal changes occur during 24 weeks?
A
Skin wrinkles, fat deposits begin
Head enlarged
Canaliculra kung devt nearly complete
Surfactant begins
21
Q
When does brown fat form?
A
20 weeks
22
Q
What significant fetal changes occur during 20 weeks?
A
Testes descends
Brown fat forms
Downy lanugo
23
Q
What significant fetal changes occur during 16 weeks?
A
Eye movement
Midbrain maturation
Uterus
Vaginal canalization
24
Q
What significant fetal changes occur during 12 weeks?
A
Centers of ossification
Skin and nails
Fingers and toes
25
What significant fetal changes occur during 4-5 weeks?
Ureteric bud from mesonephric duct will become the kidney
26
What significant fetal changes occur during 7 weeks?
Cloaca divides into rectum and urogenital sinus
27
What are the three parts of the urogenital sinus
Cephalad (vesicle): bladder
Middle (pelvic): urethra
Caudal (phallic): lower vagina, batholins and paraurethral glands
28
What significant fetal sex changes occur during 10th week?
Uterus is formed by union of mullerian ducts in the middle
29
What significant fetal sex changes occur during 16th week?
Primordial follicle begin to form which contain oogonia
30
What significant fetal sex changes occur during 20th week?
Final uterine cavity formed
| Vaginal canalization is complete (begins at 16 weeks)
31
Three fetal shunts
Ductus venosus
Foramen ovale
Ductus arteriosus
32
What are the 3 umbilical vessels
AVA
2 arteries
1 vein
33
Trace flow of blood from placenta
```
Oxygenated
- Umbilical vein
- Portal v (liver)
- Ductus vein (IVC)
Mixed blood
- IVC
- Right atrium
- foramen ovale
- left atrium
- left ventricle
- aorta
- common iliac (2)
- hypogastric a (2)
- umbilical a (2)
```
34
Functional closure
| Ductus arteriosus
10-12 hours
35
Functional closure
| Foramen ovale
Few mins
36
Functional closure
| Ligamentum venosum
10-96hours
37
Closure
| Ligamentum teres
3-4 days
38
Closure of umbilical ligament
3-4 days
39
Anatomic closure
| Ductus arteriosis
2-3 weeks
40
Anatomic closure
| Foramen ovale
1 yr
41
Anatomic closure
| Ligamentum venosum
2-3 weeks
42
```
Fetal lung development
Pseudoglandular stage (1st): growth of intrasegmental bronchial tree
```
5-17 weeks
43
When can chest wall movements be detected sonographically?
11 weeks
44
Fetal lung development
| Canicular lung development is nearly complete by
24 weeks
45
Type II pneumocytes begin to secrete surfactant by
24 weeks
46
Terminal sac stage (3rd) by?
25 weeks
47
Which stage of fetal lung development involves growth of intrasegmental bronchial tree?
A. 1st - Pseudoglandular stage
B. 2nd - canalicular stage
C. 3rd - terminal sac stage
A. Pseudoglandular stage (1) at 5-17 weeks
48
Which stage of fetal lung development involves alveoli giving rise to pulmonary alveoli and extracellular matrix development
A. 1st - Pseudoglandular stage
B. 2nd - canalicular stage
C. 3rd - terminal sac stage
C. Terminal sac stage (3) at >25 wks
49
Which stage of fetal lung development involves bronchial cartilage plates extending peripherally (terminal bronchiole > several respiratory bronchioles > multiple saccular ducts)?
A. 1st - Pseudoglandular stage
B. 2nd - canalicular stage
C. 3rd - terminal sac stage
B. Canalicular stage (2) at 16-25 weeks
50
When does fetus begin to engage in respiratory movement?
16 weeks
51
Source of amniotic fluid in early pregnancy
Maternal plasma as ultrafiltrate
52
Source of amniotic fluid in 2nd trimester pregnancy
ECF diffused through fetal skin
53
Source of amniotic fluid at over 20 weeks
Fetal urine
54
Removal and regulation of amniotic fluid
Fetal swallowing
Fetal aspiration
Exchange through skin and fetal membranes
55
Severe oligohydramnios mechanism
Renal agenesis
| Bladder obstruction
56
Causes of polyhydramnios
Esophageal atresia
Pulmonary hypoplasia
Skin has no pores *rare
57
Causes nephrotoxicity and ototoxicity in oreterms
Aminoglycosides
| Gentamycin or streptomycin
58
Gray baby syndrome
Chloramphenicol
59
Is chloramphenicol teratogenic?
No
60
```
If used in 1st tri, causes
hypoplastic left heart syndrome,
microphthalmia,
anophthalmia,
clefts and ASD
```
Nitrofurantoin
61
```
If used in 1st tri, causes
anencephaly,
left ventricular outflow tract obstruction,
choanal atresia,
diaphragmatic hernia
```
Sulfonamides
62
If used over 25 weeks AOG, causes yellowish brown discoloration of deciduous teeth
Tetracycline
63
Causes cleft
Corticosteroids
64
Miscarriage and ear defecte
Mycophenolic acid
65
hypoplastic T shaped uterine cavity,
Cervical collars,
Breast cancer
Diethylstilbestrol
66
Embryopathy (6th to 9th week)
Warfarin
67
Clover-leaf skull
Methotrexate
68
```
Wide nasal bridge
Lowset ears
Micronathia
Limb abnormalities
Skull abnormalities
```
Methotrexat
69
Irreversible hypothyroidism
Radioiodine
70
Fetal growth and behavioral abnormalities
Lead
71
Epididymal cysts, hypospadia, cryptorchidism
Diethylstilbestrol
72
Disturbances in neuronal cell division and migration
Mercury
73
Sources of mercury
Shark, swordfish, king mackerel, tilefish, albacore tuna
74
Most potent teratogen
Isotretinoin
75
Amount of retinol that can cause defects
>10000 mIU/day
76
Neonatal behavioral syndrome (drug that causes it)
SSRI/SNRI
Fluoxetine
Sertraline
Citalopram
77
Neonatal behavior syndrome (characteristifs)
```
Jittery, irritable
Hyper or hypotonia
Feeding abnormalities
Vomiting
Hypoglycemia
Thermoregulatory instability
Respiratory abnormalities
```
78
ASD and VSD
Paroxetine (SSRI)
79
Ebstein anomaly
Lithium
80
Condition with apical displacement of tricuspid valve
Ebstein anomaly
81
```
Near delivery exposure causes
Hypothyroidism
Diabetes insipidus
Cardiomegaly
Bradycardia
Ecg abno
Cyanosis
Hypotonia
```
Lithium
82
Risk of thyroid cancer
Radioiodine
83
Causes childhood developmental delay, microcephaly and severe brain damage
Mercury
84
Fetal renal damage
ACEi
85
NTDs
Antiseizures
| Valproate ate the folate
86
Fetal hydantoin syndrome
Phenytoin
87
Stippling of vertebrae, nasal hypoplasia
| Choanal atresia
Warfarin
88
Abnormal EP muscle movements
```
Antipsychotics (not a teratogen)
Haloperidol
Chlorpromazine
Fluphenazine
Clozapine
Olanzapine
Risperidone
```
89
Neonatal hypoglycemia
Oral hypoglycemic agents
90
Neonatal dependence
Barbiturates
91
Clear cell adenoCA (vagina)
diethylstilbestrol
92
Craniofacial abnormalities
Isotretinoin
93
Congenital hypothyroidism
Iodide
94
Fetal alcohol syndrome
Ethanol
95
Warfarin in 1st tri
Chondrodysplasia
96
Warfarin in 2nd tri
CNS abno
97
Warfarin in 3rd tri
Bleeding diathesis
98
Mobius sequence
Misoprostol
99
```
Withdrawal
Agitation
Abno muscle tone
Tremor
Sleepiness
Feeding difficulty
Respiratory abno
```
```
Antipsychotics (not a teratogen)
Haloperidol
Chlorpromazine
Fluphenazine
Clozapine
Olanzapine
Risperidone
```
100
Tetracycline
Yellow teeth
101
Cutis laxa
Penicillamine
102
Phocomelia
Thalidomide
103
Smoking
IUGR
104
Streptomycin
Ototoxicity
105
Aplasia cutis congenita
Methimazole
106
Kernicterus
Sulfonamides
107
Cartilage damage
Fluoroquinolone
108
Trisomy 21
Down
109
Trisomy 18
Edward
110
Trisomy 13
Patau
111
45 XO
Turner
112
47 XXY
Klinefelter
113
Microdelete
Cri du chat
114
Most common non lethal trisomy
Downs
115
Strawberry shaped cranium
Edward
116
Abnormal laryngeal development
Cri du chat
117
Most common sex chromosome abnormality
Klinefelter
118
Holoprosencephaly
Patau
119
Only monosomy compatible with life
Turner syndrome
