Fetal/Neonatal Physiology

Question 1

Gestational age: when is day 1?

Fertilization age?

-general rule fertilization age + (what)= gestational

Answer 1

day of is last day of normal menstrual period, fert is day of fert, general rule for gestational age is fert + 2 weeks

Question 2

hematopoiesis from conception through birth:

what starts it?

• after 7 weeks what takes over for the 9th-24th weeks?
• What becomes major site by the 24th week?
• what is major site of EPO transcription, as grow older?

Answer 2

Question 3

• Hemoglobin type in fetuses?
• adult hemoglobin

Answer 3

Question 4

Cord clamping:

• early vs late?
• normal hemoglobin level in cord blood

Question 5

Serum iron level in cord blood in infant compared to maternal levels?

-when does iron get depleted in infant? when does it need to be in diet in a sense

Answer 5

Question 6

Fetal Kidneys:

• nephrogenesis begins when? completed when?
• urine production? amount of amniotic fluid?

Answer 6

Question 7

When does renal function mature most rapidly?

when does functional development complete?

Answer 7

Question 8

• blood glucose levels first day?
• why?

why can’t liver conjugate bilirubin well?

Answer 8

look up why neonatal jaundice happens

Question 9

Neonatal nutritional needs:

need lots of what? why?

Answer 9

Question 10

Calcium, phosphorus, regulation during fetal development?

Answer 10

“practice”

Question 11

Iron in fetus:

• transfer of most iron happens when in utero?
• when would a premie be at high risk of anemia?

Answer 11

breastmilk has lower iron, but bioavailability is high. formula opposite.

Question 12

Vitamin C:

-storage in fetal tissues

Answer 12

Question 13

Neonatal Immunity:

• where does it inherit it?
• after first month of life what may happen? returns to normal when?
• when are immunizations necessary?
• whooping cough?

Answer 13

Question 14

prematurity:

-types of problems that are exacerbated

Answer 14

Question 15

Neonatal stress:

• Underdeveloped which axis?
• response to glucocorticoid levels?
• buffering maintained by?
• Toxic stress is?
• fetal origins of disease?

Answer 15

• stress levels in neonate are important to monitor
• hpa axis is suppressed in consistent caregiver relationship, if theyre stressed corticoids are toxic to nervous system
• chronic diseases of life go back to what happened in utero developmental time periods

Question 16

when do you start to get lung development>

Answer 16

week 28

Question 17

what type of cells secrete surfactant?

Answer 17

type II alveolar cells

Question 18

when does synthesis of surfactant begin

Answer 18

last trimester

Question 19

what stimulates breathing upon birth?

-delayed breathing?

Answer 19

Question 20

• shape of alveoli at birth?
• what type of pressure needed to overcome this?

Answer 20

Question 21

first exhalation?

Answer 21

child has to force it

Question 22

Breathing pattern upon birth

-what happens to pressure needed? when does it normalize?

Answer 22

Question 23

Hypoxia during birth causes?

Answer 23

Question 24

Respiratory distress syndrome:

• common in?
• what is pathophys?

Answer 24

Question 25

Fetal blood flow:

-umbilical artery vs vein

Answer 25

-baby receives through umbilical vein, arteries leave fetus go into mother.

Question 26

Fetal Blood Flow Rules of Thumb:

• what does not receive a lot of blood?
• shunt to avoid liver?
• shunts to avoid lungs?

Answer 26

ductus venosus avoids liver,

ductus arteriosus, allows right ventricle blood to skip pulmonary circulation, similar to how foramen ovale works to shunt right atrial blood to left

Question 27

Fetal blood flow in the placenta:

• relative amount of blood flowing through placenta?
• umbilical arteries: be a rbc
• umbilical vein, be a rbc

Answer 27

placenta has a lot of blood flow.

• umbilical arteries: branch repeatedly, return deoxygenated blood, have a dense capillary network at terminal villi, “Legs” connect to IVC
• umbilical veins: returns oxygenated blood to fetus from placenta with P02 around 30-35. blood then enters ductus venosus*

*po2 is way lower than normal 100

Question 28

what is the direct route from umbilical vein to IVC?

Answer 28

ductus venosus

Question 29

fetal blood flow Foramen Ovale:

• hole in septum between what?
• oxygenation, and what 27% of this blood goes to?
• rest goes where?
• blood from superior vena cava path?

Answer 29

-svc enters into right atrium, will want to shunt stuff into the right ventricle. this is blood coming from the brain.

Question 30

Ductus Arteriosus: from what vessel to what structure?

-role of prostaglandins?

Answer 30

Question 31

Blood flow changes upon birth:

decreased pulmonary vascular resistance

• lung size
• vasculature
• pulmonary arterial pressure, why?

Answer 31

Question 32

Blood flow changes upon birth:

• systemic vascular resistance:
• why does it increase due to placenta?

Answer 32

Question 33

Closure of foramen ovale:

-why does it close?

Answer 33

Question 34

closure of ductus arteriosus:

• why
• po2 levels cause what chemical to change

Answer 34

Question 35

PDA

-leads to ?

Answer 35

pulmonary htn, rvh

Question 36

closure of ductus venosus:

-timing, causes

Answer 36

Question 37

Neonatal stats:

HR

BP

RR

Metabolism

Kidney, and probelms associated with this

Answer 37

Question 38

be able to walk yourself through fetal circulation as an rbc