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COM - Repro > Fetal Phys - 3/3 Lopez > Flashcards

Fetal Phys - 3/3 Lopez Flashcards

1
Q

What is the primary form of placental growth?

A

Hypertrophy

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2
Q

Growth of the fetus occurs almost entirely by what?

A

Hyperplasia

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3
Q

How are length and age related in the fetus?

Weight and and age?

A

Almost proportional

Weight increases almost in proportion to the cube of the age of fetus

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4
Q

When does placental growth increase linearly until?

A

4 weeks before birth

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5
Q

What is intrauterine growth restriction (IUGR)?

Who is at risk for it?

A

Abnormality of fetal growth and development caused by decreased placental reserve caused by any insult

Mothers who smoke

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6
Q

What is the major energy source of the fetus?

A

Glucose

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7
Q

What do glucocorticoids do in the fetus?

A

Promote the storage of glucose as glycogen in the fetal liver

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8
Q

What effect does insulin (near term) have on the fetus?

A

Contributes to the storage of glucose as glycogen

Uptake and utilization of a.a. And lipogenesis

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9
Q

How does GH affect fetal growth postnatally?

A

Binds GH receptors in the liver, triggers production of IGF-1 (somatomedin)

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10
Q

What mitogenic peptides are extremely important for fetal growth?

A

IGF-1 and IGF-2

(+) correlation b/w birth weight and IGF

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11
Q

What is obligatory for normal growth and development?

A

Thyroid hormones

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12
Q

Before the 2nd trimester, what hormone is mostly from the mother?

A

T4

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13
Q

When does the heart begin to beat?

What rate?
Increases to what?

A

4th week after fertilization

65 -> 140

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14
Q

Where does blood cell formation begin? When?

Where next?

Next?

From 3 months onward?

A

Yolk sac at 3 weeks

Liver

Spleen and lymphoid tissue

Bone marrow

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15
Q

What retains the ability to form blood cells?

A

Bone marrow

Lymphoid tissue

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16
Q

% of reticulocytes in fetus at term?
Adults?

Life span of reticulocytes in term fetus?
Adult?

A

5
1

80
120

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17
Q

When are most reflexes of the fetus involving the spinal cord and brain stem present?

When does the cerebral cortex develop?

A

3-4 months after pregnancy

Continues after birth, some things 1 year

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18
Q

When does ingestion of amniotic fluid begin?

A

2nd trimester

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19
Q

What is meconium?

A

Amniotic fluid, mucus, epithelial cells

AME

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20
Q

What ions are accumulated during ossification?

What is accumulated rapidly at week 12 of gestation? Stored where and for what?

A

Calcium and phosphate

Iron stored in liver for formation of Hb

21
Q

When does urine excretion begin?

Fetal urine accounts for what?

A

2nd trimester

70-80% of amniotic fluid

22
Q

What are the stimuli for breathing at birth?

A

Asphyxiation during birth

Sudden drop in ambient Temperature and cooling of skin

23
Q

What can cause delayed breathing at birth?

A

Use of general anesthesia
Prolonged labor
Head trauma during birth -> depressed respiratory center

24
Q

Do neonates have a higher or lower tolerance for hypoxia?

A

Neonates (8-10 min)

25
Q

At birth, what state are the alveoli in?
What kind of pressure is needed to overcome surface tension for the 1st time?

When is breathing normal?

A

Collapsed
> 25 mmHg negative inspiratory pressure

40 minutes after birth

26
Q

What secretes surfactant?
What is the main constituent?

When does synthesis begin?

A

Type II alveolar epithelial cells
Phosphatidylcholine

3rd trimester

27
Q

Who is RDS common in?

Result?

A

Premature infants, and infants from diabetic mothers

Pulmonary edema

28
Q

What are the 4 shunts?

A

Placenta
Ductus venosus
Foramen ovale
Ductus arteriosus

29
Q

Blood flow to placenta shunts blood where?

Blood from the placenta goes where?

A

Away from lower trunk, lowers blood flow to kidneys and abdominal viscera

Ductus venosus

30
Q

What does the ductus venosus do?

Blood goes from where to where?

A

Bypasses the liver

Blood goes from umbilical vein to IVC directly

31
Q

From the liver blood enters where?

Crosses what to be shunted where?

A

Right atrium

Foramen ovale to left atrium

32
Q

Where is the foramen ovale located?

A

Posterior aspect of RA, in the septum dividing the atria

33
Q

Blood with the highest O2 content enters where from where?

Supplies what?

A

Enters LV from IVC

Carotid and brain

34
Q

How much of the CO that enters the RA through the IVC is shunted to the LA via the Foramen ovale?

A

27%

35
Q

What is a higher PO2: RV or LV (for the fetus)

A

LV

36
Q

What is the ductus arteriosus?

A

R to L shunt

Blood away from PA to aorta

37
Q

Patency of the ductus arteriosus is mediated by what?

A

PGE2

38
Q

At birth what happens to the systemic vascular resistance?

aortic pressure?

LV and LA pressure?

A

Increases by 2x

INC

INC

39
Q

At birth what happens to pulmonary vascular resistance? Why?

What happens to PA pressure?
RV and RA pressure?

A

DEC bc of lung expansion

DEC
DEC

40
Q

What causes the Foramen ovale to close?

A

INC venous return to LA and INC LA pressure

DEC in RA pressure

41
Q

What factors close the ductus arteriosus?

A

Aortic Pressure > Pulmonary Pressure, reversing blood flow
The high O2 causes vasoconstriction

Falling PG levels contribute also

42
Q

Babies with a patent ductus arteriosus have what?

What is happening to the blood?

A

Heart murmur

Oxygen rich blood from aorta mixes with oxygen poor from pulmonary artery –> INC BP

43
Q

What causes the ductus venosus to close?

A

Muscle wall of ductus venosus contracts strongly and closes

Portal venous pressure rises

44
Q

What is the RR of neonate?

Metabolism?

HR?

A

40

2x adult

100-150

45
Q

What is the ratio of body surface area in relation to body mass?

What does this mean?

A

Large

Temp falls easily

46
Q

What is the neonate RBC count and serum bilirubin like in the 1st 16 weeks of life?

A

Physical anemia 6-12 weeks of life

Physiological hyperbilirubinemia first 2 weeks of life

47
Q

What nutritional needs does the neonate have?

A

calcium
Vitamin D
Iron
Vitamin C

48
Q

What problems does a premature baby have?

A

RDS
Poor GI function
Immature organs
Depresses gamma globulin

49
Q

What are the 3 sequential phases of growth?

A

Pure hyperplasia
Hyperplasia and concomitant hypertrophy
Hypertrophy alone

COM - Repro (15 decks)

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