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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
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?
Collapsed > 25 mmHg negative inspiratory pressure 40 minutes after birth
26
What secretes surfactant? What is the main constituent? When does synthesis begin?
Type II alveolar epithelial cells Phosphatidylcholine 3rd trimester
27
Who is RDS common in? Result?
Premature infants, and infants from diabetic mothers Pulmonary edema
28
What are the 4 shunts?
Placenta Ductus venosus Foramen ovale Ductus arteriosus
29
Blood flow to placenta shunts blood where? Blood from the placenta goes where?
Away from lower trunk, lowers blood flow to kidneys and abdominal viscera Ductus venosus
30
What does the ductus venosus do? Blood goes from where to where?
Bypasses the liver Blood goes from umbilical vein to IVC directly
31
From the liver blood enters where? Crosses what to be shunted where?
Right atrium Foramen ovale to left atrium
32
Where is the foramen ovale located?
Posterior aspect of RA, in the septum dividing the atria
33
Blood with the highest O2 content enters where from where? Supplies what?
Enters LV from IVC Carotid and brain
34
How much of the CO that enters the RA through the IVC is shunted to the LA via the Foramen ovale?
27%
35
What is a higher PO2: RV or LV (for the fetus)
LV
36
What is the ductus arteriosus?
R to L shunt | Blood away from PA to aorta
37
Patency of the ductus arteriosus is mediated by what?
PGE2
38
At birth what happens to the systemic vascular resistance? aortic pressure? LV and LA pressure?
Increases by 2x INC INC
39
At birth what happens to pulmonary vascular resistance? Why? What happens to PA pressure? RV and RA pressure?
DEC bc of lung expansion DEC DEC
40
What causes the Foramen ovale to close?
INC venous return to LA and INC LA pressure DEC in RA pressure
41
What factors close the ductus arteriosus?
Aortic Pressure > Pulmonary Pressure, reversing blood flow The high O2 causes vasoconstriction Falling PG levels contribute also
42
Babies with a patent ductus arteriosus have what? What is happening to the blood?
Heart murmur Oxygen rich blood from aorta mixes with oxygen poor from pulmonary artery --> INC BP
43
What causes the ductus venosus to close?
Muscle wall of ductus venosus contracts strongly and closes Portal venous pressure rises
44
What is the RR of neonate? Metabolism? HR?
40 2x adult 100-150
45
What is the ratio of body surface area in relation to body mass? What does this mean?
Large Temp falls easily
46
What is the neonate RBC count and serum bilirubin like in the 1st 16 weeks of life?
Physical anemia 6-12 weeks of life Physiological hyperbilirubinemia first 2 weeks of life
47
What nutritional needs does the neonate have?
calcium Vitamin D Iron Vitamin C
48
What problems does a premature baby have?
RDS Poor GI function Immature organs Depresses gamma globulin
49
What are the 3 sequential phases of growth?
Pure hyperplasia Hyperplasia and concomitant hypertrophy Hypertrophy alone

COM - Repro (15 decks)

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