Lung Devo Flashcards
presentation resp distress
tachypnea, tachycardia
flaring nostrils
chest retraction
expiratory grunt
cyanosis
anxious express
preop management TEF and esophogeal aphasia
patient at 30derees
repogle in proximal pouch to handle secretions
Search for comorbidities
identify position of aortic arch
risk of post-natal steroids in RDS
cerebral palsy
embryonic speculation in CCAM
asynchronous maturation of developing lung bud and surrounding mesenchyme 16-20wks results in overgrowth of terminal air strucutres
at __wks, fetal luungs may be able to support life (with assistance)
24-27wks
congential cystenic adenoamatoid malformation likely a ___ anaomaly
bronchiole
most common repiratory/esophogeal abnormality
esophogeal atresia with distal esophogeal fistula (to trachea)
cray findings RDS
low lung volume
diffuse atelectasia (ground glass)
air bronchograms
pneumonia-like (but not isolated region)
infants with resp distress often develop ___ in lungs
hyalien membrane
lab findings RDS
moderate hypoxia
resp acidosis
metabolic acidosis
most common cause of resp distress in preterm infants
RDS
presentation esophogeal atresia with distal trachea-esophogeal fistula
air in bowel on X-ray
bronchoscopy indentifies fistula
pathogenesis hyaline membrane formation in respiratory distress
Type I cell injury >
breakdown of air/capillary barrier >
serum leak into alveolar lumen >
hyaline forms + surfactant disrupted
Lab tests to evaluate risk for RDS
lecithin/spingomyelin ration
presence of phosphatidylglycerol (more accurate)
presentation CCAM
single lobe
air trapping > distention
resp distress (rare)
recurrent pulmary infxn
prenatal ultrasound
delayed repair candidates for EA with distal TEF
significant pul compromise
sig cardiac anomalies
long gap atresia,
= primative alveoli
terminal sacs
histological pattern CCAM
adenomatoid
alveolar psaces lined by repsiratory and mucus secreting epithelium =glandular
risk factors RDS
Prematurity
preinatal depression
male
maternal diabetes
c section
multiple births
CCAM
mass of pulmonary tissue in which there is proliferation of broncial structures at expense of alveolar devo
pathophysiology RDS
structural+ fxnl immaturity:
underdeveloped, un-elastic parenchyma
surfactant deficeincy
CXR meconium aspiration syndrome
patchy atelectasis or consilidation
main mechanistic cause of respiratory distress
inability to keep alveoli filled with air
treatment prenatal hydrops
thracentesis
thoraco-amniotic shunt
fetal lobectomy
induce delivery and perform resection
inadequate partioning occurs due eto
abnormala or insufficient development of tacheoesophageal septum
significant production in surfact at ___wks
35 wks
(begins in cannicular period)
associated anomalies esophogeal aphasia and TEF
cardiac (VSD)
GI,
GU,
Musculoskelatal
prevention of RDS
arrest preterm labor
antenatal bethamethasone - steroids stimulate type II pneumocytes and surfactant production
