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Q2 Physio test 3 > Maternal/Fetal Circulation > Flashcards

Maternal/Fetal Circulation Flashcards

1
Q

What structures form the placenta?

A

1) Placental villus
2) fetal vessels
3) chorionic tissue (outermost extraembryonic membranes)

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2
Q

What happens to maternal blood volume during pregnancy?

A

↑ ~ 45% w/ single

↑ ~ 100% w/ multiples

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3
Q

During which trimester does maternal blood volume ↑ the most?

A

second

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4
Q

What is the erythropoietic effect?

A

↑ in maternal erythrocyte volume

~ 33%

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5
Q

What happens to the maternal hematocrit?

A

↓

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6
Q

What happens to maternal plasma volume during pregnancy?

Why?

A

↑ ~ 50%

↑ progesterone/estrogen cause vasodilation ->
↓ renal perfusion pressure ->
activates renin-angiotensin and AVP release ->
↑ plasma vol

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7
Q

What happens to maternal CO during pregnancy?

A

↑ ~ 45%

primarily the result of ↑ SV

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8
Q

What happens to maternal TPR during pregnancy?

A

↓ due to ↑ progesterone/estrogen

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9
Q

What happens to maternal MAP during pregnancy?

A

↓ at midpoint

↑ at end term

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10
Q

Maternal CO during pregnancy directed to what specific tissues?

A

large ↑ renal blood flow
large ↑ uterine blood flow
↑ heart, skin, breast blood flow
no ∆ to brain, gut, skeleton

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11
Q

4 AV shunts in fetal circulation?

A

1) placenta
2) ductus venosus
3) foramen ovale
4) ductus arteriosis

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12
Q

Action of placenta as fetal AV shunt?

A

shunts blood L to R from:

fetus’ lower body to umbilical vein to inf vena cava

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13
Q

Action of ductus venosus as fetal AV shunt?

A

shunts blood from:

liver directly from umbilical vein (oxygenated) to IVC

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14
Q

Action of foramen ovale as fetal AV shunt?

A

directly shunts from R to L atria

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15
Q

Action of ductus arteriosis as fetal AV shunt?

A

shunts blood R to L from:
pulmonary artery to aorta
downstream of supply to head/up body

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16
Q

Fetus vs neonate:

R and L sides of heart

A

fetal: pump in parallel
neonate: pump in series

17
Q

Fetus vs neonate:

CO

A

fetal: CO is combined output of L and R side of heart. R output = 66%, L output = 34%
neonate: CO is output of L heart. R and L outputs are equal.

18
Q

∆ from fetal flow to neonate flow is initiated and completed when?

A

newborn takes first breath

19
Q

Oxygen saturation of blood leaving fetal heart vs entering heart?

A

blood leaving has less O2 than blood entering

20
Q

Oxygen saturation of fetal blood in R vent vs L vent?

A

R has less O2 (gets deoxy from brain and up body).

L only gets deoxy from lungs.

21
Q

Oxygen levels in fetus vs mother?

Why?

A

fetus O2 is much lower

fetal Hb has higher affinity for O2

22
Q

Benefit of low O2 levels in fetus?

A

stimulates cell growth and differentiation

23
Q

During birth, are umbilical arteries or umbilical vein constricted?

A

arteries

reduces circulating O2

24
Q

During birth, auto-transfusion of maternal blood to fetus through the placenta accounts for how much of the baby’s total blood volume?

A

~ 1/3

25
Q

Breathing is initiated by what?

Mediated by?

A

hypoxia and hypercapnia (high CO2)

chemoreceptors
tactile stim
cold

26
Q

1st breath req’s what amount of H2O?

To move what amount of air?

A

60 cm H2O

40 ml air

27
Q

2nd breath req’s what amount of H2O?

A

40 cm H2O

28
Q

1st breath does what in the lungs?

A

opens alveoli

creates air-H2O interface

29
Q

1st breath affects plumonary vasculature how?

A

large ↓ in pulmonary resistance ->

↑ flow thru pulmonary vessels

30
Q

Blood flow away from pulmonary artery into lung vessels results in what?

A

↓ pulmonary artery P

↓ R vent P

31
Q

About when do newborn lungs reach adult compliance?

How much H2O is req’d for respiration then?

A

~ 1 hr

2.5 cm

32
Q

↓ pulmonary artery P causes what change in flow?

A

direction of ductus arteriosis flow reverses (now L to R, aorta to pulm artery)

33
Q

Ductus arteriosis flow stops when?

Permanently closes when?

A

1 wk

1 mo

34
Q

What happens to atrial pressure after birth?

A

L atrial P > R atrial P

35
Q

What does change in atrial pressures cause?

A

closure of foramen ovale ->

circulation now serial instead of parallel

36
Q

What happens to ductus venosus after birth?

A

closes ~ 3hrs post ->
↑ P in portal vein ->
establishes portal circulation in liver

37
Q

Breakdown of fetal heart inflow by system/percentage?

A

lower body 69%
up body 21%
coronary circulation 3%
lungs 7%

Q2 Physio test 3 (8 decks)

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