Module 1 Flashcards
stage of lung development at 16-25 weeks gestation that consists of canaliculi branching out of terminal bronchioles to form an acinus composed of respiratory bronchioles, alveolar ducts, and alveolar sacs
Carnalicular Stage
functional unit of the lung composed of about 6 respiratory bronchioles, alveolar ducts, and alveolar sacs
acinus
stage of lung development at 25-36 weeks gestation in which terminal saccules continue to elongate, branch and widen
septa between saccules still thick at the beginning of this stage
Saccular Stage
alveolar ducts that are elongating, branching and widening in the saccular stage of lung development
terminal saccules
At ____ weeks,
All generations of conducting and respiratory bronchioles are formed
Blood-air barrier is reduces to 3 thin layers
36
Layers of ________:
Type I pneumocytes
fusal basal membrane
capillary endothelium
Blood-air Barrier
stage of lung development at 36 weeks gestation - 3-8 years old in which saccular epithelium begins to fold over elastin and collagen fibers to form an epithelial “tube” or alveolar septum
*Initially, a primary septum separates the alveolar saccules, containing a double layer of capillaries
Alveolar Stage
onset of physiological jaundice (TSB >7 mg/dL)
after 36 hours
onset of breastfeeding-associated jaundice (TSB >7 mg/dL)
2-4 days
onset of breastmilk jaundice (TSB >7 mg/dL)
4-7 days
peak time of physiological jaundice
3-4 days in formula-fed infants
slightly later in Asian + Asian-American infants
5-7 days in breastfed infants
peak time of breastfeeding-associated jaundice
3-6 days
peak time of breastmilk jaundice
5-15 days
peak TSB of physiological jaundice
5-12 mg/dL in formula-fed infants
7-14 mg/dL in breastfed and Asian + Asian-American infants
peak TSB of breastfeeding-associated jaundice
> 12 mg/dL
peak TSB of breastmilk jaundice
> 10 mg/dL
incidence of physiological jaundice in full-term infants
50-60%
incidence of breastfeeding-associated jaundice in full-term infants
12-13%
incidence of breastmilk jaundice in full-term infants
2-4%
characteristics of breastfeeding-associated jaundice in full-term infants
jaundice appears within 1st week of life poor feeding weight loss dehydration signs infrequent urine output delayed meconium passage
characteristics of breastmilk jaundice in full-term infants
jaundice appears after 1st week of life and persists for up to 12 weeks of life
feels well
normal weight gain
normal urine output
onset of pathological jaundice
rises quickly, within 24 hours
peak time of pathological jaundice
24 hours
characteristics of pathological jaundice
visible jaundice persists after 1st week of life
poor feeding
weight loss
Risk factors:
cephalohematoma
ABO blood group or Rh (D) incompatibility
polycythemia
peak TSB of pathological jaundice
> 13 mg/dL
normal NB Hct
43-63%
normal NB Hgb
14-20 g/dL
normal NB WBC
10-30
normal NB PLT
150,000-400,000
vessels that return deoxygenated blood from the baby to the placenta
have the ability to constrict– this is important later!
umbilical arteries
vessel that carries the oxygenated blood from the placenta to the baby
umbilical vein
arteries (that branch off the internal iliac arteries) become the umbilical arteries of the umbilical cord and are responsible for returning the non-oxygenated blood, fecal waste, and carbon dioxide to the placenta.
hypogastric arteries
in fetal life, pulmonary vessels are __________
vasoconstricted
the pressure in the fetal pulmonary vessels is ______
HIGH
the pressure in the fetal systemic vessels is _______
LOW
a tiny bit of blood does flow into the ___________ and the fetal _____
pulmonary arteries; lungs
shunt that takes blood back to the aorta- allows for blood mixing (may remain open after birth in the case of cardiac abnormalities)
ductus arteriosus
3 shunts in fetal circulation
ductus venosus
foramen ovale
ductus arteriosus
constriction of the umbilical arteries at birth shuts down the:
low pressure system
oxygen dilates the pulmonary vessels causing the pressure to _______
decrease
when the pressure drops in the pulmoary vessels, the systemic circulation is now ________ than the pressure in the lungs
greater
the systemic circulation increasing in pressure results in ________ pulmonary blood flow
increased
At birth, pulmonary circulation changes from ____ to ____ resistance pathway
high to low
At birth, systemic circulation changes from ____ to ____ resistance pathway
low to high
constriction of the ductus arteriosus after birth occurs due to:
high oxygenation
decreased prostaglandins
closure of the foramen ovale after birth occurs due to:
decreased umbilical blood flow decreased venous return from the inferior vena cava MOSTLY DUE TO: decreased pressure in the right atrium increased pressure in the left atrium (**pressure gradients are reversed)
umbilical vein remains _______ after birth
dilated
these atrophy and become fibrous ligaments
foramen ovale, ductus venosus, ductus arteriosus
fetal circulation is a low pressure system with _____ to _____ shunting
right to left
fetal system is ______ pressure
high
fetal system has ______ pulmonary resistance
high
fetal system has _______ systemic resistance
low
newborn system is ______ pressure
low
newborn system has ______ pulmonary resistance
low
newborn system has _______ systemic resistance
high
alveolar stage begins at ____ weeks
36
a small amount of surfactant can be found in the ___________ stage
canalicular
stage of lung development in which alveoli increase from 50 to 500 million
alveolar
what stage is there a structure present that could support respiration (viability)?
canalicular
stage in which the epithelium begins to produce amnioitic fluid
pseudoglandular
stage in which the beginning of alveolar sacs and end of terminal bronchioles are found
alveolar
1st day of gestation that cardiac structure will develop
day 18
ductus venosus closes how soon after birth?
immediately
lecithin and sphingomyelin are the two primary ___________ in surfactant
phospholipids
________ disrupts lung development leading to hypoplasia
oligohydramnios
fetal circulation is characterized by a _____ pressure system
low
if the infant does not get enough oxygen after birth, the pulmonary vascular pressure will be:
high
a drop in prostaglandin results in closure of:
the ductus arteriosus
the most critical chemical component that initiates newborn breathing
increased CO2
pulmonary surfactant is secreted by Type ___ alveolar cells
II
vessels that are considered vasoactive in fetal/NB circulation and can constrict
pulmonary artery
ductus arteriosus
umbilical artery
birth environment that preserves newborn BAT
neutral thermal environment
Known as __________:
intestinal epithelium line of defense once armed and impermeable to antigens, it makesthe infant is “safe” from some microbial invasions via the GI tract
gut closure
gut closure occurs within ____ days for breastfed babies
days
