Neonatal Transition Physiology

Question 1

5 stages of fetal lung development

Answer 1

Every Part Comes From Age
Embryonic
Pseudoglandular
Canalicular
Saccular
Alveolar

Question 2

A baby born before __ weeks will not have enough surfactant /alveoli/blood gas barrier to be able to survive

Answer 2

24

Question 3

Fetal lung fluid

Answer 3

Ultrafiltrate of pulmonary capillary blood
Active secretion
250-300 mL/day
Essential for fetal respiration and maintenance of FRC

Question 4

2 ways fluid is removed from newborn’s lungs

Answer 4

2/3 by lymphatics and capillaries

1/3 by vaginal squeeze

Question 5

4 things you can see on x-ray when babies have transient tachypnea of the newborn (wet lungs)

Answer 5

Increased central vascular markings
Hyperaeration
Evidence of interstitial and pleural fluid
Prominent interlobar fissures

Question 6

Where is surfactant stored?

Answer 6

Lamellar bodies

Question 7

Fetal breathing movements

Answer 7

Rhythmic contractions of the diaphragm associated with movement of small volumes of fluid in the fetal airway
Inhibited by hypoxia, sedatives, alcohol, prostaglandin E2

Question 8

Benefits of delayed cord clamping time

Answer 8

Higher Hb at 24-48 hours
Reduced iron deficiency at 3-6 months
Reduced risk of intraventricular hemorrhage in preterm infants
(There is some increase in phototherapy for neonatal jaundice)

Question 9

APGAR Score

Answer 9

Appearance
Pulse
Grimace
Activity
Respiration

Question 10

4 mechanisms of heat loss

Answer 10

Radiation
Convection
Evaporation
Conduction

Question 11

Brown fat

Answer 11

Mitochondria rich

Whole point is for heat production!

Question 12

Symptomatic hypoglycemia

Answer 12

Jittery, tremor, seizure, coma
Irritable, lethargy, stupor
Hypotonia, limpness
Apnea, cyanotic spells
Poor feeding
Hypothermia