Pediatric/Congenital CP Disorders Flashcards
Development of lungs begin at __ of gestation f/b __ periods of lung maturation. The last period is the __ period, with the lungs being fully developed by the age of __.
1) 4 wks
2) 4 periods
3) Alveolar period
4) 8 y/o
From weeks 16-26, a critical event occurs > appearance of pulmonary __. __ Production also incr. during the final 2 weeks of pregancy therefore __ babies don’t have surfactant. Therefore, be sure to ask child’s __ age during pt interview.
1) capillaries
2) Surfactant
3) premature
4) gestational
Cardiac development starts in wk __ of gestation with formation of endocardial strands. By day 22-23, the heart begins to __ and by day 27 it ___ blood.
1) wk 3
2) beat
3) circulate
Fetal circulation __ the lungs to go to the LV via the foramen ovale or __ __. Fetus uses __ to obtain O2/eliminate CO2. By wk __, gestation of cardiac development is complete.
1) bypasses
2) ductus arteriosus
3) PLACENTA (literally replaces the lungs in circulation)
4) 10
Congenital Heart Defects (CHD) can be classified as cyanotic where SaO2 is __ , or acyanotic where SaO2 is __.
1) decreased
2) normal
Acyanotic lesions (incr/decr) pulmonary blood flow & oxygenated blood is __ back into lungs and body.
(L/R) to (L/R) shunting occurs.
S&S include sweating, (incr/decr) respiratory rate, & HF. It results in (incr/decr) PaO2 to periphery, (incr/decr) SV, incr. heart workload.
1) increase
2) shunted
3) Left to Right
4) incr.
5) decr.
6) decr.
Acyanotic Lesions
Name 5 acyanotic CHD lesions. Also take a moment to review the unique features about ea. (AFTER you name them :) )
1) Atrial septal defects – caused by patent foramen ovale
2) Patent ductus arteriosus – often assoc. w/ Down syndrome or prematurity
3) Ventricular Septal Defect – 1 or more small openings in wall separating the ventricles
4) Atrioventricular Septal Defects – atrioventricular canal defects or endocardial cushion defects
5) Coarctation of Aorta – obstruction of left ventricular outflow as a consequence of narrowing of the aorta
Cyanotic lesions cause
(L/R) to (L/R) shunting, where most of the blood __ the lungs. This results in (incr/decr) SaO2, incr. signal for __ BC formation (polycthemia), and incr. risk for __ insult.
1) Right to Left
2) Bypasses
3) decr.
4) Red BC
5) CV
Name 4 cyanotic CHD conditions. Also take a moment to review the unique features about ea. (AFTER you name them :) )
1) Tetralogy of Fallot – (1) pulmonary stenosis, (2) VSD, (3) overriding aorta, (4) right ventricular hypertrophy
2) Hypoplastic left heart syndrome – (1) hypoplastic left ventricle, (2) aortic and mitral valve stenosis, (3) coarctation of aorta
3) Transposition of great arteries – involves pulmonary artery leaving left ventricle and aorta exiting the right ventricle with no communication between systemic and pulmonary circulation
4) Tricuspid atresia– tricuspid valve between right atrium and ventricle is either not patent or absent
5) Truncus arteriosus– normal separation of aorta and main pulmonary artery does not occur, both right and left ventricles empty into a single large vessel
6) Total anomalous pulmonary venous return – pulmonary veins attach to right atrium
Resp. Conditions of Infancy
Name the condition:
-Born at <37 wks of gestation
-Assoc. w/ PDA
Prematurity
Also periodic breathing patterns and apnea of prematurity are abnormal
Resp. Conditions of Infancy
Name the condition:
-Seen in infants with infant respiratory distress syndrome
-can be assoc. w/ prematurity in comb w/ PDA
Persistent Pulmonary HTN
infant fails to adjust to breathing outside the uterus
Resp. Conditions of Infancy
Name the condition:
-AKA Hyaline membrane disease
-Caused by deficient amount of pulmonary surfactant
-Char. by airless alveoli, inelastic lungs, respiration rate >60 bpm, nasal flaring, intercostal and subcostal retractions, grunting on expiration, peripheral edema
Respiratory Distress Syndrome
Resp. Conditions of Infancy
Name the condition:
-Sudden, unexpected death during sleep of infant
-May be linked with resp.
-“Back to Sleep” campaign: infants should sleep supine until they have the ability to roll
Sudden Infant Death Syndrome (SIDS)
Resp. Conditions of Infancy
Name the condition:
-Factors may cause fetal rectal sphincter muscles to relax, resulting in meconium in the amniotic fluid
-infant then may aspirate amniotic fluid and meconium
Meconium Aspiration syndrome
Resp. Conditions of Infancy
Name the condition:
-Chronic respiratory disorder char. by lung scarring, thickened pulmonary arterial walls, & lung V/Q mismatch
- >1 mo. of resp. s&s, abnormal imaging, & dependence on supp. O2
-Mechanical ventilation is etiologic factor
Bronchopulmonary Dysplasia (BPD)
Resp. Conditions of Infancy
Name the condition:
-Genetic, autosomal recessive disease affecting exocrine gland function
Cystic Fibrosis
Resp. Conditions of Infancy
Name the condition:
-Rare disease in which mucociliary clearance is impaired because of defective motility of cilia
Primary Ciliary Dyskinesia
PEDIATRIC DIAGNOSES WITH SECONDARY CARDIOPULMONARY ISSUES
Name the condition:
-Assoc. w/ endocardial cushion defect, VSD, ASD, Tetralogy of Fallot
-Cardiac defects and sleep apnea are more common
-Exercise throughout life span is critical
Down Syndrome
PEDIATRIC DIAGNOSES WITH SECONDARY CARDIOPULMONARY ISSUES
Name the condition:
-Primary immunodeficiency disease, caused by deletion of chromosome 22
DiGeorge Syndrome
PEDIATRIC DIAGNOSES WITH SECONDARY CARDIOPULMONARY ISSUES
Name the condition:
-Vertebral defects, imperforate anus, tracheoesophageal fistula, radial and renal dysplasia
VATER Association
PEDIATRIC DIAGNOSES WITH SECONDARY CARDIOPULMONARY ISSUES
Name the condition:
-Connective tissue disease that is commonly assoc. w/ aortic aneurysm and aortic/mitral insufficiency
Marfan Syndrome
PEDIATRIC DIAGNOSES WITH SECONDARY CARDIOPULMONARY ISSUES
Name the condition:
-Involves deletion of long arm of chromosome 7
-Assoc. w/ supravalvular aortic stenosis and supravalvular pulmonary stenosis
Williams Syndrome
PEDIATRIC DIAGNOSES WITH SECONDARY CARDIOPULMONARY ISSUES
Name the condition:
-chronic alcohol exposure in utero
Fetal Alcohol syndrome
Pediatric conditions with decr. activity levels are d/t muscle weakness, tone issues, motor planning, motor __, & __.
1) motor learning
2) medical fragility
Pediatric conditions with decr. activity levels
Name the condition:
-Disorder caused by nonprogressive but permanent lesion of brain, occurring in utero, during birth, or immediately after birth
Cerebral Palsy
Pediatric conditions with decr. activity levels
Name the condition:
-Various types of myelodysplasia, ranging from lack of posterior vertebral arch fusion (occulta) to open spinal defects (myelomeningocele)
Spina Bifida
can include Arnold-Chiari type II malformation – ventilatory problems
Pediatric conditions with decr. activity levels
Name the condition:
-Characterized by progressive, symmetrical wasting of musculature
Duchenne Muscular Dystrophy
Pediatric conditions with decr. activity levels
Name the condition:
-LMN condition; severe weakness, muscle atrophy, contractures lead to progressive respiratory failure
Spinal Muscular Atrophy
What are the HR, RR, & BP (systolic) norms for a premature and newborn?
Premature:
HR: 100-180
RR: <40
BP: 42 +/- 10 (only diff)
Newborn:
HR: 100-180
RR: <40
BP: 60 +/- 10 (only diff)
What is a score that can quick assesses an infant’s health?
Hint: it can be taken 1 min and 5 mins after birth.
1 min = necessity for resuscitation
5 mins = predicting mortality and neurologic deficits
APGAR Score
1) What does APGAR mean?
2) How is the score interpreted
3) Take a moment to review the APGAR score chart.
1) Appearance, Pulse, Grimace (reflex irritability), Activity (tone), Respiration
2) Lower scores = higher risk of neurological impairment
3) refer to pic
