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fall '24 exams > Pediatric Terminology Lecture #1 > Flashcards

Pediatric Terminology Lecture #1 Flashcards

1
Q

The first organ to form in embryology is

A

the heart

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2
Q

in how many days does the heart become fully functional? what does the heart consist of at this stage?

A

18 to 19 days FROM THE MESODERM and begins beating and pumping blood about day 21 or 22

the heart. consist of a pair of strands called cardiogenic cords that quickly form a hollow lumen and are referred to as endocardial tubes

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3
Q

The fusion of the endocardial tubes (day 22) differentiate into these 5 things

A
  1. truncus arteriosus
  2. bulbs cordis
  3. primitive ventricle
  4. primitive atrium
  5. sinus venosus
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4
Q

Embryology between how many days

A

20-40 days

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5
Q

Paired vascular tubes results in

A

a single tube

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6
Q

Vascular tubes:
1. Aortic arches form what?
2. sinus venous forms what?
3. cardiac loop forms what?

A
  1. aortic arches form the great vessels, carotid, and pulmonary arteries and the ductus arteriosus
  2. sinus venous: forms the IVC/SVC, pulmonary veins, coronary. sinus, and posterior portions of RA
  3. Cardiac loop: forms primitive atrium, ventricle and bulbus cordis
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7
Q

D-looping is to the ________ (direction)

A

RIGHT (anatomically correct)
It is normal folding. The right ventricle is rightward and anterior to the left ventricle…

RIGHT ventricle is on the RIGHT side

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8
Q

When looping is reversed, it is referred to as

A

L-Looping
LEFT ventricle is on the RIGHT side

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9
Q

development of the right atrium The right atrium develops from most of the _______ and part of the ________.

A

primitive atrium, sinus venosus

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10
Q

The left sinus horn becomes the

A

coronary sinus

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11
Q

The right sinus horn becomes the

A

inferior vena cava

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12
Q

In abnormal development of the left sinus horn, it does not become the coronary sinus but instead becomes the

A

Left Superior Vena Cava

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13
Q

The left atrium develops from a small part of the _______ (_______). THEN… this grows toward the primitive left atrium

A

primitive atrium (sinoatrial orifice)
Then, the common pulmonary vein grows toward the primitive left atrium

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14
Q

development of pulmonary veins the pulmonary veins begin as a _________ entering the LA. As the LA grows, it absorbs the _____________, absorbing all the way to the _____ branches.

A

single vein, single pulmonary vein, four

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15
Q

This tube, made from the bulbus cordis and truncus arteriosus and allowing outflow from the heart, needs to be split in order to form the _________ and _________.

A

aorta, pulmonary trunk

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16
Q

What happens around the 5th week in regards to septation of the outflow tracts? what separates them?

A

Around the 5th week, ridges appear in the truncus and conus cordis, as swelling grow together they twist around each other.

Fusion* separates truncus into aorta and main pulmonary

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17
Q

Failure of aortopulmonary septum to separation gives rise to persistent

A

truncus arteriosus

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18
Q

formation of aortic arches the aortic sac gives rise to a total of how many pairs of arteries?

A

six pairs

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19
Q

formation of aortic arches which pair disappears at a very early stage?

A

fifth pair

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20
Q

formation of aortic arches what does the first arch contribute to?

A

maxillary, hyoid. and stapedial arteries (same as 2nd)

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21
Q

formation of aortic arches what does the second arch contribute to?

A

maxillary, hyoid, and stapedial arteries (same as 1st)

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22
Q

formation of aortic arches. what does the 3rd arch form?

A

common carotid artery and part of the proximal internal carotid artery

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23
Q

formation of aortic arches what does the 4th arch form?

A

right arch forms right subclavian artery

left arch forms part of aortic arch

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24
Q

formation of aortic arches what does 5th arch form?

A

either never forms, or forms incompletely and regresses

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25
Q

formation of aortic arches what does 6th arch form?

A

right arch forms right pulmonary artery

left arch forms left pulmonary artery and ductus arteriosus

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26
Q

In utero, the fetus has a ________ systemic resistance and a _______ pulmonary resistance.

A

LOW SYSTEMIC RESISTANCE
HIGH pulmonary RESISTANCE

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27
Q

in fetal circulation, the shunts are all (what direction)

A

right to left

ductus arteriosus is right to left
foramen ovale is right to left

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28
Q

what happens with the first breath? (4)

A
  1. pulmonary artery pressures drop
  2. O2 levels in aorta rise
  3. closes the ductus arteriosus
  4. increased pulmonary blood flow raises the LA pressure closing the foramen vale
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29
Q

post natal (after birth) the systemic circulation is ______ and the pulmonic circulation is _____.

A

systemic is high
pulmonic is low

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30
Q

situs means

A

site or position

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31
Q

solitis means

A

usual or normal

32
Q

situs solitus

A

normal position

33
Q

inversus means

A

opposite or reverse of normal

34
Q

situs ambiguous

A

uncertain, indeterminant, what the heck???

35
Q

normal situs… the normal arrangement for the organs… what is left sided?

what is right sided?

A

left sided: spleen, pancreas, stomach, sigmoid colon

right sided: liver, cecum, appendix

right main bronchus is short, left is longer

36
Q

what are a few things that can go wrong with abdominal situ ambiguous

A

the abdominal organs are abnormally symmetric and inconsistent

spleen may be absent, liver may be midline, both lungs may both have 2 or 3 lobes

37
Q

situs ambiguous is associated with

A

HETEROTAXY

38
Q

with heterotaxy syndrome, the incidence is _____ births with a male to female ratio of _______

A

1 in 10,000 births
male to female ratio of 2:1

39
Q

what is heterodoxy syndrome

A

a condition in which the internal organs are abnormally arranged in the chest and abdomen

it’s a collection of disorders usu involving the following organ systems (heart, stomach/intestine, spleen and liver)

40
Q

Asplenia is more _________ than polysplenia

A

common

41
Q

2 kinds of heterotaxy:

A
  1. right atrial isomerism/asplenia
  2. left atrial isomerism/polysplenia
42
Q

right atrial isomerism / asplenia

A

refers to BILATERAL structures both of which have morphologic right characteristics, such as morphological right atrial appendages, morphological right bronchi, and bilateral tri-lobed lungs. Could have problems with valves and septal defects, particularly pulm valve… may also have pulmonary venous connections. spleen may be absent and the liver and other organs on other side of body

43
Q

left atrial isomerism / polysplenia

A

refers to bilateral structures both of which have morphological left characteristics such as morphological left atrial appendages, left bronchi, and bilateral bi-lobed lungs. may have septal defects as well as problems with valves and the electrical system. Some have complete heart block. No spleen or many small spleens.

44
Q

3 positions of heart in thorax

A

levocardia (think “L” is left)

mesocardia (think “M” for middle)

dextrocardia (think “D” that’s my name and I’m always “right”)

45
Q

what is cardiac malposition

A

abnormal location of the heart relative to the position (situs) of the abdominal viscera

46
Q

out of the 3 heart positions in the thorax, which one is normal

A

levocardia

47
Q

2 kinds of dextrocardia

A

primary and secondary

48
Q

whats the difference between primary and secondary dextrocardia

A

primary - due to a congenital heart defect. In primary dextrocardia the apex usu. points to right

secondary - heart is pushed or pulled toward the right due to an extracardiac abnormality (emphysema, hernia) Apex may point to the left or right

49
Q

atrial situs ambiguous… there is no_______. What else… any other involvements with vessels?

A

commonly there is ONE atria due to NO septum. IVC can be interrupted. Can be. bilateral SVC. Coronary sinus can be unroofed (meaning IVC drains into coronary sinus and may look like IVC/LA connection)
***can’t use pulm. veins to identify left atrium bc could. drain into something else

50
Q

ventricular concordance, av concordance is.

A

normal

disconcordance is abnormal *study images

51
Q

what is. the infundibulum

A

it is the connecting segment between the ventricles and the great arteries

smooth-walled portion of right ventricle directly below pulmonary valve

aorticopulmonary septum: division b between aorta and pulm trunk formed from the bulbar ridges

52
Q

IVC is usu ______ and to the right of the _______

A

anterior, aorta

53
Q
A
54
Q

levocardia is normal heart position. true or false

A

true

55
Q

The shunts are all ______ to _______ in utero

A

right to left

56
Q

resting HR for EKG pediatrics

A

90-190 bpm

57
Q

transdx for newborn, what frequency

A

7.5 Mhz or higher… 12 is ideal

  • for comparison, teenage to adult is 2-2.5 MHz
58
Q

atrial shunting can be best evaluated from what view(s)

A

subxiphoid (subcostal) long-axis or short-axis views of atrial septum (bicaval)

59
Q

patency of IVC in what view

A

subcostal long axis

60
Q

high left parasternal ductal view how to get

A

high parasternal about one rib space up from the PA view…. from PLAX view rotate transdx 30-45 degrees counterclockwise… this aligns beam with ductus for patent ductus arteriosus view

61
Q

the pulmonary artery sits _____ and _____ to the aorta

A

anterior and to the left (anatomical)

62
Q

in older adults over 60, what gland atop the heart is mostly replaced by fat

A

thymus

63
Q

the left atrial appendage can often be mistaken for the

A

left upper pulmonary vein

64
Q

the pulmonary veins are best evaluated in what view

A

a high left parasternal or suprasternal short axis view (crab view)

65
Q

USU do not measure what function in children.

A

left ventricular

66
Q

for linear measurements in children, where should you. measure for LV internal diameter

A

Short axis @ MV leaflet tips

As opposed to adults, parasternal long axis views are recommended instead

67
Q

LA volumes measured at what part of cardiac cycle

A

end-systole before MV opens

68
Q

Most. common spot for an aortic arch coarctation

A

aortic isthmus

69
Q

Measurement. of arterial vessels should be made at what point. in cardiac cycle

A

during mid-systole or at their most expanded

70
Q

endocarditis of Lupus involves typically what valves

A

MV and TV

71
Q

Myocardial toxicity in it most severe form causes

A

potentially fatal CHF

72
Q

Most frequently associated cardiac abnormality with muscular dystrophy is

A

cardiomyopathy either Duchenne (CM) or Becker’s (DM)

73
Q

Lupus can manifest as these conditions of the heart

A

myocarditis
pericarditis
endocarditis

74
Q

rheumatic fever commonly affects what valves and can cause what

A

AoV and MV

can cause myocarditis with impaired function

75
Q

lutembacher syndrome is a combo of

A

mitral stenosis and left-to-right atrial shunt (can be. congenital or acquired)

76
Q

other than the subcostal view, what other view is great to see the pulmonary veins

A

suprasternal

77
Q
A

fall '24 exams (6 decks)

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