Peds Ch 2 Flashcards
when does anterior fontanel close
between 9 and 18 months of age
when does the posterior fontanel close
by 2-4 months of age
when does first tooth erupt
approx 6 months
what do the epiglottis and vocal cords look like in a neonate patient
long, omega-shaped epiglottis and the pearly white vocal cords in the neonate.
when does the respiratory system begin to develop
begins during week 4 of gestation
The critical event in the change from placental to pulmonary gas exchange is the first inspiration, which initiates ….. (3)
- pulmonary ventilation
- promotes the clearance of lung fluid
- triggers the change from the fetal to the neonatal pattern of circulation.
transpulmonary distending pressure of first breath
pressure of 40 to 80 cm H2O
TTN lasts for how many hours
24 to 72 hours
X-ray of TTN
characteristic chest radiographic appearance consisting of:
- increased perihilar markings
- fluid in the interlobar fissures
- streaky linear opacities in the parenchyma
With the onset of pulmonary ventilation, ____________ blood flow sharply increases.
pulmonary
what happens to PVR & peripheral systemic vascular resistance at the onset of pulmonary ventilation
PVR ↓
↑pulmonary blood
____________ causes an immediate closure of the flap valve mechanism of the foramen ovale and reverses the direction of shunt through the ductus arteriosus
increase in systemic afterload
what blood gas parameters change immediately after birth
the partial pressure of oxygen in arterial blood (PaO2) and pH are reduced, whereas the PaCO2 is increased immediately after birth
what is the principal factor that determines lung compliance?
volume
adult total lung capacity vs pediatric
Adults have a much greater total lung capacity (TLC) than infants
what relationship converts a small tension into a large pressure gradient
the Laplace relationship
how can the neonate ↑ FRC
by exhaling against a closed glottis.
who has higher airway resistance, term neonates or preterm?
preterm
tracheal compliance in neonates…
is twice that of adults and appears to be a consequence of cartilaginous immaturity
where does PaO2 act mainly to control ventilation?
mainly through peripheral chemoreceptors in the carotid and aortic bodies
where do PaCO2 and pH act to control ventilation?
on central chemoreceptors in the medulla
an infant’s response to hypercapnia is not potentiated by ____________
hypoxia
what depresses respiration in the neonate
high concentrations of oxygen
t/f periodic breathing is uncommon in neonates
FALSE, its common
There is a general consensus that infants may be at risk for postoperative apnea up to ____________
60 weeks after conception
how does fetal hemoglobin shift at birth
the increased fetal hemoglobin content shifts the curve to the left of the adult curve
Autonomic control of the heart in utero is mediated predominantly through the ____________ nervous system
parasympathetic
what extremity is the pediatric blood pressure higher in
blood pressure measured in the lower extremity is less than in the upper extremity in children
what kind of infants have reduced blood pressure
infants with birth asphyxia and those who require mechanical ventilation
what does the large cardiac output in neonates reflect
their greater metabolic rate (on a weight basis) and oxygen consumption compared with adults
at birth, how is the QRS axis
right sided, reflecting the predominant right ventricular intrauterine development
when does urine production begin in utero
10-12 weeks of gestation
All normal neonates should void by ____________ after birth; otherwise, they should be investigated for anomalies including posterior urethral valves
48 hours
fetal blood gas in utero
In utero, the fetus maintains a mild respiratory acidosis, with a similar plasma bicarbonate concentration, but a greater PaCO2 than its mother.
Most umbilical venous blood from the placenta passes through the ____________ to the inferior vena cava.
ductus venosus
In fetal life, the main serum protein is ____________
alpha- fetoprotein
how does phototherapy work
Phototherapy reduces serum bilirubin concentrations by converting bilirubin through structural photoisomerization and photooxidation into excretable products
the placenta is impermeable to what 2 hormones
insulin and glucagon
The normal range of hemoglobin in the neonate is ____________
14 to 20 g/dL.
Infants with anemia of prematurity have an inadequate production of ____________
erythropoietin
baby can support head at..
3 months
baby can sit alone at…
6 months
baby can stand alone at…
12 months
kid can balance on one foot at…
3 years
