Physiology Of The newborn Flashcards
Who is a new born?
“A live baby born either normal or as high risk irrespective of gestational age”
Categories of newborns
1.Based on Gestational Age(GA)
Preterm ____ completed weeks GA
Term ________ completed weeks GA
Post term- ______ weeks GA and above
<37
37 - 41
42
Categories of newborns
Based on Birth Weight
Normal birth weight (_________ and above) Low birth weight (less than _________)
2500g
2500g
The fetus has a recognizable human form by the ———- week of development.
The vital organs are not sufficiently developed to sustain life outside the uterus until the ___________ month. While in the womb, the fetus is especially susceptible to the effects of ________,__________, and ____________ .
12th
seventh
drugs ; alcohol ; X rays
Physiological adaptations
About ______% of newly born babies make the transition from intrauterine to extrauterine life without difficulty
Approximately _____% will require some assistance to begin breathing at birth
About _____% will need extensive resuscitative measures to survive
90%
10%
1%
Fetal circulation
Fetal circulation= dependency circulation with the fetal lungs mostly ____________ (only _____% blood) due to increased resistance by __________________ blood vessels.
bypassed; 10
constricted alveolar
Presence of 3 shunts in fetal circulation:
Patent __________
Patent _____________
Patent _________________
ductus venosus
foramen ovale
ductus arteriosus
At birth
Newborn no longer connected to placenta..hence will depend on the ________ as the only source of oxygen
Baby cries and takes first breath, …. and more breaths….
The ______ taken displaces the _______ in the lungs
With the air the constricted pulm vessels _________ and _________ in the lungs decrease–flow
Blood flow through the _________ subsequently reduces
lungs ; air ; fluid
relax ; resistance
ductus arteriosus
RESPIRATORY SYSTEM
FETAL LUNGS
Filled with respiratory _________
Metabolic functions; Production of _________
Occasional _________
Fluid
surfactant
gasps
Normal transition
No ___________
Breathing/crying
Good muscle tone
Heart rate >_______
______ color
Term
No meconium
100
Pink
Thermoregulation; Anatomic factors
______ surface area
_______ adipose tissue
_______ epidermis
______ humidity and ______ current
Presence of ________ on neonates body
Ambient temp. at birth ______ than intrauterine environment
Large
Less
Thin; low; fast air
fluid; cooler
Thermoregulation : Environmental factors
List 4
Evaporation
Conduction
Convection
Radiation
Newborn responses to temp
Hypothermia
Vaso__________
Increased________
Increased _____________
____________ thermogenesis
constriction
Metabolic Rate
Muscular activity
Non shivering
New born responses to temp
Hyperthermia
Vaso__________
Increased ________
Increased __________
dilation
O2 consumption
water loss
IMMUNOLOGIC ADAPTATIONS
Immunoglobins –
20th
crosses placenta; does not cross placenta
Vernix caseosa, skin & mucus membrane
Immunological adaptations
WBC has _____ capacity to produce antibodies with reduced phagocytic activity, therefore newborn is _______ susceptible to infections
RE system – Produces __________,_________,____________, and _____________.
less
more
neutrophils, monocytes, eosinophils & lymphocytes
HAEMATOLOGIC SYSTEM
Blood formation as early as _______ wk after conception
(Low or High?) rbc mass
At birth, _____ Hb due to __________~____g/dl.
Starts to drop on the _______ day of life until a minimum of ____-____g/dl on the ________ month of life – PHYSIOLOGIC ANAEMIA
3rd wk ; High
high ; relative hypoxia
20g/dl. ; 3rd
10-12g/dl ; 2nd-3rd month
Hematological system in new horns
PHYSIOLOGIC ANAEMIA - a result of the following:
_____ease in bone marrow activity
______ease in rate of hemolysis
______________ due to rapid expansion of blood volume
Normal blood volume ranging about _______ml/kg
WBC count-_______-_______ /mm3 with ____________
Decrease
Increases
Hemodilution
80
10,000-30,000; PMN
Renal adaptations
Structurally __________ , functionally __________
_______ voiding (_____x dly) for __________ days
Inability to __________ urine leading to susceptible to __________, __________, __________
mature ; immature; Frequent
7-10x ; 15 – 20 days
concentrate ;dehydration
acidosis ; electrolyte imbalance
Renal adaptations
Urine – Specific Gr ________ , _____ colour, ______ smell till ________ months
Total volume – ________ ml/ 24 hrs (________ ml /Kg per 24 hrs).
Physiologic weight loss of ~_____% of birth weight by ________ week due mainly to postnatal ________, also passage of ________, reduced calories.
1.000 ; no colour ; no smell ; 2 – 3
200 – 300ml
15 to 30 ml
10%
diuresis ; meconium
Central nervous system
(Slow or Rapid?) growth brain with peak near birth
Newborn’s brain – _____% of adult size.
Incomplete ____________ of nerve fibres.
_______________ disappear when nervous system develops.
________ and ____________ co-ordinate vital respiratory & cardiac functions
Rapid ; 25%
myelination ; Primitive reflexes
ANS ; Brainstem
Sensory adaptation
Vision :
immature
immature
Poor; hypermetropia
present ; present
Sensory Adaptation
Tear glands :
2 – 4 weeks
loud noise ; startle
Can
MUSCULO-SKELETAL ADAPTATIONS
Bones – ________ continues
Nose – Mostly _________. Frequently _________
Skull bones – (soft or hard?) bones with open sutures
Sinuses – (completely or incompletely?) formed
Muscular system (completely or incompletely?) formed – Grows in size
Ossification ; cartilaginous
flattened; soft
incompletely ; completely
GIT adaptation
Mature mostly all over.
Some salivary glands functional
Liver (mature or immature?) at first. Deficient in
–_________ enzyme leading to ______________
-decreased __________ stores Hypoglycemia
Immature
Glucoronyl; Physiological jaundice
Prothrombin & coagulation factors
Glycogen
GIT adaptation
Stomach capacity – _____ml, emptying 2 1⁄2 - 3 hrs, (slow or rapid?) peristalsis & digestion
Enzymes – Adequate for proteins & simple sugars. Pancreatic _________ deficient
90 ; rapid
amylase
GIT adaptations
Bowel movement – Frequent (7- 10), (solid or semi solid?)
Intestines – (Smaller or Larger?) in relation to body size, (less or more ?)no of secretory glands, (more or less?) surface area for absorption
Cardio-esophageal sphincter –__________, leading to (____________)
Meconium – (Amniotic fluid, mucus, bile pigments, fatty acids, epithelial cells , blood) – first ______ days
Transitional stool – By ________ day (colour, consistency, odor)
semi solid
Larger :more ; more ;Relaxed
Regurgitation ; 3 days
4th day
GIT
Birthweight is regained by _______ days in term infants , _______days in well preterms
Birthweight doubles by ______mths
Triples by _____mths
Daily wt gain (10 – 15g/kg) 20 - 30gm with adequate caloric intake
7 – 10; 10 – 14
4 – 6
12
Fluid
Term. ____-___ mls/kg/day
Prem. ___-____ml/kg/day.
60-70
80-90
Endocrine System
The ____________ axis and ____________ function separately from that of the mother to ensure adequate growth of newborn.
Peculiarities in the fetus:
____________ ____________ effects
_____ urinary 17-ketosteroid
With maternal oestrogen, breast enlargement and occasional milk production occur
pituitary adrenal ; thyroid gland
Maternal estrogenic effects
Increased
PROBLEMS OF LOW BIRTH WEIGHT
Hypo_____
Hypo________
Hypo_________
Poor ________
Apnea
Prolonged ________
Decreased ______
Hypothermia
Hypoxia
Hypoglycemia
Weight gain
NICU stay
Bonding
Pathology
Respiratory
• Respiratory __________
• _____________ syndrome
• Apnoea
•___________ aspiration
distress
Resp distress
Meconium
Pathology
Central nervous system
• ________________
• Intraventricular haemorrhage
• ____________
Perinatal asphyxia
Seizures
Pathology
Cardiovascular
_____________
Pulmonary hypertension of the newborn
_____________ diseases
Patent ductus arteriosus
Congenital heart
Pathology
Haematology
•Neonatal __________
• Neonatal _______
•____________
• Vit K deficiency
jaundice
Sepsis
Anaemia
