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NURS743 Fetal Eval > QUIZ 4 > Flashcards

QUIZ 4 Flashcards

1
Q

What occurs during GA week 1?

A

blastocyst implantation

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2
Q

What occurs during GA week 2?

A

blastocyst organizes into inner cell mass, which creates bilaminar disc

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3
Q

What occurs during GA week 3?

A

bilaminar disc under goes gastrulation –> forms trilaminar disc

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4
Q

What occurs during GA week 4?

A

later body and cephalocaudal folding; neurulation

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5
Q

What are the 3 germ layers after gastrulation occurs?

A

1) ectoderm
2) mesoderm
3) endoderm

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6
Q

Where is the trilaminar disc located?

A

B/W amniotic cavity and yolk sac

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7
Q

What occurs to the trilaminar embryo at GA 18 days?

A

1) neuralation
2) lateral body folding
3) cephalocaudal (head and tail) folding

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8
Q

Name steps of fetal heart development

A

1) single heart tube formation
2) single heart tube convolution
3) fetal heart septation
4) septation and spiraling of truncus arteriosus into great vessels

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9
Q

What occurs during lateral body fusing?

A

two endocardial heart tubes fuse

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10
Q

What occurs during cephalocaudal folding?

A

developing heart positioned in thoracic region

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11
Q

Which parts of the single heart tube convolute to become the aorta and pulmonary artery?

A

1) aortic arches

2) bulbus cordis/truncus arteriorosus

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12
Q

Which parts of the single heart tube become vena cava?

A

primitive veins in sinal horns

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13
Q

What will the primitive ventricles become?

A

4 chambers of the heart

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14
Q

When does septation occur?

A

by GA 37 days

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15
Q

What occurs during septation?

A

establishment of 4 chambers of heart

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16
Q

What does septation require?

A

endocardial cushions

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17
Q

What does the endocardial cushion become?

A

1) mitral valve
2) triscuspid valve
3) lower atrial wall
4) upper ventricular wall

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18
Q

Name 3 atrial septal defects (ASDs)

A

1) foramen ovale (ostium secundum) defect = most common
2) low ASD (ostium primum)
3) upper ASD (sinus venosus)

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19
Q

Name 2 ventricular septal defects (VSDs)

A

1) membranous VSD = most common

2) muscular/infundicular VSD

20
Q

Name 2 atrioventricular canal defects (AVSDs)

A

1) complete AVSD

2) partial AVSD

21
Q

What defect is highly associated w/ complete AVSD?

A

trisomy 21

22
Q

What is the outcome of spiraling of the truncus arteriosus?

A

1) aorta aligned w/ L ventricle

2) pulmonary artery alined w/ R ventricle

23
Q

What are the 4 defects that contribute to tetralogy of Fallot (TOF)?

A

1) VSD
2) obstructed R ventricular outflow
3) aorta that overrides VSD
4) R ventricular hypertrophy

24
Q

Summarize TOF

A

unequal septation of truncus arteriosus –> large aorta, small pulmonary artery, high-lying VSD

25
Q

Describe transposition of the great arteries (TGA)

A

truncus arteriosus does not spiral –> aorta off R ventricle; pulmonary artery off L ventricle –> blood never gets oxygenated

26
Q

Describes persistent truncus arteriosus

A

truncus arteriosus does not septate –> single great artery that receives blood from both ventricles

27
Q

List the steps of pulmonary development

A

1) pseudoglandular period: formation of larynx and trachea
2) canalicular period: formation of bronchi and bronchioles
3) terminal sac period: formation of lungs*
4) alveolar period: formation of true alveoli

28
Q

From which tube are the larynx and trachea derived?

A

endoderm of gut tube

29
Q

How does trachoesophageal fistual/atresia develop?

A

incomplete separation and fusion of trachea and foregut

30
Q

When does agenesis of the lung occur?

A

failure of larynx to divide into bronchial buds

31
Q

What are 2 defects that can occur during the canicular phase?

A

1) bronchogenic cysts
2) pulmonary paranchymal cysts
3) cystic adenomatoid malformation (C-CAM) = most common
4) congenital lobar emphysema

32
Q

What occurs during the terminal sac period?*

A

1) terminal sacs form (capable of gas exchange)
2) number of capillaries increase
3) capillaries approach respiratory epithelium
4) epithelium becomes squamous cells

33
Q

How do steroid growth factors affect the terminal sac period?

A

Stimulate…:

1) bronchial divisions and vasculature
2) epithelium and connective tissue development

34
Q

What 4 structures form the diaphragm?

A

1) lateral body wall mesoderm
2) septum transversum
3) dorsal mesentery of esophagus
4) pleuroperitoneal folds

35
Q

type 1 alveolar epithelial cells

A
  • make up squamous epithelium of early alveolar period of terminal sac period
  • permit gas exchange @ 25-26 weeks
36
Q

type 2 alveolar epithelial cells

A

develop and produce surfactant

37
Q

When is the alveolar period?

A

28 weeks GA to early childhood

38
Q

What occurs during the alveolar period?*

A

1) formation of true alveoli
2) fetal breathing movements occur
3) lungs making fluid

39
Q

Why may there be an absence of fetal breathing movements?

A

1) neurologic problems
2) polyhydramnios
3) oligohydramnios

40
Q

What can result from the absence of fetal breathing movements?

A

pulmonary hypoplasia: reduced number of bronchioles, terminal bronchioles, alveoli, and arterioles

41
Q

lung disease of prematurity

A

AKA respiratory distress syndrome AKA bronchopulmonary dysplasia

  • absence of alveoli and underdeveloped terminal sacs
  • thick, cuboidal epithelium
  • wide area b/w air-spaces and capillaries
  • surfactant deficiency d/t immature type II pneumocytes
  • arrested alveolar development –> large, underdeveloped alveoli –> less capable of gas exchange
  • reactive bronchi and bronchiole smooth muscle –> obstruction
  • inflammation and pulmonary edema
  • interstitial fibrosis w/ cystic changes
  • chronic hypoxemia –> pulmonary HTN
42
Q

Why is meconium irritating to bronchial and alveolar tissue?

A

b/c it is lipid and protein rich

43
Q

What occurs if meconium is inhaled during the birthing process?

A
  • inflammatory broncho-constriction
  • chemical pneumonitis
  • inactivates surfactant
44
Q

What causes diaphragmatic hernia?

A

incomplete fusion of developing diaphragm tissues –> allows herniation of GI structures into thoracic cavity

45
Q

What is the effect of diaphragmatic hernia?

A

no space for lung to develop = leading cause of lung hypoplasia

NURS743 Fetal Eval (5 decks)

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