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Neonatal Physiology > Test 4 - GI, Neuro, immunology, endocrine > Flashcards

Test 4 - GI, Neuro, immunology, endocrine Flashcards

1
Q

When does the Gi tract start to develop? and it progresses from Cranial-to-caudal

A

4th week

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2
Q

By the 4th week, what is present?

A

Intestine and liver

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3
Q

By what week does the urorectal septum fuse with the cloacal membrane which separates the rectum from the bladder

A

Week 7

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4
Q

What anchors the liver to the anterior abdominal wall?

A

falciform ligament

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5
Q

When is the diaphragm complete and the intestinal vili developes?

A

Week 8

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6
Q

When do the intestines re-enter the abdominal cavity?

A

Week 9-10

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7
Q

When do the pancreatic islet cells appear?

A

Week 12

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8
Q

When do the nerve cells start to innervate the bowel - neural crest cell colonize gut? This is where hirschsprung’s disease may form.

A

Week 13

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9
Q

When is meconium present and swallowing present?

A

Week 16

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10
Q

What are four major functions of the Enteric Nervous System?

A

Motility
Microcirculation
Secretions
Immune Respones

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11
Q

When is the sucking/swallowing coordinated?

A

34-36weeks

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12
Q

What is when the ventral bud of the pancreas encircles the duodenum which causes occlusion?

A

Annular Pancreas

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13
Q

At what week can esophageal atresia or stenosis form d/t failure of the lumen to recanalize?

A

Week 8

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14
Q

By what week does the midgut herniate into the umbilical cord and when does it return to abd cavity?

A

6 weeks - 10 weeks

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15
Q

When does omphalocele and gastroschisis usually appear?

A

Week 8-11weeks

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16
Q

When the rectum ends above the puborectails muscle?

A

anorectal agenesis

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17
Q

When the rectum ends below the puborectails muscle?

A

anal agenesis

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18
Q

The failure of the neural crest cells to migrate to the distal colon (lack of ganglion cells in the sigmoid colon and rectum)

A

Hirschsprung’s disease

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19
Q

What are infants more at a risk for if they have Hirschprung’s disease?

A

Hearing loss and decreased peripheral nerve function?

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20
Q

What is when the colon, urinary, and genital systems all empty via one common channel.

A

Cloacal Extrophy

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21
Q

When is the anatomy of the GI tract developed?

A

20weeks

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22
Q

When is bile metabolism start and when does it start to be secreted?

A

11 week and 22 weeks

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23
Q

The gut is initially sterile but gut colonization is needed for…

A

vit K

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24
Q

NB have limited digestion and absorption of what three main things?

A

CHO, fats, proteins

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25
Q

What is the main site of hematopoiesis by type II cells?

A

Liver

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26
Q

By the 3rd month, the liver must start to synthesis ____ and ____ so help keep the infant’s Bld glucose stable.

A

Cholesterol and glycogen

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27
Q

What are the three sources the liver receives blood from?

A

hepatic portal vein, hepatic artery, and UVC through Ductus Venosus

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28
Q

What organ metabolises CHO to glucose (galactose->fructose->glucose)

A

Liver

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29
Q

What is bilirubin comprised of?

A

the end product of heme degredation and hemoglobin from dead RBCs

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30
Q

What are the three components when Hgb is brokendown?

A

Iron - stored in the body
CO - exhaled
Biliverdin - bkdn into unconjugated bilirubin

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31
Q

What type of bilirubin binds to albumin -> goes to liver (water soluble form) ->to intestines -> excreted in stool

A

Conjugated bilirubin

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32
Q

What is when congugated bilirubin is converted back to unconjugated bilirubin which is reabsorped back into the liver

A

enterohepatic re-circulation

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33
Q

What are three main causes of poor binding of bilirubin to get excreted?

A

low albumin
drugs - compete for binding sites
pH

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34
Q

What is indirect bilirubin? physiologically rises slowly in the NB

A

Unconjugated bilirubin

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35
Q

What is direct bilirubin? freely removed. levels increase when bile flow is obstructed.

A

Conjugated bilirubin

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36
Q

When a small amt of unconjugated bilirubin is not bound to albumin and could cross the BBB leading to neuronal damage?

A

Free bilirubin

37
Q

Elevated levels of AST and ALT may indicate ____ ____.

A

hepatocyte damage

38
Q

What is the most abundant plasma protein? the level is decreased in a damaged liver = puffy

A

Albumin

39
Q

What enzymes catalyze oxidation-reduction reactions and also assess hepatic injury in the neonate?

A

dehydrogenase

40
Q

What are the 4 coagulation proteins that are produced in the liver?

A

prothrombin, factor 7 and 10, and vit K

41
Q

What are two key liver enzymes that metabolize drugs. expressed gradually making drug metabolism sluggish in neonates.

A

CYP450 and glucoronyl transferase

42
Q

What organ produces >25 digestive proteins and is immature at birth.

A

Pancreas - dorsal is much larger than the ventral segment

43
Q

When overstimulation of the islet cells from a diabetic mother leading to hypoglycemia.

A

Hyperinsulinemia

44
Q

What cell type has glucogon? insulin? and somatostatin (islet cells of the pancrease)

A

Alpha
Beta
Gamma

45
Q

When is the primary Neurulation of the fetal brain?

the Dorsal induction.

A

3-4weeks gest

46
Q

Myelination usually occurs when and continues for years postnatally?

A

Birth

47
Q

When is the Gyri formed? so you must wait if you are uncomfortable at 35 weeks.

A

38weeks

48
Q

How do the neural folds fuse? a zipper

A

From cephalic to caudal direction; from the center to the head and butt

49
Q

When does the neural tube close?

A

By the 4th week

50
Q

What is seen when there is a possible open neural tube defect? Levels peak at 10-14 wks and decrease with increaaing GA

A

Alpha-fetoprotein

51
Q

What NTD in the crainial area fails at 24-25days. The exposed brain tissue become necrotic from the A.F

A

Anencephaly

52
Q

The failure of the Caudal part to close. a bony defect with the herniation of meninges and brain tissue thru the skull.

A

Encephalocele

53
Q

When failure of the Neural tube to fold over but the back is still closed. Could have a tethered cord.

A

SpinaBifida Occulta

54
Q

NTD with a sac full of meninges, spinal cord, or both. Three different types of NTD is in this group.

A

Spina bifida cyctica

55
Q

S.B cyctica that has a sac with nerve roots, meninges, and CSF. Neurologic defect below the level of the sac

A

Meningomyelocele

56
Q

S.B. Cyctica with a sac of just CSF and meninges. Better prognosis.

A

Meningocele

57
Q

The most sever form of SB cyctica. Can be entire length of spinal cord.

A

Myeloschisis

58
Q

The downward displacement of the cerebellar which can cause a blockage of CSF leading to Hydrocephalus. Cerebellat tonsils are pulled through the foramen magnum.

A

Arnold-Chiari malformation

59
Q

What stage is between 5-6weeks when the brain divides into the forebrain and midbrain

A

Prosencephalic development

60
Q

When does neuronal proliferation begin and it peaks at _____ wks?

A

begins at 8 week and peaks - 12wks

61
Q

What are the two last areas for neuronal growth?

A

Cerebellum and cerebrum

62
Q

What is when there is a decrease in the size OR number of neuronal-glial cell units? assoc. with ETOH, cocaint, PKU, and radiation

A

Microencephaly

63
Q

When do the neurons reach thier permanent loaction. Differentiation is still occurring.

A

28 wks

64
Q

When dose myleinization begin and peaks?
Peripheral NS:
Central NS:

A

Begins at 20wks and peaks at 6-1year old
PNS - motor ->sensory
CNS - Sensory -> motor

65
Q

What can malnutrition lead to?

A

hyoplasia of cerebral white matter and decreased myelinization

66
Q

What brain part has rapid growth from 24-40 weeeks. Injury to this decreases language, behavioral and cognitive function

A

Cerebellar development

67
Q

VISION:
myelinization of optic nerve?
visual attention?

A

optic nerve - 25 weeks

attention - 30-32 weeks

68
Q

How does motor tone develop? and they increase with gest age

A

Develops from tail to head

and from distal-proximal

69
Q

What are four major categories an infant must have for autonomic regulation? CNS system is intact

A

sustaining respiration, stable HR, stable temp, and food feeding techniques

70
Q

Where is the most common source of IVH? and usually caused by asphyixa with reperfusion and birth trauma.

A

Subependymal germinal matrix

71
Q

MAP -ICP = ____ and it increases with G.A.

A

Cerebral perfusion pressure

72
Q

At what age do infants respond to taste and smell?

  • auditory processing
  • pupillary responses
  • awake visual attention
A

taste - 36
auditory - 30
pupillary - 29
visual - 30

73
Q

What refers to the brain changes in response to external experiences, ex: repeated/inappropriate stimulation

A

brain plasticity

74
Q 
Reflex:
appears: 28-32 weeks
disappears:6 months
asymmetry = brachial plexia injury
nonhabituation = cerebral injury
A

Moro

75
Q

Reflex:
appears: 28 wks
disappears: 2 months
nonhabituation = cerebral injury

A

Palmar grasp

76
Q

Reflex:
appears: 35 wks
disappears: 7 months
nonhabituation = cerebral abnormalities

A

Tonic neck

77
Q

What is under developed and is not consistant with the demands of the environment? Sensory overload.

A

CNS development

78
Q

What is when the necrotic changes in white matter that follows an ischemic episode? ongoing hypoxic episodes.

A

Periventricular Leukomalacia

79
Q

When necrosis of neurons in the cortices of cerebrum and cerebellum occurs. Free radicals are formed from re-perfusion

A

HIE - hypoxic-ischemic encephalopathy

80
Q

What involves massive discharge of neurons and intense energy consumption. Hypoxia, hypoglycemia, and other metabolic changes occure in the CNS

A

Seizures

81
Q

When does the WBC production shift to the bone marrow?

A

12th week

82
Q

When does the thymus development begin and when d the lymphocytes appear in the thymus?

A

4th week and then the 8th week

83
Q

What is the main mission of the immune system?

A

Detect, destroy, and eliminate foreign materals.

84
Q

What is the response of the immune system when the body is exposed to a foreign antigen?

A

Active immunity

85
Q

What is the acquired immunity that results from active immunity? Memory cells are established.

A

Adaptive immunity

86
Q

What are the cell-mediated factors that includes helper cells, cytotoxic cells, and suppressor cells?

A

T lymphocytes

87
Q

What are the humoral factors that includes all the immunoglobulins (IgG, IgD, IgM, IgE, IgA)

A

B Lymphocytes

88
Q

Which immunity has memory? The body remembers the particular invader so the response is higher the 2nd go round.

A

Adaptive immunity

89
Q

What are proteins that react with specific antigens. They bind to invading pathogens to be reecognized as a foreign

A

Antibodies

Neonatal Physiology (3 decks)

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