Week 8: PEDS Cardiac Flashcards
What parts of fetal circulation are unique to it specifically
Foramen Ovale
Ductus Arteriosus
Umbilical Vein
2 Umbilical Arteries
How does blood move in the fetus
Enters the baby from the umbilial vein –> umbilical vein joins the inferior vena cava –> goes to right atrium –> blood diverted from lungs through the foramen ovale –> left atrium then left ventricle –> aorta –> body gets O2
blood return to right atrium –> right ventricle –> pumped to pulmonary artery –> ductus arteriosus diverts blood to the aorta past where the carotids are, so oxygen poor blood goes back to the mom
Foramen Ovale
Hole between the L and R atria that will close after birth
it allows blood to move to the left atrium which allows blood to get around the body rather than go to the lungs (blood is already oxygenated)
So it connects the atria so that oygenated blood can get to the aorta and out to the body and brain
Ductus Arteriosus
connects the aorta and pulmonary artery so that deoxygenated blood gets to the right ventricle and then leaves via umbilical arteries or the lower half of the fetus
Umbilical Vein
1
sends oxygenated blood from the placenta to the fetus
Umbilical Artery
2
deoxygenated blood moves from fetus to placenta
We want to see how many vessels in the umbilical cord
3 - 2 UA and 1 UV
Fetal Circulation Path for oxygenated blood
oxygenated blood –> placenta –> umbilical vein –> shunted past fetal liver byductus venosa –> inferior vena cava to right atrium –> proceed through foramen ovale –> left atrium to left ventricle –> aorta –> brain and body
Fetal Circulation Path for poorly oxygenated blood
superior vena cava –> right atrium mixing with oxygenated blood –> right ventricle and then pulmonary tree (small amount to lungs which are nonfxnal and collapsed) –> ductus arteriosus –> aorta –> placenta via umbilical arteries
___ means blood away from the fetus
arteries
___ means blood to the fetus
vein
What forces the alveoli of the fetal lungs to open
when the infant takes the first breath, the dramatic increase in O2 and expansion of lungs leads to DECREASED PULMONARY VASCULAR RESISTANCE (PVR) which allows for increased pulmonary blood flow
When does the Foramen Ovale close
ideally closes at birth - can take a few days though
the blood is entering the right atrium from the top
When does the ductus arteriosus close
4 days after birth
What leads to increased systemic vascular resistance (SVR)
clamping the umbilical cord
this stops fetal circulation
Children are not just …
small adults
The child heart lies more where compared to adults
heart lies more horizontal and higher in the chest
The apex of a child’s heart is where
found at the 3rd or 4th intercostal space
How does child HR and BP differ
HR faster and BP lower
What is more common in child hearts
murmurs
regularly irregular HRs
What is never normal in neonates and what can it indicate?
Diaphoresis and/or nosebleeds (epistaxis) - never normal in neonates
can indicate heart defects or GI defects
2 types of Cardiac Dysfunction
- Congenital
2. Acquire
Congenital Cardiac Dysfunction
“Born with it”
Ex: Atrial septal defect, ventricular septal defect, patent ductus arteriosus, tetrology of fallot, hyperplastic left heart, etc.
Acquire Cardiac Dysfunction
“Develops after birth”
ex: CHF, HTN, Rheumatic Heart Dx
* CHF is sometimes congenital but not always