Chest And Heart

Question 1

When are heart abnormalities detectable?

Answer 1

-within 72 hours of birth
-some heart defects develop later on so hence 6 week SPEN

Question 2

How do lungs transition for birth?

Answer 2

-babies lungs are filled with fluid
-labour hormones causes fluid secreting cells to switch to absorption in preparation for birth
-fluid is expelled via vaginal canal

Question 3

Inspection of chest:

Answer 3

-colour
-breathing pattern
-clavicles
-shape
-nipples

Question 4

When should we suspect clavicle fracture?

Answer 4

-asymmetry of clavicles
-difficulty in palpation
-impaired Moro reflex

Question 5

Signs of respiratory distress:

Answer 5

-nasal flaring
-grunting
-cyanosis
-chest recession

Question 6

What to listen to on auscultation?

Answer 6

-inspiratory and expiratory sounds
-additional sounds
-lungs should be clear and equal

Question 7

Where to ascultate?

Answer 7

-mitral area (apex)
-tricuspid area
-pulmonary area
-aortic area

Question 8

Incidence of heart disease

Answer 8

8:1000
6.3:1000 in England

Question 9

Risk factors of CHD

Answer 9

-first degree relatives (mum= 5-12%, siblings 2-4%)
-trisomy
Drug teratogens
-Smoking/obesity
Consanguinity

Question 10

What do you palpate?

Answer 10

-femoral and brachial pulse, should be equal in strength
-capillary refill

Question 11

If screen positive?

Answer 11

Refer for neonatal review within 24 hours