Fetal lung and Heart development

Question 1

At what week are lungs fully developed

Answer 1

36 weeks

Question 2

At what stage and how many weeks do the development of the trachea and major bronchi occur

Answer 2

Embryonal stage day 26- 52

Question 3

When does surfactant development begin

Answer 3

24-25 weeks

Question 4

What is the L/S ratio

Answer 4

predictive index of lung & bone maturity before birth and the risks of development of resp distress

Question 5

How is the LS ratio test done?

Answer 5

By taking amniotic fluid

Question 6

If ratio is below 1.5 what does it mean for the baby?

Answer 6

Baby is at high risk for developing RD

Question 7

What does the fetal lung do?

Answer 7

Moves fluid

Question 8

How does gas exchange occur for NeoNates?

Answer 8

Mother provides gas exchange

Question 9

What does the umbilical arteries do?

Answer 9

return deoxygenated blood from the fetus to the
placenta

Question 10

What does umbilical vein do?

Answer 10

returns oxygenated blood from placenta to fetus

Question 11

What are the three fetal shunts

Answer 11

Ductus Venosus
Ductus Arteriosus
Foramen ovale

Question 12

What does the placenta do

Answer 12

transfers maternal oxygen and nutrients to the fetus

Question 13

What is special about fetal circulation

Answer 13

It is opposite of normal circulation

Question 14

What is a low amiotic fluid balance called

Answer 14

Oglo

Question 15

If the baby is born at 26 weeks how does it affect alveoli

Answer 15

They will not be fully developed

Question 16

If the LS ratio is = to or greater than 2 what does it mean

Answer 16

baby at low risk for RD

Question 17

If LS ratio is below 2 what does it mean

Answer 17

Baby is at risk for RD

Question 18

If LS ratio is below 1.5 what does it mean

Answer 18

Baby at high risk or RD

Question 19

How is the fetal lung different than neonate lung

Answer 19

In utero lungs serve no resp purpose

Question 20

describe the Ductus venosus

Answer 20

Fetal vascular channel in the fetus passing through liver and joining Umbilical vein with ICV

Question 21

Ductus Arteriosus

Answer 21

Fetal vascular channel joining pulmonary artery directly to the descending aorta

Question 22

Foramen ovale

Answer 22

opening in septum between right and left atria in the fetal heart

Question 23

what is a CHD

Answer 23

any anatomic abnormality present in heart at birth

Question 24

What CHDs are ductual dependent

Answer 24

coarctation of aorta
interrupted aortic arch
aortic valve stenosis
Hypoplastic left heart syndrome
Pulmonary atresia

Question 25

What is ductal dependency

Answer 25

Ductus Arteriosus needs to stay open if not baby will die

Question 26

what happens when an CHD has a right to left shunt

Answer 26

blood will bypass lungs leading to no pulmonary bloodflow enters the systemic circulation , lack of O2 gas exchange

Question 27

What happens when an CHD has a left to right shunt?

Answer 27

oxygenated blood is shunted left to right and mixes with deoxygenated blood, baby will not have proper oxygenation and circulation.

Question 28

Is a left to right shunt cyanotic or non-cyanotic

Answer 28

non cyanotic

Question 29

What is Patent Ductus Arteriosus

Answer 29

Ductus Arteriosus fails to close after birth

Question 30

What results from Patent Ductus Arteriosus

Answer 30

excess bloodflow of pulmonary circulation Hypoperfusion of systemic circulation

Question 31

How is Patent Ductus Arteriosus treated

Answer 31

Oxygen therapy Surgery Indomethacin ( helps close pda, protects baby's brain)

Question 32

How is PDA tested for?

Answer 32

Pulse ox screening

Question 33

What do results of pulse ox screening show

Answer 33

O2 sat on right wrist arm much higher than O2 sat for Foot

Question 34

what is Atrial Septal Defect (ASD)

Answer 34

A CHD where there is a hole/opening in the wall that separates the atria

Question 35

What Type of shunt is ASD

Answer 35

Left to right (non cyanotic)

Question 36

What effect does ASD have on heart

Answer 36

atrium blood flows backwards, Right ventricle becomes hypertrophic

Question 37

what are characteristics of cyanotic shunts

Answer 37

right to left Blood from right side of heart not oxygenated Bypasses lungs

Question 38

What are characteristics of Acyanotic shunts

Answer 38

Left to right shunt Blood from left side of heart (oxygenated) Transfers back to right side of heart

Question 39

What does CHD involve anatomically

Answer 39

Int walls of heart Valves inside the heart Arteries and Veins that carry blood to heart/body

Question 40

what causes MAS

Answer 40

Fetal hypoxia Stress

Question 41

How does stress cause the baby to aspirate ?

Answer 41

Fetus gasps due to vagul response when stressed and causing fluid to move past it.

Question 42

What are complications for MAS

Answer 42

o Disrupted surfactant production o Pulm hypertension  Right to left shunt Chemical pneumonitis Potential airway obstruction

Question 43

what is the most common CHD

Answer 43

Ventricular septal defect

Question 44

What does Nitric do?

Answer 44

relaxes smooth muscle of pulmonary vascular system and reduces PVR

Question 45

When is Nitric indicated

Answer 45

when OI index is greater than or equal to 25

Question 46

Why does lung development suffer with a congenital diaphragmatic hernia

Answer 46

Due to lungs being compressed in utero, leading to underdeveloped lungs and shifted heart.

Question 47

What is one of the big differences between croup and epiglottis

Answer 47

Croup is a viral infection epiglottis is a bacterial

Question 48

What is the main indicator of croup on a cxr?

Answer 48

steeple sign on neck

Question 49

What are complications of croup

Answer 49

Subglottic swelling mucus glands increase production Cillia lose effectiveness Narrowing of the airway

Question 50

Main causes of Epiglottis

Answer 50

Haemophilus influenzae type B Trauma from repeated intubation attempts

Question 51

What are risk factors for epiglottis

Answer 51

Children 2-6 years of age males

Question 52

What is main CXR presentation for epiglottis

Answer 52

thumb sign

Question 53

What is presentation of epiglottis

Answer 53

High Fever Sore throat Stridor Cherry red epiglottis