Week 2 Neonatal Assessment and Resuscitation (everything) Flashcards Preview

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This moves blood from the pulmonary artery to the aorta:

the Ductus arteriosus


enriched blood flows through the umbilical cord to the liver and

splits into 3 branches


The major vein connected to the heart

Inferior vena cava


Most blood is sent through the

ductus venosus


What is the role of the ductus venosus?

also a shunt
-lets highly oxygenated blood bypass the liver to the IVC and then to the RA of the heart.


Does any blood go to the fetal liver?

yes, a small amount of blood goes straight to the liver to give it oxygen and nutrients


**Blood enters the fetal heart via the



* from the RA blood flows through

the foramen ovale to the LA


*From the LA blood passes into

the LV


*From the LV blood passes to the



*From the aorta, blood is sent to

the heart muscle itself , the brain, and arms


*after blood circulates in the heart,brain, and arms, the blood (core circulation)

returns to the RA via the SVC


*When blood returns to the RA from the core circulation, is it oxygenated or not?

less oxygenated blood

In the RA it mixes with the oxygenated blood.


*After the core circulated blood has returned to the RA, instead of going back through the foramen ovale, it goes

to the RV


*This less oxygenated blood is pumpned from the RV into the

pulmonary artery
- a small amount of blood continues to the lungs


*From the lungs, the blood is shunted through the

ductus arteriosus to the descending aorta


*From the descending aorta, this blood enters the

umbilical arteries and flows into the placenta.


At birth, the umbilical cord is clamped and the baby no longer receives what from the mother

oxygen and nutrients


with the first breaths of life the lungs start to

expand and the alveoli are cleared of fluid


** an increase in the baby's blood pressure and a major reduction in the pulmonary pressures reduce the need for the:

Ductus arteriosus to shut blood; so it helps the shunt close


The closing of the Ductus Arteriosus raises the pressure in the ____ and lowers the pressure in the ____.

left atrium ; right atrium


** The shift in pressure b/w RA and LA, stimulates what to occur?

the foramen ovale to close


*** What three things must happen to complete the change of fetal to newborn circulation?

the closure of the:
1. ductus arteriosus
2. ductus venosus
3. foramen ovale


Preterm infants and infants requiring cesarean delivery without labor may have what difference to their lungs compared to a baby delivered vaginally?

residual liquid in the lungs.


The residual liquid that is in an infants lungs is far more in a C section baby compared to a vaginal baby, why is this (tell me the process)

If delivered by C section the infant may have greater amount of residual liquid after delivery owing to a reduced catecholamine surge at delivery that promotes sodium channel transport.

(I had always heard it was bc without vaginal delivery it could not be squeezed out lol)


*** The residual lung liquid in the infants lungs (more in there if C section) can cause what kind of issues?

leads to difficulty in initiation and maintenance of normal breathing patterns, and is the cause of transient tachypnea of the newborn. ***


What is Transient tachypnea of the newborn? (TTN)

benign, self limited condition that can present in infants of any gestational age, shortly after birth caused by delay of fluid clearance from the lungs.


Why is the neonate's first breath important and how long after delivery does it occur typically?

This first breath is important because it establishes the neonate’s functional residual capacity. (FRC)

9 sec after delivery for first breath.


Why do preterm infants have more liquid in their lungs? (we already know why C -section babies do)

2/3 of the liquid is expelled from the lungs of the term neonate by the time of delivery.

(so if pre-term more in the lungs and if pre-term c-section then even more!)


Tell me a major physiologic stimulus for the release of lung surfactant into the alveoli? (bold in ppt)

Lung inflation