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22 Cards in this Set

  • Front
  • Back
What is the path of fetal cerculation
RA --> foramin ovaly --> LA (only 10% goes to pulminary cerculation via pulminary artery)--> aorta --> ductis arteriosis (some) -->pulminary artery -->
how long does it take for the:
foramin ovaly take to close
ductis arteriosis to close
FO: as long as 3 muths
10% of population does not close
DA: 24 hours can keep it open with PGE1
what is the ductis arteriosis
a conection in all new bords from the aorta to the pulminary artery
closes at 24 - 48 hours
blue but comfterbal
(note this does not include hands and feet these are blue in may babies)
what is the diagnosis
- congenital abnormality
- right heart obstructive lesions
- sats are down in the 70's and 80's
- a singele second heart sound (a valve does not make a sound when it closes)
- may have murmer
Tetrology of filoe
1)conal septum shiften anteriorly VSD
2)PA blocked and stinosed
3)RA hypertrophy secondary to PA stinosis and VSD
4)overiding aorta
little blood goes to the PA and ductis arteriosis is esential for life
How do you treat tetrology of filow
cumfterbal but blue
decresed pulminary markings
Prostoglandin E1 PGE1
-> PGE1 opens up the ductis arteriosis
-> PGE1 might be enuff
-> Sergery
- patch and enlrge PA
- close VSD
- if PA rilly small can do a shunt from aorta to PA but not done so much only palitive
Left heart obstructive lesions
gray or ashed color not blue
poor perfusion
decresed pulses asymetric
single S2
Large heart and incresed pulminary blood flow
coarctation of the aorta
-almost alwais distal to the left subclavian
-narrowing path to the decending aorta
-often asociated with bicuspid aortic valve (80%)
asociated with turners (XO)
rib noching on CXR
what is the abnormal serculation in coarctation of aorta
high preser in LV
- lots of presure increse with closer of the ductis arteriosis
- incresed Afterload
- below carctation pulses are week
- but arms fed by subclavian are strong
-if ductis arteriosis is distal to coarktation can feed blood to the decending aorta
- if at coarctation provides a way to go around the shelf
strong arm pulse week leg pulse
carctation of the aorta
how do you treat coartation of the aorta
- PGE1
- sergical repair
- end to end anastomosis with resection
- subclavian flap
- patch angioplasty
- balood dilation good for the older pepals can be done in the cath lab. recurent coarctation.
which ventricle is trebeculated
with ventricle has a smooth wall
what do you do from people with trasposion of the great arteries
- should not use PGE1 because you may close the foramin ovaly
- use a baloon to stretch open the foramin ovaly
- arterial switch prosedure
what type of murmers get louder after a pause (pre ventricular contraction (PVC)
forword flow murmers
what is the best prognostic indicater in tetrology of fallow
the degree of PA stenosis
lots of stenosis: high preser in RA lots of R->L shunt across the VSD --> lot of unoxiginated blood going into systemic cerculation syanotic
PA not so stenosed -> L-->r shunt, CHF, pulminary adema
Where is the coarctation of the aorta normally
just distal to the subclavian
what is coarctation of the aorta asociated with
bicusped aortic valve
turners XO
rib notching on CXR
coarctation of the aorta
in what condishons do you NOT want to use PGE1
total anamolis pulminary venus conection
Transposition of the grate vessles
- when open all of the blood will go from sistemic to pulminary system, there is no way to get it back, incresed congestion. plus because of the incresed preser in the pulminary system LV you will close the PFO whish is a grate sorte of bidirecshinal mizing
egg on a string CXR
small mediastinum large heart
trasposition of grate vessles
they are one behond the oter so thin mediastinum
when do you have incresed pulminary vasculature but you are still quite cyanotic
trasposition of grate vessles
you are puting oxiginated blood back into teh lung