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66 Cards in this Set
- Front
- Back
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length change of embryo/fetus |
12 weeks=10 cm; 20 weeks=25 cm; 40 weeks=53 cm
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weight and length relationship in fetus
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weight proportional to cube of length
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earlies heart beat
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4th week at ~65 beats/min (increases to ~140 at birth)
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RBCs at 3rd week dvlp
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yolk sac and mesothelial layers of placenta; nucleated
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RBCs 4th week dvlp
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fetal mesenchyme and endothelium of fetal blood vessels; non-nucleated
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RBCs at 6th week dvlp
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lover
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RBCs 3rd month
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spleen and other lymphoid tissues
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RBCs 3rd month and on
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bone marrow gradually principal source
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what cause resp. movements in fetus
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tactile stimuli and fetal asphyxia
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why are lungs inhibited from inflation during last few months
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prevents fluid and debris from filling (ex. Meconium)
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when is myelination complete
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some aren't complete until 1 year post-natal life
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when do kidneys begin excreting urine
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2nd trimester; accounts for 70-80% amniotic fluid
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when do kidneys become completely fxnal
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few months after birth
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importance of vit B12
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RBC formation
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importance of vit C
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formation of intercellular substances (bone matrix and fibers of CT)
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importance of vit D
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bone growth; can be sotred by fetus in liver
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importance of vit E
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unclear mechanisms; normal dvlp of early embryo
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importance of vit K
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Factor VII, prothrombin, and other blood coagulation factors; prenatal storage necessary until colon colonized by bacterial flora
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cause of breathing at birth
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1) slightly asphyxiated state 2) sensory impulses in suddenly cooled skin
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hypoxia causes in delivery
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1) compression of umbilical cord 2) premature placental separation 3) excessive uterine contraction 4) excessive anesthesia
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tolerated hypoxia
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neonate survives as long as 10 mintues of not breathing; brain impariment after 8-10 minutes (adults only 4 minutes )
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pressure to overcome collapsed alveoli with first breath
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25 mmHg; neonates can create as much as 60 mmHg in intrapleual space
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hyaline membrane disease
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proteinaceous fluid, desquamated alveolar epithelial cells; looks like hyaline membrane in microscopr
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when does surfactant secretion begin
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last 1-2 months gestation by alveolar type II cells
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blood flow through lungs before/after birth
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12% to almost 100%
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percent of blood leaving fetal heart that enters systemic circulation and placenta
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45 % through fetal tissues and 55% goes to placenta
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what occurs to vascular resistance at birth
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loss of placental blood flow doubles resistance (causes increased P in aorta and L heart)
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hypoxia in fetal lungs causes what
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considerable tonic vasoconstriction of lung blood vessels
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pulmonary resistance after birth
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reduced 5 fold, reducing R heart P
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what proportion of people have permanent closure of foramen ovale within few months to years after birth
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about 2/3
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oxygen role in closing ductus arteriosus
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PO2 in fetus is 15-20 mmHg and about 100 mmHg after birth (causes smooth muscle contraction)
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postulated reason for patent ductus arteriosus and way to cure
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prostaglandin synthesis keeps dialated; indomethacin blocks prostaglandin synthesis
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ductus venosus closure
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within 1-3 hours of birth; unknown mechanism
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liver glucose supply after birth
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few hours; liver still immature preventing significant gluconeogenesis
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what does neonate use for energy until mother's milk comes in
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stored fats and proteins
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respiration of neonate
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40 breaths/min; tidal air with each breath of 16 ml; FRC half of adults in relaation to weight
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plus/minus of stripping umbilical cord to give infant extra blood volume
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may lead to mild pulmonary edema with some respiratory distress, but extra RBCs are often valuable
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average blood V at birth
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300 mL (375 if cord stripped)
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CO of neonate
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500 ml/min, twice as much as adult in relation to weight
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arterial P of neonate
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70 mmHg systolic and 50 mmHg diastolic and increases to 90/60 in first months
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RBC count in neonate
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4 million/mm^3 (.5 to .75 million additional if cord stripped)
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when does infant begin to make new RBCs
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6-8 weeks when increaseing activity stimulates production
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WBC count of neonate
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~45,000/mm^3, 5 times greater than adult
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why do bilirubin levels rise in first week after birth
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liver immature and incapable of breaking down; increases from 1 mg/dl to 5 mg/dl; physiologic hyperbilirubinemia
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how often did erythroblastosis fetalis occur before modern therapies
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mildly in 1/50 and seriously in 1/100
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fluid intake and excretion in neonate compared to adult
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7 times greater
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when is functional development of kidneys complete
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1 month post-birth; have tendancy toward acidosis
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Liver fxn at birth
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1) little bilirubin/glucuronic acid cojugation 2) plasma protein deficient formation 3) gluconeogenesis deficient 4) little coagulation factors formed
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3 differences of neonate vs older child digestion
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1) pancreatic amalase deficient 2) fat absorption less 3) glucose concentration low and unstable
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neonate protein sysntesis and storage
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as much as 90 % ingested amino acids used; much higher than adults
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what is twice the rate of adults in neonates
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metabolic rate, respiration rate, CO
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What occurs in infant who has mother with insufficient iron in diet
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severe anemia after about 3 months; otherwise infants have enough in liver storage for about 4-6 months
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What is required by infant that isn't stored in tissues
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vit C; required for cartilage, bone, and intercellular structures
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when does baby obtain normal level of gamma globulin
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12-20 months
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why isn't immunization against diptheria, measles, and poilio neccesary before 6 months
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antibodies inherited from mother protect infant for about 6 months
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what antibody isn't sufficient to protect baby via inheritance
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whooping cough; get ~1 month
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special instances in which infant endocrinology important
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1) pregnant mother with female child taking androgenic hormone 2) neonate breat dvlp and mastitis 3) diabetic mother 4) hypofunctional adrenal cortex 5) mother has hyperthyroidism 6) lack of thyroid secretion (cretin dwarfism
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respiration issues of premature infant
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vital capacity and FRC especially small; surfactant depressed/absent
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low FRC in premature infant associated with…
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periodic breathing (Cheyne-Stokes type)
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GI in an infant more than 2 months premature
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almost no fat absorbed; calcium absorption low (rickets may dvlp)
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other systems of concern in premature infant
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1) liver-coagulation and metabolites 2) kidneys-acidosis prone 3) bone marrow-anemia 4) immune-infection
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what temperature is associated with high death rate of infants/premature infants
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maintained below 96 F (35.5 C)
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excess O2 use in premature infants can cause
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blindness; too much O2 stops growth of blood vessels in retina, then they explode with growth when O2 therapy stopped; called retrolental fibroplasia
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O2 can be used safely up to…
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40% in air breathed
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brain mass of infant
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26% at birth, 55% at 1 year, adult proportions by end of 2nd year
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brain growth allowed after fontanelles closed
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20% additional growth beyond first 2 years of life
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