• Shuffle
    Toggle On
    Toggle Off
  • Alphabetize
    Toggle On
    Toggle Off
  • Front First
    Toggle On
    Toggle Off
  • Both Sides
    Toggle On
    Toggle Off
  • Read
    Toggle On
    Toggle Off

Card Range To Study



Play button


Play button




Click to flip

Use LEFT and RIGHT arrow keys to navigate between flashcards;

Use UP and DOWN arrow keys to flip the card;

H to show hint;

A reads text to speech;

56 Cards in this Set

  • Front
  • Back
at what point in development does a neonate start to "breathe"
20 weeks

start to ‘breathe’ -20 million alveoli-->fetus is moving fluid
Adult versus Fetal alveoli:

potential space (what can this lead to?)

Loose connective tissue b/t alveoli =Potential Space. Can lead to Alveolar Collapse
Adult versus Fetal alveoli:

Pore of Kohn
found in adult

path between alveoli to allow ventilation (If mucus plugs alveolar segment, Pore of Kohn allows ventilation b/t adjacent alveoli)
Adult versus Fetal alveoli:

adult: high

fetal: low
Adult versus Fetal alveoli:

alveoli are close together (what does this do)
in adult

prevents collapse
pediatric versus adult...

uses diaphragm for breathing mechanism (what does the others use?)

adult uses chest wall
when does a baby get its immune defense..and how?
3rd trimester...baby gets maternal IgG

so a TERM baby has mom's immunity for a couple months
fetal or adult:


Fetus must “steal” oxygen and “force” CO2
does fetal or adult hemoglobin bind O2 better
do children or adults consume more O2?
how many CCs per breath do adults versus a fetus take in?
adult: 5 cc/kg per breath

fetal: 1-2 cc/kg/breath
when do type I pneumocytes develop in the fetus?

what implication does this have?

1. **Magic # - 23 weeks. Usually b efore 23 weeks, fetus
cannot survive. No Type 1’s
what do type II pneumocytes do? What does this help to do?
produce surfactant

decreases surface tension, keeping the alveoli open
what is the difference if you get a 1mm swelling of the lower airway in infants versus adults?
1. Lower airway in infants-->has 75% of normal resistance
• So if 1mm swelling; get
o increase R by 16X
o cross sectional area decrease 75%
2. lower airway in adult-->40% of normal resistance
• get
o increase R by 3X
o Cross sectional area decrease 44%
what lung gets 60% of blood air and aspirations?
Right lung
what is LaPlace's Law?
As radius increases, need to decrease the pressure to maintain volume
As radius decreases, what do you have to do to P to maintain volume? what does this demonstrte?
increase P to maintain volume

this is Laplace's Law
↑ in Radius = ? Volume

____Pressure needed to maintain volume
↑ in Radius = ↑ Volume
-less Pressure needed to maintain volume
what is the Bohr effect?
o Hb binds O₂ @ lungs (when alkalotic)

o releases O₂ at muscle tissue (when acidotic)
What is the difference btw atelectasis and dead space?
atelectasis: blocked air supply (collapse)

dead space: blocked blood supply (PE)
what happens to maintain the V/Q in atelectasis?

Pulmonary Vasoconstrition-->Response to MAINTAIN V/Q ** by physiologically redirecting blood away from areas poorly ventilated
Presented with a child with the whited out lung. X ray below (no air in lung). He is tachypenic, with breaths at 32/min (normal 16-20/min). Pulse ox measures 100% oxygenation. Give child a dose of albuterol. A few seconds later, his pulse ox drops. Why did this happen?

The chuild most likely aspirated a marble, mucus, or peanut, etc. He blocked the airway to his Right lung. To maintain the V/Q ratio, his right pulmonary artery underwent physiological Hypoxic Pulmonary Vasoconstriction. He was tachypenic to maintain enough Minute ventilation thus CO2 elimination with his one functioning lung. Hence, 100% reading on the pulse ox. The β₂ agonist (albuterol) DILATED the Pulmonary artery, reversing the physiological Hypoxic vasoconstriction. Right ventricular blood now flows into the atelectatic lung, No gas in this lung, therefore blood can NOT get OXYGENATED. This increased the Venous Admixture and Pulse Ox drops . **** Your patient may actually be acting/feeling better inspite of saturation drop!!!
This is one reason you can’t use pulseox as the sole measure of illness…(many try!!)
the following are signs of what?

tachympenic, CXR white out, pulse ox drops w/ b2 agonist
Hypoxic Pulmonary Vasoconstriction
dead space versus atelectasis:

V/Q abnormal
dead space

both lungs are ventilated, but one may not be perfused enough...throwing off the V/Q
What is FRC?

what does it prevent?
after easy exhalation the volume that is left in your lung..keeps you pink

prevents atelectasis
what do you do to get people back to normal FRC?
lower the transpulmonary pressure
- Asthmatics (obstructive lung disease) – How do you tx an asthmatic or COPD to get relief?
-RESTORE FRC !!!! – Make it easier for them to breathe.
3 organs with preferred circulation in Fetal Circulation
where does the ductus venosis bring blood to first?
the liver
what gets first dibs at O2 rich blood?
coronary arteries first

then brain
where does the most acidic and hypoxic blood go to in fetal circulation?
right ventricle-->ductus arterious-->des aorta-->placenta
what happens during cord clamping?
sudden loss of placenta (30% of Fetus’s blood supply) ->increased SVR
1. By clamping the cord, back pressure forms ( ↑ in Left Ventricular End Diastolic Pressure)
2. ↑ Pressure in L.A . Result – “closure” of Foramen Ovale → ↑ RV flow→ ↑Pulm. Artery Flow
3. Baby’s first breath of Room air (O₂) vasodilates Pulm Artery → Pulmonary Erection (lungs fill with blood supply) = Functional Residual Capacity ! !
4. Alveoli OPEN up after baby squeezes through the vaginal canal. (70-140 cm/H2O pressure)
• *Physical Squeezing of cartilaginous chest squeezes out Amniotic fluid out of lungs
what removes amniotic fluid out of the lungs?
• *Physical Squeezing of cartilaginous chest squeezes out Amniotic fluid out of lungs
what is persistent fetal circulation?
o - blood is still shunted through Patent Ductus Arteriosus BYPASSING LUNGS !!!
These kids look deathly ill
Tx for Persistent Fetal Circulation
Treat cause (in mother), Oxygen, support BP, Vasodilators, mechanical support, pH
O₂ , Dopamine, bicarb
what is meconium?

1st baby stool

should be past in the first 24 hours (not inutero)
what can cause meconium to be passed inutero? what does this cause?
fetus is stressed (hypoxic/hypotensive) leads to decreased sympathetics...loosening the rectal tone

this can then get aspirated and the baby can look hypoxic and have irritants to breathing
the following describes what?

*Thickened Alveolarmembrane
*Neutrophilic infiltration
*Decreases Oxygenation
*Increases Work of Breathing
• Respiratory Distress Syndrome (RDS) or Hyaline Membrane Disease
early signs of this problem are a bell shaped chest and increased lung markings...later you will have a "ground glass" appearance, more lung markings, and loss of bell shape
Respiratory Distress Syndrome (RDS)
a child is born prematurely and has decreased surfactant and as a result is having trouble breathing..what do they have?
Respiratory Distress Syndrome (RDS)
treatment for Respiratory Distress Syndrome (RDS)?
if you see ground glass bell shaped CXR what do you have?
Respiratory Distress Syndrome (RDS)
#1 cause of neonatal sepsis?

can you tell the difference btw group B strep (Strep agalactiae) and Respiratory Distress Syndrome?
not initially!!
what is the most common cause of Meningitis in newborns?
Group B strep agalactiae
if you see an onset of 24 hours, pneumonia, and sepsis, what is the likely cause?
group B strep infection
what is the most unforgiving infection seen in 1st month of life?
neonatal herpies
if you see a staccato cough, and conjuctivitis what is the cause?
what is Pneumocystis Carinii (PCP) in babies?
Usually thought to be associated with cancer/chemo pts., but its also found in <1 mth olds because they are immunocompromised
____ is characterized by inflammation and scarring in the lungs. More specifically, the high pressures of oxygen delivery result in necrotizing bronchiolitis and alveolar septal injury, further compromising oxygenation of blood
Bronchopulmonary dysplasia
what plays a large role in the problems seen in Bronchopulmonary dysplasia (BPD)
O2 radicals
O2 therapy is like what
O₂ Therapy – painting rotten wood

***”It’s like Painting Rotten Wood”***
what is the alveolar gas equation?
[ (Baro Pressure – Vapor Pressure) × Fi O₂ %] - PCO₂ /R
a person gets carbon monoxide poisoning. what does their pulse oximetry show?


it only functional Hgb, NOT dysfunctional
in capnography, what do you need to see on the waveform?
plateau of normal exhaled CO2 (about 40torr)
definition of apnea?

(he had little arrows in his notes that he had on the ELMO..could be important to know this cold)
15 second resp pauses assoc w/physiological change