Midterm (Ken).txt

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Midterm (Ken).txt
2012-03-06 21:28:36

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  1. Which cells form the trophoblast?
    zygote/morula becomes a blastocyst. once fluid begins accumulating in this center cavity. The fluid is a combination of uterine fluids and secretions from the cells themselves. Outer layer of cells form on the blastocyst referred to as the trophblast and replaces the zona pellucida
  2. Where does the zygote normally implants?
    Zygote attaches itself to the lining of the uterus ( for nourishment). Implantation occurs in the upper portion of the uterus
  3. What are the names of the three germ layers that form during fetal development?
    • ENDODERM; The Innermost layer.; includes; respiratory tract* epithlium of the disgestive tract, bladder, thyroid* primary tissue of the liver and pancreas*
    • MESODERM; In between the endoderm and ectoderm;includes; dermis* muscle* bone* connective tissue* lymphnoid tissue* reproductive organs* cardiovascular system
    • ECTODERM; outermost layer and the thickest; includes; epidermis*nails*hair* lens of the eye* central and peripheral nervous system* Skin glands
  4. What is the period of lung development that mature surfactant is produced?
    It is during the alveolar period that mature surfactant is produced in increasing amounts by the type II cells. 27 weeks to term
  5. what L/S ratio signifies lung maturity?
    The fetal lung is considered mature when the L/S (lecithin sphingomyelin) ratio is 2:1. This usually occurs around week 35. This also coincides with the onset of mature surfactant production and indicates little chance of developing in RDS
  6. What are High- frequency sound waves used for in obstetric ultrasound?
    they are well below the level that could cause damage to tissue and are used to locate and visualize organs and tissue
  7. What is used to transmit obstetric high-frequency ultrasounds?
    Either a hand-held or transvaginal transducer
  8. How can fetal age be determined with the use of ultrasound?
    by using measurements of crown-rump length, biparietal diameter, abdominal circumference, and femur length
  9. How can Fetal weight be estimated?
    by combining head size, abdominal circumference, and femur length
  10. How can Intrauterine growth retardation (IUGR) and excessive growth (macrosomia) be determined?
    once fetal age and weight are determined
  11. What is normal, low, and high fetal heart rates during early gestation?
    • normal heart rate 120-160
    • bradycardia <100
    • tachycardia >180
  12. What is the most common method used to estimate deliver date?
    • -Nagels rule; subtract 3 months from last menstrual period, then add seven days
    • -Fundal height; measures distance from the symphysis pubis to the top of the uterine fundus, which is located on opposite end of the cervix. 1cm = 1 week, 20cm = 20 weeks
  13. What is the test used for the biophysical profile of the newborn.
    • - Contraction stress test; stress comes from an interruption of maternal blood to the intervillous spaces during contractions. A positive CST is defined a more than 50% of contractions having late decelerations. No decelerations after any contractions indicate a negative CST
    • - The nonstress test; where the heart accelerates to greater than 15BPM for at least 15sec with fetal movement 2 times in a 20min window. Nonreactive NST occurs when the fetal heart rate does not accelerate during fetal body movement over a two 20min periods. A fetus suffering from prolonged hypoxia will have a positve CST with a negative NST. A negative CST results in the presence of a negative NST indicate the problem is one of fetal sleep or maternal narcotic or sedative ingestion
  14. What are the three cardinal signs of respiratory distress?
    • 1. Nasal flaring
    • 2. grunting
    • 3. retractions
  15. What are the differences between the cardiopulmonary systems of adults and infants?
    • INFANT- tongue is proportionally larger than the adult tongue
    • INFANT-have a large amount of lymphoid tissue in the larynx
    • INFANT EPIGLOTTIS- proportionally larger, less flexible, and is omega-shaped.
    • INFANT EPIGLOTTIES - lies more horizontally than the
    • narrowest part of the infant airway is the cricoid ring ADULT is the glottis
    • INFANT LARYNX lies higher in the neck in relation to the cervical spine
  16. What is . the quickest way of determining gestational age?
    Ballard gestational age assessment; 6 physical, 6 neurological signs

    • Original System:
    • Dubowitz gestational age assessment; 11 physical 10 neurological signs
  17. What is the physical and mental characteristics used during the Ballard gestational age assessment?
    • Physical: skin, lanugo, plantar surface, breast, eye/ear, genitals, genitals female.
    • Neurological: posture, square window/wrist, arm recoil, popliteal angle, scarf sign, heel to ear.
  18. What are the major mechanisms by which drugs can cross the placenta?
    • Ultrafiltration
    • Simple diffusion
    • Facilitated diffusion
    • Active transport
    • Breaks in the placental villi
  19. What are the ways drugs can enter an infant´┐Żs body?
    through the gastrointestinal tract, intramuscular administration, by topical absorption through the skin and respiratory tract, and through direct intravenous administration.
  20. What are Sympathomimetics are also called?
    beta adrenergics
  21. What parasympatholytic is the drug of choice for bronchodilation?
    Drug of choice is Ipatropium bromide(atrovent)
  22. What is the underlying etiology for Respiratory Distress Syndrome?
    deficiency of consistent surfactant production before week 35
  23. What are the four factors linked to the pathophysiology of Brochopulmonary Dysplasia?
    • Oxygen toxicity
    • Barotrauma
    • Presence of PDA
    • Fluid overload
  24. What causes retinal vessel constriction?
    high PaO2s
  25. What are the etiologic factors for intraventricular hemorrhage?
    • 1. Hypernatremia
    • 2. Shock
    • 3. Acidosis
    • 4. Blood transfusions
    • 5. Seizures
    • 6. Rapid Volume Expansion
    • 7. Fluctuation in cerebral blood flow
  26. What two potentially devastating effects does Meconium aspiration have on the neonate?
    • airway obstruction with hyperinflation
    • inflammatory response of the tracheobronchial epithelium to the presence of meconium. This is called chemical pneumonitis
  27. What can Teratogens cause?
    spontaneous abortion, congenital malformations, intrauterine growth retardation, mental retardation, and carcinogenesis
  28. What factors are Teratogens dependent on?
    dose the fetus is exposed to, the length of exposure, age of the fetus, other drug interactions
  29. What is the most critical time for teratogens to have an effect?
    first trimester
  30. What is the term pharmacokinetics used to describe?
    • The process by which drugs enter the body(absorption), are distributed throughout the system(distribution), are changed or altered from the original compound(metabolism), and eventually leave the body(excretion)
    • "What the body does to the drug"
  31. What class of drug does albuteral fall into?