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Fetal Circulation
Elmo
18
Physiology
Professional
10/07/2008

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Cards

Term
The Placenta
Definition
  • Acts as fetal lung during gestation
  • Less efficient than the lungs
  • Less efficient blood flow pattern for gas exchange
  • "hypoxic"(less oxygen) environment
Term
Fetal Hemoglobin vs. Adult Hemoglobin
Definition

Fetal hemoglobin has higher O2 affinity than adult hemoglobin.

Fetal has lower lower P50

Term
How does the PO2 compare between fetal and maternal blood?
Definition
The PO2 gradient between maternal and fetal blood is large because of poor efficiency of diffusion.
Term
How do you improve pH and PCO2 gradients between fetal and maternal blood?
Definition
maternal hyperventilation
Term
Why does fetus maintain the same amount of O2 content as mother?
Definition

↑RBC

↓P50=↑Hb oxygen affinity

Term
Ductus venosus
Definition

Fetal shunt(vessel) that brings oxygenated blood from placenta to heart, bypassing the liver.

Term
Foramen ovale
Definition

Fetal opening that shunts blood from right to left atrium and through the left ventrical to the head.

Term
Ductus arteriosus
Definition
  • Less oxygenated blood from the brain comes to the right atrium through the superior vena cava.
  • The blood goes from right atrium to right ventricle  and out the pulmonary artery.
  • The blood bypasses the lungs through the ductus arteriosus and enters aorta.
Term
How do pulmonary vessels respond to a lack of O2?
Definition

They constrict... unlike systematic vessels

Term
Circulatory systems transition at birth:
Definition
  • right(venous) side converts to low pressure, left(aterial) side converts to high pressure.
  • Clamping the umbilical cord increases arterial vascular resistance and decreases venous return.
  • Shunts must close
Term
First Breath
Definition

Need huge negative and huge positive pressure to open the lung.

Less pressure is needed as time goes on.

Term
Surfactant
Definition

Decreases surface tension of lungs so that it can expand properly.

Premature babies don't have it.

Term
Closure of Ductus Venosus
Definition
  • Closure in 1-3 hours
  • closure of smooth muscle.
  • Mechanism not understood
Term
Closure of Foramen Ovale
Definition
  • Decreased pulmonary vascular resistance lowers right atrial pressure.
  • Blood returning from lungs raises right atrium pressure
  • valve-like Foramen Ovale closes
Term
Closure of Ductus arteriosus
Definition
  • within 1-8 days.
  • ↑O2
  • ↓Prostaglandin E
Term
Patent Ductus Arteriosus (PDA)
Definition
  • Ductus arteriosus doesn't close.
  • Blood goes from Left→ Right(Aorta to Pulmonary Artery) Acyanotic
  • Enlargement of LA, LV, and Aorta
  • If pressure gets to high in Pulmonary artery the direction of blood flow will reverse and become Cynotic. Eisenmenger's syndrome.
Term
Atrial Septic Defect(ASD), ostium secondum type A
Definition
  • Shunt between the Atrium. (Maybe foramen ovale doesn't close)
  • Can be Acyanotic or Cyanotic(Eisenmenger's)
  • Enlargement of the RA, RV, and PA
Term
Ventricular Septal Defect (VSD)
Definition

Most Common

  • Shunt between Ventricals.
  • Starts off Acyanotic but can become cyanotic.
  • Enlargement of LA and LV
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