The Male Genitals During Sexual Excitement

1. Excitement

3. the neural tube develops

4. Arm and leg buds, heart starts beating

5. Hand and foot plates, head much larger than body, lens pits and optic cups

6. digit rays form, oral and nasal cavaties confluent, elbows bent

7. nose bud, genital tubercle, body strengthens and lengthens

8. beginnings of all essential external and internal structures present

Growth and Fat development is primary, head still larger than body

But slowing of head growth, last six to eight weeks is fat, and differentiation and growth of tissues and structures

Thalidomide induced phocomelia

FAS (leading cause of retardation)

Any factor that alters normal intrauterine development (of embryo) can be considered a teratogen. This includes drugs and environmental exposures, maternal medical conditions, infectious agents and genetic factors. 

First two weeks of development all or nothing effect, during organogenesis, the organs affected are those which developing, after orgo, it might create cell apoptosis and retardation of proliferation

dose and duration important, threshold effect of drugs

2-3% have malformations

1. Ductus venosus
2. Ductus arteriosus
3. Foramen ovale
4. placenta as primary oxygenating organ

1. Fetus takes huge 40mmHg breath to push out the alveolar fluid (4-5x greater than our breath)
2. stop producing Cl fluid and instead absorb Na and fluid, upon contractions and release of catecholamines
3. Thoracic squeeze
4. the addition of oxygen to the lungs vasodilates the pulmonary veins, decreasing resistence and so blood starts flowing to the lungs instead of going through the ductus arteriosus
5. clamp cord, internal bp increases

90% of babies need little or no assistance with respiration or transitioning to newborn circulation (APGAR of 7 to 10, and need no intervention)

Given at 1 and 5 minutes of age

Appearance (color)   pale        pink w cyanosis    pink

Pulse                     0             <100                  >100

Grimace (reflex irritability) none    grimace    cough, sneeze cry

Activity                 limp    some flexion    active motion

Respiration            0              slow, irreg   good, cry

Routine Management of the Newborn (VENH)

1. Vitamin K: given to prevent vitamen K deficient hemorrhaging
1. clotting factos 2,7, 9, 10 use it
2. don't produce bacteria that produce it for 7-10 days
2. Eye Prophylaxis
1. siver nitrate 2%, or erythromycin to prevent chlamydia and gonorrhea conjunctivitis
3. New born screening (PKU), through heel stick, sickle cell, HEARING SCREENING (ABR)
4. HepB Vaccine

1. bHCG (until 8-9 wks where placental prog kicks in)
2. ACTH
3. Calcitonin
4. Relaxin
5. Placental Lactogen
6. Prog
7. Est > stimulates TBG > total T3T4 (lasts longer) and bHCG = TSH...this increases metabolism

1. Urinary: increased GFR, angiotensin (higher bp)
2. Blood: increased BP, plasma up 20%, become anemic (ratio of plasma to RBC decreases), vasodilation, increased CO, caridac murmur due to plasma increase
3. Clotting factors, coagulation increases, anticoagulation decreases