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Neonatal Patho/Physiology (Breathing (Surfactant (Reduces surface tension…
Neonatal Patho/Physiology
Breathing
Canalicular
Saccular/terminal sac (<25 wks)
Pseudo-glandular
Alveolar
Embryonic
Lung abnormalities
CDH
Pulmonary Hyperplasia
Surfactant
Reduces surface tension preventing collapse
RDS lack of. Congenital, infection, premature
Last 8 weeks
Circulation
Spiral art. 700ml/min
Intervillous pool. 2x umbilical art, 1x vein
Placenta from uterine wall + trophoblastic tissue
Must bypass Lung
Ductus arteriosus: Pulmonary art -> Aorta (Becomes ligamentun arteriosum)
Duct venosus: Umbilical vein -> IVC
Foramen ovale: RA->LA
Adaptations upon Birth
Less vascular flow IVC and RA
^ Resistance
Cord Cut: No placental return
^ LV workload
Breathing
^ LA flow from lung due to foramen ovale closing
^ O2 sats
^ O2 pulmonary vessels
Ductus arteriosus closes (1-2 days)
D. venosus slower (3-7 days)
Duct Dependent Circulation
Systemic
Aortic stenosis
Hypoplastic left heart
coarctation of aorta
Pulmonary
Pulmonary and tricuspid atresia (closing)
Tetralogy of Fallot: Overriding Aorta, Right side hypertrophy, stenosis, Atrial septal defect
Pulmonary stenosis
Transposition of great arteries
Persistent pulmonary hypertension
^BP cant pump
Goes via Duct art -> Poor sats
Stiff arterioles: Constrict