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Questions and Answers
Which of the following are phases of human lung development? (Select all that apply)
Which of the following are phases of human lung development? (Select all that apply)
The initial lung bud emerges from which of the following?
The initial lung bud emerges from which of the following?
The bronchial tree is formed at which gestational phase of lung development?
The bronchial tree is formed at which gestational phase of lung development?
The alveolar epithelial lining undergoes cell division into type I and type II pneumocytes. Which of the following correctly describe the pneumocytes?
The alveolar epithelial lining undergoes cell division into type I and type II pneumocytes. Which of the following correctly describe the pneumocytes?
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What are the minimal developmental features required for an immature human fetus to survive outside the uterus?
What are the minimal developmental features required for an immature human fetus to survive outside the uterus?
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Which of the following best describe(s) fetal lung liquid?
Which of the following best describe(s) fetal lung liquid?
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Estimates of the exact number of alveoli at birth vary widely, but investigators agree that:
Estimates of the exact number of alveoli at birth vary widely, but investigators agree that:
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Which is the lung development stage formerly believed to be the last stage before birth, characterized by relatively smooth-walled, cylindrical structures subdivided by ridges known as secondary crests?
Which is the lung development stage formerly believed to be the last stage before birth, characterized by relatively smooth-walled, cylindrical structures subdivided by ridges known as secondary crests?
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Pulmonary hypoplasia is a relatively common abnormality of lung development with a number of clinical associations, including which of the following?
Pulmonary hypoplasia is a relatively common abnormality of lung development with a number of clinical associations, including which of the following?
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Which of the following statements represent Reid's laws of human lung development?
Which of the following statements represent Reid's laws of human lung development?
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Which of the following are true statements concerning the development of the circulatory system?
Which of the following are true statements concerning the development of the circulatory system?
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Which of the following are recognizable structures during the development of the heart after the heart tubes fuse?
Which of the following are recognizable structures during the development of the heart after the heart tubes fuse?
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The oxygenated blood leaves the placenta and travels to the fetus through the __________.
The oxygenated blood leaves the placenta and travels to the fetus through the __________.
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Most of the fetal blood entering the main pulmonary artery is shunted to the aorta through the _________.
Most of the fetal blood entering the main pulmonary artery is shunted to the aorta through the _________.
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Most of the fetal blood entering via the umbilical vein is shunted to the inferior vena cava through the _________.
Most of the fetal blood entering via the umbilical vein is shunted to the inferior vena cava through the _________.
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Normal circulatory changes occurring within the transitional stage at birth include which of the following?
Normal circulatory changes occurring within the transitional stage at birth include which of the following?
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Most of the fetal blood entering via the right atrium is shunted to the left atrium through the ________.
Most of the fetal blood entering via the right atrium is shunted to the left atrium through the ________.
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When discussing fetal circulation, which of the following is true?
When discussing fetal circulation, which of the following is true?
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What one set of actions causes the systemic circulation to transition from a low-resistance system to a high-resistance system?
What one set of actions causes the systemic circulation to transition from a low-resistance system to a high-resistance system?
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Anatomic narrowing of the ductus arteriosus begins in the last trimester by which process?
Anatomic narrowing of the ductus arteriosus begins in the last trimester by which process?
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All of the following are criteria for a diagnosis of severe preeclampsia except ________________.
All of the following are criteria for a diagnosis of severe preeclampsia except ________________.
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Cesarean delivery is indicated for which of the following maternal infections?
Cesarean delivery is indicated for which of the following maternal infections?
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Polyhydramnios is associated with all of the following except ______________.
Polyhydramnios is associated with all of the following except ______________.
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Late decelerations are usually caused by __________________.
Late decelerations are usually caused by __________________.
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The earliest sign of magnesium sulfate toxicity is ___________________.
The earliest sign of magnesium sulfate toxicity is ___________________.
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When used for labor induction, misoprostol is contraindicated for patients with ____________.
When used for labor induction, misoprostol is contraindicated for patients with ____________.
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All of the following are true about the use of induction of fetal lung maturity except __________________.
All of the following are true about the use of induction of fetal lung maturity except __________________.
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In preparing the delivery or operating room for the delivery of an infant expected to require resuscitation, all of the following should be prepared except ________________________.
In preparing the delivery or operating room for the delivery of an infant expected to require resuscitation, all of the following should be prepared except ________________________.
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Study Notes
Lung Development Stages
- Phases include Embryonal, Canalicular, and Saccular stages.
- The initial lung bud arises from the pharynx.
- The bronchial tree forms during the Canalicular phase.
- Type I pneumocytes constitute over 97% of alveolar surface; Type II pneumocytes are involved in surfactant production.
- Minimum features for fetal survival outside the uterus: adequate alveolar surface for gas exchange, gestational age of 22-24 weeks, near completion of canalicular stage.
Fetal Lung Liquid and Alveoli
- Fetal lung liquid prevents airway collapse and maintains lung structure.
- Gas exchange surface area increases with oxygen consumption and body surface area.
- During birth transition, changes include reduced pulmonary vascular resistance and increased left ventricular pressure.
Pulmonary Abnormalities
- Pulmonary hypoplasia is linked to lung tissue compression, oligohydramnios, and maternal diabetes.
Circulatory System Development
- Heart development is largely complete by 32 weeks, characterized by the growth of valves and formation of four-chamber heart.
- Key structures in heart development after heart tube fusion include the bulbus cordis, atrial bulge, and truncus arteriosus.
- Oxygenated blood from the placenta travels via the umbilical vein; most fetal blood from the pulmonary artery is shunted to the aorta through the ductus arteriosus.
Transitional Circulatory Changes
- Blood entering the umbilical vein is shunted to the inferior vena cava via the ductus venosus.
- At birth, blood flow transitions from low to high resistance due to umbilical cord clamping.
- Ductus arteriosus narrowing begins in the last trimester through formation of intimal mounds.
Maternal Conditions and Interventions
- Severe preeclampsia criteria exclude generalized edema.
- Cesarean delivery is indicated for maternal anogenital herpes simplex virus infection.
- Polyhydramnios can be caused by gestational diabetes, anencephaly, and twin-twin transfusion syndrome, but not by prostaglandin synthase inhibitors.
Complications and Management
- Late decelerations in fetal heart rate are typically due to uteroplacental insufficiency.
- Early signs of magnesium sulfate toxicity include loss of deep tendon reflexes.
- Misoprostol use is contraindicated in patients with previous cesarean sections.
Induction of Fetal Lung Maturity
- Corticosteroids are beneficial for fetal lung maturity but contraindicated in premature rupture of membranes.
- Betamethasone and dexamethasone are preferred corticosteroids for this purpose.
Room Preparation for Resuscitation
- Essential preparations for at-risk infants include a warm environment and skilled staff; avoid using devices that only provide 100% oxygen for ventilation.
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