EFM exam with correct answers

EFM exam Hypoxemia - correct answer Decreased oxygen in blood Hypoxia - correct answer Not enough oxygen to supply organs Normal fetal PO2 - correct answer 15-25 mmhm What factors can change the maternal HR? - correct answer Intrinsic pacemakers (SA & AV node) Cardiac conduction system Autonomic regulation... Sympathetic, parasympathetic Humoral factors (catecholamines) Extrinsic factors (medications) Local factors (Ca, K) What are the 3 most common causes of decrease cardiac output in the OB patient? - correct answer Reduced preload (HypoTN) from -hypovolemia -compression of inferior vena cava -anesthesia In what area of the placenta does exchange of gases, nutrients, waste, hormones, antibodies & medications occur? - correct answer Maternal blood in the intervillous space and fetal blood in the villous capillaries These are separated by the blood-blood barrier Oxygen, CO2, NaCl, lipids, vitamins and some drugs are exchanged by... - correct answer Simple diffusion Glucose & carbohydrates are exchanged by... - correct answer Facilitated diffusion Amino acids, water-soluble vitamins & large ions are transported by... - correct answer Active transport What conditions decrease the volume of the blood in the intervillous space? - correct answer Abruption Infarction Thrombosis Infection ...These can also decrease the surface area of the chorionic villous thus decreasing O2 absorption (less surface area = less absorption) Diffusion across the blood-blood barrier is inversely proportional to _ - correct answer Distance. Greater distance = less diffusion Villous hemorrhage, thrombosis, infarction, deems, fibrosis...can increase distance What could result from trauma that causes damages chorionic vessels? - correct answer Maternal-fetal hemorrhage! Ruptured vasa previa - correct answer Vasa previa is a placental vessels that crosses the chorionic membrane and is close to the cervical os. It can be damaged from just a cervical exam or cervical check! What 3 shunts/mechanisms direct oxygenated blood to vital organs in the fetus? - correct answer Ductus venous, foramen ovale, ductus arteriosus When fetus is born, what changes are responsible for the fetus's transition to neonate life? - correct answer Umbilical-placental circulation is eliminated Clamping of umbilical cord eliminates umbilica.-placental circulation and raises the BP in neonate's aorta Flow across ductus arteriosus is reversed Catecholamines release increases BP & HR Expansion of neonate's lungs occurs The fetal circulation is designed to send oxygenated blood primarily to what 3 organs in the fetus? - correct answer brain, heart, adrenal gland Which ventricle is dominant in the fetal heart? - correct answer Right ventricle Because fetal circulation works in parallel rather than in series like adult circulation Umbilical vein - type of blood it carries & where? - correct answer Carries oxygenated blood from placenta to fetus Compression of umbilical vein - correct answer Can cause acceleration, sometimes before a variable or prolonged accelerations Umbilical artery - correct answer Carries deoxygenated blood from fetus to placenta Compression of umbilical artery - correct answer Variable Oxygen depletion cascade - correct answer aerobic metabolism hypoxemia tissue hypoxia anaerobic metabolism lactic acid build up metabolic acidosis CO = HR x SV for a fetus - correct answer Cardiac output for a fetus is only related to their heart rate, not their stroke volume. a fetus cannot regulate their stroke volume, only their heart rate Aerobic metabolism - correct answer O2 ATP by products are CO2 & H2O Hypoxia can lead to what time of metabolism? - correct answer Anaerobic metabolism... by product = lactic acid Sustained hypoxia sustained anaerobic metabolism with by product of lactic acid leads to _ - correct answer Metabolic acidosis Metabolic acidosis - correct answer Accumulation of lactic acid in the body (Low pH) The body then tries to use buffer bases (bicarbonate) to help increase the pH to a more basic/neutral level Eventually the buffering capacity is exceeded and the pH is low and cannot be raised to a normal level Sustained metabolic acidosis leads to _ - correct answer Metabolic acidemia When the body cannot raise the pH to a normal level with buffering bases, sustained low pH What will sustained hypoxia & metabolic acidosis lead to? - correct answer Loss of peripheral vascular smooth muscle contraction, which decreases peripheral vascular resistance Leads to Fetal Hypotension Hypoxic injuries to fetal heart & brain Distinguish between metabolic & respiratory academia - correct answer Metabolic acidemia is ^ lactic acid Respiratory academia is ^ CO2 Causes of respiratory acidemia - correct answer increased CO2 cord compression/true knot -can develop rapidly and can correct rapidly Intermittent Auscultation done with 4 devices - correct answer Stethoscope Fetoscope Doppler US TVUS - Transvaginal US