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Lecture 6
Congenital Heart Disease II pgs. 12-15
| Question | Answer |
|---|---|
| What is TAPVR (Total Anomalous Pulmonary Venous Return) | When all four pulmonary veins return to the systemic venous circulation or directly to the right atrium resulting in a mixing of systemic and venous blood |
| What defects are associated with TAPVR? | ASD or patent foramen ovale to help maintain left ventricle output |
| What is the management of TAPVR? | Surgical management is often needed in the neonatal period (reattach pulmonary veins to the left atrium |
| What is the main feature of TGA (Transplantation of the Great Arteries) | ventriculoarterial discordance with the aorta arising from the right ventricle and the pulmonary artery arising from the left ventricle |
| When you have TGAs how do you maintain oxygenation of the tissues? | Tissue oxygenation depends on mixing of blood through either an ASD, VSD, or PDA |
| What is d-TGA | Aorta is anterior and to the right of the pulmonary artery with Atrial ventricular concordance (parallel circulation) |
| What is I-TGA | Aorta is anterior and to the left of the pulmonary artery with atrial ventricular discordance resulting in "corrected" transposition (circulation in series) |
| Are infants with d-TGA or I-TGA more likely to be cyanotic in the newborn period and show signs of congestive heart failure within weeks? | d-TGA |
| How do patients with I-TGA often manifest | they are usually asymptomatic but are prone to late right ventricular dysfunction as the right ventricle is not equipped to support the systemic circulation |
| What is initial management of TGA | maintaining patency of the ductus arteriosus and or through atrial septostomy |
| what is Truncus Arteriosus | a single arterial trunk arises from a single semilunar valve and supplies teh aorta, coronary arteries and pulmonary arteries. |
| what component of fetal circulation is usually absent | Ductus Arteriosus |
| why does cyanosis develop with truncus arteriosus | extensive mixing of the oxygenated and deoxygenated blood |
| What are the four components of Tetrology of Fallot? | VSD, Right ventricular outflow obstruction, Overriding aorta, and Right Ventricular hypertrophy |
| what is a Tet spell | paroxysmal hypercyanotic spells that are usually brought on by agitation or feeding (prolonged cyring tachypnea, cyanosis and increased pulmonary stenosis murmur) |
| What is therapy for a Tet Spell | placing the baby's knees to its chest to decrease pulonary venous return and increase systemic vascular resistance. |
| What are the four defects resulting in Acyanosis and increased PBF? | the Ds (Names with a component starting with a D) ASD, VSD, AVSD, PDA |
| what are the defects that result in acyanosis and nml PBF? | the stenosis and Coarcs, Pulmonary and Aortic Stenosis and Aortic Coarctation |
| You have a kid with cyanosis and decreased pulmonary blood flow what do they have? | Pulmonary Atresia, Ebstein's Anomaly, or Tetrology of Fallot |
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UVAPATH3
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