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SMS 1053 Dr. Mohanad R. Alwan
Anatomy and Physiology <ul><li>Fetus depends on placenta to meet O2 needs while organs continue formation </li></ul><ul><l...
The Placenta <ul><li>The circulatory system of the mother is not directly connected to that of the fetus, so the placenta ...
Anatomy and Physiology Fetal Circulation <ul><li>Umbilical cord </li></ul><ul><ul><li>2 umbilical arteries:  return non-ox...
Fetal Circulation
How does the blood move?? <ul><li>Umbilical VEIN  carries oxygenated blood and nutrients from the placenta to the fetus </...
Foramen Ovale <ul><li>Blood is shunted from right atrium to left atrium, skipping the lungs. </li></ul><ul><li>More than o...
Fetal Circulation <ul><li>Blood continues to travel from the inferior vena cava to the  ductus Venosus </li></ul><ul><li>D...
What happens to the blood after it reaches the right atrium?? <ul><li>Blood flows right into the left atrium through the  ...
F.C <ul><li>Some of the  blood  entering the right atrium does not pass directly to the  left atrium  through the  foramen...
Ductus Arteriousus
Fetal Circulation <ul><li>After it proceeds to  the  left ventricle  where it is pumped to the heart and brain </li></ul><...
What about the rest of the blood?? <ul><li>The blood still in the right atrium goes into the right ventricle then to the p...
What is happening further down?? <ul><li>Common iliac arteries branch into the external and internal iliacs.  </li></ul><u...
Fetal Circulation <ul><li>Low pressure system </li></ul><ul><ul><li>Lungs are closed </li></ul></ul><ul><ul><li>Most oxyge...
What happens after birth? <ul><li>Once the baby is born and the lung, renal, digestive and liver functions are working the...
Conversion of Fetal to Infant Circulation <ul><li>At birth </li></ul><ul><ul><li>Clamping the cord shuts down low-pressure...
Conversion (cont) <ul><li>What happens to these special structures after birth? </li></ul><ul><ul><li>Umbilical arteries a...
Overview of Conversion <ul><li>Umbilical cord is clamped </li></ul><ul><li>Loose placenta </li></ul><ul><li>Closure of duc...
Fetal vs. Infant Circulation <ul><li>Fetal </li></ul><ul><li>Low pressure system </li></ul><ul><li>Right to left shunting ...
 1-fetal circulation
 1-fetal circulation
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1-fetal circulation

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1-fetal circulation

  1. 1. SMS 1053 Dr. Mohanad R. Alwan
  2. 2. Anatomy and Physiology <ul><li>Fetus depends on placenta to meet O2 needs while organs continue formation </li></ul><ul><li>Oxygenated blood flows from the placenta </li></ul><ul><li>To the fetus via the umbilical vein </li></ul><ul><li>After reaching fetus the blood flows through the inferior vena cava </li></ul>
  3. 3. The Placenta <ul><li>The circulatory system of the mother is not directly connected to that of the fetus, so the placenta functions as the respiratory center for the fetus </li></ul><ul><li>as well as a site of filtration for plasma nutrients and wastes. Water, glucose, amino acids, vitamins, and inorganic salts freely diffuse across the placenta along with oxygen. </li></ul><ul><li>The uterine arteries carry oxygenated blood to the placenta, and permeates the sponge like material there. </li></ul>
  4. 4. Anatomy and Physiology Fetal Circulation <ul><li>Umbilical cord </li></ul><ul><ul><li>2 umbilical arteries: return non-oxygenated blood, fecal waste, CO2 to placenta </li></ul></ul><ul><ul><li>1umbilical vein : brings oxygenated blood and nutrients to the fetus </li></ul></ul><ul><li>Facilitates gas and nutrient exchange between maternal and fetal blood.The blood itself does not mix. </li></ul>
  5. 5. Fetal Circulation
  6. 6. How does the blood move?? <ul><li>Umbilical VEIN carries oxygenated blood and nutrients from the placenta to the fetus </li></ul><ul><li>Where does the vein enter?? </li></ul><ul><ul><ul><li>At the navel and ascends into the liver </li></ul></ul></ul><ul><li>How is the blood dispersed?? </li></ul><ul><ul><li>½ of the blood enters the liver while the other half comes into the ductus Venosus and then into the inferior vena cava </li></ul></ul>
  7. 7. Foramen Ovale <ul><li>Blood is shunted from right atrium to left atrium, skipping the lungs. </li></ul><ul><li>More than one-third of blood takes this route. </li></ul><ul><li>Is a valve with two flaps that prevent back-flow. </li></ul>
  8. 8. Fetal Circulation <ul><li>Blood continues to travel from the inferior vena cava to the ductus Venosus </li></ul><ul><li>Ductus Venosus : shunts a significant majority (80%) of the blood flow of the umbilical vein directly to the inferior vena cava. </li></ul><ul><li>Ductus Venosus it allows oxygenated blood from the placenta to bypass the liver and puts blood into the hepatic veins. </li></ul><ul><ul><li>Small amount of blood routed to growing liver </li></ul></ul><ul><ul><li>Increased blood flow leads to large liver in newborns </li></ul></ul>
  9. 9. What happens to the blood after it reaches the right atrium?? <ul><li>Blood flows right into the left atrium through the foramen ovale. </li></ul><ul><li>Alamak,What is that? It’s Small opening in the septum of the heart </li></ul><ul><li>Foramen ovale </li></ul><ul><ul><li>Small opening in the septum of the heart </li></ul></ul><ul><ul><li>Completely by passes the non-functioning lungs </li></ul></ul><ul><li>Here again it mixes with a smaller amount of deoxygenated blood from the pulmonary veins. </li></ul>
  10. 10. F.C <ul><li>Some of the blood entering the right atrium does not pass directly to the left atrium through the foramen ovale , but enters the right ventricle and is pumped into the pulmonary artery . </li></ul><ul><li>In the fetus, there is a special connection between the pu l monary artery and the aorta , called the ductus arteriosus , which directs most of this blood away from the lungs (which aren't being used for respiration at this point as the fetus is suspended in amniotic fluid) </li></ul>
  11. 11. Ductus Arteriousus
  12. 12. Fetal Circulation <ul><li>After it proceeds to the left ventricle where it is pumped to the heart and brain </li></ul><ul><li>Blood continues journey to the left ventricle blood is then pumped into the aorta </li></ul><ul><li>Blood is circulated to the upper extremities </li></ul><ul><li>Blood then returns to the right atrium </li></ul>
  13. 13.
  14. 14. What about the rest of the blood?? <ul><li>The blood still in the right atrium goes into the right ventricle then to the pulmonary artery. </li></ul><ul><li>Once there most of the blood by passes the lungs and heads to the aorta through the ductus arteriosus. </li></ul><ul><li>About 15% of the blood flows through lungs to the right atrium by way of the pulmonary veins </li></ul><ul><li>Pulmonary arteries </li></ul><ul><ul><li>Small amount goes to the maturing lungs </li></ul></ul><ul><li>Rest of blood is shunted away from lungs by ductous ateriosus back to aorta </li></ul>
  15. 15. What is happening further down?? <ul><li>Common iliac arteries branch into the external and internal iliacs. </li></ul><ul><li>The blood in the internal iliacs come into the umbilical arteries and flow back to the placenta to gather oxygen and to get rid of the waste products </li></ul><ul><li>Some of the blood moves from the aorta through the internal iliac arteries to the umbilical arteries, and re-enters the placenta, the maternal circulation </li></ul>
  16. 16. Fetal Circulation <ul><li>Low pressure system </li></ul><ul><ul><li>Lungs are closed </li></ul></ul><ul><ul><li>Most oxygenated blood flows between the atria of the heart through the foramen ovale </li></ul></ul><ul><ul><li>This oxygen rich blood flows to the brain through the ductus arteriosus </li></ul></ul>
  17. 17. What happens after birth? <ul><li>Once the baby is born and the lung, renal, digestive and liver functions are working the fetal circulation undergoes some changes since they are no longer needed </li></ul>
  18. 18. Conversion of Fetal to Infant Circulation <ul><li>At birth </li></ul><ul><ul><li>Clamping the cord shuts down low-pressure system </li></ul></ul><ul><ul><li>Increased atmospheric pressure(increased systemic vascular resistance) causes lungs to inflate with oxygen </li></ul></ul><ul><ul><li>Lungs now become a low-pressure system </li></ul></ul><ul><ul><li>Pressure from increased blood flow </li></ul></ul>
  19. 19. Conversion (cont) <ul><li>What happens to these special structures after birth? </li></ul><ul><ul><li>Umbilical arteries atrophy </li></ul></ul><ul><ul><li>Umbilical vein becomes part of the fibrous support ligament for the liver </li></ul></ul><ul><ul><li>The foramen ovale, ductus arteriosus, ductus venosus atrophy and become fibrous ligaments </li></ul></ul>
  20. 20. Overview of Conversion <ul><li>Umbilical cord is clamped </li></ul><ul><li>Loose placenta </li></ul><ul><li>Closure of ductus venosus </li></ul><ul><li>Blood is transported to liver and portal system </li></ul>
  21. 21. Fetal vs. Infant Circulation <ul><li>Fetal </li></ul><ul><li>Low pressure system </li></ul><ul><li>Right to left shunting </li></ul><ul><li>Lungs non-functional </li></ul><ul><li>Increased pulmonary resistance </li></ul><ul><li>Decreased systemic resistance </li></ul><ul><li>Infant </li></ul><ul><li>High pressure system </li></ul><ul><li>Left to right blood flow </li></ul><ul><li>Lungs functional </li></ul><ul><li>Decreased pulmonary resistance </li></ul><ul><li>Increased systemic resistance </li></ul><ul><ul><li>Overall anatomic changes are not complete for weeks </li></ul></ul>

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