USMLE Step 1 Web Prep — Thorax: Part 2

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Thorax: Part 2
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$his results in hypertrophy of the ri%ht side of the heart and underdevelop-ent of the left side. 389595 >>> 00:0.:/3 SLIDE 5 of 25 Clinical Correlate Pre ature closure of the $% is the closure of the () durin% prenatal life. $his is the -ost clinically si%nificant A . is s-all" clinical sy-pto-s -ay be delayed as late as a%e 30.. . +f the A . Secundu !t"#e ASDs are caused by excessive resorption of the !" or reduced si#e of or both. $his results in an openin% bet&een the ri%ht and left atria 'patent ()*.389590 >>> 00:05:58 SLIDE 4 of 25 Clinical Correlate Atrial septal defects are called ASDs.

05 >>> 00:08:/1 SLIDE . !ul-onary hypertension causes -ar3ed proliferation of the tunica inti-a and -edia of pul-onary -uscular arteries and arterioles.er co #lex.to develop" and it results in left!to!ri. of 25 Clinical Correlate 'e (ranous )entricular Se#tal Defect *)SD+ 4lti-ately" the pul-onary resistance beco-es hi%her than syste-ic resistance and causes ri. SLIDE & of 25 Clinical Correlate 'e (ranous )entricular Se#tal Defect *)SD+ A -e-branous 0 . of blood throu%h the +0 fora-en.ht shuntin. !atients &ith left1to1ri%ht shuntin% co-plain of excessi-e fati.389.ue u#on exertion. . At this sta%e" the condition is called Eisen en. of blood and c"anosis. is caused by the failure of the -e-branous +0 septu.ht!to!left shuntin. 2eft1to1ri%ht shuntin% of blood is noncyanotic but causes increased blood flo& and pressure to the lun%s 'pul-onary hypertension*.00 >>> 00:07:3. 389.

10 >>> 00:09:10 SLIDE / of 25 389.fails to ali%n properly and results in '1* pul-onary stenosis" '5* overridin% aorta" '3* interventricular septal defect" and '/* ri%ht ventricular hypertrophy.ht!to!left shuntin% of blood &ith resultant c"anosis.15 >>> 00:10:35 SLIDE 0 of 25 Clinical Correlate Tetralo. +nfants born alive &ith this defect -ust have other defects that allo& -ixin% of oxy%enated and deoxy%enated blood.fails to develop in a spiral fashion and results in the aorta openin% into the ri%ht ventricle and the pul-onary trun3 openin% into the left ventricle.55 >>> 00:13:0.ht!to!left shuntin% of blood &ith resultant c"anosis.50 >>> 00:15:09 SLIDE 11 of 25 Clinical Correlate Trans#osition of the .reat -essels occurs &hen the A! septu." of $allot occurs &hen the A! septu. 389. $his causes ri. 389. . $his causes ri.389.

389. !.%.A is co--on in pre-ature infants and cases of -aternal rubella infection.venosu(ossa ovale 2i%a-entu. !rosta%landin 9 and intrauterine or neonatal asphyxia sustain patency of the ductus arteriosus.:1. SLIDE 14 of 25 Clinical Correlate Patent ductus arteriosus !rosta%landin inhibitors 'e.the li%a-entu.30 >>> 00:1/:35 SLIDE 12 of 25 Adult )esti. 389.teres 2i%a-entu.ht!to!left shuntin% of blood &ith resultant c"anosis. $he causes ri./5 >>> 00:17:0/ SLIDE 15 of 25 .SLIDE 11 of 25 Clinical Correlate Persistent truncus arteriosus occurs &hen there is only partial develop-ent of the A! septu-.35 >>> 00:15:/." indo-ethacin*" acetycholine" hista-ine" and catechola-ines pro-ote closure of the ductus arteriosus.es Deri-ed $ro the $etal Circulator" S"ste Changes After Birth 6losure of ri%ht and left u-bilical arteries 6losure of left u-bilical vein 6losure of ductus venosus 6losure of fora-en ovale 6losure of ductus arterious $able +++1513. Remnant in Adult 7edial u-bilical li%a-ents 2i%a-entu.A* occurs &hen the ductus arteriosus 'a connection bet&een the pul-onary trun3 and aorta* fails to close after birth.both the ri%ht and left ventricles. $his defect is al&ays acco-panied by -e-branous ventricular septal defect. +t causes a left1to1ri%ht shuntin% of blood '8ote: the ductus arteriosus durin% fetal develop-ent is a ri%ht1to1left shunt*. 389. 8or-ally" the ductus arteriosus closes &ithin a fe& hours after birth via s-ooth -uscle contraction to for. '!a%e 139* 389.arteriosu-./0 >>> 00:1. $his results in a condition in &hich only one lar%e vessel leaves the heart and it receives blood fro.arteriosu- SLIDE 13 of 25 Clinical Correlate Patent ductus arteriosus '!.

of 25 .55 >>> 00:50:/0 SLIDE 1.389.50 >>> 00:18:/0 SLIDE 1& of 25 389.

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