Prezzi Powerpoints Flashcards
The fetal heart begins to beat at __-__ days of gestation
36
37
A heart rate using M-mode should be sonographically obtainable with endovaginal imaging when crown rump length measures __-__ mm
4
5
In the third trimester, an average fetal heart rate is ___ bpm, with a range of 110 to 180 bpm considered normal after first trimester.
150
An elevation in the fetal heart rate is term _____
tachycardia
A decreased in the fetal heart rate is term _____
bradycardia
The heart, which is fully formed at __ weeks, is imaged most often in a cross-sectional or axial view of the fetal chest just above the fetal stomach. This transducer placement will yield the standard _______ view. The apex of the heart will be angled to the ____ of the midline, with the base, _____ to the spine.
10
four chamber
left
closest
The normal fetal heart will fill approximately _____ of the fetal chest, with its apex forming a ___ degree angle with the fetal spine.
1/3
45
The chamber closest to the fetal spine is the:
left atrium
The ______ is within the right ventricle. Normal structure that appears as an echogenic focus.
moderator band
The ____ valve is between the right ventricle and the right atrium.
tricuspid
The ____ valve is between the left ventricle and the left atrium.
mitral
The four chamber view can be used to evaluate, the separation of the chambers, structures called _____
septums
The two atria are separated by the _____ septum.
atrial
The two ventricles are separated by the _____ septum.
ventricular
The ventricular septum should be uninterrupted and of equal thickness to the:
left ventricular wall
The atrial septum is open only at the _____
foramen ovale
Three vessel view
main pulmonary artery
ascending aorta
superior vena cava
The ______ outflow tract leads to the pulmonary artery and branches.
right ventricular
The ______ outflow tract leads to the aorta.
left ventricular
The normal pulmonary artery should be positioned ____ to the aorta and should be visualized crossing over it. That means, the aorta and pulmonary artery normally criss cross each other.
anterior
The normal umbilical cord contains:
two arteries and one vein
The _______ brings oxygen-rich blood from the placenta to the fetus
umbilical vein
The _____ travels superiorly and connects to the left portal vein
umbilical vein
Half of the blood goes to the liver through the _____, whereas the other half is shunted directly into the inferior vena cava via a small branch of the umbilical vein called the _____
left portal vein
ductus venosus
The existing oxygen -rich blood in the IVC travels to the heart and enters the:
right atrium
Blood can then travel across the ______, an opening in the lower middle third of the atrial septum and into the ______, or it can eneter the right ventricle through the _____.
foramen ovale
right atrium
tricuspid valve
The blood then leaves the right ventricle through the _____.
main pulmonary artery
Blood from the right ventricle can also flow through the _____ and into the descending aorta.
ductus arteriosus
The blood returning from the lungs through the pulmonary veins enters into the _____.
left atrium
Blood then travels from the left atrium into the left ventricle via the ______
mitral valve
From the left ventricle, it travels to the ascending aorta and into the aortic arch, where it exits into the ______, _____, and ______ on its way to the thorax, upper extremities, and head.
brachiocephalic artery
left common carotid artery
left subclavian artery
The blood will return from the head and upper torso via the _____ to the right atrium.
superior vena cava
The ______ return the deoxygenated blood from the fetus back to the placenta.
umbilical arteries
The ______ diverts blood from right to left atrium, bypassing the pulmonary circulation. It closes to become the _____
foramen ovale
fossa ovalis
The ______diverts blood from pulmonary artery to aorta, bypassing pulmonary circulation
ductus arteriosus
The ductus arteriosus diverts __% of umbilical vein blood away from the liver.
80
a group of anomalies characterized sonographically as a small or absent left ventricle
hypoplastic left heart syndrome
the leading cause of cardiac death in the neonatal period, with 95% dying within the first month of life if surgery is not performed
hypoplastic left heart syndrome
When HLHS is found in girls ______ must be suspected. There is also a connection with _____
Turner syndrome
trisomy 18
sonographic findings of HLHS
absent or small left ventricle
no communication between left atrium and left ventricle
aortic atresia
aortic stenosis
coarctation of the aorta
sonographically identified as a small or an absent right ventricle; most often results from pulmonary stenosis or pulmonary atresia, but it may result from stenosis or atresia of the tricuspid valve
hypoplastic right heart syndrome
sonographic findings of hypoplastic right heart syndrome
absent of small right ventricle
enlarged left ventricle
fetal hydrops (secondary to cardiac failure)
narrowing of the pulmonary valveab
abnormal opening in the septum between the two atria of the heart
atrial septal defect
sonographic findings of atrial septal defect
absence of part of the atrial septum
combination of both ASD and AVD
atrioventricular septal defect
results from the abnormal development of the central portion of the heart
atrioventricular septal defect
endocardial cushion defect
atrioventricular septal defect
AVSD is commonly associated with ____, ______, and _____
aneuploidy
trisomy 21
trisomy 18
sonographic findings of AVSD
absence of the atrial and ventricular septum
malformation of malpositioning of the tricuspid valve
Ebstein anomaly
In ebstein anomaly. the right ventricle is contiguous with the right atrium, a finding referred to as _____
“atrialized” right ventricle
Sonographic findings of Ebstein anomaly
malpositioned tricuspid valve
right and left atrial shunting
tricuspid regurgitation
enlarged right atrium
deviation of the atrial septum to the left
fetal hydrops (secondary to cardiac failure)
abnormal opening in the septum between the two ventricles of the heart
ventricular septal defect
sonographic findings of ventricular septal defect
absence of part of the ventricular septum
Most common form of cardiac defect
ventricular septal defect
fluid located around the heart
pericardial effusion
anechoic fluid surrounding the heart
pericardial effusion
narrowing of the aortic arch
coarctation of the aorta
The most common location of coarctation of the aorta is:
between the left subclavian artery and the ductus arteriosus
Sonographic findings of coarctation of the aorta
narrowing of the aortic arch
right ventricular enlargement
pulmonary artery enlargement
outflow tracts reversed; the pulmonary artery arises from the left ventricle and the aorta arises from the right ventricle
transposition of the great vessels
Most often seen within the left ventricle; thought to represent the calcification of the papillary muscle or chordae tendinae
echogenic intracardiac focus
sonographic findings of echogenic intracardiac focus
echogenic structure most commonly located in the left ventricle
most common fetal cardiac tumor
rhabdomyoma
Tumor located within the myocardium of the heart
rhabdomyoma
Rhabdomyoma is associated with ______
tuberous sclerosis
heart is located either partially or completely outside of the chest
ectopic cords
g group of anomalies that combine ectopic cordis and an existing omphalocele
Pentalogy of Cantrell
defined as an overriding aortic root, subaortic VSD, pulmonary stenosis, and right ventricular hypertrophy
Tetralogy of Fallot
sonographic findings of Tetralogy of Fallot
overriding aortic root, VSD, pulmonary atresia, right ventricular hypertrophy
Functional fetal lung tissue does not typically exist until after ___ weeks
25
The normal L/S ratio is ___=___ and is significant for appropriate fetal lung development
2.0
2.5
An L/S ratio of less than ____ is significant for immature fetal lung development
2.0
L/S ratio is:
lecitihin to sphingomyelin ratio
As the lungs mature the level of lecithin _____ whereas the level of sphingomyelin _____
increases
decreases
Begins at 4-5 weeks of gestation, where two tiny buds branch off to form either side of the lungs
embryonic phase
Begins at 5-17 weeks of gestation when a barrier develops between the air and gas-carrying tissues
canalicular phase
Begins at the 26th week of gestation when the surfactant starts to develop, keeping the delicate lung tissues from sticking
Saccular phase
Final stage continues even after delivery, where the additional production of surfactant states, and bronchioles and air sacs (alveoli) grow
alveolar phase
5 phases of lung development
embryonic
pseudoglandular
canalicular
saccular
alveolar
underdevelopment of the lungs
pulmonary hypoplasia
caused by a decreased number of lung cells, airways, and alveoli
pulmonary hypoplasia
Pulmonary hypoplasia is a common finding with _____
oligiohydramnios
The most common lesion that occupies the chest, resulting in pulmonary hypoplasia is:
diaphramatic hernia
Pulmonary hypoplasia is associated with:
Potter syndrome
fluid surrounding the lungs
pleural effusion
also known as hydrothorax
pleural effusion
anechoic fluid surrounding the fetal lungs
pleural effusion
also referred to as congenital cystic adenomatoid malformation (CCAM)
cystic adenomatoid malformation
mass consisting of abnormal bronchial and lung tissue
CCAM
mass that has both cystic and solid components, however it can also appear completely echogenic
CCAM
lung mass with varying degrees of cystic and solid components, completely echogenic mass within the lungs
sonographic appears of CCAM
also referred to as bronchopulmonary sequestration
pulmonary sequestration
separate mass of nonfunctioning lung tissue with its own blood supply to
pulmonary sequestration
echogenic, triangular-shaped mass, typically located with the left side of the fetal chest
pulmonary sequestration
sonographic findings of pulmonary sequestration
echogenic triangular shaped mass in the fetal chest; pleural effusion may be present
most common reason for fetal cardiac malpostion
diaphragmatic hernia
results in abnormal opening in the fetal diaphragm that allows the herniation of abdominal contents into the chest cavity
diaphragmatic hernia
Most common location of diaphragmatic hernia
left side of chest
Left sided diaphragmatic hernia located on the left side is called:
Bockdalek hernia
Sonographic findings of diaphragmatic hernia
malposition of the heart
anechoic stomach bubble noted adjacent to the fetal heart in the four chamber view
other abdominal organs including the liver, pancreas, and spleen may be located within the chest
The fetal thymus is located anterior to the:
mediastinum
The thymus is apart of the immune system because it provides a place for the maturation of _____, which are specialized white blood cells
T cell
hypoechoic structure located in the anterior chest at the level of the sternum between the lungs
thymus
genetic disorder characterized by an absent or a hypoplastic thymus, which ultimately leads to impairment of the immune system and susceptibility to infection, as well as cognitive disorders, congenital heart defects, palate defects, and hormonal abnormalities
DiGeorge syndrome
The spine consists of five sections:
cervical
thoracic
lumbar
sacrum
coccyx
Each fetal vertebra consists of three echogenic ossification centers:
one centrum and two neural processes
The axial skeleton begins to form between the __ and ___ weeks.
6
8
The axial skeleton consists of the:
cranium
spine
hypoechoic line at structure that extends from the base of the cranium to the distal spine
spinal cord
_____ and ____ are the most common neural defects, occurring in 1 of every 1000 births
anencephaly
spina bifida
____ spina bifida is not associated with elevated MSAFP because of the skin covering
closed
It has been reported that __% of spina bifida cases can be detected with AFP screening in combination with sonography.
80
Distortion of the spine can be seen with:
hemivertebrae
myelomeningoceles
amniotic band syndrome
limb-body wall complex
a deformity of the spine in which there is an abnormal lateral curvature
scolisiosis
abnormal posterior curvatures of the spine
kyphosis
when the lower back, above the buttocks, curves inward too much; also konwn as swayback
lordosis
When the upper spine curves too far outward, forming a hump on the upper back
lordosis
deformity of the spine in which there is an abnormal lateral curvature of the spine
scoliosis
abnormal posterior curvature of the spine
kyphosis
also referred to as body stalk anomaly or short umbilical cord syndrome
limb body wall complex
Three postulated causes for limb body wall complex
vascular occlusion
amnion rupture
embryonic dysgenesis
most common sonographic findings of limb body wall complex
short or absent umbilical cord
ventral wall defects
limb defects
craniofacial defects
scoliosis
fetus will appear closely connected with the placenta
Because of the opening in the ventral wall, ____ levels of MSAFP can be detected in the second trimester in limb body wall complex
elevated
________ has very similar sonographic findings to limb body wall complex and may actually be seen simultaneously
Amniotic band syndrome
A common sonographic findings of LBWC is:
short or absent umbilical cord
denotes the abnormal development of a structure
dysplasia
More than ___ skeletal dysplasias have been identified
271
Four most common skeletal dysplasia
achondroplasia
achondrogenesis
osteogenesis imperfecta
thanatoprhoic dysplasia
most common nonlethal skeletal dysplasia
achondroplasia
a type of dwarfism in which the proximal portions of the limbs, the humerus and femurs, are much shorter than the distal portion of the limbs
heterozygous achondroplasia
proximal portions of the limbs are much shorter than the distal portions of the limbs
rhizomelia
sonographic findings of heterozygous achondroplasia
micromelia
macrocrania
frontal bossing
flattened nasal bridge
trident hand
can occur when both parents are dwarfs, it is usually fatal within the first two years of life
homozygous achondroplasia
rare lethal condition, resulting in absent mineralization of the skeletal bones
achondrogenesis
severely shortened limbs
micromelia
sonographic findings of achondrogenesis
micromelia
absent mineralization of the skull, spine, pelvis, and limbs
large skull
narrow chest and distended abdomen
polyhydramnios
commonly known as brittle bone disease
osteogenesis imperfecta
group of disorders that results in multiple fractures that can occur in utero
osteogenesis imperfecta
The fractures in osteogenesis imperfecta are a result of decreased _____ and poor ______
mineralization
ossification
Osteogenesis imperfecta ___ is the most severe form
II
when transducer pressure is applied to skull, the shape of the “soft” skull can be distorted
osteogenesis imperfecta
“death-bearing” dysplasia
thanatophoric dysplasia
most common lethal dysplasia
thanatophoric dysplasia
fetus will have a cloverleaf skull with frontal bossing and hydrocephalus
thanatophoric dysplasia
cloverleaf skull
hydrocephalus
depressed nasal bridge
bell-shaped crest (narrow thorax)
polyhydramnios
redundant soft tissue
telephone-receiver long shaped bones
sonographic findings of thanatorphic dysplasia
Most common location of spina bifida
lumbosacral region
neural tube defect that occurs when the embryonic neural tube fails to close
spina bifida
Two groups of spina bifida
spina bifida occulta (closed)
spina bifida aperta (open)
may be referred to as spinal dysraphism, meningocele, myelomeningocele
spina bifida
open spina bifida
spina bifida aperta
Most common form of spina bifida
spina bifida aperta
