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OB 2 > Chapter 27: Sonographic Assessment of the Fetal Abdomen (Includes Abdominal wall) > Flashcards

Chapter 27: Sonographic Assessment of the Fetal Abdomen (Includes Abdominal wall) Flashcards

1
Q

accumulation of fluid in the abdominal cavity

A

ascites

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2
Q

congenital blockage or absence of the bilde duct

A

biliary atresia

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3
Q

congenital absence or closing of the duodenal lumen

A

duodenal atresia

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4
Q

membrane-free ventral wall defect with protrusion of abdominal contents laterla to umbilical cord

A

gastroschisis

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5
Q

Half-Fourier acquisition single-shot turbo spin-echo; a fast spin method to obtain the MRI dataset

A

HASTE

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6
Q

Formation of blood cells

A

hematopoesis

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7
Q

congenital lack of nerves in the colon resulting in fetal impaction and a megacolon

A

Hirschprung disease

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8
Q

areas of high intensity or increased brightness on MRI image

A

hyperintense

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9
Q

areas of low intensity or decreased brightness on MRI iamge

A

hypointense

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10
Q

areas of similar intensity or increased brightness on MRI image

A

isointense

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11
Q

bowel obstructed by mucus

A

meconium ileus

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12
Q

Bowel obstructed owing to bowel twisting

A

midgut volvulus

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13
Q

congenital disorder where the spinal cord does not close before birth

A

myelomeningocele

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14
Q

membrane-covered ventral wall defect containing abdominal contents involving the umbilical cord

A

omphalocele

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15
Q

reversal of normal organ position

A

situs inversus

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16
Q

Genetic abnormality where there is a presence of three copies of a particular chromosome

A

Trisomy

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17
Q

radiographic study using barium sulfate as a contrast agent to outline and fill gastrointestinal tract

A

Upper GI

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18
Q

simple tool for evaluating the performance of each reference curve for a given population to optimize the sensitivity and specificity of screening for fetal growth abnormalities

A

Z-score

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19
Q

caused by:
fetal anemia
Rh incompatability

A

immune fetal hydrops

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20
Q

caused by:
heart arrythymias
intrauterine infections
chromosomal anomalies
masses causing venous obstruction
blood disorders
renal anomalies
maternal diabetes

A

nonimmune fetal hydrops

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21
Q

Sonographic features of fetal hydrops

A

anasarca
pleural effusion
ascites
hepatomegaly
splenomegaly
thick placenta

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22
Q

herniation of abdominal viscera into base of umbilical cord; liver involvement common

A

omphalocele

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23
Q

complex membrane, enclosed sac; midline anterior wall defect continuous with umbilical cord; size varies with amount of involved viscera

A

omphalocele

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24
Q

herniation of abdominal viscera through an off-midline defect in the abdominal wall, usually located just to the right of the umbilicus; liver involvement very unsual

A

gastrochiasis

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25
Q

free-floating bowel loops are not bound by a sac, normal umbilical cord insertion

A

gastroschisis

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26
Q

protrusion of a small amount of intestine at umbilicus; covered by skin and subcutaneous tissue; usually 2-4 cm

A

umbilical cord hernia

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27
Q

congenital failure of the abdominal wall to develop over bladder; urinary bladder may be everted; no fluid-filled intrapelvic bladder; most common in boys

A

bladder exstrophy

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28
Q

defect of lower sternum and anterior abdominal wall; heart protrudes into extrathoracic sac covered by skin or a thin membrane; the beating heart protrudes through the anterior abdominal wall into the amniotic fluid

A

ectopic cordis

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29
Q

a complex of anomalies including lateral body wall defects of thorax and abdomen with herniation of viscera;

A

limb-body wall complex

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30
Q

herniated viscera within a complex membrane involved mass, severe scoliosis, cranial, and spinal defects; severe form of amniotic band syndrome through to play a major role in pathogenesis

A

limb-body wall complex

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31
Q

stomach, bowel, or other abdominal organs within chest
peristalsis of structures within chest
small abdominal biometry
descension and ascension of organs with fetal breathing
pleural effusion
polydramnios
documentation of portal and umbilical vessels via color Doppler

A

sonographic features of congenital diaphragmatic hernia

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32
Q

fluid-filled proximal duodenum
polyhydramnios
echogenic mass inferior to liver
dilated bowel loops
whirlpool sign
twisted vessels with color Doppler

A

Midgut volvulus

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33
Q

fluid-filled stomach and duodenum creating the double-bubble sign
symmetric intrauterine growth retardation
polyhydramnios

A

Duodenal atresia

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34
Q

Dilated echogenic ileum
intraperitoneal fluid
possible pseudocyst
intra-abdominal calcifications
polyhydramnios
dilated small bowel
increased abdominal biometery
decreased bowel peristalsis

A

meconium ileus

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35
Q

Organs attain normal adult position when”

A

early 2nd trimester

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36
Q

Umbilical arteries course _____ to the fetal bladder

A

caudally

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37
Q

Umbilical vein runs course cephalic into the _____

A

portal vein

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38
Q

Right parasagittal views through thorax and abdomen allow evaluation of ____ and ____

A

fetal lung
liver

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39
Q

Left parasaggital views through thorax and abdomen allow evaluation of _____ and _____

A

stomach
left kidney

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40
Q

Midline sagittal views allow evaluation of ______ with _______

A

umbilicus
anterior abdominal wall

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41
Q

Which type of situs inversus has an increased incidence of abnormalities?

A

partial

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42
Q

mirror imaging or thoracic and abdominal contents

A

situs inversus totalis

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43
Q

With situs inversus totalis the heart is on the ____ side of the thorax and the abdominal organs are _____

A

right
transposed

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44
Q

Normal abdominal organs should be seen in cephalic position

A

spine, stomach, umbilical vein clockwise

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45
Q

outer echogenic skin line and a deeper 1-3 mm hypoechoic muscular layer

A

abdominal wall

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46
Q

3 main muscle groups of abdominal wall

A

internal oblique
transverse abdominal
external oblique

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47
Q

The hypoechoic muscular layer of the abdominal wall is also referred to as:

A

pseudoascites

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48
Q

caudal outpouching of yolk sac; involved in early blood production

A

allantois

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49
Q

The blood vessels of the allantois eventually become:

A

umbilical vessels

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50
Q

A two vessel cord is more common in ____ pregnancies

A

twin

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51
Q

acts as a conduit between portal and system veins

A

fetal ductus venossu

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52
Q

echogenic line in fissue of ligamentum venosum between left and caudate lobes

A

ductus venosus

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53
Q

carry most of fetal aortic blood to placenta

A

umbilical arteries

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54
Q

A fetus from a _____ mother will have increased abdominal tissue and larger AC measurements

A

diabetic

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55
Q

The liver, gallbladder, ducts, pancreas develop from ______

A

embryonic foregut

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56
Q

outgrowth development on caudal portion of foregut; the hepatic diverticulum

A

liver

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57
Q

In the second trimester the liver is ___% of the fetal weight.

A

1o

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58
Q

In the __ week hematopoeisis begins

A

6

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59
Q

In the ___ week the bile secretion begins

A

12

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60
Q

forms from caudal portion of hepatic diverticulum; ducts canalize through degeneration of epithelial cells

A

gallbladder

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61
Q

After ___ weeks, the biles empties into the duodenum

A

13

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62
Q

The spleen is part of the _____ system

A

lymphatic

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63
Q

The spleen develops during the __ weeks

A

5th

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64
Q

large, homogenously echogenic organ occupying RUQ

A

liver

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65
Q

located to the right of midline, separates the right lobe from the medial left lobe, tear drop shape, posteroinferior to the liver

A

gallbladder

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66
Q

homogenous, located posterior to stomach and superior to left kidney;

A

spleen

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67
Q

begins as dilation of stomach primordium site in fourth week

A

stomach

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68
Q

The _____ is the result of faster growth of dorsal border of stomach primordium

A

greater curvature

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69
Q

formed by the caudal portion of foregut, splanchnic mesenchyme, and cranial portion of the midgut

A

duodenum

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70
Q

During the __ to __ week, the duodenal lumen closes until degeneration of epithelial cells resulting in recanalized lumen at end of first trimester

A

5
6

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71
Q

The umbilical herniation begins during the first part of the __ week

A

6th

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72
Q

The umbilical herniation contains structures that will become the small intestine, these include:

A

most of the duodenum
cecum
appendix
ascending colon
2/3 transverse colon

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73
Q

provides communication between midgut and yolk sac through 10th week

A

yolk stalk or vitelline duct

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74
Q

After _______, structures return to abdomen.

A

midgut loop rotation

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75
Q

If there is echogenicity within the stomach:

A

swallowed blood or varix

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76
Q

Echogenicity within the stomach is indicative of:

A

placental abruption

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76
Q

Midgut herniation resolves by __ weeks

A

12

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77
Q

heterogenous echogenic pseudomass without shadowing occupying a substantial portion of the abdomen

A

small bowel

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78
Q

Z scores greater than 8 after 25 weeks gestation are indicative of:

A

small bowel pathology

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79
Q

long, continuous tubular structure with a hypoechoic lumen at abdominal periphery

A

colon

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80
Q

The transverse colon is just ____ to the liver

A

caudad

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81
Q

composed of materials fetus ingests during gestation

A

meconium

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82
Q

A thickened abdominal wall is visualized in fetuses:

A

fetal hydrops
offspring of gestational diabetic mothers

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83
Q

smaller AC owing to loss of glycogen stores in liver, decrease in liver size

A

asymmetric intrauterine growth retardation

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84
Q

Two most common types of ventral abdominal wall defects

A

omphaloceles
gastrochisis

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85
Q

linea alba defect and protruding bowel covered by skin and subcutaneous tissue

A

umbilical hernia

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86
Q

Four ectomesodermal layers aid in development of abdominal wall:

A

cephalic, caudal, pair of lateral folds

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87
Q

Abdominal wall defects have elevated _____ levels in amniotic fluid or maternal serum

A

alpha-fetoprotein

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88
Q

Midline defect where the bowel does not migrate back into abdomen and remnant in extraembryonic coelem of umbilical cord; may contain only bowel or organs and bowel

A

omphalocele

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89
Q

develops owing to body stalk persistence in an area normally occupied by abdominal wall

A

omphalocele

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90
Q

fusion failure of lateral ectodermal folds

A

Type I omphalocele

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91
Q

failure of muscle, fascia, and skin to fuse

A

type II omphalocele

92
Q

Omphaloceles measure between __ and __ cm.

A

2
10

93
Q

The membrane of an omphalocele is made up of _____ and _____

A

amnion
peritoneum

94
Q

Omphalocele may be suggested early in pregnancy if cord containing midgut has a maximal dimension of ___ mm or greater

A

7

95
Q

___-___% of omphaloceles are associated with other anomalies

A

50-70

96
Q

omphalocele associated with ectopia cordis

A

pentalogy of Cantrell

97
Q

Gastroshisis masses are between __-__ cm.

A

2
4

98
Q

Typically occurs just to the right umbilical cord insertion; abnormal involution of right umbilical vein and disruption of omphalomesenteric artery

A

gastroshisis

99
Q

comprise small or large bowel; free-floating; not covered by a membrane; leads to a development of fibrinous coating on bowel

A

herniated viscera (gastroshisis)

100
Q

Gastroshisis images as early as __-__ week.

A

14-16

101
Q

fluid within the peritoneum

A

ascites

102
Q

Ascites is seen best within the _____, flanks, _____, and pelvis

A

subhepatic space
abdominal cavity

103
Q

results from bladder outlet obstruction or renal forniceal rupture

A

urinary ascites

104
Q

result of bowel obstruction, or dilatation of the pyelocaliceal system or bladder indicating a GU problem

A

Bowel dilatation

105
Q

may cause walls for form around areas of greatest meconium concentration within peritoneum, forming meconium pseudocysts

A

localized fibrotic reactions

106
Q

simulation of fluid that lies along the inner aspect of the abdominal wall; fetuses over 18 weeks gestation; created by hypoechoic quality of abdominal wall musculature sandwiched between the highly echogenic subcuteaneous and preperitoneal tissue

A

pseudoascites

107
Q

The liver enlarges in association with ____

A

hydrops

108
Q

Growth retarded infants have ___ livers.

A

small

109
Q

Diabetic mothers and macromsomic fetuses have ____ livers.

A

large

110
Q

may develop because of interruption of development of intrahepatic biliary tree

A

solitary liver cysts

111
Q

Most common type of choledochal cysts

A

cystic dilatation of the CBD

112
Q

Choledochal cysts usually lie in anterior location adjacent to the _____

A

gallbladder

113
Q

Most common vascular tumor

A

infantile hemangioendothelioma

114
Q

echogenic masses within the fetal gallbladder that may or may not demonstrate posterior shadowing; often resolve as a result of postnatal hydration or because of changes in bile metabolism

A

gallstones

115
Q

There is a significant correlation between perimeter measurement of the spleen and ______

A

fetal hemoglobin defecit

116
Q

Asplenia and polysplenia associated with significant:

A

congenital heart disease

117
Q

Most common type of esophageal atresia

A

proximal esophageal pouch

118
Q

unequal partitioning of the foregut

A

esophageal atresia

119
Q

Most common atresia

A

anorectal

120
Q

_____ and stress of _____ may result in absence of stomach fluid

A

oligohydramnios
nonimmune hydrops

121
Q

caused by errors of GI lumen recanalization or errors in development of normal inpouching of longitudinal folds

A

duplication of stomach and bowel

122
Q

obstruction caused by bowel twisting upon its blood supply

A

midgut volvulus

123
Q

In volvulus the bowel twists around the _____

A

superior mesenteric artery

124
Q

usually diagnosed within first few days of life; infant may present with distention or obstruction, and biliary vomiting

A

volvulus

125
Q

fluid filled proximal duodenum with an arrowhead twist at point of descending or transverse duodenal obstruction; mild polyhydramnios; echogenic mass under fetal liver; slightly dilated bowel loops

A

volvulus

126
Q

the gold standard for midgut volvulus is:

A

upper GI

127
Q

failure of duodenum to change from a solid cord of tissue during development to a tube

A

duodenal atresia

128
Q

Majority of duodenal atresias occur distal to:

A

ampulla of Vater

129
Q

formed by pancreatic and common bile duct

A

hepatopancreatic ampulla

130
Q

major landmark marking foregut to midgut transition

A

hepatopancreatic ampulla

131
Q

occur high in abdomen; demonstrate multiple cystic structures with associated hydramnios

A

venjunoileal or ileal atresia or stensos

132
Q

most common sites of involvement in venjunoilieal or ileal atresia or stenosis

A

proximal jejunum and distal ileum

133
Q

known as apple peel or christmas tree atresia

A

extensive small bowel atresia

134
Q

fluid filling stomach and duodenum at site of obstruction

A

“double bubble” sign

135
Q

Duodenal atresia is most commonly associated with _____

A

trisomy 21

136
Q

third most common bowel obstruction

A

meconium ileus

137
Q

Meconium ileus is most often owing to ______

A

cystic fibrosis

138
Q

occurs when the meconium becomes thickened and congested in the ileum

A

meconium ileus

139
Q

dysfunction of the exocrine and mucus-producing glands

A

cystic fibrosis

140
Q

small bowel obstruction of distal ileus; increased stickiness and and thickness of meconium

A

meconium impaction

141
Q

Meconium peritonitis may result from ______ and _____

A

meconium ileus
cystic fibrosis

142
Q

Meconium peritonitis occurs following:

A

rupture of bowel

143
Q

Meconium peritonitis is usually seen within ___ days of rupture

A

8

144
Q

functional disorder of distal colon that results in perpetually contracted or tonic bowel; colon does not relax because of neuroenteric ganglion cells in mucosal layer of bowel

A

large bowel obstruction

145
Q

Descending colon measurement greater than __ mm in preterm fetus is abnormal

A

20

146
Q

The fetal rectosigmoid colon can reach __-__ cm near term

A

2
3

147
Q

Antenatal indication of Hischsprung

A

focal bowel dilatation proximal to obstruction

148
Q

most common echogenic fetal mass found in abdomen

A

echogenic bowel

149
Q

echogenic nonshadowing mass in lower abdomen and pelvis

A

collapsed small bowel

150
Q

cystic or solid appearing structures; formed by an inner epithelium of a respiratory or intestinal type and a two layer smooth muscle wall

A

enteric inclusion cysts

151
Q

dialysate of maternal serum

A

amniotic fluid

152
Q

essential for maintenance of an even fetal temperature and biochemical homeostasis; presence allows fetal movement and growth

A

amniotic fluid

153
Q

AFV 12 weeks

A

60 mL

154
Q

The AFV increases __-__ mL until week 16

A

20-25

155
Q

The AFV increases to __-__ mL until week 20

A

50-100

156
Q

Fetal urine production begins at __ weeks

A

12

157
Q

In the late third trimester, fetal urine production is ___ mL a day.

A

450

158
Q

decreased fluid surrounding fetus

A

oligohydramnios

159
Q

The umbilical cord consists of one _____ and two ______

A

umbilical vein
umbilical arteries

160
Q

Measure the ______ in a true axial plane of the abdomen, demonstrating the transverse spine, left-sided stomach, and umbilical vein entering into left portal vein.

A

abdominal circumference

161
Q

Measurements are made along the ____ perimeter of the abdomen

A

outer

162
Q

Echoes within the stomach can be associated with ______

A

swallowed blood

163
Q

By week ___, the small bowel should not be herniated within the base of the umbilical cord.

A

12

164
Q

An _____ has a covering, whereas the ______ demonstrates free-floating bowel within the amniotic fluid

A

omphalocele
gastroshisis

165
Q

The internal structure of the fetal kidneys are not reliably assessed before __ to __ weeks

A

14-16

166
Q

Polyhydramnios is common with _____

A

GI malformation

167
Q

Oligohydramnios is common with ______

A

renal malformation

168
Q

______ is the twisting of bowel around the blood supply

A

Midgut volvulus

169
Q

The characteristic finding of duodenal atresias on both the radiograph and the prenatal sonogram is called the _____ sign

A

double bubble

170
Q

The ______ presents as a dilated, echogenic mass or structure on sonographic examination

A

meconium ileus

171
Q

The fetal organ that is usually not seen well is the second trimester is the:

A

pancreas

172
Q

Left parasagittal views of the fetal abdomen demonstrate the:

A

stomach and left kidney

172
Q

The umbilical vein can be followed in a sagittal view from the anterior abdominal wall into the:

A

liver’s left portal vein

173
Q

The allantois is:
a. involved in early placental maturation
b. involved in early blood production
c. involved in the production of Wharton jelly
d. a permanent structure

A

b

174
Q

After birth, the ductus venosus closes and becomes the:

A

ligamentum venosum

175
Q

Fetuses of diabetic mothers often display:

A

increase abdominal circumference

176
Q

A correct AC measure includes the:

A

soft tissue surrounding the ribs/spine

177
Q

The spleen is part of the:

A

lymphatic system

178
Q

In a fetus, the spleen in similar in echogenicity to the:

A

kidney

179
Q

Herniation of the midgut resolves by week:

A

12

180
Q

Complete situs inversus means the:

A

cardiac apex is on the right and liver on left

181
Q

Duodenal atresia involves a fluid-filled stomach and duodenum at the site of obstruction, which demonstrates a(n):

A

“double-bubble” image

182
Q

The descending colon wall-to-wall diameter measurement varies with fetal gestational age, but should not measure greater than __ in a preterm fetus

A

2 cm

183
Q

Mean fluid volume of amniotic fluid in a 20 week is:

A

500 mL

184
Q

Oligohydramnios is common with:

A

renal anomalies

185
Q

Single umbilical artery is usually insignificant, but is mostly assocaited with all except:
a. gastrointestinal tract anomalies
b. renal and cardiac abnormalities
c. increased incidence of trisomy
d. pulmonary anomalies

A

d

186
Q

Gastroschisis is a wall defect that typically occurs ____ the umbilical cord insertion.

A

to the right of

187
Q

Ultrasound displays the fetal liver echotexture as:

A

homogenous

188
Q

Fetal abdominal organs have attained their normal adult position and structure in the early ____ trimester.

A

second

189
Q

The presence of intact skin surface covering vertebral bodies is helpful to rul out ______

A

myelomeningocele

190
Q

The fetal abdominal wall displays an outer ___genic skin line and deeper, 1- to 3- mm _____echoic muscular layer.

A

echo
hypo

191
Q

A two-vessel cord is most common in a ____ pregnancy.

A

twin

192
Q

An abdominal circumference should be obtained at the level of the junction of the umbilical vein, _____, and fetal stomach

A

portal vein

193
Q

Absence of the fetal gallbladder may be associated with biliary ____

A

atresia

194
Q

Filling and emptying of the stomach occur causing absent stomach images, which requires ____ by a sonographer.

A

follow up

195
Q

Midgut herniation is seen on an early fetus at the ______ portion of the embryo

A

ventral

196
Q

Duodenal atresia is the failure of the duodenum to change from a solid _____ of tissue during development to a _____.

A

cord
tube

197
Q

A _____ is an obstruction caused by the bowel twisting upon its blood suplly

A

volvulus

198
Q

Meconium ileus is most often owing to ______

A

cystic fibrosis

199
Q

The umbilical cord consists of ___ umbilical vein and ____ umbilical arteries

A

1
2

200
Q

Echogenic bowel can be assocaited with swallowed _______

A

blood or vernix

201
Q

An omphalocele has a membrane whereas gastrochisis doesn ot.

A

membrane

202
Q

Midgut volvulus is usually diagnosed in the first days of life; the infant typically presents with ______

A

bilious vomiting

203
Q

The internal structures of the fetal kidneys are not reliably assessed before _____ weeks

A

14-16

204
Q

Esophageal maldevelopment is most related to the ____ gender.

A

male

205
Q

An echogenic mass within the fetal gallbladder may be related to ____ or ____

A

sludge
gallstones

206
Q

Diffuse liver calcifications occur in fetuses with intrauterine ____, especially those caused by pathogens responsible for _____ infections

A

infections
TORCH

207
Q

Oligohydramnios and the stress of nonimmune hydrops may result in the physiologic absence of _____ fluid.

A

stomach

208
Q

The most common fetal bowel obstructions

A

midgut volvulus
duodenal atresia
meconium ileus

209
Q
A
210
Q

Echogenic bowel is associated with all of the following except:
A. Fetal demise
B. Cytomegalovirus
C. Growth restriction
D. Beckwith Weidemann syndrome

A

D

211
Q

Normal physiological bowel herniating normally resolves by:

A

12 weeks

212
Q

Which of the following is often associated with duodenal atresia?
A. Trisomy 21
B. Trisomy 18
C. Trisomy 13
D. Triploidy

A

A

213
Q

An excessive amount of amniotic fluid is termed:

A

Polyhedramnios

214
Q

The most common abnormality of the liver is:

A

Hepatomegaly

215
Q

Which of the following is associated with Echogenic bowel?
A. Fetal anemia
B. Cystic fibrosis
C. Radial ray syndrome
D. Portal hypertension

A

B

216
Q

The stomach should be visualized by:

A

14 weeks

217
Q

An abnormal connection between the duodenum and the trachea is termed:

A

Tracheoesophageal fistula

218
Q

The congenital absence of part of the esophagus is termed:

A

Esophageal atresia

219
Q

The double bubble sign is indicative of:

A

Duodenal atresia

220
Q

Which of the following lab values would be significant in detection of an abdominal wall defect?
A. MSAFP
B. HcG
C. Maternal serum amylase
D. Estradiol

A

A

221
Q

What is an inherited disorder in which mucus secreting organs such as the lungs, pancreas, and digestive organs produce thick and sticky secretions instead of normal secretions?

A

Cystic fibrosis

222
Q

The fetal gut develops at the end of the fifth menstrual week and can be divided into allof the following except:
A. Midgut
B. Hindgut
C. Central gut
D. Foregut

A

C

223
Q

Which of the following best describes a choledochal cyst?
A. Cystic dilation of the common bile duct
B. Herniation of the umbilical contents into the umbilical cord
C. Congenital absence of the cystic duct
D. Inflammation of the biliary tree due to obstruction

A

A

224
Q

The congenital maldevelopment of the rectum and absence of anal opening in termed:

A

Anorectal atresia

225
Q

Fetal mechoium typically consist of all of the following except:
A. Skin
B. Hair
C. Bile
D. Blood

A

D

226
Q

The majority of amniotic fluid is composed of:

A

Fetal urine

227
Q

What is the most common fetal abnormality noted during an obstetric sonogram?

A

Hydronephrosis

OB 2 (17 decks)

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