2nd & 3rd Tri Assessment

Question 1

What weeks are 2nd trimester? 3rd?

Answer 1

2nd: 13-26 wks
3rd: 27-40, can go to 42

Question 2

What are the 3 germ layers from inner to outer?

Answer 2

endoderm, mesoderm, ectoderm

Question 3

What does the endoderm become?

Answer 3

GI & respiratory systems

Question 4

What does the mesoderm become?

Answer 4

MSK & circulatory systems

Question 5

What does the ectoderm become?

Answer 5

brain, nervous system, skin

Question 6

What are the two variants of vertex position?

Answer 6

anterior occiput: face toward mat spine
posterior occiput

Question 7

What type of cephalic positioning is better for labor and delivery?

Answer 7

anterior occiput

Question 8

What are the 3 types of breech positioning?

Answer 8

• complete: fetal bottom down, legs folded
• incomplete: bottom down, one leg bent & one straight up near ear
• frank: bottom down, legs straight up near ears

Question 9

When are bony and soft tissue structures of the face seen?

Answer 9

bony: wk 12
soft tissue: wk 16

Question 10

What facial structures do you see in a sagittal view?

Answer 10

frontal bone, nasal bone/nose, chin

Question 11

What facial structures do you see in the coronal view?

Answer 11

• upper lip
• orbits/lens
• nostrils
• palate

Question 12

What are two facial measurements?

Answer 12

OOD: outer to outer orbital diam
IOD: inner orbital diam

Question 13

What structures are located within the thorax?

Answer 13

• lungs
• thymus
• diaphragm
• heart
• great vessels

Question 14

How does the size of the thorax compare to the abdominal cavity?

Answer 14

thorax is slightly smaller

Question 15

What 3 structures border the lungs medially, inferiorly, and laterally?

Answer 15

medial: heart
inferior: diaphragm
lateral: rib cage

Question 16

What is the US appearance of fetal lungs?

Answer 16

solid, homogeneous, slightly more echogenic than liver

Question 17

How much time does the fetus practice breathing?

Answer 17

1/3 of time

Question 18

What are the two ways to record fetal respiration?

Answer 18

• watch diaphragm & ribs move
• CF on nostrils

Question 19

How is the diaphragm best visualized? What does it look like?

Answer 19

• best vis. in sag, spine down
• thin, hypo line separating chest & abd cavities

Question 20

What are fetal risk factors for fetal echo?

Answer 20

• IUGR
• IVF
• arrythmias
• abnormal amniocentesis w/ trisomy
• abnormal HR
• hydrops

Question 21

What is fetal hydrops?

Answer 21

Fatal condition w/ abn accumulation of fluid in 2 or more compartments

Question 22

What are maternal risk factors for fetal echo?

Answer 22

• family/personal hx of heart defect
• DM
• lupus
• substance abuse
• abnormal HR

Question 23

What structures should be visualized in the 4 chamber heart?

Answer 23

• atria & ventricles
• valves
• intracardiac septae
• papillary muscles
• foramen ovale
• great vessels (ao, pulm art/vein, ivc/svc)

Question 24

What is the RVOT?

Answer 24

pulmonary artery, leaves rt ventricle, PA has hockey stick appearance (ductal arch)

Question 25

What is the LVOT?

Answer 25

aorta, leaves lt ventricle, ao has candy cane appearance

Question 26

How is oxygenated blood supplied to the fetus?

Answer 26

brought to fetus by umbilical vein from placenta

Question 27

Where does the umbilical cord enter the abdomen?

Answer 27

umbilicus

Question 28

What happens to the blood as it reaches the liver via falciform ligament?

Answer 28

1/2 filters through the liver, 1/2 bypasses the liver via the ductus venosus

Question 29

What hepatic vessel does the umbilical vein join?

Answer 29

left portal vein

Question 30

Where does the IVC join the heart?

Answer 30

right atrium

Question 31

How does the blood travel after entering the right atrium?

Answer 31

- portion travels to left atrium via foramen ovale - rest travels from rt atrium to rt vent via tricuspid valve - blood then leaves rt ventricle through pulm artery

Question 32

How does blood travel from right to left atrium?

Answer 32

foramen ovale

Question 33

How does blood travel from right atrium to right ventricle?

Answer 33

tricuspid valve

Question 34

Where does blood travel after leaving the right ventricle through the rvot?

Answer 34

most enters ductus arteriosus & bypasses lungs, small amount travels to the lungs

Question 35

What happens after the ductus arteriosus enters the descending aorta?

Answer 35

- desc ao enters umbilical arteries - umbilical arteries within umbilical cord enter placenta - bring blood from fetus back to placenta

Question 36

What happens to the small amount of blood that travels to the lungs through the pulmonary artery?

Answer 36

- returns to lt atrium via pulmonary veins - travels from lt atrium to lt ventricle via mitral valve - travels from lt ventricle to asc. aorta via aortic valve

Question 37

How does blood travel between the left atrium and left ventricle?

Answer 37

mitral valve

Question 38

How does blood travel from the left ventricle to the ascending aorta?

Answer 38

aortic valve

Question 39

What is the ratio of heart to thorax size?

Answer 39

1:3

Question 40

How do the atria and ventricle size compare?

Answer 40

equal

Question 41

How does the foramen ovale move?

Answer 41

it moves to the left with systole

Question 42

What are the 3 embryologic components of the abdomen? What are they formed by?

Answer 42

foregut: cranial end fold midgut: side folds hindgut: caudal end fold

Question 43

What does the foregut become?

Answer 43

- esophagus - stomach - duodenum - liver - biliary - pancreas - spleen

Question 44

What does the midgut become?

Answer 44

- small intestines - majority of colon - cecum - cloaca

Question 45

What does the hindgut become?

Answer 45

- descending colon - sigmoid colon - bladder - urethra

Question 46

How does the growth of the midgut compare to the growth of the abdominal cavity?

Answer 46

midgut grows faster than abdominal cavity

Question 47

What is the result of the liver and kidneys growing faster than the abdominal cavity?

Answer 47

results in herniation of the bowel which extends to the prox umbilical cord

Question 48

When does fetal bowel herniation resolve?

Answer 48

week 11

Question 49

When does the esophagus reach final length?

Answer 49

week 7

Question 50

What divides the trachea and esophagus?

Answer 50

tracheoesophageal septum

Question 51

When is the stomach visualized?

Answer 51

seen at 11 weeks due to swallowed amniotic fluid, must be seen after 16 weeks

Question 52

What do the intestines appear like?

Answer 52

slightly hyperechoic to liver, appears mass-like

Question 53

When are small and large intestines differentiated? When is peristalsis seen?

Answer 53

small and large differentiated at 20 weeks, peristalsis seen after 27 wks

Question 54

What happens to the umbilical vein following birth?

Answer 54

forms ligamentum teres

Question 55

How does fetal liver size compare to the body?

Answer 55

liver is 10% of fetal weight at 11 weeks and 5% at birth

Question 56

What landmarks are included in AC measurement?

Answer 56

trv spine, fluid filled stomach, umbilical vein

Question 57

What does the genitourinary system develop from?

Answer 57

intermediate mesoderm

Question 58

What is the cloaca?

Answer 58

How feces & urine pass in embryos, at the end of the hindgut & divides into rectum, urinary tract & genitalia

Question 59

What is the ureteral bud?

Answer 59

Forms from outpouching of wolffian duct, gives rise to ureter, renal sinus, collecting tubules

Question 60

When does urine production begin?

Answer 60

week 16

Question 61

What are the 3 sets of embryologic urinary excretory glands?

Answer 61

- pronephros: first set of kidneys, nonfunctioning - mesonephros: 2nd set of kidneys, function for short period & degenerate - metanephros: permanent kidneys, develop at wk 5 while mesonephros are acting

Question 62

When do the kidneys rise in the abdomen and separate?

Answer 62

week 9

Question 63

How does the appearance of the kidneys change from before 13 weeks to after 15 weeks?

Answer 63

before 13: hyperechoic after 15: decreased echogenicity, still hyperechoic to surroudings