Assessment of Second Trimester Flashcards
(90 cards)
1
Q
BPD is an accurate predictor of gest age before
A
20 w
2
Q
BPD is measured in a place that passes through the
A
3rd ventricle and thalami
3
Q
BPD is above the level of the
A
orbits and cerebellum
4
Q
BPD is below the level of the
A
ventricular atrium
5
Q
BPD landmarks
A
falx, 3rd ventricle, thalamic nuclei, cavum septum pellucidi and atrium of lateral ventricle
6
Q
Measure BPD perpendicular to
A
falx, placing calipers from outer margins of upper cranium to the inner margin of lower cranium
7
Q
HC is a reliable measurement independent of
A
cranial shape
8
Q
HC measure in a plane that must include the
A
CSP and tentorial hiatus
9
Q
HC measured parallel to the base of
A
skull, placing the calipers on the outer margins of the cranium
10
Q
Measurement of the HC cannot always be obtained in what plane
A
BPD
11
Q
Cehaplic Index is devised to determine the
A
normality of the fetal head shape
12
Q
Ceaphlic Index is abnormal when less than ____ or greater than ____
A
74%
83%
13
Q
ABD predictor of
A
fetal growth not gest age
14
Q
Most difficult measurement to obtain
A
ABD
15
Q
ABD measurement location
A
slightly superior to CI at junction of lt and rt PV or demonstrate a short length of umb vein, lt PV, and fetal sto
16
Q
Measure at ABD circumference at level to include
A
liver
17
Q
parallel to fem shaft placing calipers at level of fem ehad cartilage and dist fem condyle
A
Femur length measurement
18
Q
Alpha- fetoprotein is produced by
A
fetus
19
Q
AFP is found in
A
amniotic fluid and maternal serum
20
Q
AFP normal value varies with
A
gest age
21
Q
- fetus older than expected
- multiple gest
- open neural tube defect
- abd wall defect
- cystic hygroma
- renal anomalies
- fetal demise
A
Causes of High AFP
22
Q
- fetus younger than expected
- chromosomal abnormalities
- trophoblastic disease
- long standing fetal demise
- chronic maternal hypertension or diabetes
A
Causes of low AFP
23
Q
Oxygenated blood leaves the placenta and enters the fetus through the
A
umbilical vein
24
Q
After entering the abd, blood courses through the
A
ductus venosum reaching the rt atrium of the heart
25
blood travels from the rt and lt atrium through
foramen ovale
26
From the left atrium to the left ventricle, blood ascends the
AO distributing blood to the fetal tissue
27
Approx half of the blood leaves through the
umb arteries and goes back to plac for reoxygenation
28
- junction of ant, occipital, and temporal horn
- located slightly inf to level of BPD
- evaluated for ventricular enlargement
Atrium of lateral ventricles
29
- hyper thin ventricle wall
- hyper choroid plexus
- measured perpendicular to ventricle walls from glomus of choroid plexus to lateral ventricular wall
- measures b/t 6 - 10 mm throughout pregnancy
- choroid plexus should almost fill the lateral ventricle
Atrium of lat ventricle sono appearance
30
- presence exclused almost every subtle midling brain malformation
- filled with cerebral spinal fluid
- found at level of BPD
- located inf to ant horns of lat ventricles
- closes by 2 yrs of age
Cavum Septi Pellucidi
31
Cavum Septi Pellucidi sono appearence
small anechoic box located in midline portion of ant brain
32
- consists of vermis and two lateral horns
- located in post fossa
- assists in balance
Cerebellum
33
Cerebellum sono findings
dumbell shaped echogenic structure located in midline of post fossa
34
- echogenic cluster of cells
- important in the production of cerebrospinal fluid
- found at level of BPD
- located inferior to ant horns of lat ventricle
- chroid plexus cysts will normally regress by 23 gest age
Choroid Plexus
35
- hyper structures located within each lat ventricle
- lie along the atrium of lat ventricle
- cyst my be displayed within choroid
Choroid plexus sono findings
36
fluid filled spaces located between the underface of cerebellum and medulla oblongata
Cisterna Magna
37
CM sono findings
- AP
38
- begins ossification around 11 gest w
| - ovoid in shape
Cranium
39
cranium sono appearence
hyper outline surrounding the brain
40
- intrahemisphere fissure
| - separates the cerebral hemisphere
Falx Cerebri
41
Falx cerebri sono findings
echo midline linear structure
42
- soft tissue thickness between the calvaria and posterior skin line
- measured in the axial plane at a level to include the cerebellum, CM, and Cavum speti cellucidi
- accurate up to 20 w
- thickening assoc w/ anueploidy
Nuchal Thickness
43
Nuchal Thickness sono findings
thickness
44
Thalami
provide synopsis b/t cerebellu and post brain
45
- hypo ovoid structures in midportion of brain located in each hemisphere
- 3rd ventricle is located b/t each individual thalamus
Thalami Sono findings
46
- muscle seperating thorax and abd cavities
| - courses ant to post
Diaphragm
47
- curvilinear hypo structure
- abd content lie inf
- chest contents lie sup
Diaphragm sono findings
48
- apex points toward left side of body at 45 degree angle
- rt ventricle most ant
- lt atrium most post
Heart
49
- lies midline in chest
- hyper ventricular and atrial septa
- 120-160 bpm
- hyper focus w/in ventricle is most likely the papillary muscle
Heart sono findings
50
- serve as lat border to heart
| - lie sup to diaphragm
Lungs
51
- moderately echo
- homo
- increases in echo as gestation progressess
Lung sono findings
52
- signifies genitourinary system is working
- bladder fills and empties every 30 - 60 min
- should be vis by 13 w
Bladder
53
- round anechoic structure located centrally in inf pelvis
| - variable in size
Bladder sono appearance
54
- meconium begins to accumulate in the small bowel
- small bowel becomes vis in late second trim
- large bowl becomes vis in 3rd trim
Bowel
55
- moderately echo
- hyper compared to liver
- hyper compared to bone
- distinguished after 22 w
Small bowel sono app
56
large bowel sono appearence
hypo to small bowel
57
- vis peaks around 20-32 gest w
| - signifies the presence of biliary tree
Gallbladder
58
- elongated fluid filled structures
| - located inf and to rt of umb vein
gallbladder sono appearance
59
- urine formation begins near the end of 1st trim
- may be identified as early as 15 wks
- consistently identified by 20 w
Kidneys
60
- iso or hypo locaed on each side of spine
- bilateral
renal pelvis should contain small amount of fluid
Kidneys sono appearance
61
Kidneys renal pelvis measurements
> 4 mm up to 33 w
| > 7 mm from 33 w to term
62
liver
- largest organ in torso
| - reflect change in fetal growth
63
liver sono appearence
- moderately echogenic structure
- left love is larger than rt lobe
- occupies most of upper abd
64
- reliabily vis by 13 w
| - signifies normal fetal swallowing sequence
Stomach
65
- anechoic structure located in the LUQ
- size and shape will vary with recent swallowing
- echogenic debris w/in sto may be vis
Stomach sono appearance
66
- placental insertion generally located in midportion of plac
Umb cord insert
67
- smooth abd wall at umb insert
- umb vein courses sup toward liver
- umb arteries arise from hypogastric arteries on each side of bladder
Umb cord instert sono appearance
68
Long bones start ossification by
11 w
69
pelvis iliac wings ossify at
12 gest w
70
pelvic ischium ossifies by
20 w
71
Spine widens near the base of the____ and tapers near the _____
skull
| sacrum
72
ossification of spine should be complete by
18 w
73
What surrounds and protects the fetus?
Amniotic fluid
74
Amniotic fluid provides important info on
fetal renal and plac function
75
What becomes the major producer of AF through shallowing and urine after 16 w
Fetus
76
length of cx determines
competence
77
length of cx is measured b/t
internal os and external os
78
normal cx length
2.5 - 4cm
79
What communicates between fetus and mother
placenta
80
The placenta provides
nutrition and products of metabolism to fetus
81
Whats the connecting lifeline between fetus and plac
Umb cord
82
How many arteries and veins in umb cord
2 arteries
| 1 vein
83
umb cord enters the
lt portal vein
84
umbilical arteries arise from
internal iliac arteries
| hypogastric
85
umb cord normally insert into the
midportion of plac
86
umb cord is covered in
Whartons jelly
87
plac is hyper compared to
myo
88
plac thickness
89
umb artery
- low resistive near fetal insert
| - high resistive near plac insert
90
umb vein
- continuous flow through stystole and diastolic
| - flow is directed from plac to the fetus
