Chapter 49- 2nd and 3rd Trimester

Question 1

the ventricles of the heart come to a point called the _________; normally is directed toward the left hip

Answer 1

apex

Question 2

the portion of the cerebral ventricular system where the lateral lobes, temporal lobes, and occipital lobes connect; located posterior and lateral to the thalami

Answer 2

atrium of the lateral

Question 3

indicates that the fetal head is toward the fundus of the uterus

Answer 3

breech

Question 4

a cavity within the septum pellucidum in the anterior midportion of the fetal brain

Answer 4

cavum septum pellucidum

Question 5

echogenic tissue within the lateral ventricles that produces central nervous system fluid and is seen prominently during second-trimester fetal sonography

Answer 5

choroid plexus

Question 6

a posterior fossa cistern that contains cerebrospinal fluid

Answer 6

cisterna magna

Question 7

a narrow band of compact tissue forming a solid covering over the roof of the third ventricle and connecting the hemispheres of the brain

Answer 7

corpus callosum

Question 8

structure that carries oxygenated blood from the pulmonary artery to the descending aorta

Answer 8

ductus arteriosus

Question 9

structure that carries oxygenated blood from the umbilical vein to the inferior vena cava

Answer 9

ductus venosus

Question 10

an echo within a fetal heart chamber that is as bright (echogenic) as bone and persists despite changes in the sonographic plane

Answer 10

echogenic intracardiac focus (EIF)

Question 11

protrusion or bulging of the forehead

Answer 11

frontal bossing

Question 12

adjusting an individual patient’s risk assessment for aneuploidy based on the presence or absence of sonographic markers

Answer 12

genetic sonogram

Question 13

increased echogenicity of the bowel associated with aneuploidy risk and fetal pathology

Answer 13

hyperechoic bowel

Question 14

the largest portion of the ventricular system in the fetal cranium

Answer 14

lateral ventricles

Question 15

the probability that a fetus exhibiting a specific finding will be affected by a specific condition; likelihood ratios in pregnancy are typically used to predict risk for aneuploidy

Answer 15

likelihood ratio

Question 16

a large tongue seen persistently extending outside of the fetal mouth

Answer 16

macroglossia

Question 17

abnormally small chin

Answer 17

micrognathia

Question 18

linear echoes located centrally in the fetal head that are produced by the borders of the opposing cerebral hemispheres

Answer 18

midline echo (the falx)

Question 19

written representation by graphs, diagrams, or charts of the relationship between numeric variables

Answer 19

nomogram

Question 20

typical position of the abdominal organs with the liver and inferior vena cava on the right, the stomach on the left, and the apex of the heart directed toward the left

Answer 20

normal situs

Question 21

the thickness of fetal skin at the back of the fetal neck that may be visualized and measured between 16 and 20 weeks’ gestational age to assess aneuploidy risk

Answer 21

nuchal skin fold

Question 22

mild dilation of the renal pelvis

Answer 22

pyelectasis

Question 23

indicates that the fetus is lying transversely in the uterus, horizontally, or perpendicular to the maternal sagittal axis

Answer 23

transverse fetal lie

Question 24

enlargement of the cerebral ventricles

Answer 24

vertriculomegaly

Question 25

indicates that the fetus is positioned head down in uterus

Answer 25

vertex

Question 26

What weeks are considered the 1st trimester

Answer 26

0-12

Question 27

What weeks are considered the 2nd trimester

Answer 27

13-26

Question 28

What weeks are considered the 3rd trimester

Answer 28

27-42

Question 29

As sonographers, what are we evaluating in the 2nd trimester scan

Answer 29

1) Surveying the uterus 2) Observing cardiac activity 3) Position, number of fetuses, and placenta 4) Assess amniotic fluid 5) Look for uterine or placental masses as well as fetal anomalies

Question 30

Anatomically, the stomach is on the _____GB on the _____ and the apex of the heart should be toward the fetal _____ side.

Answer 30

1) left 2) right 3) left side

Question 31

What are the 2 types of fetal brain tissue?

Answer 31

The dura and pia arachnoid

Question 32

By week ____, the cranial bones ossify

Answer 32

12

Question 33

By week ___ the texture characteristics of each brain structure have been determined

Answer 33

18

Question 34

The cranium may appear hypoechoic or cystic True/False

Answer 34

True

Question 35

Water content in fetal brain is ________ High or low?

Answer 35

high

Question 36

When scanning a 2-3rd trimester patient, what are we looking for?

Answer 36

``` Surveying the uterus Cardiac Activity Position and # of fetus and placenta Assess amniotic fluid Look for uterine or placental masses and fetal anomalies. ```

Question 37

What are the 4 fetal presentations?

Answer 37

1) Vertex 2) Breech 3) Transverse 4) Situs

Question 38

Breech means that the ______ is closest in proximity to the direction of the cervix and the ______ is directed toward the uterine fundus. Words: Cranium/Body

Answer 38

Body cranium

Question 39

Vertex means the _____ is the closest in proximity to the cervix and the ____is directed towards the uterine fundus Words: Cranium/Body

Answer 39

cranium body

Question 40

There are 3 fetal lie. What are they?

Answer 40

1) Longitudinal 2) Transverse 3) Oblique

Question 41

Situs is determining the fetus' ____ and ____, which is EXTREMELY important.

Answer 41

right and left side

Question 42

What are the two types of fetal brain tissue?

Answer 42

Dura and pia arachnoid

Question 43

What are the functions of the amniotic fluid?

Answer 43

1) Allows fetus to move freely 2) Maintains intrauterine cavity temp. 3) Protects fetus from injury 4) Produced by umbilical cord and membranes, lungs, skin, and kidneys 5) Fetal urination accounts for nearly the total AFF in 2nd trimester

Question 44

The placenta's major role is to deliver _______ and ______

Answer 44

oxygen and nutrients

Question 45

The echogenicity of the placenta is heterogenous during the 2nd trimester? T/F

Answer 45

FALSE The placenta is homogenous during 2nd trimester and becomes hetergenous during the 3rd trimester.

Question 46

Position of placenta is not that important. T/F

Answer 46

FALSE

Question 47

With the umbilical cord, there are two arteries and one vein T/F

Answer 47

True

Question 48

When imaging the extremities, what are we looking for?

Answer 48

#, echogenicity, normal growth patterns, bowing, fractures and demineralization.

Question 49

The kidneys are located on either side of the spine and are apparent as early as ______ weeks

Answer 49

15 weeks

Question 50

What are we looking for in the urinary system?

Answer 50

Kidneys, adrenal glands, ureter, and bladder.

Question 51

What are we looking for in the gastrointestinal system?

Answer 51

Esophagus, stomach, small intestines, and large intestines (note echogenicity)

Question 52

The stomach can be seen as early as _____ weeks, and should be seen in full at ______ weeks

Answer 52

11, 16

Question 53

Fetoplacental circulation. Look at the:

Answer 53

liver, PV system, hepatic veins/arteries, GB and bile duct.

Question 54

muscle that seperates the thorax from abdomen

Answer 54

diaphragm

Question 55

To rule out diaphragmatic hernia, it is important to look and see a intact ______.

Answer 55

diaphragm

Question 56

The heart should be evaluated for:

Answer 56

position, presence of right ventricle, equal size of ventricles and atria, septal defects, and rhythm and rate.

Question 57

landmark for assessing fetal heart location Observed as solid homogenous masses of tissue bordered medially by the heart, inferiorly by diagram, and laterally by ribs.

Answer 57

The thorax

Question 58

Spine should taper towards the sacrum. T/F

Answer 58

True

Question 59

Spine should have the double lined "Railway sign" appearance. T/F

Answer 59

True

Question 60

A renal pelvis that measures >10 mm beyond 20 weeks is normal T/F

Answer 60

False It is ABNORMAL

Question 61

Adrenal glands are most frequently seen in transverse as early as _____weeks?

Answer 61

20 weeks

Question 62

When imaging the fetal profile what are we looking for?

Answer 62

Frontal Bossing (protruding forehead) and Micrognathia (undersized jaw) and to r/o clefting

Question 63

The BPD is aquired at the widest transverse diameter and has the landmarks of thalmus, CSP, and midline echo complex T/F

Answer 63

True

Question 64

Fetal Head Survey How should the contour be?

Answer 64

round or oval w/ smooth surface

Question 65

Fetal Head Survey Transverse plane. What are your images?

Answer 65

1) IHF or falx cerebri observed 2) 2 paried ventricles, midline 3rd and 4th 3) choroid plexus 4) Cavum septum pellucidi 5) Thalmus 6) Posterior fossa