chapter 62 fetal anterior abdominal wall Flashcards Preview

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Flashcards in chapter 62 fetal anterior abdominal wall Deck (47)
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1
Q

abdominal wall defects occur during the ____ trimester

A

first trimester

2
Q

the midgut usually returns into the abdominal cavity by week

A

11-12

3
Q

most common types of abdominal wall defects

A
  • gastroschisis
  • omphalocele
  • umbilical hernia
4
Q

this develops when there is a midline defect of the abdominal muscles, fascia, and skin that results in herniation of intraabdominal structures into the base of the umbilical cord

A

omphalocele

5
Q

omphalocele: AFP levels:

A

normal or slightly elevated

6
Q

two types of omphalocele:

A
  1. contains liver in the sac

2. contains bowel w/o liver

7
Q

this type of omphalocele has a higher risk for chromosomal abnormalities

A

bowel omphalocele

8
Q

this omphalocele affects the abdominal wall muscles, fascia, and skin

A

liver omphalocele

9
Q

fetal mortality with isolated omphalocele

A

10%

10
Q

fetal mortality increases to ____% when more than 1 abnormality exists

A

80%

11
Q

bowel omphaloceles appear ____

A

echogenic

12
Q

bowel omphaloceles must be distinguished from umbilical hernia, this is done by:

A

checking the cord insertion: normal cord insert suggests umbilical hernia

13
Q

assosciated anomalies with omphalocele:

A
  • cardiac
  • gastrointestinal
  • neural tube defects
  • genitourinary tract
14
Q

Periumbilical defect, opening in the layers of the abdominal wall with herniation of bowel.

A

gastroschisis

15
Q

gastroschisis is almost always located:

A

to the right of the umbilicus

16
Q

gastroschisis infrequently involves:

A
  • stomach
  • genitourinary organs
  • rarely involves liver
17
Q

theoretically, gastroschisis is a consequence of

A

atrophy of the right umbilical vein or distruption of the omphalomesentric artery

18
Q

gastroschisis size:

A

2-4cm

19
Q

umbilical cord insertion in fetuses with gastroschisis:

A

normal

20
Q

_____ is always found in the herniation of gastroschisis

A

small bowel

21
Q

AFP levels with gastroschisis

A

highly elevated

22
Q

why are AFP levels elevated in gastroschisis

A

because it is an open defect–exposed bowel

23
Q

gastroschisis is more common in

A

males

24
Q

Gastroschisis is sonographically detectable after ___ weeks gestation

A

12 weeks

25
Q

notably dilated bowel may suggest :

A

infarction or bowel atresia

26
Q

rupture of the amnion which leads to the entrapment/entanglement of fetal parts:

A

amniotic band syndrome

27
Q

How do you differentiate an omphalocele from gastroschisis

A
  • presence of membrane(gastro doesn’t have one)
  • look at cord(gastroschisis will have a normal cord)
  • omphalocele often occurs with chromosomal anomalies
28
Q

Rare group of disorders that involves macroglossia, omphalocele, visceromegaly(enlarged abdominal organs)

A

Beckwith-Weidmann syndrome

29
Q

defect in the lower abdominal wall & anterior wall of the bladder

A

bladder exstrophy

30
Q

protrusion of bladder through the abdominal wall defect

A

bladder exstrophy

31
Q

bladder exstrophy is accompanied with

A
omphalocele
inguinal hernia
chrytorchidism
-anal problems
genital malformations
32
Q

in bladder exstrophy, the urinary bladder is ___

A

not visible

33
Q

soft tissue mass that represents the exposed bladder mucosa seen on the surface of the lower abdominal wall:

A

bladder exstrophy

34
Q

occurs in early development with involvement of primitive gut and persistent cloaca

A

cloacal exstrophy

35
Q

extrophy of badder in which two hemibladders are separated by intestinal mucosa

A

cloacal exstrophy

36
Q

cloacal exstrophy involves

A
  • lower abdominal wall defect below the cord insertion including extrophy of bladder and protrusion of intestines
  • lower limb abnormalities
  • spinal defects
  • anal atresia
37
Q

primary finding in cloacal exstrophy

A

anterior abdominal wall defect

38
Q

cloacal extrophy may also have abnormally ____ cord insert

A

low

39
Q

Rare, association of all 5 defects:

  1. cleft in distal sternum
  2. Diphragmatic defect
  3. Midline anterior ventral defect
  4. Defect of apical pericardium with communication into peritoneum
  5. internal cardiac defect
A

Pentalogy of Cantrell

40
Q

usual primary finding in Pentalogy of Cantrell

A

high or superumbilical omphalocele

41
Q

Exposed heart presents outside chest through a cleft sternum:

A

ectopia cordis

42
Q

ectopia cordis is associated with these anomalies;

A
  • omphalocele
  • cardiovascular malformations
  • craniofacial defects
43
Q

occurs with fusion of amnion and chorion

A

limb-body-wall complex

44
Q

limb-body-wall defects: more commonly affects what side:

A

affects the left side 3x more than the right

45
Q

associated with

  • large cranial defects
  • facial clefting
  • body wall complex defects involving throrax and abdomen
  • limb defects
  • scoliosis
  • various internal malformations
A

limb-body-wall complex

46
Q

with limb-body-wall complex, the umbilical cord is:

A

short and adherent to placental membranes or absent

47
Q

limb-body-wall complex sonographically:

A
  • large defects
  • involve abdomen and thorax
  • bizarre appearing mass entangled with membranes