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Chapters 25-29 > Fetal Heart and Chest > Flashcards

Fetal Heart and Chest Flashcards

1
Q

The embryonic heart begins as :

A

two tubes

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2
Q

The heart begins to contract at :

A

36-37 days of gestation

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3
Q

The heart is initially recognized by its motion, which can be seen adjacent to the ___________, often before an embryo is distinguishable.

A

secondary yolk sac

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4
Q

A HR should be sonographically obtainable with endovaginal imaging when the CRL measures ______ to _____ mm.

A

4-5

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5
Q

During a BPP in the third trimester, an average fetal heart rate is _____ bpm, with a range of ____ to _____ bpm considered normal after the first trimester.

A

150

110-180

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6
Q

The heart is fully formed by:

A

10 weeks

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7
Q

The heart is most often imaged in a _____ or ____ view of the fetal chest, just above the fetal stomach.

A

cross-sectional or axial

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8
Q

The _____ of the heart will be angled to the left of the midline, with the _____ closest to the spine.

A

apex

base

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9
Q

the normal fetal heart will fill approximately _____ of the fetal chest.

A

1/3

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10
Q

The apex of the fetal heart will form a _____ degree angle with the fetal spine.

A

45

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11
Q

The chamber closest to the fetal spine is the :

A

left atrium

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12
Q

The two atria are separated by the

A

atrial septum

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13
Q

The two ventricles are separated by the:

A

ventricular septum

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14
Q

The Ventricular septum should be ______ and of equal thickness to the left ventricular wall.

A

uninterrupted

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15
Q

Atrial septum is open at the :

A

foramen ovale

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16
Q

Within the right ventricle can be seen the _____ _____, a normal structure that appears as an echogenic focus.

A

moderator band

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17
Q

Between the right ventricle and the right atrium, you should visualize:

A

tricuspid valve

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18
Q

Between the left ventricle and left atrium you should visualize:

A

mitral valve

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19
Q

Normally the tricuspid valve is positioned closer to the ______ _____ than the mitral valve.

A

cardiac apex

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20
Q

The right ventricular outflow tract leads to the :

A

Pulmonary artery and branches

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21
Q

The left ventricular outflow tract leads to the :

A

aorta

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22
Q

An important anatomic finding is the normal pulmonary artery should be positioned _______ to the aorta and should be visualized crossing _____ it.

A

anterior

over

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23
Q

The aorta and the pulmonary artery are normally ______ each other.

A

crisscross

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24
Q

The normal umbilical cord contains:

A

2 arteries and 1 vein

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25
Q

The umbilical vein enters at the ______, bringing oxygen-rich blood from the ______ to the fetus.

A

umbilicus

placenta

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26
Q

The umbilical vein travels _________ where it connects to the left portal vein.

A

superiorly

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27
Q

Through the umbilical vein half of the blood will go to the liver through the LPV, while the other half is shunted directly into the :

A

IVC via ductus venosus

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28
Q

The blood that was taken to the liver is used to oxygenate the liver and is then returned back to the IVC by the:

A

hepatic veins

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29
Q

The oxygen-rich blood in the IVC travels up to the heart and enters the :

A

right atrium

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30
Q

Blood can travel across the foramen ovale, into the________, or it can enter the right ventricle through the ________.

A

left atrium

tricuspid valve

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31
Q

Blood leaves the right ventricle through the :

A

Main pulmonary artery

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32
Q

Blood from the right ventricle can also flow through the ______ ______ and into the descending aorta.

A

ductus arteriosus

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33
Q

Blood returning from the lungs through the pulmonary veins enters into the ________.

A

left atrium

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34
Q

Once the blood returns from the lungs through the pulmonary veins and enters the left atrium, it then travels from the left atrium into the left ventricle via the :

A

mitral valve

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35
Q

From the left ventricle, blood travels to the ascending aorta and into the aortic arch, where it exits into the _______, _______, ________ on its way to the thorax, upper extremities, and head.

A

brachiocephalic artery, LCCA, and Left subclavian artery

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36
Q

The blood will return from the head and upper torso via the ________ to the right atrium.

A

superior vena cava

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37
Q

The umbilical arteries return the deoxygenated blood from the fetus back to the :

A

placenta

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38
Q

Small or absent left ventricle:

A

hypoplastic left heart sydrome

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39
Q

Hypoplastic left heart syndrome is the leading cause of cardiac death in the ______ period.

A

neonatal

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40
Q

To distinguish hypoplastic left heart syndrome, from the complete absence of the left side of the heart, a ______________ must be visualized

A

small or normal left atrium

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41
Q

When hypoplastic left heart syndrome is found in females, ______ should be suspected.

A

turner syndrome

There is also a connection with trisomy 18

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42
Q

Hypoplastic right heart syndrome is sonographically identified as :

A

a small or absent right ventricle

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43
Q

hypoplastic heart syndrome most often results from :

A

pulmonary stenosis

pulmonary atresia but may result from stenosis or atresia of the tricuspid valve

44
Q

Abnormal opening in the septum between the two ventricles of the heart:

A

Ventricular septal defect

45
Q

The most common form of cardiac defect

A

VSD

46
Q

An abnormal opening in the septum between the two atria of the heart:

A

atrial septal defect

47
Q

The combination of both atrial and ventricular septal defects is termed :

A

atrioventricular defect or atrioventricular canals (AVSD)

48
Q

AVSD results from the abnormal development of :

A

the central portion of the heart

49
Q

The central portion of the heart is referred to as the

A

Endocardial cushion

50
Q

AVSDs are commonly associated with:

A

aneuploidy, trisomy 21, and trisomy 18

51
Q

Malformation or malpositioning of the tricuspid valve results in:

A

Ebstein anomaly

52
Q

With ebstein anomaly The right ventricle is:

A

contiguous with the right atrium, referred to as atrialized right ventricle

53
Q

Ebstein anomaly is associated with:

A

tricuspid regurgitation, atrial septal defects, tetralogy of Fallot, transposition of the great vessels, and coarctation of the aorta

54
Q

Is the narrowing of the aortic arch:

A

coarctation of the aorta

55
Q

The most common location for coarctation of the aorta is:

A

between the left subclavian artery and the ductus arteriosis

56
Q

The tetralogy of Fallot is defined as:

A

an overriding aortic root, subaortic ventricular septal defect, pulmonary stenosis, right ventricular hypertrophy

57
Q

With_______________, the outflow tracts are reversed.

A

transposition of the great vessels

58
Q

The pulmonary artery will abnormally arise from the ________ with transposition of the great vessels.

A

left ventricle

59
Q

The aorta will abnormally arise from the ________ with transposition of the great vessels.

A

right ventricle

60
Q

With the transposition of the great vessels the orientation of the outflow tracts will be positioned:

A

parallel to each other, with the aorta noted anterior and to the right of the pulmonary artery

61
Q

An echogenic intracardiac focus (EIF) is most often seen within the :

A

the left ventricle of the heart

62
Q

An EIF is thought to represent the calcification of:

A

papillary muscle or chordae tendineae

63
Q

There have been studies that have linked the incidence of an EIF with:

A

trisomy 21, particularly if there is more than one EIF detected

64
Q

The echogenicity of the EIF is comparable to that of the:

A

fetal bone

65
Q

The most common fetal cardiac tumor is the :

A

rhabdomyoma

66
Q

Rhabdomyomas are located within the:

A

myocardium of the heart

67
Q

Rhabdomyomas have an association with :

A

tuberous sclerosis, eventual cardiac failure, and subsequent development of fetal hydrops

68
Q

Rhabdomyoma typically appears:

A

echogenic and may be isolated or multiple

69
Q

Fluid located around the heart:

A

pericardial effusion

70
Q

Pericardial effusion can be isolated or associated with:

A

fetal hydrops

71
Q

The normal _______ appearance of the myocardium can mimic the sonographic appearance of small pericardial effusions.

A

hypoechoic

72
Q

When the heart is located either partially or co mpletely outside of the chest it is termed:

A

ectopic cordis

73
Q

_________________ is a group of anomalies that combines ectopic cordis and an existing omphalocele.

A

Pentalogy of cantrell

74
Q

Functional fetal lung tissue does not typically exist until :

A

after 25 weeks

75
Q

Fetal lung maturity can be assessed using the:

A

lecithin to sphingomyelin ratio

L/S ratio

76
Q

As the lungs mature, the level of lecithin ________, while the level of sphingomyelin ________.

A

increases, decreases

77
Q

__________ is performed for the lecithin to sphingomyelin ratio, and the lab findings indicate the levels of lecithin and sphingomyelin.

A

amniocentesis

78
Q

Pulmonary hypoplasia, or underdevelopment of the lungs, is caused by:

A

decrease number of lung cells, airways, and alveoli

79
Q

The most common lesion that occupies the chest, resulting in pulmonary hypoplasia, is:

A

diaphragmatic hernia

80
Q

A fetus surrounded by little or no amniotic fluid is at increased risk for:

A

pulmonary hypoplasia

81
Q

Pulmonary hypoplasia is a common finding with:

A

oligohydramnios

82
Q

Pulmonary hypoplasia with oligohydramnios is also associated with bilateral renal agenesis and the abnormal facial features in the condition known as:

A

Potter’s Syndrome

83
Q

Fluid surrounding the lungs is referred to as a :

A

pleural effusion or hydrothorax

84
Q

Pleural effusions that occur in utero may spontaneously resolve or be found in the presence of :

A

fetal hydrops, other chest abnormalities, and turner syndrome

85
Q

A pleural effusion will appear sonographically as:

A

anechoic fluid within the chest surrounding the fetal lung

86
Q

___________ sign has been used to describe the appearance of pleural effusions.

A

bat wing

87
Q

Fetal pleural effusions can be treated with an:

A

ultrasound-guided thoracentesis

88
Q

Mass that consists of abnormal bronchial and lung tissue:

A

CCAM - cystic adenomatoid malformation aka congenital cystic adenomatoid malformation.

89
Q

There are ____ forms of CAM

A

3

90
Q

The sonographic appearance of CAM most often appears as a mass that has:

A

Both cystic and solid compnents

91
Q

Type III CCAM may appear similar to :

A

pulmonary sequestration, as it is echogenic in form

92
Q

Most CAMs are ______ and may resolve spontaneously, although large masses can lead to fetal hydrops.

A

unilateral

93
Q

A separate mass of non-functioning lung tissue with its own blood supply:

A

pulmonary sequestration, or bronchopulmonary sequestration

94
Q

The most common sonographic appearance of pulmonary sequestration is:

A

echogenic, triangular-shaped mass within the left side of the fetal chest

95
Q

Most common reason for fetal cardiac malposition is the existence of:

A

diaphragmatic hernia

96
Q

Diaphragmatic hernia results in an abnormal opening in the fetal diaphragm that allows the herniation of:

A

abdominal contents into the chest cavity

97
Q

The most common location for a diaphragmatic hernia is:

A

on the left side

98
Q

Diaphragmatic hernia on the left side may also be referred to as:

A

bochdalek hernia

99
Q

The foramen of bochdalek is located in the left ______ portion of the diaphragm

A

posterolateral

100
Q

In most cases of a bochdalek hernia ______, _______, and ______ are found within the chest.

A

stomach, bowel, and the left love of the liver

101
Q

The foramen of Morgagni, is located ______ ________ within the diaphragm.

A

right anteromedially

102
Q

Differential diagnosis of diaphragmatic hernia, which is a lack of muscle in the dome of the diaphragm:

A

eventration of the diaphragm

103
Q

The thymus gland is located:

A

anterior to the mediastimum

104
Q

The fetal thymus is a part of the ________ , it provides a place for the maturation of T cells, which are specialized white blood cells.

A

immune system

105
Q

Sonographically, the thymus appears as a :

A

hypoechoic structure located in the anterior chest at the level of the sternum between the lungs

106
Q

_____________ _________ is a genetic disorder characterized by an absent or hypoplastic thymus, which lead to impairment of the immune system.

A

DiGeorge syndrome

Chapters 25-29 (6 decks)

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