Fetal heart/circulation registry review

Question 1

Embryology

Answer 1

Initially 2 tubes that fuse and fold to form 4 chambers

Question 2

Heart contractions

Answer 2

Begin at 36 days gestation (5 weeks), detected on US by CRL 5mm

Question 3

Normal FHR

Answer 3

120-180BPM

Question 4

Full formation of heart

Answer 4

10 weeks

Question 5

Normal anatomy

Answer 5

Apex angled to left of midline at 45 degree angle from spine, stomach and apex of heart pointing to left of fetus

Question 6

Levocardia

Answer 6

Normal cardiac position

Question 7

Dextrocardia

Answer 7

Abnormal cardiac situs, apex pointing to the right chest

Question 7

Normal cardiac rythem

Answer 7

Atrial and ventricular beats documented simultaneously

Question 8

Documentation of normal cardiac rythem

Answer 8

M mode through ventricle and atrium, doppler of inflow/outflow

Question 8

4CH view

Answer 8

-Left and right ventricles separated by interventricular septum
-RV and LV should be similar in size
-Lt/Rt atria separated by atrial septum opening at foramen ovale

Question 9

Opening from left atrium to left ventricle

Answer 9

Mitral valve

Question 10

Opening from right atrium to right ventricle

Answer 10

Tricuspid valve

Question 11

Chamber closest to sternum

Answer 11

Right ventricle

Question 12

Chamber closest to spine

Answer 12

Descending aorta

Question 13

Outflow tracts

Answer 13

Right ventricular outflow tract (RVOT)
Left ventricular outflow tract (LVOT)

Question 14

LVOT

Answer 14

Shows left ventricle to Aorta

Question 15

MPA

Answer 15

Main pulmonary artery

Question 16

RVOT

Answer 16

Shows right ventricle to MPA

Question 17

3 vessel view (3VV)

Answer 17

Pulmonary artery, aorta, superior vena cava (stack of coins)

Question 18

Fetal oxygenated blood

Answer 18

Comes from the umbilical vein and not the lungs, requires “bypasses”

Question 19

Left side of heart + aorta

Answer 19

Directed by shunts to supply most of the blood to the body

Question 20

3 fetal heart bypasses

Answer 20

Ductus venosus, foramen ovale, ductus arteriosus

Question 21

Ductus venosus

Answer 21

Umbilical vein to IVC, bypasses liver

Question 22

Foramen ovale

Answer 22

Rt atrium to lt atrium

Question 23

Ductus arteriosus

Answer 23

MPA to aorta, bypasses lungs

Question 24

Deoxygentated blood from mom--> oxygenated fetal blood

Answer 24

Through placenta goes from deoxygenated to oxygenated

Question 25

OXBlood FLOW from fetal heart to fetal body

Answer 25

Placenta (O2)-->umbilical vein-->fetal liver(stops at liver) AND ductus venosus -->IVC +SVC-->Rt atrium-->Foramen ovale (--> left atrium) AND tricuspid valve--> right ventricle-->main pulmonary artery--> ductus arteriosis--> aorta--> body

Question 26

Blood FLOW returning to fetal heart from lungs

Answer 26

Pulmonary vein --> lt atrium --> mitral valve --> left ventricle--> aorta

Question 27

DEOXBlood FLOW from fetal body to placenta

Answer 27

Internal iliac arteries--> umbilical arteries--> Placenta