Final Exam

Question 1

When scanning a baby in the 2nd/3rd trimester, a heart rate of 110-180 BPM is not too concerning

Answer 1

True

Question 2

3VTV consists of the 3W structures (pulmonary artery, AO, SVC) plus

Answer 2

trachea

Question 3

Which will be closer to the anterior side of the baby

Answer 3

right ventricle

Question 4

Which arises from the left ventricle, and is imaged in longitudinal plane

Answer 4

aortic arch

Question 5

The aortic arch vs ductus arteriosus

Answer 5

will have branches off it

Question 6

Which has the “whale tail” or “snail” like sonographic appearance

Answer 6

RVOT

Question 7

In 2nd trimester, the typical average HR measures at

Answer 7

120-160 BPM

Question 8

To image the 3VV, you should start here then move towards baby’s head

Answer 8

RVOT

Question 9

You should be TRV on the fetal chest for this view

Answer 9

4CH

Question 10

The heart apex should be pointed

Answer 10

45 degrees to the left

Question 11

The heart should take up this much space in the thorax

Answer 11

1/3

Question 12

Which heart chamber will always be closest to the spine

Answer 12

left atrium

Question 13

Which prevents the blood from flowing back into the right atrium from the right ventricle during systole

Answer 13

tricuspid valve

Question 14

To get an image of the LVOT, you should start here then move slightly towards baby’s head

Answer 14

4CH

Question 15

The left ventricle is smaller because it contains the moderator band

Answer 15

False

Question 16

The LVOT

Answer 16

gives rise to the aorta

Question 17

3VV consists of the

Answer 17

pulmonary artery, aorta, SVC

Question 18

Around 6-7 weeks, you can expect the fetal HR to be roughly

Answer 18

90 BPM

Question 19

The foramen ovale

Answer 19

is the opening between the left and right atrium

Question 20

The moderator band

Answer 20

connects the interventricular septum to the papillary muscle

Question 21

When using M-mode, what is the best method/technique to help ensure you get an accurate waveform when obtaining fetal heartrate?

Answer 21

place sample gate on heart valve for maximum movement and better pattern

Question 22

Which structure(s) should never be seen in a Stomach/Abdominal Circumference image?

Answer 22

kidneys, it means you’re inferior to the level on the fetus that you should be

Question 23

Which two structures should be imaged in the Presentation image?

Answer 23

internal os of cervix and identifying part of fetus

Question 24

Why is it important for the Situs images to be within a few seconds of each other?

Answer 24

to prove fetus hasn’t moved/rotated

Question 25

To accurately obtain AFI quadrant measurements, how must the sonographer manipulate/hold the transducer?

Answer 25

transducer must be perpendicular to the floor for all 4 quadrant images

Question 26

Placental cord insertion should be imaged with color Doppler

Answer 26

True

Question 27

Fetal cord insertion should be imaged with color Doppler

Answer 27

False

Question 28

Which measurements constitute biometry?

Answer 28

Head circumference with biparietal diameter, abdominal circumference and femur length

Question 29

Before taking any heart images, sonographers should always look at the heart in the transverse chest to evaluate it for three different physical aspects. Those aspects are?

Answer 29

size is 1/3 of chest, pointed left and at a 45 degree angle

Question 30

Normally, the largest heart chamber is the ?

Answer 30

left ventricle

Question 31

What does a sonographer typically image to prove a 3 vessel umbilical cord exists?

Answer 31

transverse urinary bladder with color Doppler to show vessels bilaterally

Question 32

If the fetus has clenched fists throughout the exam, this is an indicator of Down syndrome

Answer 32

True

Question 33

What are the appropriate landmarks for an accurate head circumference/biparietal diameter measurement?

Answer 33

hypothalmus, falx cerebri and if possible cavum septum pellucidum

Question 34

What are the appropriate landmarks for an accurate abdominal circumference/stomach measurement?

Answer 34

spine, stomach, left portal vein, elongated ribs on sides

Question 35

Why is it best practice to image both legs together when the opportunity is presented?

Answer 35

to prove there are two

Question 36

When measuring femur length, it is most accurate to manipulate your transducer to have the bone horizontal onscreen. Of the two femurs that will be onscreen, which should be measured?

Answer 36

always the anterior presenting one

Question 37

When measuring lateral ventricle, it is most accurate to manipulate your transducer to have the head horizontal onscreen. Of the two ventricles onscreen, which should be measured?

Answer 37

always the posterior presenting one

Question 38

Which three measurements are taken at the level of the posterior fossa?

Answer 38

cerebellum, cisterna magna and nuchal fold

Question 39

What does a songrapher prove when imaging the edge of the placenta as it relates to the internal os of the cervix?

Answer 39

presence or absence of placenta previa

Question 40

It is mandatory to image bilateral ovaries during the 2nd and 3rd trimester anatomy exam.

Answer 40

False

Question 41

Which chamber of the heart is closest to the spine?

Answer 41

Lt atrium

Question 42

When is the most accurate time to 'date' a pregnancy?

Answer 42

Entire first trimester is the correct answer

Question 43

During a biophysical profile exam, a fetus must demonstrate one instance of _______________ seconds of breathing within the 30 minute exam.

Answer 43

30 sec

Question 44

During a biophysical profile exam, a fetus must demonstrate discrete body movements. How many movements must be demonstrated within the 30 minute exam?

Answer 44

3 movements

Question 45

Which structure is typically seen in the normal right ventricle of the fetal heart?

Answer 45

moderator band

Question 46

Fetal Breathing movements

Answer 46

One or more episodes of fetal breathing lasting at least 30 seconds within 30 minutes.

Question 47

Gross Body Movement

Answer 47

3 or more discrete body or limb movements within 30 minutes.

Question 48

Fetal Tone

Answer 48

One or more episodes of active extension and flexion of a fetal extremity OR opening and closing of the hand within 30 minutes.

Question 49

Amniotic Fluid Volume e*

Answer 49

A single deepest vertical pocket of amniotic fluid measures greater than 2 centimeters is present.

Question 50

First-Trimester Ultrasound Examination

Answer 50

a. Confirmation of the presence of an intrauterine pregnancy3–5; b. Evaluation of a suspected ectopic pregnancy6,7; c. Defining the cause of vaginal bleeding; d. Evaluation of pelvic pain; e. Estimation of gestational (menstrual)c age; f. Diagnosis or evaluation of multiple gestations; g. Confirmation of cardiac activity;

Question 51

Second- and Third-Trimester Ultrasound Examination16–1

Answer 51

a. Screening for fetal anomalies19–22; b. Evaluation of fetal anatomy; c. Estimation of gestational (menstrual) age; d. Evaluation of fetal growth; e. Evaluation of vaginal bleeding; f. Evaluation of abdominal or pelvic pain; g. Evaluation of cervical insufficiency; h. Determination of fetal presentation; i. Evaluation of suspected multiple gestation;

Question 52

What is the main goal in obstetrical sonography for the sonographer?

Answer 52

Determine life (confirm viability) •To exclude or include pathology/abnormalities

Question 53

Sperm meets Ovum (within first week) •Forms zygote •Undergoes cleavage •Morula: 16+ cell stage •Enters endometrial cavity •Blastocyst - implants

Question 54

Layers of Decidua

Answer 54

Decidua Basalis (aka placentalis, interacts with trophoblast) •Decidua Capularis (fuses with Parietalis @ 4th month) •Decidua Parietalis (aka Vera, intermediate layer)

Question 55

Gestational Sac

Answer 55

Hypoechoic area surrounded by echogenic ring •Eccentric location relative to the endometrium •Location near the fundus •Shape is round, oval, or crescent-shaped •Smooth contours

Question 56

Gestational Sac •Intradecidual sign

Answer 56

Eccentric location of GS adjacent to central endometrial •Fundal location

Question 57

Double Sac Sign

Answer 57

Two hyperechoic curvilinear lines surrounding most of gestational sac separated by a hypoechoic fluid

Question 58

Yolk Sac

Answer 58

Provides nutrients to the embryo •Initial site of hematopoiesis (RBC formation) •Spherical membrane, echogenic and readily seen •Constant in size •Should not exceed 6 mm •Measure inner to inner, A/P

Question 59

Crown Rump Length (CRL)

Answer 59

Considered to be the most accurate method of dating a pregnancy •Measure from top of crown to bottom of rump

Question 60

Normal YS < 6 mm

Question 61

Mean sac diameter = L + AP + W / 3