Module 7.2 : Detailed Scan Flashcards Preview

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Flashcards in Module 7.2 : Detailed Scan Deck (50)
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1

overall sagittal sweep

- sag plane to the other sweep from cervix to fundus of uterus to assess th position of fundus
- image sag fundus/cervix pic
- check for fetal heart motion
- check for number of fetus
- assess for presence of amniotic fluid

2

overall transverse sweep

- transverse sweep along the lateral aspect of the uterus to include adnexa

3

overall transverse assessment

- fibroids
+ document in 2 planes
+ measure in 3 dimensions
+ doppler
- assess for adnexal masses usually arising from ovary
+ corpus luteal cyst
+ dermoid cyst
- two planes 3 dimensions

4

need to establish

- viable fetus
- fetal lie
- fetal number
- placental localization

5

placenta

- look at placenta position
- asses placental texture
- decide if placenta is low or not
+ placenta previa = placenta over cervix
+ LOWER PLACENTAL EDGE SHOULD BE A MINIMUM OF 2 CM AWAY FROM INTERNAL OS OF CERVIX
- document cervix length measure
- document and measure placental edge to internal is

6

what to start with in OB scanning

- start with whatever is up
- if fetus with back up anterior start with spine and kidneys
- if fetus laying with chest up always start with heart and face profile

7

cranium

- asses head shape
- high on fetal head or cephalic on the fetus the head the shape is round
- at BPD level fetal had more oval

8

cranial images

- BPD, OFD, HC
- ventricular image
- bilateral choroid image
- cerebellar image
- orbital image
- nose lip image
- profile

9

BPD assesses

- cavum septum pellucidi
- third ventricle
- ambient cistern
- falx cerebri
- shape

10

ventricular image

- assesses the dependent ventricle
+ ventricle farthest from transducer
- measure ventricular atrium size
+ upper normal is 10mm
- assess echo texture of dependent choroid

11

bilateral choroid image

- assess echo texture of both choroid together

12

cerebellar image / posterior fossa

- used to assess the cerebellar shape and size
+ if vermis is present
- presence and size of cisterna magna
+ what is upper limit of normal 10mm
- nuchal fold thickness
+ 10mm

13

orbital image

- assess for
+ hyper telorism = to far
+ hypoterlorism = to close
- size of orbits
+ micropthalmia (small eyes)
- seeing lenses on the eyes rules out
+ anopthalima (no eyes)

14

nose lip image

- image skims the nose and slip
- rule out
+ cleft lip and abnormal nostrils
- want 2 nostrils and septum between

15

profile

- line up forehead nose and chin on image
- assess chin
+ micrognathia (small mandible)
+ retrognathia (receding chin)
- assess nasal bone
+ present >2.5mm
+ absent or hypoplastic

16

ossification

- anterior ossification center is the vertebral body
- posterior ossifications laminar junction
- THESE ARE ONLY VISIBLE AREAS OF THE FETAL SPINE ON ULTRASOUND

17

spinal ossification

- as the gestational age increases the lamina ossifies into a linear structure rather than circular
- ossification is not complete until 18 weeks gestation

18

spine

- must be viewed in 2 planes
+ trans and sag
- if you can not view in a sag plan than coronal acceptable

19

imaging spine

- one image at distal end to include sacrum
- on image at cephalic end to include cervical spine into cranium
- include as many vertebral ossifications in image as possible
- MOST IMPORTANT IS TO SWEEP THROUGH SPINE IN TRANSVERSE
- only image taken in trans is at lumbosacral junction (spina bifida)

20

trans spine at sacrum

- ideal image include both iliac crests and all 3 ossifications centers
- transducer directly over spine
- fetal bladder included as well
- looking for herniation
- should see amniotic fluid behind spine

21

abdominal circumference (AC)

- assesses presence of stomach and position of organs
- is the stomach on the left side
- should only see one stomach bubble
- the GB may be seen
+ do not confuse with stomach
+ ovoid looking on right side

22

what is a good AC

- umbilical vein runs in the falciform ligament and becomes ligamentum teres after birth
- confluence of umbilical vein and left portal vein
- referred to as portal sinus

23

heart

- 4 chamber view
- assess the size of all chambers and valve placement
- M-MODE ADN MEASURE THE FETAL HEART RATE
- could do chest circumference if needed

24

heart size and placement

- size of heart should be 1/3 of chest
- toward the left 45'

25

outflow images

- done to rule out great vessel abnormalities
- RVOT
- LVOT
- not lung tissue around the heart

26

LVOT

- should see valve in aortic sinus
- probe more cephalic

27

RVOT

- need to take long axis
- should see branches

28

3 vessel view

- see SVC, aortic arch and pulmonary artery

29

cine clip 6-12 seconds

- beginning at fetal stomach in trans
- sweeping cephalic
- demonstrate
+ stomach
+ 4 chamber
+ LVOT
+ RVOT
+ 3 vessel view

30

fetal heart cine clip

- fetal heart in horizontal plane
- while performing the cine clip LVOT should appear with and change to probe plane
- RVOT should follow
- 3 vessel should be just superior to RVOT