Module 8.1 : Normal Fetal Anatomy - Heart Flashcards Preview

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Flashcards in Module 8.1 : Normal Fetal Anatomy - Heart Deck (33)
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1

when does heart tube begin to develop

- develops from the mesoderm at 5th week LMP

2

when is the heart tube fully formed

- 10th week LMP

3

heart tube evaluations done when

- evaluated from 18 or 20 weeks to term or delivery
- best between 18-24 weeks

4

fetal circulation - specialized structures

- ductus venosus
- foramen ovale
- ductus arteriosus
- 3 places where there is shunts

5

heart position within the fetus

- sits completely horizontal in the fetal chest
- located left of midline
- apex points 45' to left
- occupies 1/3 of chest

6

chambers of the heart

- 2 atria sit posterior to 2 ventricles
- left atrium most posterior
- right ventricle most anterior

7

moderator band

- thick muscle makes right ventricle chamber look smaller than left
- used to prove which chamber is right ventricle in abnormal hearts

8

mitral valve

- aka bicuspid valve
- contains 2 cusps
- passes blood from left atrium to the left ventricle

9

tricuspid valve

- contains 3 cusps
- passes blood from right atrium to the right ventricle
- mitral and tricuspid valves open and close together and at same level in heart

10

aortic valve

- 3 cusps
- assess oxygenated blood from the left ventricle to the aorta to be distributed to the rest of the body
- seen in LVOT view

11

pulmonary valve

- contains 3 cusps
- passes deoxygenated blood from right ventricle to pulmonary artery to be oxygenated by longs
- pulmonary artery sits more anterior than the aorta
- want to see it in long axis not short axis

12

ductus arteriosis

- shunts blood from the pulmonary artery to the aortic arch to bypass the lungs during fetal life
- after deliver the ductus arteriosis closes

13

foramen ovale

- opening between the atria
- blood flows from right atrium to the left atrium
- also helps bypass lungs
- ovale flaps open into left atrium

14

IVC and SVC

- bring deoxygenated blood back from the body to the right atrium
- long horn vie you see both

15

pulmonary veins

- 4 pulmonary veins the bring oxygenated blood from lungs to the left atrium in new born
- on ultrasound usually see 2

16

routine images of heart

- 4 chamber heart (trans)
- left outflow tract (more superior)
- right outflow tract (more mores superior)
- 3 vessel view (most superior)
- cine clip
- fetal M mode
+ 120-160bpm in 2nd and 3rd trimester
+ can go higher but worrisome if goes lower

17

4 chamber heart

- shows all 4 chambers with the septum
- valves closed = systole
- valves open = diastole

18

LVOT

- demonstrates the left ventricle with the aorta
- anterior wall of the aorta should continue with the IVS

19

RVOT

- demonstrates the right ventricle with the pulmonary artery
- LVOT and RVOT should cross eachother
- if parallel to each other the tubes didn't twist

20

3 vessel view

- should see pulmonary artery
- aortic arch
- SVC
- assess diameter

21

cine clip 12 seconds

- begin at level of AC
+ demonstrate stomach for situs
- sweep cephalic
- demonstrate 4 chamber
- then LVOT
- then RVOT
- then 3 vessel
- sweep all the way to fetal neck

22

heart tracing

- use M mode
- place cursor over the heart area where you catch wall of one atria and one ventricle
- usually one beat
- only way to prove viability
- assess if atria and ventricle beating at same rate

23

tachycardia

- fetus won't survive in tachycardia
- heart is quivering no blood into systems
- may see hydrops - end stage disease fluid in one or more cavities

24

normal fetal heart rate

- 120-160bpm

25

heart rate under 100 in first

- concerning
- early pregnancies heart may actually stop for a few seconds (conduction is weak)
- move to different area then go back

26

third trimester heart rate

- up to 180 in third is normal with activity

27

bradycardia

- under 100 sustained in 2nd 3rd trimester

28

additional images

- short axis (circle and sausage)
- SVC IVC with right atrium
- aortic arch
- ductal arch
- pulmonary veins with left atrium

29

short axis view

- demonstrates the right and left atrium
- right ventricle
- pulmonary artery
- ductus arteriosis
- all circling aorta

30

SVC and IVC

- shown with right atrium
- steers head