Test 3

Question 1

when does pregnancy enter the second trimester?

Answer 1

after the first 12 weeks of pregnancy

Question 2

by 20 weeks, what are the primary biometric parameters?

Answer 2

• biparietal diameter
• head circumference
• abdominal circumference
• femur length

Question 3

when does a fetus enter the growth stage of pregnancy?

Answer 3

after midterm or 20 weeks gestational weeks?

Question 4

what are measurements in thr 2nd and 3rd trimester more accurate for?

Answer 4

gestational size rather than age

Question 5

what is considered to be one of the best predictors for gestational age?

Answer 5

BPD

Question 6

what is the BPD?

Answer 6

a biometric measurement preformed in the transaxial view of the fetal head just above the level of the ears

Question 7

how is the sound beam faced when looking for BPD?

Answer 7

from the lateral aspect of the fetal head, with the sound beam perpindicular to the interhemispheric fissue, also known as the cerebral falx

Question 8

what should be seen when looking for BPD near the center of the cranium?

Answer 8

the diamond shaped hypoechoic thalmus

Question 9

what should the BPD not show?

Answer 9

orbital rims anteriorly or the cerebellum posteriorly

Question 10

how should the calipers be placed for BPD?

Answer 10

placed on the outer edge of the near fiels cranium and the inner edge of the far-field cranium

Question 11

what is brachycephaly?

Answer 11

an abnormally widened BPD

Question 12

what is dolichocephaly?

Answer 12

an abnormally shortened BPD

Question 13

what plane is used when calculating head circumferance?

Answer 13

same as BPD

Question 14

how should the ellipse tracing be placed for head circumferance?

Answer 14

placed along the outer border of the fetal cranium and should not include the soft tissues of the fetal scalp

Question 15

why is HC helpful in cases of abnormal fetal head shape?

Answer 15

becuase it is least influenced by shape

Question 16

what is calculation of AC used for?

Answer 16

estimation of fetal size or weight

Question 17

how should the AC be obtained?

Answer 17

with the true transverse plane of the fetal abdomen at the level of the umbilical vein junction with the left portal vein

Question 18

what should not be seen in the image of the AC?

Answer 18

kidneys should not be seen

Question 19

what are the limitations for assessment of gestatinal age?

Answer 19

• fetal crowding can alter the fetal abdomen shape and its size
• oligohydramnois and advanced gestational age may influence the AC
• the fetal abdomen also has a large variation during the 3rd trimester because of biologic influences
• fetal AC is influenced more by fetal size than fetal age, especially in the 3rd trimester

Question 20

can gestational age be relied on by the AC?

Answer 20

no, particullary in the 3rd trimester

Question 21

what is the second to the BPD in accuracy for prediction of gestational age in the 2nd trimester?

Answer 21

femur length

Question 22

what is least affected by surrounding structure?

Answer 22

femur length

Question 23

should both or 1 femur be visualized be examined?

Answer 23

both femurs in the presence of ossification and gross symmetry

Question 24

what femur should be examined?

Answer 24

the femur closest to the trasducer

Question 25

how may occipital frontal diameter (OFD) be used?

Answer 25

may be used along with the BPD to determine the fetal head shape and size

Question 26

what is the cephalic index calculation?

Answer 26

CI=(BPD/OFD) x 100

Question 27

what is a normal cephlaic index?

Answer 27

76 to 84

Question 28

what does a high cephalic index indicate?

Answer 28

brachycephalic

Question 29

what does a low cephalic index indicate?

Answer 29

dolichocephalic

Question 30

how is OFD demonstrated?

Answer 30

by the caliper line over the cerebral falx

Question 31

what is the binocular measurement?

Answer 31

measurement across the distance of both orbital rims

Question 32

what may binocular measurment assist in diagnosing?

Answer 32

facial abnormalities such as: - hypotelorism - hypertelorism

Question 33

what is the transcerebellar (TCD) measurment?

Answer 33

the posterior fossa region of the fetal head evaluated for evidence of pathology (cerebellar hypoplasia)

Question 34

what may be used as a secondary biometric measurement to assess gestational age?

Answer 34

TCD

Question 35

what can be visualized when measureing the TCD?

Answer 35

- cerebellum - cerebral peduncles - thalmus

Question 36

how are the cerebrellar hemispheres identified?

Answer 36

as 2 hypoechoic circular structures with echogenic borders on both sides of midline

Question 37

what is the vermis?

Answer 37

brightly echogenic wedge shaped between the cerebellar hemispheres

Question 38

what are the other structures included in the posterior fossa?

Answer 38

- cisterna magna | - nuchal fold

Question 39

when does the cerebral hemispheres correlate with gestational age?

Answer 39

between 15-25 weeks

Question 40

what is the cisterna magna?

Answer 40

anechoic space located in the posterior fossa immediately posterior to the cerebellum

Question 41

what may an abnormal sized cisterna magna (1cm) suggest?

Answer 41

- ventriculomegaly - cerebellar hypoplasia - dandy-walker malformation

Question 42

what is absence of obliteration of the cisterna magna associated with?

Answer 42

fetal spinal dysraphism

Question 43

what is the nuchal fold measured for?

Answer 43

in the 2nd trimester to identify a risk for trisomy 21

Question 44

what is the nuchal fold?

Answer 44

skin at the posterior edge of the fetal cranium

Question 45

what measurments of nuchal fold suggest trisomy 21?

Answer 45

thickness of 5-6mm or more between weeks 18 and 24

Question 46

where is the atrium of the lateral ventricle located?

Answer 46

inferior to the level of the BPD

Question 47

what is the atrium of the lateral ventricle?

Answer 47

junction of the anterior, occipital, and temporal horns

Question 48

what is the measuerment of the atrium of the lateral ventricles?

Answer 48

6-10mm throughout pregnancy

Question 49

what does the choroid plexus produce?

Answer 49

CSF

Question 50

what does thoracic circumferance get measured for?

Answer 50

diagnosis of potentially lethal fetal abnormalities

Question 51

what can comparison of thoracic and abdominal provide information about?

Answer 51

skeletal dysplasias

Question 52

what may an abnormally small thoracic to AC ratio assist in the assessment of?

Answer 52

risk of pulmonary hypoplasia

Question 53

what is the normal heart circuferance>

Answer 53

1/3 of the thoracic circumferance

Question 54

what does biophysical profile indirectly test for?

Answer 54

fetal hypoxia

Question 55

how long is the fetus observed for in biophysical profile?

Answer 55

30 minutes

Question 56

what are the 5 parameters assesed in biophysical profile?

Answer 56

- fetal tone - fetal breathing - body movements - amniotic fluid volume - nonstress test or placenta grade

Question 57

placental grading-grade 0

Answer 57

<18 weeks

Question 58

placental grading-grade 1

Answer 58

occasional parenchymal calcification (18-29 wks)

Question 59

placental grading-grade 2

Answer 59

occasional basal calcifications with indentations of chorionic plate

Question 60

placental grading-grade 3

Answer 60

significant basal calcifications with chorionic plate indentations to the basal layer (>39 wks)

Question 61

what is fetal tone?

Answer 61

one complete episode of flexion to extension and back to flexion

Question 62

what is fetal movement?

Answer 62

three seperate fetal movements within 30 minutes

Question 63

what is fetal breathing movement?

Answer 63

movement of the diaphragm >30s

Question 64

what is amniotic fluid volume?

Answer 64

amniotic pocket >2cm OR | amniotic fluid index >5cm

Question 65

what is a nonstress test?

Answer 65

exhibits two fetal heart accelerations within 20 min or placental grade >2

Question 66

what are the total points in biophysical test?

Answer 66

>8

Question 67

what are markers for acute fetal hypoxia?

Answer 67

- nonstress findings - fetal tone - breathing and body movements

Question 68

what is a marker for chronic fetal hypoxia?

Answer 68

amniotic fluid volume

Question 69

what is fetal presentation?

Answer 69

realtionship of the fetal head with the internal cervical os

Question 70

when does fetal position change less frequently?

Answer 70

after 34 weeks

Question 71

what is cephalic or vertex position?

Answer 71

fetal head lies most inferior, closest to the cervical os

Question 72

what is the transverse postion?

Answer 72

- fetal head and body lie across the maternal abdomen | - check for signs of placenta previa

Question 73

what is the oblique presentation?

Answer 73

-fetal head and body are lying at a 45 degree angle to the maternal sag plane

Question 74

what is breech presentation?

Answer 74

- fetal head located in the superior portion of the uterus | - presenting part should be determines after 36 weeks gestation

Question 75

what is frank breech presentation?

Answer 75

- fetal buttocks are presenting with the feet near head | - hips flexed and knees extended (most common)

Question 76

what is complete breech presentation?

Answer 76

- fetal buttocks are presenting with the knees bent and feet down - both hips and knees are flexed ( most common)

Question 77

what is an incomplete breech presentation?

Answer 77

- footling breech-fetal foot is the presenting part - one or both hips and knees are extended - greatest risk for prolapsed cord