Test 4 Flashcards
(368 cards)
1
Q
first thing to determine in 2nd and 3rd tri scanning
A
determine fetal position in relationship to mother/cervix
2
Q
after determining fetal position, what should be done next?
A
determine left and right side (situs)
3
Q
fetal lie is describe in relationship to ___________
A
maternal long axis
4
Q
what does “cephalic position” mean
A
head closest to cervix. vertex
5
Q
fetus lying perpendicular to long axis of mother
A
transverse fetal lie
6
Q
what should be reported when fetus is in transverse fetal lie
A
position of fetal head (maternal right/left)
position of spine (inferior, superior, anterior, posterior)
7
Q
in oblique fetal presentation, describe ______ and ______
A
quadrant of the head and direction of the spine
8
Q
cranial bones ossify by _____
A
12 weeks
9
Q
survey the head checking for ____
A
contour or outline of skull bones highest level in brain
10
Q
head appears as circle at _____
A
highest level
11
Q
head appears as an oval at _____
A
ventricular, peduncular and basal levels
12
Q
distortion of skull shape is caused by (4)
A
extracranial masses
CNS anomalies
skeletal pathology
fetal death
13
Q
normal fetal brain parenchyma appears _____ because of _____
A
hypoechoic
small size and high H2O content
14
Q
sulcus and gyrus echogenicity
A
more echogenic
15
Q
Branches of anterior cerebral artery run within _____ and pulsate
A
sulci
16
Q
Standard OB exam requires records of (6)
A
cerebellum choroid plexus cisterna magna lateral ventricles midline falx cavum septum pellucidi
17
Q
at what level is midline falx seen
A
superior level in TRV
18
Q
white matter tracts location (2)
A
lateral and parallel to midline falx
above level of lateral ventricles
19
Q
choroid plexus location
A
roofs of each ventricles except frontal ventricular horn
20
Q
connection of inferior portion of lateral ventricles with temporal and posterior horns
A
atrium of lateral ventricles
21
Q
shape of choroid plexus
A
tear-shaped
22
Q
most inferior portion of choroid plexus
A
glomus
23
Q
site of atrium
A
glomus (most inferior portion of choroid plexus)
24
Q
normal atrium measurement
A
6.5mm
25
atrium measurement of more than ______ warrants serial imaging
10mm
26
what do you see inferior to ventricular atrium
thalami and ambient cicterns
27
location for BPD measurement
inferior to ventricular atrium
| area of thalami
28
brain structures seen at BPD level
cavum septum pellucidum
midline echo
thalamus
29
location of 3rd ventricle
between thalami
30
location of cavum septum pellucidum (CSP)
anterior to thalamus
| between leaves of septum pellucidum
31
location and echogenicity of corpus collosum
echopenic (low echogenicity)
| between frontal ventricular horns
32
pulsations from _____ artery observed between lobes of peduncles at interpeduncular cistern
basilar
33
location of circle of willis
anterior to midbrain
34
shape of circle of willis
triangular region
35
what is seen in the center of circle of willis
suprasellar cistern
36
location of cerebellum
back of cerebral peduncles within posterior fossa
37
cerebellar hemispheres are joined by _____
cerebellar vermis
38
distortion of cerebellum suggests _______
spina bifida
39
location of cisterna magna
behind cerebellum
40
what excludes almost all open spinal defects
normal cisterna magna
41
thinned out or obliterated cisterna magna suggests ______
Arnold-Chiari malfornation
42
normal size of cisterna magna
3-11mm
| average 5-6mm
43
how is cisterna magna measuremed
vermis to inner skull
44
echogenic structures within cisterna magna
dural folds attaching falx cerebelli
45
at what level is nuchal skin fold measured (3)
cavum septi pellucidi
cerebellum
cisterna magna
46
normal nuchal skin fold thickness
5mm or less up to 20 weeks
47
site of pituitary gland
junction of sphenoid wings and petrous bones
| at sella turcica
48
location of sella turcica
junction of sphenoid wings and petrous bones
49
where are orbits visualized
below cerebellar plane
50
anophthalmia
absence of eyes
51
hypotelorism
fused or closely spaced eyes
52
hypertelorism
widened eyes
53
how are orbits measured (2)
coronal scan - posterior to glabella-alveolar line
| TRV - below BPD
54
in what position are orbital distances determined
occipitoposterior
55
how is IOD measured
(inner orbital distance)
| medial border of orbit to opposite medial border
56
how is OOD measured
(outer orbital distance)
| lateral border of one orbit to lateral of the other
57
micrognathia
small chin
58
frontal bossing
forehead more prominent than usual as in skeletal dusplasia
59
frontal slanting
opposite of frontal bossing
| forehead caves in
60
when is frontal slanting seen
microcephaly
61
when are oral cavity and tongue outlined
during swallowing
62
macroglossia
large tongue
63
macroglossia is associated with (2)
Beckwith-Wiedeman sundrom and aneuploidies
64
in what view is cleft lip diagnosed
coronal
65
Standard antepartum OB exam spine requirements (4)
```
cervical
thoracic
lumbar
sacral spine
(to exclude malformations)
```
66
what should be seen on each vertebra and in what view are they seen
3 ossification points.
| TRV
67
railway sign
double line appearance of spine
68
appearance of vertebral column (pedicles) in spinal defects
V, C, or U shaped
69
landmark for heart and its position
lungs
70
what do fetal lungs look like
solid, fluid filled homogenous masses
71
borders of lungs
heart medially
rib cage laterally
diaphragm inferiorly
72
what can displacement of the heart suggest
lung masses or subdiaphragmatic hernia
73
bony landmarks of chest cavity (3)
ribs
scapulae
clavicles
74
when do you see total length of ribs
oblique sections
75
when are clavicles observed
coronal sections of thorax
76
in what views is scapula seen and what does it appear like
sagittal, TRV or full length in oblique
| echogenic linear echo adjacent to rib shadows
77
in what view is the sternum seen
axial sections showing bony sequence of echoes
78
lie of fetal heart and why
more TRV because lungs are not inflated
79
4 chamber heart can be seen in what views
beam perpendicular to septum
beam perpendicular to valves
angling cephalad after obtaining TRV abdomen
80
what should you access in 4 chamber view of heart (5)
```
cardiac position
situs
axis
apex pointing to the left
presence of both ventricles
```
81
Which ventricle is larger and why
right
| pumps blood through ductus arteriosus and descending aorta
82
which heart valve is lower
tricuspid
83
EIF
echogenic intracardiac focus
| echogenic structure within chamber that persists despite different transducer approaches
84
in what plane is the diaphragm viewd
longitudinal
85
what's suggested by diaphragm curving towards abdomen
increased thoracic pressure due to mass or effusion
86
on what side is diaphragm more obvious and why
right because of liver interface
87
what excludes left sided diaphragmatic hernia
visualization of stomach inferior to diaphragm
88
sign of left-sided diaphragmatic hernia
fetal heart displaced to the right
89
what helps determine location of CCA and how is it outlined
esophagus and oropharynx
| outlined during swallowing
90
where does fetal oxygenation occur
placenta within intervillous spaces
91
what shunt blood away from the lungs
ductus arteriosus
92
what shunts blood directly to heart
ductus venosus
93
flow of blood to fetus
```
placenta
umbilical vein
course cephalad along falciform ligament
through liver
left portal vein
right posterior and anterior portal veins
liver sinusoids
hepatic veins
IVC
heart
Ao from l ventricle and pulmonary art from r ventricle
ductus arteriosus (from r ventricle)
```
```
OR
placenta
umbilical vein
ductus venosus
IVC
```
94
right ventricle pumps blood to
pulmonary artery
ductus arteriosus
descending aorta
95
left ventricle pumps blood to
ascending aorta and brain
96
where do umbilical arteries arise from
fetal iliac arteries
97
what makes up fetal hepatobiliary system (6)
```
liver
portal veins
hepatic veins
hepatic arteries
GB
bile ducts
```
98
fetal heart failure may be diagnosed by doppler evaluation of ______
ductus venosus
99
what lobe of liver is larger and why
left
| large quantity of oxygenated blood
100
what discerns the liver and what echogenicity is it
pebble gray echogenicity
| portal and hepatic veins
101
storage site for glucose sensitive to disturbances in growth
liver
102
GB is located below _____
left portal vein
103
GB should not be mistaken for _____
left portal vein
104
fetal pancreas location and how should the fetus be luing
posterior to stomach, anterior to splenic vein
| fetus lying spine down
105
location of spleen
in TRV posterior and left of stomach
106
fetal GI tract is composed of ____ (4)
esophagus
stomach
small intestine
large intestine (colon)
107
when is stomach apparent and why
11th week
| fills with swallowed amniotic fluid
108
when should full stomach be seen
>16 weeks
109
when can small bowel be differentiated from large bowel
>20 weeks
110
large bowel measurement
20mm in preterm and larger in postdate
111
echogenicity of bowel
greater than liver
112
what is hyperechoic bowel
bowel as echogenic as bone
113
what is hyperechoic bowel associated with
aneuploidy and neonatal pathology
114
components of urinary system (3)
kidneys, ureters, bladder
115
when are kidneys seen and what do they look like
13th week
| ovoid retroperitoneal structures without distinctive borders
116
echo-free area in the center of kidney
renal pelvis
117
abnormal renal pelvis measurements
>5mm before 20 weeks
>8mm 20-30 weeks
>10mm beyond 30 weeks
118
pyelectasis
persistent bilateral renal pelvis dilation
119
when and how are adrenals seen
TRV above kidneys
| 20 weeks
120
center of adrenal gland
echogenic line surrounded by less echogenic tissue
121
left adrenal gland is close to ____
TRV aorta
122
how often does the fetus void
once an hour
123
failure to visualize bladder in oligohydromnios suggests ____ (2)
renal abnormality or premature rupture of membranes
124
how do you locate fetal genitalia
follow long axis of fetus towards hips
bladder is posterior to genital organs
tangential scanning planes between thighs
125
when can gender be appreciated
12 weeks
126
in what plane is female genitalia seen
TRV
127
why can labia appear edematous and swollen
due to circulating maternal hormones
128
what does scrotal sac look like
mass of soft tissue between hips with scrotal septum and testicles
129
common benign finding in male genetalia
hydrocele
130
short femur and humerus are associated with
aneuploidy
131
how is humerus located
sagittal plane laterally from ribs and scapula
132
how is long axis humerus seen
lateral to scapular echo
133
when are epiphyseal ossification centers of humerus seen
39 weeks
134
what does TRV humerus appear as
solitary bone surrounded by muscle and skin
135
how are radius and ulna imaged
tracing humerus to elbow
136
example of positive demonstration of fetal tone
hand movement
137
what does visualization of distal femoral epiphysis within cartilage at knee signify
33-35 weeks gestation
138
what is proximal epiphyseal center found at tibial end
35 weeks
139
which bone is larger, tibia or fibula
tibia
140
what is persistent and abnormal flexion of ankle associated with
clubfeet
141
what should you evaluate after the fetus has been studies (3)
placenta
amniotic fluid
pelvis
142
what are absent cord twists associated with
poor pregnancy outcome
143
max umbilical vein diameter by 30 weeks
.9cm
144
velamentous cord insertion
atypical insertion location
145
echogenicity of placenta in early pregnancy
pebble-gray
146
functions of amniotic fluid (5)
```
free movement
maintenance of intrauterine pressure
maintenance of temperature
protection from injury
lung development
```
147
up to what time does volume of amniotic fluid increase and when does it diminish
increase until 34 weeks and diminish after
148
true or false:
| amnion is contiguous with membrane lining umbilical cord
true
149
subamniotic collection
fluid under membrane floating on top of placenta
150
subchorionic collection
fluid under membrane ending at edge of placenta
151
when should transperineal and transvaginal imaging of cervix be done
when cervix is shortened or theres a risk of incompetent cervix or premature delivery
152
length of normal cervix
3cm or more
153
how should you measure a round sac
one inner to inner
154
how do you measure an ovoid sac
two measurements inner to inner
| perpendicular to each other
155
how long is the fetal pole when cardiac activity should be seen
>7mm
156
at what GA is CRL measured
6-12 weeks
157
when is EHR measured (2)
5-9 weeks
| CRL
158
how accurate is EHR
+-6days
159
what does it mean when EHR is more than 6 days behind CRL
impending 1st trimester failure
160
how fast does EHR accelerate (3)
3.3bpm/day
10 beats every 4 days
>100 beats in 1st month
161
how is BPD measured
leading edge to leading edge
| outer to inner
162
how do you measure HC
outer margins of skull
163
how is coronal head circumference (CHC) measured and what should you see
perpendicular to TRV HC
| thalamus and brain stem
164
Where is AC measurement taken
umbilical portion of left portal vein
165
how is femur length measured
greater trochanter to femoral condyles
166
what should not be included in femur length
epiphyseal cartilages and dustal femoral point (DFP)
167
normal femur shape
straight lateral border and curved medial border
168
which bone is lateral and thinner (tibia or fibula)
fibula
169
what bone is longer
(ulna or radius)
and where is is longer
ulna
| longer proximally
170
orbital diameter normal measurements
13mm at 12 weeks to 59mm at term
171
at what level is the cerebellum measured (3)
cerebellum
vermis
4th ventricle
172
how are cistern magnum and nuchal fold recorded
by angling inferior from cerebellum
173
definition of IUGR
decreased rate of fetal growth
| weight at or below 10%
174
maternal risk factors for IUGR (6)
```
previous IUGR fetus
HTN
smoking
uterine anomaly
placental hemorrhage
placental insufficiency
```
175
definition of SGA
weight below 10th percentile without reference to cause
176
two types of IUGR
symmetric and asymmetric
177
cause and time of symmetric IUGR
1st trimester insult like chromosomal anomaly or infection
178
cause and time of symmetric IUGR
late 2nd and 3rd trimester
| caused by placental insufficiency
179
clinical signs of IUGR
decreased fundal height
decreased fetal motion
GRADE 3 PLACENTA B/F 36 WEEKS or decreased thickness
increased RI in umbilical artery }(S/D >3)
180
most sensitive indicator of IUGR
AC measured at portal-umbilical venous complex
181
biophysical profile tests (5)
```
cardiac nonstress test (NST)
fetal breathing movement (FBM)
fetal body movement (FM)
fetal tone (FT)
amniotic fluid volume (AFV)
```
182
what is true breathing movement
inward movement of chest wall and outward movement of abdominal wall
183
what is an alternative area to watch for fetal breathing
fetal kidney in long
184
fetal tone
extension and flexion of one of limbs or trunk
185
definition of macrosomia (2)
>4000g
| too large for pelvis
186
risk factors for macrosomia (8)
```
multiparity
age >35
pre-pregnancy weight >70kg/154lb
PI in upper 10%
pregnancy weight gain >20kg/44lb
postdate pregnancy
history of LGA
DM
```
187
malformation resulting in increased fetal size
beckwith-wiedemann
marshall-smith
soto's
weaver's
188
two types of macrosomia
mechanical and metabolic
189
mechanical macrosomia types (3)
fetus generally large
large fetus with large shoulders
normal trunk but large head
190
mechanical macrosomia with generally large fetus occurs due to _____ (3)
genetic factors
prolonged pregnancy
multiparity
191
mechanical macrosomia with large fetus and large shoulders occurs in _______
diabetic mothers
192
mechanical macrosomia with normal trunk but large head is caused by _____
```
genetic constitution
pathologic process (hydrocephalus)
```
193
decidua basali
reaction between blastocyst and myometrium
194
decidua capsularis
reaction over blastocyst closest to endometrium
195
decidua vera (parietalis)
reaction except for areas beneath and above implanted
196
chorion fondosum
forms fetal part of placenta, contains villi
197
chorion leave
nonvillious part of chorion around gestational sac
198
chorionic plate
fetal surface of placenta
199
basal plate
maternal surface of placenta
200
functions of placenta (6)
```
respiration
nutrition
excretion
protection
storage
hormonal production
```
201
oxygenated blood is thought to placenta through _____
end spiral arteries
202
what separates fetal blood from maternal blood and what is it composed of _______ (3)
thin layer of capillary wall, trophoblastic basement membrane and thin rim of cytoplasm of cyncytiotrophoblasts
203
how is fetal placenta anchored to maternal placenta
cystotrophoblastic shell and anchoring villi
204
maternal placental circulation may be reduced by ________
decreased uterine blood flow
HTN
renal disease
placental infarction
205
abnormal cordal attachments to placenta (2)
battledore and velamentous placenta
206
where does secondary yolk sac form
ventral surface of embryonic disk
207
fetal membranes (4)
chorion
amnion
allantois
yolk sac
208
when does amnion develop and where is it attached
28th menstrual day
| margins of embryonic disk
209
when does amnion fuse with chorion
16th week
210
separation of amnion and chorion beyond 16th week suggests ____ (3)
polyhydramnios, aneuploidy or prior amniocenthesis
211
separation of amnion and chorion may also be simulated by _______
hemorrhage
212
normal cord diamater
1-2cm
213
normal cord length
40-60cm
214
functional endocrine unit of placenta
chronic villi
215
inner layer of placenta and what does it produce
cytotrophoblast
| neuropeptides
216
outer layer of placenta and what does it produce
syncytiotrophoblast
| hCG, human placental lactogen hPL, sex steroids (estrogen and progesterone)
217
what/who produces progesterone
maternal-placental interaction
| no contribution from the fetus
218
what/who produces estrogen
maternal, placental and fetal contributions
219
fetal surface of placenta
echogenic chorionic plate along
220
basal plate
maternal portion of placenta next to myometrium
221
what can vessels behind basal plate be confused with
placental abruption
222
when can normal placenta be identified
8 weeks
223
appearance of placenta at 8-20 weeks (3)
homogenous
mid-level gray
smooth borders
224
thickness of placenta
2-3cm >23 weeks
225
appearance of placenta after 20 weeks
intraplacental sonolucenies and placental calcifications
226
what are placental lakes
placental sonolucencies
may have blood flow
"swirling flow"
227
what separates placenta from myometrium
subplacental venous complex
228
normal and abnormal AFI
8-22 normal
| 22 is increased
229
3 types of cord insertions
placental, marginal, velamentous
230
when is cervix falsely elongated
full bladder
231
when cervix is elongated, how does normal placenta look
may appear to be covering internal cervical os and give false impression of previa
232
how do you better demonstrate internal cervical os (2)
trendelenburg position
| relieve pressure of uterus on lower uterine segment
233
best imaging tool for lower uterine segment and inferior edge of placenta
TV
234
succenturiate placenta
anterior and posterior placenta that does NOT communicate
| (accessory) - joined to main placenta by blood vessels
235
placental migration
position of placenta changes because of physiologic changes in lower uterine segment
low blood supply in LUS - atrophy
High blood supply in fundus - hypertrophy
236
uterine artery resistence
high during 1st tri
| low during 2nd tri
237
where is lowest resistance of uterine artery seen
placental side
238
abnormal trophoblastic invasion of apiral arteries is associated with (produces high RI) (4)
placental insufficiency
IUGR
preeclampsia
placental abruption
239
normal placenta characteristics at delivery (4)
15-20cm in diameter
discoid in shape
600g
240
complications of short umbilical cord (8)
```
traction during labor
rearing of cord
abruption
inversion of uterus
preterm delivery
decreased heart rate
meconium staining
fetal anomalies
```
241
complications of long umbilical cord (3)
prolapsing
twisting
tying in true knots
242
where is fibrin most pronounced
floor of placenta
243
causes for placentomegaly (9)
```
DM
anemima
thalassemia
Rh sensitivity
fetomaternal hemorrhage
chronic intrauterine infections
TTTS
congenital neoplasms
fetal malformations
```
244
causes for small placenta (3)
IUGR
infection
aneuploidy
245
risk factors for placenta previa (7)
```
c section
advanced maternal age
smoking
cocaine abuse
prior placenta previa
multiparity
uterine surgery
```
246
complications of placenta previa (5)
```
preterm delivery
maternal hemorrhage
placental invasion
postpartum hemorrhage
IUGR
```
247
painless bright red vaginal bleeding in 3rd trimester signifies with possible myometrial contractions
placenta previa
248
vasa previa
fetal vessels run in membranes across cervical os
249
causes of vasa previa
velamentous insertion
| succenturiate lobe
250
what does placenta increta result from
underdeveloped decidualization of endometrium
251
placenta increta is associated with ______
placenta previa
252
curcumvallate/circumarginate placenta
placenta attached to fetal surface rather than to villous placental margin
chorionic villing around borders of placenta not covered by chorionic plate
placental margin is folded, thickened or elevated
253
what is circumvallate/circummarginate placenta associated with (4)
PROM
preterm labor
IUGR
placental abruption
254
sites of placental hemorrhage (4)
reptoplacental
subchorionic
subamniotic
intraplacental
255
placental abruption
separation of normally implanted placenta prior to term delivery
premature placental detachment
256
where does bleeding from placental abruption occur
decidua basalis
257
what does retroplacental abruption result from
rupture of spiral arteries causing high pressure bleed
258
retroplacental abruption is associated with _____ (2)
HIT
| vascular disease
259
presentation of retroplacental abruption (4)
asumptomatic or bleeding
thickened placenta
hypoechoic in older bleeds
separation of placenta from uterine wall
260
most common type of placental abruption and what is it known as
marginal
| subchorionic bleeds
261
what causes marginal hemorrhage and what kind of bleed is it
tears of marginal veins
| low-pressure bleed
262
subchorionic hemorrhage accumulates _____
at the site of separation
263
what causes intervillous thrombosis
intraplacental hemorrhage caused by breaks in villous capillaries
264
placental infarcts
focal discrete lesion caused by ischemic necrosis
265
what do large placenta infarcs reflect
underlying maternal vascular disease
266
placental infarcts are difficult to distinguish from ____
intraplacental hemorrhages
267
clinical symptoms of gestational trophoblastic disease (4)
N/V
elevated hCG
vaginal bleeding
larger than dates
268
chorioangioma
most common
| benign vascular tumor of placental consisting of fetal vessels (capillary hemangiomas arising beneath chorionic plate)
269
large chorioangiomas may act as ----------
arteriovenous malformation shunting blood from fetus
270
fetal complications of chorioangioma (6)
```
polyhydramnios
hydrops
anemia
cardiomegaly
IUGR
demise
```
271
lab values of chorioangioma
elevated AFP in AF and maternal blood
272
Di/Di monozygotic twins occur if separation occurs during ______ days of pregnancy
first 4
273
risk of monochorionic twins
placental vascular anastomosis
274
risk of monoamniotic twins
entanglement of umbilical cord
275
when does the umbilical cord form and from what
first 5 weeks
| fusion of yolk stalk and allantoid ducts
276
what does outpouching from urinary bladder form
urachus
277
allantoic vessels become _______
umbilical vessels
278
cord acquires epithelial lining as a result of (2)
enlargement of amniotic cavity
| envelopment of the cord by amniotic membrane
279
diameter and length of cord
1-2cm
| 40-60cm
280
umbilical arteries arise from _____ and course along _____
internal iliac arteries
| fetal bladder
281
what is the umbilical vein formed by
confluence of chorionic veins of placenta
282
after birth, umbilical arteries become _____ and vein becomes ____
lateral ligaments of bladder/superior vesical arteries
| ligament of liver
283
ductus venosus
thin intrahepatic channel with echogenic walls between left and caudate lobes
284
umbilical cord length in 1st tri
same as CRL
285
short umbilical cord
286
short umbilical cord is associated with (7)
```
oligohydramnios
restricted space/multiple gest
intrinsic fetal anomaly
tethering of fetus by cord
inadequate fetal descent
cord compression
fetal distress
```
287
coiling of umbilical cord is related to ____
fetal activity
288
how does umbilical cord coil
to the left near fetal insertion site
289
what happens is cord is atretic and fetus is attached to placenta at umbilicus
omphalocele is present
290
long umbilical cord
>80cm
291
long umbilical cord is associated with (7)
```
polyhydramnios
nuchal cord
true knots
cord compression
cord presentation
prolapsed cord
stricture or torsion
```
292
diameter of long cord
2.6-6cm
293
abnormally thick cord is associated with(4)
DM
Edema/hydrops
Rh incompatibility
fetal demise
294
cystic mass in a cord is usually _______ origin (2) and ____ size
omphalomesenteric or allantoic
295
where are cystic cord masses usually located
fetal end of cord
296
masses associated with umbilical cord (10)
```
omphalocele
gastroschisis
umbilical herniation
teratoma
aneurysm
varix
hematoma
true knot
angioma
thrombosis
```
297
omphalocele
failure of intestine to return to abdome
298
gastroschisis
right paraumbilical defect measuring 204cm
| not covered by membrane
299
lab associated with gastroschisis
elevated AFP
300
omphalomesenteric cyst
cystic lesion and dilation of segment of omphalomesenteric duct
lined by epithelium
301
size of omphalomesenteric cyst
up to 6cm
302
omphalomesenteric cyst is associated with ______
meckel's diverticulum
303
most common location of umbilical cord thrombosis
umbilical vein
304
incidence of umbilical vein thrombosis is higher in _______
infants of diabetic mothers
305
secondary umbilical thrombosis is due to _____ (5)
```
torsion
knotting
looping
compression
hematoma
```
306
phlebitis and arteritis may cause _____
umbilical thrombosis
307
true knots are associated with (4)
long cords
polyhydramnios
IUGR
monoamniotic twins
308
false knots are seen when ____
vessels are longer than cord
309
most common cord entanglement in fetus
nuchal cord
310
nuchal cord
multiple coils aound fetal neck
311
battledore placenta
marginal insertion of the cord
312
when is battledore placenta significant and why
when cord insertion is near the os
| may prolapse or be compressed during contractions
313
velamentous insertion of cord
cord inserts into membranes before entering placenta
314
rinks of velamentous cord insertion (3)
thrombosis
cord rupture at delivery
vasa previa
315
velamentous insertion is associated with (5)
```
low birth weight
SGA
preterm
low apgar scores
abnormal HR pattern
```
316
single umbilical artery has been associated with (4)
congenital anomalies
IUGR
perinatal mortality
chromosomal abnormalities
317
single umbilical artery is most often associated with what system anomalies?
MSK
318
where does focal dilation of umbilical vein occur
intraabdominally, extrahepatic location
319
amniotic fluid is produced by _____ (5)
```
umbilical cord
membranes
lungs
skin
kidneys
```
320
amount of amniotic fluid is regulated by (5)
```
production
removal
fluid exchange within lungs
membranes
cord
```
321
skin is permeable to water until _______ at ________ weeks
keritinization
| 24-26
322
production of urine and ability to swallow begins ____
8-11 weeks
323
most significant amount of urine is produced at _____
18-20 weeks
324
by _____ weeks, AF volume incerases by ______
20 weeks
| 10ml/day
325
oligohydramnios measurement
AFI
326
polyhydramnios measurement
AFI>24cm
| largest vertical pocket 8cm or more
327
normal single pocket AF
2-8cm
328
two diameter AF pocket measurement and what's normal
horizontal x vertical to obrain volume
| 15-50cm is normal
329
what measurement is the best predictor of oligohydramnios
two-diameter pocket
330
what measurement is the best predictor of polyhydramnions
largest vertical pocket
331
dolichocephaly and BPD accuracy
head large in AP diameter
| BPD underestimated
332
brachycephaly and BPD accuracy
head large in TRV
| BPD overestimated
333
polyhydramnios definition
AF >2000ml
334
polyhydramnios uterus size
larger than dates
335
acute onset of hydramnios may be _______ (4)
painful
compress organs and vascular structures
cause hydronephrosis
produce SOB
336
polydydramnios is associated with ____ (5)
```
CNS disorders - depressed swallowing
GI problems - esophageal atresia, stomach, duodenum or small bowel
hydrops
skeletal anomalies
renal disorders
```
337
maternal conditions associated with polyhydramnios (5)
```
DM
obesity
Rh incompatibility
anemia
CHF
```
338
development of oligohydramnios is attributed to (5)
```
congenital anomalies
IUGR
postterm pregnancies
ROM
aitrogenesis
```
339
maternal conditions associated with oligohydramnios (5)
```
HTN
preeclammpsia
cardiac and renal disease
connective tissue disorders
patients on indomethacin
```
340
fetal hypoxia may produce _______ and _____
growth restriction and oligohydramnios
341
iatrogenic causes of oligohydramnios (4)
medications
fluid loss
maternal fluid depletion
procedures such as CVS
342
medications associated with oligohydromnios (4)
nonsteroidal antiinflammatory
angiotensin-converting enzyme inhibitors
calcium channel blockers
nitrous oxide
343
fetal conditions associated with oligohydramnios (5)
```
IPCKD
renal agenesis
posterior urethral valve syndrome
dysplastic kidney
chromosomal abnormalities
```
344
patient presents with sudden gush or leaking fluid
rupture of membranes
345
what is used to determine presence of AF in vaginal secretions
nitrazine paper and fern test
346
abnormal ROM associated with (6)
```
preterm delivery
fetal/neonatal death
RDS
prolapsed umbilical cord
chorioamnionitis
placental abruption
```
347
amniotic band syndrome is associated with _______ and can cause ______
abnormality in fetal membranes
| malformation of limbs, craniofacial region and trunk
348
synonyms for amniotic band syndrome (4)
ADAM
amniotic band sequence
aberrant tissue bands
congenital constricting bands
349
etiology of amniotic band syndrome
rupture of amnion leading to entanglement by firous mesodermic bands from chorionic side
350
entrapment of fetal parts by amniotic band syndrome can cause (3)
lymphedema
amputations
slash defects
351
common findings of amniotic band syndrome (4)
facial clefts
asymmetric encephalocele
constriction or amputation of extremities
clubfoot
352
amniotic sheets, shelves and folds
echogenic, nonfloating bands crossing amniotic cavity
353
difference between amniotic sheets, shelve, folds vs amniotic band syndrome (3)
shelves, sheets and folds are thicker
do not cause malformations
signify uterine synechiae
354
amniotic sheets are caused by (3)
uterine scars from instrumentation
c-section
endometritis
355
who's at risk for developing endometrial scars (5)
```
D&C
intrauterine infections
edometritis
removal of fibroids and polyps
prior c-section
```
356
what are synechiae associated with
infertility and miscarriages
357
patients with synechiae and infertility may also have _____
asherman's syndrome
358
echodense line separated from uterine wall by echolucent space
may surround fetus or be freely mobile
amniotic sheets
359
hydrops
disparity between amounts of fluid produced and absorbed leading to edema
360
types of edema in hydrops (5)
```
pleaural effusions
ascites
cardiac effusion
skin edema
anasarca
```
361
other findings in hydrops (4)
enlarged umbilical cord
polyhydramnios
placental edema
enlarged liver or spleen
362
what can abdominal musculature be mistaken for
hydrops/ascites
363
skin edema has what measurement
>5-6mm
364
measurement of pericardial effusion
>2mm
365
placental edema measurement
thickened placenta
| >4-4.5cm in AP
366
immune hydrops is associated with
alloimmune hemolytic disease
| Rh immunication
367
causes of nonimmune hydrops (2)
```
sporatid
cardiac insufficiency (due to tumors or arrhythmia)
```
368
nuchal skin fold location and measurement
cavum septi pellucidi
cerebellum
cisterna magma
5mm or less at
