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ob > 2nd & 3rd Tri Assessment > Flashcards

2nd & 3rd Tri Assessment Flashcards

1
Q

What weeks are 2nd trimester? 3rd?

A

2nd: 13-26 wks
3rd: 27-40, can go to 42

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2
Q

What are the 3 germ layers from inner to outer?

A

endoderm, mesoderm, ectoderm

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3
Q

What does the endoderm become?

A

GI & respiratory systems

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4
Q

What does the mesoderm become?

A

MSK & circulatory systems

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5
Q

What does the ectoderm become?

A

brain, nervous system, skin

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6
Q

What are the two variants of vertex position?

A

anterior occiput: face toward mat spine
posterior occiput

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7
Q

What type of cephalic positioning is better for labor and delivery?

A

anterior occiput

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8
Q

What are the 3 types of breech positioning?

A
  • complete: fetal bottom down, legs folded
  • incomplete: bottom down, one leg bent & one straight up near ear
  • frank: bottom down, legs straight up near ears
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9
Q

When are bony and soft tissue structures of the face seen?

A

bony: wk 12
soft tissue: wk 16

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10
Q

What facial structures do you see in a sagittal view?

A

frontal bone, nasal bone/nose, chin

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11
Q

What facial structures do you see in the coronal view?

A
  • upper lip
  • orbits/lens
  • nostrils
  • palate
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12
Q

What are two facial measurements?

A

OOD: outer to outer orbital diam
IOD: inner orbital diam

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13
Q

What structures are located within the thorax?

A
  • lungs
  • thymus
  • diaphragm
  • heart
  • great vessels
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14
Q

How does the size of the thorax compare to the abdominal cavity?

A

thorax is slightly smaller

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15
Q

What 3 structures border the lungs medially, inferiorly, and laterally?

A

medial: heart
inferior: diaphragm
lateral: rib cage

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16
Q

What is the US appearance of fetal lungs?

A

solid, homogeneous, slightly more echogenic than liver

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17
Q

How much time does the fetus practice breathing?

A

1/3 of time

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18
Q

What are the two ways to record fetal respiration?

A
  • watch diaphragm & ribs move
  • CF on nostrils
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19
Q

How is the diaphragm best visualized? What does it look like?

A
  • best vis. in sag, spine down
  • thin, hypo line separating chest & abd cavities
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20
Q

What are fetal risk factors for fetal echo?

A
  • IUGR
  • IVF
  • arrythmias
  • abnormal amniocentesis w/ trisomy
  • abnormal HR
  • hydrops
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21
Q

What is fetal hydrops?

A

Fatal condition w/ abn accumulation of fluid in 2 or more compartments

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22
Q

What are maternal risk factors for fetal echo?

A
  • family/personal hx of heart defect
  • DM
  • lupus
  • substance abuse
  • abnormal HR
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23
Q

What structures should be visualized in the 4 chamber heart?

A
  • atria & ventricles
  • valves
  • intracardiac septae
  • papillary muscles
  • foramen ovale
  • great vessels (ao, pulm art/vein, ivc/svc)
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24
Q

What is the RVOT?

A

pulmonary artery, leaves rt ventricle, PA has hockey stick appearance (ductal arch)

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25
Q

What is the LVOT?

A

aorta, leaves lt ventricle, ao has candy cane appearance

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26
Q

How is oxygenated blood supplied to the fetus?

A

brought to fetus by umbilical vein from placenta

27
Q

Where does the umbilical cord enter the abdomen?

A

umbilicus

28
Q

What happens to the blood as it reaches the liver via falciform ligament?

A

1/2 filters through the liver, 1/2 bypasses the liver via the ductus venosus

29
Q

What hepatic vessel does the umbilical vein join?

A

left portal vein

30
Q

Where does the IVC join the heart?

A

right atrium

31
Q

How does the blood travel after entering the right atrium?

A
  • portion travels to left atrium via foramen ovale
  • rest travels from rt atrium to rt vent via tricuspid valve
  • blood then leaves rt ventricle through pulm artery
32
Q

How does blood travel from right to left atrium?

A

foramen ovale

33
Q

How does blood travel from right atrium to right ventricle?

A

tricuspid valve

34
Q

Where does blood travel after leaving the right ventricle through the rvot?

A

most enters ductus arteriosus & bypasses lungs, small amount travels to the lungs

35
Q

What happens after the ductus arteriosus enters the descending aorta?

A
  • desc ao enters umbilical arteries
  • umbilical arteries within umbilical cord enter placenta
  • bring blood from fetus back to placenta
36
Q

What happens to the small amount of blood that travels to the lungs through the pulmonary artery?

A
  • returns to lt atrium via pulmonary veins
  • travels from lt atrium to lt ventricle via mitral valve
  • travels from lt ventricle to asc. aorta via aortic valve
37
Q

How does blood travel between the left atrium and left ventricle?

A

mitral valve

38
Q

How does blood travel from the left ventricle to the ascending aorta?

A

aortic valve

39
Q

What is the ratio of heart to thorax size?

A

1:3

40
Q

How do the atria and ventricle size compare?

A

equal

41
Q

How does the foramen ovale move?

A

it moves to the left with systole

42
Q

What are the 3 embryologic components of the abdomen? What are they formed by?

A

foregut: cranial end fold
midgut: side folds
hindgut: caudal end fold

43
Q

What does the foregut become?

A
  • esophagus
  • stomach
  • duodenum
  • liver
  • biliary
  • pancreas
  • spleen
44
Q

What does the midgut become?

A
  • small intestines
  • majority of colon
  • cecum
  • cloaca
45
Q

What does the hindgut become?

A
  • descending colon
  • sigmoid colon
  • bladder
  • urethra
46
Q

How does the growth of the midgut compare to the growth of the abdominal cavity?

A

midgut grows faster than abdominal cavity

47
Q

What is the result of the liver and kidneys growing faster than the abdominal cavity?

A

results in herniation of the bowel which extends to the prox umbilical cord

48
Q

When does fetal bowel herniation resolve?

A

week 11

49
Q

When does the esophagus reach final length?

A

week 7

50
Q

What divides the trachea and esophagus?

A

tracheoesophageal septum

51
Q

When is the stomach visualized?

A

seen at 11 weeks due to swallowed amniotic fluid, must be seen after 16 weeks

52
Q

What do the intestines appear like?

A

slightly hyperechoic to liver, appears mass-like

53
Q

When are small and large intestines differentiated? When is peristalsis seen?

A

small and large differentiated at 20 weeks, peristalsis seen after 27 wks

54
Q

What happens to the umbilical vein following birth?

A

forms ligamentum teres

55
Q

How does fetal liver size compare to the body?

A

liver is 10% of fetal weight at 11 weeks and 5% at birth

56
Q

What landmarks are included in AC measurement?

A

trv spine, fluid filled stomach, umbilical vein

57
Q

What does the genitourinary system develop from?

A

intermediate mesoderm

58
Q

What is the cloaca?

A

How feces & urine pass in embryos, at the end of the hindgut & divides into rectum, urinary tract & genitalia

59
Q

What is the ureteral bud?

A

Forms from outpouching of wolffian duct, gives rise to ureter, renal sinus, collecting tubules

60
Q

When does urine production begin?

A

week 16

61
Q

What are the 3 sets of embryologic urinary excretory glands?

A
  • pronephros: first set of kidneys, nonfunctioning
  • mesonephros: 2nd set of kidneys, function for short period & degenerate
  • metanephros: permanent kidneys, develop at wk 5 while mesonephros are acting
62
Q

When do the kidneys rise in the abdomen and separate?

A

week 9

63
Q

How does the appearance of the kidneys change from before 13 weeks to after 15 weeks?

A

before 13: hyperechoic
after 15: decreased echogenicity, still hyperechoic to surroudings

ob (6 decks)

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