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OB/GYN REVIEW > 2nd & 3rd Tri: Chest > Flashcards

2nd & 3rd Tri: Chest Flashcards

1
Q

How much of the thorax should the heart occupy?

A

1/3 thoracic cavity

pg. E 108

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2
Q

What do normal fetal lungs appear like sonographically?

A 
solid
homogenous
granular
slighty more echogenic than the liver
pg. E 108
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3
Q

When is the optimal time to evaluate the fetal heart?

A

18-24 weeks

pg. E 108

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4
Q

What can fetal echocardiography help diagnose?

A 
structural heart abnormalities
fetal arrhythmias
coarctation of the aorta
cardiomegaly
focal masses
ductal patentcy
pg. E 108
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5
Q

How often does congenital heart disease (CHD) occur?

A

8: 1000 births

pg. E 108

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6
Q

What are the risk factors for CHD?

A 
family hx
maternal diabetes
teratogen exposure
chromosome abnormalities
lupus
increased NT measurement
pg. E 108
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7
Q

Through which structure does oxygenated blood enter the fetus?

A

umbilical vein

pg. E 109

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8
Q

What is the ductus venosus?

A

allows blood to bypass liver and go into the right atrium of the heart
pg. E 109

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9
Q

What is the foramen ovale?

A

shunts blood from right atrium to left atrium

pg. E 109

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10
Q

What is the ductus arteriosus?

A

allows oxygen-rich blood from pulmonary artery into aortic arch
pg. E 109

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11
Q

What are some routine views of the heart?

A 
4 chamber
LVOT
RVOT
Aortic arch
Ductal arch
Tracheal/3 vessel view
pg. E 110
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12
Q

Which heart chamber is closest to the spine?

A

left atrium

pg. E 110

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13
Q

Which side does the apex point to?

A

45 degrees to the left

pg. E 110

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14
Q

What arises from the LV?

A

aorta

pg. E 110

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15
Q

What arises from the RV?

A

pulmonary a. trunk

pg. E 110

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16
Q

How does the aortic arch appear sonographically?

A

Oblique sagittal plane
candy cane
arises from aortic arch
pg. E 111

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17
Q

How does the ductal arch appear sonographically?

A

ductus arteriosis
hockey stick
arises more anterior in heart
pg. E 111

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18
Q

What is the tracheal or 3 vessel view of heart?

A

above level of 4 chamber heart
ensures orientation of outflow tracts
SVC, Ao, and Pulmonary a.
pg. E 111

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19
Q

What is ventricular septal defect?

A

incomplete closure of the interventricular foramen and failure of the membranous part of the IV septum
pg. E 112

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20
Q

What are the sonographic findings of ventricular septal defect?

A

opening between the ventricles
bidirectional flow
pg. E 112

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21
Q

What is an atrial septal defect?

A

abnormal opening between atria
different from foremen ovale
pg. E 112

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22
Q

What are the sonographic findings of an atrial septal defect?

A

demonstration of echo dropout at level of of the atrial septum
pg. E 112

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23
Q

What is hypoplastic right heart syndrome?

A

pulmonary atresia with an intact interventricular septum

pg. E 112

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24
Q

What are the sonographic findings of hypoplastic right heart syndrome?

A

absent/small RV
absent or small pulmonary a.
pg. E 112

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25
Q

What is hypoplastic left heart syndrome?

A

Small left ventricle due to decreased blood flow into or out of left ventricle
pg. E 113

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26
Q

What are the sonographic findings of hypoplastic left heart syndrome?

A

absent/small LV
hypoplastic mitral valve and aorta
pg. E 113

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27
Q

What is Transposition of the Great Arteries (TGA)?

A

aorta arises from RV
pulmonary a. arises from LV
pg. E 113 O 392

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28
Q

What are the sonographic findings of transposition of the great arteries?

A

image of outflow tracts appear parallel

pg. E 113 O 392

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29
Q

What is truncus arteriosus?

A

single large vessel arising from base of heart rather than separate outflow tracts
pg. E 113

30
Q

What is present along with truncus arteriosus?

A

Ventricular septal defect

pg. E 113

31
Q

What is ectopia cordis?

A

partial or complete displacement of the heart outside the thorax
pg. E 113 O 391

32
Q

What is associated with ectopia cordis?

A

intracardiac anomalies
omphalocele
Pentalogy of Cantrell
pg. E 113

33
Q

What is double outlet right ventricle?

A

Both pulmonary a. and aorta arise from RV

pg. E 114

34
Q

What are some types of cardiac tumors?

A 
rhabdomyomas
cardiac fibromas
myxomas
teratomas
pg. E 114
35
Q

What is atrioventricular canal defect?

A

failure of the AV orifice to separate into mitral and tricuspid valves
defect is in crux of heart
pg. E 114

36
Q

What is the Tetralogy of Fallot?

A 
4 anatomic abnormalities:
VSD
overriding aorta
stenosis of RVOT (pulmonic stenosis)
RV hypertrophy
pg. E 114 O 392
37
Q

What is the most common cyanotic heart disease?

A

Tetraology of Fallot

pg. O 392

38
Q

What is Ebstein anomaly?

A

malformation of the tricuspid valve
enlarged right atrium
pg. E 114 O 392

39
Q

What is ventricular hypertrophy associated with?

A

cardiac outlet obstruction

pg. E 114

40
Q

What is the typical range of heart rates prior to 6 weeks?

A

100-115 bpm

pg. E 115

41
Q

What is the typical range of heart rates between 6-8 weeks?

A

144-159 bpm

pg. E 115

42
Q

What is the typical range of heart rates after 9 weeks?

A

120-160 bpm

pg. E 115

43
Q

What are arrhythmias associated with?

A

maternal caffeine intake
smoking
alcohol use
pg. E 115

44
Q

What is a fetal arrhythmia?

A

premature ventricular or atrial contractions (PVCs and PACs)

pg. E 115

45
Q

How long do fetal arrhythmias occur?

A

disappear in utero or early neonatal period

pg. E 115

46
Q

What is tachycardia?

A

heart rate > 180 bpm

pg. E 115

47
Q

What is bradycardia?

A

heart rate < 100 bpm

pg. E 115

48
Q

What is more severe tachy- or bradycardia?

A

bradycardia, associated with complete heart block

pg. E 115

49
Q

What is another name for pleural effusion?

A

hydrothorax

pg. E 116

50
Q

What is pleural effusion?

A

fluid within the thorax
can be isolated or associated with hydrops fetalis
pg. E 116

51
Q

What are the sonographic findings of pleural effusion?

A

anechoic fluid conforming to the thoracic cavity

pg. E 116

52
Q

What is the most common developmental abnormality of the diaphragm?

A

congenital diaphragmatic hernia

pg. E 116

53
Q

What causes congenital diaphragmatic hernias?

A

defective fusion or formation of the diaphragm, allowing stomach, spleen, liver and/or colon to herniate into chest
pg. E 116

54
Q

What is a foramen of Bochdalek?

A

most common CDH
left sided
pg. E 116

55
Q

What is the Foramen of Morgagni?

A

CDH anterior medial

56
Q

What are the sonographic findings of congenital diaphragmatic hernias?

A

fluid-filled bowel and stomach in chest
heart displaced towards the right
polyhydramnios
pg. E 116

57
Q

Are congenital diaphragmatic hernias typically associated with other anomalies?

A

cardiac and brain anomalies

pg. E 116

58
Q

What is pulmonary sequestration?

A

uncommon malformation in which there is a mass of pulmonary separate from the lung
pg. E 117

59
Q

What are the sonographic findings of pulmonary sequestration?

A

homogeneous echogenic intrathoracic mass
color Doppler shows blood supply from the aorta to the mass
pg.. E 117

60
Q

What is congenital cystic adenomatoid malformation?

A

unilateral abnormal tissue that replaces lung tissue

pg. E 117

61
Q

What is Type I CCAM?

A

one or more large cysts >2 cm

pg. E 117

62
Q

What is Type II CCAM?

A

multiple small cysts < 1-2 cm

pg. E 117

63
Q

What is Type III CCAM?

A

mulitple small cysts, too small to distinguish, looks anechoic
pg. E 117

64
Q

What are the sonographic findings of congenital cystic adenomatoid malformation?

A 
complex mass in fetal lung
lateral displacement of the heart 
hydrops fetalis
polyhydramnios
pg. E 117
65
Q

How should the heart be oriented in the chest?

A

45 degrees to the left

pg. E 118

66
Q

Does the ductus arteriosus carry oxygenated or deoxygenated blood?

A

Oxygenated blood from pulmonary artery to aorta

67
Q

Does the ductus venosus carry oxygenated or deoxygenate blood?

A

Oxygenated blood from umbilical vein to IVC

pg. 1224

68
Q

What does the lecithin/sphingomyelin ratio evaluate?

A

Lung maturation

URR Exam

69
Q

What is the best plane to image the fetal diaphragm?

A

Coronal

70
Q

When can fetal cardiac activity be identified with US?

A

6 weeks

71
Q

The tricuspid valve inserts _______ to the mitral valve.

A

Inferior

72
Q

What is the most common congenital heart defect?

A

VSD

OB/GYN REVIEW (16 decks)

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