2nd & 3rd Tri: Chest Flashcards
How much of the thorax should the heart occupy?
1/3 thoracic cavity
pg. E 108
What do normal fetal lungs appear like sonographically?
solid homogenous granular slighty more echogenic than the liver pg. E 108
When is the optimal time to evaluate the fetal heart?
18-24 weeks
pg. E 108
What can fetal echocardiography help diagnose?
structural heart abnormalities fetal arrhythmias coarctation of the aorta cardiomegaly focal masses ductal patentcy pg. E 108
How often does congenital heart disease (CHD) occur?
8: 1000 births
pg. E 108
What are the risk factors for CHD?
family hx maternal diabetes teratogen exposure chromosome abnormalities lupus increased NT measurement pg. E 108
Through which structure does oxygenated blood enter the fetus?
umbilical vein
pg. E 109
What is the ductus venosus?
allows blood to bypass liver and go into the right atrium of the heart
pg. E 109
What is the foramen ovale?
shunts blood from right atrium to left atrium
pg. E 109
What is the ductus arteriosus?
allows oxygen-rich blood from pulmonary artery into aortic arch
pg. E 109
What are some routine views of the heart?
4 chamber LVOT RVOT Aortic arch Ductal arch Tracheal/3 vessel view pg. E 110
Which heart chamber is closest to the spine?
left atrium
pg. E 110
Which side does the apex point to?
45 degrees to the left
pg. E 110
What arises from the LV?
aorta
pg. E 110
What arises from the RV?
pulmonary a. trunk
pg. E 110
How does the aortic arch appear sonographically?
Oblique sagittal plane
candy cane
arises from aortic arch
pg. E 111
How does the ductal arch appear sonographically?
ductus arteriosis
hockey stick
arises more anterior in heart
pg. E 111
What is the tracheal or 3 vessel view of heart?
above level of 4 chamber heart
ensures orientation of outflow tracts
SVC, Ao, and Pulmonary a.
pg. E 111
What is ventricular septal defect?
incomplete closure of the interventricular foramen and failure of the membranous part of the IV septum
pg. E 112
What are the sonographic findings of ventricular septal defect?
opening between the ventricles
bidirectional flow
pg. E 112
What is an atrial septal defect?
abnormal opening between atria
different from foremen ovale
pg. E 112
What are the sonographic findings of an atrial septal defect?
demonstration of echo dropout at level of of the atrial septum
pg. E 112
What is hypoplastic right heart syndrome?
pulmonary atresia with an intact interventricular septum
pg. E 112
What are the sonographic findings of hypoplastic right heart syndrome?
absent/small RV
absent or small pulmonary a.
pg. E 112
What is hypoplastic left heart syndrome?
Small left ventricle due to decreased blood flow into or out of left ventricle
pg. E 113
What are the sonographic findings of hypoplastic left heart syndrome?
absent/small LV
hypoplastic mitral valve and aorta
pg. E 113
What is Transposition of the Great Arteries (TGA)?
aorta arises from RV
pulmonary a. arises from LV
pg. E 113 O 392
What are the sonographic findings of transposition of the great arteries?
image of outflow tracts appear parallel
pg. E 113 O 392
What is truncus arteriosus?
single large vessel arising from base of heart rather than separate outflow tracts
pg. E 113
What is present along with truncus arteriosus?
Ventricular septal defect
pg. E 113
What is ectopia cordis?
partial or complete displacement of the heart outside the thorax
pg. E 113 O 391
What is associated with ectopia cordis?
intracardiac anomalies
omphalocele
Pentalogy of Cantrell
pg. E 113
What is double outlet right ventricle?
Both pulmonary a. and aorta arise from RV
pg. E 114
What are some types of cardiac tumors?
rhabdomyomas cardiac fibromas myxomas teratomas pg. E 114
What is atrioventricular canal defect?
failure of the AV orifice to separate into mitral and tricuspid valves
defect is in crux of heart
pg. E 114
What is the Tetralogy of Fallot?
4 anatomic abnormalities: VSD overriding aorta stenosis of RVOT (pulmonic stenosis) RV hypertrophy pg. E 114 O 392
What is the most common cyanotic heart disease?
Tetraology of Fallot
pg. O 392
What is Ebstein anomaly?
malformation of the tricuspid valve
enlarged right atrium
pg. E 114 O 392
What is ventricular hypertrophy associated with?
cardiac outlet obstruction
pg. E 114
What is the typical range of heart rates prior to 6 weeks?
100-115 bpm
pg. E 115
What is the typical range of heart rates between 6-8 weeks?
144-159 bpm
pg. E 115
What is the typical range of heart rates after 9 weeks?
120-160 bpm
pg. E 115
What are arrhythmias associated with?
maternal caffeine intake
smoking
alcohol use
pg. E 115
What is a fetal arrhythmia?
premature ventricular or atrial contractions (PVCs and PACs)
pg. E 115
How long do fetal arrhythmias occur?
disappear in utero or early neonatal period
pg. E 115
What is tachycardia?
heart rate > 180 bpm
pg. E 115
What is bradycardia?
heart rate < 100 bpm
pg. E 115
What is more severe tachy- or bradycardia?
bradycardia, associated with complete heart block
pg. E 115
What is another name for pleural effusion?
hydrothorax
pg. E 116
What is pleural effusion?
fluid within the thorax
can be isolated or associated with hydrops fetalis
pg. E 116
What are the sonographic findings of pleural effusion?
anechoic fluid conforming to the thoracic cavity
pg. E 116
What is the most common developmental abnormality of the diaphragm?
congenital diaphragmatic hernia
pg. E 116
What causes congenital diaphragmatic hernias?
defective fusion or formation of the diaphragm, allowing stomach, spleen, liver and/or colon to herniate into chest
pg. E 116
What is a foramen of Bochdalek?
most common CDH
left sided
pg. E 116
What is the Foramen of Morgagni?
CDH anterior medial
What are the sonographic findings of congenital diaphragmatic hernias?
fluid-filled bowel and stomach in chest
heart displaced towards the right
polyhydramnios
pg. E 116
Are congenital diaphragmatic hernias typically associated with other anomalies?
cardiac and brain anomalies
pg. E 116
What is pulmonary sequestration?
uncommon malformation in which there is a mass of pulmonary separate from the lung
pg. E 117
What are the sonographic findings of pulmonary sequestration?
homogeneous echogenic intrathoracic mass
color Doppler shows blood supply from the aorta to the mass
pg.. E 117
What is congenital cystic adenomatoid malformation?
unilateral abnormal tissue that replaces lung tissue
pg. E 117
What is Type I CCAM?
one or more large cysts >2 cm
pg. E 117
What is Type II CCAM?
multiple small cysts < 1-2 cm
pg. E 117
What is Type III CCAM?
mulitple small cysts, too small to distinguish, looks anechoic
pg. E 117
What are the sonographic findings of congenital cystic adenomatoid malformation?
complex mass in fetal lung lateral displacement of the heart hydrops fetalis polyhydramnios pg. E 117
How should the heart be oriented in the chest?
45 degrees to the left
pg. E 118
Does the ductus arteriosus carry oxygenated or deoxygenated blood?
Oxygenated blood from pulmonary artery to aorta
Does the ductus venosus carry oxygenated or deoxygenate blood?
Oxygenated blood from umbilical vein to IVC
pg. 1224
What does the lecithin/sphingomyelin ratio evaluate?
Lung maturation
URR Exam
What is the best plane to image the fetal diaphragm?
Coronal
When can fetal cardiac activity be identified with US?
6 weeks
The tricuspid valve inserts _______ to the mitral valve.
Inferior
What is the most common congenital heart defect?
VSD