2nd/3rd trimester anatomy (37%) Flashcards
blood entering the fetus in the umbilical vein is divided between
a. the portal vein and the ductus venosus
b. the IVC and the ductus venosus
c. the portal vein and the ductus ateriosus
d. the portal vein and the IVC
a
blood entering the fetus in the umbilical vein is divided between the ductus venosus and the portal vein. the majority of the oxygenated blood enters the left portal vein
______ refers to a normal finding of sebum and epithelial cells that cause white free-floating debris within the amniotic fluid late in pregnancy
a. meconium
b. pseudomyxomatous peritonei
c. vernix
d. chadwicks sign
c
vernix refers to a normal finding of sebum and epithelial cells that cause white free-floating debris within the amniotic fluid late in pregnancy. meconium refers to an abnormal finding of fetal waste, sebum and epithelial cells, that cause hypoechoic free-floating debris within the amniotic fluid late in pregnancy. normally meconium is visualized in the fetal colon in near term pregnancies. if the fetus has a bowel movement it is a sign of fetal distress
the fetal testicles normally descend into the scrotum before _____ weeks gestation
a. 16
b. 26
c. 22
d. 34
d
the fetal testicles normally descend into the scrotum between 26-34 weeks gestation. if one or both fail to descend, cryptorchidism is present.
peristalsis of the fetal bowel should normally be identified ______
a. just after midgut herniation retracts
b. after 35 weeks gestation
c. before the midgut herniation retracts
d. in the late 2nd trimester
d
peristalsis of the fetal bowel should normally be identified late in the 2nd trimester
peristalsis of the fetal bowel should normally be identified ______
a. just after midgut herniation retracts
b. after 35 weeks gestation
c. before the midgut herniation retracts
d. in the late 2nd trimester
d
peristalsis of the fetal bowel should normally be identified late in the 2nd trimester
which of the following describes the normal fetal diaphragm
a. hypoechoic done shaped structure with the top of the dome facing cephalad
b. hyperechoic done shaped structure with the top of the dome facing cephalad
c. hypoechoic cup shaped structure with the bottom of the cup facing caudal
d. hyperechoic linear structure that separates the abdomen from the chest
a
the normal diaphragm is demonstrated on ultrasound as a hypoechoic dome shaped structure with the top of the dome facing cephalad
the second trimester of pregnancy is defined as
a. weeks 14 through 28 gestational age
b. weeks 13 through 26 gestational ages
c. weeks 20 through 30 gestational age
d. weeks 12 through 24 gestational age
a
pregnancy consists of 3 trimesters
1st trimester - weeks 1 through week 13 gestational age
2nd trimester - weeks 14 through weeks 28 gestational age
3rd trimester - weeks 29 until delivery
which of the following is described as ectopic lobe(s) pf placenta tissue separate from the main placenta a. placenta previa b. placenta accreta c. placenta increta succenturiate placenta
c
a succenturiate placenta refers to a smaller accessory placental lob that is separate from the main placenta
the proximal pulmonary artery and aorta demonstrate a normal appearance when
a. the pulmonary artery crosses anterior to the aorta as they both exit the heart
b. the diameter of the aorta is at least 2x the diameter of the pulmonary artery
c. the aorta crosses anterior to the pulmonary artery as they both exit the heart
d. they exit the heart parallel to one another
a
the proximal pulmonary artery and aorta demonstrates a normal appearance when the pulmonary artery crosses anterior to the aorta as they both exit the heart. the PA is the same as or slightly larger in diameter that the aorta in the 2nd and 3rd trimester fetus. parallel great vessels OR the aorta crosses anterior to the pulmonary artery + transposition of the great vessels
the left atrium receives blood from what vessel(s)
a. pulmonary veins
b. pulmonary arteries
c. IVC
d. ductus arteriosus
a
the right ventricle sends deoxygenated blood to the lungs through the pulmonary artery. the oxygenated blood leaves the lungs through the right and left pulmonary veins to enter the left atrium. there are usually two sets of pulmonary veins on each side: right upper, right lower, left upper, left lower
which normal cranial structures are identified within the lateral ventricles bilaterally
a. lobes of the thalamus
b. choroid plexus
c. cavum septum pellucidum
d. cerebellar pedicles
b
choroid plexus
in a normal pregnancy the placental thickness should be relatively equal to the:
a. gestational age in weeks + 10mm
b. fetal head circumference
c. length of the cervix
d. gestational age in weeks
a
in a normal pregnancy the thickness of the placenta in millimeters should be equal to the weeks of gestation +10mm
at what gestational age do the fetal kidneys begin to produce urine
a. 10
b. 12
c. 14
d. 16
b
the fetal kidneys begin producing amniotic fluid around 12 weeks gestation and completely take over fluid production by 16 weeks
if 2 fetuses are different genders this indicates
a. monozygous twins
b. monoamniotic twins
c. identical twins
d. dizygous twins
d
fetuses of the same gender can be dizygous or monozygous. fetuses of different gender must always be dizygous
the ______ is located between the right atrium and ventricle while the _____ is located between the left atrium and ventricle
a. tricuspid valve, mitral valve
b. tricuspid valve, pulmonary valve
c. mitral valve, aortic valve
d. mitral valve, tricuspid valve
a
the tricuspid valve is located between the RA and RV. the mitral valve is located between the LA and LV. the aortic valve is located between the RV and the pulmonary artery
in a small amount of adults meckels diverticulum can be identified as a remnant of fetal embryology what causes this anatomic variant?
a. the placental umbilcal cord attachment persists as a diverticulum in the ileum portion of the bowel
b. the gestational sac persists as a diverticulum in the ileum portion of the bowel
c. the placenta persists as a diverticulum in the ileum portion of the bowel
d. the yolk sac persists as a diverticulum in the ileum portion of the bowel
d
meckels diverticulum refers to when the yolk sac persist into adult life as a diverticulum in the ileum portion of the bowel
the ductus arteriosus id
a. a vessel that connects the umbilical vein to the IVC to bypass the liver
b. a vessel that connects the umbilical artery to the aorta to bypass the fetal lung
c. an opening between the right and left atrium to shunt flow away from the fetal lungs
d. a vessel that connects the pulmonary artery to the aorta to bypass the fetal lungs
d
the ductus arteriosus is a vessel that connects the pulmonary artery to the aorta to allow most flow to bypass the fetal lungs
the lambda sign indicates _____ while the T sign indicates ______
a. dichorionic diamniotic twins, monochorionic monoamniotic twins
b. dichorionic diamniotic twins, monochorionic diamniotic twins
c. monochorionic monoamniotic twins, conjoined twins
d. monochorionic diamniotic twins, dichorionic diamniotic twins
b
the lambda sign indicates dichoionic diamniotic twins the thick membrane has a triangle of placental tissue at the base of the membrane. the T sign indicates monochorionic diamniotic twins. the membrane attaches to the uterus wall without placental tissue at the base
as the pregnancy advances the sonographic appearance of the fetal lungs will
a. increase in echogenicity
b. become increasingly heterogeneous
c. become more anechoic
d. decrease in echogenicity
a
normal lung tissue is more echogenic than the fetal liver. as the pregnancy advances the sonographic appearance of the fetal lungs will increase in echogenicity
which type of breech position is defined as the fetus with the butt first with legs extended adjacent to fetal abdomen
a. complete
b. frank
c. footing
d. partial
b
frank breech = butt down legs straight up in front of abdomen; complete breech = butt down legs folded knees bent ankles crossed; footing breech = feet down baby “standing” on cervix
which type of breech position is defined as the fetus presenting butt first and sitting cross legged with knees bent
a. complete
b. partial
c. footling
d. frank
a
frank breech = butt down legs straight up in front of abdomen; complete breech = butt down legs folded knees bent ankles crossed; footling = feet down baby “standing” on cervix
which of the following terms describes the connecting vessel from the main pulmonary trunk to the descending aorta found in the fetal circulation
a. ductus venosus
b. left atrial appendage
c. ductus arteriosus
d. foramen ovale
c
the foramen ovale describes the opening in the interatrial septum that allows normal shunting between the atria. it functions to as a shunt for the fetal flow to the atria. it functions to as a shunt for the fetal flow to bypass the fetal lungs. the foramen ovale normally closes very soon after birth. the ductus arteriosus describes the connecting vessel from the main pulmonary trunk to the descending aorta in fetal circulation. it functions as a shunt to bypass the fetal lungs. the ductus venosus describes the vessel that shunts blood flow around the fetal liver in fetal circulation. both ductus connections also close shortly after birth
what intracranial structure is located between the two lobes of the thalamus
a. 4th ventricle
b. pituitary gland
c. 3rd ventricle
d. cisterna magna
c
the 3rd ventricle is located between the two lobs of the thalamus. the 4th ventricle is a rhomboid shaped cavity in the hindbrain, between the cerebellum and medulla. the cisterna magna is fluid filled space posterior inferior to the cerebellum
the corpus callosum should be completely formed by which week of gestation
a. 12
b. 14
c. 16
d. 18
d
the corpus callosum should be completely formed by 18wks. if it is not identified after 18 weeks, agenesis should be suspected
how many bones make up each of the fetal fingers
a. 2
b. 3
c. 4
d. 5
b
each finger has a proximal middle and distal phalanx. the thumb only has a proximal and distal phalanx
the normal corpus luteal cyst seen with pregnancy begins to regress at \_\_\_\_\_\_ gestation and should be totally resolved by week \_\_\_\_\_\_ a. 14, 16 b. 16, 20 c. 12, 16 d, 20, 28
a
the normal corpus luteal cyst seen with pregnancy begins to regress at 14 weeks gestation and should be totally resolved by week 16
the normal anterior- posterior renal pelvic diameter (APRPD) in a second trimester fetus is ______and in a 3rd trimester fetus ______ is considered normal
a. less than 2mm, less than 4mm
b. less than 8mm, less than 16mm
c. less than 4mm, less than 7mm
d. less than 10mm, less than 20mm
c
the normal anterior-posterior renal pelvic diameter (APRPD) in a second trimester fetus is less than 4mm and in a 3rd trimester fetus less than 7mm is considered normal pyelectasis. severe hydronephrosis is indicated in the 2nd trimester with APRPD of more than 10mm. severe hydronephrosis is indicated in the 3rd trimester with APRPD of more than 15mm. an increase in the APRPD between the second and third trimesters indicates high possibility of postnatal abnrmalities
the normal fetal bladder should empty and refill every _____
a. 15-20m
b. 30-45m
c. 1-2h
d. 3-4h
b
the normal fetal bladder should empty and refill every 30-45m
which cranial structure is considered abnormal if it increases in size between ultrasound exams performed at 20 and 28 weeks
a. cerebellum
b. lateral ventricles
c. choroid plexus
d. thalamus
b
the lateral ventricles are usually consistent in size throughout pregnancy. an increase in size between serial exams can indicate a developing problem with CNS drainage
which hormone stimulates the formation of the cervical mucous plug found with pregnancy
a. estrogen
b. progesterone
c. bhCG
d. oxytocin
b
estrogen stimulates the cervix to produce mucous just prior to ovulation. increasing progesterone levels with pregnancy cause the cervical mucous to “dry up” and the cervix to tighten leading to mucous plug formation
which of the following correctly describes how to differentiate the umbilical vein and the gallbladder in a fetus
a. the umbilical vein is normally parallel to the abdominal wall while the gallbladder is perpendicular to the abdominal wall
b. the gallbladder is normally parallel to the abdominal wall while the umbilical vein is perpendicular to the abdominal wall
c. the umbilical vein is located centrally in the abdomen while the gallbladder is locate to the right between the right and left lobes of the liver
d. color doppler will demonstrate the flow filling the lumen of the portal vein but flow will only be demonstrated within the walls of the gallbladder
c
the umbilical vein and the gallbladder are usually oriented perpendicular to the abdominal wall. color doppler can be used to differentiate the umbilical and liver vasculature from the gallbladder. no color flow will fill the lumen (or the walls) of the gallbladder. the umbilical vein is located centrally in the abdomen while the gallbladder is located to the right between the right and the left lobes of the liver
normal amniotic fluid levels are mandatory for proper development of the fetal
a. lungs
b. digestive tract
c. kidneys
d. bladder
normal amniotic levels are mandatory for proper development of the fetal lungs. if oligohydramnios is present this leads to pulmonary hypoplasia
