2nd and 3rd Trimester Flashcards by Rexlin Sebastin

During a 32 week OB scan, you measure the AFI and determine that it is 4 cm. Is this within the normal range?

yes

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If the adrenal glands are “laying down” in the renal fossa, what is indicated?

normal kidneys

renal cysts

renal agenesis

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You are performing a BPP exam on an OB patient who is 36 weeks. You have been observing the fetus for 18 minutes and have yet to observe adequate fetal movement. What should you do?

record the score for fetal movement as 0

call the ordering physician

continue observing for full 30 minutes

send patient to ER

end exam and reschedule patient for another day

continue observing for full 30 minutes

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Amniotic fluid is performed measured using the __________ of the fluid pocket.

vertical depth

width

vertical depth

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All of the following are sonographic components of a biophysical profile except:

fetal tone

fetal movement

amniotic fluid

biometric measurements

fetal breathing

biometric measurements

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ypically, choroid plexus cyst will disappear by ______ weeks

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The cisterna magna is a cerebral spinal fluid space located between the _________ and the __________.

cerebellum and occipital bone

cavum septum pellucidum and corpus callosum
cavum septum pellucidum and occipital bone

corpus callosum and frontal bone

cerebellum and occipital bone

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The fetal heart should occupy ____________ of thoracic cavity.

2/3

1/4 to 1/3

1/3 to 1/2

3/4

1/4

1/3 to 1/2

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All of the following describe the normal sonographic appearance of fetal lungs except:

slightly more echogenic than liver
granular appearance
homogeneous
heterogeneous

heterogeneous

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All of the following are possible fetal presentations except:

vernix

breech

cephalic

transverse

variable

vernix

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If the fetal stomach appears small or absent, which of the following should the sonographer do?

A. immediately inform the patient

C and D

C. check for diaphragmatic hernia

A and B

B. allow sufficient time for stomach to fill

D. complete exam and send patient home without notifying physician

B and C

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The fetal thymus gland is located anterior to all of the following except:

SVC

aortic arch

pulmonary trunk

lungs

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Which femur is used when obtaining femur length measurement?

vertical femurs

anterior femur

posterior femur

anterior femur

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The flap of the foramen ovale should open into which fetal heart chamber?

left ventricle

right atrium

right ventricle

left atrium

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Which chamber of the fetal heart is normally located closest to the spine?

left ventricle

left atrium

right ventricle

right atrium

left atrium

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An OB patient has arrived for her 20 week ultrasound exam for fetal anatomy, size, and dates. As part of the assessment, maternal anatomy is also evaluated. You should exam and document which of the following?

A. uterus

B and C

B. adnexa
A and B
A, B, and C

C. cervix

A, B, and C

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Which of the following fetal assessments is documented using M-mode?

amniotic fluid

placental lakes

cerebral evaluation

cardiac activity

respirations

cardiac activity

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What is the most common fetal presentation?

shoulder

cephalic

frank breech

complete breech

footling

cephalic

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The ____________ view is considered to be the single most important view of the fetal heart.

ductal arch

aortic arch

RVOT

4-chamber

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Which of the following describes the sono appearance of a normal fetal diaphragm?

thick, hyperechoic, arched-line separating the abdomen from chest

thin, hyperechoic, arched-line separating abdomen from chest

thin, hypoechoic, arched-line separating abdomen from chest

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What is the normal measurement for the lateral ventricles?

less than 1 mm

greater than 20 mm

greater than 10 mm

less than 10 mm

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The sagittal view of the fetal face is obtained whenever possible to demonstrate all of the following except:

forehead

chin

nuchal fold

lips

nasal bone

nuchal fold

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If the myometrium is less than 3 mm in the lower uterine segment, then the myometrium should be assessed. This is because the patient is at increased risk for ___________.

adenomyosis

endometriosis

uterine rupture

ectopic pregnancy

uterine rupture

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Which of the following statements regarding a normal fetal heart is not true:

Valves separate both atrium from ventricles

Tricuspid valve inserts on IVS

Ventricles are approx same size (until later in pregnancy when right > left)

Right ventricle lies anteriorly, closest to chest wall

Heart apex points left 45 degrees & touches anterior chest wall

Tricuspid valve inserts on IVS

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If an ovarian cyst is visualized early in the pregnancy, it is most likely a _____________ cyst. corpus luteum dermoid cyst chocolate cyst

corpus luteum

Obliteration of cisterna magna is commonly found with which of the following? mega-cisterna magna Down syndrome spina bifida rhombencephalo

spina bifida

When during a pregnancy should you normally see abdominal wall gut herniation? (I am not asking when it is supposed to return, but when is it supposed to occur). between 12-16 weeks between 9-11 weeks between 4-8 weeks between 18-20 weeks

between 9-11 weeks

What gives fetal kidneys an echogenic border in 3rd trimester? renal capsule maturation of renal arteries renal cysts renal calculi

renal capsule

The thymus gland is normally located in the anterior _____________ of the fetus. abdomen cranium pelvis mediastinum

mediastinum

A nuchal fold measurement greater than 6 mm between 15 and 22 weeks is associated most commonly with _______________. Meckel-Gruber syndrome Cleft palate Trisomy 4X Turner's syndrome Trisomy 21

Trisomy 21

Ossification in the fetal spine begins in the ____________ section. thoracic cervical lumbar sacral

thoracic

During the 2nd trimester, the kidneys should appear as ____________ structures adjacent to fetal spine. anechoic isoechoic hyperechoic

isoechoic

You are measuring the amniotic fluid on a 34 week gestation. The amniotic fluid in the single largest pocket measured 3 cm. Is this within the normal range? no yes

yes

A normal ureter is 1-2 mm in diameter and is usually visible during the OB ultrasound exam. True False

False

A fluid-filled stomach can be used to demonstrate an intact left diaphragm. True False

True

A transvaginal scan may be performed if placenta previa is suspected or if the cervix is abnormally short. True False

True

Adnexal cysts are an uncommon finding during gestation. True False

False

After 16 weeks, renal function becomes the major source of amniotic fluid. True False

True

Biophysical profile was designed to detect fetal hypoxemia. True False

True

By 10 to 12 weeks, most of cerebral structures of the fetus can be sonographically identified. True False

False

By week 11, the kidneys begin to produce urine. True False

True

Each vertebra develops 4 ossification centers. True False

False

Four fetal measurements are taken to assess the gestational age and fetal weight. These four measurements are femur length, BPD, abdominal circumference, and head circumference. True False

True

Presence of choroid plexus cyst is always associated with presence of Trisomy 18. True False

False

The 3 standard views of the fetal brain are thalamic, ventricular, and cerebellar. True False

True

The abdominal circumference should be taken at the level of the stomach and umbilical cord insertion into the abdomen. True False

False

The atrium of the occipital horn of the lateral ventricle is considered the landmark for measuring the lateral ventricle. True False

True

The best time to sonograpically evaluate the fetal heart is between 18 to 24 weeks. True False

True

The head and neck vessels help differentiate the aortic arch from the ductal arch. True False

True

The heart position and axis are variable in a normal fetus. True False

False

ypically, the stomach will fill within a 30 minute exam. True False

True

When measuring femur length, the ossified diaphysis and epiphyseal cartilage are included in the measurement. True False

False

Why is it important to identify the adrenal glands separate from the kidneys? so bladder failure can be detected so thyroid function can be assessed so renal agenesis is not missed

so renal agenesis is not missed

While obtaining an amniotic fluid measurement, the area should be free of ________________ and ___________________. umbilical cord fetal vernix fetal anatomy

umbilical cord fetal anatomy

Which weeks of gestation would it be abnormal to see physiologic gut herniation during an ultrasound exam? select more than one answer. 26 10 14 11 22

26 14 22

The biparietal diameter measurement is taken at which level or view? What brain structure should be seen? cerebellar ventricular thalamic

thalamic

Why is it mandatory to image the fetal upper lip? micrognathia absent orbit fetal cleft lip

fetal cleft lip

Normally, cisterna magna should measure between _____ mm to _____ mm. .5 10 12 2

10 2

Diaphragm motion can be visualized sonographically as early as ________ weeks. 30 25 10

This measurement is obtained by measuring the vertical depth of fluid in the 4 quadrants of the uterus. The measurements are then added together to obtain: single pocket AFI

AFI

Why is it important to confirm the fetal stomach is on the left? to ensure the HC is measured at the correct level to rule out associated heterotaxy syndromes to ensure the bladder is filling correctly

to rule out associated heterotaxy syndromes

What does the thymus parenchyma contain that helps distinguish it sonographically from the lungs? triangular reflections spherical aspects spindle shaped echogenicities

spindle shaped echogenicities

Typically, ultrasound evaluation of fetal anatomy is performed between 16 and 22 weeks of gestation. True False

True

True or False: When preforming a BPP if the baby preforms breathing for 10 secs you can score them 1 point for that part of exam. True False

False

What are the four components scored in a BPP?

Fetal breathing, fetal movement, fetal tone, amniotic fluid

f the fetal adrenal gland appear to be "lying down" what can this indicate? renal agenesis

renal agenesis

What is fetal renal function related to the production of?

amnotic fluid

What in the fetus is a thin-walled organ located in the anterior pelvis and has the umbilical arteries coursing laterally to it?

Bladder

By what fetal gestational age should the bowel be positioned back into the abdomen after rotation? 12 weeks 13 weeks 14 weeks 11 weeks

12 weeks

At how many weeks gestational age can the diaphragm motion be detected? 6 weeks 13 weeks 10 weeks 12 weeks

10 weeks

When measuring the femur length which femur should be used? closest farthest

closest

True or False: When measuring the femur you should include the entire length even the epiphyseal cartilage. True False

False

The fetal heart should occupy ___________ of the fetal thoracic cavity. (select all that apply) 3/4 1/3 2/3 1/2 1/4

1/3 1/2

When measuring amniotic fluid levels the pocket being measured should be free of what two things?

umbilical cord, fetal anatomy

In fetal development the kidney's originate in what location of the fetal body?

Pelvis

A fetal right-sided stomach and right-sided heart is an indication of what? partial situs inversus total situs inversus

total situs inversus

By what gestational week should the fetal stomach be visualized by? 15 weeks 14 weeks 16 weeks 13 weeks

14 weeks

On what side of the fetus should the stomach lye in normal presentation? Left Right

Left

If the fetal stomach is absent or small what abnormality should be evaluated for?

Diaphragmatic hernia

True or False: the BPP is a timed exam and you must give the baby a maximum of 30 minutes to preform all aspects of this exam. False True

True

The ossification process of the fetal spine starts in which portion? sacrum lower cervical spine lower thoracic spine lower lumbar spine

lower thoracic spine

True of False: A normal fetal ureter is 1-2 mm in diameter and normally is visible during exams. True False

False

In the fetus by what gestational age should the kidneys begin to produce urine? 11 weeks 14 weeks 12 weeks 13 weeks

11 weeks

True or False: the BPP is done to determine fetal well being. True False

True

The presence of a choroid plexus cyst should normally disappear at 28 weeks gestation. True False

True

What are the three standard view or scan plans of the fetal brain? thymatic thalamic cerebellar ventricular fronto-occipital

thalamic cerebellar ventricular

Match the four standard fetal measurements that are used to assess fetal weight and growth with the body part they measure.. BPD outer parietal bone to inner parietal bone AC stomach level around ribs showing portal/umbilical junction FL ossified diaphysis of the thigh bone HC around the outer skull edge

BPD outer parietal bone to inner parietal bone AC stomach level around ribs showing portal/umbilical junction FL ossified diaphysis of the thigh bone HC around the outer skull edge

The three standard fetal brain views can detect what precent of sonographically detectable cerebral anomalies? 85% 75% 95% 90%

95%

4-26cm is considered the normal range for the measurement of AFI. True False

False

When measuring the FOD which of the following is the correct method? right to left outer frontal to outer occipital all the way around outer frontal to inner occipital

outer frontal to outer occipital

What is the most common fetal presentation? transverse cephalic footling breech

cephalic

What is measured directly behind the cerebellum and in front of the occipital bone? cisterna magna lateral ventricles CSP

cisterna magna

The normal measurement of the lateral ventricle is? greater than 10mm less than 5mm greater than 12mm less than 10mm

less than 10mm

The fetal lie is determined in relationship of the fetal _____________ axis to the long axis of the mother. short long

long

In what way should a sonographer document fetal heart rate that is ALARA compliant? The only way mentioned on the powerpoint. color doppler pulse wave m-mode b-mode

m-mode

When doing the fetal survey exam, the neck area should be evaluated for all of the following except what? L-spine c-spine positioning of the neck masses

L-spine

The upper lip should always be imaged during an anatomy scan to rule out a cleft lip. True False

True

Deficiency of amniotic fluid is known as? Oligohydramnios Polyhydramnios

Oligohydramnios

When a patients myometrium appears ____ 3mm, it puts the patient at risk for uterine rupture. less than greater than

less than

If you suspect the patient's cervical length is short you should not perform a transvaginal exam. True False

False

Which pathologic condition can cause the obliteration of the cisterna magna? spina bifida ventriculomegaly mega cisterna magna choroid plexus cyst

spina bifida

At which level of the fetal brain should the Biparietal diameter (BPD) be measured at? Ventricular level Cerebellar level Thalamic level

Thalamic level