2nd and 3rd Trimester Flashcards
During a 32 week OB scan, you measure the AFI and determine that it is 4 cm. Is this within the normal range?
no
yes
no
If the adrenal glands are “laying down” in the renal fossa, what is indicated?
normal kidneys
renal cysts
renal agenesis
renal agenesis
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
Amniotic fluid is performed measured using the __________ of the fluid pocket.
vertical depth
width
vertical depth
All of the following are sonographic components of a biophysical profile except:
fetal tone
fetal movement
amniotic fluid
biometric measurements
fetal breathing
biometric measurements
ypically, choroid plexus cyst will disappear by ______ weeks
16
24
20
28
28
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
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
All of the following describe the normal sonographic appearance of fetal lungs except:
slightly more echogenic than liver
granular appearance
homogeneous
heterogeneous
heterogeneous
All of the following are possible fetal presentations except:
vernix
breech
cephalic
transverse
variable
vernix
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
B and C
The fetal thymus gland is located anterior to all of the following except:
SVC
aortic arch
pulmonary trunk
lungs
lungs
Which femur is used when obtaining femur length measurement?
vertical femurs
anterior femur
posterior femur
anterior femur
The flap of the foramen ovale should open into which fetal heart chamber?
left ventricle
right atrium
right ventricle
left atrium
left atrium
Which chamber of the fetal heart is normally located closest to the spine?
left ventricle
left atrium
right ventricle
right atrium
left atrium
left atrium
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
Which of the following fetal assessments is documented using M-mode?
amniotic fluid
placental lakes
cerebral evaluation
cardiac activity
respirations
cardiac activity
What is the most common fetal presentation?
shoulder
cephalic
frank breech
complete breech
footling
cephalic
The ____________ view is considered to be the single most important view of the fetal heart.
ductal arch
aortic arch
RVOT
4-chamber
4-chamber
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
thin, hypoechoic, arched-line separating abdomen from chest
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
less than 10 mm
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
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
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
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
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
