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OB Review > Assessment of Second Trimester > Flashcards

Assessment of Second Trimester Flashcards

1
Q

BPD is an accurate predictor of gest age before

A

20 w

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2
Q

BPD is measured in a place that passes through the

A

3rd ventricle and thalami

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3
Q

BPD is above the level of the

A

orbits and cerebellum

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4
Q

BPD is below the level of the

A

ventricular atrium

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5
Q

BPD landmarks

A

falx, 3rd ventricle, thalamic nuclei, cavum septum pellucidi and atrium of lateral ventricle

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6
Q

Measure BPD perpendicular to

A

falx, placing calipers from outer margins of upper cranium to the inner margin of lower cranium

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7
Q

HC is a reliable measurement independent of

A

cranial shape

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8
Q

HC measure in a plane that must include the

A

CSP and tentorial hiatus

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9
Q

HC measured parallel to the base of

A

skull, placing the calipers on the outer margins of the cranium

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10
Q

Measurement of the HC cannot always be obtained in what plane

A

BPD

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11
Q

Cehaplic Index is devised to determine the

A

normality of the fetal head shape

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12
Q

Ceaphlic Index is abnormal when less than ____ or greater than ____

A

74%

83%

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13
Q

ABD predictor of

A

fetal growth not gest age

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14
Q

Most difficult measurement to obtain

A

ABD

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15
Q

ABD measurement location

A

slightly superior to CI at junction of lt and rt PV or demonstrate a short length of umb vein, lt PV, and fetal sto

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16
Q

Measure at ABD circumference at level to include

A

liver

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17
Q

parallel to fem shaft placing calipers at level of fem ehad cartilage and dist fem condyle

A

Femur length measurement

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18
Q

Alpha- fetoprotein is produced by

A

fetus

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19
Q

AFP is found in

A

amniotic fluid and maternal serum

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20
Q

AFP normal value varies with

A

gest age

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21
Q
  • fetus older than expected
  • multiple gest
  • open neural tube defect
  • abd wall defect
  • cystic hygroma
  • renal anomalies
  • fetal demise
A

Causes of High AFP

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22
Q
  • fetus younger than expected
  • chromosomal abnormalities
  • trophoblastic disease
  • long standing fetal demise
  • chronic maternal hypertension or diabetes
A

Causes of low AFP

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23
Q

Oxygenated blood leaves the placenta and enters the fetus through the

A

umbilical vein

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24
Q

After entering the abd, blood courses through the

A

ductus venosum reaching the rt atrium of the heart

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25
Q

blood travels from the rt and lt atrium through

A

foramen ovale

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26
Q

From the left atrium to the left ventricle, blood ascends the

A

AO distributing blood to the fetal tissue

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27
Q

Approx half of the blood leaves through the

A

umb arteries and goes back to plac for reoxygenation

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28
Q
  • junction of ant, occipital, and temporal horn
  • located slightly inf to level of BPD
  • evaluated for ventricular enlargement
A

Atrium of lateral ventricles

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29
Q
  • hyper thin ventricle wall
  • hyper choroid plexus
  • measured perpendicular to ventricle walls from glomus of choroid plexus to lateral ventricular wall
  • measures b/t 6 - 10 mm throughout pregnancy
  • choroid plexus should almost fill the lateral ventricle
A

Atrium of lat ventricle sono appearance

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30
Q
  • presence exclused almost every subtle midling brain malformation
  • filled with cerebral spinal fluid
  • found at level of BPD
  • located inf to ant horns of lat ventricles
  • closes by 2 yrs of age
A

Cavum Septi Pellucidi

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31
Q

Cavum Septi Pellucidi sono appearence

A

small anechoic box located in midline portion of ant brain

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32
Q
  • consists of vermis and two lateral horns
  • located in post fossa
  • assists in balance
A

Cerebellum

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33
Q

Cerebellum sono findings

A

dumbell shaped echogenic structure located in midline of post fossa

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34
Q
  • echogenic cluster of cells
  • important in the production of cerebrospinal fluid
  • found at level of BPD
  • located inferior to ant horns of lat ventricle
  • chroid plexus cysts will normally regress by 23 gest age
A

Choroid Plexus

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35
Q
  • hyper structures located within each lat ventricle
  • lie along the atrium of lat ventricle
  • cyst my be displayed within choroid
A

Choroid plexus sono findings

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36
Q

fluid filled spaces located between the underface of cerebellum and medulla oblongata

A

Cisterna Magna

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37
Q

CM sono findings

A
  • AP
38
Q
  • begins ossification around 11 gest w

- ovoid in shape

A

Cranium

39
Q

cranium sono appearence

A

hyper outline surrounding the brain

40
Q
  • intrahemisphere fissure

- separates the cerebral hemisphere

A

Falx Cerebri

41
Q

Falx cerebri sono findings

A

echo midline linear structure

42
Q
  • soft tissue thickness between the calvaria and posterior skin line
  • measured in the axial plane at a level to include the cerebellum, CM, and Cavum speti cellucidi
  • accurate up to 20 w
  • thickening assoc w/ anueploidy
A

Nuchal Thickness

43
Q

Nuchal Thickness sono findings

A

thickness

44
Q

Thalami

A

provide synopsis b/t cerebellu and post brain

45
Q
  • hypo ovoid structures in midportion of brain located in each hemisphere
  • 3rd ventricle is located b/t each individual thalamus
A

Thalami Sono findings

46
Q
  • muscle seperating thorax and abd cavities

- courses ant to post

A

Diaphragm

47
Q
  • curvilinear hypo structure
  • abd content lie inf
  • chest contents lie sup
A

Diaphragm sono findings

48
Q
  • apex points toward left side of body at 45 degree angle
  • rt ventricle most ant
  • lt atrium most post
A

Heart

49
Q
  • lies midline in chest
  • hyper ventricular and atrial septa
  • 120-160 bpm
  • hyper focus w/in ventricle is most likely the papillary muscle
A

Heart sono findings

50
Q
  • serve as lat border to heart

- lie sup to diaphragm

A

Lungs

51
Q
  • moderately echo
  • homo
  • increases in echo as gestation progressess
A

Lung sono findings

52
Q
  • signifies genitourinary system is working
  • bladder fills and empties every 30 - 60 min
  • should be vis by 13 w
A

Bladder

53
Q
  • round anechoic structure located centrally in inf pelvis

- variable in size

A

Bladder sono appearance

54
Q
  • meconium begins to accumulate in the small bowel
  • small bowel becomes vis in late second trim
  • large bowl becomes vis in 3rd trim
A

Bowel

55
Q
  • moderately echo
  • hyper compared to liver
  • hyper compared to bone
  • distinguished after 22 w
A

Small bowel sono app

56
Q

large bowel sono appearence

A

hypo to small bowel

57
Q
  • vis peaks around 20-32 gest w

- signifies the presence of biliary tree

A

Gallbladder

58
Q
  • elongated fluid filled structures

- located inf and to rt of umb vein

A

gallbladder sono appearance

59
Q
  • urine formation begins near the end of 1st trim
  • may be identified as early as 15 wks
  • consistently identified by 20 w
A

Kidneys

60
Q
  • iso or hypo locaed on each side of spine
  • bilateral
    renal pelvis should contain small amount of fluid
A

Kidneys sono appearance

61
Q

Kidneys renal pelvis measurements

A

> 4 mm up to 33 w

> 7 mm from 33 w to term

62
Q

liver

A
  • largest organ in torso

- reflect change in fetal growth

63
Q

liver sono appearence

A
  • moderately echogenic structure
  • left love is larger than rt lobe
  • occupies most of upper abd
64
Q
  • reliabily vis by 13 w

- signifies normal fetal swallowing sequence

A

Stomach

65
Q
  • anechoic structure located in the LUQ
  • size and shape will vary with recent swallowing
  • echogenic debris w/in sto may be vis
A

Stomach sono appearance

66
Q
  • placental insertion generally located in midportion of plac
A

Umb cord insert

67
Q
  • smooth abd wall at umb insert
  • umb vein courses sup toward liver
  • umb arteries arise from hypogastric arteries on each side of bladder
A

Umb cord instert sono appearance

68
Q

Long bones start ossification by

A

11 w

69
Q

pelvis iliac wings ossify at

A

12 gest w

70
Q

pelvic ischium ossifies by

A

20 w

71
Q

Spine widens near the base of the____ and tapers near the _____

A

skull

sacrum

72
Q

ossification of spine should be complete by

A

18 w

73
Q

What surrounds and protects the fetus?

A

Amniotic fluid

74
Q

Amniotic fluid provides important info on

A

fetal renal and plac function

75
Q

What becomes the major producer of AF through shallowing and urine after 16 w

A

Fetus

76
Q

length of cx determines

A

competence

77
Q

length of cx is measured b/t

A

internal os and external os

78
Q

normal cx length

A

2.5 - 4cm

79
Q

What communicates between fetus and mother

A

placenta

80
Q

The placenta provides

A

nutrition and products of metabolism to fetus

81
Q

Whats the connecting lifeline between fetus and plac

A

Umb cord

82
Q

How many arteries and veins in umb cord

A

2 arteries

1 vein

83
Q

umb cord enters the

A

lt portal vein

84
Q

umbilical arteries arise from

A

internal iliac arteries

hypogastric

85
Q

umb cord normally insert into the

A

midportion of plac

86
Q

umb cord is covered in

A

Whartons jelly

87
Q

plac is hyper compared to

A

myo

88
Q

plac thickness

A
89
Q

umb artery

A
  • low resistive near fetal insert

- high resistive near plac insert

90
Q

umb vein

A
  • continuous flow through stystole and diastolic

- flow is directed from plac to the fetus

OB Review (12 decks)

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