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OBGYN 1 > C8.1 Norm Fetal Heart Anatomy > Flashcards

C8.1 Norm Fetal Heart Anatomy Flashcards

1
Q

When does the heart tube begin to develop and when is it fully formed? From what tissue does it develop from

A
  • starts to develop at 5 wks, fully formed by 10th wk

- develops from mesoderm

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2
Q

When do we routinely scan the fetal heart?

When is it best been?

A

From 18wks to term (40 wks)

-b/w 18-24 wks

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3
Q

When does the heart start beating

A

22-2 days post conception

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4
Q

What are the 3 structures in the heart that are specifically to fetal circulation?

A

-ductus venosus
+ umbilical vein

-foramen ovale
+ shunts blood from RA to LA (1/2 of the blood crosses to LA and 1/2 to PV)

-ductus arteriosus
+ connects the PV and the AO

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5
Q

What’s another name for the umbilical arteries?

Do they carry high or low O2 blood?

A

Hypogastric arteries

Low 02

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6
Q

Describe the position of the heart in the fetal chest

A
  • horizontal
  • left of midline (compare to the stomach)
  • apex is 45 degrees to the L
  • takes up 1/3 of chest
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7
Q

Which chamber of the heart if most anterior and which is most posterior

A

LA is most posterior

RV is most anterior

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8
Q

What is the moderator band used to prove?

A

-used to prove which chamber is the RV in abnormal hearts

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9
Q

What are we looking for when assessing the AV/LVOT?

A

Looking to see that the wall of the AV is continuous with the IVS

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10
Q

Which structure is more anterior? The PA of the AO?

A

PA

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11
Q

What’s the function of the ductus arteriosis

A

Shunts blood from the PA to the AO arch to bypass the lungs

-should close after delivery

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12
Q

What is the foramen ovale?

A
  • Opening b/w the atria, the ovale flap opens into the LA

- also helps bypass the lungs

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13
Q

What are the routine images of the heart?

A 
4 chamber
LVOT
RVOT
3 vessel view
Cine clip (Sometimes)
Fetal heart M-mode
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14
Q

How should the LVOT and the RVOT be located in relation to one another?

A

LVOT and RVOT should cross each other

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15
Q

What does the 3 vessel view show

A

SVC
PA
AO arch

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16
Q

What does the 12sec cine clip show? Where does it start and end

A

Starts at the level of the AC showing fetal stomach…

… then shows 4 chamber view, LVOT, RVOT and 3 vessel view… sweep all the way up tp fetal neck

17
Q

How do you do an M mode tracing of the fetal heart?

A

Place the cursor through the heart crossing both the atria and the ventricles to check for heart block

-usually record only 1 beat

18
Q

What is a norm HR?

What value is concerning?

A

120-160

  • <100 in 1st trimester is concerning and <100 in 2nd or 3rd trimester is bradycardia
  • up to 180 in 3rd trimester can be normal…. >200 is tachycardia
19
Q

What are the additional images that we take of the heart?

A
  • short axis
  • SVC- IIVC w/ RA (long horn view)
  • AO arch
  • Ductal Arch
  • PV w/ LA
20
Q

What are we looking for when looking at the AO Arch?

A

Look for coarchtation of the AO…. narrrowing of the AO arch

21
Q

What does the ductal arch view show

A

The RV joking the AO (hockey stick appearance)

22
Q

What are techniques you can use to enhance the visualization of the heart

A
  • sector down
  • zoom up
  • decrease dynamic range
23
Q

when assessing the 3 vessel view, if the circle in the middle is small what does this tell us

A

theres an abnormality of the L heart

24
Q

when assessing the 3 vessel view, if the circle on the left is small what does this tell us

A

theres an abnormality of the R heart

25
Q

what info does the 3 vessel view give us in general

A

info about the outflow tracts of the fetal heart

26
Q

How do the atria sit in relationship to the ventricles?

A

More posterior

27
Q

The apex of the heart should have the same situs as which other organ?

A

Stomach

28
Q

How many PVeins do we see w/ US of the fetal heart

A

2

29
Q

How would the 3vv look w/ hypoplastoc L heart syndrome

A

AO would be very small and SVC/PA would be normal

OBGYN 1 (24 decks)

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