Ch. 11 Fetal Abdomen and Abdominal Wall

Question 1

Which plane is most optimal when imaging the fetal diaphragm

Answer 1

Coronal

Question 2

T or F, the Left lobe of the fetal liver is larger than the right lobe in the normal fetus

Answer 2

T

Question 3

Around what gestational age should midgut herniation return back into the fetal abdomen

Answer 3

By the 12th week

Question 4

Relatively small defect involving all three layers of the abd wall which allows protrusion of the intestines into the amniotic cavity

Answer 4

Gastroschisis

Question 5

On which side of the umbilical cord insertion does gastroschisis usually occur

Answer 5

TO THE RIDE OF THE UMBILICAL CORD

Question 6

T or F, gastroschisis is covered by a membranous sac

Answer 6

FALSE. It is NOT covered by a sac

Question 7

T or F, gastroschisis is associated with anomalies and an increased risk of chromosomal abnormalities

Answer 7

FALSE. It is NOT associated with anomalies or chromosomal abnormalities

Question 8

What has gastro been linked to

Answer 8

Recreational drugs such as aspirin or acetaminophen

Question 9

Results from the failure of the intestines to return to the abd during the second stage of intestinal rotation

Answer 9

Omphalocele - the defect is covered by a membrane which is a layer of amnion and peritoneum

Question 10

What complications could arise from delivery of a fetus with an omphalocele

Answer 10

Rupture of the sac during vaginal delivery may cause sepsis

Question 11

What type of defects and trisomies are associated with omphaloceles

Answer 11

Cardiac defects, Trisomy 13 and 18 aka Patau syndrome and Edwards syndrome

Question 12

Omphaloceles containing —– have a greater risk of associated chromosomal abnormalities

Answer 12

Bowel only

Question 13

Omphaloceles are contiguous with the

Answer 13

umbilical cord

Question 14

A midline defect which involves the lower abd wall as well as the anterior wall of the urinary bladder

Answer 14

Bladder exstrophy

Question 15

Sono finds of bladder exstrophy

Answer 15

Nonidentifiable bladder over 30 min of scanning but normal AFI, possible soft tissue protrusion from lower abd wall, separation of pubic bones (diastasis), microphallus in the male fetus

Question 16

Defect in which there is a discontinuity of the esophagus

Answer 16

Esophageal atresia

Question 17

90% of esophageal atresia cases are accompanied by a

Answer 17

distal tracheo- esophageal fistula

Question 18

Sono finds of esophageal atresia

Answer 18

Small to absent fetal stomach, associated polyhydramnios, not ALWAYS able to detect with US depending on whether or not a TE fistula is present

Question 19

The most common perinatal intestinal obstruction, associated with cardiac and vertebral anomalies. 31% of infants with this defect are born with what trisomy

Answer 19

Duodenal atresia, Trisomy 21

Question 20

Sono finds of duodenal atresia

Answer 20

“DOUBLE BUBBLE SIGN” - dilated stomach and proximal duodenum.
POLYhydramnios
may not become apparent until after 24 weeks

Question 21

Obstruction of the intestine with subsequent distention of bowel loops, may occur anywhere along the intestinal tract or at the level of the anus

Answer 21

Intestinal atresia

Question 22

Sono finds of Intestinal atresia

Answer 22

multiple fluid-filledsmall bowel internal diameter > 7 mm, POLYhydramnios

Question 23

Sterile chemical peritonitis caused by small bowel perforation in utero. Cystic fibrosis is thought to be the etiology of this condition

Answer 23

meconium peritonitis

Question 24

How should you properly determine hyperechoic bowel

Answer 24

turn off harmonic imaging
use low freq
lower gain to see if bowel or bone disappears first

Question 25

List common etiologies for hyperechoic bowel

Answer 25

normal variant
TRISOMY 21
CMV infection
Cystic fibrosis
swallowed intra-amniotic blood (rare)

Question 26

Fetal ascites is most commonly associated with what other condition

Answer 26

Hydrops fetalis

Question 27

When the umbilical vein courses toward the left side of the fetal abd. the UV is actually entering the RT portal vein rather than the Lt portal vein

Answer 27

Persistent right umbilical vein