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OB GYN REGISTRY > Ch. 12 Fetal Chest and Cardiovascular System > Flashcards

Ch. 12 Fetal Chest and Cardiovascular System Flashcards

1
Q

What structure can be seen located anteriorly in the upper mediastinum, it is best seen at the 3VV

A

Thymus gland

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2
Q

When is the optimal time to evaluate the fetal heart

A

between 18 and 22 weeks

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3
Q

List some congenital heart disease (CHD) risk factors

A

Family hx
maternal diabetes mellitus
teratogen exposure
chromosome abnormalities
Lupus
Increased NT measurement

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4
Q

Oxygenated blood from the placenta enters the fetus through the —–

A

Umbilical vein

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5
Q

The —– partially bypasses the liver to send oxygen-rich blood to the right atrium

A

Ductus venosus

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6
Q

The —– shunts some of the rt atrium blood directly into the lt atrium

A

foramen ovale

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7
Q

the —– allows oxygen-rich blood from the PA into the AoA to circulate throughout the fetus (bypasses the LUNGS)

A

Ductus arteriosis

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8
Q

Which atrium is the closest to the fetal spine

A

Left atrium

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9
Q

The apex of the heart should point how many degrees from midline to lt anterior chest wall

A

45 degrees +/- 20 degrees (Levocardia)

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10
Q

The flap of the foramen ovale opens into the

A

Left atrium

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11
Q

In what chamber of the heart is the moderator band located

A

Apex of Rt ventricle

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12
Q

Pulmonary veins enter the

A

Left atrium

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13
Q

Which AV valve is positioned more inferiorly or more apical than the other

A

The tricuspid valve

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14
Q

Where is the tricuspid valve located

A

between the rt atria and rt ventricle

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15
Q

Where is the mitral valve located

A

Between the lt atria and lt ventricle

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16
Q

Which view is used to identify the origin of the Aorta arising from the left ventricle

A

LVOT, left ventricular outflow tract

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17
Q

What cardiac view is used to identify the origin of the pulmonary trunk arising from the Rt ventricle

A

RVOT, Right ventricular outflow tract

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18
Q

T or F, the Aorta should always be larger in diameter compared to the Pulmonary artery

A

FALSE. The PA should have a 9% larger diameter compared to the aorta

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19
Q

Which cardiac view ensures the orientation of the outflow tracts

A

3VV

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20
Q

In the 3VT view, what colors should the ductus arteriosus and the aorta be?

A

The same color

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21
Q

What are the vessels seen arising from the AoA

A

The head and neck vessels. Brachiocephalic/Innominate, Lt carotid and Lt subclavian arteries

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22
Q

What is the Ductal arch view demonstrating

A

The ductus arteriosus traveling into the Ao

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23
Q

The most common cardiac defect postnatally
the most teratogen-associated fetal defect
and is associated with other cardiac anomalies 50% of the time

A

Ventricular septal defect (VSD)

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24
Q

What would a VSD show on color doppler (what type of flow)

A

Bidirectional flow

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25
Q

What is the most common type of ASD

A

Ostium secundum defect

26
Q

Small right ventricle due to decreased blood flow out of the right ventricle. Pulmonary atresia with an intact IVS

A

Hypoplastic right heart syndrome

27
Q

Sono finds of hypoplastic right heart syndrome

A

absent or very small rt ventricle on 4CH view, absent or small PA

28
Q

List primary abnormalities associated with hypoplastic left heart syndrome

A

Aortic stenosis, Ao coarctation (80% of cases), Mitral and or Ao valve atresia

29
Q

Condition in which the origins of the great vessels are transposed so the aorta arises from the RT ventricle and the pulmonary trunk arises from the LT ventricle

A

Transposition of the great arteries (TGA)

30
Q

Sono finds of TGA

A

Correct left-right orientation is a MUST
outflow tracts demonstrate anomalous origin
parallel orientation of outflow tracts

31
Q

Heart defect in which a single large vessel arises from the base of the heart (rather than separate outflow tracts) A VSD is usually present and 48% of fetuses have other non-cardiac anomalies

A

Common arterial trunk/ Truncus arteriosus

32
Q

Heart defect in which all or part of the heart is located outside of the chest cavity

A

Ectopia cordis

33
Q

What is ectopia cordis associated with?

A

Omphalocele in pentalogy of cantrell

34
Q

Heart defect in which the pulmonary artery and Ao arise from the RT ventricle

A

Double outlet right ventricle

35
Q

What is double outlet right ventricle associated with?

A

Other cardiac defects, maternal diabetes, maternal alcohol consumption

36
Q

Cardiac tumors are rare but are most frequently

A

Rhabdomyomas

37
Q

There is a strong association between rhabdomyomas and —–

A

Tuberous sclerosis

38
Q

Heart defect in which there is a failure of the common AV orifice to separate into mitral and tricuspid valves, resulting in a defect in the Crux (center) of the heart

A

Atrioventricular (A-V) canal defect/ endocardial cushion defect
(associated with trisomy 21)

39
Q

List the defects that make up Tetralogy of fallot

A

VSD, overriding aorta, stenosis of the RVOT/Pulmonary stenosis, and right ventricular hypertrophy

40
Q

Malformation of the tricuspid valve with low insertion, resulting in a grossly enlarged RT atrium

A

Ebstein’s anomaly

41
Q

What two things are ventricular hypertrophy most commonly associated with

A

Cardiac outlet obstruction, maternal diabetes

42
Q

A variety of cardiac anomalies are associated with asplenia and polysplenia in what type of syndromes

A

heterotaxy syndromes

43
Q

What is the normal heart rate range prior to 6 weeks

A

100-115 BPM

44
Q

What is the normal fetal heart rate range

A

120-160 BPM

45
Q

What is the correct placement of the M-mode cursor

A

The cursor should be placed through the atrium and ventricle

46
Q

Arrhythmias are generally due to —–. they are associated with —-

A

Premature atrial contractions (PACs)
Maternal caffeine intake, cigarette smoking, alcohol use

47
Q

Fetal tachycardia is defined as a heart rate greater than

A

180 BPM

48
Q

Bradycardia is a heart rate less than or equal to

A

100 BPM

49
Q

Bradycardia is associated with

A

Complete heart block

50
Q

Bradycardia less than 80 BPM may be associated with

A

Fetal asphyxia

51
Q

Most commonly diagnosed fetal intrathoracic abnormality

A

Pleural effusion aka Hydrothorax

52
Q

The most common developmental abnormality of the diaphragm

A

Congenital diaphragmatic hernia (CDH)

53
Q

What is the most common CDH and on which side does it occur most often?

A

Bochdalek hernia (85% of cases), LT side

54
Q

What side does the Morgani hernia occur?

A

On the RT

55
Q

Diaphragmatic hernias are associated with what condition as a result of pressure on the thoracic cavity

A

Pulmonary hypoplasia (you will also notice cardio-mediastinal shift, the most recognizable sono feature)

56
Q

Sono finds of Congenital Diaphragmatic Hernias

A

fluid-filled bowel and especially the stomach in the chest at the level of the 4CH.
displaced heart from the LT chest toward the RT
Associated Polyhydramnios

57
Q

Uncommon malformation in which a mass of non-functioning pulmonary tissue is separate from the lung

A

Pulmonary sequestration

58
Q

Describe the blood flow in a pulmonary sequestration

A

This mass receives its blood supply from the systemic circulation (Ao) and does NOT communicate with the bronchial tree.

59
Q

Sono finds of pulmonary sequestration

A

homo echogenic intrathoracic mass
color may show an arterial vessel arising from the Ao into the mass and NO pulmonary artery branch supplying the mass
hydrops fetalis (rare)

60
Q

Unilateral condition characterized by the replacement of normal lung tissue with ABnormal tissue, which often include visible cysts. There are three types

A

Congenital pulmonary airway malformation (CPAM) aka Congenital Cystic Adenomatoid Malformation (CCAM)

61
Q

Describe the types of CCAMs

A

Type 1- one or more LARGE cysts > or + 2 cm
Type 2- multiple small cysts <1-2cm
Type 3- multiple small cysts, too small to see on US so lung appears HYPERECHOIC

62
Q

Sono finds of CCAMs

A

Non-pulsatile echogenic (w/solid and cystic components) mass in fetal lung
Lateral displacement of the heart
possible signs of hydrops fetalis(most common with CPAM type 2)
Associated polyhydramnios

OB GYN REGISTRY (19 decks)

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