Ch. 51 Test Flashcards

1
Q

What biometric fetal measurements are routinely done in the 2nd and 3rd trimester

A

BPD, HC, AC, FL, HR, cerebellum, cistern magna, lateral ventricles

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2
Q

Should the sonographer routinely include evaluation of the adnexa, uterine walls and cervix on the OB sonogram

A

yes, to evaluate for masses, fibroids and cysts

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3
Q

Give a reason for evaluating each of the following fetal structures: CEREBRAL VENTRICLES

A

hydrocephalus

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4
Q

Give a reason for evaluating each of the following fetal structures: SPINE

A

spina bifida, sacrococcygeal teratoma

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5
Q

Give a reason for evaluating each of the following fetal structures: STOMACH

A

duodenal atresia, esophageal atresia, situs inversus, diaphragmatic hernia

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6
Q

Give a reason for evaluating each of the following fetal structures: HEART

A

4 chambers, great vessels

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7
Q

Give a reason for evaluating each of the following fetal structures: KIDNEYS/URINARY BLADDER

A

renal agenesis, hydrocephalus

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8
Q

Give a reason for evaluating each of the following fetal structures: UMBILICAL CORD INSERTION

A

omphalocele, gastroschisis

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9
Q

Give a reason for evaluating each of the following fetal structures: FACE

A

clef palate, other craniofacial malformation

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10
Q

Give a reason for evaluating each of the following fetal structures: CEREBELLUM

A

congenital anomalies

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11
Q

Give a reason for evaluating each of the following fetal structures: CISTERNA MAGNA

A

dandy walker malformation, spina bifida

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12
Q

Why is it important for the sonographer to have a systematic and organized approach to performing OB sonograms

A

ensure you document all criteria and dont forget to image a structure

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13
Q

If the LMP is unknown or the patient has irregular menstrual cycles, what are some other parameters that can be used to determine the due date

A

fundal height, doptones, lab tests, CRL, gest sac diameter

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14
Q

A post term pregnancy is defined as one that has gone beyond _____ weeks

A

42

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15
Q

Explain the gravidity and parity of a woman who is G5P3104

A

5th pregnancy, 3 full term pregnancies, 1 premature birth, 0 abortions/miscarriages, 4 living children

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16
Q

Fetal presentation refers to

A

the part of the fetus that is closest to the cervix

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17
Q

Fetal lie refers to

A

the direction the fetal body is lying in relation to the maternal spine

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18
Q

It is important to know which side of the baby is true left and true right in order to determine

A

situs

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19
Q

The major structures in the superior cut of the fetal cranium are the

A

lateral ventricles, choroid plexus, midline falx

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20
Q

The major structures evaluated in the mid cut of the fetal cranium are the

A

thalamus, CSP, BP, 3rd ventricle, falx

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21
Q

`The major structures evaluated in the inferior cut of the fetal cranium are the

A

cerebellum, cistern magna, circle of willis, cerebral pedicles

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22
Q

Which level of the cranium is the appropriate level for measurement of the BPD and HC

A

mid cut

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23
Q

Label the following as echogenic, hypoechoic or cystic: FALX CEREBRI

A

echogenic

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24
Q

Label the following as echogenic, hypoechoic or cystic: THALAMI

A

cystic

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25
Q

Label the following as echogenic, hypoechoic or cystic: CHOROID PLEXUS

A

echogenic

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26
Q

Label the following as echogenic, hypoechoic or cystic: LATERAL VENTRICLES

A

cystic

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27
Q

Label the following as echogenic, hypoechoic or cystic: CEREBELLUM

A

hypoechoic

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28
Q

Label the following as echogenic, hypoechoic or cystic: CIRCLE OF WILLIS

A

echogenic

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29
Q

Label the following as echogenic, hypoechoic or cystic: CAVUM SEPTUM PELLUCIDUM

A

echogenic with cystic border

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30
Q

Label the following as echogenic, hypoechoic or cystic: CRANIAL BONES

A

echogenic

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31
Q

Label the following as echogenic, hypoechoic or cystic: LENS OF THE EYES

A

echogenic

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32
Q

The upper limit of normal for the diameter of the lateral ventricle is

A

10mm

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33
Q

Define frontal bossing

A

lemon sign

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34
Q

Define micrognathia

A

underdeveloped lower jaw, receding chin

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35
Q

VUC transverse view vertebra is

A

abnormal

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36
Q

Rooftop transverse view vertebra is

A

normal

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37
Q

The spine should ________ at the sacrum

A

taper

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38
Q

The spine should _____ as it joins the skull

A

flare

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39
Q

Why is it important to image the fetal diaphragm

A

exclude diaphragmatic hernia

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40
Q

What structures should be superior to the diaphragm

A

lungs, heart

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41
Q

What structures should be inferior to the diaphragm

A

stomach, liver, bowel, spleen

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42
Q

The view of the heart that is common to the routine OB sonogram is

A

4 chamber view

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43
Q

The apex of the fetal heart should point toward the ____ of the fetus

A

left side

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44
Q

The foramen ovale should open into the _____ in the fetal heart

A

left atrium

45
Q

As blood is shunted through the foramen ovale, it is bypassing the

A

lungs

46
Q

The mitral and tricuspid valves should _____ during diastole and _____ during systole

A

open, closed

47
Q

If the interventricular septum of the fetal heart is not a continuous line from the valves to the apex, what abnormality is most likely present

A

ventricular septal defect

48
Q

______ is a specialized exam that is targeted to evaluate for fetal cardiac anomalies

A

fetal echocardiography

49
Q

Visualization of the ______ inferior to the diaphragm generally excludes the presence of a left side diaphragmatic hernia

A

stomach

50
Q

The aorta leaves the heart, loops posteriorly, and descends anterior to the spine, forming the _____ sign

A

candy cane

51
Q

List the 3 vessels that arise from the aortic arch

A

brachiocephalic artery, left CCA, left subclavian artery

52
Q

In the fetus, the hypogastric arteries can be seen diverging around the

A

bladder

53
Q

Oxygen rich blood reaches the fetus via the

A

umbilical vein

54
Q

Oxygen poor blood leaves the fetus via the

A

umbilical arteries

55
Q

The ______ is a special connection for fetal circulation between the umbilical vein and the IVC

A

ductus venosus

56
Q

The _____ is a special connection for fetal circulation between the aorta and the pulmonary artery

A

ductus arteriosis

57
Q

The blood travels through the ductus venosus bypasses the

A

liver

58
Q

The blood that travels through the ductus arteriosis bypasses the

A

lungs

59
Q

How much of the fetal blood actually circulates through the fetal lungs

A

5-10%

60
Q

The fetal liver is the main storage site for

A

glucose

61
Q

The decreased abdominal circumference associated with IUGR is due to decreased size of the

A

liver

62
Q

Is fluid around the fetal liver cause for concern? Why?

A

yes, ascites

63
Q

Describe the appearance and location of the fetal gallbladder

A

anechoic, tear drop shaped, next to portal vein

64
Q

Is the spleen often seen on the routine OB sonogram? What problems may be associated with enlargement of the fetal spleen

A

no, RA sensitivity and partial sinus inversus

65
Q

List the components of the fetal GI tract

A

esophagus, stomach, small bowel, colon

66
Q

Why is it important to visualize fluid in the fetal stomach

A

may indicate esophageal atresia, fetal swallowing, craniofacial abnormality

67
Q

If the fetus is scanned and looks normal except for visualization of the stomach, what should be done first

A

have the pt come back, baby’s stomach could have just emptied and needs to swallow again to fill

68
Q

The small bowel can be differentiated from the large bowel after ____ weeks

A

20

69
Q

As the fetus matures, more and more ____ can be seen in the large bowel

A

meconium

70
Q

Meconium is

A

fecal matter

71
Q

In cases of _____ the fetus may pass meconium into the amniotic fluid

A

normal term fetus, fetal distress

72
Q

The anatomical structure of the fetal kidneys becomes visible sonographically in the ____ trimester

A

2nd

73
Q

If there is fluid in the renal pelvis that measures more than ____, it is considered hydronephrosis

A

10mm

74
Q

Large echogenic kidneys in the fetus is indicative of

A

polycystic kidney disease, renal infection

75
Q

In what cases is it normal to see fluid within the renal pelvis

A

polyhydramnios, mother has full bladder, late 3rd trimester

76
Q

The fetal adrenal glands have a characteristic _____ appearance on sonogram by 23 weeks

A

rice grain

77
Q

Which vessels are used as landmarks to locate the fetal adrenal glands

A

IVC and aorta

78
Q

The fetal adrenal gland may sometimes be mistaken for the fetal

A

kidney

79
Q

Why is it important to see the fetal bladder empty on sonogram when it appears to be large

A

can indicate urinary obstruction or polyhydramnios

80
Q

What conditions can cause the normal fetal bladder to be large

A

polyhydramnios, mother has full bladder

81
Q

At what gestational age should the sonographer tell the parent that the gender of the fetus should be visible for male

A

15 weeks

82
Q

At what gestational age should the sonographer tell the parent that the gender of the fetus should be visible for female

A

20 weeks

83
Q

In what cases would detecting the gender of the fetus be important

A

when there is a possibility of gender linked disorder

84
Q

Should the sonographer guess at the fetal gender if he/she is not sure

A

no

85
Q

What genital parts must be seen to determine that the fetus is male

A

penis and scrotum

86
Q

Why may the labia majora on the female fetus be sometimes mistaken for scrotum

A

swollen due to increased maternal hormones

87
Q

Why are hydroceles often seen in male fetuses

A

increased maternal hormones

88
Q

The fetal long bones should be surveyed for

A

bowing, fractures, demineralization

89
Q

Why is it important to do a thorough survey of the entire fetal skeleton

A

rule out skeletal dysplasia

90
Q

Which long bone is typically measured in fetal biometry

A

femur

91
Q

When should measurements of the other long bones be beneficial

A

suspected abnormality or skeletal dysplasia

92
Q

If the sole of the fetal foot can be seen in the same image as the tibia and fibula of the same leg, what pathology is present

A

club foot

93
Q

Why is it important to identify the placental insertion of the umbilical cord

A

evaluate for mass and velamentous insertion

94
Q

The umbilical arteries and vein should spiral around each other. Is absence of the cord twists significant? Why or why not?

A

yes, may be associated with poor pregnancy outcome

95
Q

How does the sonographer survey the gravid uterus

A

long, trans, placental location, placental grade, cervix, adnexa

96
Q

Why is it important to try to locate the maternal ovaries when performing an OB sonogram

A

evaluate for ovarian mass or cyst

97
Q

What is the major role of the placenta

A

nutrient, oxygen and waste exchange

98
Q

How does the sonographer perform the AFI

A

measure A/P of all quadrants without fetal parts and add together

99
Q

What is the normal range for AFI

A

5-22cm

100
Q

When does the amniotic fluid volume peak

A

34 weeks

101
Q

Amniotic fluid must be inhaled in order for the fetal lungs to develop properly

A

true

102
Q

What may happen to the fetal lungs in the presence of oligohydramnios

A

small and hypoplastic

103
Q

Describe the appearance of amniotic fluid volume in second trimester

A

surround fetus

104
Q

Describe the appearance of amniotic fluid volume in early third trimester

A

generous

105
Q

Describe the appearance of amniotic fluid volume in late third trimester

A

scanty/isolated pockets

106
Q

Which has been shown to be more accurate in identifying oligohydramnios or polyhydramnios

A

AFI

107
Q

_____ often is the cause of sparkly debris in the amniotic fluid, especially in late pregnancy

A

vernix caseosa

108
Q

What broad category of fetal anomalies would be suspected with polyhydramnios

A

macrosomia, swelling, neural tube defects, GI tract