Ch 61 Fetal Anterior Abdominal Wall

Question 1

What are the three most common abdominal wall defects?

Answer 1

1. Omphalocele
2. Umbilical Hernia
3. Gastroschisis

Question 2

What are some other RARE defects? {5}

Answer 2

Ectopic Cordis, Penology of Cantrell, Limb-Body Wall Complex, Amniotic Band Syndrome, & Bladder/Cloacal Exstrohpy

Question 3

Abdominal wall defects cause distortion of the normal contour of the _____ or ______ surface of the fetal abdomen.

Answer 3

Ventral or Anterior surface

Question 4

Does gastroschisis have a membrane?

Answer 4

NO

Question 5

What is the cord insertion with omphalocele and gastroschisis like?

Answer 5

omphalocele- cord goes through

gastroschisis- is to the right of the cord

Question 6

Omphaloceles often occurs with _________.

Answer 6

Chromosomal abnormalities

Question 7

When trying to differentiate gastroschisis from omphaloceles consider…. {5}

Answer 7

1. Look for presence of a membrane
2. Look at the umbilical cord insertion
3. Determine which organs are eviscerated
4. Determine if bowel is normal in texture
5. Look for other anomalies because omphaloceles often occurs with chromosomal anomalies

Question 8

Develops when there is a midline defect of the abdominal muscles, fascia, & skin that results in herniation of intra-abdominal structures into the base of the umbilical cord.

Answer 8

Omphalocele

Question 9

An omphalocele herniation is covered by a membrane that consists of _____ and ______.

Answer 9

Amnion and Peritoneum

Question 10

AFP with Omphalocele is…

Answer 10

May be slightly elevated or normal {because it is covered by a membrane}

Question 11

Two types of omphalocele…

Answer 11

1. Contains liver in the sac {may or may not contain bowel}

2. Contain a variable amount of bowel WITHOUT liver

Question 12

Bowel only ompaloceles have a greater risk for chromosomal abnormalities and other anomalies {T/F}

Answer 12

TRUE

Question 13

Most common chromosomal abnormalities associated with omphaloceles are what?

Answer 13

Trisomy 13 and 18

Question 14

Consider __________ when scoliosis is found with omphalocele.

Answer 14

Limb-body wall complex

Question 15

Beckwith-Weidmann syndrome is made up of… {3}

Answer 15

1. Macroglossia
2. Omphalocele
3. Visceromegaly

Question 16

Herniation of small bowel into amniotic fluid through an open defect {usually an isolated event}

Answer 16

Gastroschisis

Question 17

What are the two most likely causes of gastroschisis?

Answer 17

1. Atrohpy of the RIGHT umbilical VEIN

2. Disruption of the omphalomesenteric ARTERY

Question 18

Is AFP elevated with gastroschisis?

Answer 18

YES, significantly elevated AFP with gastroschisis

Question 19

Is gastroschisis more common in males or females?

Answer 19

MALES

Question 20

Coexisting anomalies are rare with gastroschisis {T/F]

Answer 20

TRUE

Question 21

With gastroschisis there is mildly dilated bowel and wall thickening. Extremely dilated bowel may suggest _____ or ______.

Answer 21

Infarction or bowel atresia

Question 22

Severe body wall defects are secondary to ______.

Answer 22

Amniotic band syndrome

Question 23

Also associated with gastroschisis is… {3}

Answer 23

Hydronephrosis, bladder deviation, and exstrohpy

Question 24

Rupture of membranes which entangles or entraps fetal parts by “sticky” chorion.

Answer 24

Amniotic band syndrome

Question 25

Amniotic band syndrome is ______. Occurs in ____ out of ____ births.

Answer 25

RARE. Occurs in 7.8 out of 10,000 births.

Question 26

_____ is characterized by a defect in the lower abdominal wall and anterior wall of the urinary bladder.

Answer 26

Bladder exstrophy

Question 27

Bladder exstrophy may include... {4}

Answer 27

1. Omphalocele 2. Inguinal hernia 3. Undistended testes 4. Anal problems

Question 28

Cloacal exstrophy is rare & complex. It occurs ____ in development.

Answer 28

early

Question 29

_____ results in exstrohpy of the bladder in which two hemibladders are separated by intestinal mucosa

Answer 29

Cloacal exstrophy

Question 30

Bladder exstrophy is characterized by a defect in the ______ abdominal wall and the _____ wall of the urinary bladder.

Answer 30

Lower abdominal wall and anterior wall of the urinary bladder

Question 31

Penology of Cantrell is _____.

Answer 31

RARE

Question 32

What are 5 defects associated with Penology of Cantrell?

Answer 32

1. Higher or super umbilical omphalocele 2. Ectopia cordis {heart outside the chest} 3. Distal sternum defect 4. Diaphragmatic hernia 5. Diaphragmatic pericardium

Question 33

abnormal condition in which the brain is located outside the cranium

Answer 33

exencephaly

Question 34

protrusion of the brain through a cranial fissure

Answer 34

encephalocele

Question 35

anomaly with large cranial defects, facial cleft, large body wall defects, and limb abnormalities

Answer 35

limb-body wall complex

Question 36

rare anomaly with five defects: omphalocele, ectopic heart, lower sternum, anterior diaphragm, and diaphragmatic pericardium

Answer 36

pentalogy of Cantrell

Question 37

The severe form of amniotic band syndrome is ____.

Answer 37

Limb-body wall complex

Question 38

limb-body wall complex is a _____ condition.

Answer 38

LETHAL

Question 39

With limb-body wall complex the ____ side body wall defects are 3 times more common than ____ sided defects

Answer 39

Left is 3 times more common than right

Question 40

Anomalies associated with limb body wall complex ... {5}

Answer 40

1. Omphalocele 2. Severe scoliosis and spinal defects 3. Limb anomalies 4. Large cranial and facial cleft 5. SHORT UMBILICAL CORD

Question 41

Cloacal bladder is also known as ______ complex

Answer 41

OEIS complex * O omphalocle * E exstrohpy * I imperforate anus * S spina bifida

Question 42

The exposed heart presents outside the chest wall through a cleft sternum in ________

Answer 42

Ectopic Cordis