Chapter 49- 2nd and 3rd Trimester Flashcards
the ventricles of the heart come to a point called the _________; normally is directed toward the left hip
apex
the portion of the cerebral ventricular system where the lateral lobes, temporal lobes, and occipital lobes connect; located posterior and lateral to the thalami
atrium of the lateral
indicates that the fetal head is toward the fundus of the uterus
breech
a cavity within the septum pellucidum in the anterior midportion of the fetal brain
cavum septum pellucidum
echogenic tissue within the lateral ventricles that produces central nervous system fluid and is seen prominently during second-trimester fetal sonography
choroid plexus
a posterior fossa cistern that contains cerebrospinal fluid
cisterna magna
a narrow band of compact tissue forming a solid covering over the roof of the third ventricle and connecting the hemispheres of the brain
corpus callosum
structure that carries oxygenated blood from the pulmonary artery to the descending aorta
ductus arteriosus
structure that carries oxygenated blood from the umbilical vein to the inferior vena cava
ductus venosus
an echo within a fetal heart chamber that is as bright (echogenic) as bone and persists despite changes in the sonographic plane
echogenic intracardiac focus (EIF)
protrusion or bulging of the forehead
frontal bossing
adjusting an individual patient’s risk assessment for aneuploidy based on the presence or absence of sonographic markers
genetic sonogram
increased echogenicity of the bowel associated with aneuploidy risk and fetal pathology
hyperechoic bowel
the largest portion of the ventricular system in the fetal cranium
lateral ventricles
the probability that a fetus exhibiting a specific finding will be affected by a specific condition; likelihood ratios in pregnancy are typically used to predict risk for aneuploidy
likelihood ratio
a large tongue seen persistently extending outside of the fetal mouth
macroglossia
abnormally small chin
micrognathia
linear echoes located centrally in the fetal head that are produced by the borders of the opposing cerebral hemispheres
midline echo (the falx)
written representation by graphs, diagrams, or charts of the relationship between numeric variables
nomogram
typical position of the abdominal organs with the liver and inferior vena cava on the right, the stomach on the left, and the apex of the heart directed toward the left
normal situs
the thickness of fetal skin at the back of the fetal neck that may be visualized and measured between 16 and 20 weeks’ gestational age to assess aneuploidy risk
nuchal skin fold
mild dilation of the renal pelvis
pyelectasis
indicates that the fetus is lying transversely in the uterus, horizontally, or perpendicular to the maternal sagittal axis
transverse fetal lie
enlargement of the cerebral ventricles
vertriculomegaly
indicates that the fetus is positioned head down in uterus
vertex
What weeks are considered the 1st trimester
0-12
What weeks are considered the 2nd trimester
13-26
What weeks are considered the 3rd trimester
27-42
As sonographers, what are we evaluating in the 2nd trimester scan
1) Surveying the uterus
2) Observing cardiac activity
3) Position, number of fetuses, and placenta
4) Assess amniotic fluid
5) Look for uterine or placental masses as well as fetal anomalies
Anatomically, the stomach is on the _____GB on the _____ and the apex of the heart should be toward the fetal _____ side.
1) left
2) right
3) left side
What are the 2 types of fetal brain tissue?
The dura and pia arachnoid
By week ____, the cranial bones ossify
12
By week ___ the texture characteristics of each brain structure have been determined
18
The cranium may appear hypoechoic or cystic
True/False
True
Water content in fetal brain is ________
High or low?
high
When scanning a 2-3rd trimester patient, what are we looking for?
Surveying the uterus Cardiac Activity Position and # of fetus and placenta Assess amniotic fluid Look for uterine or placental masses and fetal anomalies.
What are the 4 fetal presentations?
1) Vertex
2) Breech
3) Transverse
4) Situs
Breech means that the ______ is closest in proximity to the direction of the cervix and the ______ is directed toward the uterine fundus.
Words:
Cranium/Body
Body
cranium
Vertex means the _____ is the closest in proximity to the cervix and the ____is directed towards the uterine fundus
Words:
Cranium/Body
cranium
body
There are 3 fetal lie. What are they?
1) Longitudinal
2) Transverse
3) Oblique
Situs is determining the fetus’ ____ and ____, which is EXTREMELY important.
right and left side
What are the two types of fetal brain tissue?
Dura and pia arachnoid
What are the functions of the amniotic fluid?
1) Allows fetus to move freely
2) Maintains intrauterine cavity temp.
3) Protects fetus from injury
4) Produced by umbilical cord and membranes, lungs, skin, and kidneys
5) Fetal urination accounts for nearly the total AFF in 2nd trimester
The placenta’s major role is to deliver _______ and ______
oxygen and nutrients
The echogenicity of the placenta is heterogenous during the 2nd trimester?
T/F
FALSE
The placenta is homogenous during 2nd trimester and becomes hetergenous during the 3rd trimester.
Position of placenta is not that important.
T/F
FALSE
With the umbilical cord, there are two arteries and one vein
T/F
True
When imaging the extremities, what are we looking for?
, echogenicity, normal growth patterns, bowing, fractures and demineralization.
The kidneys are located on either side of the spine and are apparent as early as ______ weeks
15 weeks
What are we looking for in the urinary system?
Kidneys, adrenal glands, ureter, and bladder.
What are we looking for in the gastrointestinal system?
Esophagus, stomach, small intestines, and large intestines (note echogenicity)
The stomach can be seen as early as _____ weeks, and should be seen in full at ______ weeks
11, 16
Fetoplacental circulation. Look at the:
liver, PV system, hepatic veins/arteries, GB and bile duct.
muscle that seperates the thorax from abdomen
diaphragm
To rule out diaphragmatic hernia, it is important to look and see a intact ______.
diaphragm
The heart should be evaluated for:
position, presence of right ventricle, equal size of ventricles and atria, septal defects, and rhythm and rate.
landmark for assessing fetal heart location
Observed as solid homogenous masses of tissue bordered medially by the heart, inferiorly by diagram, and laterally by ribs.
The thorax
Spine should taper towards the sacrum.
T/F
True
Spine should have the double lined “Railway sign” appearance.
T/F
True
A renal pelvis that measures >10 mm beyond 20 weeks is normal
T/F
False
It is ABNORMAL
Adrenal glands are most frequently seen in transverse as early as _____weeks?
20 weeks
When imaging the fetal profile what are we looking for?
Frontal Bossing (protruding forehead) and Micrognathia (undersized jaw) and to r/o clefting
The BPD is aquired at the widest transverse diameter and has the landmarks of thalmus, CSP, and midline echo complex
T/F
True
Fetal Head Survey
How should the contour be?
round or oval w/ smooth surface
Fetal Head Survey
Transverse plane. What are your images?
1) IHF or falx cerebri observed
2) 2 paried ventricles, midline 3rd and 4th
3) choroid plexus
4) Cavum septum pellucidi
5) Thalmus
6) Posterior fossa
