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OB Gyn class 2 > chapter 62 reverse > Flashcards

chapter 62 reverse Flashcards

1
Q

bile formation by hepatic cells begin when

A

12 wks

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2
Q

the midgut is suspended by

A

elongated dorsal mesentery

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3
Q

The Hindgut is supplied by

A

inferior mesenteric artery

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4
Q

Stomach should be seen by

A

14 to 16 weeks

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5
Q

Echogenic debris may sometimes be seen along dependent wall of stomach

A

Vernix

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6
Q

If stomach seen in right upper quadrant, condition is called

A

situs inversus

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7
Q

If fetus is in vertex presentation with spine up, both aorta and stomach should be seen to left of spine

A

Stomach

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8
Q

can be visualized in thorax during second and third trimesters as two or more parallel echogenic lines (“multilayered” pattern)

A

Normal esophagus

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9
Q

Measured at level of portal sinus and umbilical portion of left portal vein (“hockey stick” appearance on sonogram)

A

Abdominal Circumference

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10
Q

Abdominal circumference should be round, not oval.

A

Abdominal Circumference

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11
Q

Joins umbilical portion of left portal vein at caudal margin of left intersegmental fissure of liver

A

Umbilical Cord Insertion

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12
Q

Visualization of insertion site must be made to rule out presence of omphalocele, gastroschisis, hernia, and mass formation.

A

Umbilical Cord Insertion

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13
Q

Movement of gastric musculature begins in

A

approximately fourth to fifth month of gestation

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14
Q

After 15th to 16th week, meconium begins to accumulate in distal part of small intestine

A

Bowel

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15
Q

Appears as ill-defined area of increased echogenicity in mid to lower abdomen

A

Bowel

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16
Q

Hyperechoic appearance could be secondary to reflections from walls of collapsed loops of small bowel or from mesenteric fat between loops

A

Bowel

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17
Q

As pregnancy progresses: Hyperechoic area becomes less prominent Small bowel located more centrally in abdomen than colon

A

Bowel

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18
Q

Normal diameter of small bowel lumen ≤5 mm, with length of 15 mm near term

A

bowel

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19
Q

Haustral folds of colon help to differentiate it from small bowel

A

Bowel

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20
Q

In early gestation, haustral folds appear as thin linear echoes within lumen of colon Later, colon diameter increases and folds become longer and thicker

A

Bowel

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21
Q

Colon seen near end of second trimester as long tubular hypoechoic structure with well-defined walls

A

Bowel

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22
Q

Normal measurements of colon diameter range from 3 to 5 mm at 20 weeks to 23 mm or larger at term

A

Bowel

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23
Q

does not have peristalsis like small bowel

A

Colon

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24
Q

more peripheral than small bowel

A

Colon

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25
Q

After 14 weeks of gestation, lipid absorbed from fetal colon and remaining contents collect in colon as meconium

A

Bowel

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26
Q

hypoechoic relative to fetal liver and in comparison with bowel wall

A

Meconium within lumen of colon

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27
Q

Accounts for 10% of total weight of fetus at 11 weeks and 5% of total weight at term

A

Liver

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28
Q

Left lobe of liver larger than right in utero secondary to greater supply of oxygenated blood Reverses after birth

A

Liver

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29
Q

Distinguished by location to right of portal-umbilical vein and as oblong, more oval structure than “tubular” intrahepatic umbilical vein

A

Gallbladder

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30
Q

Lies in the retroperitoneal cavity anterior to the superior mesenteric vessels, aorta, and inferior vena cava (IVC)

A

Pancreas

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31
Q

Normal fetal pancreas has been seen in utero but is more difficult to routinely visualize because of the lack of fatty tissue within the gland

A

Pancreas

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32
Q

Homogeneous in texture Similar in echogenicity to kidney Slightly less echogenic than liver Increases in size during gestation Imaged on transverse plane posterior and to left of fetal stomach

A

Spleen

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33
Q

Is involved in several congenital anomalies but rarely affected by isolated hepatic lesions

A

Abnormalities of the Hepatobiliary System

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34
Q

Liver parenchymal cysts and hemangiomas of liver have been reported. Enlarges in fetuses with Rh-immune disease in response to increased hematopoiesis

A

Abnormalities of the Hepatobiliary System

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35
Q

Liver tumors, hamartoma, hepatoblastoma uncommon but may be seen

A

Liver

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36
Q

Hemangioendothelioma Most common symptomatic, vascular hepatic tumor of infancy (although rare) May cause nonimmune hydrops in fetus

A

Liver

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37
Q

Sonographic Findings of the liver

A

Most liver tumors appear as hypoechoic solid masses; cystic components have also been reported as mixed with solid masses

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38
Q

Partial situs divided into asplenia and polysplenia

A

Situs Inversus

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39
Q

Choledochal cyst (dilation of CBD) may be diagnosed when

A

cystic mass identified adjacent to fetal stomach and gallbladder

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40
Q

Agenesis of gallbladder occurs in approximately

A

20% of patients with biliary atresia

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41
Q

Absence of gallbladder can occur in association with

A

polysplenia and rare multiple anomaly syndromes

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42
Q

Combination of polyhydramnios and absent stomach over repeated studies may be suggestive of

A

esophageal atresia

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43
Q

In >50% of cases, stomach present because fistula usually present that leads to fluid filling stomach

A

Esophageal Atresia

44
Q

About 30% of fetuses with duodenal atresia have

A

trisomy 21 (Down syndrome)

45
Q

Anomalies occur in approximately with duodenal atresia

A

50%

46
Q

Occurs in 1 in 3000 to 5000 live births; thought to be secondary to vascular accident, volvulus or gastroschisis or be sporadic

A

Bowel Intestinal Obstructions

47
Q

Meconium begins to accumulate in the fetal bowel in the second trimester, at which time it can be seen sonographically as tiny echogenic reflections within the peristaltic small bowel.

A

Meconium Ileus

48
Q

True ascites in fetal abdomen always

A

abnormal

49
Q

Other conditions that may cause ascites to develop include bowel perforation or urinary ascites secondary to bladder rupture.

A

Ascites

50
Q

Pharynx Lower respiratory system Esophagus Stomach Part of the duodenum Liver and biliary apparatus Pancreas

A

foregut

51
Q

Results from abnormal deviation of tracheoesophageal septum in posterior direction

A

Esophageal atresia

52
Q

Appears as fusiform dilation of caudal part of foregut During fifth and sixth weeks, dorsal border (greater curvature) grows faster than ventral border (lesser curvature)

A

Stomach

53
Q

Develops from caudal part of foregut and cranial part of midgut Comes to lie primarily in retroperitoneum

A

Duodenum

54
Q

Liver, gallbladder, biliary ducts arise as bud from most caudal part of foregut in fourth week

A

Liver and Biliary System

55
Q

(blood formation) begins during sixth week

A

Hemopoiesis

56
Q

Blockage of bile ducts results from failure to recanalize following solid stage of development

A

Extrahepatic biliary atresia

57
Q

Develops from dorsal and ventral pancreatic buds of endodermal cells that arise from caudal part of foregut

A

Pancreas

58
Q

Lymphatic organ derived from mass of mesenchymal cells located between layers of dorsal mesogastrium

A

Spleen

59
Q

Small intestines Cecum and cloaca exstrophy Ascending colon Most of transverse colon

A

The Midgut

60
Q

All structures supplied by superior mesenteric artery

A

The Midgut

61
Q

Usually by 10th or 11th week, midgut herniation returns to abdomen

A

The Midgut

62
Q

Is usually located to right of umbilical cord

A

Gastroschisis

63
Q

Forms when: Intestines return normally to abdominal cavity Herniate either prenatally or postnatally through inadequately closed umbilicus

A

Umbilical Hernia

64
Q

Is the most common malformation of midgut Remnant of proximal part of yolk stalk that fails to degenerate and disappear during early fetal period

A

Meckel’s Diverticulum

65
Q

Derivatives of hindgut: Left part of transverse colon Descending colon Sigmoid colon Rectum Superior portion of anal canal Epithelium of urinary bladder Most of urethra

A

The Hindgut

66
Q

Central nervous system problem (swallowing disorders) Obstruction Oligohydramnios Atresia

A

if stomach is not seen RO

67
Q

Distinction of large bowel from small bowel possible after 20 menstrual weeks

A

Bowel

68
Q

After 27 weeks

A

peristalsis occurs

69
Q

Relatively large compared with other intraabdominal organs Occupies most of upper abdomen in fetus

A

Liver

70
Q

Hepatic veins and fissures formed by end of first trimester

A

Liver

71
Q

May be seen sonographically after 20 weeks of gestation

A

Gallbladder

72
Q

Normal fetal pancreas has been seen in utero but is more difficult to routinely visualize because of the lack of fatty tissue within the gland

A

Pancreas

73
Q

Is more severe disorder May develop in two different combinations of organ reversals Thoracic viscera usually reversed Abdominal viscera may or may not be reversed

A

Partial situs inversus

74
Q

At least two spleens present along greater curvature of stomach Heart block common in polysplenia syndrome

A

Polysplenia

75
Q

Cardiac malformations common (99%) in asplenia syndrome; are seen with less frequency in polysplenia syndrome (90%)

A

Situs Inversus

76
Q

Endocardial cushion defects Hypoplastic left heart Transposition of great vessels

A

Cardiac defects of situs inversus

77
Q

usually has normal outcome

A

total situs inversus

78
Q

extremely high; death occurs in 90% to 95% with asplenia syndrome and 80% with polysplenia syndrome

A

Mortality rate for partial situs inversus

79
Q

right-sided heart axis and aorta; transposition of liver, stomach, spleen; left-sided gallbladder)

A

Total situs inversus

80
Q

(right-sided stomach, left-sided liver); dextrocardia with normal stomach position (see previous section)

A

Partial situs inversus

81
Q

Genitourinary Gastrointestinal Liver Cardiac Infections Metabolic storage disorders Idiopathic

A

Causes of Ascites

82
Q

Cholelithiasis (gallstones)

A

identified in fetus when calcifications are found within gallbladder.

83
Q

Develop when portion of bowel grows and infarcts Occurs anywhere in gastrointestinal tract Polyhydramnios evident on ultrasound

A

Atresias

84
Q

back-up of amniotic fluid and hydramnios

A

Blockage results in

85
Q

Most common form occurs in conjunction with a fistula, communicating between trachea and esophagus (tracheoesophageal fistula). allows passage of amniotic fluid into stomach

A

Esophageal Atresia

86
Q

Gastric secretions may contribute to stomach fluid

A

Esophageal Atresia

87
Q

Hydramnios may exist from impaired reabsorption of swallowed fluid and be associated with esophageal atresia; usually does not develop until third trimester

A

Esophageal Atresia

88
Q

Growth restriction present in 40% of cases Chromosomal trisomies (18 and 21) reported Coexisting anomalies common in 50% to 70% of fetuses with esophageal atresia

A

Esophageal Atresia

89
Q

Blockage of duodenal lumen by membrane that prohibits passage of swallowed amniotic fluid

A

Duodenal Atresia

90
Q

Two echo-free communicating structures (stomach and duodenum) found in upper fetal abdomen Sonographic appearance termed “double bubble sign” Hydramnios almost always seen with duodenal atresias later in pregnancy

A

Duodenal Atresia Sonographic Findings

91
Q

Duodenal atresia Duodenal stenosis Annular pancreas Ladd’s bands Proximal jejunal atresia Malrotation Diaphragmatic hernia

A

Causes of Double Bubble

92
Q

Atresia or stenosis of jejunum or ileum, or both, and small bowel atresia slightly more common than duodenal atresia

A

Bowel Intestinal Obstructions

93
Q

(jejunoileal atresia or stenosis) appears as multiple cystic structures (more than two) proximal to site of atresia within fetal abdomen

A

Blockage of jejunum and ileal bowel segments

94
Q

General rule: The more distal the obstruction, the less severe the hydramnios, and the later it will develop.

A

Bowel Intestinal Obstructions

95
Q

Malrotation Atresias Volvulus Peritoneal bands Cystic fibrosis Dilated bowel loops isolated or associated with other anomalies, ascites, or meconium peritonitis

A

Causes of fetal small-bowel obstruction include:

96
Q

Intestinal obstructions appear as cystic bowel loops discontinuous with stomach Fetal intestinal obstruction should be suspected when clear cystic structures found in pelvis Vascular restriction may lead to obstruction secondary to gastroschisis

A

Sonographic Findings

97
Q

Is a small-bowel disorder marked by presence of thick meconium in distal ileum

A

Meconium Ileus

98
Q

10% to 15% of patients; is third most common form of neonatal bowel obstruction after atresia and malrotation

A

Earliest manifestation of cystic fibrosis occurring (%)

99
Q

The anal sphincter prevents the passage of meconium (meconium plug) into the amniotic fluid, unless the fetus is stressed or traumatized.

A

Meconium Ileus

100
Q

Ileum dilates because of impacted meconium (which appears echogenic) Increased production of mucus by GI organs and electrolyte imbalance explains overproduction of meconium (characteristic of cystic fibrosis)

A

Meconium Ileus Sonographic Findings

101
Q

Presents as complex disorder of bowel and genitourinary tract Imperforate anus is disorder that occurs when membrane covers anus, prohibiting expulsion of meconium

A

Anorectal Atresia

102
Q

Megacolon is congenital disorder in which there is abnormal innervation of large intestine

A

Hirschsprung’s Disease

103
Q

Condition that may arise when fetus has sterile chemical peritonitis secondary to in utero bowel perforation Hydramnios present in 65% of fetuses

A

Meconium Peritonitis

104
Q

Calcifications seen on peritoneal surfaces or in scrotum via processus vaginalis Ascitic fluid may be echogenic. Is unusual to see calcification in meconium ileus in fetus with cystic fibrosis

A

Sonographic FindingsMeconium Peritonitis

105
Q

Grade 1: Mildly echogenic and typically diffuse Grade 2: Moderately echogenic and typically focal Grade 3: Very echogenic; similar to that of bone structures

A

Hyperechoic Bowel

106
Q

poor in nonimmune hydrops

A

Prognosis is

OB Gyn class 2 (20 decks)

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