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DMS 400 OB/GYN > Class 19: Fetal Heart > Flashcards

Class 19: Fetal Heart Flashcards

1
Q

what is the great vessel on the right side of the heart?

A

pulmonary artery

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2
Q

what is the great vessel on the left side of the heart?

A

aorta

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3
Q

what is the AV valve on the right side of the heart?

A

tricuspid

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4
Q

what is the AV valve on the left side of the heart?

A

bicuspid/mitral

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5
Q

what is the semilunar valve on the right side of the heart?

A

pulmonary valve

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6
Q

what is the semilunar valve on the left side of the heart?

A

aortic valve

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7
Q

what does the aortic arch branch of to? (4)

A
  1. descending AO
  2. brachiocephalic artery
  3. LCCA
  4. LT subclavian artery
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8
Q

the ___ exchanges O2 & CO2 from fetal circulation to mom’s circulation

A

placenta

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9
Q

why does fetal circulation shunt most blood away from fetal lungs?

A

fetal lungs aren’t needed – blood is shunted to more important locations

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10
Q

at birth, circulation changes occur due to ___ changes

A

pressure changes

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11
Q

circulation of O2-rich blood in fetus (start from UV)

A

UV –> ductus venosus –> IVC –> RA –> foramen ovale –> LA –> LV –> AAO –> brain

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12
Q

circulation of O2-medium blood in fetus (start from UV)

A

UV –> LPV –> HVS –> IVC –> RA –> RV –> PA –> ductus arteriosus –> AO arch/prox DAO –> lower body & trunk

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13
Q

the ductus venosus shunts blood away from the ___ to the ___

A

liver to the IVC

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14
Q

the ductus venosus is regulated by a __

A

sphincter

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15
Q

the ductus arteriosus prevents what?

A

protects the lungs from circulatory overload

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16
Q

the ductus arteriosus allows the ___ to strengthen

A

right ventricle

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17
Q

after birth, the ductus venosus becomes the ___

A

ligamentum venosum (LV of liver)

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18
Q

after birth, the ductus arteriosus becomes the ___

A

ligamentum arteriosum (at pulmonary trunk)

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19
Q

after birth, the foramen ovale becomes the ___

A

fossa ovalis

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20
Q

after birth, the umbilical vein becomes the ___

A

ligamentum teres (LT)/round ligament

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21
Q

after birth, the umbilical arteries become the ___

A

umbilical ligaments

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22
Q

the 4 chamber view of the heart can be achieved 99% of the time at ___ weeks

A

20+ weeks

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23
Q

the 4 chamber view rules out about ___% of heart abnormalities

A

65%

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24
Q

what is the normal heart rate of the fetus?

A

~120-160 BPM

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25
Q

what is levocardia?

A

when the apex of the heart points to the left

26
Q

what is the normal angle of the fetal heart?

A

45 degrees

27
Q

which is bigger: left or right atrium?

A

they should be around the same size

28
Q

which is bigger: left or right ventricle?

A

RV is a little bigger

29
Q

why is the right ventricle slightly larger than the left?

A

the RV has a thick muscular mediator band

30
Q

which chamber of the heart is closest to the spine?

A

left atrium

31
Q

which chamber of the heart is closest to the anterior chest wall?

A

right ventricle

32
Q

the __ valve lies a bit inferior to the ___

A

tricuspid; mitral

33
Q

the 4C view assesses all of the following except:
- ventricle & atria size
- intact septums
- AV valve movement
- echogenic foci
- ductus arteriosus

A

ductus arteriosus; it assesses the foramen ovale

34
Q

what does the LVOT show?

A

the LV giving rise to the AAO

35
Q

what does the RVOT show?

A

the RV giving rise to the pulmonary artery

36
Q

how do the LVOT & RVOT look on US?

A

cross-perpendicular

37
Q

what is the most common form of congenital heart disease?

A

VSD – ventricular septal defect

38
Q

what does VSD do?

A

allows mixing of O2 rich & O2 poor blood

39
Q

why are atrial septal defects hard to diagnose in the fetus?

A

foramen ovale

40
Q

what is ventricular hypertrophy?

A

the enlargement of 1+ ventricles

41
Q

ventricular hypertrophy is associated with which 2 types of stenosis/obstructions?

A
  1. aortic valve stenosis
  2. pulmonary valve stenosis
42
Q

with hypoplastic heart syndrome, which ventricle is affected more often?

A

left ventricle

43
Q

what happens to the side of the heart affected by hypoplastic heart syndrome?

A

the entire side is smaller

44
Q

what is coarctation of the aorta?

A

narrowing of the aorta

45
Q

where are the 2 locations where coarctation of the aorta are most common?

A
  1. distal to left subclavian artery
  2. level of aortic valve
46
Q

to view coarctation of the AO, we want to use the 4 chamber view on US. T/F?

A

false – 5 chamber view

47
Q

what are the most common defects associated with turner’s syndrome?

A

coarctation of the aorta & VSD

48
Q

what is endocardial cushion defect another name for?

A

atrioventricular valve defects

49
Q

what are AV defects?

A

when the AV orifice fails to separate into tricuspid & bicuspid valves, leading to hypoplastic AV valves

50
Q

types of endocardial cushion defects?

A
  1. complete AV canal
  2. partial AV canal
51
Q

when using color doppler to evaluate AV defects, what does the sonographer commonly see?

A

the letter “H”

52
Q

which trisomy are endocardial cushion defects associated with?

A

trisomy 21

53
Q

what are the 4 characteristics of the tetralogy of fallot & how are they related to each other?

A

(1) VSD dt (2) overriding AO
(3) pulmonary stenosis –> RV works harder –> (4) RV hypertrophy

54
Q

what does an overriding aorta look like on US?

A

the letter “Y”

55
Q

to view an overriding AO, which U/S view does the sonographer want to use: 4C or 5C?

A

5 chamber view

56
Q

what is ebstein’s malformation?

A

1 or 2 of 3 leaflets of the tricuspid valve are displaced, leading to an incompetent tricuspid valve & malformation

57
Q

which atrium may be enlarged with ebstein’s anomaly

A

right atrium

58
Q

how does transposition of the great arteries look like on US?

A

when viewing RVOT, vessels (pulmonary artery & AAO) are parallel instead of perpendicular

59
Q

how do infants survive with transposition of the great arteries?

A

only if a shunt is placed between 2 sides of the heart

60
Q

what is truncus arteriosus?

A

when 1 large blood vessel comes out of the heart instead of 2 separate vessels (AO & PA)

DMS 400 OB/GYN (21 decks)

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