Fetal chest and cardiovascular system

Question 1

Single most important image

Answer 1

4 chamber view of heart

Question 2

____ of heart pointes 45 degree angle to left anterior chest wall and should occupy 13 of chest cavity (left atrium closest to spine)

Answer 2

Apex

Question 3

opens into left atrium and closes after birth

Answer 3

Flap of Forman

Question 4

_____ present in the right ventricle

Answer 4

Moderate bands

Question 5

is more apical then mitral valve (LT)

Answer 5

Tricuspid valve (between RT atria and ventricle

Question 6

RVOT (right ventricular outflow tract) - Rt ventricle

Answer 6

Pulmonary valve -> pulmonary artery divides into LT and RT pulmonary arteries —> lungs

Question 7

LVOT (left ventricular outflow tract) – Lt ventricle

Answer 7

Aortic valve —-> Aorta

Question 8

consists of descending AO and branches into

Answer 8

Aortic arch

• left subclavian
• left cca
• rt braciocephalic

Question 9

Blood returns TO heart from body (via SVC & IVC) into RT Atrium → RT Ventricle (via tricuspid valve); RVOT → Pulmonary Artery (via pulmonary valve) & divides into LT & RT sides (PA) & go to LUNGS for oxygenation. Pulmonary Veins leave LUNGS w/oxygenated blood & drain into the LT Atrium → LT Ventricle (via mitral valve); LVOT → Aorta (via Aortic valve)

Answer 9

Normal flow of heart

Question 10

1. Oxygenated blood enters fetus via UMBILICAL VEIN
2. Ductus venosus shunts 80% of oxygen rich blood to the RT ATRIUM bypassing liver
3. The foramen ovale shunts the blood from the RT ATRIUM directly into the LT ATRIUM
4. Ductus arteriosus allows oxygen rich blood from the pulmonary artery into the Aortic arch circulating throughout the fetus

Answer 10

Fetal circulation

Question 11

• MC cardiac anomaly caused by teratogen assoc. defects
• Incomplete closure between ventricles. (Septum)
• Sono: opening between ventricles on 4 CH w/ bidirectional flow

Answer 11

Ventricular septal defect (VSD)

Question 12

• An abnormal opening between the atria

* Difficult to diagnose sue to foramen ovale

Answer 12

Atrial Septal defect (ASD)

Question 13

• Aorta arises from RT ventricle and Pulmonary trunk arises from LT
• Outflows course parallel and do not cross

Answer 13

Transposition of the great arteries (TGA)

Question 14

single large vessel arises form the base of the heart

Answer 14

trunkus arteriosus

Question 15

• Both pulmonary artery and AO arise from Rt ventricle

* Assoc. w/ maternal diabetes & alcohol or other cardiac defects

Answer 15

Double outlet right ventricle

Question 16

consists of all 5 defects @ the same time

1. Ectopic cordis- the heart is outside the thoracic cavity
2. Omphalocele
3. Intra-cardiac Defects
4. Defect of sternum
5. Diaphragmatic Hernia

Answer 16

Pathology of Cantrell

Question 17

-4 anatomic abnormalities
MC cause of “BLUE BABY SYNDROME”
1. VSD
2. Overriding Aorta- connects both Rt and Lt ventricles
3. Pulmonary stenosis or atresia- narrowing of pulmonary vein @ RVOT
4. Right Ventricular Hypertrophy- more muscular & thick Rt ventricle

Answer 17

Tetralogy of Fallot

Question 18

MC intracadiac tumor (RSRE)

Answer 18

Rhabdomyoma

Question 19

inferior displacement of the tricepses valve therefor RT atrium id enlarged

Answer 19

Abstains Anomaly

Question 20

fetal heart rate >180

Answer 20

Tachycardia

Question 21

heart rate < 100 (can be related to increased intrauterine pressure)
below 8- bpm can be ass with fetal asphyxia

Answer 21

Bradycardia

Question 22

Congenital cystic adenomatoid malformation (CCAM)
• Replacement of normal lung parenchyma with abnormal tissue including visible cysts
• Typically unilateral & 3 types:
o Type I- Macrocystic, large cysts 2-10cm
o Type II- multiple cysts <2cm
o Type III- Microcystic appears as solid homogenous, echogenic lung mass
• Type I & II have better prognosis and can regress by 3rd trimester.
• Type III- can associated w/ hydrops fetalis & POLY

Answer 22

Pulmonary anomalies

Question 23

• The separation of a mass from pulmonary parenchyma from the normal lung, no communication w/ bronchial tree
• Mass has its own blood supply fed from a single vessel from the Aorta

Answer 23

Pulmonary sequestration