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MIDS 187 - OB2 + OB3 > Fetal Chest (lesson 10) > Flashcards

Fetal Chest (lesson 10) Flashcards

1
Q

In the bony thorax, clavicles ossify as early as… ?

A

8 wks

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2
Q

In the bony thorax, the scapulae ossify at… ?

A

10 wks

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3
Q

The sternum begins to ossify between weeks… ?

A

21 - 27 wks

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4
Q

When examining the posterior skin surface, you find a break in the skin surface - what is this associated with?

A

Myelomeningocele

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5
Q

The muscles of the chest wall are which echogenicity?

A

Hypoechoic

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6
Q

Diabetics mothers can cause their baby’s soft tissues to appear…

A

thick with generalized edema (swelling) due to the subcutaneous fat deposits

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7
Q

Thoracic Circumference may be taken to assess… and rule out…

A

Assessing gestational age or rule out pulmonary hypoplasia

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8
Q

Where is the Thoracic Circumference taken from?

A

True TRV, above the diaphragm at the level of the heart

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9
Q

Thoracic Circumference is measured how?

A

Outer to outer

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10
Q

If the fetal heart takes up more than 1/3 of the chest, what should be considered?

A

Pulmonary hypoplasia, or cardiomegaly

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11
Q

The lungs begin development in the embryo as a _______ extending from the ________ bud.

A

diverticulum
tracheal

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12
Q

The primary bronchial buds grow _________ into what will become the ________ cavity.

A

laterally
pleural

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13
Q

In the ______ week, those buds join with the primitive trachea to form the _______.

A

fifth
trachea

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14
Q

What happens during the pseudoglandular period?

A

The bronchi divide into secondary bronchi which forms the lobar, segmental, and intersegmental branches!

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15
Q

Respiration becomes possible at what week?

A

24th week

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16
Q

The terminal saccules make what possible?

A

Respiration

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17
Q

From 26 weeks to birth, what period is occuring?

A

The terminal saccular

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18
Q

What occurs during the terminal saccular period?

A

Continued development of the saccules and an increase of the lung’s ability to perform gas exchange

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19
Q

What period overlaps the terminal saccular period?

A

Alveolar period

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20
Q

When does the aleveolar period occur?

A

32 wks to birth

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21
Q

What can the echogenicity of the lungs be compared to?

A

That of the spleen or liver

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22
Q

Early in gestation, lung echogenicity is…

A

is equal to or slightly less than that of the liver

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23
Q

Can sonography assess lung maturity?

A

No

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24
Q

What is the best way to assess lung maturity?

A

Amniocentesis

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25
Q

How can you rule out pulmonary agenesis?

A

Colour Doppler!

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26
Q

What does imaging the diaphragm help differentiate?

A

Cystic intrathoracic masses of pulmonary origin from those that are intraabdominal origin

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27
Q

Where is the thymus located?

A

Posterior to the sternum at the level of the great vessels of the heart; anterior to the aorta and pulmonary artery

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28
Q

When is the thymus imaged?

A

When a large pleural effusion is present.

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29
Q

Assessing the fetal thymus may be useful when determining…

A

IUGR, chorioamnionitis

30
Q

The larynx is located in the fetal neck anterior to the trachea at the level of which cervical vertebrae?

A

Third to sixth

31
Q

When filled with fluid, what structures are best seen coronally?

A

Oropharynx and laryngeal

32
Q

A persistently fluid filled trachea can indicate…

A

Laryngeal atresia or stenosis

33
Q

Pleural effusion is associated with…

A

Hydrops, congenital cardiac anomalies, orchromosomal anomalies and polydatyly

34
Q

A small trace amount of fluid in the chest is normal. True or false.

A

False. NO FLUID IN THE CHEST IS OK

35
Q

What is CCAM?

A

Congenital Cystic Adenomatoid Malformation

36
Q

The most frequently identified mass in the fetal chest is…

A

CCAM

37
Q

How many types of CCAM are there?

A

3 types!

38
Q

Describe CCAM I

A

A single cyst or multiple large cysts measuring 2-10cm in diameter with trabeculated wall or smaller cystic outpouchings

39
Q

Describe CCAM II

A

A mass made of multiple, uniform-sized cysts, 0.5-2cm in diameter

40
Q

Describe CCAM III

A

Multiple microscopic cysts measuring between 0.5 - 5.0 mm, present numerous reflecting surfaces to the US beam. Small cysts cannot be resolved individually, appear as a single, solid, homogenously echogenic mass.

41
Q

Patients with CCAM may have associated…

A

renal, cardiac, or gastrointestinal malformations (common with CCAM II)

42
Q

CCAM types I and II have a better prognosis than CCAM III - true or false?

A

True

43
Q

Which CCAM is…

an echogenic mass containing small cysts?

A

CCAM II

44
Q

Which CCAM is…

a unilateral pulmonary mass with one or more large cysts?

A

CCAM I

45
Q

Which CCAM is…

Homogenous echogenic mass?

A

CCAM III

46
Q

The mass effect of CCAM can cause…

A

hydrops, pleural effusion, and inversion of the diaphragm

47
Q

How does Colour Doppler differentiate CCAM from Pulmonary Sequestration and Diaphragmatic Hernia?

A

CCAM has flow going into the mass from arterial supply via the pulmonary vessels

48
Q

What is pulmonary sequestration?

A

Is a solid, nonfuctioning mass of lung tissue contained within the pleural sac that lacks communication with the trachebronchial tree and has a systemic arterial blood supply.

49
Q

Pulmonary Sequestration is more common in males or females?

A

Males

50
Q

The extralobar type either above or below the diaphragm has its own…

A

Pleural sac and systemic venous drainage

51
Q

The lung mass of an intraloblar pulmonary sequestration is found where?

A

Inferior to the diaphragm

52
Q

Nuchal edema is associated with…

A

nonimmune fetal hydrops, fetal demise, and some skeletal dysplasias

53
Q

Fetal edema is typically limited to the…

A

Neck

54
Q

Fetal edema, while typically limited to the neck, can be associated with fetal hydrops and…

A

inreased thickness, forming a halo pattern around the neck, thorax, or abdomen

55
Q

Cystic hygromas is what?

A

Benign abnormalities of lymphatic origin

56
Q

What is one of the most common abnormalities to see in the first trimester?

A

Cystic hygromas

57
Q

What does cystic hygromas look like on US?

A

Lymphatic sacs dilate and appear unilocular or multiple locular cystic masses. Can also cause venous obstruction.

58
Q

What are the causes of Immune Fetal Hydrops?

A

Fetal anemia, and Rh incompatibility

59
Q

What are the causes of Nonimmune Fetal Hydrops?

A

Heart arrhythmias, intrauterine infection, chromosomal anomalies, masses causing venous obstruction, blood disorders, renal anomalies, maternal disease

60
Q

What are the sonographic findings of Nonimmune Fetal Hydrops?

A

Skin thickening, pleural and pericardial effusion, ascites, hepatomegaly, splenomegaly.

Placenta thickens to greater than 4cm due to fetal anemia.

Polyhydramnios is a warning sign.

61
Q

What is CDH?

A

Congenital Diaphragmatic Hernia.

A defect of the diaphragm that allows the contents of the abdomen to migrate into the thorax.

62
Q

The posterolateral hernitation through the foramen of Bochdalek is found on the right or left side?

A

On the left side

63
Q

CDH happens more commonly in females or males?

A

Males

64
Q

CDH occurs more commonly on the left or right side?

A

Left

65
Q

A posterior diaphragmatic defect will allow which organs to move into the chest?

A

The stomach, bowel, or other organs

66
Q

What can simulate CDH?

A

Cystic abnormalities

67
Q

A fetus with CDH has a larger or smaller than normal AC measurement?

A

smaller

68
Q

The heart and the mediastinum shift _____ from the side of herniation.

A

away

69
Q

When does surgery need to be completed by for CDH intervention?

A

24 wks

70
Q

What organ in the abdomen during CDH shows the highest survival rate?

A

The Liver!

MIDS 187 - OB2 + OB3 (8 decks)

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