Fetal Heart and Chest Flashcards
1
Q
The embryonic heart begins as :
A
two tubes
2
Q
The heart begins to contract at :
A
36-37 days of gestation
3
Q
The heart is initially recognized by its motion, which can be seen adjacent to the ___________, often before an embryo is distinguishable.
A
secondary yolk sac
4
Q
A HR should be sonographically obtainable with endovaginal imaging when the CRL measures ______ to _____ mm.
A
4-5
5
Q
During a BPP in the third trimester, an average fetal heart rate is _____ bpm, with a range of ____ to _____ bpm considered normal after the first trimester.
A
150
110-180
6
Q
The heart is fully formed by:
A
10 weeks
7
Q
The heart is most often imaged in a _____ or ____ view of the fetal chest, just above the fetal stomach.
A
cross-sectional or axial
8
Q
The _____ of the heart will be angled to the left of the midline, with the _____ closest to the spine.
A
apex
base
9
Q
the normal fetal heart will fill approximately _____ of the fetal chest.
A
1/3
10
Q
The apex of the fetal heart will form a _____ degree angle with the fetal spine.
A
45
11
Q
The chamber closest to the fetal spine is the :
A
left atrium
12
Q
The two atria are separated by the
A
atrial septum
13
Q
The two ventricles are separated by the:
A
ventricular septum
14
Q
The Ventricular septum should be ______ and of equal thickness to the left ventricular wall.
A
uninterrupted
15
Q
Atrial septum is open at the :
A
foramen ovale
16
Q
Within the right ventricle can be seen the _____ _____, a normal structure that appears as an echogenic focus.
A
moderator band
17
Q
Between the right ventricle and the right atrium, you should visualize:
A
tricuspid valve
18
Q
Between the left ventricle and left atrium you should visualize:
A
mitral valve
19
Q
Normally the tricuspid valve is positioned closer to the ______ _____ than the mitral valve.
A
cardiac apex
20
Q
The right ventricular outflow tract leads to the :
A
Pulmonary artery and branches
21
Q
The left ventricular outflow tract leads to the :
A
aorta
22
Q
An important anatomic finding is the normal pulmonary artery should be positioned _______ to the aorta and should be visualized crossing _____ it.
A
anterior
over
23
Q
The aorta and the pulmonary artery are normally ______ each other.
A
crisscross
24
Q
The normal umbilical cord contains:
A
2 arteries and 1 vein
25
The umbilical vein enters at the ______, bringing oxygen-rich blood from the ______ to the fetus.
umbilicus
| placenta
26
The umbilical vein travels _________ where it connects to the left portal vein.
superiorly
27
Through the umbilical vein half of the blood will go to the liver through the LPV, while the other half is shunted directly into the :
IVC via ductus venosus
28
The blood that was taken to the liver is used to oxygenate the liver and is then returned back to the IVC by the:
hepatic veins
29
The oxygen-rich blood in the IVC travels up to the heart and enters the :
right atrium
30
Blood can travel across the foramen ovale, into the________, or it can enter the right ventricle through the ________.
left atrium
| tricuspid valve
31
Blood leaves the right ventricle through the :
Main pulmonary artery
32
Blood from the right ventricle can also flow through the ______ ______ and into the descending aorta.
ductus arteriosus
33
Blood returning from the lungs through the pulmonary veins enters into the ________.
left atrium
34
Once the blood returns from the lungs through the pulmonary veins and enters the left atrium, it then travels from the left atrium into the left ventricle via the :
mitral valve
35
From the left ventricle, blood travels to the ascending aorta and into the aortic arch, where it exits into the _______, _______, ________ on its way to the thorax, upper extremities, and head.
brachiocephalic artery, LCCA, and Left subclavian artery
36
The blood will return from the head and upper torso via the ________ to the right atrium.
superior vena cava
37
The umbilical arteries return the deoxygenated blood from the fetus back to the :
placenta
38
Small or absent left ventricle:
hypoplastic left heart sydrome
39
Hypoplastic left heart syndrome is the leading cause of cardiac death in the ______ period.
neonatal
40
To distinguish hypoplastic left heart syndrome, from the complete absence of the left side of the heart, a ______________ must be visualized
small or normal left atrium
41
When hypoplastic left heart syndrome is found in females, ______ should be suspected.
turner syndrome
| There is also a connection with trisomy 18
42
Hypoplastic right heart syndrome is sonographically identified as :
a small or absent right ventricle
43
hypoplastic heart syndrome most often results from :
pulmonary stenosis
| pulmonary atresia but may result from stenosis or atresia of the tricuspid valve
44
Abnormal opening in the septum between the two ventricles of the heart:
Ventricular septal defect
45
The most common form of cardiac defect
VSD
46
An abnormal opening in the septum between the two atria of the heart:
atrial septal defect
47
The combination of both atrial and ventricular septal defects is termed :
atrioventricular defect or atrioventricular canals (AVSD)
48
AVSD results from the abnormal development of :
the central portion of the heart
49
The central portion of the heart is referred to as the
Endocardial cushion
50
AVSDs are commonly associated with:
aneuploidy, trisomy 21, and trisomy 18
51
Malformation or malpositioning of the tricuspid valve results in:
Ebstein anomaly
52
With ebstein anomaly The right ventricle is:
contiguous with the right atrium, referred to as atrialized right ventricle
53
Ebstein anomaly is associated with:
tricuspid regurgitation, atrial septal defects, tetralogy of Fallot, transposition of the great vessels, and coarctation of the aorta
54
Is the narrowing of the aortic arch:
coarctation of the aorta
55
The most common location for coarctation of the aorta is:
between the left subclavian artery and the ductus arteriosis
56
The tetralogy of Fallot is defined as:
an overriding aortic root, subaortic ventricular septal defect, pulmonary stenosis, right ventricular hypertrophy
57
With_______________, the outflow tracts are reversed.
transposition of the great vessels
58
The pulmonary artery will abnormally arise from the ________ with transposition of the great vessels.
left ventricle
59
The aorta will abnormally arise from the ________ with transposition of the great vessels.
right ventricle
60
With the transposition of the great vessels the orientation of the outflow tracts will be positioned:
parallel to each other, with the aorta noted anterior and to the right of the pulmonary artery
61
An echogenic intracardiac focus (EIF) is most often seen within the :
the left ventricle of the heart
62
An EIF is thought to represent the calcification of:
papillary muscle or chordae tendineae
63
There have been studies that have linked the incidence of an EIF with:
trisomy 21, particularly if there is more than one EIF detected
64
The echogenicity of the EIF is comparable to that of the:
fetal bone
65
The most common fetal cardiac tumor is the :
rhabdomyoma
66
Rhabdomyomas are located within the:
myocardium of the heart
67
Rhabdomyomas have an association with :
tuberous sclerosis, eventual cardiac failure, and subsequent development of fetal hydrops
68
Rhabdomyoma typically appears:
echogenic and may be isolated or multiple
69
Fluid located around the heart:
pericardial effusion
70
Pericardial effusion can be isolated or associated with:
fetal hydrops
71
The normal _______ appearance of the myocardium can mimic the sonographic appearance of small pericardial effusions.
hypoechoic
72
When the heart is located either partially or co mpletely outside of the chest it is termed:
ectopic cordis
73
_________________ is a group of anomalies that combines ectopic cordis and an existing omphalocele.
Pentalogy of cantrell
74
Functional fetal lung tissue does not typically exist until :
after 25 weeks
75
Fetal lung maturity can be assessed using the:
lecithin to sphingomyelin ratio
| L/S ratio
76
As the lungs mature, the level of lecithin ________, while the level of sphingomyelin ________.
increases, decreases
77
__________ is performed for the lecithin to sphingomyelin ratio, and the lab findings indicate the levels of lecithin and sphingomyelin.
amniocentesis
78
Pulmonary hypoplasia, or underdevelopment of the lungs, is caused by:
decrease number of lung cells, airways, and alveoli
79
The most common lesion that occupies the chest, resulting in pulmonary hypoplasia, is:
diaphragmatic hernia
80
A fetus surrounded by little or no amniotic fluid is at increased risk for:
pulmonary hypoplasia
81
Pulmonary hypoplasia is a common finding with:
oligohydramnios
82
Pulmonary hypoplasia with oligohydramnios is also associated with bilateral renal agenesis and the abnormal facial features in the condition known as:
Potter's Syndrome
83
Fluid surrounding the lungs is referred to as a :
pleural effusion or hydrothorax
84
Pleural effusions that occur in utero may spontaneously resolve or be found in the presence of :
fetal hydrops, other chest abnormalities, and turner syndrome
85
A pleural effusion will appear sonographically as:
anechoic fluid within the chest surrounding the fetal lung
86
___________ sign has been used to describe the appearance of pleural effusions.
bat wing
87
Fetal pleural effusions can be treated with an:
ultrasound-guided thoracentesis
88
Mass that consists of abnormal bronchial and lung tissue:
CCAM - cystic adenomatoid malformation aka congenital cystic adenomatoid malformation.
89
There are ____ forms of CAM
3
90
The sonographic appearance of CAM most often appears as a mass that has:
Both cystic and solid compnents
91
Type III CCAM may appear similar to :
pulmonary sequestration, as it is echogenic in form
92
Most CAMs are ______ and may resolve spontaneously, although large masses can lead to fetal hydrops.
unilateral
93
A separate mass of non-functioning lung tissue with its own blood supply:
pulmonary sequestration, or bronchopulmonary sequestration
94
The most common sonographic appearance of pulmonary sequestration is:
echogenic, triangular-shaped mass within the left side of the fetal chest
95
Most common reason for fetal cardiac malposition is the existence of:
diaphragmatic hernia
96
Diaphragmatic hernia results in an abnormal opening in the fetal diaphragm that allows the herniation of:
abdominal contents into the chest cavity
97
The most common location for a diaphragmatic hernia is:
on the left side
98
Diaphragmatic hernia on the left side may also be referred to as:
bochdalek hernia
99
The foramen of bochdalek is located in the left ______ portion of the diaphragm
posterolateral
100
In most cases of a bochdalek hernia ______, _______, and ______ are found within the chest.
stomach, bowel, and the left love of the liver
101
The foramen of Morgagni, is located ______ ________ within the diaphragm.
right anteromedially
102
Differential diagnosis of diaphragmatic hernia, which is a lack of muscle in the dome of the diaphragm:
eventration of the diaphragm
103
The thymus gland is located:
anterior to the mediastimum
104
The fetal thymus is a part of the ________ , it provides a place for the maturation of T cells, which are specialized white blood cells.
immune system
105
Sonographically, the thymus appears as a :
hypoechoic structure located in the anterior chest at the level of the sternum between the lungs
106
_____________ _________ is a genetic disorder characterized by an absent or hypoplastic thymus, which lead to impairment of the immune system.
DiGeorge syndrome
