Fetal Thorax

Question 1

Congenital diaphragmatic hernia is caused by

Answer 1

Failure of pleuroperitoneal membrane

Question 2

What side do congenital diaphragmatic hernias usually occur?

Answer 2

Left

Question 3

Congenital diaphragmatic hernias may compress lungs and cause

Answer 3

Pulmonary ipsilateral hypoplasia and secondary respiratory distress

Question 4

Two forms of congenital diaphragmatic hernia

Answer 4

Bochdalek - in posterolateral aspect (most common)

Morgagni - anterior aspect, very rare

Question 5

Sono traits of congenital diaphragmatic hernias

Answer 5

Displaced heart (to right)
Cystic mass (stomach) in thorax 
Absence of intraabdominal stomach
Hypoechoic/cystic structures representing bowel in chest

Question 6

Fetal hydro thorax is

Answer 6

A pleural effusion

Question 7

Common associations with fetal hydro thorax

Answer 7

Hydrops fetalis 
Congestive heart failure 
Chromosomal abnormalities
Chylothorax (accumulation of lymph fluid)
Pulmonary hypoplasia

Question 8

Severe effusions may compress heart, displace lungs, and occupy the entire chest cavity.
T/F

Answer 8

False, compress lungs and displace heart

Question 9

Cystic adenomatoid malformation of the lung is a:

Answer 9

Benign lung tumor

Question 10

CAMs are usually unilateral, affecting the whole lung.

T/F

Answer 10

False, a single lob

Question 11

Classification of CAM

Answer 11

Type 1 - single/multiple large cysts measuring 2 cm or greater
Type 2 - multiple small cysts less than 1 cm in diameter
Type 3 - multiple tiny non visible cysts resulting in bulky and hyperechoic appearance, appears solid, displaces mediastinal structure

Question 12

CAMs often enlarge after the beginning of the third trimester, and rarely decrease in size.
T/F

Answer 12

False, rarely enlarge, often decrease

Question 13

Survival rate of CAM is good unless what is present?

Answer 13

Hydrops

Question 14

Bronchopulmonary sequestration is a lesion comprised of lung tissue that

Answer 14

Is separated from normal tracheobronchial tree

Question 15

Sono traits of bronchopulmonary sequestration

Answer 15

Echogenic mass at base of lung
May be triangular
Looks similar to CAM and Teratomas

Question 16

Pulmonary hypoplasia is caused by

Answer 16

Decrease in the number of lung cells, airways, and alveoli that causes decrease in organ size and weight

Question 17

Factors associated with abnormal lung growth

Answer 17

Phrenic nerve agenesis
Oligohydramnios 
Renal agenesis
Prolonged premature rupture of membranes
Skeletal dysplasia’s with small thorax
Congenital diaphragmatic hernia
Pleural effusion
CAM