Fetal Thorax

Question 1

4 important factors for lung development

Answer 1

1. Adequate chest space
2. Fetal breathing tones
3. Fluid in the lungs
4. Adequate AFI

Question 2

Average amniotic fluid amounts

Answer 2

5-25cm

Question 3

______ can cause pulmonary hyperplasia

Answer 3

Oligohydramnios

Question 4

Normal appearance of lungs

Answer 4

Bell shaped

Homogenous, slowly becoming more echogenic in later trimesters

Question 5

Some common thorax abnormalities

Answer 5

Pleural mass
Pleural effusion 
Diaphragmatic hernia 
Pulmonary hyperplasia
Cystic lung mass

Question 6

_____ and _____ commonly occur with lung masses

Answer 6

Fetal hydrops and cardiac arrhythmia are associated with lung masses

Question 7

Explain pleural effusion

Answer 7

Collection of fluid between the parietal and visceral pleura
Preventing expansion of lungs

Question 8

Pleural effusion is associated with

Answer 8

Fetal infection, CHF, Tri 21, Tri 18, Hydrops

Question 9

Pulmonary Hyperplasia

Answer 9

Where lungs fail to form completely or not at all

Question 10

Causes of pulmonary hyperplasia

Answer 10

Unilateral - usually just developmental
Bilateral -
Lack of AF, PROM, renal agenesis, PUV

Question 11

What does CAM stand for

Answer 11

Congenital cystic Adenomatoid Malformation

Question 12

Explain CAM

Answer 12

Lung is replaced with abnormal and cystic tissue caused by a genetic alteration
4 types

Question 13

Describe the 4 types of CAM

Answer 13

Type 1: one or more large cyst, 2-10cm
Type 2: many small cysts, less than 2cm (poor outcomes)
Type 3: bulky large non-cystic lesions, less than 5cm (hydrops)
Type 4: look for lateral displacement of the heart

Question 14

Most common lung cyst prenatally

Answer 14

Congenital Bronchogenic Cyst

Question 15

Explain congenital bronchgenic cysts

Answer 15

Most common to find in utero
No symptoms with no communication to the trachea
Unilocular/multilocular

Question 16

Explain Pulmonary Sequestration

Answer 16

Extra lobe of the lung with no communication to bronchial tree
Supplied by the aorta

Question 17

Pulmonary Sequestration is associated with

Answer 17

Fetal Hydrops

Question 18

2 locations for Pulmonary Sequestration to appear

Answer 18

Interlobar - within pleural sac

Extralobar - inferior to lung with its own separate covering

Question 19

CAM gets blood from ______

Pulmonary Sequestration gets blood from ______

Answer 19

CAM gets blood from the Pulmonary Arteries

Pulm Sequestration gets blood from the descending aorta

Question 20

Bronchial Atresia

Answer 20

Rare! Narrowing/absence of bronchial or laryngeal lumen
Most common in the lt upper lobe
Can accumulate lung secretions

Question 21

Congenital Diaphragmatic Hernia

Answer 21

Diaphragm fails to close, causing abd viscera to herniate

Lt side is most common

Question 22

2 most common locations for a diaphragmatic hernia to occur

Weird names

Answer 22

Foramen of Bochdalek - most common! Posterolateral lung

Foramen of Morgagni - rare! Herniation into anterior mediastinum

Question 23

Some signs of a diaphragmatic hernia

Answer 23

• Possible polyhydramnios
• Requires surgery after birth
• Displaced heart, bowel, spleen
• Small AC, CNS abnormalities