final Flashcards
What are the small vessels found on the periphery of the uterus?
arcuate vessels
Endovaginal length and anteverted uterus: tell where the cervix and fundus of uterus are located.
cervix is seen on rt side of screen
fundus on the lt side
Nabothian cysts, where are they located?
cervix (on cervix or near endocervical canal)
Complications in delivery can occur if there is a fibroid located where?
near or over cervix
An acquired condition with obstruction of the cervical canal?
cervical stenosed
(hydrometracolpus-fluid filled, hematometracolpus-blood filled, pyometracolpus-pus filled)
Know about adenomyosis
benign growth of the endometrium that may cause heavy, painful menstrual bleeding
ectopic tissue of adenomyosis arises from stratum besalis of the endometrium and causes heavy, painful periods
endometrial tissue within myometrium
Know how the measurement of the endometrium should be done and what time it should be measured?
should be measured in long plane
hyperechoic to hyperechoic
What is a Gardner’s duct cyst?
cyst found in vagina
Most common adnexal mass during a pregnancy
corpus luteum cyst
Tumor with a history of endometriosis
endometrioma
Know the normal ovarian texture
homogeneous echotexture
may exhibit a central, more echogenic medulla
What’s the most common benign tumor of the ovary?
dermoid
Partial or complete rotation of the ovary leads to what?
torsion
What is PID?
Pelvic Inflammatory Disease
risk factors: early sexual contact, multiple sexual partners, history of sexually transmitted disease, previous history of PID, use of ICUD, douching
What’s an infection of the fallopian tube?
salpingitis
Most common uterine anomaly associated with infertility
sepate uterus, T-shaped
PCOS: Know all about it
endocrine disorder associated with chronic anovulation
includes Stein-Leventhal(infertility, oligomenorrhea, hirsutism, obesity)
Progesterone, after ovulation, is secreted by what structure?
corpus luteum cyst
Caudal regression syndrome: seen most commonly in patients with what disorder?
diabetes
The development of conjoined twins: when will it take place?
if division occurs after 13 days
Seizures and coma in the 3rd trimester, what is this?
eclampsia
When fetal death occurs and the baby has not been reabsorbed, what is this called?
papyrcus
Pregnant with increase in hypertension, proteinuria, and edema. What is this?
pre-eclampsia
A condition in which ascites is present in the fetal abdomen
non-immune hydrops
What findings confirm the pressence of a diamniotic preg?
two amniotic sacs
(membrane that separates the fetuses)
Overlapping of the skull bones
spalding sign
In an Rh sensitized patient, what are the sonographic findings of fetal hydrops?
scalp edema, pleural effusion, pericardial effusion, ascites, polyhydramnios, and thickened placenta
Uterine contractions resolve typically in what time period?
20-30min
What is caudal regression syndrome?
lack of development of the caudal spine and cord
Premature labor, how many weeks is that?
before 37 weeks
Mono chorionic twin preg. If one develops without a head, what is it called?
acardiac anomaly
What’s another name for poly-oli?
stuck twin syndrome
A di-di preg, what will you see?
two amnions
two chorions
(each will have their own placenta, chorion, and sac)
Know twin to twin transfusion
exists when there is an arteriovenous shunt within the placenta
arterial blood of one twin is pumped into the venous system of the other
one twin has less blood flow (develops oligo)
one twin has more blood flow (develops poly)
Amniocentesis: what is it used for?
first used to relieve polyhydramnios, to predict Rh isoimmunization, and document fetal lung maturity
Reasons to perform an amnio (why do we do them?)
offered to patients who are at risk for chromosomal abnormalities or biochemical disorders
performed to determine karyotype, lung maturity, and Rh condition
Sonographic findings that may suggest a chromosomal anomaly
Nuchal thickness, shortened femurs, echogenic bowel, heart defects, duodenal atresia, talipes, omphalocele, clenched hands, holoprosencephaly, cleft lip and palate, renal anomalies, polydactyly, cranial defects, facial defects, hydrops, cystic hygroma
Where is AFP found in the fetus?
produced by yolk sac in early gest and later by the fetal liver
found in fetal spine, gastrointestinal tract, liver, kidneys
What does the quad screen evaluate?
AFP, human chorionic gonadotropin (hCG), and unconjugated estriol
Early noninvassive means of assessing aneuploidy?
NT test
What is the condition of increased nuchal thickening shortened femurs, cardiac anomaly, and fluid in the kidneys?
Trisomy 21 (Down’s syndrome)
Cranial anomalies, choroid plexus cyst, facial anomalies, and rocker bottom feet
Trisomy 18 (Edward’s syndrome)
What disorder has holoprosencephaly and a proboscus?
Trisomy 13
Large cystic hygroma, hydrops, and coarctation of the aorta
Turner’s syndrome
Most common aneuploidy condition
Trisomy 21 (Down’s syndrome)
Amniotic fluid AFP, what does it do with fetal age?
decreases
Post amniocentesis: the sonographer demonstrates what?
fetal cardiac activity
4D ultrasound, what is it?
also known as active matrix arrays
3D real time ultrasound
Advantages of 3D ultrasound
Easier to demonstrate a fetal anomaly to the parents
Excellent diagnostic tool for evaluation of fetal anomalies throughout the pregnancy
Surgeons are requesting 3D/4D ultrasound to aid in the localization of a mass before surgery
If you see a single umbilical artery, what should you look for?
genitourinary defect
Most common cord entanglement
nuchal cord
What is it when the cord is over the fetal haed and shoulder?
true knot
Cord insertsinto the membranes before it inserts into the placenta, what is this known as?
velamentous (membranous)
What leads to inadequate fetal descent?
short cord
4D: x-ray mode and volume rendering
x-ray mode(transparent mode)- best for viewing a relatively low-contrast block of soft tissue, not very useful with obstetric imaging
method is an extension of the planar reconstruction method, because the additional image processing techniques are applied to a region of interest within the 3D volume data set
What is ductus venosus and ductus arteriosis?
connects umbilical vein to the IVC and allows oxygenated blood to bypass the liver and return directly to the heart (collapses and becomes ligamentum venosum after birth)
communicating structure that carries oxygenated blood from the pulmonary artery to the descending aorta, closes after birth
What forms the umbilical cord?
fusion of the omphalomesenteric (yolk stalk) and allantois ducts, during first 5 wks
What’s the length of the umbilical cord?
short cord= less than 35cm
long cord= greater than 80cm
normal= 40cm to 60cm
What is a cystic mass in the umbilical cord?
omphalomesenteric or allantoic in origin
Prolapse cord
cord lies below the presenting part
Acrania and anencephaly: what makes them different?
acrania- absence of skull
anencephaly- absence of skull and brain
How do sonographers typically evaluate AF?
eyeball assessment
Most common neck mass of a fetus
cystic hygroma colli
Anomaly where a proboscis is present
holoprosencephaly
cleft lips and palate
most common malformation of the face
most often seen in groups with: trisomies 13, 18, 21
triploidy
translocations
Spina bifida: scanning parameters-what’s the best view?
coronal
Meckel-Gruber Syndrome
commonly associated with cephaloceles anr encephalocele, polydactyly, polycystic kidneys
Arnold-Chiari malformation
demonstrates a banana shaped cerebellum and scalloping frontal bones producing a lemon shaped head
Ventriculomegaly
considered dilated when diameter is greater than 10mm
teratoma may cause dilation
common causes: spina bifida and encephaloceles
abnormalities linked with: aqueductal stenosis, arachnoid cysts, and vein of Galen aneurysms
Hydrocephalus
Associated with: ventriculomegaly, Dandy-Walker malformation, agenesis of the corpus callosum, lissencephaly, schizencephaly, holoprosencephaly
Encephalocele
herniation of the meninges and brain through the defect
Fetal viability: what’s the most important piece of info?
pulmonary development
Chest: normal fetal thorax (all it should include)
cardiac rates
thoracic cavity-symmetrically bell shaped: with the ribs forming the lateral margins, clavicles forming the upper margins, and the diaphragm forming the lower margins, lungs serve as the lateral borders for the heart and lie superior to the diaphragm
normal: 120-160bpm
bradycardia: <90bpm
tachycardia: > 170bpm
CCAM: Congenital Cystic Adenomatoid Malformation
Type I (macrocystic)- single or multiple large cysts 2cm in diameter, good pronosis after resection of affected lung
Type II (macrocystic w/microcystic component)- multiple small cysts <1cm in diameter, echogenic; high incident of other congenital anomalies (renal, gastrointestinal)
Type III (microcystic)- large, bulky, non cystic lesions producing mediastinal shift, poor prognosis
Most common lung cysts
bronchogenic cysts
Texture of the lungs- what should they look like?
homogeneous with moderate echogenicity
Diaphragmatic hernias
allows the abdominal organs to enter the fetal chest
opening in the pleuroperitoneal membrane primitive diaphragm is intact by end of 8th gest wk
most common type occurs posteriorly and laterally in the diaphragm over 90% (herniation through the foramen of Bachdalek)
Amnion rupture: what does it lead to?
amniotic band syndrome
Limb-body wall complex
more common on left side
anomally with large cranial, facial, and body wall defects
occurs with the fusion of the amnion and chorion, amnion does not cover the umbilical cord normally, but extends as a sheet from the margin of the cord and is continuous with both the body wall and the placenta
omphalocele
evisceration of bowel or a combo of liver and bowel into the base of the umbilical cord
bowel omphaloceles appear as echogenic and must be distinguished from an umbilical hernia
membrane composed of peritoneum and amnion forms the omphalocele sac encasing the herniated organs
gastroschisis
consequence of atrophy of the rt umbilical vein, or a disruption of the omphalomesenteric artery
visceration of bowel to the right of the umbilical cord
defects are small: 2-4mm
located next to normal cord insert
umbilical hernia
omphalocele with normal cord insertion
covered by skin and fat
Abdominal wall-development of area
intestines return to the abdominal cavity by the 12th wk of gest
most common defects: omphalocele and gastroschisis
Situs Inversus and partial situs inversus
full- right side heart axis and aorta
transposition of liver, stomach, and spleen; left side gb
partial- thoracic viscera are usually reversed
abdominal viscera may ar may not be reversed
Haustral folds- where do we find them?
colon
What other anomalies may be seen with esophageal atresia?
most common- anorectal atresia
others- vertebral defects, heart defects, renal and limb anomalies (VACTERL)
What are the 5 types of conjoined twins?
thoracopagus- joined at thorax
omphalopagus- joined at the anterior wall
craniopagus- joined at the cranium (syncephalus-conjoined twins with one head)
pygopagus- joined at ischial region
ischiopagus- attached at the buttocks
Know about the bladder
dilated bladder with keyhole appearance-posterior urethral valve obstruction
extrophy of bladder- males, 1/50,000 births; protrusion of the posterior wall of the bladder which contains the trigone and ureteric orifices; caused by the defective closure of the inferior part of abdominal wall during 4th wk gest
Fetus has both ovarian and testicular tissue, what is it?
hermaphroditism
Findings when there is renal agenesis
oligohydramnios
absence of fetal bladder
small thorax
Potter’s Syndrome
renal agenesis, oligohydramnios, pulmonary hyperplasia, abnormal facies, and malformed hands and feet
multicystic dysplastic kidney
multiple noncommunicating cysts of variable sizes
Normal AP diameter of the renal pelvis should not exceed what at 20wks?
4mm
Cystic dilatation of the ureter
ureterocele
Normal amniotic fluid and renal agenesis
14-16wks
Infantile polycystic kidney disease
enlarged fetal kidneys, echogenic, bilateral
Terms for bone length
rhizomelia-shortened prox extremities
mesomelia-shortened middle extremities
micromelia-all extremities are shortened
sirenomelia-fusion of lower extremities
phocomelia-hands or feet connected to long bones (no middle bones)
amelia-absence of one or more extremities
achieropodia-symmetric absence of the hands and feet
Ellis-Van Creveld syndrome
associated with the amish community
known as chondoectodermal dysplasia
limb shortening, polydactyly, heart defects (50%), narrow thorax, death up to 50%
survivors- short, normal intellect
Thanatorphoric Dysplasia
cloverleaf skull, extreme micromelia, short ribs
most common nonlethal skeletal abnormality
achondroplasia
most common lethal skeletal abnormality
thanatorphoric dysplasia
Robert’s syndrome
rare condition characterized by phocomelia and facial anomalies
Jeune’s syndrome
small thorax, rhizomelia, renal dysplasia, and polydactyly
short rib polydactyly
lethal skeletal dysplasia characterized by short ribs, short limbs, and polydactyly
Abnormal displacement of the septal lead of the tricuspid valve
ebsteins
most common form of cyanotic heart disease in infants and children
Tetralogy of Fallout
clinodactyly
overlapping of digits
VACTERL Association
Associated with anorectal atresia
grouping of complex anomalies
Vertebral defects-Anal atresia-Cardiac anomalies-Transesophageal fistula-Renal anomalies-Limb displaysia
Lethal multiple pterygium
webbing across joint in multiple contrapers
Pena shokeir syndrome
same as US characteristics of trisomy 18
Lena Saldino syndrome (achondrogenesis type II)
less severe, more common, spontaneous mutation
Arthrovrtosis multiplex congenita
Omphalocele vs gastroschisis
membrane, card goes through defect, high percentage of chromosomal anomalies
no membrane, cord is to the left (defect is to the right)
