Lesson 19A: Fetal Abdomen Flashcards
Fetal abdominal organs attain their normal adult position and structure early in the _________ _________.
Second Trimester
This organ is seen less often in the fetal abdomen
Pancreas
When fetus is in cephalic presentation, the spine, stomach, and umbilical vein should be in a __________ manner. While breeched, should be in a ___________ manner.
Clockwise
Counterclockwise
What echogenicity is the skin around the abdomen?
Echogenic/Hyperechoic
What causes pseudoascites?
Hypoechoic muscles of the fetal abdomen
What vessels carry most of the aortic blood to the placenta?
Two umbilical arteries
The two umbilical arteries insert on the _______ wall cord insertion site and can be followed caudally down to the _______ iliac arteries, which are __________ to the bladder.
anterior
internal
lateral
The embyonic foregut develops into the ________, ________, __________, and __________.
Liver
Gallbladder
Ducts
Pancreas
The Liver, gallbladder, ducts, and pancreas develop from the _______ _________.
Embryonic Foregut
An outgrowth of the caudal portion of the forgut develops in the ______ week.
Fourth (4th)
The liver undergoes rapid growth in week _____ to ______ - occupying most of the abdominal cavity.
5th to 10th
The second-trimester liver makes up ____% of the fetal weight, decreasing by ___% by term.
10%
5%
Hematopoiesis causes the liver to have its bright red appearance in week ______.
Six (6)
What does hematopoiesis do to the liver?
Gives it the bright red appearance
Bile secretion begins in week ______.
Twelve (12)
This organ is teardrop shaped, off midline position, extrahepatic and posteroinferior.
Gallbladder
Unlike the umbilical vein, the gallbladder does not reach the _______ abdominal wall.
Anterior
The pancreas and spleen appear ________ to their surrounding structures.
isoechoic
These two structures can sometimes help to identify the pancreas
1) Stomach (fluid filled)
2) Splenic Vein
The fetal pancreas is slightly ________ in echogenicity than the liver.
Greater
The spleen is slightly _______ in echogenicity compared to the lvier.
Lesser
What do you do if you don’t see the stomach during an exam?
Wait a while, try again at end of the exam, take a representative image, schedule for follow up.
What causes echogenic material in the fetal stomach?
Blood or vernix
The small bowel appears as ________ before it is filled with fluid.
Heterogenous
Small bowel appears as ______ echogenic than the liver, but ______ echogenic than bones.
More
Less
In the third trimester, bowel becomes ________ echogenic and more sharply defined.
Less
This can be seen in the small bowel
Peristalsis
As gestational age increases, diameter of small bowel _______.
increases
The colon has a lumen that is of _______ echogenicity
Hypoechoic
The colon is more often seen in the ________ trimester.
Third (3rd)
Meconium is composed of what the fetus digests, such as: ______, ______, and ______.
1) Mucous
2) Amniotic fluid
3) Bile
Meconium appears as a _________ echogenicity and can sometimes be mistaken for _________.
1) Hypoechoic
2) Cysts
What are the two most common types of abdominal wall defects?
1) Omphalocele
2) Gastroschisis
The distinguising feature between an Omphalocele and an Umbilical hernia is the position of the ______ ________.
Cord insertion
A defect in the linea alba with protruding bowel that is completely covered by skin and subcutaneous tissue is known as an ________ __________.
Umbilical Hernia
An omphalocele is covered by thin membrane such as 1)_________ and 2)_________.
1) Peritoneum
2) Amnion
By week __________, the gut herniation should be fully resorbed.
Thirteen (13)
An omphalocele can range is size from _____ to _____ cm.
2 - 10 cm
An omphalocele may be suggested if the cord containting midgut has a maximum dimension of _____ mm or greater.
7 mm
True or False: In the first trimester, an omphalocele must be larger than the abdomen to be a definitive diagnosis.
True
The presence of the ______ or ______ in the sac of an omphalocele is associated with a poor outcome.
Spleen
Heart
Gastroschisis commonly measure between _____ to _____ cm, and usually occurs to the _______ of the cord insertion.
2 to 4 cm
Right of the CI
Increases in __________ levels in the amniotic fluid are associated with Gastroschisis.
Alpha-fetoprotein (AFP)
True or False: Gastroschisis is associated with the umbilical cord.
False
True or False: When Gastroschisis is present, it is usually in young mothers
True
Vasoactive substances, like nicotine and cocaine can increase the risk of development of fetal __________.
Gastroschisis
An omphalocele caused by a fusion failure of the lateral ectomesodermal folds is Type _____.
One (1)
An omphalocele caused by the failure of the muscles, fascia, and skin to fuse is Type ____.
Two (2)
Bowel malrotation, chromosomal abnormalities, Turners, Klinefelter, triploidy, jejunal and ileal atresia are commonly associated with _________.
Omphaloceles
True or False: Gastroschisis rarely occurs with other anomalies outside of bowel malformation.
True
An abdominal defect associated with small AC is _______.
Gastroschisis - this is due to the abdominal contents migrating into the amnion (loops of free floating bowel)
True or false: In 1/3 of cases of gastroschisis, oligohydraminos is also present.
True
True or false: Fetal ascites is normal.
FALSE: always abnormal
Ascites can extend into the scrotum and produce _________.
Hydroceles
Ascites can be an isolated finding in bowel _________.
Perforation
Bladder outlet obstruction and/or renal forniceal rupture can cause ________ ascites.
Urinary
Immune and Non-Immune fetal hyrdops can cause this organ to enlarge due to the production of RBC’s.
The liver
Interuption of the intrahepatic biliary tree development can cause solitary liver _________.
Cysts
Intrauterine infections, especially those that cause TORCH can cause the liver to develop ______________.
Calcifications
The most common Esophogeal Atresia consists of a ________, esophageal pouch, which communicates with _________ tract, through a __________.
Proximal
GI
Fistual
Esophageal atresia is associated with Trisomy ____.
21
True or False: Stomach fluid directly correlates with the amount of amniotic fluid.
True: Oligohydraminos and can cause absence of stomach fluid.
What is a guarded prognosis?
Issues with baby, not mum
A volvulus is an __________ caused by bowel ________ causing lack of blood supply.
Obstruction
Twisting
What vessel can bowel volvulus primarily affect?
SMA (superior mesenteric artery)
Bilous vomitting in an infant is a common sign of _____
_______.
Midgut Volvulus
The failure of the duodenum to change from a solid cord of tissue into a tube causes duodenal _______.
Atresia
The three types of duodenal recanalization anomalies are: 1)__________________, 2)______________ 3)____________
1) Duodenal diaphragm or web (stenotic)
2) Solid cord with atresia
3) Partial absence of duodenum
This organ can surround the duodenum and cause obstruction or stenosis
Pancreas
Duodenal atresia is most commonly associated with Trisomy _______.
21
This is the most common echogenic mass found in the fetal abdomen
Bowel
True or False: 50% of Echogenic bowel cases spontaneously resolve
True
What trimester is echogenic bowel considered to be normal?
Third (3rd) Trimester
(Due to Meconium!)
How do you measure the echogenicity of bowel?
Compare to fetal bone by turning down gains
Bowel echogenicity _______ than the echogenicity of nearby fetal bone has been known to indicate a greater risk for meconium ileus/cystic fibrosis.
Greater
