Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Ob/Gyne 2 > Module 7 : Fetal Chest Pathology > Flashcards

Module 7 : Fetal Chest Pathology Flashcards

1
Q

contents of the chest

A
  • lung
  • heart
  • muscle and diaphragm
  • trachea
  • esophagus
  • ribs
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

what is the diaphragm

A
  • hypo echoic liner structure between lungs and abdomen
  • easier to see in later gestations
  • note shape and continuity
  • usually visualized on parasagittal scans
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

why is the diaphragm hypo echoic

A
  • lung tissue is filled with fluid and collapsed so diaphragm appears hypo echoic
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

fetal lungs

A
  • homogenous
  • echogenicity compared to liver can be
    + isoechoic
    + hyperechoic
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

fetal heart position and chamber

A
  • 4 chambers
  • occupies 1/3 of the fetal chest
  • apex points to the left with axis about 45º
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

9 lung pathology

A
  • pulmonary hypoplasia
  • congenital cystic adenomatoid malformation (CCAM)
  • congenital pulmonary airway malformation (CPAM)
  • pulmonary sequestration
  • bronchogenic cyst
  • diaphragmatic hernia
  • pleural effusions
  • tracheal atresia
  • esophageal atresia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

pulmonary hypoplasia

A
  • when one or both lungs are underdeveloped
  • can be lethal
  • fetuses < 24 weeks are not considered viable due to pulmonary immaturity
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

causes of pulmonary hypoplasia at term

A 
- restricted chest cage
  \+ some skeletal dysplasia 
- decreased amniotic fluid
- chest masses
- pleural effusion
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

what is the most frequent cause of pulmonary hypoplasia

A
  • due to lack of fluid
    + PROM = premature rupture of membranes
    + GU anomalies = genitourinary
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

amniotic fluid things

A
  • produced by membranes until fetal kidney begin to produce urine
  • fetus swallows amniotic fluid
  • fluid goes through the GI track absorbed by the GI track excreted by the kidneys as urine fetus urinates back into the amniotic cavity
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

cause of polyhydramnious and oligohydramnios

A
  • poly= any high GI obstruction/swallowing deficits

- oligo = any bilateral GU obstruction/renal agenisis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

thoracic/ chest circumference

A
  • method to predict pulmonary hypoplasia
  • transverse chest circumference at level of 4 chamber heat
  • measure outer to outer
    + except in cases of skin edema/hydrops
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

congenital cystic adenomatoid malformation CCAM

A 
- now called CPAM
  \+ congenital pulmonary airway malformation 
- three classifications 
  \+ type I, type II, type III
- type of hamartoma (1 lobe effected)
- communicates with tracheobronchial tee
- large may see mediastinal shift
-
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

what is CPAM associated with

A
  • hydrops
  • pulmonary hypoplasia
  • polyhydramnious
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

type I CPAM

A
  • macrocystic

- > 2cm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

type II CPAM

A
  • macro and microcystic

+ < 1.5cm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

type III CPAM

A
  • microcystic

- monographically hyperechoic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

prognosis and treatment of CPAM

A
  • depends on mediastinal shift and hydrops
  • may regress or disappear on its own
  • no intervention is performed unless hydrops is noted
  • may drain cyst or surgically resect the mass
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

DDX of CPAM

A
  • sequestration
  • bronchogenic cysts
  • CDH = congenital diaphragmatic hernia
20
Q

pulmonary sequestration characteristics

A
  • a mass of ectopic pulmonary tissue covered by its own pleura
  • no communication of this tissue with bronchial tree
  • ectopic ARTERIAL supply
    + off descending aorta
  • venous to systemic system not pulmonary veins
  • usually left lung base
21
Q

sonographic appearance of pulmonary sequestration

A
  • uniform hyperechoic mass
  • associated with hydrops and polyhydramnios
  • look for FEEDING ARTERY OFF THE AORTA
  • prognosis is good unless associate with hydrops
  • often resolve on their own
22
Q

DDX of pulmonary sequestration

A

CCAM III

23
Q

bronchogenic cysts characteristics

A
  • cyst in lung lined with bronchial epithelium
24
Q

what is bronchogenic cysts associated with

A
  • associated with foregut anomalies
    + TE fistula
    + lung sequestration
25
Q

sonographic appearance of bronchogenic cysts

A
  • uni/multilocular cyst

- mediastinal shift

26
Q

DDX of bronchogenic cysts

A

CPAM I

* cannot differentiate between the two

27
Q

diaphragmatic hernia characteristics

A 
- a defect in the diaphragm which allows abdominal contents to herniate up into the chest 
  \+ intestines
  \+ stomach
  \+ liver
- causes pulmonary hypoplasia
28
Q

two major types of diaphragmatic hernias

A
  • foramen of bochdalek

- foramen of maorgagni

29
Q

foramen of bochdalek

A
  • posterior lateral defect

- MORE COMMON OF LEFT

30
Q

foramen of bochdalek - left hernia

A
  • may see stomach or intestines in chest

- lung with absence of diaphragm + mediastinal shift

31
Q

foramen of bochdalek - right hernia

A
  • may see liver in chest
  • difficult to recognize liver from lung
  • may not appreciate mediastinal shift
  • leads to pulmonary hypoplasia
32
Q

foramen of morgangi

A
  • partial or complete absence of the central diaphragm
  • usually liver herniated
    + may see portal flow in chest
  • MEDIASTINAL SHIFT EVEN THOUGH HEART IS STILL ON LEFT SIDE THE AXIS WILL BE SHIFTED
33
Q

CDH on sonography

A 
- mediastinal shift
  \+ KEY SONGRAPHIC SIGN
- cystic component in fetal chest
  \+ difficult to catch 
  \+ only if fetus has recently swalloed
- diaphragm no intact on sagittal scans 
- stomach not seen in abdomen
34
Q

what is eventuation of the diaphragm

A
  • lacks muscle therefore the abdominal contents push into chest area
  • may causes pulmonary hypoplasia
35
Q

what are pleural effusions

A
  • any amount of pleural fluid is abnormal in any gestations
  • if large can cause pulmonary hypoplasia
  • appear as sonolucent fluid collection
  • may displace lung toward midline
36
Q

2 types of pearl effusions

A
  • serous

- chylous

37
Q

serous pleural effusion

A
  • sign of hydrops

- associated with downs and turners

38
Q

chylous pleural effusion

A
  • lymphatic fluid
39
Q

sonographic appearance of pleural effusion

A
  • cystic collection above the diaphragm
  • unilateral = may cause mediastinal shift
  • may invert diaphragm
40
Q

treatment of pleural effusions

A
  • hydrothorax and chylothorax
    + thoracentisis
    + shunt fluid into abdomen or amniotic cavity
    + may resolve on their own
41
Q

what is tracheal atresia

A
  • congenitally non patent airway

- tiny amount of fluid is produced in fetal lungs and cannot get out

42
Q

sonographic appearance of tracheal atresia

A
  • bilaterally enlarged lungs with distended airways
  • flat diaphragms
  • ascites and polyhydramnios
43
Q

what is esophageal atresiA

A
  • congenitally non patent esophagus
  • often associated with TE fistula
  • associated with Down syndrome and VACTERL
44
Q

sonographic appearance of esophageal atresia

A
  • no stomach bubble
  • cystic structure in neck (disappears)
  • may note polyhydramnious
45
Q

4 chest wall shape abnormalities

A
  • narrow
  • long
  • bell shaped
  • dwarfism (skeletal dysplasia)
  • may cause pulmonary hypoplasia
46
Q

what is ectopia cords

A
  • anterior chest wall fusion defect

- heart outside of cavity

47
Q

the pentology of cantrell

A
  • sternum defects
  • anterior diaphragm defects
  • pericardium defects
  • ectopia cordis with heart defects
  • omphalocele

Ob/Gyne 2 (19 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions