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Ob/Gyne > Module 8.1 : Normal Fetal Anatomy - Heart > Flashcards

Module 8.1 : Normal Fetal Anatomy - Heart Flashcards

1
Q

when does heart tube begin to develop

A
  • develops from the mesoderm at 5th week LMP
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2
Q

when is the heart tube fully formed

A
  • 10th week LMP
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3
Q

heart tube evaluations done when

A
  • evaluated from 18 or 20 weeks to term or delivery

- best between 18-24 weeks

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4
Q

fetal circulation - specialized structures

A
  • ductus venosus
  • foramen ovale
  • ductus arteriosus
  • 3 places where there is shunts
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5
Q

heart position within the fetus

A
  • sits completely horizontal in the fetal chest
  • located left of midline
  • apex points 45’ to left
  • occupies 1/3 of chest
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6
Q

chambers of the heart

A
  • 2 atria sit posterior to 2 ventricles
  • left atrium most posterior
  • right ventricle most anterior
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7
Q

moderator band

A
  • thick muscle makes right ventricle chamber look smaller than left
  • used to prove which chamber is right ventricle in abnormal hearts
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8
Q

mitral valve

A
  • aka bicuspid valve
  • contains 2 cusps
  • passes blood from left atrium to the left ventricle
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9
Q

tricuspid valve

A
  • contains 3 cusps
  • passes blood from right atrium to the right ventricle
  • mitral and tricuspid valves open and close together and at same level in heart
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10
Q

aortic valve

A
  • 3 cusps
  • assess oxygenated blood from the left ventricle to the aorta to be distributed to the rest of the body
  • seen in LVOT view
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11
Q

pulmonary valve

A
  • contains 3 cusps
  • passes deoxygenated blood from right ventricle to pulmonary artery to be oxygenated by longs
  • pulmonary artery sits more anterior than the aorta
  • want to see it in long axis not short axis
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12
Q

ductus arteriosis

A
  • shunts blood from the pulmonary artery to the aortic arch to bypass the lungs during fetal life
  • after deliver the ductus arteriosis closes
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13
Q

foramen ovale

A
  • opening between the atria
  • blood flows from right atrium to the left atrium
  • also helps bypass lungs
  • ovale flaps open into left atrium
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14
Q

IVC and SVC

A
  • bring deoxygenated blood back from the body to the right atrium
  • long horn vie you see both
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15
Q

pulmonary veins

A
  • 4 pulmonary veins the bring oxygenated blood from lungs to the left atrium in new born
  • on ultrasound usually see 2
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16
Q

routine images of heart

A
  • 4 chamber heart (trans)
  • left outflow tract (more superior)
  • right outflow tract (more mores superior)
  • 3 vessel view (most superior)
  • cine clip
  • fetal M mode
    + 120-160bpm in 2nd and 3rd trimester
    + can go higher but worrisome if goes lower
17
Q

4 chamber heart

A
  • shows all 4 chambers with the septum
  • valves closed = systole
  • valves open = diastole
18
Q

LVOT

A
  • demonstrates the left ventricle with the aorta

- anterior wall of the aorta should continue with the IVS

19
Q

RVOT

A
  • demonstrates the right ventricle with the pulmonary artery
  • LVOT and RVOT should cross eachother
  • if parallel to each other the tubes didn’t twist
20
Q

3 vessel view

A
  • should see pulmonary artery
  • aortic arch
  • SVC
  • assess diameter
21
Q

cine clip 12 seconds

A 
- begin at level of AC
  \+ demonstrate stomach for situs
- sweep cephalic 
- demonstrate 4 chamber
- then LVOT
- then RVOT
- then 3 vessel 
- sweep all the way to fetal neck
22
Q

heart tracing

A
  • use M mode
  • place cursor over the heart area where you catch wall of one atria and one ventricle
  • usually one beat
  • only way to prove viability
  • assess if atria and ventricle beating at same rate
23
Q

tachycardia

A
  • fetus won’t survive in tachycardia
  • heart is quivering no blood into systems
  • may see hydrops - end stage disease fluid in one or more cavities
24
Q

normal fetal heart rate

A
  • 120-160bpm
25
Q

heart rate under 100 in first

A
  • concerning
  • early pregnancies heart may actually stop for a few seconds (conduction is weak)
  • move to different area then go back
26
Q

third trimester heart rate

A
  • up to 180 in third is normal with activity
27
Q

bradycardia

A
  • under 100 sustained in 2nd 3rd trimester
28
Q

additional images

A
  • short axis (circle and sausage)
  • SVC IVC with right atrium
  • aortic arch
  • ductal arch
  • pulmonary veins with left atrium
29
Q

short axis view

A
  • demonstrates the right and left atrium
  • right ventricle
  • pulmonary artery
  • ductus arteriosis
  • all circling aorta
30
Q

SVC and IVC

A
  • shown with right atrium

- steers head

31
Q

aortic arch

A
  • candy cane
  • see 3 vessels
    + brachiocephalic artery
    + left common carotid artery
    + left subclavian artery
32
Q

ductal arch

A
  • right ventricle with ductus joining the aorta

- hockey stick

33
Q

pulmonary veins

A
  • usually see 2 veins entering right atrium

Ob/Gyne (24 decks)

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