Normal 2nd & 3rd TM

Question 0

Landmarks of the spine

Answer 0

Cervical- neck
Thoracic- heart
Lumbar-kidneys
Sacral- bladder or femur
Identified in most pregnancies by 16 weeks

Question 1

Nagele’s Rule

Answer 1

EDC= LMP-3months+ 7 days

To calc due date

Question 2

Femur length

Answer 2

Most commonly measured bone.from greater trochanter to femoral condyles. Hyperechoic linear structures represents ossified portion of the femoral diaphysis. Measure shaft of femur. Predictor of GA & indicator of skeletal dysplasias & asymmetric growth retardation. 10 1/2 weeks ossification center of femur (1mm)

Question 3

Humerus

Answer 3

Identified by imaging fetal spine in upper thoracic-lower cervical region, identify scapula then rotate.

Question 4

Ulna & radius

Answer 4

Ulna is the Larger of the 2 bones and Longer then the radius. Lower end is slender. Both hyperechoic shaft meet at the wrist where no ossified hypechoic carpel bones are located

Question 5

Tibia & Fibula

Answer 5

Tibia in the front fibula behind. Tibia is the longer and thicker. Lower end of the tibia articulates with one of the tarsals to form the ankle joint.

Question 6

Fetal heart

Answer 6

2 ventricles 2 Atriums. RV is the most anterior chamber. Descending aorta is immediately anterior and slightly to the left of the spine. LA is anterior to the aorta. Inter ventricular septum is the echo genie line btw RV & LV. Former ovals is seen btw LA & RA. 120-180 BPM average. Atria & Ventricle 1:1. Apex points left when spine at 6:00

Question 7

Stomach

Answer 7

Should be seen by 14-16 weeks. LUQ. Fetus swallows AF at 16 weeks. AF volume reaches about 400-500 ml.

Question 8

Kidneys

Answer 8

Seen around 15-16 weeks. Visualization becomes consistent by 20 weeks. AP diameter should be less than 5 mm. Circumference about 1/3 size of abdomen (.27-.30) PF=peri euphoric fat P=pyramids A=adrenal

Question 9

Bladder

Answer 9

Can be seen by 15 weeks. Fills every 30-45 mins. Wall should be thin. Ureter <1mm.

Question 10

Umbilical Cord Insertion

Answer 10

Connects fetus to placenta. Goes into liver and heart. 2 arteries and 1 vein. Arteries go on either side of the bladder.

Question 11

Liver

Answer 11

10% of weight at 11 weeks. 5% of weight at full term.

Question 12

GB

Answer 12

Normally seen at 20 weeks. Located to the right of the portal vein

Question 13

Small Bowel

Answer 13

Seen after 27 weeks, seen more in the center

Question 14

Colon

Answer 14

Seen near the end if the 2nd TM. Hypechoic area around outer wall is normal it’s not fluid it’s muscle.

Question 15

ABD abdominal diameter

Answer 15

Average of 2 diameters. 1st from spine to anterior abd wall. 2nd perp to 1 st measurement.
ABD= 2(3.14)r. ABD=(3.14)d

Question 16

BPD

Answer 16

Leading edge to leading edge. Midbrain: falx, cavum septi pellucidi, & thalamus. Not as accurate of measurement in 3 rd TM. Always just check lateral ventricles, they are superior to BPD

Question 17

Cephalic Index

Answer 17

BPD/OFD(100)

BPD is always smaller

Question 18

Occipito Frontal Diameter (OFD)

Answer 18

Front to back measurement. Done at the same level as BPD, but measures outer to outer. Determines if baby’s head is shaped the right way.

Question 19

Brachiocephalic

Answer 19

Round head

Question 20

Dolichocephalic

Answer 20

Elongated head

Question 21

Area corrected BPD (BPDa)

Answer 21

BPDa= the square root of (BPDxFOD)/1.265
(BPD+FOD/2)(3.14) = (BPD+FOD) x 1.57

Question 22

Cerebellum

Answer 22

Start at BPD and angle back part of probe posterior. Cerebellum is in the back of the head. If really small it could be herniated

Question 23

AC

Answer 23

AC=2(3.14)r

R=radius(diameter divided by 2)

Question 24

Preterm

Answer 24

Born before 37th week. The earlier their born the less developed the organs are

Question 25

Preeclampsia

Answer 25

Mother gets high blood pressure which compromises flow to fetus

Question 26

Mean Gestational Age

Answer 26

Mean gestational age= GA (today) + GA (prior)= #/2= MGA

Question 27

Interval Growth

Answer 27

BPD (today) - BPD (last) = growth mm/wk