Normal anatomy pt2

Question 1

by the end of the third week of the LMP, the ______ begins to implant into the decidulized endometrium

Answer 1

blastocyst

Question 2

during the implantation process, as the ______ tissue invades the endometrium, occasional vaginal bleeding can occur. This is perceived by the patient as spotting

Answer 2

trophoblastic

Question 3

what are the sonographic findings of the implantation phase?

Answer 3

there are three distinct layers of decidulized endometrium that can be observed (Decidua basalis, decidua capsularis, and ducidua parietalis)

Question 4

______ develops where the blastocyst implants, it is the maternal contribution to the placenta

Answer 4

decidua basalis

Question 5

______ closes over and surrounds the blastocyst

Answer 5

decidua capsularis

Question 6

______or ______ is the uninvolved endometrial tissue that is hyped up because of hormones

Answer 6

decidua perietalis or decidua vera

Question 7

the placenta is derived from both the ______ and ______ tissue

Answer 7

maternal and fetal

Question 8

what are the maternal components derived from?

Answer 8

decidua basalis

Question 9

what are the fetal components derived from?

Answer 9

trophoblastic tissue

Question 10

the trophoblast develops into ______ which come in contract with the ducidua basalis to preliferate and become the ______ or the fetal part of the placenta

Answer 10

chorionic villi, chorion frondosum

Question 11

what forms from the inner mass and becomes a cavity to fill the chorionic or uterine cavity?

Answer 11

the amnion

Question 12

the ______ and _______ begin to fuse by the middle of the first trimester and fusion is complete by ______ weeks

Answer 12

amnion and chorion, 16 weeks- it is perfectly normal to see sonographic separation of the two membranes before 16 weeks

Question 13

what is intra decidual sac sign and when is it seen?

Answer 13

seen when serum beta hCG level is 1000 and mlu/ml or greater, it is a cystic space within the uterine cavity

Question 14

what is the double decidual sac sign?

Answer 14

inner anechoic amnionic sac, surrounding echogenic decidula capsularis, surrounding anechoic uterine cavity, and outer echogenic decidula vera

Question 15

how do you measure the mean sac diameter?

Answer 15

length+height+width divided by three

Question 16

the ______ is the first structure seen within the gestational sac

Answer 16

yolk sac

Question 17

where is the yolk sac located?

Answer 17

between the chorion and the amniotic cavity

Question 18

what is the function of the yolk sac?

Answer 18

to make fetal blood until the fetus can take over

Question 19

how do you measure the yolk sac?

Answer 19

from inner to inner

Question 20

what do you use when you date a pregnancy?

Answer 20

only the most advanced structure!, if you only have the gestational sac use that, but if a fetus is developed used the crown rump length only

Question 21

do you ever use both the gestational sac measurement and the crown rump measurement?

Answer 21

No! only the advanced most part of the pregnancy

Question 22

embryo grows at a rate of ______ per day

Answer 22

1mm

Question 23

with ______ imaging the embryonic anatomy can be seen earlier than with transabdominal

Answer 23

transvaginal

Question 24

Always used transvaginal sonography to evaluate the early pregnancy, but what is the only time you would not?

Answer 24

in the case of patients adamant refusal even after she has been explained the benefits

Question 25

______ is an anechoic structure seen in the posterior part of the fetal brain from 8-11 weeks

Answer 25

rhombencephalon

Question 26

what does rhombencephalon look like?

Answer 26

a cyst in the brain

Question 27

do you ever measure the rhombencephalon?

Answer 27

no, it is normal development of the central nervous system and it must not be confused with an abnormality

Question 28

the ______ herniates into the base of the umbilical cord at 9 weeks and returns to the abdominal cavity at 12 weeks

Answer 28

midgut- it is a normal physiologic function and should never be confused for Omphalocele or Gastroschesis