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LMC Ultrasound > OB Ch 62, 63, 64 > Flashcards

OB Ch 62, 63, 64 Flashcards

1
Q

What is the difference between partial situs inversus and complete situs inversus?

A

Complete: total reversal of thoracic and abdominal organs
Partial: more severe, thoracic viscera are usually reversed and abdominal viscera may/may not be reversed; two combinations of organ reversals, asplenia or polysplenia pg. 1342

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2
Q

What is double bubble?

A

Blockage of the duodenal lumen by a membrane that prohibits the passage of swallowed amniotic fluid
-Also called Duodenal Atresia Pg. 1345

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3
Q

What should you look for when you encounter loops of dilated echogenic bowel?

A

-Bowel obstruction
-Meconium ileus
-Cystic Fibrosis
Pg. 1346?
possible chromosomal abnormalities so check everything thoroughly

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4
Q

What is the normal position of the spleen in reference to other parts of the body?

A

Posterior and to the left of the fetal stomach. Imaged in transverse plane Pg. 1342

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5
Q

What are the possibilities if you find echogenic areas in the fetal abdomen?

A

Calcified Peritoneal calcifications: Meconium peritonitis, hydrometrocolpos Intraluminal meconium calcifations: anorectal atresia, small bowel atresia, Parenchymal: Liver, splenic, adrenal, ovarian cyst Cholelithiasis: gallbladder Noncalcified Echogenic Meconium, intraabdominal extrathoracic pulmonary sequestration, tumors, adrenal hemorrhage Green Box: pg. 1348

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6
Q

What would a cystic growth on the common bile duct be termed?

A

Choledochal Cyst pg. 1343

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7
Q

Haustral folds are seen on the ___.

A

Colon Pg. 1340

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8
Q

What is Meckel diverticulum?

A

Remnant of proximal part of yolk stalk that fails to degenerate and disappear during early fetal period.
Small finger-like sac, about 5 cm long, that projects from the border of the ileum
Pg. 1338

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9
Q

A normal esophagus will appear with a ___ pattern during the second and third trimester

A

multi-layered per Beth
Has two or more parallel echogenic lines
p 1338

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10
Q

Which malformation of the midgut is most common?

A

Meckel’s Diverticulum Pg. 1338

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11
Q

At how many weeks should you be able to tell the difference between large and small bowel?

A

After 20 menstrual weeks. Pg. 1340

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12
Q

Information about the stomach.

A

Fetuses 14-16 wks should have fluid in stomach
There may be a significant change in size of stomach
Echogenic debris can sometimes be seen along dependent wall
Esophageal anomalies are the LEAST common problem for nonvisualization of the stomach Pg. 1338

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13
Q

What is polysplenia?

A

-More than one spleen -
-Represented by transposition of liver, spleen, and stomach and absent GB
Pg. 1342

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14
Q

What is psuedoascites?

A

Sonolucent band near the fetal anterior abdominal wall found in fetuses over 18 weeks gestation Pg. 1343

-Never outlines the falciform ligament like true ascites

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15
Q

What is the most reliable criteria for diagnosing dilated bowel loops?

A

Bowel diameter Pg. 1344

  • Normal diameter of the small bowel lumen is less than or equal to 5 mm, with a length of 15 mm near term p 1340
  • Normal diameter of the colon range from 3 to 5mm at 20 weeks to 23mm or larger at term p 1340-1341
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16
Q

What are the causes for a double bubble?

A

–Duodenal atresia
-Duodenal stenosis
-Annular pancreas
-Ladd’s bands
-Proximal jejunal atresia
-Malrotation
-Diaphragmatic hernia
Pg. 1345

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17
Q

What are some other defects that may coexist with esophageal defects?

A

Tracheoesophageal fistula Pg. 1336
Most commonly observed is anorectal atresia
Others include: vertebral defects, heart defects, and renal and limb anomalies (VACTERL)
Growth Restriction Trisomies 18 and 21
Pg. 1344

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18
Q

What is a derivative of the hindgut?

A

-Left part of transverse colon
-Descending colon
-Sigmoid colon
-Rectum
-Superior portion of anal canal
-Epithelium of Bladder
-Most of Urethra
Pg. 1338

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19
Q

At 30 weeks, what are the peritoneal calcifications of the fetus?

A

Meconium peritonitis and Hydrometrocolpos? Pg. 1348 (green box)

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20
Q

What is the VACTERL group of anomalies?

A 
V= Vertebral 
A= Anal 
C= Cardiac 
T= Trachea 
E= Esophageal 
R= Renals 
L= Limbs
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21
Q

What is correct about the normal liver?

A
  • Relatively large in comparison to other intraabdominal organs and occupies most of upper abdomen
  • Accounts for 10% of total weight at 11 weeks and 5% at term
  • Hepatic veins and fissures formed by the end of the first trimester
  • Left lobe is larger than right in utero secondary to greater supply of oxgenated blood
    pg. 1341
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22
Q

What is anorectal atresia?

A

Presents as a complex disorder of the bowel and genitourinary tract and may be present as part of the VACTERL association or in caudal regression.
One of the findings in this is an imperforate anus, which is when a membrane covers the anus prohibiting the expulsion of meconium.
Prognosis is poor because of associated anomalies. Incontinence of both bowel and bladder is common. pg. 1347

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23
Q

At how many weeks should you see fetal kidneys on ultrasound?

A

12 weeks Per Beth

What seniors had-By 13 weeks? Pg. 1354 18 weeks? kidneys should be documented in all fetuses sonographically Pg. 1354 Please check this, the book has 3 different weeks….

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24
Q

What is the protrusion of the posterior wall of the bladder?

A

Exstrophy of the Bladder Pg. 1361

-caused by the defective closure of the inferior part of the anterior abdominal wall during the 4th week of gestation.

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25
Q

What is it called when a fetus has both ovarian and testicular tissue?

A

True Hermaphroditism Pg. 1377

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26
Q

What will you find with complete renal agenesis?

A

-Severe Oligo after 13-15 weeks
-Absence of urine in fetal bladder
-No visualization of kidneys or renal arteries
-Small thorax Pg. 1360
You will not find a dilated fetal bladder quizlet

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27
Q

What are some specifics to Potter’s syndrome?

A
  • Potter’s facies: flat nose, recessed chin, abnormal ears, and wide-set eyes, as well as abnormal or malpositioned limbs (these deformities caused by a lack of amniotic fluid)
  • Cardiac defect Musculoskeletal disorders: sirenomelia, absent radius and fibula, anomalies of digits, sacral agenesis, diphragmatic hernia, and cleft palate
  • CNS anomalies: hydrocephalus, meningocele, cephalocele, holoprosencephaly, anencephaly, and microcephaly
  • GI anomalies: duodenal atresia, imperforate anus, tracheoesophageal fistula, malrotation, and omphalocele
  • Uterine anomalies Testicular hypoplasia, agenesis, and hypospadias pg. 1359

Renal agensis, oligphydramnios, pulmonary hypoplasia, abnormal fancies, malformed hands/feet Quizlet

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28
Q

What is multicystic dysplastic kidney disease?

A

Characterized by multiple, smooth- walled, nonfunctioning, noncommunicating cysts of varying sizes and numbers. Renal tissue is replaced by cysts that are found throughout the kidney. The entire kidney or only a portion may be affected. The affected kidney is nonfunctional. pg. 1364

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29
Q

What is the most common kidney obstruction?

A

UPJ-ureteropelvic junction

*most common for hydronephrosis in neonate

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30
Q

What is the criteria for hydronephosis

A

Abnormal intrapelvic AP diameter measurement.
Measurement greater than 4-4.5 mm before the third trimester or greater than 7 mm after the third trimester. Another useful guide is that if the measurement exceeds 1/3 of the renal diameter. Pg. 1368

Intrapelvic diameter:
>7mm = mild hydro
7-15mm = moderate hydro
>15mm = severe hydro

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31
Q

What is a keyhole bladder?

A

Posterior Urethral Valves (PUV) – abnormal congenital membrane within posterior urethra Pg. 1371

*most common urethral anomaly

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32
Q

What is prune belly syndrome?

A

Characterized by 3 features:
-cryptorchidism
-agenesis, or hypoplasia of anterior abdominal wall muscle
-dilation of the fetal abdomen secondary to severe bilateral hydronephrosis and fetal ascites; fetus also has oligohydramnios and pulmonary hypoplasia Pg. 1373
Sono findings include all except: renal agenesis quizlet

*also referred to as Eagle Barrett syndrome

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33
Q

What is the normal thickness of a fetal bladder wall?

A

2mm or less and is best measured at the level of the umbilical artery
Pg. 1356

34
Q

What is renal agenesis?

A

Complete absence of kidneys Pg. 1359
-Occurs when the ureteric buds fails to develop or when they degenerate before they can induce the metanephric mesoderm to form nephrons

35
Q

Where do the permanent kidneys derive from?

A

Metanephros Pg. 1351

*develop early in the 5th week

36
Q

What do the ureteric buds give rise to?

A

-Ureter
-Renal pelvis
-Calyces
-Collecting Tubules Pg. 1351
Doesn’t give rise to Bowman Capsule quizlet

37
Q

In what position do the fetal kidneys initially lie?

A

Very close together in the pelvis Pg. 1351

38
Q

What may encounter if the allantois persists while the urachous forms

A

Urachal Fistula develops, – causes urine to drain from bladder to umbilicus Pg. 1361

*Urachal cysts or Vesicoallantoic cyst p 1362

39
Q

At 20 weeks, how much pyelectasis can occur?

A

.4cm Per Beth

40
Q

What might a cystic structure in the fetal bladder at the distal ureter be?

A

Ureterocele pg. 1374

41
Q

What is the most likely cause of bilateral hydronephrosis?

A

Posterior Urethral Valves (PUV) Pg. 1357 ***Bladder Outlet Obstruction and may be apparent with severe oligohydramnios
Pg. 1368

42
Q

Normal amniotic fluid volume cannot exclude renal agenesis before how many weeks?

A

15-18 weeks Pg. 1359

14-16 weeks (quizlet)

43
Q

What are the sonographic finding of posterior urethral valves?

A

-Severe bladder dilatation
-Massive Hydronephrosis with dysplastic changes seen in the renal tissue
-Dilated tortuous ureters
-Oligohydramnios
Pg. 1372
Doesn’t include thinning of bladder wall Quizlet

44
Q

What are the sonographic findings of a fetal ovarian cyst?

A

Anechoic or Hypoechoic
If Torsed, complex or solid appearance Pg. 1379
This statement is incorrect: A fetal ovarian cyst has no diagnostic significance Quizlet

*most common cystic mass in female fetuses. Results from maternal hormones stimulation and is usually benign. Usually located on one side of the abdomen or lower pelvis

45
Q

What are we looking at if the fetal kidneys are enlarged and echogenic?

A 
Infantile Polycystic Kidney Disease: Syndromes assoc: 
-Meckel-Gruber syndrome 
-Patau's syndrome (trisomy 13) 
-Beckwith-Wiedemann syndrome 
-Juene syndrome
-Short Rib Polydactyly syndrome 
-Laurence-Moon syndrome (Bardet-Biedl syndrome
Pg. 1363 (green box)
46
Q

What are the 2 ways to divide renal malformations?

A
  1. Congenital Malformation

2. Those resulting from obstructive process Pg. 1358

47
Q

What is the term when there is only 1 teste visible within scrotal sac?

A

Cryptorchidism or undescended testis

pg 1377

48
Q

What is Pena Shokier syndrome?

A

Abnormal joint contractures, facial abnormalities, polyhydramnios, IUGR, and pulmonary hypoplasia. Pg. 1390

*have similar features with trisomy 18

49
Q

Micromelia and a hitchhiker thumb can indicate ___.

A

Diastrophic Dysplasia Pg. 1387

50
Q

What is the term for the shortening of a proximal portion of an extremity?

A

Rhizomelia – humerus and femur Pg. 1382

51
Q

What is thanataphoric dysplasia?

A

-Most common lethal skeletal dysplasia
-Occurs in 1 in 4,000 to 10,000 births
-Two types:
-Type I = characterized by short, curved femurs and flat vertebral bodies.
-Type II = straight, short femurs, flat vertebral bodies and a cloverleaf skull
-Die shortly after birth as a result of pulmonary hypoplasia due to narrow thorax
-Associated with polyhydramnios, hydrocephalus, and nonimmune hydrops
Pg. 1382, 1383

52
Q

What is the anomaly associated with the Amish community?

A

Ellis-van Creveld Syndrome AKA: Chrondroectodermal Dysplasia Pg. 1389

53
Q

What might we be looking at if we see multiple fractures and a compressed calvarium?

A

Osteogenesis Imperfecta Pg. 1385

54
Q

Who has the cloverleaf skull?

A

Thanataphoric Dysplasia Type 2 has cloverleaf skull, Type 1 does NOT! Pg. 1382

55
Q

What is the most common nonlethal skeletal dysplasia?

A

Achondroplasia Pg. 1383

56
Q

Who has an alkaline phosphatase deficiency

A

Congenital Hypophosphatasia Pg. 1386

57
Q

What is the congenital collagen production disorder?

A

Osteogenesis Imperfecta Pg. 1385

58
Q

Severe micromelia, decreased or absent ossification of the spine, macrocephaly, and micrognathia are characteristics of ___.

A

Achondrogenesis Pg. 1384

59
Q

Who has bent long bones?

A

Camptomelic Dysplasia Pg. 1387

60
Q

A small thorax, rhizomelia, renal dysplasia, and polydactyly describe ___.

A

Jeune’s Syndrome Pg. 1389

61
Q

When diagnosing talipes, what is the positioning of the foot and lower leg?

A

Abnormal inversion of the foot perpendicular to the lower leg Pg. 1393

*Clubfoot

62
Q

What is fusion of the lower extremities?

A

Sirenomelia- mermaid. Pg. 1390

63
Q

Sonographic features of achondroplasia may not be evident until after how many weeks?

A

22 weeks Pg. 1384

64
Q

What is the most common lethal skeletal dysplasia?

A

Thanataphoric Dysplasia Pg. 1382

65
Q

There are 2 types of achondroplasia, which does not have a good survival rate?

A

Homozygous Achondroplasia Pg. 1383

66
Q

Which classification of osteogenesis imperfecta is most severe?

A

Type 2 Pg. 1385

67
Q

Which rare condition with phocalmelia with facial anomalies?

A

Roberts Syndrome Pg. 1387

68
Q

The majority of cases of clubfoot are..

A

Idiopathic and isolated findings
Associated with chromosomal anomalies, syndromes, musculoskeletal disorders, and spina bifida
Also identified with oligohydramnios and in multiple gestations
p 1393

69
Q

Define skeletal dysplasia.

A

Abnormal growth and density of cartilage and bone Pg. 1380

70
Q

What is achondrogenesis?

A

Rare and lethal-infants either being stillborn or die shortly after birth; pulmonary hypoplasia
Caused by cartilage abnormalities that result in abnormal bone formation and hypomineralization.
Two types:
-Type 1 (Parenti-Fraccaro): most severe (autosomal recessive)
-Type 2 ( Langer- Saldino): less severe, more common (spontaneous mutation)
Pg. 1384

71
Q

Which lethal skeletal dysplasia has short ribs, short limbs, and polydactyly?

A

Short Rib Polydactyly Syndrome Pg. 1389

72
Q

A fetus with webbing across the joints and multiple contractures may have ___.

A

Lethal Multiple Pterygium Syndrome Pg. 1390

73
Q

What is overlapping digits called?

A

Clinodactyly

p1392

74
Q

Congenital absence of one or more extremities is termed..

A

Amelia

p 1391

75
Q

Term for flat vertebral bodies

A

Platyspondyly

p 1383

76
Q

Syndactyly refers to..

A

Fused digits

p 1391

77
Q

True name for hand deformity

A

`

78
Q

Testes don’t descend until the..

A

28th week

p 1377

79
Q

Mesomelis

A

Shortening of the middle segments (radius/ulna and tibia/fibula)
p 1382

80
Q

Micromelia

A

Shortening of the entire extremity

p 1382

81
Q

What is Meconium peritonitis?

A

A condition that may arise when the fetus has a sterile chemical peritonitis secondary to in utero bowel perforation
Hydramnios is present in 65%
p 1348

LMC Ultrasound (32 decks)

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