OB II Final Review from PP slides Flashcards
1
Q
What is Menarche
A
Onset of menstruation
2
Q
What is Menopause
A
Stop of menstruation
3
Q
What is Metrorrhea
A
irregular bleeding
4
Q
What days does menstruation occur in the cycle
A
1-4 days
5
Q
What is the sonographic appearance of the endometrial canal during mestruation
A
hypoechoic line
6
Q
What is a corpus luteum
A
small endocrine structure that develops in a ruptured ovarian follicle.
7
Q
What hormones does a corpus luteum secrete
A
progesterone and estrogen
8
Q
What is the broad ligament
A
double fold of peritoneum that covers the uterus, ovaries and fallopian tubes
9
Q
what are the round ligaments
A
Between layers of broad ligament
In front and below fallopian tubes
10
Q
What are the cardinal ligaments
A
supports the cervix
11
Q
Where is the Posterior Cul-de-sac
A
between the uterus and rectum
12
Q
What are other names for the posterior cul-de-sac
A
pouch of douglas
rectouterine pouch
13
Q
Where is the anterior cul-de-sac
A
between the bladder and uterus
14
Q
what is another name for the anterior cul-de-sac
A
vesicouterine pouch
15
Q
what is the blood supply to the vagina
A
anterior uterine artery
posterior branch of internal iliac
16
Q
where is the space of retzius
A
Between the anterior bladder wall and pubic symphysis
17
Q
what is another name for the space of retzius
A
retropubic space
18
Q
what is the blood supply to the ovaries
A
aorta
ovarian arteries
uterine arteries
19
Q
what do the ovarian veins drain into
A
left vein: drains into left renal vein
right vein: drains into IVC
20
Q
what is the blood supply to the fallopian tubes
A
ovarian arteries and veins
21
Q
where are arcuate vessels found
A
along the peripheral edge of the uterus
22
Q
what is the embryology of the uterus and vagina
A
they both develop from the mullerian ducts between 7-12weeks
23
Q
what are the 3 layers of the uterus
A
perimetrium
myometrium
endometrium
24
Q
what are the 2 layers of the endometrium
A
zona functionalis (superficial functional layer) zona basalis (deep basil layer)
25
what is the songraphic appererance of the endometrium
echogenic to hypoechoic, depending on cycle
26
What layer sheds during menses
zona functionalis
27
What is the size of ovaries
3x2x2
28
What supports the ovary posteriorly
broad ligament via mesovarium
29
what is the sonographic appearance of the ovary
homogeneous, with an echogenic medulla
30
what supports the ovary medially
ovarian ligament
31
what supports the ovary laterally
suspensory ligament (infundibulopelvic)
32
what is ovarian torsion
complete or partial rotation of the ovary, cutting off the blood supply
33
what day does ovulation occur
day 14
34
what is the menstrual cycle
menstraution = 1-4days
proliferative phase = 5-14 days
secretory phase = 15-28 days
35
what is the ovarian cycle
follicular phase = 1-14 days
| luteal phase = 15-28 days
36
what is the size of a graafian follicle
2cm
37
what is the rate of growth of a graafian follicle
2-3mm per day
38
what is the length of the fallopian tubes
10-12cm
39
what are the sections of the fallopain tube
infundibulum, ampulla, isthums and inerstitial portion
40
what section of the fallopian tube is the widest
ampulla
41
what are cysts in the cervix called
nabothian cysts
42
what are cysts in the vagina called
gartners duct cyss
43
what are the most common tumors of the uterus
fibroids (leiomyomas)
44
where can fibroids form
submucosal
intramural - most common site
subserosal
pedunculated
45
what is adenomyosis
nests of endometrial tissue within the myometrium
46
what can cause calcifications within the uterus
fibroids and arcuate arteries
47
what is the size of a vaginal cuff
2cm
48
who can acquire endometritis
postpartum patients,
| occurs with PID too
49
what is the most common ovarian mass
simple ovarian cysts
50
simple ovarian cysts in postmenopausal women can be what size
less than 5cm before consider malignant
51
what are thecomas
benign, unilateral mass seen in postmenopausal women
52
what pelvic organ in the most involved with metastatic disease
ovaries
53
what % of postmenopausal bleeding is endometrial carcinoma
10%
54
what is the most common mass during pregnancy
corpus leutal cyst
55
what is another term for endometriomas
chocolate cysts
56
where are endometriomas commonly located
ovaries, cul-de-sac, retrovegainal septum, peritoneal surface of posterior wall of uterus
57
what is the most common benign tumor of the ovary
dermoid
58
what is a mucinous cystadenoma
Epithelial tumor lined with mucinous elements of endodermis and bowel
Typically larger than serous cystadenoma
Simple, septated cyst with differing echogenicity
59
what is a serous cystadenomas
2nd most common benign tumor of ovary
Smaller than mucinous cystadenomas
Unilateral, septated, irregular borders
60
what is another name for PCOS
Stein-Leventhal syndrome
61
what is PCOS
disorder with chronic anovulation
bilateral enlarged round ovaries
teens-twenties
amenorrhea, obesity, infertile, hirsutism
62
what is salpingitis
infected fallopian tubes
63
septate uterus can cause what
infertility
64
what is hydrops
excessive fluid within fetal body cavities
| ascites, pericardial effusion, pleural effusion, polyhydramnios
65
What is nonimmume hydrops
hydrops that is not related to Rh factor
66
what is the sonographic appearance of hydrops
```
scalp edema
pleural effusion
pericardial effusion
ascites
polyhydramnios
thick placenta
```
67
what are sonographic markers for downs
```
thick NT/nuchal fold
choroid plexus cysts
echogengic bowel
pylectasis
short long bones
EIF
absent nasal bone
omphalocele
talipes
micrognathia
diaphragmatic hernia
```
68
how often does trisomy 21 occur
1/600 births
69
how often does trisomy 18 occur
3/10,000 births
70
what are sonographic markers for Edwards
```
heart defects
clench hands
omphalocele
micrognathia
talipes
choroid plexus cysts
strawberry head
cleft lip & palate
diaphragmatic hernia
```
71
how often does trisomy 13 occur
1/5,000 births
72
what are sonographic markers for Pataus
```
holoprosenchephaly
polydactyly
talipes
cleft lip & palate
renal anomalies
menignomylocele
```
73
what are sonographic makers for Turners Syndrome
```
cystic hygroma
heart defects
coarctaion of the aorta
hydrops
renal anomalies
```
74
what commonly causes triploidy
1 ova fertilized by 2 sperm
75
what are sonographic markers for Triploidy
```
heart defects
omphalocele
renal anomalies
cranial defects
facial defects
```
76
what is VACTERL
```
vertebral defects
anal atresia
cardiac anomalies
transesophageal fistula
renal anomalies
limb dysplasia
```
77
what diseases can happen to pregnant women
diabetes
| hypertension (chronic or pregnancy induced)
78
hypertensive mothers can have what size placenta
small
79
what are some sonographic markers in diabetic pregnancies
```
polyhydramnios
macrosomia
caudal regression syndrome
NT defects
heart defects
renal anomalies
GI defects
single umbilical artery
```
80
what is preeclampsia
high blood pressure
proteinuria
edema
81
what is eclampsia
preeclamptic signs with seizures
82
maternal obesity can cause what type of defects
neural tube defects
83
at what week is it still considered preterm labor
37 weeks
84
what are dizygotic twins
2 separate ova fertilized by 2 separate sperm
85
what are monozygotic twins
1 fertilized egg that divides into 2 fetuses
86
when does Di-Di twinning occur
division of zygote at 1-3 days
87
when does Di-Mono twinning occur
division of zygote at 4-8 days
88
when does Mono-Mono twinning occurs
division of zygote at 8 days
89
when does conjoined twinning occurs
division of zygote after 13 days
90
what is a vanishing twin
early fetal demise that is absorbed
91
what is fetus papyraceous
fetal demise still in utero
92
what is poly-oli sequence
"stuck twin" occurs around 16-26weeks
one twin has polyhydramnios
the other has oligohydramnios
93
what is twin to twin transfusion
an arteriovenous shunt within the placenta
| the arterial blood of 1 is pumped into the venous system of 2
94
what happens to the fetuses in twin to twin
the donor twin becomes anemic and growth restricted
(oligo, pulmonary hypoplasia, renal hypoplasia) poor outcome
the recipient grows too quickly, too much blood,has polyhydramnios, can have heart failure, and hydropic
95
what type of twinning is twin to twin transfustion
monochorionic
| diamniotic
96
what is acradiac twin
twin abnormality where 1 twin develops without an upper half, occurs in monochorionic twins
97
what are the 5 different locations for conjoined twins
```
thoracopagues
omphalopagus
craniopagues
pygopagus
ischiopagus
```
98
What is Fitz-Hugh-Curtis syndrome
Perihepatic inflammation that can result from PID or endometritis
99
What are the 2 types of 3D acquisitions
Manual "free hand"
| Automatic
100
What are the 2 types of 3D imaging modes
Multiplanar reconstruction mode
| Volume rendering mode
101
What is multiplanar reconstruction
Demonstrates anatomy in 3 different planes and angles (long, trans, coronal)
102
What is volume rendering
An extension of multiplanar, where the techniques are applied to a ROI 3D volume data set
103
What are the 2 types of 3D rendering modes
Surface rendering
| Transparent rendering
104
What is surface rendering
Displays surface detail of anatomy
| Ex. Fetal face
105
What is transparent rendering
Looks beyond the surface anatomy to reveal structures located within
106
What are other modes to transparent rendering
Maximum
Minimum
X-ray
107
When does the umbilical cord form
Develops in the first 5 weeks
108
Where does the umbilical cord rise from
Omphalomesenteric (yolk stalk) and allantios ducts
109
How long are the intestines herniated outside the fetal abdomen
From 7-10 weeks
110
What covers the umbilical cord
Whartons jelly
111
What is the diameter of the umbilical cord
1-2cm
112
What is the normal length of the umbilical cord
40-60 cm
113
What is the ductus venosus
Conduit between the portal system and systemic veins
114
What is a short cord
Less than 35cm
115
What is a long cord
Greater than 80cm
116
What are true knots
Knot is formed when a loop of cord is slipped over the fetal head or shoulders
117
What are true knots associated with
Long cords
Polyhydramnios
IUGR
Mono mono twins
118
What is a velamentous cord insertion
Cord inserts into the membranes before the placenta
119
What is the occurrence of cleft lip and palate with different races
Blacks 1/3,000
Whites 1/600
Asians 1/350
Native Americans 1/150-250
120
What is exophtalmia
Abnormal protrusion of the eyeballs
121
What is the most common neck mass
Cystic hygroma
122
What is anencephaly
Absence of skull and brain
123
What is the occurrence of anencephaly
1/1,200
124
What are cephaloceles
A neural tube defect in which the meninges or meninges and brain herniate thru a defect in the calvarium
125
What abnormalities associate with cephaloceles
Trisomy 13
| Meckel Gruber syndrome
126
What can cause a celphalocele
Amniotic band syndrome
127
What is a encephalocele
A herniation of the meninges and brain thru a defect
128
What abnormalities associate with encephaloceles
Meckel Gruber
129
What malformation is associated with a banana shaped cerebellum and lemon shaped head
Arnold Chiari
130
What are the sonographic findings of spina bifida
```
Splaying of posterior ossification center
Meningocele
Meningomylocele
Cleft in skin
Intracranial malformations
```
131
What kind of intracranial malformations could be present with spina bifida
Lemon head
Banana cerebellum
Absent cisterna magna
Ventriculomegaly
132
When is a ventricle considered dilated
Greater than 10mm
133
What can cause ventriculomegaly
Spina bifida
| Encephalocele
134
Fetuses younger than ____ are considered non viable, due to pulmonary development
24 weeks
135
how do you evaluate the fetal chest
size
shape
symmetry
136
ultrasound cannot asses what in the fetal chest
lung maturity
137
what is congetntial cystic adenomatoid malformation (CCAM)
abnormal cystic growths within the bronchial trees that can cause a mediastinal shift, hydrops and polyhydramnios
138
how many types of CCAM are there
3
139
what is type 1 CCAM
one or more large cysts that replace normal lung tissue
2-10cm
favorable outcome
140
what is type 2 CCAM
lesions that have multiple small cysts
poor outcome
141
what is type 3 CCAM
large bulky noncystic mass
142
what are bronchogenic cysts
most common lung mass that is a small circumscribed masses without a mediastinal shift
143
what is pulmonary hypoplasia
poor or reduced lung growth causing inadequate lungs
144
what is are common causes for pulmonary hypoplasia
prolonged oligohydramnios
| or a small thoracic cavity
145
what % of neonates die from pulmonary hypoplasia
80%
146
what is pleural effusion
accumulation of fluid within the pleural cavity
147
if pleural effusion is seen, what structures should be carefully search
lungs, heart and diaphragm to rule out associated abnormalities
148
what is the occurrence of a congenital diaphragmatic hernia
1/2,000 to 1/5,000
149
at how many weeks is the diaphragm intact
by the end of the 8th week
150
what is the most common type of diaphragmatic hernia
hernias 90% of the time are thru the foramen of Bochdalek
151
where is the foramen of Bochdalek located
posterior and laterally
152
what are the 2 most common anterior abdominal wall defects
gastroschisis
| omphalocele
153
what process helps the embryo transform itself into a cylindrical shape
"folding"
154
when do the intestines return to the abdominal cavity
12 weeks
155
what is an ompalocele
central abdominal wall defect with eviscerated bowel and or liver into the base of the umbilical cord
156
what forms the membrane that surrounds the omphalocele
peritoneum and amnion
157
what can occur with omphaloceles
```
ascites
polyhydramnios
complex cardia diseases
GI defects
NT defects
genitourinary tract anomalies
diaphragmatic hernia
```
158
what is gastroschisis
an opening in the abdominal wall with a herniation of bowel, no membranous covering
the herniation of the stomach and genitrourinary organs happen infrequently
159
what causes gastroschisis
atrophy of the right umbilical vein
or
disruption of the omphalomesenteric artery
160
how big are gastroschisis defects
2-4cm located to the right of a normal cord insertion
161
gastroschisis causes an elevation in what lab
MSAFP
162
markedly dilated bowel in gastroschisis may suggest what
infarction or bowel atresia
163
early entrapment in amniotic bands can lead to what
severe craniofacial defects
| internal malformations
164
limb body wall complex involves what other defects
cranial defects
facial clefts
body-wall defect of thorax / abdomen (or both)
limb defects
165
scoliosis is associated with what type of defect
limb body wall defect
166
what side is more common to be affected by limb body wall
left side 3x more likely than right
167
what side is more common to be affected by limb body wall
left side 3x more likely than right
168
what is the sonographic appearance of haustral folds
thin linear echoes with the lumen of the colon
169
what is the normal diameter of the colon at full term
14-18mm
170
what is the appearance of meconium as it grows near term
increasing echogenicty
171
what is situs inversus
total or partial reversal of thoracic and abdominal organs
172
what organs are involved with partial situs inversus
only the heart or abdominal organs are reversed, the stomach may or may not be involved
173
what is pseudoascites
a sonolucent band near the fetal anterior abdominal wall
174
when can pseudoascites be seen
18 weeker or greater
175
what happens in duodenal atresia
the duodenal lumen is blocked by a membrane that prohibits the passage of amniotic fluid, causing a double bubble
176
where are most cases of duodenal atresia founds
below the ampulla
177
what abnormality can often coexist with double bubble
an annular pancreas
178
what % of double bubble cases have trisomy 21
30%
179
what % of duodenal atresia have other anomiles
50%
180
what is the occurrence of esophageal atresia
1/2,500 live births
181
what % of esophageal atresia cases have coexisting anomalies
50%-70%
182
what is the most common anomaly found with esophageal atresia
anorectal atresia
| others could be VACTERL
183
what is the occurrence of extrophy of the bladder
1/50,000 male births
184
what causes bladder extrophy
a defective closure of the inferior part of the abdominal wall at 4 weeks
185
what 2 renal findings are incompatible with life
renal agenesis
| infantile polycystic kidney disease
186
when do the fetal kidney start contributing to amniotic fluid
14-16 weeks
187
in renal agenesis what structures can be mistaken for as kidneys
adrenal glands
188
what is the sonographic appearance of renal agenesis
severe oligohydramnios
persistent absence of the bladder
failure to see kidneys
small thorax
189
what is Potters syndrome associated with
```
renal agenesis
oligohydramnios
pulmonary hypoplasia
abnormal facies
malformed hands and feet
```
190
how many types of Potters syndrome are there
4
191
what is type 1 Potters syndrome
(AR) infantile polycystic kidney disease
192
what is type 2 Potters syndrome
renal agenesis, multicystic kidneys, renal dysplasia
193
what is type 3 Potters syndrome
(AD) polycystic kidney disease
194
what is type 4 Potters sydndrome
renal dysplasia
| obstructive kidney disease
195
what is the most common form of renal cystic disease in infants and neonates
multicystic dysplastic kidney disease
196
what happens in multicystic dysplastic kidney disease
renal tissue is replace by multiple noncommunicating cysts, causing the kidney to be nonfunctional
197
what is the sonographic appearance of infantile polycystic kidney dieases
kidneys appear enlarged
198
what is the most common reason for hydronephorsis in utero
UPJ
199
where does the UPJ obstruction occur
at the junction between the renal pelvis and ureter
200
True/False
| UPJ's are usually a unilateral defect
True
201
what can cause UPJ
abnormal bend/kinks in ureter
abnormal valves in ureter
abnormal outlet shape
202
what findings occur with posterior urethral valves
hydronephrosis
hydroureters
enlarged bladder and posterior urethra "keyhole" appearance
203
what is the most common fetal anomaly
hydronephrosis
204
the renal pelvis should not measure more than ____
4mm
205
what is skeletal dysplasia
abnormal growth and density of cartilage and bone
206
how many types of skeletal dysplasia are there
over 100, but not all are detected by ultrasound
207
dwarfism occurs ______ to a skeletal dysplaisa
secondary
208
what is rhizomelia
short long bones (Hum/Fem)
209
what is mesomelia
short distal bone (ulna/radius, tib/fib)
210
what is micromelia
shortening of all the extremity bones
211
what are sonographic findings of thanatophoric dysplaisa
```
rhizomelia & bowed long bones
narrow thorax
large head or cloverleaf head
flat vertebral bodies
frontal bossing
hypertelorism
```
212
what is type 1 thanatophoric dysplaisa
short, curved femurs and flat vertebral bodies
213
what is type 2 thanatophoric dysplaisa
straight, short femurs, flat vertebral bodies and cloverleaf skull
214
what is the most common nonlethal skeletal dysplaisa
achondroplasia
215
what is the occurence of achondroplasia
5-15/10,000 births
1/66,000 births in USA
216
what type of bones does achondroplasia produce
short, squat bones
217
what % of achondroplasia cases are from spontaneous mutation
80%
but some can be transmitted in an autosomal form
218
what is osteogenesis imperfecta
disorder of production, secretion or function of collagen causing brittle bones and hypomineralization
219
what is the occurrence of osteogenesis imperfecta
1/20,000 - 30,000 births
220
what are findings of osteogenesis imperfecta type 2
numerous fractures
short femurs
decreased mineralization of bones and calvarium
221
what is the occurrence of osteogenesis imperfecta type 2
1/60,000 births
222
jeunes syndrome has what
a very narrow thorax, causing pulmonary hypoplasia
223
how is jeunes syndrome acquired
inherited by an auto-recessive manner
224
what are sonographic findings of jeunes syndrome
small thorax
rhizomelia
renal dysplasia
polydactyly
225
how often does club foot occur
1/400 births
| unilateral & higher in males
226
what chromosomal anomaly has rocker-bottom feet
trisomy 18
227
how often does Ellis-Van Creveld syndrome occur
1/200,000 births
228
what community has a high incidence of Ellis-Van Creveld
Amish
229
what is another name for Ellis-Van Creveld
chondoectodermal dysplasia
230
what are sonographic features of Ellis-Van Creveld
short limbs
polydactyly
heart defects 50%
narrow thorax
