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Sonography > Obstetric > Flashcards

Obstetric Flashcards

1
Q

After fertilization the ovum turns into what which contains 46 chromosomes

A

zygote

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2
Q

after a zygote goes through a division process called cleavage and then transitions into a which contains 16-32 cells

A

morula

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3
Q

on day 18-19 the morula exits the fallopian tubes into the uterine cavity and endometrial fluid penetrates the cell mass and creates what

A

blastocyst

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4
Q

what is the blastocyst inner cell mass as well as the outer shell of cells

A

-embryoblast (future embryo)
-trophoblast (future placenta)

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5
Q

what are the two layers of the trophoblast

A

-syncytiotrophoblast (outer)
-cytotrophoblast (inner) becomes the amnion

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6
Q

Which hormone is produced by the trophoblast

A

hCG (Human Chorionic Gonadotropin)

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7
Q

What days does the blastocyst attach to the endometrium

A

day 20-21

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8
Q

this is the anchor point for the blastocyst and begins the development of the primitive placenta

A

decidual basalis

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9
Q

Refers to the changes that occur in the endometrium in response to the implantation of a fertilized egg. The stromal cells of the endometrium enlarge, forming into decidual cells.

A

decidua reaction

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10
Q

if pregnancy takes place what two layers will begin to form at the syncytiotrophoblast to serve as the blood vessels to the placenta

A

chorionic villi to chorionic frondosum

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11
Q

a normal gestational sac is a rounded anechoic structure and seen in ultrasound at approximately what weeks LMP

A

5 weeks

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12
Q

early sonographic depiction of the GS (gestational sac) with an anechoic endometrial space and further out of the decidua capsularis. This is known as.

A

the double sac sign is a reliable indicator of a developing pregnancy in the very early stages

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13
Q

-initiation of placental development
-develops alimentary canal
-neuroplate develops into neurotube (future brain)
-fetal lungs beginning to develop but not yet active

A

Ovarian phase weeks 4-5

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14
Q

-primitive heart begins to beat
-primitive brain consists of : forebrain (prosencephalon), midbrain (mesencephalon), hindbrain (rhombencephalon)

A

embryonic phase weeks 6-10

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15
Q

-formation of anterior and lateral abdominal walls
-yolk sac fuses with vitelline duct to become umbilical cord

A

weeks 7-8

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16
Q

-mineralization of skeleton begins
-embryo becomes c-shaped with limb buds
-small bowel herniates at base of umbilical cord (developed outside of baby body before the abdominal walls closes on it) AKA gastroschisis

A

weeks 8

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17
Q

-functional fetal kidneys appear
-major organ system is established
-embryo demonstrates baby features

A

week 10

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18
Q

-organ development
-fetal intestinal activity begins
-fetal swallowing

A

fetal phase weeks 11-12

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19
Q

developed into nanotube brain and spinal cord

A

neuroplate

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20
Q

The innermost membrane of developing embryo

A

Amnion

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21
Q

Outermost layer of the developing embryo

A

chorion

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22
Q

Structure is responsible for production of amniotic fluid

A

-chorion frondosum
-chorionic and amniotic membrane
-skin, respiratory, and urinary tract

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23
Q

structures involved in reduction of amniotic fluid

A

-gastrointestinal system
-amniotic - chorionic interface

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24
Q

MSD (mean sac diameter)

A

(Length + Depth + Height)/3 = MSD
Most accurate to get GA; must be completed within the first 6 weeks

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25
Q

measurement made from top of the head to middle of buttocks

A

CRL (Crown Rump Length)

26
Q

To determine the fetal risk for aneuploidy; is the measurement of the fluid that normally collects at the back of the fetus neck during the first trimester between 11-13 weeks; 3-3.5 cm if bigger it means congenital abnormality

A

NT Measurement (Nuchal Translucency)

27
Q

membrane formed from scarring or adhesions secondary to surgery or infection inside the GS

A

uterine synechia; doesnt attach to embryo

28
Q

-normal levels increases doubling every 48 hours
-2000 is the level at which a sac will be seen in most early pregnancies

A

B-HCG test (Beta Human Chorionic Gonadotropin)

29
Q

-elevated levels indicate fetal abnormalities
-found in maternal blood and AF

A

AFP (Alpha-Fetoprotein)

30
Q

Triple marker screen: all 3 are indicators of certain embryonic/fetal abnormalities

A

AFP, uE3 (Unconjugated Estriol), HCG

31
Q

the importance of testing the maternal/paternal blood typing

A

-determine blood type and Rh factor
-if mismatched mother’s antibodies will attack baby’s RBC’s and lead to miscarriage

32
Q

fluid in amniotic sac measures degree of fetal lungs

A

LS ratio ( Lecithin-to-Sphingomyline)

33
Q

1st trimester can be termed as

A

trimester of differentiation and developement

34
Q

2nd/3rd trimester can be termed as

A

trimester of growth and maturation

35
Q

placenta grading

A

Grade
- 0: smooth chorionic plate. Basal layer is free of bright reflective densities.
- 1: placenta exhibits a few scattered hyperechoic calcifications
-2: chorionic plate exhibits, mild or midsize indentations
- 3: Obvious indentations in chorionic plate that extends as far as basal layer

36
Q

Four types of placenta previa

A

-Total or complete; the placenta covers the entire internal os
-Partial or incomplete; partially covers the internal os
-Marginal; small edge of the placenta encroaches upon the internal os, but does not cover
-low lying; lower edge lies within 0.5 to 5 cm from internal os

37
Q

permits growth, prevents adhesions, protects the fetus, and temperature control. Particles flowing consist of skin flakes, hair, urine.

A

Amniotic fluid

38
Q

normal AFV (amniotic fluid volume) quantity

A

Greater than 2 cm in a single pocket or four quadrant measurement (AFI) of 8 to 25 cm

39
Q

Too much amniotic fluid over 30 cm; the baby is not swallowing properly and looks abnormally tiny

A

Polyhydraminos

40
Q

Two little amniotic fluid less than 6 cm; the baby is smooshed within the uterus due to kidney issues

A

oligohydraminos

41
Q

measures outer to inner wall of the head; can be used at 10 weeks or to term. It is less accurate in the late third trimester.

A

BPD (Biparietal Diameter)

42
Q

Measures from outer to outer wall of the head; can be used from 12 to 40 weeks

A

HC (Head circumference)

43
Q

measures the perimeter of the abdomen, including the soft tissues. Taken in the transverse plane at the level of ductus Venosum. Good from 12 to 40 weeks.

A

AC (abdominal circumference)

44
Q

Measures the straight shaft of the femur, do not include epiphysis

A

FL (femur length)

45
Q

For head shape, used to verify accuracy of the BPD

A

Cephalic index (cI)
-Dolichocephalic: rolled out dough
- Bradycephalic: wider, protruding forehead

46
Q

test completed for a second trimester anatomical survey (sonographic); not as reliable for EDD (estimated due date) compared to first trimester calculations

A

1- R/O ectopic pregnancy, ovaries, myometrium to R/O fibroid or myoma
2- placenta location, R/O previa, cervix length, umbilical cord insertion, Age/grade of placenta
3- Fetus measurements (BPD/HC, AC, FL)

47
Q

Which markers are used during the BPD measurement

A

-Cava septum pellucidum; square shaped with white border
-midline falx
-thalamus

48
Q

what markers are used during the abdominal circumference test?

A

-Stomach bubble
-umbilical vein; the intrahepatic portion should be visible at the level of the portal sinus
-vertebra; three circular dots and should be in the three or 9 o’clock position
-kidneys; should not be visible
-adrenal glands; Maybe visible next to the vertebra

49
Q

DCDA (Dichorionic Diamniotic)

A

two placenta, two sacs (1-3 days)

50
Q

MCDA (Monochorionic Diamniotic)

A

one placenta, two sacs (4-8 days)

51
Q

MCMA (Monochorionic Monoamniotic)

A

one placenta, one sac (9-12 days)

52
Q

Formed embryonic disc joined between 13-15 days

A

conjoined twins

53
Q

Fetus without the cranial vault (functioning brain)

A

-anencephaly

54
Q

fetus lacking closure of the vertebral column with extrusion of spinal cord and meninges

A

spina bifida

55
Q

sac of lymph fluid at the fetal head and neck region

A

cystic hygroma

56
Q

fetus with an absence of the kidneys

A

renal agenesis

57
Q

Fetus with intestines are outside the abdomen and surrounded by a membrane; very dangerous

A

omphalocele

58
Q

fetus with intestines are outside the abdomen without a surrounding membrane and free floating; surgically repairable

A

gastroschisis

59
Q

fetal blood flow beginning from placenta

A

placenta > umbilical vein > Ductus venosus > IVC > Rt. Atrium > Foramen Ovale > Lt. Atrium > pulmonary trunk > lungs
» pulmonary trunk&raquo_space; foramen ovale&raquo_space; AO

60
Q

TGC

A

Time Gain Compensation

Sonography (5 decks)

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