Prezzi Powerpoints Flashcards
The fetal heart begins to beat at __-__ days of gestation
36
37
A heart rate using M-mode should be sonographically obtainable with endovaginal imaging when crown rump length measures __-__ mm
4
5
In the third trimester, an average fetal heart rate is ___ bpm, with a range of 110 to 180 bpm considered normal after first trimester.
150
An elevation in the fetal heart rate is term _____
tachycardia
A decreased in the fetal heart rate is term _____
bradycardia
The heart, which is fully formed at __ weeks, is imaged most often in a cross-sectional or axial view of the fetal chest just above the fetal stomach. This transducer placement will yield the standard _______ view. The apex of the heart will be angled to the ____ of the midline, with the base, _____ to the spine.
10
four chamber
left
closest
The normal fetal heart will fill approximately _____ of the fetal chest, with its apex forming a ___ degree angle with the fetal spine.
1/3
45
The chamber closest to the fetal spine is the:
left atrium
The ______ is within the right ventricle. Normal structure that appears as an echogenic focus.
moderator band
The ____ valve is between the right ventricle and the right atrium.
tricuspid
The ____ valve is between the left ventricle and the left atrium.
mitral
The four chamber view can be used to evaluate, the separation of the chambers, structures called _____
septums
The two atria are separated by the _____ septum.
atrial
The two ventricles are separated by the _____ septum.
ventricular
The ventricular septum should be uninterrupted and of equal thickness to the:
left ventricular wall
The atrial septum is open only at the _____
foramen ovale
Three vessel view
main pulmonary artery
ascending aorta
superior vena cava
The ______ outflow tract leads to the pulmonary artery and branches.
right ventricular
The ______ outflow tract leads to the aorta.
left ventricular
The normal pulmonary artery should be positioned ____ to the aorta and should be visualized crossing over it. That means, the aorta and pulmonary artery normally criss cross each other.
anterior
The normal umbilical cord contains:
two arteries and one vein
The _______ brings oxygen-rich blood from the placenta to the fetus
umbilical vein
The _____ travels superiorly and connects to the left portal vein
umbilical vein
Half of the blood goes to the liver through the _____, whereas the other half is shunted directly into the inferior vena cava via a small branch of the umbilical vein called the _____
left portal vein
ductus venosus
The existing oxygen -rich blood in the IVC travels to the heart and enters the:
right atrium
Blood can then travel across the ______, an opening in the lower middle third of the atrial septum and into the ______, or it can eneter the right ventricle through the _____.
foramen ovale
right atrium
tricuspid valve
The blood then leaves the right ventricle through the _____.
main pulmonary artery
Blood from the right ventricle can also flow through the _____ and into the descending aorta.
ductus arteriosus
The blood returning from the lungs through the pulmonary veins enters into the _____.
left atrium
Blood then travels from the left atrium into the left ventricle via the ______
mitral valve
From the left ventricle, it travels to the ascending aorta and into the aortic arch, where it exits into the ______, _____, and ______ on its way to the thorax, upper extremities, and head.
brachiocephalic artery
left common carotid artery
left subclavian artery
The blood will return from the head and upper torso via the _____ to the right atrium.
superior vena cava
The ______ return the deoxygenated blood from the fetus back to the placenta.
umbilical arteries
The ______ diverts blood from right to left atrium, bypassing the pulmonary circulation. It closes to become the _____
foramen ovale
fossa ovalis
The ______diverts blood from pulmonary artery to aorta, bypassing pulmonary circulation
ductus arteriosus
The ductus arteriosus diverts __% of umbilical vein blood away from the liver.
80
a group of anomalies characterized sonographically as a small or absent left ventricle
hypoplastic left heart syndrome
the leading cause of cardiac death in the neonatal period, with 95% dying within the first month of life if surgery is not performed
hypoplastic left heart syndrome
When HLHS is found in girls ______ must be suspected. There is also a connection with _____
Turner syndrome
trisomy 18
sonographic findings of HLHS
absent or small left ventricle
no communication between left atrium and left ventricle
aortic atresia
aortic stenosis
coarctation of the aorta
sonographically identified as a small or an absent right ventricle; most often results from pulmonary stenosis or pulmonary atresia, but it may result from stenosis or atresia of the tricuspid valve
hypoplastic right heart syndrome
sonographic findings of hypoplastic right heart syndrome
absent of small right ventricle
enlarged left ventricle
fetal hydrops (secondary to cardiac failure)
narrowing of the pulmonary valveab
abnormal opening in the septum between the two atria of the heart
atrial septal defect
sonographic findings of atrial septal defect
absence of part of the atrial septum
combination of both ASD and AVD
atrioventricular septal defect
results from the abnormal development of the central portion of the heart
atrioventricular septal defect
endocardial cushion defect
atrioventricular septal defect
AVSD is commonly associated with ____, ______, and _____
aneuploidy
trisomy 21
trisomy 18
sonographic findings of AVSD
absence of the atrial and ventricular septum
malformation of malpositioning of the tricuspid valve
Ebstein anomaly
In ebstein anomaly. the right ventricle is contiguous with the right atrium, a finding referred to as _____
“atrialized” right ventricle
Sonographic findings of Ebstein anomaly
malpositioned tricuspid valve
right and left atrial shunting
tricuspid regurgitation
enlarged right atrium
deviation of the atrial septum to the left
fetal hydrops (secondary to cardiac failure)
abnormal opening in the septum between the two ventricles of the heart
ventricular septal defect
sonographic findings of ventricular septal defect
absence of part of the ventricular septum
Most common form of cardiac defect
ventricular septal defect
fluid located around the heart
pericardial effusion
anechoic fluid surrounding the heart
pericardial effusion
narrowing of the aortic arch
coarctation of the aorta
The most common location of coarctation of the aorta is:
between the left subclavian artery and the ductus arteriosus
Sonographic findings of coarctation of the aorta
narrowing of the aortic arch
right ventricular enlargement
pulmonary artery enlargement
outflow tracts reversed; the pulmonary artery arises from the left ventricle and the aorta arises from the right ventricle
transposition of the great vessels
Most often seen within the left ventricle; thought to represent the calcification of the papillary muscle or chordae tendinae
echogenic intracardiac focus
sonographic findings of echogenic intracardiac focus
echogenic structure most commonly located in the left ventricle
most common fetal cardiac tumor
rhabdomyoma
Tumor located within the myocardium of the heart
rhabdomyoma
Rhabdomyoma is associated with ______
tuberous sclerosis
heart is located either partially or completely outside of the chest
ectopic cords
g group of anomalies that combine ectopic cordis and an existing omphalocele
Pentalogy of Cantrell
defined as an overriding aortic root, subaortic VSD, pulmonary stenosis, and right ventricular hypertrophy
Tetralogy of Fallot
sonographic findings of Tetralogy of Fallot
overriding aortic root, VSD, pulmonary atresia, right ventricular hypertrophy
Functional fetal lung tissue does not typically exist until after ___ weeks
25
The normal L/S ratio is ___=___ and is significant for appropriate fetal lung development
2.0
2.5
An L/S ratio of less than ____ is significant for immature fetal lung development
2.0
L/S ratio is:
lecitihin to sphingomyelin ratio
As the lungs mature the level of lecithin _____ whereas the level of sphingomyelin _____
increases
decreases
Begins at 4-5 weeks of gestation, where two tiny buds branch off to form either side of the lungs
embryonic phase
Begins at 5-17 weeks of gestation when a barrier develops between the air and gas-carrying tissues
canalicular phase
Begins at the 26th week of gestation when the surfactant starts to develop, keeping the delicate lung tissues from sticking
Saccular phase
Final stage continues even after delivery, where the additional production of surfactant states, and bronchioles and air sacs (alveoli) grow
alveolar phase
5 phases of lung development
embryonic
pseudoglandular
canalicular
saccular
alveolar
underdevelopment of the lungs
pulmonary hypoplasia
caused by a decreased number of lung cells, airways, and alveoli
pulmonary hypoplasia
Pulmonary hypoplasia is a common finding with _____
oligiohydramnios
The most common lesion that occupies the chest, resulting in pulmonary hypoplasia is:
diaphramatic hernia
Pulmonary hypoplasia is associated with:
Potter syndrome
fluid surrounding the lungs
pleural effusion
also known as hydrothorax
pleural effusion
anechoic fluid surrounding the fetal lungs
pleural effusion
also referred to as congenital cystic adenomatoid malformation (CCAM)
cystic adenomatoid malformation
mass consisting of abnormal bronchial and lung tissue
CCAM
mass that has both cystic and solid components, however it can also appear completely echogenic
CCAM
lung mass with varying degrees of cystic and solid components, completely echogenic mass within the lungs
sonographic appears of CCAM
also referred to as bronchopulmonary sequestration
pulmonary sequestration
separate mass of nonfunctioning lung tissue with its own blood supply to
pulmonary sequestration
echogenic, triangular-shaped mass, typically located with the left side of the fetal chest
pulmonary sequestration
sonographic findings of pulmonary sequestration
echogenic triangular shaped mass in the fetal chest; pleural effusion may be present
most common reason for fetal cardiac malpostion
diaphragmatic hernia
results in abnormal opening in the fetal diaphragm that allows the herniation of abdominal contents into the chest cavity
diaphragmatic hernia
Most common location of diaphragmatic hernia
left side of chest
Left sided diaphragmatic hernia located on the left side is called:
Bockdalek hernia
Sonographic findings of diaphragmatic hernia
malposition of the heart
anechoic stomach bubble noted adjacent to the fetal heart in the four chamber view
other abdominal organs including the liver, pancreas, and spleen may be located within the chest
The fetal thymus is located anterior to the:
mediastinum
The thymus is apart of the immune system because it provides a place for the maturation of _____, which are specialized white blood cells
T cell
hypoechoic structure located in the anterior chest at the level of the sternum between the lungs
thymus
genetic disorder characterized by an absent or a hypoplastic thymus, which ultimately leads to impairment of the immune system and susceptibility to infection, as well as cognitive disorders, congenital heart defects, palate defects, and hormonal abnormalities
DiGeorge syndrome
The spine consists of five sections:
cervical
thoracic
lumbar
sacrum
coccyx
Each fetal vertebra consists of three echogenic ossification centers:
one centrum and two neural processes
The axial skeleton begins to form between the __ and ___ weeks.
6
8
The axial skeleton consists of the:
cranium
spine
hypoechoic line at structure that extends from the base of the cranium to the distal spine
spinal cord
_____ and ____ are the most common neural defects, occurring in 1 of every 1000 births
anencephaly
spina bifida
____ spina bifida is not associated with elevated MSAFP because of the skin covering
closed
It has been reported that __% of spina bifida cases can be detected with AFP screening in combination with sonography.
80
Distortion of the spine can be seen with:
hemivertebrae
myelomeningoceles
amniotic band syndrome
limb-body wall complex
a deformity of the spine in which there is an abnormal lateral curvature
scolisiosis
abnormal posterior curvatures of the spine
kyphosis
when the lower back, above the buttocks, curves inward too much; also konwn as swayback
lordosis
When the upper spine curves too far outward, forming a hump on the upper back
lordosis
deformity of the spine in which there is an abnormal lateral curvature of the spine
scoliosis
abnormal posterior curvature of the spine
kyphosis
also referred to as body stalk anomaly or short umbilical cord syndrome
limb body wall complex
Three postulated causes for limb body wall complex
vascular occlusion
amnion rupture
embryonic dysgenesis
most common sonographic findings of limb body wall complex
short or absent umbilical cord
ventral wall defects
limb defects
craniofacial defects
scoliosis
fetus will appear closely connected with the placenta
Because of the opening in the ventral wall, ____ levels of MSAFP can be detected in the second trimester in limb body wall complex
elevated
________ has very similar sonographic findings to limb body wall complex and may actually be seen simultaneously
Amniotic band syndrome
A common sonographic findings of LBWC is:
short or absent umbilical cord
denotes the abnormal development of a structure
dysplasia
More than ___ skeletal dysplasias have been identified
271
Four most common skeletal dysplasia
achondroplasia
achondrogenesis
osteogenesis imperfecta
thanatoprhoic dysplasia
most common nonlethal skeletal dysplasia
achondroplasia
a type of dwarfism in which the proximal portions of the limbs, the humerus and femurs, are much shorter than the distal portion of the limbs
heterozygous achondroplasia
proximal portions of the limbs are much shorter than the distal portions of the limbs
rhizomelia
sonographic findings of heterozygous achondroplasia
micromelia
macrocrania
frontal bossing
flattened nasal bridge
trident hand
can occur when both parents are dwarfs, it is usually fatal within the first two years of life
homozygous achondroplasia
rare lethal condition, resulting in absent mineralization of the skeletal bones
achondrogenesis
severely shortened limbs
micromelia
sonographic findings of achondrogenesis
micromelia
absent mineralization of the skull, spine, pelvis, and limbs
large skull
narrow chest and distended abdomen
polyhydramnios
commonly known as brittle bone disease
osteogenesis imperfecta
group of disorders that results in multiple fractures that can occur in utero
osteogenesis imperfecta
The fractures in osteogenesis imperfecta are a result of decreased _____ and poor ______
mineralization
ossification
Osteogenesis imperfecta ___ is the most severe form
II
when transducer pressure is applied to skull, the shape of the “soft” skull can be distorted
osteogenesis imperfecta
“death-bearing” dysplasia
thanatophoric dysplasia
most common lethal dysplasia
thanatophoric dysplasia
fetus will have a cloverleaf skull with frontal bossing and hydrocephalus
thanatophoric dysplasia
cloverleaf skull
hydrocephalus
depressed nasal bridge
bell-shaped crest (narrow thorax)
polyhydramnios
redundant soft tissue
telephone-receiver long shaped bones
sonographic findings of thanatorphic dysplasia
Most common location of spina bifida
lumbosacral region
neural tube defect that occurs when the embryonic neural tube fails to close
spina bifida
Two groups of spina bifida
spina bifida occulta (closed)
spina bifida aperta (open)
may be referred to as spinal dysraphism, meningocele, myelomeningocele
spina bifida
open spina bifida
spina bifida aperta
Most common form of spina bifida
spina bifida aperta
The mass only contain spinal cord (meninges only)
meningocele
spina bifida cystica
meningomyeloceles
mass that contains meninges and nerve roots
spina bifida cystica
closed spina bifida
spina bifida occulta
No herniation of spinal contents outside spinal column
spina bifida occulta
In the postnatal period, ______ is suspected when a sacral dimple, hemangioma, lipoma, or tuft of hair is identified in midline of newborn, directly over distal spine.
spina bifida occulta
Spina bifida is associated with two yellow fruits
banana
lemon
Spina bifida is often recognized by its associated cranial findings, a group of abnormalities called the ______ malformation.
Arnold-Chiari II
The pressure of a large mass in the distal spine pulling on the spinal cord causes malformations of the _____ and ______ contents.
cranium
intracranial
When the frontal bones becomes flattened (bifrontal concavity) and yield a lemon shaped cranium
“lemon sign”
scalloping of the frontal bones
“lemon sign”
The cerebellum will become displaced inferiorly and posteriorly and appear curved in appearance of spina bifida. This is referred to as the ____
“banana sign”
syndrome associated with the absence of the sacrum and coccyx
caudal regression syndrome
also referred to as sacral agenesis
caudal regression syndrome
What has a strong associated with caudal regression syndrome?
uncontrolled maternal pregestational diabetes
absent sacrum and possibly part of lumbar vertebra
possible abnormalities in the lower extremities
caudal regression syndrome
a fetal anomaly characterized by fusion of the lower extremities, renal agenesis, and oligiohydramnios
sirenomelia
may also be referred to as mermaid syndrome
sirenomelia
Sirenomelia is almost always lethal because of ______
bilateral renal agenesis
Defects that may be seen with sirenomelia
cardiac anomalies
genital absence
two vessel cord
Sacrococcygeal is a______ tumor
germ cell
germ cell layers
endoderm
mesoderm
ectoderm
most common congenital neoplasm
sacrococcygeal teratoma
Sacrococcygeal tumors are more frequently found in:
females
Tumor that has the potential to grow inside of the pelvis and may cause obstruction of the urinary tract and destruction of the sacrum and pelvic bones
Sacrococcygeal teratoma
_____ SCTs have a malignant potential
large
complex mass extending from distal fetal spine; can be highly vascular; hydronephrosis may be present; fetal hydrops may be present; cardiomegaly
Sacrococcygeal teratoma
includes bones of upper extremities, lower extremities, and pelvic girdle
appendicular skeleton
First sonographic appearances of fetal limbs are referred to as:
limb buds
The appendicular skeleton begins to form between the __ and __ menstrual week.
6
8
Upper extremities of the appendicular skeleton
phalanges (fingers)
metacarpals
carpals
radius
ulna
humerus
clavicle
scapula
Lower extremities of the appendicular skeleton
phalanges (toes)
metatarsals
tarsals
tibia
fibula
femur
Measurements of long bones, especially the _____, are included in the OB sonogram
femur
Sonographic determination of shortening of a limb is made when the long bones measure :
more than four standard deviations below the norm for gestational age
absent hand
achieria
shortening of distal segment of limb
acromelia
absent limb
ameliai
absent foot
apodia
limitation of fetal motion
arthrogyroposis
deviation of a finger
clinodactyl
malformation of the bones of the foot in which the foot is most often rotated medially, and the metatarsals and toes lie in the same plane as the tibia and fibula
clubfoot
absent part of an extremity distal to the elbow or knee
hemimelia
shortening of the middle segment of a limb
mesomelia
shortening of an entire limb
micromelia
having less than the normal number of digits
oligodactyl
absent long bones with the hands and feet arising from the shoulders and hips
phocomelia
having more than the normal number of digits
polydactyl
shortening of the proximal segment of the limb
rhizomelia
abnormal curved shape of the sole of the feet
rocker bottom feet
exaggerated distance between the first toe and the second toe
sandal gap
fusion of the digits
syndactyl
fusion of the legs
sirenomelia (mermaid syndrome)
clubhand
talipomanus
increases space between the third finger and the fourth finger
trident hand
the absence of underdevelopment of the radius
radial ray defect
absent or hypoplastic radius, various defects in other systems
radial ray defect
also referred to as talipes or talipes equinovarus
clubfoot
malformation of the bones of the foot
clubfoot
In clubfoot, the foot is most often _____ and rotated _____
inverted
medially
Sonographic diagnosis can be made for clubfoot when the metatarsals and toes lie in the same plane as the ______ and _____
tibia and fibula
Limb reduction can be caused by ______ syndrome.
amniotic band
The sticky bands in amniotic band syndrome result from:
the rupture of the amnion
amputation of fetal parts or severe edema in the affected area, thin linear bands may be seen, facial clefting
amniotic band syndrome
Whenever any form of ______ is suspected, a thorough facial evaluation should be performed to assess for the associated facial abnormalities that often accompany this unfortunate brain malformation
holoprosencephaly
a decrease in the size of the eye
microphalthmia
fusion of the orbits
cyclopia
absence of the eyes
anopthalmia
close-set eyes (hypotelorism) and a nose with a single nostril
cebocephaly
obtained from lateral canthus or orbit to medial canthus of same orbit
ocular diameter
length between the orbits
interocular diameter
includes both orbits; distance between lateral canthi of each eye
binocular diameter
The corners of the eyes are referred to as _____ and _____
medial canthus
lateral canthus
abnormal division in the lip
cleft lip
abnormal development of the soft and/or hard palate of the mouth where there is a division in the palate
cleft palate
displaces orbits laterally, most common cause of hypertelorism
anterior cephalocele
Most common cause of hypotelorism
holoprosencephaly
increased distance between orbits
hypertelorism
a condition in which there is no nose and a proboscis separating two close-set orbits; associated with holoprosencephaly
ethmocephaly
Anomalies of the ears, including low-set ears, have been noted with trisomies:
13
18
21
small ears; have a strong like with Down syndrome
microtia
There is a notable like between the absence of the fetal nasal bone and _____
Down syndrome
failure of ear to develop
anotia
unusual protuberance of the tongue
macroglossa
Macroglossia is most commonly associated with ______ and _____
Beckwith-Weidemann syndrome
Down syndrome
The maxilla tends to shorter in fetuses with:
trisomy 21
an oral teratoma
epignathus
The fetal lip typically closes between __-__ weeks
7
8
The palate typically closes by __ weeks
12
abnormal closure or incomplete closure of lip and palate
cleft lip and cleft palate
Cleft lip/palate is associated with:
holoprosencephaly
trisomy 13
amniotic band syndrome
small mandible and recessed brain; associated with trisomy 13 and 18
micrognathia
associated with Turner syndrome, fetal hydrops, aneuploidy, trisomy 21, 13, 18
Cystic hygromas
also referred to as a lymphangioma
cystic hygroma
results in abnormal accumulation of lymphatic fluid within the soft tissue
cystic hygromas
Most common location of cystic hygroma
neck
can be the cause of overtreatment of maternal Graves disease, iodine deficiency, or hypothyroidism
fetal goiter
Nuchal fold measurement of __mm or larger is considered abnormal.
6
Nuchal thickening, edema, or redundant skin in back of neck are common findings during second trimester in fetuses with ______.
Down Sydrome
By ____ weeks, the neural plate has developed.
4.5
Initially, the brain is divided into three primary vesicles:
prosencephalon
mesencephalon
rhombencephalon
forebrain
prosencephalon
midbrain
mesenecephalon
hindbrain
rhombencephalon
The _____ will become the fourth ventricle as well as the medulla oblongata and cerebellum.
rhombencephalon
The prosencephalon matures into two other vesicles, the _______ and ______.
telencephalon
diencephalon
The ______ forms the cerebral hemispheres, lateral ventricles, and third ventricle.
telencephalon
The ______ will become the thalamus and hypothalamus.
diencephalon
The ______ will become the midbrain, including superior parts of the brainstem.
mesencephalon
The ______ may be seen as a cystic structure within the fetal head at 7-8 week.
rhombencephalon
The brain is divided into two main parts, the _____ and the _____.
cerebrum
cerebellum
The cerebrum is divided into left and right hemispheres by the ________.
interhemispheric fissure
The ______ is located within the interhemispheric fissure.
falx cerebri
The cerebral hemispheres are linked in the midline by the ______
corpus callosum
The corpus callosum forms late in gestation but should be completely in tact between __ and __ weeks
18
20
The absence of all or part of the corpus callosum is referred to as:
agenesis of the corpus callosum
The _______ is a midline structure located in the anterior portion of the brain.
cavum septum pellucidum
The ______ is a vital brain structure that has numerous functions and is a significant landmark
thalamus
The ______ is a landmark for the BPD.
thalamus
The skull consists of eight cranial bones known as _____
sutures
Premature fusion of the sutures is termed _____
craniosynostosis
The ventricular system is composed of ____ ventricles.
4
Within the lateral ventricles, is the ______
choroid plexus
The _______, which is mostly located within the atria of the lateral ventricles, is responsible for producing CSF.
choroid plexus
The third ventricle connects to the fourth ventricle inferiorly by means of a long tubelike structure called the ______
aqueduct of sylvius or the cerebral aqueduct
The cerebellum is located in the ______
posterior fossa
The cerebellum consists of two hemispheres that are coupled in the midline by the ________
cerebellar vermis
The normal _______ is dumbbell shaped in the posterior cranium of the fetus.
cerebellum
________, located in the posterior fossa of the cranium, is the largest cistern in the head.
cisternal magna
anechoic area posterior to the cerebellum between the cerebellar vermis
cisternal magna
Head circumference is taken at the same time as the _____.
BPD
_______ measurement is measured in the transaxial plane at the level of the atrium.
Lateral ventricle
The normal lateral ventricle does not typically does not measure more than ___ mm at the level of the atrium.
10
The cerebellum grows at a rate of __ mm per week between 14-21 weeks and thus correlates with gestational age
1
____ is obtained at the same level as the BPD and HC.
OFD
For the ____, one caliper is placed in the anterior midline in the middle of the frontal bone, whereas the other is placed in the middle of the echogenic line of the occipital bone.
OFD
Cisterna magna measurement should not measure more than ___ mm or less than __mm in the transcerebellar plane.
10
2
BFD/OFD x 100
cephalic index
small head
microcephaly
associated with:
TORCH infections
Trisomy 13 and 18
Meckel-Gruber Syndrome
Fetal Alcohol Syndrome
microcephaly
enlarged head circumference
macrocephaly
associated with:
hydrocephalus
hydranencephaly
intracranial tumors
familial inheritance
Beckwidth-Wiedemann syndrome
macrocephaly
round skull shape
brachycephaly
associated with:
craniosynostosis
trisomy 18 and 21
brachycephaly
cephalic index more than 85
brachycephaly
an elongated narrow head shape
dolichocephaly
may also be referred to as scaphocephaly
dolichocephaly
associated with:
craniosynostosis
dolichocephaly
cephalic index less than 75
dolichocephaly
The _______ cells are the cells that produce the pregnancy hormone HCG
trophoblastic
The gestational sac is also referred to as the _____
chorionic sac
The sperm unites with the egg in the distal one third of the fallopian tube, usually the _____
ampulla
The ________ regresses during week 4 and the chorionic sac is formed.
primary yolk sac
A mature ovum is released through ovulation at around day ___ of the menstrual cycle because the graafian follicle ruptures and liberates the ovum into the peritoneal cavity
14
On day __ or __ of the menstrual cycle, the blastocyst begins to implant into the decidualized endometrium at the level of the fundus.
20
21
By ___ days, complete implantation has occurred.
28
Conception usually takes place within ___ hours after ovulation
24
_______ age or ______ age is used by obstetricians to date a pregnancy
menstrual
gestational
The ______ is visible during the latter half of the first trimester as a tortuous structure connecting the fetus to the developing placenta.
umbilical cord
The developing _____ may be noted at the end of the first trimester as a well-defined, crescent shaped mass of tissue along the margins of the gestational sac.
placenta
The placenta is formed by the _______, the maternal contribution and the ________ the fetal contribution
decidua basalis
chorion frondosum
a functional cyst that is maintained during the first trimester by HcG, which is produced by the developing placenta
Corpus Luteum
Most common pelvic mass associated with pregnancy
corpus luteum cyst
also referred to as extrauterine pregnancy
ectopic pregnancy
Most common location of ectopic pregnancy
ampullary portion of the fallopian tube
______ is used to treat ectopic pregnancies.
methotrexate
classic clinical triad of ectopic pregnancy
pain
vaginal bleeding
palpable abdominal/pelvic mass
coexisting EUP and IUP
heterotopic pregnancy
Optimal measurement timing of NT
between 11 weeks and 13 weeks 6 days
An NT measurement greater than __ mm is considered abnormal between 11 and 13 weeks 6 days.
3
Most common abnormalities associated with abnormal NT
trisomy 18 and 21
Turner syndrome
In the first trimester, HCG maintains the ______ so that it can continue to produce progesterone
corpus luteum cyst
HCG can be detected in maternal blood as early as ___ days menstrual age.
23
The laboratory test to detect pregnancy is ____
HCG
A ________, the earliest definitive sign of an IUP, should generally be visualized between ____ and ____ mIU per ML with transvaginal sonography.
gestational sac
1000
2000
Normal HcG levels ____ every 48 hours in the first trimester.
double
The period given to describe the earliest sonographic detection of an IUP
discriminatory zone
By adding 30 to the MSD, sonographers can obtain as estimate for:
gestational age in days
Limb buds are identified between __-__ weeks
7
8
__-__ weeks physiologic bowel herniation may be visualized.
9
12
Physiologic bowel herniation should resolve by __ weeks
12
The yolk sac is located within the ______
chorionic cavity
At 5.5 weeks the _______ is the first structure seen in the gestational sac.
secondary yolk sac
The yolk sac is connected to the embryo by the ______
vitelline duct
The most accurate sonographic measurement of pregnancy is the ____
CRL
Decidual reactions occurs between weeks __ and __
3
4
During decidual reaction, the endometrium appears:
thickened and echogenic
First definitive sign of an IUP is identification of the gestational sac in the _______
decidualized endomtrium
If physiologic bowel herniation is not resolved by ___ weeks, a follow up is warranted.
12
Measurement of the _______ is the earliest sonographic measurement that can be obtained
gestational sac
By 6 weeks, the embryo can be seen located within the _____ adjacent to the yolk sac with transvaginal sonography
amniotic cavity
The heart rate of the embryo at 6 weeks is:
between 100-110 bpm
Mean sac diameter equation
L x W x H /3
The first trimester is defined as weeks __ - ___
1
12
The second trimester is defined as weeks ___-___
13
26
the third trimester is defined as weeks ___-___
27
42
Normal pregnancy lasts for ___ months, ____ weeks, or _____ days.
9
40
280
Month 0
weeks 1-4
Month 1
weeks 5-8
Month 2
weeks 9-12
Month 3
weeks 13-17
month 4
18-21
month 5
22-25
month 6
26-30
month 7
31-34
month 8
35-38
month 9
39-42
reduction in blood return to the maternal heart caused by the gravid uterus compressing the maternal IVC
supine hypointensive syndrome
TV transducers should undergo ______ disinfection
high level
Patient prep TA
full bladder
most often used during early pregnancy, offers better resolution
TV probe
Relevant OB labs
estriol
HcG
Maternal serum AFP
triple and quadruple screen
denotes the number of times a woman has been pregnant
gravidity
denotes the number of pregnancies that led to the birth of a fetus at or beyond 20 weeks or an infant who weight at least 500g
parity
artifacts in OB imaging
comet-tail
reverberation
shadowing
posterior acoustic enhancement
ring down
3 breech presentations
complete
incomplete
Frank
fetal legs flexed at hip and there is flexion of the knees
complete breech
fetal buttocks are closest to the cervix
Frank breech
most common fetal presentation
cephalic
Presentation of the fetus is determined by identifying fetal anatomy closest to ______
internal os of the cervix
Large ovarian cysts or masses can lead to:
ovarian torsion
______ is common during late pregnancy secondary to large size of uterus
hydronephrosis
The most common pelvic mass associated with pregnancy is:
corpus luteum cysts
Measurements in the first trimester
YS
GS
CRL
NT
The purpose of the BPP
investigate for signs of fetal hypoxia and assess overall fetal well being
The BPP exam last ___ minutes
30
The highest possible score of a BPP without NST is:
8
The highest possible score of a BPP with NST is:
10
