The 2nd Trimester Detailed Anatomy Scan Flashcards
pario
to bear
when is baby considered viable
24 weeks gestation
gestation
development from conception to birth
perinatology
study of an infant before, during, and after birth
Hyster-hystero
uterus or womb
salpinx
Fallopian or uterine tubes
Parturient
woman in labor
bleeding with pain can be (2)
Abruption (marginal or retroplacental)
Ectopic
bleeding without pain can be (3)
Placenta previa
Molar pregnancy
Implantation bleed
detailed anatomy scan performee between __ and ____ weeks
18
20
supine hypotension
caused by pregnancy putting pressure on the IVC and lower aorta reducing venous return = BP/HR drop = syncope
what way to role patient if going to pas out
onto left side (away from you)
overall sag sweep (4)
position of fetus
fetal heart motion
number of fetuses
presence of amniotic fluid
trans sweep overall (2)
fibroids on the uterus
adnexal masses usually arising from ovary
7 maternal images
sag cervix
sag fundus
placenta postion (sa/trans)
cervix/placenta distance
placenta cord insertion
adnexae/ovaries
fetal enviro (amniotic fluid)
normal length of cervix
> 3cm
if cervix 9cm what do you do
likely braxton hicks so wait for contraction to stop and remeasure
placenta should be a minimum of _____ away from the internal os of the cervix
2cm
previa
low lying baby (placenta <2cm from cervix)
cord insertion should be ___ from placental edge in both planes
> 2cm
is fluid measured during 2nd trimester scan
no
what two pockets of amniotic fluid can be measure
deepest vertical pocket (DVP)
single deepest pocket (SDP)
AFI is done after
amniotic fluid index measurement
26-28weeks
_____ = polyhydramnios
_____ = oligohydroamnios
8cm
2x1cm
if fetus lying up start with
heart then face/profile
if fetus lying with back up start with
spine and kidneys
fetal anatomy groupings (6)
head
spine (kidneys)
abdomen
heart
limbs
genitalia
8 fetal head images
BPD/HC
choroid plexus
ventricles
cerebllar image/post fossa
orbital image
face image
nose lip image
profile
colichocephalic
narrow head
brachycephalic
wide head
calvarium
bones of head
highest straight plane in head
transventricular
lower straight plane in head
transthalamic
oblique plane in head
transcerebellar
BPD is perpendicular to ____ and measured from ____ to ___
falx
outer bone edge
inner bone edge
BPD assesses (5)
cavum septi pellucidi
thalami
third ventricle
falx cerebri
size, shape, integrity, and bone density of cranium
ventricular image is an ___ view of the head just above the _______ plane. It is taken at the level of the ____ and the ____ is the anterior landmark
axial
transthalamic
lat ventricles
CSP
do you measure ant or post ventricle
post due to reverb artifact on ant one
upper limit of normal for lat ventricles
10mm
choroid plexus image is used to asses the ____ of both choroid together
echotexture
CPC
choroid plexus cysts
3 things cerebellar/post fossa image is used for
asses cerebellar size/shape
presence/size of cisterna magna
nuchal fold thickness
cisterna magna upper limit of normal
10mm
nuchal fold thickness upper limit of normal
6mm
hypertelorism
eyes too far apart
hypotelorism
eyes too close together
microopthalmia
small eyes
anopthalima
no eyes
what do you need to see to rule out anopthalima
lenses of the eyes
tangential plane
plane used to image the nose and lips
nose/lip image used to rule out
cleft lip
abnormal nostrils
micrognathia
small mandible
retrognathia
receding chin
how to locate profile
find BPD
slide to front of head
rotate 90 to get profile
BPD taken in _____ plane
transthalamic
post fossa taken in ____ plane
transcerebellar
fetal spine images (3)
sag upper mid lower spine
trans at level of sacrum (iliac crests)
trans kidneys
+/- sag kidneys
what is the visible portion of the spine on US
3 ossification centers
the ant ossification center is the ____
vertebrak body
the post ossification centers are the _____
pedicle laminar junction
ossification is not complete until ____ weeks gestation
18
2 images taken for sag spine
one distal for sacrum
one cephalic for cervical spine into cranium
what should you try to visualize on sag spine levels
skin line
what is most important for spine
sweep in trans
trans spine includes and where is spine
3 oss centers
iliac crests
spine up
what is also usually seen in trans spine image
fetal bladder
renal pelvises are ___ and minimally dilated up to ___. ___ is the upper limit of normal in the 2nd trimester
hypoechoic
3mm
5mm
for kidney image have spine where and what level is it taken at
spine in middle
at level of renal pelvis
adrenals are ___ with _____ centers
hypoechoic
echogenic
are adrenals a required image
no
7 fetal abdomen images
abd circumference
stomach
cord insertion into bladder
bladder
2 umbilical arteris
3 vessel cord
+/- sag diaphragm with stomach or heart
AC used for (2)
presence of stomach
position of organs (situs)
____ may be seen on AC and confused as stomach
GB
AC landmarks (6)
stomach
umbilical vein -> portal sinus
round shape
rib symmetry
adrenal glands (not kidneys)
spine (lateral orientation)
bladder should fill and empty every ___
20 mins
presence of bladder indicates
at least one functioning kidney
umbilical cord consists of
2 arteries and 1 vein
image umbilical cord in ___
trans
image cord insertion into _____ and into ____
abdominal wall
placenta
cord should insert into the placenta more than ____ away from edge of placenta
2cm
2 umbilical arteries at bladder will add ___ or ____ doppler
colour
power
assess location of ___ in relation to diaphragm
stomach
long image of abd/chest assess echotexture of lungs compared to _____
liver
lungs should be ____ to ____ to liver
isoechoic
slightly hyperechoic
logn abd/chest includes (3)
heart
diaprhagm
stomach
long abd/chest taken in what plane
parasagittal on the left
large bowel ____ in diameter at term
17mm
what trimester may include meconium partical and appear more hypoechoic and prominant
3rd
8 fetal heart images
4 chamber view
left outflow tract
right outlflow tracg
3 vessel view
IVS (horiz 4CH)
heart axis/situs
heart rate (m mode)
+/- sag diaphragm with heart
from abd AC view slide cephalic to find (4 fetal heart images in order)
4CH
LVOT
RVOT
3 vessel view
what image is m mode taken in
4Ch
3 things to look for in 4Ch
heart position: left of midline
heart axis: apex 45 degrees left
heart size: occupies 1/3 of chest
fetal heart optimization (4)
fetal echo preset
OR
decrease sector width
zoom
increase contrast (decrease dynamic range)
4Ch apex should be pointed
up
if you have IVS _____ to apex to get 4CH
slide
LVOT included
LV
RV
AoV
LA
think A3C
RVOT includes
RA
RV
PA
think PSAX base
cine clip of heart should be _____s long for fetal heart sweep
6-12
fetal heart sweep includes (5)
stomach
4CH
LVOT
RVOT
3 vessel view
