week 10 fetal GI & urinary Flashcards
3 parts of the gut tube
- foregut
- midgut
- hindgut
blood supply to the foregut
celiac artery
blood supply to the midgut
SMA
blood supply to the hindgut
IMA
esophagus, stomach, prox. duodenum, liver, biliary, pancreas formed from
foregut
pharynx, lower respiratory system formed from
foregut
small intestines, distal duonedum, cecum, appendix, ascending colon, right half of trv olon formed from the
midgut
the left half of trv colon, descending colon, and sigmoid colon, rectum, superior anal canal from the
hindgut
epithelium of the urinary bladder and most of the urethra from the
hindgut
layer contributing to: mucosal epithelium, mucosal glands, and submucosal glands of the GI tract
endoderm
layer contributing to: lamina propria, muscularis mucosae, submucosal connective tissue and blood vessels, muscularis externa, and adventitia/serosa
mesoderm
layer contributing to: neurons and nerves of the submucosal and myenteric plexes
neural crest
fetal esophagus runs from ___ to ____
pharynx to stomach
Can be visualized as early as __ weeks gestation as two echogenic parallel lines in the neck and posterior chest
fetal esophagus
15
After __ weeks fetal esophagus appears as a tubular echogenic structure having one of two patterns
26
This is seen in 49% of cases prior to 26 weeks gestation and in 87% of cases after 26 weeks gestation
several parallel echogenic lines (multilayered pattern)
The __ esophagus can be visualized in about 90% of cases, the ___ esophagus (between the pharynx and the upper limit of the chest) in 19% of cases and the ___ segments (between diaphragm and stomach) in 30% of cases (1)
thoracic
cervical
abdominal
2 patterns the esophagus may be seen as after 26 weeks
- two parallel echogenic lines
2. several parallel echogenic lines
trachea is ___ and bifurcates into main bronchi whereas esophagus is ___ and continues to stomach ___ bifurcation
anterior
posterior
withOUT
___ shows variation in size
esophagus
____ vein courses parallel and to the right of the spine
Azygous
spleen is __ visualized and tends to be __ echogenic that surrounding tissue
poorly
less
t/f: fetal liver appears homogeneous much like adult liver
true
the __ lobe is larger in fetal liver due to blood supply in utero
left
fetal spleen is ___-echoic to liver
hypoechoic
fetal lung is ___ to liver
hyperechoic
pancreas is ___-echoic to surroundings
hyperechoic
gallbladder is visualized in most fetuses after ___ weeks
20
t/f: it is concerning if the gallbladder is not seen at 20 weeks
false
fetal stomach is seen as early as __ weeks
11
non-visualization of the stomach after __ weeks may be result of abnormal fetus
19
what does the fetal stomach contain?
amniotic fluid
when may the stomach not be seen
- low amnionic fluid
- if stomach recently emptied into small bowel
time for fetal stomach to refill
45 min
stomach must be seen on same side as ___
apex of heart
Small bowel initially appears as an ____ pseudomass
echogenic
small bowel becomes ___ echogenic with time as greater amounts of fluid enter the bowel
less
By 30 weeks small bowel ___ may be observed
peristalsis
max diameter of small bowel
5mm
if baby bowel is same echogenicity as bone, it indicates
downsyndrome (trisomy 21)
appearance of large bowel
anechoic
small bowel may be differentiated from large bowel after 20 weeks by ____ and ____. Peristalsis and even fluid filled bowel loops may be observed.
central location
cluster of bowel loops
Large bowel (ascending, transverse and descending colon) appears ____ and is identified by its ____ location
hypoechoic
peripheral
term for contents of the large bowel that at birth appears as dark green mucous material in stools
meconium
max diameter of colon (large bowel) in 3rd trimester
23mm
What is normal echogenicity of the small bowel compare to liver?
hypoechoic - fills with fluid
what system is the spleen part of
lymphatic
What are the three different sets of kidneys during the embryological development (3)
- pronephro
- mesonephros
- metanephros
function of pronephros
non-functional
function of mesonephros
give rise to testes, creates urine from week 6-10 before kidney
function of metanephros
develop into permanent kidneys
when MUST kidneys be seen on fetal ultrasound
18 weeks (observed by 15)
What is the maximum diameter of renal pelvis
5mm
What is the role of thumb for renal length measurement
renal length after 18 weeks = gestational age of fetus in weeks
During routine sonography of 18 weeks fetus sonographer was unable to visualized bladder what should he/ she do next
- indicate renal malfunction ( MUST be visualized by 18 weeks)
- Wait for 45 min until it may fill then if still not there look at the kidneys bc maybe there is a blockage
Cloaca comes from ___ and produces urinary bladder & urethra
ectoderm
Urine is first produced by the kidneys around the ___ - ___ LMP
11 - 12
The urine is excreted into the ___ ___ and forms a portion of the ___ fluid.
amnionic cavity
amnionic
metanephros begin to develop in ___ LMP and are functional kidneys by ___ LP
7
11
wolffian and mullerian ducts develop from
mesonephros
t/f: visualization of fetus ureter indicates pathology
true
Normal fetal ureter size
1mm
bladder completely developed by __ week and sonographically seen by ___ week
12th
13th
After 14 weeks, two thirds of the normal amniotic fluid is produced by ____ and one third from ___
fetal urination
pulmonary fluid
superior to kidneys
adrenal glands
adrenal glands in the 3rd trimester and at birth they are ___ their adult size
20X
Adrenal glands have Linear ___ center (medulla) with ___ rind like rim (cortex)
echogenic
hypoechoic
t/f: Almost impossible to identify gender in a breech fetus
true
May be seen as early as 16 weeks (14-1 6 wk) although more readily defined by 20 to 22 weeks
genitalia
Observation of genitalia is dependent on___, ___, ___
- fetal lie
- amount of amnionic fluid
- fetal leg position
Testicles descend into scrotum at ___ weeks
28
___ appears as a bilateral soft tissue mass separated by a linear echogenic line representing the ___ septum
scrotum
scrotal
A small ___ (fluid around the scrotum) is a normal benign finding in utero
hydrocele
Females may be recognized by observation of the ___ with a linear echo in between representing the labia minora
labia
t/f: labia may appear swollen and can be confused with scrotum
true
GI and pulmonary systems from
endoderm
muscles (heart), urinary, skeletal system from
mesoderm
outer layer, glands / skin & nervous system from
ectoderm
testes and ovaries go ___ as they develop
down
kidneys move ___ as they develop
up
