week 7 - fetal heart Flashcards
first system to function in embryo
cardiovascular
witha ___ scan, the heart flickers can be appreciated shortly after 5wk LMP
transvaginal
fetal heart begins to beat at __ weeks
5
The heart begins as a set of paired tubular structures known as the ____ ____
cardiogenic cords
cardiogenic cords fuse on the 22nd day of development to form the ________
heart tube
the heart tube consists of : (2)
endocardial tube and myoepicardial mantle
the ____ portion of the heart tube bends right and ventrally
cephalic
the ___ portion of heart tube bends leftward in dorsocranial matter
caudal
the ___ portion becomes the atriums
caudal/left heart tube
the ___ portion becomes the ventricles
cephalic / right
when the tube bends left/ right resulting in a small atrium and large ventricle, this is called ____ then ____ forms connecting the early atrium to the early ventricles
atrioventricular loop
atrioventricular canal
___ cords, ____ structures, are the first sign of heart development.
cardiogenic
tubular
The ____ ___ forms as the tube bends.
atrioventricular loop
Endocardial cushions develop, separating the atria
and ventricles, at approximately ___ weeks.
6th
In the ___ week, the truncus arteriosus forms, twisting into their proper location
9th
___ sets of aortic arches form and regress
several
Fetal circulation has three bypasses: (3) ___, ___, ___ which close at parturition.
ductus arteriosus
foramen ovale
ductus venosus
___ is the most common malformation
CHD
The best time to examine the fetal heart with ultra- sound is between ___ -___ weeks
18-22
The normal heart is at a __-degree angle to the left of midline (levocardia)
45
what mode helps detect heart rhythm anomalies when the M-line placement is through the atria and ventricle
M-mode
Atrial and venous ends of the heart tube are fixed by the ____ at the arterial end, and the _____ at the venous end
brachial arches
septum transversum
Because atrial and venous ends are fixed, and the ___ and ventricle grow faster then the other regions, the heart bends ___ itself, forming a U shaped
bulbus cordis
upon
name for the u-shape when the heart bends on itself (day 37-38 LMP)
bulboventricular loop
as the heart bends, the ___ and the ___ come to lie dorsal to the bulbus cordis, Truncus arteriosus and ventricle
atrium
sinus venosus
what is formed resulting from the ingrowths of the cushions
mitral and tricuspid valves
The ventricular septum begins to form as the primitive ventricles begin to dilate, causing the fusion of their medial walls. This process starts at the ___ of the heart, with the ___ portion of the septum forming first, followed by the ___ portion.
apex
muscular
membraneous
____ vein brings brings oxygenated blood to the liver of baby or through ductus venosus
umbilical
ductus venosus meets up with ____
IVC
T/f: you can find oxygenated blood in the IVCof bbay
true
blood from IVC dumps into ___
right atrium
blood from SVC dumps into ___
right atrium
shortcut to bypass the liver (from umbilical vein to IVC)
ductus venosus
blood flow of deoxygenated blood
- right atrium
- right ventricle (some)
- pulmonary artery
- lungs
fetal circulation starting at placenta
- umbilical vein –> liver OR
- ductus venosus
- IVC
- right atrium –> right ventricle –> pulmonary artery –> ductus arteriosus –> aorta
OR right atrium… - foramen ovale
- left atrium
- left ventricle
- aorta
hypoxic pulmonary vasoconstriction
alveoli cause constriction on arteriole
pressure in pulmonary artery increases due to
resistance in lung
foramen ovale
allows blood to go from right atrium to left atrium
allows blood to go from right atrium to left atrium
foramen ovale
fetus circulation adaptations (5) that are NOT present after birth
- umbilical vein
- ductus venosus
- foramen ovale
- ductus arteriosus
- umbilical artery
allows blood to go from pulmonary artery to aorta
ductus arteriosus
why does blood go from pulmonary artery to aorta
because of high pressure in pulmonary artery/ high pressure in lungs
why don’t you get much blood into pulmonary vein
bc most of it goes into aorta
brings blood back to the placenta bc placenta has low resistance and blood flows towards low pressure
umbilical artery
The great vessels (aorta and pulmonary arteries) arise from the common vessel of the ____.
truncus arteriosus
fetal heart is more ___ in chest due to large liver
horizontal
right ventricle is ___
anterior
left atrium is ___
posterior
apex points to
left
normal fetal heart rate
120-160BPM
the cardiac apex points to the left (normal heart axis)
levocardia
the cardiac apex points to the midline
mesocardia
the cardiac apex points to the right
dextrocardia
4 chamber heart view is a ___ image through the thorax just above diaphragm
axial/trv
allows eval of cardiac size, position in chest, axis , chamber size, atri
4 chamber heart view
1/4 of the thorax on the left is ___
heart
___ is closest to the anterior chest wall and contains the moderator band
right ventricle
forms the apex of the heart
left ventricle
tricuspid valve separates the
right atrium and right ventricle
mitral valve separates the
left atrium and left ventricle
interventricular septum separates
left and right ventricles
arises from crus of heart and projects into the space bw left and right atria
atrial septum premum
permits flow of blood from right atrium to left atrium (bypassing pulmonary vasculature)
foramen ovale
vessels seen in 4-chamber view
descending aorta
2 pulmonary veins entering the left atrium
chamber closest to aorta
left atrium
what is next to the spine in 4 chamber view
descending aorta
4chamber view is done in ___ plane at the level of the __ rib
trv
4
in normal situs the ___ and ___ are on the left side
apex of heart
stomach
right atrium has ___ diameter than left atirum
larger
foramen ovale is in the___
interatrialseptum
interatrial septum bows from ___ to ___
right
left
purpose of ductus arteriosa
bypass the lungs
what ducts does the ductus arteriosa connect
pulmonary artery –> aorta
the moderator band is located in the ___ that connects the interventricular septum to the anterior papillary muscle
right ventricular apex
reason for left ventricular outflow tract view & right ventricular outflow tract view
see anomalies that cannot be seen in 4 chamber view
___ gives rise to the aorta
left ventricle
___ gives rise to the pulmonary artery
right ventricle
what is seen in left ventricular outflow tract view
aorta left atrium mitral valve left ventricle right ventricle interventricular septum **ascending aorta arises entirely ffrom L ventricle arotic valve
continuity of the interventricular septum is seen with the ___ wall of aorta
anterior
continuity of the mitral valve is seen with the ___ wall of aorta
posterior
when we look at the heart what do we need to look at (3) and (+2) is permitted
- heart rate/ rhythm
- position of apex & stomach on same side (left)
- 4 chambers
- 3 chamber
- 5 chamber
The ___ and ___cross over each other as they exit their respective ventricles of the heart
aorta
pulmonary artery
The five chamber view is obtained by angling the transducer ___ and anterior from the four chamber view.
cephalad
what you must see in 5 chamber view
- left atrium
- right atrium
- left ventricle
- right ventricle
- aorta
what you must see in 5 chamber view
- left atrium
- right atrium
- left ventricle
- right ventricle
- abdominal aorta
how to confirm normal outflow tract orientation
perpendicular crossing of outflow tracts
aorta and pulmonary artery are ___ in size
comparable (equal)
everything in the ROTV can be seen in the ___ view of the great arteries
short axis
what you can see in the right outflow tract view
- R & L ventricles
- pulmonic valve
- main pulmonary artery (branches into l & r pulmonary arteries)
- pulmonary artery
- abdominal aorta
what you can see in the right outflow tract view
- R & L ventricles
- pulmonic valve
- main pulmonary artery (branches into l & r pulmonary arteries)
- pulmonary artery
- abdominal aorta
This view demonstrates the relationship between the aorta, pulmonary artery and superior vena cava
3 vessel view
smallest to largest structures on the 3 vessel view
- SVC
- aorta
- pulmonary artery (largest)
___ and ___ are seen in sagittal view
ductal arch
aortic arch
ductal arch connects __ and ___
main pulmonary artery
thoracic artery
___ arch allows legs to get blood
ductal
type of arch that looks like hockey stick
ductal
type of arch looks like candy cane
aortic arch
aortic arch connects ___ and ____
ascending aorta
thoracic aorta
List the images that should be taken for the fetal heart?
7
- 4 chamber
- 3 vessels
- ROTV
- LOTV
- aortic arches
- upper abdomen
- basal short axis view