ch 49 2nd/3rd trimester

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rbeacr
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139397
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ch 49 2nd/3rd trimester
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2012-03-03 20:09:20
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2nd 3rd trimester
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ch 49 2md/3rd trimester
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  1. transverse fetal lie
    • fetal head at maternal right or left
    • spine superior, inferior, anterior, posterior
  2. vertex/cephalic
    • longitudnal
    • head down
  3. breech
    • longitudinal
    • head up
    • frank breech can be turned
    • complete and incomplete breech can not be turned
    • head may be dolichephalic- elongated
  4. situs
    • positionoing of fetal organs
    • normal= stomach on left side, apex of heart left
  5. cranial bones ossify
    • 12 weeks
    • not completely closed
  6. cranum appearance sup to inf
    • sup appears circular
    • oval at ventricular, peduncular, basal levels
  7. falx
    • midline echo
    • interhemisphere fissue
    • falx cerebri
    • seperation of cerebellum has occured
  8. lateral ventricles
    • white matter tracts above
    • contains cerebrospinal fluid that coats brain and cord
  9. choroid plexus
    • tissue in lateral ventricles that produces csf
    • echogenic and prominent in early preg
    • small cysts in it may be seen in early preg
  10. third ventricle
    • csf travels to it from lateral ventricles through foramen of monro
    • from here it goes through aqueduct of sylvius to 4th ventricle
  11. fourth ventricle
    csf flows from here to cerebral and spinal subarachnoid spaces to foramen of luschka
  12. ventriculomegaly/hydrocepalus
    • dilated ventricular system
    • may be sign of cns abnormality
    • spinal defects with dilation of whole system including 4th ventricle
  13. normal atrium measurement
    6.5mm should not be greater than 10mm
  14. thalami
    • inferior to the ventricular atrium
    • widest transverse diameter of skull
    • third ventricle between thalami
  15. cavum septum pellucidum
    • box like structure near falx
    • largest point of head
    • connects hemispheres
    • anterior to thalamus
  16. midline brain structures
    • cavum septeum pellicudum
    • midline echo
    • thalami
  17. corpus callosum
    echopenic structure band of tissue between frontal vebtricular horns
  18. ambient cisterns
    pulsitile vascular structures by post verebral artery bordering thalmus posteriorly
  19. cerebellum
    • back of cerebral peduncles in posterior fossa
    • bannana sign- spina bifida, arnold chiari malformation (small displaced cerebellum)
  20. cisterna magna
    • 3-11mm in depth normally 5-6mm
    • behind cerebellum
    • obliterated in arond chiari malf.
    • large cisterna magna- dandy walker malf
  21. nuchal skin fold
    • measured in plane with cavum septum pellucidum, cereb, and cm
    • 6mm or less up to 20 weeks
    • increased aneploidy risk if thickened
  22. anaphthalmia
    eyes are missing
  23. hypotelerism
    fused or closely spaced eyes
  24. hypertelorism
    • widely spaced eyes
    • associated with anacephaly
  25. IOD OOD
    • inner orbital distance
    • outter orbital distance
  26. frontal bossing
    • bulging of forehead
    • opposite is frontal slanting- forehead slopes backwards (microcephaly)
  27. microganthia
    small chin
  28. nasal bone
    • downs- small nose or midface hypoplasia
    • absent nasal bone-downs, trisomy 18, 13
  29. macroglossia
    • large tounge
    • beckwith widemann syd and aneploidy
  30. fetal spine images
    • cervical thoracic lumbar sacral
    • studied in coronal, long, and trans
    • widest at base of skull tapers at end
  31. thorax
    1/3 lung, 1/3 mediastinum, 1/3 lung
  32. if heart is misplaced
    • lung mass
    • or subdiaphragmatic hernia
  33. fetal lung tissue
    homogenous and more echogenic than liver
  34. 4 chamber view of heart
    • 16 weeks
    • must by 20

    outflow tracks 22-24 wks
  35. heart direction
    • apex to left anterior
    • right ventricle closest to chest wall
    • left atrium closest to spine
  36. moderator bands
    right ventricle
  37. right ventricle may be bigger
    pumps blood to ductus arteriosus to desending aorta
  38. foramen ovale
    • opens from right to left atrium
    • so blood bypasses lungs
  39. normal heart rythm
    120-160 bpm
  40. echogenic intracardial focus EIF
    echogenic area in heart associated with risk of aneploidy and cardiac defects
  41. carotid and jug orientation
    • carotid- lateral to esophagus
    • jugular- lateral to carotid
  42. must see great vessles by
    16weeks
  43. ductus venosus
    • in liver- blood to ivc- right atrium-ovale- left atrium
    • shunts o2 rich blood to heart and brain
  44. flow of o2 blood from mother through fetus
    • placenta
    • umbilical vein- fetal cord insertion
    • vein goes up to liver along falciform lig and connects with left portal vein
    • left pv goes posterior to right ant and post pvs-blood to liver
  45. ductus arteriosus
    blood from right vent and pulm arteries go through ductus arteriosus to descending aorta to abd organs
  46. umbilical arteries
    • arise from illiac arteries
    • deoxygenated blood exits back to placenta
  47. liver
    • recieved blood from ductus venosus
    • left lobe larger than right
    • main storage for glucose
  48. gallbladder
    • below left portal vein
    • cone or tear drop shape
  49. stomach seen at
    12 weeks
  50. prevent stomach filling
    • oligohydraminos, prom
    • esophogeal atresia
  51. small and large bowel seen
    • small 20 weeks
    • large 24-26 weeks
  52. hyperechoic bowel
    • echogenic as bone
    • should be little more than liver
    • can be aneploidy or pathology- cystic fibrosis
  53. when see kidney bladder
    14 weeks
  54. differentiation of kidney parts
    18weeks
  55. genitalia seen
    18 weeks
  56. fluid in renal pelvis
    • small amount is normal
    • abnormal if
    • under 20 wks- greater than 5mm
    • 20-30 weeks- greater than 8mm
    • beyond 30wk- greater than 10mm
  57. pyelectasis
    • bilateral renal pelvis dilitation
    • associated with aneploidy
  58. adrenal glands
    • appear large and should not be confused with the kidney
    • 23 weeks
    • 1/3 of kidney
  59. fetal tone
    positive demonstration of hand movements
  60. clenched hands
    trisomy 18 edwards
  61. tibia and fibula
    • tibia is larger and medial
    • fibula is lateral
  62. what contributes to amniotic fluid production
    • umbilical cord
    • membranes
    • lungs
    • skin
    • kidneys
  63. vernix caseosa
    fatty material found on fetal skin and in amniotic fluid in late pregnancy
  64. amnion and chorion fuse
    16weeks
  65. subamniotic fluid
    fluid under a membrane floating on top of the placenta and anchored at placental cord insertion
  66. subchorionic fluid
    fluid under a membrane and fluid collects at the edge of the placenta
  67. genetic sonogram
    • nuchal fold
    • echogenic bowel
    • humerus legnth
    • femur legnth
    • EIF
    • renal pyelectasis
  68. club foot
    • 1. neuro defect
    • 2. neurotube
    • 3. isolated bony anomoly
    • 4. enviornmental- foot stuck
  69. macrosomia
    over 8lbs 13 oz
  70. chorionic plate
    basal plate
    • chorionic- fetus
    • basal- maternal
  71. polyhydraminous
    • 50% idiopathic- no effect
    • 25% fetal
    • 25% maternal

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