ch. 56 Umbilical cord

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Author:
rbeacr
ID:
139523
Filename:
ch. 56 Umbilical cord
Updated:
2012-03-04 12:57:09
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56 Umbilical cord
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Description:
umbilical cord
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  1. what covers cord
    • amnion
    • blends with fetal skin at umbilicus
  2. vessles
    • 2 arteries
    • 1 vein
  3. ub cord visualized
    8 weeks til term
  4. ub cord forms
    • during first 5 weeks (7menst)
    • fusion of yolk stalk and allantoic ducts
  5. allantoic vessles
    become ub vein
  6. herniation of bowel into ub
    • 7-12 weeks
    • intestines grow faster than abdome
  7. normal cord legnth/ diameter
    • 40-60 cm
    • 2.6-6cm
  8. ub arteris arise from
    internal illiacs along bladder
  9. ub vein from
    chorionic veins of placenta
  10. ub arteries become
    • lateral ligaments of bladder after birth
    • superior vessicle arteries
  11. no cord twists
    decreased fetal movement and bad outcome
  12. cord larger in mothers with
    gest diabetes
  13. blood from ductus venosus to
    ivc and right portal to liver
  14. short umbilical cord
    under 35cm
  15. short cord associated with
    • oligohydraminos
    • restricted space
    • tethering by band
    • fetal distress
    • omphalocele
    • gastroshisis
    • limb wall complex
  16. long umb cord
    80 cm +
  17. long cord associated with
    • polyhydraminos
    • nuchal cord
    • true knots
    • cord compression
    • stricture or torsion from excessive movement
  18. omphalocele
    • associated with other anomolies
    • membrane covering
  19. gastrischisis
    • not associated with other anomolies
    • no membrane covering
    • exposed to amn fluid
  20. omphalomesenteric cyst
    • cyst of umbilical cord
    • females for than males
    • associated with meckles diverticulum
  21. hemangioma of cord
    • rare
    • near placenta end
  22. hematoma of cord
    • trauma
    • blood into whartons jelly
    • new- hyperechoic
    • old- hypoechoic with septations
  23. thrombus of umb vessles
    • occulusion of one or more vessles
    • usually vein
    • higher with diabetic mothers
    • second to torsion knotting compression
    • poor prognosis
  24. true knots
    • long cord
    • polyhydraminos
    • iugr
    • monoamniotic twins- 80% mortality
    • single or multiple
    • can happen in delivery- but no anoxia
    • color to show no flow
  25. false knots
    • blood vessles are longer than the cord
    • folded on themselves
  26. nuchal cord
    • most common cord entanglement
    • coils around neck
    • problem during delivery when head descends and cuts off oxygen
  27. marginal insertion of cord
    battledore
  28. membranous insertion of cord
    velamentous
  29. prolapse
    • when cord is below presenting part
    • may be abnormal presenting fetus (trv or breech)
  30. vasa previa
    • umb cord crossing internal os of cervix
    • high mortality if vag delivery
    • color doppler
    • velementous insertion
    • succenturiate lobe
    • low lying placenta
  31. cord presentation / prolapse
    • cord into vagina
    • mortlaity of 25-60% when cord is compressed in vag delivery
    • long cord
    • premature
    • myoma
    • polyhydraminos
    • valementous insertions
    • marginal insertion in low lying placenta
    • incompetent cervix
  32. single umbilical artery
    • twin pregnancy
    • miscarriages
    • marginal insertion more common than membranous
    • atrophy of one umb artery (left more common)
    • congential anomolies
    • 50% born normal with single artery
  33. aneyurism and varix
    • focal dilitation of vessle
    • normal outcome
  34. persistent intrahepatic right portal vein
    • paired umb veins carry blood to heart
    • right umb vein regresses (6wks) and left enlarges
    • sometime right persists instead of lt
    • usually other anomolies too

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