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29 Cards in this Set

  • Front
  • Back
What is an ultasound?
High Frequency Sound Waves
> 20,000 Cycles/Second
What does frequency mean?
Number of Wave that cross a given point in one second, expressed as Hertz (Hz).
Most Machines: 2-10 Million Hz (2-10 MHz)
How does image quality relate to frequency?
Image Quality:
Improved at Higher Frequencies
However, Depth Penetration is Reduced
What is the average frequency for transvaginal versus abdominal transudcers?
Image Quality:
Improved at Higher Frequencies
However, Depth Penetration is Reduced
Abdominal Transducers:
Operate at 3.5 to 5 MHz, lower frequency, higher penetration
Transvaginal Transducers:
Operate at 5 to 7.5 MHz
What are the different modes of the transducer and what are they used for?
M (Motion) Mode:
Useful for Fetal Echocardiography
B (Brightness) Mode:
Generates Real Time Images
3 and 4 dimensional ultrasound
Doppler Mode:
Vascular Studies
Cord Studies
Power Mode:
Like Doppler
Does Not Discriminate Direction
What are the different ultrasound types?
First trimester Ultrasound
Basic ultrasound
Targeted Ultrasound
Limited Ultrasound
What is noted in a first trimester ultrasound?
Site of gestational sac
No of gestational sac
No of fetuses
Yolk sac,
Amniotic fluid assessment
Placenta location
Size & position of uterus
Uterine abnormalities
Measurement of the cervix
Evaluation of both adnexa

Crown rump length
Fetal cardiac activity
Fetal movements
Nuchal translucency
What is the targated ultrasound and when should it be included?
The targeted ultrasound includes the basic ultrasound plus a fetal anatomical scan.

A targeted ultrasound should be included in the initial ultrasound done after 14 weeks.
What are the indications of a limited ultrasound?
Assessment of amniotic fluid volume
Fetal biophysical profile testing
Ultrasonography- guided amniocentesis
Confirmation of fetal life or death
Localization of placenta in antepartum hemorrhage
Confirmation of fetal presentation
When is serial ultrasound used?
To rule out hydrops
Post urethral valves
Pleural effusion
Congenital diaphrgamatic hernia
Dilated bowel
Cardiac defects
ovarian cysts
Twin twin transfusion syndrome
What are the causes of hydrops?
What can targated ultrasound be used to visualize?
Cerebral ventricles
Posterior Fossa
4 chambered heart
Outflow tracts
Trivascular cord
Cord insertion
Upper extremeties
Lower extremeties
Doppler studies
What is the accuracy of gestational age indicators of ultrasound and physical exam?
First trimester physical examination + 2 weeks
Second trimester physical examination + 4 weeks
Third trimester physical examination + 6 weeks

First trimester ultrasound + 5-7 days
Second trimester ultrasound + 10-14 days
Third trimester ultrasound + 17-21 days
What happens in anecephaly? what is missing? What causes anecephaly?
Defect in anterior neural tube closure resulting in cranial vault absence
Absence of forebrain, meninges, skull, skin
Folic acid antagonist
Valproic acid
Elevated MSAFP
How is ventriculomegaly defined and what causes it?
Dilated Ventricles: atrium >10mm
Aqueductal Stenosis
Communicating hydrocephaly
Dandy-Walker syndrome
Arnold-Chari malformation with NTD,
Tumors, hemorrhage,
X-linked aqueductal stenosis
What are the inheritance trates of Dandy-Walker Syndrome? What is missing?
Chromosomal anomalies 15-30%
Congenital infection
Mendelian syndrome
35% postnatal mortality
I/3 of survivors have IQ > 80

A posterior fossa cyst
A defect in the cerebellar vermis
Communication between cyst and 4th ventricle
Dandy Walker syndrome: absent vermis, enlarged posterior fossa, dilated 4th ventricle
What is the inheritance of holoprosencephaly? What are the causes? And What are the symptoms?
Trisomy 13, 18,
Mendelian inheritance
Retnoic acid,

LETHAL Forebrain cleavage abnormalities resulting in fusion of cerebral hemispheres
Fused thalami
Facial defects (Cyclops/ proboscis Median cleft lip)
What is encephalocele? What are the causes? and what are the symptoms?
Neural tube defect resulting in a mid-line mass overlying a skull defect
Meckel-Gruber syndrome
Cocaine, Rubella, hyperthermia
Prognosis dependent on associated malformations & amount of brain tissue involved
What is intraventricular hemmorage?
Clot in frontal horn, dilated 3rd ventricle
What are the cranial abnormalities found in spina bifida?
Overlapping coronal bones termed lemon sign

Compressed cerebellum termed Banana sign
What can be seen in a normal transverse section of the spine?
3 ossification centers arranged in a circle

Transverse scan shows spinal structures surrounding spinal cord
What is the definition of hydrops?
Fluid collection in two or more body cavities, including:
Skin edema
Pleural space (effusion)
Pericardial space (effusion)
Abomen (ascites)
Placental edema
what is a congenital diaphragmatic hernia?
Protusion of abdominal contents into the chest cavity through diaphragmatic defects resulting from a failure of closure.
Posterolateral =Foramen of Bochdalek
Retrosternal= Foramen of Morgagni
Left sided= stomach
Right sided= Liver( worse prognosis)
Mortality due to pulmonary hypoplasia
What are congenital cystadenomotid malformations?
Commonest pulmonary congenital defect
Hamartoma or focal dysplasia of lungs
Due to failure of normal lung to develop
Type 1- macrocystic = cysts 2-10 cm
Type II- medium-size cysts
Type III- microcystic =cysts 0.3-.0.5 cm
Pulmonary hypoplasia or hydrops may occur
What are the signs of bowel obstruction?
Double Bubble Sign, Dilated Loops of Bowel, Duodenal atresia
What is gastroschisis?
Evisceration of fetal intestine through a paramedian wall defect
Usually isolated
Elevated MSAFP
Intestinal obstruction/atresia
>90% newborn survival with surgery
What is an omphalocele?
Herniation of abdominal viscera into umbilical ring
Associated anomaly in 50% Elevated MSAFP
Viscera is covered by a membrane 80% contain liver
What are urinary tract defects?
Obstructive Uropathy with normal bladder
UPJ obstruction
Obstructive Uropathy with large bladder
Posterior urethral valves
Lethal Urinary Tract Defects
Infantile polycystic kidney disease
Bilateral Multicystic kidneys
Bilateral Renal Agenesis
What is hydronephrosis?
Distension of pelvis & calyces with urine
Ureteropelvic junction obstruction is common cause
Vesicoureteric reflux is common