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83 Cards in this Set
- Front
- Back
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The 3 layers of the dicidua
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1. Decidua Capsularis (surrounds blastocyst)
2. Decidua Vera/Parietalis (lines remainder of endo cavity) 3. Decidua Basalis - attachment by blastocyst to support the trophobastic implanatation. |
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When can you first see the Gestational Sac and at what size?
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GS is first seen at 4.5 weeks
GS size is 3-5 mm |
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How fast does the gestational sac grow mm/day?
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1 mm/day
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How big is the GS at 5 weeks?
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10 mm or 1 cm
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When can you first see the Yolk Sac?
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6 weeks
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When can you first see the fetal heart and at what size?
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5 weeks at 4 mm
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How big is the embryo at 6 weeks
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5 mm
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How big is the GS at 7 weeks and embryo?
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GS = 2.4 embryo = 1 cm
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When does embryogenesis end?
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10 weeks and choroid plexus is dominant within the fetal brain.
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What amount pelvic dilation is normal in 2nd/3 tri?
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4.33 mm or less.
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Two components of the placenta?
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1. chorion frondosum - from blastocyst (fetal portion)
2. Decidua basalis - maternal portion |
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You can see the difference in amnion chorion until about how many weeks?
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15-16 weeks.
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velamentous cord insertion means?
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The c0ord inserts at one edge and into the membranes.
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What are allantoic cysts?
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Cysts where the cord enters the fetal abdomen.
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Classic features of placenta previa?
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painless vaginal bleeding in second and tird trimester?
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What is vasa previa with velamentous cord insertion
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Occurs when thef etal vessels from placenta cross between the internal cervical os and the presenting fetal part.
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Ratio of S/D in
1. umbelical artery 2. middle cerebral artery |
- Umbelical artery= high velocity with considerable diastolic flow.
- MCA = high resistance flow withy little diastolic flow |
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When is CRL used to date pregnancy?
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5-12 weeks
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When can you use transcerebellar measurements for dating?
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- until approximately 20 weeks the transcerebellar measurement is approximately equivalent to gestational age.
- when bpd is distorted |
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How big should these be?
- Lat Vent - Cisterna magna - NT -NF |
- Lat vent = <11 mm
- CM = <10 > 2 -NT = <3 -NF = <6 |
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Maternal causes of IUGR
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- Poor nutrition
-smoking -heart conditions (including HTN) -diabetes -chronic renal disease |
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Placental causes of IUGR
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-placental ischemia and infarcts
- abruption |
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Fetal causes of IUGR
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- Infections (TORCH)
-chromosomal anomalies -mutiples - TWINS and cause -polyhydramnios too |
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Appearance of twins with Twin-to-Twin transfusion syndrom
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- recipient twin = large, hydrops
- donor = small, IUGR |
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Appearance of twins with Acardiac parabolic twins
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Pump twin = - edemous and hydropic
Donor twin = grossly thickened skin with cystic hygromas |
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Sono appearance of macrosomic babies - >90%
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polyhydramnios , thick skin, enlarged placenta
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What is VACTERAL ( more common in diabetics)
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V- vertebral
A - norectal C-ardiac T-racheal E-sophageal R-enal L-imb deformities |
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Finding of Rh isoimmunization fetus
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- hydrops
-pleural effusion -pericardial effusion -ascities -skin thickening -enlarged placenta -polyhydramnios |
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Causes of polyhydramnios
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- skeletal dysplasia
-CNS anomalies GI anomalies -maternal diabetes -chest/abdominal masses -Rh incompatability |
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Diagnostic limit for Polyhydramnios
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- > 20 cm - 4 quads
- >8 cm - single pocket |
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Causes of Oligohydramnios (DRIPPC)
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D- emise
R-enal anomalies I-UGR P-ROM -Postdates -C-hromosomal anomalies |
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Amount of fluid with oligohydramnios
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4 pockets = 5-10 cm
1 pocket - >2 cm |
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MSAFP
- Decreased with - Increased with |
-Decreased with Downs
-Increased with * spina bifida -anencephaly -encephalocele -incephaly -abdominal wall defects -gastroschisis -omphalocele -triplody -placental mass and thickening -multiple gestations -fetal death |
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What is measured with tripple screen and most often used to screen for what?
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1. MSAFP
2. decreased estriol 3. increased hCG Down's Syndrom / T21 |
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5 most common seen chromosomal anomalies seen with US
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1. Down's syndrom (T21)
2. Edwards' syndrom (T18) 3. Patau's syndrom (T13) 4. Turner's syndrom (monosomy X 5. Triploidy |
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Symtoms of Dandy-Walker syndrome
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- 4th ventricle obstruction & dilated
-Dilation of 3rd and lateral ventricle -hypoplastic cerebellar vermis |
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US symptoms of Arnold-chiarii II malformation
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- spinabifida
-banana-shaped cerebellum, displaced posteriorly, and a lemon-shaped cranium |
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US symptoms of Hydrancephaly (brain infarct with desctuction of parenchyma in frontal and paraetotemproal regions)
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- complete absence of brain above the level of the brainstem
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U/S symptoms of Holoprosencephaly
What is it strongly associated with (other defects) |
- lateral ventricles are fused
-thalamus is fused -absent 3rd ventricle -fused common ventricle expands into dorsal cyst - Other midline defects -T 13 - midline facial malformations probosscis |
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US symptom of cephalocele and encepholacele
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- meninges and or/ brain protrude through a bony defect
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What are central defects strongly associated with
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T 13 and holoprosencephaly
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2 syndroms micrognathia is associated with
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T 13
T 18 |
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What syndroms are cystic hygromas associated with
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* Turmers
- T 21, T18 Lesser association with T13 |
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What is seen with Open spina bifida (spina bifida cystica)
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- meningocele ( minenges protrude through the defect and make a sac with CSF)
- myelominingocele - neural elements and CSF protrude into a sac enclosed by meninges ELEVATED AFP |
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What is seen with closed spina bifida (oculta)
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- Small bony defect covered by skin
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Associations with omphaloceles
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- Chromosomal anomalies
- Increased MSAFP |
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What are Gastroschesis associated with?
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Right of umb cord, no membrane!
No association with other anomolies or karyotype. Increased MSAFP |
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Appearance of Pentalogy of Cantrell
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- omphalocele and heart are located outside of the chest
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Levels of CAMs
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- (fluid in lungs) cystic or solid-looking mass in thorax, displacing heart
Type I: large cysts, anechoic areas Type II: numerous small to medium-sized cysts Type III: multiple tiny cysts forming a solid, echogenic mass |
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Diaphragmatic hernias
-occur most often on what side -associated with |
- Left side
- chromosomal anomalies and heart problems |
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Autosomal recessive (infantile) polycystic kidney DZ
Causes what? |
- oligohydramnios or anhydramnios
-enlarged, echogenic kidneys - small or no bladder |
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Multicystic dysplastic kidney diz is
- TMC cystic renal abnormality |
- unilateral, bilat (fatal).
- affected kidney is large with multiple noncommunicating cysts |
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Causes of hydronephrosis
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- renal abnormalities
-obstruction of fetal urinary tract - |
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Ureteropelvic junction obstruction causes?
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- dilated renal pelvis and calyces, often bilat
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Posterior uretheral valve obstruction causes?
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- males, dilated, thick-walled bladder with dilated posterior urethera (keyhole sign),
0bilat hydro neurphosis and hydroureter - oligohydramnios -ascites |
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Duodenal atresia is associated with what syndrom
- appearance by U/S |
Down's Syndrom (T21)
- distended stomach and proximal duodenum (double bubble) -polyhydramnios |
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What is the apperance of meconium cysts and meconium periotonitis
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-dilated loops of bowel
psedocysts with echogenic and calcified walls -intrabdominal fluid |
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What is Rizomelia
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Shortening of proximal limbs
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What is Mesomelia
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Shortening of middle segment of limb
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What is micromelia
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Shortening of entire limb
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What is Acromelia
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Shortened distal segments (hands/feet)
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Achondrogeneisis (lethal, short-limb dysplasia)
-results in |
- polyhydramnios
-short ribs -very short limbs -bell shaped abdomen |
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Thananatophioric dysplasi (TMC lethal form of dwarfism)
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- polyhydramnios
very short bones -bowed femurs -protruding, bell-shaped abadomen with small thorax -macrocephaly with cloverleaf skull -trident hand |
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Achondroplasia (autosomal diminant( lethal in homozygous form(
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Fetus appears normal until 24 weeks, then
-short limbs, bell shaped trunk, large head, flat nose, prominant forehead |
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Osteogenesis imperfecta (3 forms) type
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-bowed, irregular, fragile bones with fractures, hypominiealization of skeleton
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What is associated with Clubfoot (abnormal angle beetween the lower leg and foot
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- oligohydramnios, neurologic disorders, spina bifida, chromosomal disorders
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What Trisomy is polydactyly associated with
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T 13 (pateaus)
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Characteristics of Beckwith-Wiedemann Syndrom
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- autosomal dominant with enlargement of all organs
-omphalocle -cardiac anomalies -macroglossia |
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Characteristics of Down syndrom (T21)
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Dodenal atresia
-endocardial cusion defects -posterior urethral valves - screen with tripple screen -thickend NT Short femur and humerous Echogenic bowl sandal gap between toes |
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Characteristics of T 18 (Edwards's Sytndrom)
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-diaphragmatic hernia
congenital heart defects -clenched hand clubfeet/hands choroid plexus cyst omphalocle IUGR 2 vessel cord |
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Characteristics of T13 (Patau's syndrom(
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- holoprosencephaly
facial abnormalities (midline defects) - congenital heart lesions -clubfeet -omphalocle -IUGR -Two -vessel cord |
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What viruses are included with TORCH
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T-oxoplasmosis
C-ytomegalic inclusion disease P-arvo virus H-iv/ Herpes |
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What are the 3 forms of gestational trophoblastic disese? (high hCG)
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1. Hytadidiform mole
2. Invasive moles 3. Choriocarcinoma |
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Normal size of UT
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Pre cvx 2:1
9x3x4 |
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Potential spaces for fluid accumulation
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1. anterior cul-de-sac
2. posterior cul-de-sac (pouch of douglas) 3. Space of Retzius between pubic symphisis and anterior bladder wall |
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What is Ashermans syndrom, US signs?
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Adhensions in uterous
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Endometrium measurement for postmenopause
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3-5
no greater than 8 |
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Appearance of endometrial CA
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- thickend endo with variable echogenicity
-polypoid mass -low impedance floor endometrial halo |
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What are dermoids/cystic teratomas
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B-9
Tip of the iceberg, hair, teeth, skin, fat |
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What are cystadenomas (serous and muscinous(
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B-9 thin, serous septa or papillary projections, often bilateral
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What are stromal tumors (2)
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B-9
Fibromas and thecomas solid tumors |
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What tumor is Meig's syndrom associated with
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Fibromas, abdominal ascitees, pleaural effusions
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Doppler patterns B-9 and malignant masses and corpus lutea
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B-9 = high resistance doppler
Malignant = low resistance doppler Theca Lutea- low resistance doppler |
