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169 Cards in this Set

  • Front
  • Back
Mesenchymal buds from the early _____ form & penetrate masses destined to become ____.
trachea, lungs
What structures are developed through multiple divisions & budding?
bronchi, bronchioles, alveolar ducts, and alveoli
Between what weeks do the normal number of bronchi form?
16- 20 weeks
After 24 weeks there is a progressive _____ of the ____ cells lining the air spaces.
flattening, epithelial
What is the shape of the thorax?
symmetrically bell shaped
What are the lateral margins of the thorax?
ribs
What are the superior margins of the thorax?
clavicles
The ____ is the inferior margin of the thorax.
diaphragm
The thorax is slightly smaller than the ____ ____.
abdominal cavity
A small chest size is caused by:
oligohydramnios
What does oligohydramnios cause?
pulmonary hypoplasia, & decrease in thoracic size
When should chest circumference measurements be taken?
when the chest size is felt to be abnormal
Where should the chest circumference measurement be taken?
at the level of the 4 chamber heart in trv
The heart circumference measures _____ of the thoracic circumference.
1/3
What is the formula for chest circumference?
CA - HA x 100 / CA
The central thorax is occupied by _____.
mediastinum
The base of the heart is _____ to the diaphragm.
horizontal
The lungs have a _____ echo texture.
homogeneous
The lungs have a similar echogenicity to the _____ in the 2nd trimester.
liver
The lungs are slightly more ____ in the third trimester.
more echogenic
The lungs lie ____ to the diaphragm and serve as the lateral borders of the ____.
superior, heart
T or F. Ultrasound cannot be used to assess lung maturity.
true
The fetal lung is more echogenic on the side up due to:
shadowing in the far field.
The muscle separating the thorax and the abdomen is:
diaphragm
The diaphragm is inferior to the ____ but superior to the ____.
heart, liver
When evaluating the diaphragm bilaterally, you exclude the _____ _____.
diaphragmatic hernia
What is the sonographic appearance of the diaphragm?
curvilinear area w/ decreased echogenicity
The ____ diaphragm is usually easier to image because of the strong ____ interface.
right, liver
The voice box is known as the:
larynx
What is the sonographic appearance of the larynx?
anechoic tubular structure seen in SAG cross section
The ____ is a soft organ w/ 2 lobes.
thymus
Where is the thymus located?
anterior to the ascending aorta, and posterior to the mediastinum
The thymus is ____ in children but ____ in size after puberty.
large, decreases
A normal thymus is the most frequent cause of a _____ _____.
widened mediastinum
The thymic lobes often differ significantly in ____, giving an impression of a ____.
size, mass
What is the primary function of the thymus?
maturation of t-lymphocytes
What does the thymus produce?
the hormone thymosin
What does thymosin do?
stimulates maturation of lymphocytes in other lymphatic organs
On US, the thymus can be seen as a ____ ____ like structure draped over the ____ vessels.
soft pancake-like, mediastinal
Prenatal ultrasound is helpful to diagnose ____ ____.
thymic cysts
The esophagus is difficult to visualize on US unless the fetus is ____ or has ____.
swallowing, stenosis
The thymus is ____ w/ tiny echogenic ____, which differentiate from the lungs.
homogeneous, foci
Where is the AP diameter of the thymus measured?
in the ML @ the sternum
Respiration results in the aspiration of ____ ____ into the ____.
amniotic fluid, lungs
When is fetal breathing more prominent?
in the 2nd and 3rd trimesters
The fetus may breathe in response to what 2 things?
maternal activities, substance ingestion
Sugar ingestion ____ fetal breathing responses, while smoking ____.
increases, decreases
Fetal breathing movements are evaluated from at least ____ seconds.
20
Color flow doppler is observed through the ____ ____.
fetal nostrils
Fluid in the lungs @ birth clears by what 3 routes?
mouth & nose, into pulmonary capillaries, and into the lymphatics & pulmonary vessels
What is the major reason why fetuses younger than 24 weeks GA are considered non-viable?
pulmonary immaturity
Primitive fetal lungs mature & become capable of functioning sometime after ____ weeks GA.
24
What must be identified when evaluating fetal heart?
fetal position & situs, cardiac axis, heart/thoracic ratio, m-mode, 4 chambers, great vessels,
The fetal heart has a ____ position in the fetal chest.
horizontal
The fetal diaphragm is situated relatively high due to:
large liver & un-inflated lungs
How is the identification of the normal 4 chambers achieved?
taken w/ the beam perpendicular to the septum of the valves
What is the angle of the cardiac axis?
45 degree angle
The apex of the heart should not exceed a ____ degree angle from the line drawn perpendicular to the fetal spine.
45 degree
The normal fetal heart rate is _____ BPM.
120-160
What does the 4-chamber anatomy demonstrate?
atria, ventricles, atrio-ventricular valves, papillary muscles, foramen ovale/septum primum, and intercardiac septae
What do the atrio-ventricular valves consist of?
tricuspid & mitral valves
Where does the foramen ovale flap open?
in the left atrium
The right & left atria are ____ in size.
equal
The ____ ____ is considered the communication between the right & left atria.
foramen ovale
The apex may appear thicker due to the _____ _____.
moderator band
The ____ ventricle may be larger than the ____ ventricle late in pregnancy.
right, left (by 20%)
Why would the right ventricle be larger than the left late in pregnancy?
because it pumps blood thru the ductus arteriosus to the aorta & placenta
What is seen in a standard 4 chamber view of the fetal heart that moves with heart beat?
echogenic focus left ventricle (echogenic papillary muscle or chordae tendinae)
The ____ muscles hold the valves in place.
papillary
Echogenic focus of the left ventricle affects ____% of the fetal population & is more common in _____.
5%, asians
The _____ _____ is a soft marker for down syndrome when seen with other markers.
echogenic papillary muscle/chordae tendinae
A band of muscles that crosses the apex of the right ventricle is the ____ ____.
moderator band
What is known as the anatomic landmark to identify the morphologic right ventricle?
moderator band
The ____ valve inserts lower/ closer to the apex than the ____ valve.
tricuspid, mitral
Both valves open during ____ and close during ____.
diastole, systole
What are the 2 great vessels of the fetal heart?
aorta, and pulmonary artery
What are the 2 types of outflow tracts?
LVOT (left ventricular outflow tract) & RVOT (right ventricular outflow tract)
The LVOT includes the ____ exiting the ____ ____.
aorta, left ventricle
The RVOT includes the ____ ____ exiting the ____ ____.
pulmonary artery, right ventricle
The RVOT bifurcates into the ____ ____.
pulmonary arteries
About ____ of structural malformations of the fetal heart can be R/O by imaging the 4 chamber heart & great vessels.
85%
Normal outflow tracts should ____ each other.
cross
The aorta exits the ____ ____ and forms the aortic arch.
left ventricle
The communication between main pulmonary artery & descending aorta is the ____ ____.
ductal arch
What is the "hockey stick" shape/sign?
ductal arch
Where does the IVC enter into the heart?
right atrium
The SVC enters the right atrium from ____ the heart.
above
Subcostal view can demonstrate continuity of the interventricular septum to the ____ ____.
aortic root
Where do the pulmonary veins enter?
left atrium
Optimal timing for fetal echocardiography is between ____ weeks GA.
18 - 22
The upper chambers are the ____ and are also known as the ____ chambers.
atria, filling
After birth there is no direct communication between the RT & LT ____.
atria
What is the right atrium connected to?
connected to the 2 great veins (SVC & IVC)
Oxygenated blood returns to the left atrium via 4 ____ ____.
pulmonary veins
From the left atrium, blood passes thru the ____ ____ into the ____ ____ & thru the ____ ____ into the ____ ____.
mitral valve, left ventricle, aortic valve, ascending aorta
The lower chambers are the ____ & are known as the ____ chambers.
ventricles, pumping
The pumping chambers pump blood _____ from the heart.
away
The lower chambers are connected to ____ ____ w/ ____ valves.
outflow tracts, semilunar
What do the LVOT/RVOT control?
The exit of blood from the heart
The RVOT involves the ____ ____.
pulmonary artery
The pulmonary exits the ____ ____ within the RVOT.
right ventricle
After the main pulmonary artery exits the right ventricle what does it bifurcate into?
Rt & Lt pulmonary arteries
The LVOT includes the ____ ____.
ascending aorta (or aortic root)
What does blood in the right atrium consist of?
a combo of oxygenated blood from the IVC & poorly oxygenated blood from the SVC
The ____ ____ acts as a one way valve allowing blood to pass from right to left only, between atria.
foramen ovale
What are the 3 shunts?
1st- ductus venosus
2nd- foramen ovale
3rd- ductus arteriosus
Only _____% of blood circulates to the fetal lungs.
5 - 10%
T or F. Fetal lungs do not oxygenate blood.
True
Most pulmonary artery blood bypasses lungs & flows thru the ____ ____ to the arch.
ductus arteriosus
The pulmonary artery & aorta are connected by the ____ ____.
ductus arteriosus
Since fetal lungs are collapsed, only a small amount of blood circulates thru the ____ ____.
pulmonary capillaries
The ductus venosus becomes the ____ ____.
ligamentum venosum
The foramen ovale becomes the ____ ____.
foramen ovalis
The one way valve allowing blood to pass from Rt to Lt ventricle is:
foramen ovale
The ductus arteriosus becomes the ____ ____.
ligamentum arteriosum
What does the ductus arteriosus do?
shunts blood away from the lungs
What are the fetal cardiac structures no longer needed after birth?
foramen ovale, ductus arteriosus, ductus venosus, umbilical vessels
The ductus arteriosus usually constricts after birth. If the communication persists it's called:
patent ductus arteriosus
How does complete closure of the foramen ovale occur?
adhesion of the septum primum to the left margin of the septum secundum
The umbilical ____ constricts right after birth while the umbilical ____ can remain patent for some time s/p birth.
artery, vein
The optimal time for imaging cardiac structures is _____ weeks.
18 - 22 weeks
What is the most common cardiac defect?
atrial or ventricular septal defects
The left side of the heart perfuses the fetal _____.
cranium
The right side of the heart perfuses the _____ _____ of the fetus.
systemic circulation
Normal outflow tracts ____ eachother.
cross
The heart develops from the ____ ____.
splanchnic mesoderm
The endocardial tubes are situated _____ beneath the pharynx.
ventrolaterally
The endocardial tubes eventually fuse to form a single ____ ____ ____.
straight cardiac tube
The cardiac tube consists of what 2 layers?
endocardium & epicardium
What surrounds the cardiac tube layers?
the pericardial cavity
The primitive heart tube occurs at _____ days, after ovulation.
21-23
The heart tubes form 5 primitive areas longitudinally. What are they?
truncus arteriosus, bulbus cordis, ventricle, atrium, sinus venosus
The embryonic ____ veins empty into the ____ ____.
cardinal, sinus venosus (2 horns)
The right horn of the sinus venosus eventually leads to the ____ & ____.
IVC & SVC
The left horn of the sinus venosus leads to the ____ ____.
coronary sinus
The sinus venosus opens thru an ____ into the ____.
orifice, atrium
Between the atrium & the ventricle is a ____ ____.
atrioventricular canal
What is the most cephalic part of the heart tube?
truncus arteriosus
The truncus arteriosus connects the ____ thru the ____ ____ w/ the ____ ____.
ventricle, bulbus cordis, aortic root
The heart tube grows rapidly making an s-shape & it is called _____ _____.
cardiac looping
Rightward direction of looping is termed ____ ____.
dextro looping
Leftward direction of looping is called ____ ____ & is ____.
levo looping, abnormal
During normal looping, the atrial region is established by ____ ____ of the common ____.
transverse dilation, atrium
The ventricle if formed by the bent ____ ____ of the s-shaped tube & moves ____.
mid-portion, caudally
When does the heart start to beat?
@ 24 days GA
The ____ has a faster pulsation rate.
atrium
The origin of the cardiac pacemaker is the ____ ____.
right atrium
@ the 4th week of development ____ ____ of aortic arches form.
6 sets
Aortic arch 1 & 2 contribute to the _____ & _____ arteries.
Mandibular & maxillary
Aortic arch 3 leads to the ____ ____ ____ artery.
left common carotid
Aortic arch 4 goes two different ways. The left leads to the ____ ____ ____.
transverse aortic arch
The right part of aortic arch 4 leads to the ____ ____ artery & ____ ____.
left subclavian, brachiocephalic trunk
Aortic arch 6 forms the ____ ____ & right/left ____ arteries.
pulmonary trunk , pulmonary
The distal portion of the left 6th arch retains its connection & is known as the ____ ____.
ductus arteriosus
What does the ductus arteriosus connect?
The left pulmonary artery to the aortic arch
The IVS & EC eventually join, but early on has an opening called the ____ ____.
interventricular foramen
When does the interventricular foramen close?
When fetal length is 15-17 mm
The septum secondum fails to close leaving a large hole called the ____ ____.
foramen ovale
The septum spurium regresses & becomes the ____ ____.
crista terminalis
The ____ ____ cells initiate the septation process in the developing heart.
neural crest
The neural crest cells w/in the ____ ____ trigger the formation of the ____ ____ ____.
truncus arteriosus, aortico pulmonary septum
What does the aortico pulmonary septum do?
During looping it separates the root of the aorta from the pulmonary artery
The ____ of the ____ process divides the LVOT & RVOT from eachother.
septation, truncus
T or F. Septation & innervation of the heart occur simultaneously.
True
The ____ ____ leaflets attach to the ____ muscles thru the ____ _____.
atrioventricular valve, papillary, chordae tendinae
After septation of the truncus arteriosus & LVOT/RVOT, the ____ & ____ valves develop @ the roots of the ____ & ____ ____.
aortic, pulmonary
aorta, pulmonary artery
What is a persistant truncus arteriosus defect?
a congenital anomaly w/ 1 great vessel & 1 large semilunar valve that can have 2-6 cusps
Infants w/ patent ductus arteriosus are given ____ to help close the ductus.
indocin
A patent foramen ovale causes ____.
cyanosis