Chapter 56 Umbilical Cord (from quizlet) Flashcards

1
Q

In the fetus, the vein carries ______ blood to the fetus, whereas the arteries bring venous blood back to the _____

A

oxygenated; placenta

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2
Q

When can the umbilical cord be visualized sonographically?

A

8 weeks to full term

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3
Q

When does the umbilical cord form?

A

first 5 weeks gestation

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4
Q

Fusion of which two vessels is the umbilical cord?

A

omphalomesenteric (yolk stalk) and allantoic ducts

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5
Q

Why is the insertion of the umbilical cord important?

A

to look for abdominal wall defects (omphalocele and gastroschisis) and limb-body wall complex

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6
Q

<p>When do the intestines normally herniate into the umbilical cord?</p>

A

<p>7 weeks and stay till 12 weeks gestation</p>

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7
Q

What is the normal diameter of the umbilical cord?

A

1-2 CM

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8
Q

What is the normal length of the umbilical cord?

A

40-60 cm

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9
Q

Where do the umbilical arteries arise from?

A

The fetal internal iliac arteries which course along the fetal bladder and exit the umbilicus to form part of the umbilical cord

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10
Q

Which vessel does the umbilical vein join after it enters the umbilicus?

A

the left portal vein

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11
Q

What does the umbilical vein become after birth?

A

the round ligament aka ligamentum teres

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12
Q

What does the umbilical cord consist of?

A

2 arteries and one vein

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13
Q

Where does the umbilical blood travel after it leaves the left portal vein?

A

travels through the ductus venosus to the systemic veins (IVC or hepatics), bypassing the liver, or through the right portal sinus to the right portal vein

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14
Q

What does a short umbilical cord measure?

A

less than 35 cm

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15
Q

What does a long umbilical cord measure?

A

greater than 80 cm

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16
Q

What conditions are associated with short umbilical cord?

A

oligohydramnios, restricted space (as in multiple gestations) intrinsic fetal anomaly, tethering of the fetus by an amniotic band, inadequate fetal descent, cord compression, fetal distress

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17
Q

Is coiling of the umbilical cord normal?

A

yes; may coil as many as 40 times, and usually to the left and near the fetal insertion site

18
Q

What is an indirect sign of decreased fetal movement?

A

absence of cord twisting

19
Q

Preterm delivery, decreased heart rate during delivery, meconium staining secondary to fetal distress, and fetal anomalies are other obstetric problems associated with?

A

short umbilical cord

20
Q

Polyhydramnios, nuchal cord, true cord knots, umbilical cord compression, cord presentation and prolapse of the cord leading to fetal distress, umbilical cord stricture or torsion resulting from excessive fetal motion are all associated with?

A

long umbilical cord

21
Q

Variations in cord diameter are usually attributed to diffuse accumulation of what?

A

Wharton’s Jelly

22
Q

Variation in cord diameter are associated with?

A

maternal diabetes, edema secondary to fetal hydrops, Rh incompatibility and fetal demise

23
Q

Masses associated with the umbilical cord are?

A

omphalocele, gastroschisis, umbilical herniation, teratoma of the umbilical cord, aneruysm of the cord, varix of the cord, hematoma of the cord, true knot, angioma, thrombosis

24
Q

What results from failure of the intestines to return to the abdomen?

A

Omphalocele

25
Q

What is a congenital defective opening in the wall of the abdomen just to the right of the umbilical cord; bowel and other organs may protrude outside the abdomen from this opening?

A

gastroschisis

26
Q

What is it when the intestines return normally to the abdominal cavity and then herniate prenatally or postnatally through an inadequately closed umbilicus?

A

Umbilical Herniation

27
Q

What is a cystic lesion of the umbilical cord caused by persistence and dilatation of a segment of the omphalomesenteric duct lined by epithelium of GI origin?

A

Omphalomesenteric Cyst

28
Q

Does omphalomesenteric cyst affect males or females?

A

females

29
Q

What is surrounded by edema and myxomatous degeneration of Wharton’s Jelly?

A

Hemangioma of the Cord

30
Q

What happens when usually trauma causes extravasation of blood into Wharton’s Jelly?

A

hematoma of the cord

31
Q

What is occlusion of one or more vessels of the umbilical cord and primarily occurs in the umbilical vein?

A

Thrombosis of the umbilical vessels

32
Q

Associated with long cords, polyhydramnios, IUGR and monoamniotic twins

A

True knots

33
Q

What is seen when blood vessels are longer than the cord?

A

false knots

34
Q

What is the most common cord entanglement in the fetus?

A

nuchal cord

35
Q

What is it called when the umbilical cord implants into the edge of the placenta is called?

A

Battledore placenta

36
Q

What is it when the cord inserts into the membranes before it enters the placenta, rather than inserting directly into the placenta?

A

membranous or velamentous insertion of the cord

37
Q

What type of insertion is associated with higher risk of low birth weight, small for gestational age, preterm delivery, low Apgar scores, and abnormal intrapartum fetal heart rate pattern?

A

Velamentous umbilical cord insertion

38
Q

In 10% of cases, esophageal atresia, obstructive uropathies, congenital hip dislocation, spina bifida, ventricular septal defect, and cleft palate are associated anomalies of?

A

velamentous umbilical cord insertion

39
Q

What is the presence of umbilical cord vessels crossing the internal os of the cervix?

A

Vasa previa

40
Q

Congenital anomalies in 20%-50% of cases, increased incidence of IUGR, increased perinatal mortality, and increased incidence of chromosomal abnormalities are associated with?

A

single umbilical artery

41
Q

Which organ systems are affected by SUA?

A

musculoskeletal 23%

42
Q

Cardiac defects, skeletal abnormalities, abdominal wall defcts, diaphragmatic hernia, holoprosencephaly and hydrocephalus are major anomalies of?

A

SUA