OB Ch 62, 63, 64 Flashcards Preview

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Flashcards in OB Ch 62, 63, 64 Deck (81)
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1

What is the difference between partial situs inversus and complete situs inversus?

Complete: total reversal of thoracic and abdominal organs
Partial: more severe, thoracic viscera are usually reversed and abdominal viscera may/may not be reversed; two combinations of organ reversals, asplenia or polysplenia pg. 1342

2

What is double bubble?

Blockage of the duodenal lumen by a membrane that prohibits the passage of swallowed amniotic fluid
-Also called Duodenal Atresia Pg. 1345

3

What should you look for when you encounter loops of dilated echogenic bowel?

-Bowel obstruction
-Meconium ileus
-Cystic Fibrosis
Pg. 1346?
possible chromosomal abnormalities so check everything thoroughly

4

What is the normal position of the spleen in reference to other parts of the body?

Posterior and to the left of the fetal stomach. Imaged in transverse plane Pg. 1342

5

What are the possibilities if you find echogenic areas in the fetal abdomen?

Calcified Peritoneal calcifications: Meconium peritonitis, hydrometrocolpos Intraluminal meconium calcifations: anorectal atresia, small bowel atresia, Parenchymal: Liver, splenic, adrenal, ovarian cyst Cholelithiasis: gallbladder Noncalcified Echogenic Meconium, intraabdominal extrathoracic pulmonary sequestration, tumors, adrenal hemorrhage Green Box: pg. 1348

6

What would a cystic growth on the common bile duct be termed?

Choledochal Cyst pg. 1343

7

Haustral folds are seen on the ___.

Colon Pg. 1340

8

What is Meckel diverticulum?

Remnant of proximal part of yolk stalk that fails to degenerate and disappear during early fetal period.
Small finger-like sac, about 5 cm long, that projects from the border of the ileum
Pg. 1338

9

A normal esophagus will appear with a ___ pattern during the second and third trimester

multi-layered per Beth
Has two or more parallel echogenic lines
p 1338

10

Which malformation of the midgut is most common?

Meckel's Diverticulum Pg. 1338

11

At how many weeks should you be able to tell the difference between large and small bowel?

After 20 menstrual weeks. Pg. 1340

12

Information about the stomach.

Fetuses 14-16 wks should have fluid in stomach
There may be a significant change in size of stomach
Echogenic debris can sometimes be seen along dependent wall
Esophageal anomalies are the LEAST common problem for nonvisualization of the stomach Pg. 1338

13

What is polysplenia?

-More than one spleen -
-Represented by transposition of liver, spleen, and stomach and absent GB
Pg. 1342

14

What is psuedoascites?

Sonolucent band near the fetal anterior abdominal wall found in fetuses over 18 weeks gestation Pg. 1343

-Never outlines the falciform ligament like true ascites

15

What is the most reliable criteria for diagnosing dilated bowel loops?

Bowel diameter Pg. 1344

-Normal diameter of the small bowel lumen is less than or equal to 5 mm, with a length of 15 mm near term p 1340
-Normal diameter of the colon range from 3 to 5mm at 20 weeks to 23mm or larger at term p 1340-1341

16

What are the causes for a double bubble?

--Duodenal atresia
-Duodenal stenosis
-Annular pancreas
-Ladd's bands
-Proximal jejunal atresia
-Malrotation
-Diaphragmatic hernia
Pg. 1345

17

What are some other defects that may coexist with esophageal defects?

Tracheoesophageal fistula Pg. 1336
Most commonly observed is anorectal atresia
Others include: vertebral defects, heart defects, and renal and limb anomalies (VACTERL)
Growth Restriction Trisomies 18 and 21
Pg. 1344

18

What is a derivative of the hindgut?

-Left part of transverse colon
-Descending colon
-Sigmoid colon
-Rectum
-Superior portion of anal canal
-Epithelium of Bladder
-Most of Urethra
Pg. 1338

19

At 30 weeks, what are the peritoneal calcifications of the fetus?

Meconium peritonitis and Hydrometrocolpos? Pg. 1348 (green box)

20

What is the VACTERL group of anomalies?

V= Vertebral
A= Anal
C= Cardiac
T= Trachea
E= Esophageal
R= Renals
L= Limbs

21

What is correct about the normal liver?

-Relatively large in comparison to other intraabdominal organs and occupies most of upper abdomen
-Accounts for 10% of total weight at 11 weeks and 5% at term
-Hepatic veins and fissures formed by the end of the first trimester
-Left lobe is larger than right in utero secondary to greater supply of oxgenated blood
pg. 1341

22

What is anorectal atresia?

Presents as a complex disorder of the bowel and genitourinary tract and may be present as part of the VACTERL association or in caudal regression.
One of the findings in this is an imperforate anus, which is when a membrane covers the anus prohibiting the expulsion of meconium.
Prognosis is poor because of associated anomalies. Incontinence of both bowel and bladder is common. pg. 1347

23

At how many weeks should you see fetal kidneys on ultrasound?

12 weeks Per Beth

What seniors had-By 13 weeks? Pg. 1354 18 weeks? kidneys should be documented in all fetuses sonographically Pg. 1354 Please check this, the book has 3 different weeks....

24

What is the protrusion of the posterior wall of the bladder?

Exstrophy of the Bladder Pg. 1361

-caused by the defective closure of the inferior part of the anterior abdominal wall during the 4th week of gestation.

25

What is it called when a fetus has both ovarian and testicular tissue?

True Hermaphroditism Pg. 1377

26

What will you find with complete renal agenesis?

-Severe Oligo after 13-15 weeks
-Absence of urine in fetal bladder
-No visualization of kidneys or renal arteries
-Small thorax Pg. 1360
You will not find a dilated fetal bladder quizlet

27

What are some specifics to Potter's syndrome?

-Potter's facies: flat nose, recessed chin, abnormal ears, and wide-set eyes, as well as abnormal or malpositioned limbs (these deformities caused by a lack of amniotic fluid)
-Cardiac defect Musculoskeletal disorders: sirenomelia, absent radius and fibula, anomalies of digits, sacral agenesis, diphragmatic hernia, and cleft palate
-CNS anomalies: hydrocephalus, meningocele, cephalocele, holoprosencephaly, anencephaly, and microcephaly
-GI anomalies: duodenal atresia, imperforate anus, tracheoesophageal fistula, malrotation, and omphalocele
-Uterine anomalies Testicular hypoplasia, agenesis, and hypospadias pg. 1359

Renal agensis, oligphydramnios, pulmonary hypoplasia, abnormal fancies, malformed hands/feet Quizlet

28

What is multicystic dysplastic kidney disease?

Characterized by multiple, smooth- walled, nonfunctioning, noncommunicating cysts of varying sizes and numbers. Renal tissue is replaced by cysts that are found throughout the kidney. The entire kidney or only a portion may be affected. The affected kidney is nonfunctional. pg. 1364

29

What is the most common kidney obstruction?

UPJ-ureteropelvic junction

*most common for hydronephrosis in neonate

30

What is the criteria for hydronephosis

Abnormal intrapelvic AP diameter measurement.
Measurement greater than 4-4.5 mm before the third trimester or greater than 7 mm after the third trimester. Another useful guide is that if the measurement exceeds 1/3 of the renal diameter. Pg. 1368

Intrapelvic diameter:
>7mm = mild hydro
7-15mm = moderate hydro
>15mm = severe hydro