OB 2 Wk 9 Quiz

acronym to help with sonographic detection of heart disease

CHRISTMAS

most heart diseases are commonly associated with trisomy

21

- ASD

- tetralogy of fallot

- double outlet RV

- coarctation of AO

- hypoplastic left heart

cardiac anomalies associated with chromosomal defects

the most common severe congenital abnormality

congenital heart disease

normal heart positioning

levocardia

heart is in right chest, with the apex pointing to the right of thorax

dextrocardia

heart is in right side of chest with cardiac apex pointing medially or to the left

dextroposition

dextroposition is normally found with ________ factors

intrinsic

heart is displaced further towards the left chest

levoposition

cardiac apex is pointing towards the midline of the chest

mesocardia

disease of myocardial tissue in the heart, due to exposure to virus or bacteria, errors of metabolism, and endocardial fibroelastosis

cardiomyopathy

characterized by necrosis and destruction of myocardial cells and inflammatory infiltrate

myocarditis

with viral myocarditis, all 4 chambers will be

dilated with thin walls

abnormal collection of fluid surrounding the epicardial layer of the heart

pericardial effusion

normal hypoechoic area in the peripheral part of the epicardial/pericardial interface should be

2mm or less

pericardial effusion is separation greater than

2mm

defect that creates a communication between the right and left atrium

atrial septal defect

most common atrial septal defect, but most difficult to see

osteum secundum

atrial septal defect associated with trisomy 21

osteum primum

least common atrial septal defect, located near entrance of SVC into RA

sinus venosus

failure of the ________ to close may cause an atrial septal defect

foramen ovale

most common congenital lesion of the heart

ventricular septal defect

ventricular defects smaller than ______ are not detected by US

2mm

VSD has a ______ prognosis

good

AKA endocardial cushion defect or AV malformation

atrioventricular septal defect

defect in the atrial and ventricular septum --resulting in a defect in then crux of the heart

AVSD

caused by failure of the common AV orifice to separate into the mitral and tricuspid valves

AVSD

there is an increased incidence of

- down syndrome

- asplenia

- polysplenia

AVSD

interruption of the growth of tricuspid leaflets causing the valve to be hypoplastic or atresic

tricuspid atresia

in the 4 chamber view, there will be:

- large, dilated LV

- small, underdeveloped RV

- mitral valve is dominant

- echogenic tricuspid annulus

tricuspid atresia

abnormal displacement of the septal leaflet of the tricuspid valve, towards the apex of the RV

Ebsteins anomaly

with ebstein's anomaly, the ________ will be massively dilated

right atrium

- malformed tricuspid valve

- atrialized portion of RV

- reduced capacity of pumping portion of RV

3 factors causing abnormal function of right side of heart

defect where right heart is underdeveloped, due to obstruction of RVOT secondary to pulmonary stenosis

hypoplastic right heart

on US:

small RV and RA

small tricuspid valve

hypoplastic right heart

defect where the left heart is underdeveloped

hypoplastic left heart

there will be a hypertrophied left ventricle with a hypoechoic, enlarged appearance

hypoplastic left heart

a mother who had a child with a left heart abnormality has a significantly ______ risk of delivering another child with same abnormality

higher

the risk of left heart abnormalities ________ significantly with each pregnancy

increases

most common form of cyanotic heart disease in infants and children

tetralogy of fallot

tetralogy of fallot consists of _____ abnormalities

4

- VSD

- over-riding AO

- pulmonary stenosis

- RV hypertrophy

4 abnormalities associated with tetralogy of fallot

large septal defect with mild to moderate pulmonary stenosis

acyanotic disease

large septal defect with severe pulmonary stenosis, will have "blue baby" at birth

cyanotic disease

if the aorta overrides over 50%, it is termed

double-outlet right ventricle

this means that both the great vessels arise from the right side of the heart

double-outlet right ventricle

most common form of RVOT obstruction

pulmonary stenosis

abnormal pulmonic cusps become thickened and the main pulmonary artery may become hypoplastic

pulmonary stenosis

when the AO is abnormally connected to the right ventricle and the MPA is abnormally connected to the left ventricle

transposition of the great arteries

this view is key in imaging the great arteries and their relationship

RVOT

in normal RVOT, the pulmonary artery is seen _______ to AO

anterior

in transposition, the relationship between AO and MPA is

not present

in LVOT, you should see a normal criss crossing pattern--with transposition this is not possible and the great arteries are seen ________

parallel

a heart lesion in which only 1 great artery arises from the base of the heart

truncus arteriosus

on US:

an abnormal, large, single vessel arising from the ventricle

truncus arteriosus

shelf like lesion in the isthmus of the aortic arch

coarctation of the AO

narrowing or kink in the AO

coarctation of the AO

- aortic stenosis

- aortic insufficiency

- septal defects

- transposition

- truncus arteriosus

- double outlet RV

associated intracardiac malformations seen with AO coarctation

most cardiac tumors are

benign and isolated

less than 10% of cardiac tumors are

malignant

most common heart lesion

rhabdomyoma

second most common heart lesion

teratoma

rhabdomyoma is associated with

Tuberous sclerosis

rhabdomyoma is best seen in _________ view

4 chamber

consists of 2 atria and 1 ventricle

single ventricle defect

1 ventricle receives both the mitral and tricuspid valves

single ventricle defect

abnormal development of the heart outside of the chest

ectopia cordis

seen as an echogenic structure within the heart as bright as bone

echogenic intracardiac focus

echogenic intracardiac focus is seen in __________ of heart

left ventricle

echogenic intracardiac focus can be normal or associated with

trisomy 21

develops from caudal region of the primitive heart

sinus venosus

receives all blood returning to the heart from the common cardinal veins, vitelline veins, and umbilical veins

sinus venosus

develops into right and left atria

primitive atrium

develops into left ventricle

primitive ventricle

develops into right ventricle

bulbus cordis

dilates to form aortic sac from which the aortic arches arise

truncus arteriosus

devision of 4 chambers occurs during the ________ weeks if fetal development

4th, 5th

develop in the atrioventricular region of heart and fuse to divide into the atrioventricular canal

endocardial cushions

allows communication from the right atrium to the left atrium

foramen ovale

foramen oval opens towards the

L atrium

allows fetal circulation to bypass the lungs

ductus arteriosus

allows for communication from the pulmonary artery to the aortic arch

ductus arteriosus

allows fetal circulation to bypass the liver

ductus venosus

blood passes from the umbilical vein, through the ductus venosus, into the

IVC

at birth, placental blood flow is interrupted causing oxygen levels to ________ and carbon dioxide levels to _______

decrease , increase

this causes the newborn to take the first breath and begin neonatal lung function

decrease in oxygen and increase in carbon dioxide

after first breath, the lungs fill with air vs fluid and allows for a _________ in vascular resistance and an _________ in pulmonary blood flow

decrease , increase

pressure in the left atrium becomes _______ than in the right atrium and causes the foamed ovale to close

higher

if the foramen ovale does not close at birth, it is termed

patent foramen ovale

with a patent foramen ovale, flow is often _______ or can become ________

reversed

mixed

the ductus arteriosus becomes the _________ in the neonate

ligamentum arteriosum

normal fetal HR

120-160

bradycardia is heart rate below

100

tachycardia is heart rate above

200

- IUGR

- cardiac arrhythmias

- abnormal amniocentesis

- abnormal AF collections

- abnormal HR

- thickened NT

- hydrops

fetal indicators for an echo

- previous child with heart disease

- parent with heart disease

- diabetes

- lupus

- drug/alcohol abuse

maternal indicators for an echo

apex of heart should be at a ______ angle to midline

45

- 4 chamber heart

- RVOT and LVOT

- aortic arch

- ductal arch

normal cardiac study views

most commonly acquired view of the fetal heart

4 chamber

moderator band is seen in

right ventricle