EDITED EDITED EDITED OB GYN: CTL 2nd/3rd Trimester Anatomy 37% Exam

Meow Mixer Version 635.27

The normal spine has three ossification centers called: A) anterior and posterior neural processes and the magnum B) anterior and posterior neural processes and the centrum C) medial and lateral neural processes and the centrum D) right and left neural processes and the centrum

D) right and left neural processes and the centrum

Which of the following correctly describes how to differentiate the umbilical vein and the gallbladder in a fetus? A) The gallbladder is normally parallel to the abdominal wall while the umbilical vein is perpendicular to the abdominal wall. B) The umbilical vein is located centrally in the abdomen while the gallbladder is located to the right between the right and left lobes of the liver. C) The umbilical vein is normally parallel to the abdominal wall while the gallbladder is perpendicular to the abdominal wall. D) Color Doppler will demonstrate flow filling the lumen of the portal vein but flow will only be demonstrated within the walls of the gallbladder.

B) The umbilical vein is located centrally in the abdomen while the gallbladder is located to the right between the right and left lobes of the liver.

What is the function of the choroid plexus? A) The choroid plexus is responsible for releasing multiple types of hormones that control fetal lung maturation. B) The choroid plexus is responsible for production of cerebrospinal fluid. C) The choroid plexus is responsible for releasing multiple types of hormones that control circulation and blood pressures. D) The choroid plexus is responsible for releasing multiple types of hormones that control fetal growth and metabolism.

B) The choroid plexus is responsible for production of cerebrospinal fluid.

Blood entering the fetus in the umbilical vein is divided between: A) the portal vein and the ductus venosus B) the portal vein and the IVC C) the portal vein and the ductus arteriosus D) the IVC and the ductus venosus

A) the portal vein and the ductus venosus

If two fetuses are different genders, this indicates: A) monoamniotic twins B) dizygous twins C) monozygous twins D) identical twins

B) dizygous twins

Which hormone stimulates the formation of the cervical mucus plug found with pregnancy? A) Oxytocin B) Progesterone C) Estrogen D) hCG

B) Progesterone

The ratio of kidney diameter to the abdominal diameter should stay between ______ for the entire pregnancy. A) 0.33 - 0.44 B) 0.33 - 0.27 C) 0.5 - 0.57 D) 0.3 - 0.4

B) 0.33 - 0.27

Peristalsis of the fetal bowel should normally be identified: A) in the late 2nd trimester B) just after midgut herniation retracts C) before the midgut herniation retracts D) after 35 weeks gestation

A) in the late 2nd trimester

The normal fetal bladder should empty and refill every ______. A) 15-20 minutes B) 30-45 minutes C) 1-2 hours D) 3-4 hours

B) 30-45 minutes

What normal fetal structure produces alpha-fetoprotein? A) heart B) pancreas C) kidneys D) liver

D) liver

Which type of breech position is defined as the fetus presenting butt first and sitting cross legged with knees bent? A) Partial B) Frank C) Complete D) Footling

C) Complete

The fetal stomach should be routinely visualized by week _____. A) 10 B) 12 C) 16 D) 14

D) 14

The ductus arteriosus is: A) a vessel that connects the pulmonary artery to the aorta to allow flow to bypass the fetal lungs B) a vessel that connects the umbilical artery to the aorta to allow flow to bypass the fetal lungs C) a vessel that connects the umbilical vein to the IVC to allow flow to bypass the liver D) an opening between the right and left atrium to shunt flow away from the fetal lungs

A) a vessel that connects the pulmonary artery to the aorta to allow flow to bypass the fetal lungs

Which of the following fetal structures is not subject to changes in shape due to molding? A) femur length B) biparietal diameter C) abdomen circumference D) head circumference

A) femur length

The __________ empties blood into the right atrium and, while the __________ empties blood into the left atrium. A) pulmonary veins, inferior vena cava B) inferior vena cava, superior vena cava C) tricuspid valve, mitral valve D) inferior vena cava, pulmonary veins

D) inferior vena cava, pulmonary veins

Herniation of the midgut is an abnormal finding in gestations over ______ in age. A) 8 wks B) 10 wks C) 12 wks D) 14 wks

C) 12 wks

Dizygotic twins: A) are always the same sex. B) are formed by the union of 2 sperm and one egg. C) are less common than monozygotic twins. D) will usually demonstrate two chorions, two amnions and two placentas.

D) will usually demonstrate two chorions, two amnions and two placentas.

In a normal pregnancy, the placental thickness should be relatively equal to the: A) gestational age in weeks B) gestational age in weeks + 10 mm C) fetal head circumference D) length of the cervix

B) gestational age in weeks + 10 mm

Which of the following terms describes the opening in the interatrial septum that allows normal shunting between the atria? A) patent ductus arteriosus B) foramen ovale C) muscular septal defect D) patent ductus venosus

B) foramen ovale

Which of the following structures is considered the most reliable for determining fetal situs? A) stomach and heart B) stomach and liver C) aorta and IVC D) liver and gall bladder

C) aorta and IVC

In a small number of adults, Meckel's diverticulum can be identified as a remnant of fetal embryology. What causes this anatomic variation? A) the placental umbilical cord attachment persists as a diverticulum in the ileum portion of the bowel B) the yolk sac persists as a diverticulum in the ileum portion of the bowel C) the placenta persists as a diverticulum in the ileum portion of the bowel D) the gestational sac persists as a diverticulum in the ileum portion of the bowel

B) the yolk sac persists as a diverticulum in the ileum portion of the bowel

The three vessel view of the fetal heart demonstrates all of the following, except: A) pulmonary artery B) aorta C) inferior vena cava D) superior vena cava

C) inferior vena cava

Which of the following is described as ectopic lobe(s) of placental tissue separate from the main placenta? A) placenta accreta B) placenta increta C) placenta previa D) succenturiate placenta

D) succenturiate placenta

Which normal cranial structures are identified within the lateral ventricles bilaterally? A) cavum septum pellucidum B) lobes of the thalamus C) choroid plexus D) cerebellar pedicles

C) choroid plexus

The umbilical vein: A) carries oxygenated blood B) is usually much longer than the 2 arteries C) normally doubles in diameter near the placental insertion D) is absent in patients with a two vessel cord

A) carries oxygenated blood

The post-partum period usually lasts ______. A) 2-4 wks B) 4-6 wks C) 6-8 wks D) up to 12 wks

C) 6-8 wks

The second trimester of pregnancy is defined as: A) weeks 20 through 30 gestational age B) weeks 13 through 26 gestational age C) weeks 14 through 28 gestational age D) weeks 12 through 24 gestational age

C) weeks 14 through 28 gestational age

What is the functional unit of the placenta? A) nephron B) lobule C) cotyledon D) lobe

C) cotyledon

The normal anterior-posterior renal pelvic diameter (APRPD) in a second trimester fetus is ______, and in a 3rd trimester fetus ______ is considered normal. A) less than 2 mm, less than 4 mm B) less than 8 mm, less than 16 mm C) less than 4 mm, less than 7 mm D) less than 10 mm, less than 20 mm

C) less than 4 mm, less than 7 mm

The visualization of a normal stomach indicates a normal ______ is present. A) small intestine B) colon C) palate D) esophagus

D) esophagus

Fetal stool is referred to as ______, while fetal urine is referred to as ______. A) vernix, meconium B) Wharton jelly, amniotic fluid C) meconium, amniotic fluid D) meconium, vernix

C) meconium, amniotic fluid

Average normal heart rate in a 2nd trimester fetus is ______. A) 160-200 bpm B) 80-120 bpm C) 100-140 bpm D) 120-160 bpm

D) 120-160 bpm

The cisterna magna is enlarged if it measures more than: A) 5 mm B) 7 mm C) 10 mm D) 12 mm

C) 10 mm

The fetal umbilical arteries branch from the: A) fetal internal iliac arteries B) maternal aorta C) fetal aorta D) maternal internal iliac arteries

A) fetal internal iliac arteries

The Mickey Mouse sign is associated with __________, and the Frog Eyes appearance is associated with __________. A) exencephaly, anencephaly B) hypertelorism, hypotelorism C) alobar holoprosencephaly, lobar holoprosencephaly D) hypotelorism, hypertelorism

A) exencephaly, anencephaly

The lambda sign indicates ______ while the T sign indicates ______. A) monochorionic monoamniotic twins, conjoined twins B) dichorionic diamniotic twins, monochorionic monoamniotic twins C) monochorionic diamniotic twins, dichorionic diamniotic twins D) dichorionic diamniotic twins, monochorionic diamniotic twins

D) dichorionic diamniotic twins, monochorionic diamniotic twins

The proximal femoral epiphyseal plates should be visualized sonographically by what gestational age? A) 13 wks B) 18 wks C) 30 wks D) 35 wks

D) 35 wks

Advanced maternal age refers to a pregnant woman who is greater than ______ of age. A) 40 yrs B) 45 yrs C) 33 yrs D) 35 yrs

D) 35 yrs

Chromosomal defects may be present in a pregnancy where the amnion and chorion have not completely fused by ______ gestational age. A) 8 weeks B) 12 weeks C) 16 weeks D) 20 weeks

C) 16 weeks

All of the following correctly describe a normal fetal spine, except: A) a skin dimple on the back marks the tip of the normal spinal cord B) tapering of the sacral spine C) in the late 3rd trimester the spinal cord tip is at the level of L3 D) widening of the proximal spine

A) a skin dimple on the back marks the tip of the normal spinal cord

The __________ is located between the right atrium and ventricle, while the __________ is located between the left atrium and ventricle. A) tricuspid valve, mitral valve B) mitral valve, tricuspid valve C) mitral valve, aortic valve D) tricuspid valve, pulmonary valve

A) tricuspid valve, mitral valve

Late in the 3rd trimester the tip of the spinal cord should be identified at the level of: A) S1 B) S3 C) L5 D) L3

D) L3

The fetal testicles normally descend into the scrotum before ______ weeks gestation. A) 22 B) 34 C) 26 D) 16

B) 34

The normal direction of flow through the fetal foramen ovale is: A) left atrium to right atrium B) umbilical vein to fetal IVC C) pulmonary artery to aorta D) right atrium to left atrium

D) right atrium to left atrium

Which of the following terms describes the vessel that allows some umbilical blood to bypass the fetal liver in fetal circulation? A) foramen ovale B) umbilical vein C) ductus venosus D) ductus arteriosus

C) ductus venosus

On a fetal ultrasound, the LVOT refers to the ______ and the RVOT refers to the ______. A) aortic arch, pulmonary vein B) ascending aorta, pulmonary artery C) descending aorta, peripheral pulmonary arteries D) aortic valve, pulmonic valve

B) ascending aorta, pulmonary artery

What view is used to demonstrate the fetal thymus gland and where is it located? A) three vessel view, posterior to the sternum at the level of the aorta and pulmonary artery B) axial cervical spine view, surrounding the larynx and posterior to the esophagus C) axial cranial view, just below the cisterna magna in the neck D) transverse abdominal view, in the suprarenic space

A) three vessel view, posterior to the sternum at the level of the aorta and pulmonary artery

At what gestational age do the fetal kidneys begin to produce urine? A) 10 B) 12 C) 14 D) 16

B) 12

Which type of breech position is defined as fetus with one or both feet in the lower uterine segment? A) Complete B) Partial C) Footling D) Frank

C) Footling

The normal corpus luteal cyst seen with pregnancy begins to regress at ______ gestation and should be totally resolved by week ______. A) 14, 16 B) 16, 20 C) 12, 16 D) 20, 28

A) 14, 16

What intracranial structure is located anterior to the lobes of the thalamus? A) cerebellum B) choroid plexus C) third ventricle D) cavum septum pellucidum

D) cavum septum pellucidum

The first cardiac chamber to receive oxygenated blood from the placenta is: A) right atrium B) left atrium C) left ventricle D) right ventricle

A) right atrium

In a normal 4 chamber heart view, what cardiac chamber is closest to the spine? A) left atrium B) right ventricle C) left ventricle D) right atrium

A) left atrium

______ refers to a normal finding of sebum and epithelial cells that cause white free-floating debris within the amniotic fluid late in pregnancy. A) meconium B) vernix C) pseudomyxomatous peritonei D) Chadwick's sign

B) vernix

The level of amniotic fluid continues to rise throughout pregnancy until approximately ______ weeks in gestational age where it will plateau then decline until birth. A) 16 B) 20 C) 28 D) 33

D) 33

As the pregnancy advances, the sonographic appearance of the fetal lungs will: A) decrease in echogenicity B) become increasingly heterogeneous C) become more anechoic D) increase in echogenicity

D) increase in echogenicity

What cardiac structure is described as having a hockey stick appearance on sagittal views of the chest? A) ductus venosus B) ductus arteriosus C) aortic arch D) main pulmonary artery

B) ductus arteriosus

The aqueduct of Sylvius connects the __________ in the brain. A) 4th ventricle and cisterna magna B) 3rd ventricle and lateral ventricles C) 3rd and 4th ventricles D) lateral ventricles and 4th ventricle

C) 3rd and 4th ventricles

The fetal heart normally sits at a ______ degree angle in the chest with the apex pointed toward the left anterior chest wall. A) 30 B) 45 C) 60 D) 90

B) 45

The optimal 4 chamber view of the fetal heart should include: A) Cross section of two ribs on both sides of the chest B) At least one rib in profile of the left side of the chest C) A single rib in profile on both sides of the chest D) Cartilage between the ribs, with no bony shadowing present on both sides of the chest

C) A single rib in profile on both sides of the chest

The proximal pulmonary artery and aorta demonstrate a normal appearance when: A) the aorta crosses anterior to the pulmonary artery as they both exit the heart B) the pulmonary artery crosses anterior to the aorta as they both exit the heart C) they exit the heart parallel to one another D) the diameter of the aorta is at least 2x the diameter of the pulmonary artery

B) the pulmonary artery crosses anterior to the aorta as they both exit the heart

In normal pregnancies, fetal age derived from biometric measurements should be within ______ of the average fetal parameter age for that measurement. A) 5% B) 10% C) 7.5% D) 15%

B) 10%

During renal development, the kidneys normally migrate: A) from the pelvic region superiorly into the lower abdomen. B) from their origination point centrally in the abdomen to a more lateral location adjacent to the ribs. C) from the lower right side of the spine superiorly and separate once the fetus reaches 11 wks. D) from the upper abdomen into an inferior retroperitoneal location.

A) from the pelvic region superiorly into the lower abdomen.

The corpus callosum should be completely formed by which week of gestation? A) 12 B) 14 C) 10 D) 18

D) 18

Normal amniotic fluid levels are mandatory for proper development of the fetal: A) bladder B) lungs C) kidneys D) digestive tract

B) lungs

A 4 mm thick membrane separating two fetuses indicates: A) monochorionic twins B) twin to twin transfusion C) potential fetal demise D) dichorionic twins

D) dichorionic twins

The normal heart occupies about ______ of the fetal chest. A) 60% B) 55% C) 33% D) 25%

C) 33%

Which of the following terms describes the connecting vessel from the main pulmonary trunk to the descending aorta found in fetal circulation? A) foramen ovale B) ductus venosus C) left atrial appendage D) ductus arteriosus

D) ductus arteriosus

The most common type of twins is __________. A) dizygotic B) monozygotic C) identical D) monoamniotic

A) dizygotic

At what gestational age does the fetus completely take over the amniotic fluid production? A) 16 wks B) 12 wks C) 24 wks D) 20 wks

A) 16 wks

Which type of breech position is defined as fetus with butt first with legs extended adjacent to fetal abdomen? A) Complete B) Footling C) Partial D) Frank

D) Frank

Which cardiac chamber is normally located most anterior in the fetus? A) right atrium B) left ventricle C) left atrium D) right ventricle

D) right ventricle

What intracranial structure is located between the two lobes of the thalamus? A) 3rd ventricle B) cisterna magna C) pituitary gland D) 4th ventricle

A) 3rd ventricle

Which of the following describes the normal fetal diaphragm? A) hyperechoic dome shaped structure with the top of the dome facing cephalad B) hypoechoic dome shaped structure with the top of the dome facing cephalad C) hypoechoic cup shaped structure with the bottom of the cup facing caudal D) hyperechoic linear structure that separates the abdomen from the chest

B) hypoechoic dome shaped structure with the top of the dome facing cephalad

Which cranial structure is considered abnormal if it increases in size between ultrasound exams performed at 20 and 28 weeks? A) thalamus B) lateral ventricle C) cerebellum D) choroid plexus

B) lateral ventricle

How many bones make up each of the fetal fingers? A) 2 B) 3 C) 4 D) 5

B) 3

Where is Wharton jelly found? A) amniotic fluid B) fossa of Waldeyer C) umbilical cord D) cervical mucous plug

C) umbilical cord

Twins will exhibit the same fetal growth pattern as a fetus in a singleton pregnancy until ______ weeks. A) 30 B) 33 C) 36 D) 24

A) 30

What is the lateral bone of the forearm called? A) fibula B) ulna C) radius D) humerus

C) radius

The right atrium receives blood from which of the following vessels? A) SVC B) Pulmonary Veins C) Pulmonary arteries D) Ductus arteriosus

A) SVC

The left atrium receives blood from what vessel(s)? A) pulmonary veins B) pulmonary arteries C) IVC D) ductus arteriosus

A) pulmonary veins

The most common type of twins is?

A) Dizygotic
B) Monozygotic
C) Identical
D) Monoamniotic

A) Dizygotic

What is number 1?

Main pulmonary artery

What is number 2?

Descending aorta

What is number 3?

Left pulmonary artery

What is number 4?

Ascending aorta

What is number 5?

Right pulmonary artery

What is number 6?

Superior vena cava

What is number 7?

Spine

At what gestational age does the fetus completely take over the amniotic fluid production?

A) 16 weeks
B) 12 weeks
C) 24 weeks
D) 20 weeks

A) 16 weeks

Which segment of the fetal spine is identified on the image?

A) Thoracic
B) Lumbar
C) Sacral
D) Cervical

C) Sacral

Which of the following describes the normal fetal diaphragm?

A) Hyperechoic dome shaped structure with the top of the dome facing cephalad
B) Hypoechoic dome shaped structure with the top of the dome facing cephalad
C) Hypoechoic cup shaped structure with the bottom of the cup facing caudal
D) Hyperechoic linear structure that separates the abdomen from the chest

B) Hypoechoic dome shaped structure with the top of the dome facing cephalad

What intracranial structure is located between the two lobes of the thalamus?

A) 3rd ventricle
B) Cisterna magna
C) Pituitary gland
D) 4th ventricle

A) 3rd ventricle

The left atrium receives blood from what vessel(s)?

A) Pulmonary veins
B) Pulmonary arteries
C) IVC
D) Ductus arteriosus

A) Pulmonary veins

If the fetus is in a breech position, where is the left lobe of the thalamus located?

Number 3

What fetal structure is indicated by #5?

A) Right lung
B) Diaphragm
C) Rib
D) Left lung

C) Rib

What is number 1?

Stomach

what is number 2?

Thoracic spine

What is number 3?

Umbilical vein

What is number 4?

Liver