Fetal abdomen and abdominal wall

What are the three germ layers?

ectoderm

mesoderm

endoderm

Forms the respiratory system and GI tract

Endoderm

Forms the circulatory and musculoskeletal system

mesoderm

forms the brain, CNS and skin

ectoderm

____________ us a critical part of the process of closing the abdominal wall

folding

Fore gut arterial supply

celiac artery

Midgut arterial supply

SMA

Hindgut arterial suplly

IMA

Connection of _____ ___ and ____ _____ will form umbilical cord at ventral region of embryo

yolk sac and body stalk

Intestines should return to the abdominal cavity by ____ week

12th

Three most common types of abdominal wall defects:

gastroschisis

omphalocele

umbilical hernia

Gastroschisis is typically found to the _______ of the cord

right

Membrane consisting of peritoneum and amnion forms ________ sac encasing herniated organs.

omphalocele

A hernia will have a ______ cord insertion

normal

Chromosomal anomalies occur in ___% to ___% of omphaloceles.

35-60%

Bowel only omphaloceles associated with

trisomy 21

When scoliosis is found, consider

limb body wall complex

Abnormal fusion of the amnion and chorion extends as a sheet from the cord and adheres to the fetus and placenta.

amniotic band syndrome

is considered when a large omphalocele, diaphragmatic hernia, ectopia cordis (evisceration of heart), and other heart defects are observed

pentalogy of Cantrell

Opening / defect in layers of abdominal wall with evisceration (herniation) of bowel. Infrequently, stomach & genitourinary organs (rarely the liver)

gastroschisis

Free-floating herniated small bowel is sonography consistent with

gastroschisis

Rupture of amnion leads to entrapment or entanglement of fetal parts by “sticky” chorion

amniotic band syndrome

Is a rare group of disorders having in common coexistence of omphalocele, macroglossia, and visceromegaly.

Beckwith-Wiedemann syndrome

Defect in lower abdominal wall and anterior wall of urinary bladder.

bladder exstrophy

Condition occurs early in development with involvement of primitive gut and persistent cloaca.

cloacal exstrophy

5 features of pentalogy of Cantrell:

Cleft distal sternum

diaphragmatic defect

ectopic cordis

cardiovascular malformations

omphalocele

Exposed heart presents outside chest wall through cleft sternum.

ectopic cordis

Occurs with fusion of amnion and chorion. • Amnion does not cover umbilical cord normally. • Extends as sheet from margin of cord. • Is continuous with both body wall and placenta.

limb-body wall complex

_____ sided defects are three times more common in limb body wall complex

left sided

____________ septum partitions trachea from esophagus

tracheoesophageal septum

Esophageal atresia is usually associated with ___________ ________

tracheoesophageal fistula

Lesser sac and greater sac communicate through ______ ________

epiploic foramen

Duodenum develops from _____ part of the foregut and ______ part of the midgut

caudal and cranial

Hematopoiesis begins in the ____ week

6th

Blockage of bile ducts results from failure to recanalize

extrahepatic biliary atresia

Most common malformation of the midgut

Meckel’s diverticulum

If the stomach is seen in the RUQ this is called ______ ______

situs inversus

What are the structures visible when taking AC?

LPV

Umbilical vein

Aorta

Stomach

IVC

Sonographic appearance of bowel varies with _______

age

Small bowel is slightly _______ compared to the liver

hyperechoic

Does the colon peristalsis?

no

__________ within lumen of colon appears hypoechoic to fetal liver and bowel wall.

meconium

Which lobe of the liver is larger in fetus?

left

Most common symptomatic, vascular hepatic tumor of infancy

hemangioendothelioma

Gallbladder is seen after ____ weeks

20

Asplenia

absence of spleen

Complete situs inversus outcome

normal outcome

Partial situs inversus outcome

more severe

right sided heart axis and aorta; transposition of liver, stomach, spleen; left-sided gallbladder.

total situs inversus

right sided stomach, left-sided liver; dextrocardia with normal stomach position.

partial situs inversus

Pseudoascites never outlines _______ ligament like true ascites

falciform

Congenital blockage of esophagus from faulty separation of foregut into respiratory and digestive components.

esophageal atresia

Most common form of esophageal atresia

with distal fistula

Coexisting anomalies common in __% to __% of fetuses with esophageal atresia.

50-70%

VACTERL

vertebral defects

heart defects

renal and limb anomalies

Duodenal atresia sonographic sign

double bubble

Atresia or stenosis of jejunum or ileum, or both, and small bowel atresia slightly more common than ____________ atresia.

duodenal

The more ________- the obstruction, the less severe the hydramnios, and the later it will develop

distal

Small-bowel disorder marked by presence of thick meconium in distal ileum.

meconium ileus

may occur secondary to perforation of obstructed bowel.

meconium peritonitis

Condition that may arise when fetus has sterile chemical peritonitis secondary to in utero bowel perforation.

meconium peritonitis

Megacolon is congenital disorder in which there is abnormal innervation of large intestine.

Hirschsprung disease

Grade 3 hyperechoic bowel is similar to which structure

similar to bone

Prognosis for nonimmune hydrops

poor