Penny Chapters 19-25

Intrauterine devices create posterior shadowing and have been described as producing an

"Entrance and exit echo"

lissencephaly

"Smooth brain"; condition where there is little to no gyri or sulci within cerebral cortex

With agenesis of the corpus callosum, the sulci tend to have a more perpendicular or radial arrangement, and often appear to have a

"Spoke wheel" pattern

The cerebellum will become displaced inferiorly and posteriorly and appear curved in the presence of spina bifida, which is referred to as the _____ sign

"banana"

The sonographic appearance of anencephaly has been described as having a _____ faces, or bulging eyes, and absence of the cranial vault.

"froglike"

Decidua capsularis

*Portion of decidua opposite uterine cavity *Across from decidua basalis

Patau syndrome

-A chromosomal aberration in which there is a third chromosome 13 also referred to as trisomy 13

hydranencephaly

-A fatal condition in which the entire cerebrum is replaced by a large sac containing cerebrospinal fluid

mega cisterna magna

-An enlargement of the cisterns magna as defined by a depth of more than 10 mm

Trisomy 8

-Chromosomal aberration in which there is a third chromosome 8 -also referred to as Warkany syndrome 2

lobar holoprosencephaly

-The least severe form of the holoprosencephaly

Complete (spontaneous) abortion

-all products of conception expelled -no intrauterine products of conception identified -prominent endometrium, which may contain hemorrhage

First trimester is weeks

1 through 12

A gestational sac, the earliest definitive sign of a IUP, should generally be visualized between _____ and ____ mIU per mL with transvaginal sonography.

1,000 and 2,000

The NT is optimally measured between ____ and ____ weeks and ___ days gestation, when the CRL measures between 45 and 84 mm

11 and 13 weeks and 6 days gestation

Second trimester weeks

13 through 26

The triple screen is a maternal blood test performed between ____ and ____ gestational weeks.

15 and 20

Third trimester weeks

27 through 42

the measurement of the endometrium during the early proliferative phase ranges from

4 to 8 mm

What is the average age of menopause

51

Comet tail artifact

A type of reverberation artifact, caused by several small, highly reflective interfaces such as gas bubbles

______ exits the fetus through an opening in the neural tube if one is present, thus allowing for a greater amount to pass into the maternal circulation.

AFP

Thecoma

Benign ovarian sex-cord stromal tumor that produces estrogen in older women

The ______ does not communicate with the ventricular system, and its absence is associated with multiple cerebral malformations, including agenesis of the corpus callosum

CSP

The anechoic midline brain structure located between the frontal horms of the lateral ventricles is the:

CSP

The BPD is obtained in the axial plane at the level of the

CSP, thalamus and falx cerebri

Reverberation artifact

Caused by a large acoustic interface and subsequent production false echoes

____ _____, which is mostly located within the atria of the lateral ventricles, is responsible for producing CSF.

Choroid plexus

____ ____ cysts often regress, although there is a slight association with Trisomy 18.

Choroid plexus cysts

Endometrial polyps are associated with all of the following except:

Coronary heart disease

The short and narrow segment of the Fallopian tube distal to the interstitial segment is the: A) Ampulla B) Fimbria C) Infundibulum D) Isthmus

D. ishthmus

If the cerebellar vermis is absent and the fourth ventricle is enlarged, then _____ must be suspected.

DWM

What would increase a patient's likelihood of suffering from thromboembolism?

ERT

_____ _____ is the most common female genital tract malignancy

Endometrial carcinoma

______ appears sonographically as a thickened or irregular-appearing endometrium that may contain some intraluminal fluid.

Endometritis

Turner syndrome triple screen findings

Estriol decrease hCG decrease MSAFP decrease Inhibin A decrease

Edwards syndrome (Trisomy 18) triple screen findings

Estriol decreased hCG decreased MSAFP increased inhibin A decreased

chorionic villi

Fingerlike extension of trophoblastic tissue that invades decidualized endometrium

The liver capsule can become inflamed, thus leading to a clinical presentation much like galbladder disease. This event is called

Fitz-high-Curtis syndrome

which of the following should not be included in the correct level for an HC measurement? Falx cerebri Fourth ventricle Thalamus CSP

Fourth ventricle

The most accurate measurement for estimating gestation age is:

HC

what ovarian tumor will most likely have a moth-eaten appearance on sonography?

Kruckenberg tumor

The hormone that surges at ovulation is:

LH

The lack of sulci within the fetal cerebrum is reliable indicator of:

Lissencephaly

metopic suture

Located within frontal bone along midline of forehead

Patau syndrome (trisomy 13) triple screen findings

MSAFP -mildly increase inhibin A increase

What fetal suture is located within the frontal bone along the midline of the forehead?

Metopic suture

Which of the following could also be described as intermenstrual bleeding?

Metrorrhagia

the CSF moves from the lateral ventricles into the third ventricle via the foramina of ...

Monro

Cryptomenorrhea

Monthly symptoms of menstruation w/o bleeding

an endometrioma most likely appears as a

Mostly cystic mass with low-level echoes

"ovaries freely let every period start"

Ovary Follicular Luteal Endometrium Proliferative Secretory

For the imaging diagnosis of _______, one or both ovaries should contain 12 or more follicles that measure between 2 and 9 mm in diameter, and the ovarian volume should exceed 10 mL. A threshold of 25 small follicles can also be used.

PCOS

Endometrial hyperplasia may also be caused by

POS, obesity, tamoxifen therapy, estrogen producing ovarian tumors (ovarian thecoma or granulosa cell tumor)

Following an intracranial hemorrhage, a cyst is noted within the cerebrum that communicates with the lateral ventricle. This is referred to as:

Porencephaly

preeclampsia

Pregnancy-induced maternal high blood pressure & excess protein in urine after 20 weeks gestation

Posterior enhancment

Produced when the sound beam is barely attenuated through a fluid or a fluid containing structure

Within the fetal head, a cystic structure may be noted. This most often represents the _______, which will develop into the fourth ventricle and other essential brain structures.

Rhombencephalon

______ is associated with the development of fluid-filled clefts within the cerebrum

Schizencephaly

What ovarian mass is associated with virilization?

Sertoli-Leydig cell tumor

Chorionic cavity

Space between gestational sac and amniotic sac. Location of secondary yolk sac

TORCH infections

T - toxoplasmosis O - other (syphilis) R - rubella C - cytomegalovirus H - herpes

The most common intracranial tumor found in utero is the ____.

Teratoma

Cloverleaf shaped skull

Thanatophoric dysplasia

The interthalamic adhesion (massa intermedia) passes through the:

Third ventricle

strawberry shaped skull

Trisomy 18

Threatened abortion

Vaginal bleeding before 20 weeks gestation Closed cervical os Low fetal heart rate

inevitable abortion

Vaginal bleeding with dilated cervix low-lying gestation sac open internal os of cervix

Subchorionic hemorrhage

a bleed between the endometrium and the gestational sac at the edge of the placenta

Holoprosencephaly

a group of brain abnormalities consisting of varying degrees of fusion of the lateral ventricles, absence of the midline structures, and associated facial anomalies

Basal ganglia

a group of nuclei within the brain that function in several ways, including information processing and emotional response

Beckwith-Wiedemann syndrome

a growth disorder syndrome synonymous with enlargement of several organs including the skull, tongue, and liver

Fitz-hugh-curtis syndrome

a perihepatic infection that results in liver capsule inflammation from pelvic infections such as gonorrhea and chlamydia

three line sign

a periovulatory endometrial sonographic appearance in which the outer echogenic basal layer surrounds the more hypoechoic functional layer, while the functional layer is separated by the echogenic endometrial stripe

Dandy-Walker complex

a spectrum of posterior fossa abnormalities that involves the cystic dilatation of the cisterna magna and fourth ventricle

Asherman syndrome

a syndrome characterized by endometrial adhesions that typically occur as a result of scar formation after some types of uterine surgery

Endometrial hyperplasia is a common cause of

abnormal vaginal bleeding

All of the following are clinical features of an ectopic pregnancy except: pain vaginal bleeding shoulder pain adnexal ring

adnexal ring

All of the following are contributing factors for an ectopic pregnancy except: PID assisted reproductive therapy IUCD advanced paternal age

advanced paternal age

The "sunburnt" of the cerebral sulci is a sonographic finding of:

agenesis of the corpus callosum

dolichocephaly

an elongated, narrow head shape; may also be referred to as scaphocephaly

The yolk sac produces alpha-fetoprotein and plays an important role in

angiogenesis and hematopoiesis during early embryologic development

frontal bones

anterior

ethmoid bone

anterior (between orbits)

the hypothalamus releases GnRH, which influences the

anterior pituitary gland

The fourth ventricle is located:

anterior to the cerebellar vermis

____ ____ is a genetic disorder that includes craniosynostosis, midline facial hypoplasia, and syndatyly

apert syndrome

The third ventricle connects to the fourth ventricle inferiorly by means of the long, tubelike structure called the

aqueduct of Sylvius or the cerebral aqueduct

Ring-down artifact

artifact that appears as a solid streak or a chain of parallel bands radiating away from a structure

Coronal suture

between frontal and two parietal bones

lambdoid suture

between parietal bones and occipital bone

squamosal suture

between temporal and parietal bones

Sagittal suture

between the two parietal bones

A purpose of _____ _____ scoring is to investigate for signs of fetal hypoxia. Each examination of the fetus lasts 30 minutes

biophysical profile

A cephalic index of more than 85 denotes a

brachiocephalic shaped head

The anterior fontanel, when completely filled with bone is referred to as the

bregma

Shadowing

caused by attenuation of the sound beam

Lemon shaped skull

chiari 2 malformation

What is the most common form of gestational trophoblastic disease?

choriocarcinoma

In the early gestation, where is the secondary yolk sac located?

chorionic cavity

The yolk sac is located within the

chorionic cavity

With a normal pregnancy, the first structure noted within the decidualized endometrium is the:

chorionic sac

What is another name for menopause

climacteric

cebocephaly

close-set eyes (hypotelorism) and a nose with a single nostril

The most common form of Gestational trophoblastic disease (GTD) id the

complete molar pregnancy

Dandy-Walker malformation

congenital brain malformation in which there is enlargement of the cisterna magna, agenesis of the cerebellar vermis, and dilation of the fourth ventricle

The most common cause of hydrocephalus in utero is due to

congenital obstruction of the ventricular system, by means of aqueduct stenosis

The band of tissue that allows communication between the right and left cerebral hemispheres is the:

corpus callosum

The production of hCG maintains the

corpus luteum

A cephalic index of less than 75 denotes a

dolichocephalic shaped head

An ____ _____ also referred to as an ___ ____, is the most common cause of pelvic pain with a positive pregnancy test.

ectopic pregnancy, extrauterine pregnancy

The most common cause of PMB (postmenopausal vaginal bleeding) is

endometrial atrophy

Unopposed estrogen exposure on the endometrium increases the risk for

endometrial hyperplasia and endometrial carcinoma

Prior to performing a postmenopausal pelvic sonogram, it is vital for the sonographer to inquire if the patient is undergoing HRT, because HRT will influence the sonographic appearance of the

endometrium

The ovary produces estrogen and progesterone, which influences the

endometrium

Fibroids are stimulated by

estrogen

The most common location of an EUP is within the

fallopian tube, specifically the ampulla portion of the tube

All of the following may be visualized at the correct level of the head circumference except: third ventricle thalamus CSP falx cerebelli

falx cerebelli

The ____ _____ separates the cerebral hemispheres, whereas the corpus callosum connects the cerebral hemispheres and allows communication between the two lobes

falx cerebri

Missed abortion

fetal demise with retained fetus no detectable fetal heart motion detected abnormal fetal shape

With what ovarian tumor is Meigs syndrome most likely associated? a) dysgerminoma b) cystic teratoma c) fibroma d) yolk sac tumor

fibroma

Another opening of the fourth ventricle, located in the midline, is the median aperture, which is also referred to as the _____ ___ ______. This opening allows CSF to pass from the fourth ventricle to the cisterna magna and subarachnoid space.

foramen of Magendie.

The fourth ventricle has three apertures or openings through which CSF travels. There are two lateral apertures that are also referred to as the ______ _____. These two apertures allow CSF to travel from the fourth ventricle to the subarachnoid space around the brain.

foramina of Luschka

With what structure doe the posterior fossa cyst associated with DWM communicate?

fourth ventricle

Apert Syndrome

genetic disorder that includes craniosynostosis, midline facial hypoplasia, and syndactyly

Another name for the chorionic sac is the:

gestational sac

The resistance pattern of the middle cerebral artery should be ____ than that of the umbilical artery, and thus should be compared when fetal shunting is suspected.

greater

Molar pregnancy has a markedly increase in

hCG

The laboratory test used to detect pregnancy is

hCG

what hormone maintains the corpus luteum during pregnancy?

hCG

Down syndrome (trisomy 21) triple screen findings

hCG increased MASFP decreased Estriol decreased Inhibin A increased

Gastroschisis

herniation of abdominal contents through a right-sided, periumbilical abdominal wall defect

with ______, there will be evidence of a horseshoe-shaped monoventricle, and the lobes of the thalamus may be fused and echogenic in appearance.

holoprosencephaly

During the early proliferative phase, the functional layer gradually increases in size and becomes more _______. it can measure between 4 and 8 mm.

hypoechoic

While in the periovulatory phase, the outer echogenic basal layer of the endometrium will be seen surrounding the more ____ ____ ____, while the functional layer is separated by the echogenic uterine cavity.

hypoechoic functional layer

temporal bones

inferior and lateral

PID has been linked with

infertility and ectopic pregnancy

A key clinical feature of a patient with an endometrial polyp is

intermenstrual bleeding

The most common forms of malignant GTD are the

invasive mole and choriocarcinoma

The posterior fontanel is referred to as the

lambda

periovulatory phase is also called

late proliferative phase

sphenoid bone

lateral

Positive postmenopausal vaginal bleeding measurement

less than or equal to 5mm

Negative postmenopausal vaginal bleeding measurement

less than or equal to 8mm

All of the following may be sonographic findings in the presence of an ectopic pregnancy except: pseudo gestation sac corpus luteum cyst adnexal ring low beta-hCG

low beta-hCG

Pulsed doppler of the uterine cavity may indicate ____ _____ flow in the presence of endometrial carcinoma

low impedance

The malignant ovarian mass that is associated with pseudomyxoma peritonei is the:

mucinous cystadenocarcinoma

Ovulation induction medications dramatically increase the risk of

multiple gestations and OHS

The most common location for a cephalocele is in the ______ region

occipital

Communicating hydrocephalus is apparent when the obstruction lies

outside the ventricular system

Stein - Leventhal syndrome is related to all of the following except:

ovarian hyperstimulation syndrome

Which of the following would not be a cause of AUB?

ovarian torsion

The anterior pituitary gland produces FSH and LH, which influences the

ovary

the most common location of endometriosis is the

ovary

The clinical triad of an EUP includes

pain, vaginal bleeding and palpable abdominal/pelvic mass.

Incomplete abortion

part of the products of conception expelled Thickened and irregular endometrium enlarged uterus

Hepatorenal space

peritoneal space located between the liver and right kidney; also referred to as Morison pouch

The most common cause of painless vaginal bleeding in the second trimester is

placenta previa

The most common cause of painful vaginal bleeding in the second trimester is

placental abruption

occipital bones

posterior

_______ is responsible for maintaining the thickness of the endometrium and inducing its secretory activity as the endometrium prepares for the possible implantation of a pregnancy.

progesterone

Supine hypotensive syndrome

reduction in blood return to maternal heart caused by gravid uterus compressing maternal IVC

Possible benefits of ERT include all of the following except:

reduction in endometrial cancer risk

hydrocephalus

refers to the dilatation of the ventricular system caused by an increased volume of cerebrospinal fluid, resulting in increased intraventricular pressure

Over-hyperstimulation syndrome can initiate

renal failure, thromboembolism, and acute respiratory distress syndrome

brachycephalic

round skull shape

The sonographic evidence of a hyperemic fallopian tube is consistent with:

salpingitis

The development of fluid-filled cleft within the cerebrum is consistent with:

schizencephaly

The second phase of the endormetrial cycle is the

secretory phase

"string of pearls" sign

sonographic finding that is described as the presence of 10 or more small cysts measuring 2 to 18 mm along the periphery of the ovary

During the late proliferative phase or periovulatory phase, which is between days 5 and 14, the endometrial layers display a

stark contrast and can measure between 6 and 10 mm

Polycystic ovary syndrome can also be referred to as

stein-Leventhal syndrome

parietal bones

superior and lateral

colpocephaly

the abnormal lateral ventricle shape in which there is a small frontal horn and enlarged occipital horn

Decidua parietalis

the decidualized tissue along the uterine cavity adjacent to the decidua basalis

Chorion frondusum

the decidualized tissue at the implantation site containing the chorionic villi. The fetal contribution of the placenta

Cerebral aqueduct

the duct that connects the third ventricle of the brain to the fourth ventricle; also referred to as the aqueduct of slylvius

Decidua basalis

the endometrial tissue at the implantation site, and the maternal contribution of the placenta

hydatidiform mole

the most common form of gestational trophoblastic disease in which there is excessive growth of the placenta and high levels of human chorionic gonadotropin; typically benign

thanatophoric dysplasia

the most common lethal skeletal dysplasia characterized by a cloverleaf skull with frontal bossing and hydrocephalus

Chorion leave

the portion of the chorion that does not contain chorionic villi

Craniosynostosis

the premature fusing of the skull bones (sutures)

Placental abruption

the premature separation of the placenta from the uterine wall before the birth of the fetus

The ovarian mass associated with a molar pregnancy and elevated hCG is the

theca lutein cyst

which of the following is an estrogen-producing ovarian tumor?

thecoma

Following ovulation, the secretory endometrium is maintained by the production of progesterone because the endometrium becomes

thickened and echogenic in appearance and measures between 7 and 14 mm

The sonographic appearance of endometrial carcinoma is that of a

thickened endometrium with variable echogenicity

Progesterone maintains the

thickness of the endometrium in preparation for implantation

During menses, the endometrium typically appears as a

thin, echogenic line that can measure up to 4 mm

The choroid plexus cyst could be associated with an increase risk of:

trisomy 18

With ____ ____ ____ the ovaries and tubes are more readily recognized ad distinct structures, but the ovaries will not be able to be separated from the tube by pushing with the vaginal probe.

tubo-ovarian complex

Which of the following would increase the risk of a patient developing endometrial cancer?

unopposed ERT

The yolk sac is connected to the embryo by the ____ ____, also referred to as the omphalomesenteric duct, which contains one artery and one vein.

vitelline duct

Placenta previa

when the placenta covers or nearly covers the internal os of the cervix

noncommunicating hydrocephalus is when the obstruction level is located

within the ventricular system

a patient with an ovarian mass presents with an elevated serum AFP. which of the following would be the most likely?

yolk sac tumor