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
