WorksheetsSecond Trimester 3/3
Total questions: 69
Worksheet time: 36mins
Why are the fetal eyes and orbits evaluated during an ultrasound exam?
To determine fetal presentation and measure placental thickness
To assist with fetal dating and detect facial anomalies
To measure placental thickness and to assist with fetal dating
To assess amniotic fluid volume and detect facial anomalies
Measurements of the fetal orbits are primarily used for which purpose?
Dating the fetus and identifying abnormal orbital spacing
Estimating fetal weight and dating the fetus
Confirming fetal gender and estimating fetal weight
Measuring skull thickness and identifying abnormal orbital spacing
Abnormal spacing of the fetal orbits may indicate which conditions?
Microcephaly and macrocephaly
Anencephaly and spina bifida
Hypotelorism and hypertelorism
Hydrocephalus and ventriculomegaly
Which measurements are used when evaluating fetal orbital spacing?
Biocular distance and interocular distance
Biparietal and occipitofrontal diameters
Head circumference and facial angle
Nasal bone length and mandibular width
Which fetal facial structures are evaluated when imaging the lower part of the face?
Orbits and lenses
Nares and upper lip
Mandible and maxilla only
Ears and temporal bones
In which imaging plane is the lower fetal face best visualized?
Oblique coronal section
Axial plane
Midline sagittal plane
Transverse facial plane
What congenital abnormalities can be detected when evaluating the lower fetal face?
Microcephaly
Craniosynostosis
Cleft lip or cleft palate
Hydrocephalus
What fetal functions can be assessed when visualizing the tongue during facial during?
Breathing movements
Sucking and swallowing
Heart rate
Limb movement
Which imaging plane allows visualization of the fetal chin and nose?
Midline sagittal view
Coronal plane through the lips
Axial plane through the orbits
Oblique transverse plane
What part of the fetal ear can be visualized on ultrasound?
Cochlea
Auditory canal
Tympanic membrane
Pinna of the ear
How does the appearance of the fetal ear change as gestational age increases?
It remains smooth throughout pregnancy
It is ridged early and becomes smooth with decreasing gestational age
It becomes smaller and less defined with decreasing gestational age
It is smooth initially and becomes ridged with increasing gestational age
In which imaging planes should the fetal neck be examined on ultrasound?
(a)
What is the primary abnormal finding the sonographer is assessing for when evaluating the fetal neck?
Cardiac malposition
Abnormal lung echogenicity
Spinal cervature
Protrusions or masses arising from the neck
Which additional structures may be evaluated during a third-trimester fetal neck assessment?
Cerebellum and cisterna magna
Normal neck vasculature and thyroid gland
Facial bone and cerebellum
Renal arteries and thyroid gland
By what gestational age can the fetal vertebrae typically by well visualized on ultrasound?
10 weeks
12 weeks
16 weeks
20 weeks
In the transverse plane, how many ossification centers should be seen in the fetal spine?
Three
Two
Four
One
How are the ossification centers of the fetal spine arranged in the transverse plane?
Two anterior and one posterior to the spinal canal
Two posterior and one anterior
Three posterior to the spinal canal
One lateral and two anterior
How do normal fetal vertebral ossification centers appear sonographically?
Hypoechoic
Anechoic
Moderately echogenic
Highly echogenic
Which sonographic findings is suggestive of a neural tube defect?
Splaying of the posterior elements
Absence of vertebral body
Fusion of posterior elements
Decreased echogenicity of the spine
In the sagittal plane, how many echogenic lines should the fetal spine show?
One
Three
Four
Two
What lies between the anterior and posterior spinal lines?
Echogenic tissue
Anechoic spinal canal
Hypoechoic cord
Amniotic fluid
Why must the spinal lines be continuous and unbroken?
To rule out neural tube defects
To confirm fetal position
To assess fetal growth
To estimate gestational age
Which portion of the fetal spine widens toward the skull base?
Thoracic
Lumbar
Cervical
Sacral
As the spine approaches the lumbar-sacral region, the ossified elements:
Converge
Disappear
Diverge
Remain parallel
In which imaging plane is the fetal spine evaluated to visualize two echogenic posterior ossification centers?
Axial
Sagittal
Oblique
Coronal
What sonographic findings is characteristic of the fetal spine when imaged in the coronal plane?
Single hyperechoic midline structure
Two echogenic posterior ossification centers
Vertebral bodies with ribs
Spinal canal only
From which regions of the fetus can the spine be imaged on ultrasound?
Cervical region through the lumbosacral region
Thoracic region through the cerebellum region
Cranial to thoracic region only
Lumber region only
Which imaging plane is preferred for evaluating the fetal spine?
Axial
Coronal
Transverse
Sagittal
What major structures should be evaluated when imaging the fetal chest?
Liver, stomach, and spleen
Bony elements, lungs, and heart
Kidneys, adrenal glands, and body elements
Bladder, bowel, and spleen
How do fetal lungs typically appear on ultrasound in terms of structure and location?
Solid masses location between the ribs and the heart
Cystic structures located posterior to the spine
Fluid-filled structures adjacent to the diaphragm
Air-filled organs anterior to the sternum
How does the echogenicity of the fetal lungs change throughout gestation when compared to the fetal liver?
Hyperechoic to the liver early in pregnancy and isoechoic later
Isoechoic or slightly hypoechoic to the liver early, becoming hyperechoic later in fetal life
Consistently hypoechoic compared to the liver throughout gestation
Anechoic in later fetal life, and hyperechoic to the liver only after birth
Can fetal lung maturity be determined by ultrasound imaging?
Yes, by evaluating lung echogenicity
Yes, by measuring lung size
No, lung maturity cannot be determined by ultrasound
No, lung maturity can be determined by ultrasound
What test is used to assess fetal lung maturity?
Lecithin-sphingomyelin ratio
Alpha-fetoprotein levels
Biophysical profile score
Amniotic fluid index
What is the function of the fetal diaphragm?
Separates the pelvic cavity from the abdomen
Support the lungs
Separates the heart from the lungs
Divides the abdomen from the thorax
By approximately what gestational age can the fetal diaphragm be visualized in most fetuses?
16 weeks
12 weeks
28 weeks
20 weeks
How does the fetal diaphragm typically appear on ultrasound?
Thin hypoechoic curvilinear structure
Heterogeneous muscular band
Hyperechoic ring surrounding the lungs
Thick echogenic linear structure
In which imaging planes should the fetal abdominal wall be evaluated?
Sagittal and transverse planes
Coronal and sagittal planes
Sagittal, transverse, and coronal planes
transverse only
What does a sagittal view of the fetal abdomen and thorax best demonstrate?
Location of the kidneys
Amniotic fluid volume from the posterior wall of the abdomen
Fetal presentation
Continuity of the anterior abdominal wall
Why must the posterior abdominal wall be carefully evaluated during fetal abdominal wall assessment?
To confirm stomach position
To assess placental attachment
To measure abdominal circumference
To evaluate for spinal defects
Where is normal cord insertion located relative to the stomach?
At the same level as the stomach
Slightly below the level of the stomach
Above the diaphragm
At the level of the kidneys
In which imaging plane should cord insertion be documented?
TRV
SAG
Oblique
COR
The intrahepatic portion of the umbilical vein is best visualized in which plane?
SAG
COR
TRV
Oblique
Where are fetal kidneys located on ultrasound?
Cranial to the stomach
Posterior to the bladder
Within the liver
Caudal to the stomach on either side of the spine
By what gestational age can fetal kidneys usually be visualized?
15-16 weeks
13-14 weeks
20 weeks
10-12 weeks
How do fetal kidneys appear early in gestation?
Hyperechoic
Anechoic
Cystic
Hypoechoic
During which trimester is the fetal bowel typically visualized?
Second
First
Third
Which finding may be seen in normal fetal bowel?
Shadowing calcifications
Fixed dilation
Solid echogenic mass
Peristalsis
By what gestational age should the fetal bladder be visualized?
20 weeks
12 weeks
28 weeks
16 weeks
Visualization of the fetal bladder confirms the presence of at least one:
Kidney
Lung
Ureter
Adrenal gland
Which long bone is measured in the lower extremity?
Femur
Radius
Humerus
Ulna
Which bones are located in the upper extremity?
Femur and tibia
Tibia and fibula
Radius and ulna
Ilium and ischium
Which measurement may also be used for fetal dating?
AC only
Biorbital diameter
BPD only
Placental thickness
Fetal genitalia may first be visualized at approximately:
(a)
Accurate fetal sex determination is most reliable after:
(a)
The "turtle sign" indicates:
Male genitalia
Female genitalia
Placental abnormality
Ambiguous genitalia
Which trimester includes weeks 13-26?
Second
Third
First
Which maternal change normally occurs during pregnancy?
Decreased blood volume
Increased blood volume
Increased respiratory activity
Decreased respiratory activity
Physiologic hydronephrosis is most common in which trimester(s)?
First and second
Third only
Second only
Second and third
Maternal hydronephrosis is more common on which side?
Right
Left
Posterior
Anterior
What position can cause inferior vena cava compression?
Supine
LLD
Standing
What is the correct treatment for IVC compression symptoms?
Continue exam
Sit patient upright
Turn patient onto right side
Turn patient onto left side
Amniotic fluid volume normally peaks at:
32-36 weeks
24 weeks
28 weeks
36-38 weeks
What echogenic findings may be seen in amniotic fluid in the 3rd trimester?
Blood clots
Meconium
Vernix
Calcifications
Which condition is commonly associated with olifohydramnios?
Maternal diabetes
PROM
Twin pregnancy
Placenta previa
What AFI measurement defines polyhydramnios?
>24 cm
<18 cm
<24 cm
>18 cm
The most common cause of polyhydramnios is:
Maternal diabetes
Idiopathic
Fetal anomalies
Placental insufficiency
By what gestational age do the amnion and chorion normally fuse?
16-18 weeks
10-12 weeks
13-15 weeks
20-22 weeks
A floating amniotic membrane after 16 weeks is considered:
Always abnormal
Diagnostic of rupture if fetus is not involved
indicative of twins
Normal if fetus is not involved
Fetal involvement with amniotic membranes may result in:
Amniotic band syndrome
Hydrops
IUGR
Placenta accreta
