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Directions:
Students are required to complete each area based on the scan comp completed to
receive maximum points.
There are 10 sections; each section is worth a maximum of 5 points. Answers
provided must relate to specific information requested. Additional information
including non-applicable information will result in point deduction
Before the exam: Patient Interview, Chart Review, Possible Pathology, Patient Set
Up, and Preparation
Section 1:
Identify the patients age, sex, ethnicity, current symptoms and pertinent history relevant to
the exam.
Answer:
The patient was a 24 year old Caucasian female. The patient was experiencing no
symptoms, and was having a routine anatomy scan. She was a gravida two, para one. Her
current pregnancy had a gestational age of 19w2d. She had a history of diabetes and
anemia.
Identify the patients labs relevant to the exam (as high, low, or normal) and explain what
the patients lab values indicate.
If the patient had no labs, identify the labs relevant to the exam (with normal values) and
explain what deviations in these lab values indicate.
Answer:
The patient had a positive qualitative hCG-urine pregnancy test. This value is either
positive or negative and indicates if the patient is pregnant or not. She also had a positive
quantitative hCG-blood pregnancy test. This value is either positive or negative, and
indicates the same thing. The patient had not had the AFP blood test, or a Triple or Quad
Screen done at this time. High AFP levels indicate open neural tube defects, and low levels
indicate Downs Syndrome. The Triple and Quad Screen exams are used to detect
chromosome abnormalities.
Identify the patients previous exams and results relevant to the exam.
If the patient had no previous exams, identify one other imaging modality that could be used
to evaluate your patients symptoms. Explain why this modality would be used in
conjunction with sonography.
Answer:
The patient had a previous exam performed on 11/13/2014 for a first trimester
confirmation. The crown rump length revealed a gestational age of 8w4d, which was earlier
than the patients previously stated LMP. She had given a LMP of 8/25/2014. The ultrasound
revealed a single IUP with a normal fetal heart rate of 175 BMP. A yolk sac was visualized as
well as a corpus luteum on the right ovary measuring 1.5 cm. Both of these findings were
within normal limits. Her uterus and ovaries measured normal. No masses or abnormalities
were visualized in either adnexa.
TX T SP
Three vertebral points at the level of the heart, indicating thoracic vertebrae
Hyperechoic ribs visualized on each side of the vertebrae encasing the thoracic cavity
SAG LS SP
5 lumbar and 5 sacral vertebrae that were properly aligned with one another, and the
coccyx bringing the vertebral column down to a point
Section 5:
Identify all protocol measurements obtained and identify if the measurement is normal or
abnormal. If abnormal, what is indicated?
Answer:
No measurements were required for this exam.
Grade for
Section 5
Section 6:
Identify the pathology documented during the exam, including location, size, vascularity,
and sonographic features.
If no pathology is seen, identify a common pathology seen with this exam and how you
would need to modify your protocol to document this pathology.
Answer:
There were no pathologies visualized during this exam. A common pathology that may be
seen when examining the spine and extremities is clinodactyly. This is a curvature of a digit,
usually the fifth, towards the adjacent fourth digit. It often occurs along with other
abnormalities in many genetic syndromes, such as Trisomy 21.
This is correct, because this preset has optimal resolution for good visualization of
small structures, such as vertebrae, digits, and the boundaries at the end of long
bones. It allows a very thorough check for fetal pathologies.
TransducerC-1-5
This is correct, because it allows for good penetration when looking at fetal structures
deep within the mothers abdomen. It also has a wide field of view. This allows for
large portions of the baby to be visualized and included in each image if needed.
Frequency3 MHz
This is correct, because it is the best choice for penetration and resolution working
together. It is a lower frequency which allows for penetration through the mothers
abdomen, and different structures of the baby, while maintaining good resolution for
borders and small pathologies.
For your fetal upper extremity longitudinal right ulna/radius image, identify depth and focal
zone(s) used and why they were correct.
Answer:
Depth10 cm
This is correct, because it includes the entire portion of the upper extremity in the
image, making sure to include all borders of the skin lines.
Focal Zone6 cm
This is correct, because the best resolution is at the level of the ulna and radius,
ensuring that both bones are completely visualized to rule out abnormalities like
possible chromosome issues.
For your transverse LS-SP, identify depth and focal zone(s) used and why they were correct.
Answer:
Depth12 cm
This is correct, because it goes just a couple of centimeters beyond the inferior part
of the fetus to show the full length of the L/S spine. This allows visualization of any
spinal abnormalities, which are common in this area.
This is correct, because it ensures that the best resolution in the image is focused on
the spine. This is very beneficial when examining the tiny vertebrae for anomalies
such as hemivertebrae.
Grade for
Section 7
Patient MRN:
Exam order on request:
Performance date of final scan
comp:
Is this a second attempt written
comp?
34911
Fetal Anatomy Survey
1/22/2015
No
Points
Description