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MIDS 227 (module 4) > Ch 6 Spine Pathology > Flashcards

Ch 6 Spine Pathology Flashcards

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1
Q

List 2 normal spine variants?

A

Filar cyst + ventriculus terminalis

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2
Q

Main difference b/w a filar cyst + ventriculus terminalis?

A

Filar: inferior to conus
Ventriculus: within conus

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3
Q

What is a filar cyst?

A

Anechoic structure within filum terminale, just inferior to conus medullaris

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4
Q

What is ventriculus terminalis?

A

-Widening of the distal central canal, located within conus
-Typically resolves within first few months of life

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5
Q

Another name for ventriculus terminalis?

A

5th ventricle or persistent terminal ventricle

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6
Q

What is spinal dysraphism + what causes it?

A

Broad group of spinal abnormalities due to improper fusion of the neural tube during fetal development

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7
Q

Where are spinal dysraphism defects m/c located?

A

Lower spine

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8
Q

When is the neural tube finished developing?

A

8th week gestation

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9
Q

The neural tube is formed by the closure of the ___?

A

Neural plate

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10
Q

Should a normal neural plate completely fuse?

A

Yes! Or else dysraphism occurs

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11
Q

Differentiate b/w open + closed spinal dysraphism?

A

Open:
-aka spina bifida aperta
-no skin covering sac
-neural tissue communicates with outside via defect

Closed: (harder to see)
-aka spina bifida occulta
-skin covered abnormality

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12
Q

Differentiate b/w a meningocele, myelomeningocele + myelocele?

A

Meningocele:
-protrusion of meninges w/o neural tissue
-closed defect

Myelomeningocele:
-protrusion of meninges + neural tissue
-bulge above skin
-open defect

Myelocele:
-exposed neural tissue flush with skin surface + has no skin or meninges covering spinal cord
-open defect

(myelo = neural tissue, meningo = meninges)

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13
Q

List the 2 types of open spinal dysraphism?

A

Myelocele + myelomeningocele (visible on outside of skin)

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14
Q

Myeloceles + myelomeningoceles are herniation’s through a defect in the ___ mater?

A

Dura

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15
Q

What is the m/c open spinal dysraphism?

A

Myelomeningocele

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16
Q

With open spinal dysraphism, the spinal cord is ___ at the level of the abnormality?

A

Tethered

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17
Q

List 3 complications of open spinal dysraphism?

A

-Decreased lower limb function to paralysis
-Bladder + bowel dysfunction
-Hydrocephalus

(similar complications to closed spinal dysraphism)

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18
Q

___ occurs due to an enlarged subarachnoid space?

A

Myelomeningocele

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19
Q

SF’s of open spinal dysraphism?

A

-Loss of normal conus
-Fluid filled sac
-Mass continuous with spinal canal

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20
Q

Closed spinal dysraphism is present with skin-covered ___ or ___?

A

Subcutaneous mass or various skin markers

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21
Q

List 2 subcutaneous masses associated with closed spinal dysraphism?

A

Lipomyelocele/lipomyelomeningocele + myelocystocele

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22
Q

List the m/c skin marker associated with closed spinal dysraphism?

A

Sacral dimples

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23
Q

Closed spinal dysraphism anomalies are associated with a ___?

A

Tethered cord

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24
Q

Tethered cord is a type of ___?

A

Closed spinal dysraphism

25
Q

What is a tethered cord?

A

Low lying cord with a thickened filum terminale

26
Q

What happens as the spinal column grows + tethering occurs?

A

Causes stretching of spinal cord + limits its movement

27
Q

Tethered cord is almost always associated with ___ anomalies?

A

Dysraphic spinal

28
Q

Tethered cord symptoms are similar to OSD/CSD but may present earlier or later on?

A

Later on - as the child grows the spinal cord gets pulled tight, causing neurological symptoms

29
Q

What 5 anomalies are highly suspicious for a spinal abnormality?

A

-Hair tufts
-Vascular malformations
-Deep dimples
-Skin tags
-Deep clefts

(especially in lumbar region)

30
Q

Tethered cord has a high association with ___ syndrome?

A

VACTERL

31
Q

4 main SF’s of a tethered cord?

A

-Conus is at or below L3
-Decreased movement of filum terminale + nerve roots (cauda equina)
-Filum terminale will be thick (>2mm) or fatty
-Conus looks abnormally elongated + lack normal tapering

32
Q

What is diastomyelia?

A

-Longitudinal split of the spinal cord into 2 hemicords (usually reunites to form single distal cord)

-Aka split cord malformation

33
Q

Where does diastomyelia m/c occur?

A

In thoracolumbar region

34
Q

Tethered cord, scoliosis, clubfoot, vertebral anomalies + dilation of the central canal is associated with ___?

A

Diastomyelia

35
Q

Diastomyelia is diagnosed in what plane?

A

TRV (b/c 2 hemicords will be seen in this plane)

36
Q

What is a dorsal dermal sinus?

A

-Thin epithelial lined tract that courses from skin towards spinal canal
-Focal disruption of fusion of spinal canal

37
Q

Dorsal dermal sinuses m/c occur where?

A

In lumbosacral region

38
Q

Dorsal dermal sinuses clinically appear as deep midline ___?

A

Dimples/pits

39
Q

What is the main SF of a dorsal dermal sinus?

A

Midline tract from spinal cord to skin (m/c in area of a skin marker/abnormality)

40
Q

___ is the m/c reason an infant is referred for a spinal u/s?

A

Sacral dimple (located <2.5mm from anus)

41
Q

Sacral dimples can be associated with a ___ sinus?

A

Pilonidal sinus (this has no connection to the normal spine)

42
Q

What is a spinal lipoma?

A

Collections of encapsulated fat/connective tissue with a definite connection to the spinal cord

(accounts for 20-50% of closed spinal defects)

43
Q

Name the 3 types of spinal lipomas?

A

-Lipomyelocele/lipomyelomeningocele (m/c)
-Intradural lipoma
-Lipomas of filum terminale

44
Q

What is the m/c spinal lipoma?

A

Lipomyelocele/lipomyelomeningocele

45
Q

What is a lipomyelocele/lipomyelomeningocele?

A

-Skin covered echogenic fatty back mass that distorts + tethers the spinal cord
-M/c in lumbar region

46
Q

How do intradural lipomas + lipomas of the filum terminale differ from lipomyeloceles/lipomyelomeningoceles?

A

They do not have an associated subcutaneous mass

47
Q

What is an intradural lipoma?

A

Mass within spinal cord that is completely confined by the dura

48
Q

What is a lipoma of the filum terminale?

A

-Small echogenic fatty mass in filum
-Filum thickens (>2mm)

49
Q

What is a terminal myelocystocele?

A

-Skin covered cystic lumbar mass protruding through a dysraphic defect
-Abnormal dilatation of the terminal ventricle that communicates with the central spinal cord

50
Q

What is a block vertebrae?

A

When 2 adjacent vertebral bodies fail to separate

51
Q

What is a hemivertebrae?

A

Congenital lack of formation of one half of a vertebral body

52
Q

What is a butterfly vertebrae?

A

Cleft/failure of fusion of the lateral halves of the vertebral body

53
Q

What is the m/c type of germ cell tumour occuring in the neonatal period?

A

Sacrococcygeal teratoma

54
Q

What is a sacrococcygeal teratoma?

A

Benign sacral mass (risk of malignancy)

55
Q

Birth trauma is m/c assessed with what imaging modality?

A

MRI

56
Q

___ is performed on infants with sepsis to obtain CSF for culture?

A

Lumbar punctures

57
Q

How does the appearance of hematomas vary with age?

A

Initially: echogenic
Later on: anechoic as it resolves

58
Q

Filum terminale is considered thick beyond what value?

A

2mm

59
Q

How does a myelocele differ from a myelomeningocele?

A

Myelocele is flushed to skin with no meninges/skin covering it

MIDS 227 (module 4) (11 decks)

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