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Penny - OB CH > Chapter 24 - the Fetal head and brain > Flashcards

Chapter 24 - the Fetal head and brain Flashcards

1
Q

By 4.5 weeks the neural plate will give rise to the

A

Central nervous system

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2
Q

What will give rise to the central nervous system

A

Neural plate

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3
Q

The neural plate will give rise to the

A

Neural tube

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4
Q

The neural tube will become the

A

Spine and Brain

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5
Q

The brain is divided into three primary vesicles

A

Prosencephalon (forebrain)
-Mesencephalon (midbrain
Rhomobencephalon (hind brain

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6
Q

The skull consists of how many cranial bones

A

8

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7
Q

The bones of the skull are. connected by structures known as

A

Sutures

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8
Q

Premature fusion of the sutures of the brain

A

Craniosynostosis

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9
Q

Spaces that exist between the fetal bones are known as

A

Fontanelles or soft spots

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10
Q

Anterior fontanelle is known as

A

Bregma

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11
Q

Posterior fontanel is known as

A

Lambda

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12
Q

Opening in the base of the cranium through which the spinal cord travels

A

Foramen Magnum

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13
Q

The brain can be divided in two man parts

A

Cerebrum
Cerebellum

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14
Q

Largest part of the brain

A

Cerebrum

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15
Q

The normal cerebrum contains multiple

A

Sulci
Gyri

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16
Q

How many cerebral lobes are there

A

Six

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17
Q

What are the 6 cerebral lobes

A

Frontal Lobe
(2) temporal
(2) parietal
Occipital

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18
Q

Cerebrum can be divided into ___

A

Rt hemisphere
Lt hemisphere

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19
Q

Intehemisphere fissure divides

A

Cerebrum into Rt and Lt hemisphere

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20
Q

a double fold of dura mater

A

Falx cerebri

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21
Q

Where is the falx cerebra located in

A

The inethermispheric fissure

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22
Q

Provides communication between Right and left haves of the brain and link the cerebral hemispheres in the midline

A

Corpus Callous

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23
Q

Three protective tissue layers that cover the brain and spinal cord

A

Meninges

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24
Q

Inner most layer of meninges

A

Pia Matera

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25
Q

Middle layer of meninges

A

Arachnoid membrane

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26
Q

Outermost layer of the meninges

A

Dura mater

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27
Q

The corpus callous should be fully intact by when

A

18 to 20 weeks

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28
Q

Corpus callous consists of 4 parts

A

Rostrum
Genu
Body
Splenium

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29
Q

Absence of the all or part of the corpus callous is referred to as what

A

Agenesis of the Corpus Callous

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30
Q

Cavum septum Pellucidum is

A

Midline brain structure

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31
Q

Where is the CSP located

A

Anterior portion between the frontal horns of the lateral ventricles

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32
Q

What appears as an anechoic box shaped structure in the axial plane

A

CSP

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33
Q

CSP should also be seen between what weeks

A

18 and 37 weeks

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34
Q

The CSP does not communicate with what

A

Ventricular system

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35
Q

The two lobes of the thalamus are located on both sides of the

A

Third ventricle

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36
Q

What passes through the third ventricle to connect to the two lobes of the thalamus

A

Massa intermedia
Interthalamic Adhesion

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37
Q

The ventricular system is composed of how many ventricles

A

Four

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38
Q

What is the primary function of the ventricular system

A

Provides cushioning for the brain

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39
Q

Each ventricle is lined by a membrane known as

A

Ependyma

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40
Q

Where are the paired lateral ventricles located on

A

Both sides of the falx cerebra within the cerebral hemispheres

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41
Q

Lateral ventricles are also known as

A

Right & Left
1st and 2nd

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42
Q

Each lateral ventricle consists of what

A

Frontal
Temporal
Occipital horn

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43
Q

The body of the lateral ventricle is located between

A

Frontal and Occipital horn

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44
Q

Where do the body, temporal horn, and occipital horn meet at?

A

Trigone of the left atrium

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45
Q

Within the atria of both lateral ventricles lies

A

Choroid plexus

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46
Q

Cells responsible for production of CSF

A

choroid plexus

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47
Q

Where are the chorioid plexus found

A

in the roof of the 3rd and 4th ventricles

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48
Q

What allows communication between the third ventricle and lateral ventricles?

A

The foramen of Monro

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49
Q

The third ventricle is located between

A

The two lobes of the thalamus

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50
Q

The third ventricle connects to the fourth ventricle by what?

A

Aqueduct of Sylvius
(cerebral aqeuduc)

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51
Q

The fourth ventricle is located how to the cerebellum

A

Anteriorly

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52
Q

4th ventricle has how many apertures

A

three

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53
Q

The fourth ventricle has three apertures that are referred to as what?

A

Foramina of Luscka

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54
Q

Two apertures of the fourth ventricle allow?

A

CSF to travel from the fourth ventricle to the subarachnoid space

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55
Q

Aperture allows CSF to cistern magna

A

Foramen of MAgendie

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56
Q

Flow of CSF

A

Lateral Ventricles

Foramina of Monro

Third Ventricle

Cerebral Aqueduct

Fourth Ventricle

Median or lateral aperatures

57
Q

Reabsorption of CSF into the venous system

A

Arachnoid Granulations or
also called arachnoid villi

58
Q

Cistern magna is located

A

In the posterior fossa of the carnium

59
Q

Largest cistern of the head

A

Cistern Magna

60
Q

Cistern magna is located where

A

-posterior to the cerebellum -between the cerebellar vermis,
-inferior surface of the occipital bone

61
Q

Cerebellum consists of what

A

Two hemispheres
RT & LT

62
Q

Structure noted on the under surface of the cerebellum and become distorted with spina bifida

A

Cerebellar tonsils

63
Q

BPD is obtained at the level of the?

A

Falx cerebri
Thalamus
CSP
3rd ventricle

64
Q

How is BPD obtained

A

Outer table of the proximal parietal bone

Inner table of the distal parietal bone

65
Q

BPD is from

A

leading edge to leading edge

66
Q

Head shape that is too wide or round

A

Brachycephalic

67
Q

Head shape is too elongated or narrow

A

Dolichocephaly (scaphocephaly)

68
Q

Normal to Medium sized skull is termed

A

Mesocephalic

69
Q

Cephalic Index is what?

A

BPD/OFD x 100

70
Q

A cephalic index of less than 75 deonates what?

A

Dolichocephalic

71
Q

A cephalic index of more than 85 denotes what

A

Brachiocephalic

72
Q

Where is the lateral ventricle measured at

A

Transaxial plane of the level of the left atrium

73
Q

Why is the atrium the optimal site for measuring the lateral ventricle?

A

Because this is where the first region where ventricular enlargement occurs

74
Q

Lateral Ventricles does not typically measure more than ?

75
Q

Enlargment beyond 10mm is referred to as?

A

Ventriculomegaly

76
Q

The cerebellum grows at a rate of ?

A

1mm per week between 14 and 21 weeks

77
Q

The depth of the cisterna magna should not measure?

A

More than 10 mm
Less than 2 mm

78
Q

CM measures bigger than 10 mm is known as

A

Mega cistern Magna
Dandy Walke complex

79
Q

CM measures less than 2 mm is

A

Arnold Chiari II malformation

80
Q

The abnormal enlargement of the ventricles within the brain

A

Ventriculomegaly

81
Q

Dilatation of the ventricular system caused by an increased volume of CSF

A

Hydrocephalus

82
Q

Severe case of Ventriculomegaly

A

Hydrocephalus

83
Q

What does Aqueductal Stenosis Cause?

A

Hydrocephalus ;Obstruction to the flow of CSF, resulting in a backup of the fluid in cerebral ventricles

84
Q

The most common cranial abnormality ?

A

Ventriculomegaly

85
Q

Suspicion of ventricular dilatation occurs when?

A

atrial diameter measures more than 10mm

86
Q

Ventriculomegaly can have what sonographic finding?

A

Dangling chorioid plexus cyst

87
Q

Echogenic choriod plexus, hanging limp and surrounded by CSF within dilated lateral ventricle

A

Dangling choroid plexus cyst

88
Q

Hydrocephalus can be describes as what

A

Mild
Moderate
Severe

89
Q

There are two types of hydrocephalus

A

Communicating
Non communicating

90
Q

Obstruction lies outside the ventricular system

A

Communicating hydrocephalus

91
Q

Obstruction lies within the ventricular system

A

Noncommunicating

92
Q

The most common cause of Hydrocephalus?

A

Aqueduct stenosis

93
Q

Sonographic Findings of Ventriculomegaly

A

Atrium of the lateral ventricle measures greater than 10 mm

Atrial measurement measuring 15 mmis considered ventriculomegaly

Dangling choriod plexus

Dilatation of any part of the ventricular system

94
Q

When the cerebral aqueduct between the third and fourth ventricles of the brain are narrowed

A

Aqueduct stenosis

95
Q

Entire cerebrum is replaced by a large sac containing CSF

A

Hydrancephaly

96
Q

with hydrancephaly ____

A

Falx Cerebri is partially or completely absent

Brain stem and basal ganglia are maintained and surrounded by CSF

Cerebral cortex will not be identified

97
Q

What causes hydrancephaly

A

Bilateral occlusion of the internal carotid arteries

Intrauterine Infections (Cystomegalovirus / Toxoplasomosis)

98
Q

Severe Ventriculomegaly and Hydranencephaly what will be present?

A

Rim of cerebral tissue maintained

99
Q

Hydranencephaly there what will not be visualized?

A

Cerebral mantal

100
Q

Midline brain anomaly that is associated with not only brain abberations but also atypical facial features

A

Holoproencephaly

101
Q

There are three main types of holoproencephaly

A

Alobar
Semilobar
Lobar

102
Q

Cortex will look like a pancake, cup, or ball

A

ALobar holoproencephaly

103
Q

Alobar is Holoproencephaly diagnosed when what is absent?

A

Absence of Corpus Callosum, CSP, Third Ventricle, Interhemisphereic Fissure, and FAlx Cerebri

104
Q

What are the Sonographic Features of Alobar Holoproencephaly

A

Horseshoe shaped monoventricle

Fused echogenic thalami

Absence of CSP, Corpus Callosum, Third Ventricle, Falx Cerebri, Interhemisphereic Fissure

105
Q

Facial Anomalies of Alobar Holoproencephaly

A

Cyclopia

Hypotelorism

Proboscis

Median cleft lip

Anopthalmia

Cebocephaly

106
Q

Spectrum of posterior fossa abnormalities that involve the cystic dilatation of the Cisterna Magna and Fourth Ventricle

A

Dandy Walker Malformation

107
Q

Dandy walker Malformation

A

Developmental abnormaility in the roof of the fourth ventricle

108
Q

Sono findings of DWM

A

Enlargement of Cisterna Magna > 10 mm in the anteroposterior dimension

Communication of the enlarged Cisterna Magna with a dilated fourth ventricle

Agenesis or hypoplsia of the Cerebellar Vermis

Varying degrees of Ventriculomegaly

109
Q

Enlargement of the Cisterna Magna without the involvement of the fourth ventricle

A

Mega cistern Magna

110
Q

Sono findings of Mega cistern magna

A

Enlargement of the Cisterna Magna > 10 mm in the anteroposterior dimension

Normal cerebellum and fourth ventricle

111
Q

Bridge of tissue located within the midline of the brain that connects the two cerebral hemispheres.

A

Corpus callousum

112
Q

What is located inferior to the Corpus Callosum

113
Q

Mostly often if the Corpus Callosum is absent then what else is also absent?

114
Q

Agenesis of the Corpus Callosum and CSP is linked to what anomalies?

A

Trisomy 8

Trisomy 13

Trisomy 18

holoprosencephaly

Aqueductal Stenosis

Apert Syndrome

DWM

115
Q

Sonographic Findings of Agenesis of the Corpus Callosum and CSP

A

Partial or complete absence of the Corpus Callosum and CSP

Sunburst Sign - Radial arrangement of the sulci which produces a “spoke wheel” pattern

Colpocephaly - Small frontal horns and enlarged occiptal horns

Elevated and dilated third ventricle

116
Q

Development of fluid filled clefts within the cerebrum

A

Schizencephaly

117
Q

Cyst communicates with the ventricular system

A

Porencephaly

118
Q

Porencephaly

A

Fetus has experience a hemorrhage within one or both hemispheres of the brain

119
Q

Smooth brain where there is no gyri or sulci within the brain

A

Lizzencephaly

120
Q

Protrusions of intracranial contents through a defect in the skull

A

Cephalocele

121
Q

The most common location for a Cephalocele?

A

Occipital region

122
Q

Protrusions that include brain tissue

A

Encephalocele

123
Q

Toxoplasmosis

Other Infections

Rubella

Cystomegalovirus

Herpes

A

Torch stands for

124
Q

The most common intracranial tumor found in utero is what?

125
Q

Choroid Plexus Papillomas

A

Found in the CP increased production of CSF which leads to ventriculomegaly

126
Q

Intracranial Hemorrhage is a common worry for infants?

A

Weighing less than 1,500 and those born before 32 weeks

127
Q

The most common risk for intrauterine intracranial hemorrhage is listed as?

A

Maternal placental disorder (Cociane and Amniocentesis are others)

128
Q

Origin of the Intracranial Hemorrhage is?

A

Germinal matrix

129
Q

Group of thin walled pressure sensitive vessels located in the subependymal layer of the ventricle

A

germinal matrix

130
Q

Normal cerebral circulation typically has what kind of Doppler pattern?

A

High impedance

131
Q

Doppler assessment of the Middle Cerebral Artery is effective for evaluating?

A

Potential Hypoxia

132
Q

Brain Sparring Syndrome

A

Fetus is starved for oxygen

Redistribution of the blood to the vital organs (BRAIN)

Occurs in order to spare it from damage

133
Q

The pulsatility index of the MCA varies?

A

With gestational age, normally decreases with advancing gestational age

134
Q

The resistance pattern of the MCA should be?

A

Greater than the umbilical artery

135
Q

The MCA/Umbilical Artery Resistive Index is?

A

normally above 1.0

136
Q

MCA / Umbilical Artery Resistive Index less than 1.0 is considered?

137
Q

Ateriovenous malformation that occurs within the fetal brain

A

Vein of Galen anyerusm

138
Q

Anechoic mass within the midline of the brain that contains turbulent arterial and venous flow

Fetal Hydrops

Cardiomegaly

A

Sonofindings of vein of glean anyersum

Penny - OB CH (18 decks)

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