Chapter 59 Fetal Face/neck Flashcards
Many facial & neck anomalies are caused by _____
Maternal drug use
Features of the fetal face can be identified at the ____
End of 1st trimester
View best to image cleft lip and palate:
Modified coronal
Maxilla & orbits are best imaged in the _____ plane
True coronal
The lens of the eye is seen as a ___
Small echogenic circle within the orbit
View that demonstrates the nasal bones, soft tissue, and mandible:
Longitudinal
Longitudinal view demonstrating the nasal bones soft tissue and mandible is useful to rule out:
Micrognathia, anterior encephalocele, nasal bridge defects, examine upper lip
View that shows orbital abnormalities and intraorbital distances:
Transverse
Transverse view showing orbital abnormalities an intraorbital distances is useful to evaluate:
Maxilla, mandible, tongue
Protrusion of brain from cranial cavity
Cephalocele
Anterior cephaloceles may cause
Hypertelorism(eyes fat apart)
AKA Kleeblattschadel
Clover-lead skull
Clover leaf skull is associated with ______ and _____
Skeletal dysplasia and ventriculomegally
May cause forehead to have elongated appearance in sagittal plane & triangular shape in axial plane
Trigonocephaly
Frontal bossing may be observed in fetus with:
lemon-shaped skull or skeletal dysplasias
Premature closure of any or all six cranial sutures
Craniosynostosis
Midface hypoplasia will have a depressed or absent ____
Nasal bridge
Midface hypoplasia may be seen in fetuses with chromosome anomaly
Trisomy 21
Flat face defect is more easily noted with
Coexisting frontal bossing
A median cleft face syndrome consisting of a range of midline facial defects involving the eyes forehead and nose
Frontal dysplasia
Primary ultrasound finding in frontal dysplasia
Hypertelorism
Cause of frontal dysplasia
Unknown, occurrence is sporadic
Fetal criteria for NT
Between 11-13 weeks and 6 days
CRL of 45-84mm
A NT measurement of ___ is abnormal
> 3mm
Tumors such as ______ or _______ may disrupt the facial contour in the sagittal plane
Epignathus(tumor in mouth)
Teratoma
Macroglossia is found in pts with ____
Beckwith-Weidemann syndrome
Tongue protrusion may suggest
Macroglossia
When small chin is observed, ___ should be suspected
Micrognathia
Micrognathia may be so severe that _____ occurs because of the inability for the fetus to swallow
Polyhydramnios
May be observed in Goldenhar’s syndrome with anophthalmia(absent eye), hemifacial microsomia(one side of face is small).
Ear malformations
Rare anomaly where absence of the mandible causes ears to form close together anteriorly & toward the neck
Otocephaly
Decreases distance between orbits
Hypotelorism
Hypotelorism is most commonly associated with
Holoprosencephaly
Increased distance between orbits
Hypertelorism
______ may widen the space between the eyes
Frontal cephaloceles
Obvious hypotelorism will be seen in _____ and _____
Ethmocephaly & cebocephaly
Most common congenital anomaly of the face
Cleft lip
Occurs because of failure to fuse primary and secondary plate
Cleft lip
Occurs when lateral palatine processes fail to fuse in midline
Cleft palate
When cleft lip is unilateral, it most commonly originated on the ____ side of the face
Left
If cleft lip is bilateral, _____ of fetus’ will also have cleft palate
85%
If cleft lip is unilateral, _____ of fetus’ will also have cleft palate
70%
Teratoma located in the oropharynx
Epignathus
Epignathus: swallowing may be impaired, resulting in _____
Polyhydramnios
Small ____ may be present with epignathus
Small stomach
Most common neck mass
Cystic hygroma
Abnormality commonly associated with cystic hygroma
Turners syndrome
A goiter observed prenatally suggest that the mother may have
Thyroid disease
Cystic hygroma is a malformation of the ______
Lymphatic system
Failure of lymphatic system to properly connect with the venous system results in ______
distention of the jugular lymph sac
Accumulation of lymph in fetal tissue
_____% of hygromas involve the neck
70%
Cystic hygromas usually arise from the _____ aspect of the neck bilaterally
Posterior
_____% of cystic hygromas are associated with chromosomal abnormalities
50%
Cystic hygroma with _____ has a 100% mortality rate
Fetal hydrops
Usually appears as a symmetrical, solid, and homogeneous mass, arising from the anterior fetal neck and region of the fetal thyroid gland
Fetal goiter
With a large goiter, _____ may be obstructed and fetal neck may be ______
Esophagus
Hyperextended
Fetal goiter obstructing the esophagus may result in
Hydramnios and a small/absent stomach
Teratoma’s are usually ____ & ______
Unilateral and anterior
Teratoma can cause ____ of the neck
Hyperextension
_____ can help differentiate a mass from an atypical hygroma
Color Doppler
Color Doppler helps differentiate a mass/teratoma from an atypical hygroma because:
A teratoma will have blood flow while a cystic hygroma won’t
