CNS Flashcards

1
Q

maturation pattern in neonate

A

reach adult T1 in 1 yr
adult T2 in 2 yr

inf > sup
post > ant
cent > periphr
sens > motor

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2
Q

what is the last part of the brain mylinate

A

subcortical WM.
occipt > 12 mo
front > 18 mo
FT finsih > 40 mo

PS: BS and post IC > mylinated at birth

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3
Q

MC anomaly ass w/ ACC

A

IH lipoma

mcl: IH 2nd: Quadriq cistern
not tru neoplasm. cong

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4
Q

Iniecephaly

A

extreme retrofelx of the head = star gazing fetus
large for mag
visceral anomaly
short neck

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5
Q

Rhombencephalosynapsis

A

absence of the vermis and continuity of the cerebellar hemispheres, dentate nuclei, and superior cerebellar peduncles.

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6
Q

DW varient vs DWM

A

vermis is hypoplastic in both

vs. DWM:
cerebellum is hypoplastic
no marked hydro
post. fossa is normal in size

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7
Q

meckel gruber syndrome

A

occiptal enchepahlocele
polycystic kid
polydactyl
holoprosnch

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8
Q

azygous ACA

A

lobar HPE

SOD

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9
Q

SOD

A

ab. SP
ab. optic tract
schizencephaly

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10
Q

Dyke-Davidoff-Masson syndrome

A

unlike Ramussen’s encph

there is calv expansion and sinuses pneumotization

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11
Q

mildest form of lissencphaly

A

double cortex band hetrotopia
Xlinked, F>M

classic one is autosomal. M=F, CMV

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12
Q

cobblestone lissencephaly

A

overmigration.
ass w/ congenital muscular dysplasia
retinal detach

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13
Q

hydranencephaly causes

A

HSV is the mcc

2nd: toxo, CMV

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14
Q

IH hypotension

A
Downward displacement of brain through incisura (brain "sagging")
Diffuse dural thickening/enhancement
Veins, dural sinuses distended
Engorged pituitary gland
Subdural hygromas/hematomas
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15
Q

mcl of arachniod cyst

A

middle cranial fossa

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16
Q

NB mets in kids

A

orbit
skull
dura
NOT BRAIN

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17
Q

Pleomorphic Xanthoastrocytoma

A
cortical based, periphral, solid and cyst
Temporal lobe mcl
Supratentorial 
enhancing dural tail, no T2 edema
peds
= DIG
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18
Q

Dysembryoplastic neuroepithelial tumor (DNET)

A
Benign mixed glial-neuronal neoplasm
focal cortical dysplasia
T lobe >> drug resistant seizure 
bubbly appearance  > NO C+
peds < 20
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19
Q

Oligodendroglioma

A

F lobe
1p/19q deletion > gd px
IDH1 > T2/flair mismatch

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20
Q

medulloblastoma ass w/

A

Turcot syn: GBM

Gorlin syn: basal cell navus skin ca, odontogenic cyst

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21
Q

mcc of IV mass in adult

A

central neurocytoma

|&raquo_space; calcify, hetrogen, cystic and solid

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22
Q

mcl of subependymoma

A

4th vent, foramen of monro
homogen C+
might not enhance
soft&raquo_space; no hydro

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23
Q

choriod plexus pap/ca

A

ca only in kids.

adult = 4th vent

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24
Q

Meningoma in nuke

A

+ octerotide

+ Tc-MDP

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25
Q

mcl of dermiod cyst

A

1st: supracellar cistern
2nd: post. fossa
NF-2

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26
Q

Hemangiopericytoma

A

sarcoma
mimic aggressive mening
invade skull» but no calc no hyperostosis

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27
Q

dysmoplastic infantile ganglioma

A

large cystic
supraten
< 1yr.
one lobe

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28
Q

NPH

A

> 0.3 evans index

LP: drainage of 30-40 ml

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29
Q

porenchephalic cyst

A

WM lining the cyst

mcc: 2/2 to periventricular hge infarct

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30
Q

perivent leukomalacia

A

wavy countors of lat ven
low vol of WM
ab SI

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31
Q

Joubert synd

A

ARD
molar teeth is high Sn but not Sp. for joubert
molar teeth means&raquo_space; ataxia, develop delay and hypotonia

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32
Q

ACC is WNL

A
  • up to 18 wk GA. you cant Dx ACC before that

- agyric smooth app of the brain WNL until 26 GA

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33
Q

psuedotum cerebri LP pressure

A

> 25 mmHg

TRV sinus stenosis is seen up 90%mc

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34
Q

mc ass w/ SOD

A

schizonepchaly

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35
Q

earliest manifestation of osmotic demylination

A

+DWI pons

extrapontine loc might be seen: BG, EC, amygdala, cerebellum

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36
Q

Marchiafava-Bignami disease (MBD)

A
  • is a rare CNS disorder
    alcoholism and malnutrition.
  • classically involves the corpus callosum with necrosis and demyelination. no ME.
  • notice WE does not involve CC
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37
Q

methanol toxcity

A

optic nerve atrophy
hge putamen
WM necrosis

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38
Q

CO

A

GP hypoHU.

T2 bright

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39
Q

mc CNS tumor post RTX

A

meningoma

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40
Q

mc brain changes post RTX

A

vascular mal

cavernoma/teleangectasia

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41
Q

Chasing the dragon

A

Herion

semiovale WM. PL of IC, deep cerebellum WM

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42
Q

mcl of MS in children

A

post. fossa.

M = F

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43
Q

most Sn seq for spine and infratent MS

A

T2

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44
Q

subcortical arteriosclerosis encephalopathy

A

multi infarct dementia that involves the WM. spares U fibers
old
HTN

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45
Q

CADASIL

A
< 40 YO
mc heredidatry stroke
T lobe >>> classic
F and P lobes can be +
spares occipital L.
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46
Q

Hurler’s diz

A
lysosomal
beaked L1 VB
metopic carcniosyn
prominant perivascular space
macrocephaly
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47
Q

MELAS

A

maternally inhertied
mitoch dis
elev lactate in spectro
involves P-O lobes

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48
Q

metachromatic leukodystrophy

A

AR lysosomal

non SP WM + spares U fibers

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49
Q

X-linked leukodystrophy

A

P-O WM

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50
Q

canvan diz

A
AR, neonate, poor head control, hypotonia
High NAA
diffuse WM involve
GP
thalami 
spares putamen
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51
Q

congenital HIV

A

BG Ca⁺⁺ in (not in adult)
Cerebral atrophy&raquo_space; frontal
fusiform vasculopathy stroke
subarachnoid hemorrhage

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52
Q

congenital HSV encephalitis

A

hge encephalitis vs Rubella&raquo_space; ischemia

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53
Q

cryptococcus

A

Dilated PVSs in deep gray nuclei of AIDS patient, no enhancement

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54
Q

Brain TB

A

basilar C+
hydrocephalus
vasculitis&raquo_space; infarct
CN involve

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55
Q

Most Sn seq for HSV

A

DWI > T2

you might see bleeding in the adult type

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56
Q

west nile

A

T2 bright BG and thalamus
hge

pt from saudi

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57
Q

CJD = prion diz

A

Pulvinar sign: post thalamus
Hockey stick sign: dorsomedial tthalamus
rapidly progressive atrophy
gyriform DWI+

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58
Q

mcc of epi/subdural empyema

A

frontal sinusitis

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59
Q

cephalohematoma

A

subperiosteal hematoma
elevate the periostum. limited by stutures
no CL Sg.
mcl: P and O lobes

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60
Q

subgalaeal hematoma

A

not limited space.

underneath galeal aponiorosis

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61
Q

sutural diastesis comp in adult

A

dural venous sinus thrombosis

kids: leptomeningeal cyst

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62
Q

mc parasitic diz of the CNS

A

neurocystoscreosis

stage I vesicular: no edema or C+, cystic
stage II colliodal: edema C+
stage III grandular less edema and C+. start to calc
stage IV: nodular calcified: calc

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63
Q

non ketoic hyperglycemia

A

BG and BS CT hyperdensity
T1: high
no ME, no C+

looks similar to HE. look at Hx

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64
Q

WE

A

spares BG in adult

common in children

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65
Q

opioid overdose, methanol tox

A

putamen hge necrosis SPARES GP
optic nerve atrophy

NO tox similar to B12 deficiency&raquo_space; post col.

66
Q

putamen hge necrosis seen in

A

methanol
cynaide
opiod

67
Q

PRESS

A

involves both cortical and subcortical.
P and O lobes
DWI is -ve. but sever diz might be +ve

68
Q

HE

A

acute: b/l symmetric insular and cingulate DWI+ve

Bilateral T1WI hyperintensity in basal ganglia (BG), particularly globus pallidus (GP)

69
Q

hypo glu injury

A

GM > WM
CC and IC
hippocampus
BS, thalami and cerebllum&raquo_space; spared

70
Q

artery of percheron

A

paramedian thalami DWI+

71
Q

Recurrent artery of Heubner infarct

A

Caudate and IC infarct

The recurrent artery of Huebner is a br off the ACA.
might get clipped during ACOM aneurysm Rx.

72
Q

risk of IC aneurysm rupture

A

post circ > ant

> 10mm 1% risk of rupture

73
Q

risk of AVM rupture

A

small
small draining v
aneurysm
BG loc

74
Q

mcc of IC vasculitis

A

PAN

75
Q

mcc of CVD in the brain

A

SLE

76
Q

sinonasal polyoposis pattern RF

A

CF

ASA sensitivity

77
Q

epistaxis

A

ant nasal septum
In max a
might be anastomosis between In max a and opthalmic a. pay attension to the eye

78
Q

Parotid gland duct

Stenson

A

arises from the anterior surface of the gland, traversing the masseter muscle. The duct then pierces the buccinator, moving medially.
It opens out into: the second upper molar.

79
Q

Submandibular duct

Wharton’s duct

A

allows the passage of saliva from the submandibular gland to the sublingual papilla located anteriorly. … It runs forward with lingual nerve and vein and hypoglossal nerve and opens into the sublingual papilla at the side of the frenulum of the tongue.

80
Q

torus palatinus

A

bony exostosis off the hard palate. WNL

81
Q

Dentigerous cyst = follicular cyst

A

Benign developmental jaw cyst associated with crown of unerupted tooth
3rd molar&raquo_space; MCL

82
Q

Keratocystic odontogenic tumor

A

B9 cystic neoplasm of jaw with aggressive behavior and high recurrence rate
no cortical destruction
mcc mand tumor

83
Q

Ameblastoma = adamantinoma

A
expansile multiloculated mixed cystic & solid mandible mass, usually near 3rd molar
2nd mcc of mabible tumor
arise from dentigerous cyst 5-20%
painless 
ADULT
84
Q

odontoma

A

mcc mand tumor.
hamartoma
mature solid tum w/ lucent border

85
Q

tornwoldt’s cyst

A

Ovoid, cystic mass in midline nasopharyngeal mucosal space

between longus coli ms

86
Q

warhtin’s tum on nuke is +ve on

A

FDG
Tc-Pert
Tc-MDP

87
Q

mcc malg partiod tum

A

mucoepidermiod

2nd: ACC&raquo_space; perineuoral spread ( melanoma too)

88
Q

Rx of tonsillar ab

A

ABx
PTA: I&D
RP abscess&raquo_space; Sx drainge

89
Q

mcc of cong neck cyst

A

TGD cyst

90
Q

mcc of 1ry mass in the prestyliod parapharngyeal space

A

salv gland BMT

mcc lesion is extension from adjacent space

91
Q

pott puffy tumor

A

OM
frontal sinusitis
epidural abscess
pic

92
Q

nasal glial hetrotopia loc

A

no connecton w/ IC component

dont C+ much

93
Q

chonal atresia

A

bony comp is almost alwz

pyriform aperture , 4 mm

94
Q

Dx of CNS vasculitis

A

Sx BX

95
Q

mc features of VA dissection

A

arterial stenosis
gold Dx: DSA
RX; AC if no hge infarct
ENV coil, or Sx embolization

96
Q

rever cerebral vasocons synd: RCVS

A

female
SAH&raquo_space; HA
vasospasm of small and med vessels
resolve both S&S and img within 3 mo

97
Q

Mx of Cartiod cav fistual

A

direct: coil, stent or ballon or surgical ligation
indirect: conservative

98
Q

moya moya is known as

A

pial vascular engorgement&raquo_space; Ivy sign
Rx: conservatove, ASA in mild cases.
ECA and MCA anastimosis in sever cases

99
Q

venous infarct SI

A

DWI might be -ve

100
Q

most deadly comp of SAH

A

vasospasm
Dx: angiographic
fisher scale
Rx; NSAID, CCB, endovasc

101
Q

MCC of septic CS thrombosis

A

S.aurus
fungal in immunocomp
Mx: ABx, AC, I&D if needed
SOV prominance seen in both CST and CCF

102
Q

IC Amyloid affect which vessels

A

small and med size vs.
MRI is the SOC.
sporadic > hereditary
ADD

103
Q

Rathke cleft cyst T2 SI?

A

T2 : hyperintense cyst with a hypointense, intracystic nodule

104
Q

what are the types of hypothalnic hamartoma

A

parahypothalamic: precausious puberity
intrahypothalamic: galaztetic seizure

all F/U GM SI. no C+

105
Q

Lymphocytic hypophysitis RF?

A

1- ipilimumab for metastatic melanoma. immuno Rx
2- Preg
3- post partum

so both men and women can get it
enlarged. Enhances intensely, uniformly
S&S depends on which seg is affected,

106
Q

mcc of Jagular foramne mass

A

1st: paragan
2nd: shawanoma» cystic, hge, no bone destruction
3: meningoma&raquo_space; skull hyperostosis

mc nerve > 9

107
Q

inverted pap

A

more in male
high rate of recurrence if not comp resected
rare transfor&raquo_space; SCC

108
Q

where do u measure nuchal thickness?

A

measured at cerebellum and thalamus

>5 mm 97% Sp for Down

109
Q

features of pulm nodules ass w/ malg

A

1- semi sold
2- irrg
3- slow doubling
4- lack of calc

110
Q

mc cause of CJD

A

sporadic

rarely zoontic

111
Q

pointing toward the ventricle GM based mass

A

DNET&raquo_space; no C+

if there DDxL gamglioma, oligo

112
Q

most reliable sign of ch DVT

A

prior US

113
Q

chrionic pumb ass w/ ?

A

increased miscarriage X2

114
Q

what is blake’s pouch cyst

A

infravermian cyst that communicates with fourth ventricle

115
Q

dehiscent jugular bulb

A

sigmoid plate between a high riding jugular bulb and the middle ear is absent, allowing the wall of the jugular bulb to bulge into the middle ear cavity.

116
Q

esthino NB Px ?

A

good relative to othet H&N ca
arise from olf bulb
Mx: Sx and Rtx

117
Q

how to differ b9 from path spine fracture ?

A
BM
STx
post element involve
hx of OP 
but C+ is the least helpful features as both non healed fracture and ca will C+
118
Q

eagle syndrome ? patak syndrome

A

elongated styliod > 3 cm
or cacl styliohyiod lig.
CN comp

119
Q

DJD post spinal fusion most common loc ?

A

mcl&raquo_space; lumber spine
above > lower level of fusion
least common T spine
10% of ppl get it

120
Q

normal length of the styliod process ?

A

2.5 cm

]> 3 cm Eagle syndrome

121
Q

Esinthenomueroblastoma time of onset ?

A

2nd and 6th decades
peritumor cysts
GD px !!!!

122
Q

CADASIL MCL

A

ant temp lobe

123
Q

MCL of spinal hemangioblastoma

A

thoracic. eccentric

124
Q

MCL of giant perivascular space

A

1st: mesoncephalothalaic
2nd: WM

125
Q

earliest finding of Osm demylination

A

DWI of the pons

126
Q

MCL of inverted pap

A

lat wall of the nasal cavity, middle turbinate and max ostioum.

127
Q

MCL of allergic fungal sinistis

A

ethmiod

128
Q

CPA facial nerve shawanoma

A

super rare.

MCL&raquo_space; middle ear. dont call CPA mass CN VII shawanoma

129
Q

NF1 mode of inheritance

A

50% genetic

50% acquired mutation

130
Q

major reason of M&M w/ SAH

A

vasospasm

131
Q

Enphesamtous OM organism ?

A

FusobCetrium
Clostridium
Enterobacteria GNR

132
Q

MCL of spontaneous RP hge

A

Psoas ms

133
Q

MCC of B9 cong orbital mass ?

A

Dermoid > extraoccular

134
Q

MCC extraoccular orbital ca in kids?

A

rhabdo

RB&raquo_space; INTRAOCCULAR

135
Q

Tolso Hunt dis

A

IgG4 of the cavernous sinus

136
Q

MCC of spontanous orbital hge

A

variz

137
Q

MCC of orbital malg

A

mets

138
Q

MCC of exopthalmus

A

graves

139
Q

arachnioditis Mx?

A
intrathecal steriod
adhesion lysis
MCL: L/S
pseudomass on myeolgram 
archnioditis ossificans
140
Q

RA vs CPPD

A

RA: no calc. disc is normal. +ve lig laxity and ADI widening. invagination of the foramnen mag

CPPD: calc. psueodumass

141
Q

Wt is the MCC of inherited polyneuropathy?

A

charcort Marrie tooth diz.
type 1: MC one, ADD
type II: 2nd mc, Xlinked
both motor and senor polyneurpathy

fusiform nerve enlargement NNO NO NO C+

Vs: NF1, lymphoma, amyliod or sarciodosis

142
Q

Mx of chrodoma?

A

Sx + RTx

143
Q

MCC of extradural mass?

A

mets

144
Q

MCC of intradural extramed?

A

1st: shawanoma
2nd: menin: MCL: T>C>L

145
Q

shawanoma:

A

NF2-
no malg degen
hge + cystic changes common
NEVER degen&raquo_space; ca

146
Q

neurofibroma

A

target&raquo_space; non Sp.
might undergo malg degen
NF1

147
Q

MTx of PNST?

A

Sx but reccurance is high w/ NF1/2

presents w/ pain > weakness 2/2 DRG

148
Q

MCL of OO in the spine

A

L/S

149
Q

VHL Chr?

A

ADD

Ch.3p

150
Q

MCL of astrocytoma?

A

T > C
long segm 4-7 VB
eccentric
inflitrative

151
Q

MCL of epend?

A

C>T

central

152
Q

Rx of aggressive spine hemang?

A
transarterial embol
RTx
veretroplasty
ethanol inj
Sx
153
Q

MCC of Spine diz in HIV pt?

A

HIV myelitis
T > C.
ATROPHY
POST col.

154
Q

MCC of CN ab ass/ GBS?

A

CN VII

155
Q

MCL loc of spine hemangioblastoma

A

T > C

156
Q

Type I caudal regression?

A

Sacral agensis > S1

cord terminates at T11-T12, blunted

157
Q

type II caudal reg?

A

cocyx agenisis

conus terminates at L3-L4

158
Q

Cong ab ass/ w/ caudal regression

A

MC GU: renal agensii and hydro
MC GI: anal atresia, imper anus
VB seg anomaly

159
Q

Wt is block VB?

A

fusion w/ disc

160
Q

Normal C+ of CNVII?

A

labyrnith, tympnaic, Ganiculate, mastiod

AB: cancicular, cictsernal and extratemporal

161
Q

Weekly QC mr ?

A
Center fr
Table position 
Setup and scanning
Geometric accuracy 
High And low contrast resolution >> phantom
Artifact analysis 
Film quality control
Visual check list
162
Q

Annual QC mr

A

B0 homogeneous
Slice thickened accuracy and position
RF coil
Display monitor