Fetal face and neck

Question 1

The upper liip and the Nares are best seen in the __________ ________ with respect to the fetus

Answer 1

Coronal plane

Question 2

True or False

You must have this image, including the upper lip and the two Nares

Answer 2

True

Question 3

Why is it important to image the upper lip and the Nares?

Answer 3

To exclude the possibility of facial clefting (this part of the normal second trimester US)

Question 4

In what planes can the feral eyes be imaged?

Answer 4

Coronally or tranversely

Question 5

In times past, the inner orbital distances were used to evaluate the _______

Answer 5

Pregnancy

Question 6

The inner orbital distances are really only used when trying to evaluated for other fetal cranial abnormalities like ___________

Answer 6

Holoprosencephaly

Question 7

The presence of a nasal bone is _________ noted

Answer 7

Usually

Question 8

Hypoplastic or absent nasal bones maybe associated with______________

Answer 8

Trisomy 21

Question 9

Soft tissue in the neck are evaluated in the _____________ or ______________

Answer 9

Transverse or sagittal plane

Question 10

The AP dimensions or thickness of the nuchal fold is evaluated in fetuses less than ___________

Answer 10

24 weeks

Question 11

The measurement of the fetal neck should be taken from ______________to the ______________

Answer 11

Outer echogenic skull to the outer skin line

Question 12

Fetal neck measurement should be

Answer 12

less than 6mm

Question 13

When the neck measurement is greater than six, there is an association with

Answer 13

Trisomy 21

Question 14

When should the neck measurement no longer be taken?

Answer 14

If the fetus is greater than 24 weeks

Question 15

Marked thickening of the nuchal fold is also associated with

Answer 15

Turner’s syndrome, called a cystic hygroma

Question 16

Decreased intraorbital distance

Answer 16

Hypotelorism

Question 17

Hypotelorism is associated with

Answer 17

Syndromes and holoprosencephaly

Question 18

Increased intraorbital distance

Answer 18

Hypertelorism

Question 19

Hypertelorism is associated with

Answer 19

Anterior Cephalocele and many syndromes

Question 20

The most common congenital facial abnormality

Answer 20

Facial clefting

Question 21

_________% cleft lip only

Answer 21

25

Question 22

________% cleft lip and palate

Answer 22

50

Question 23

_______% cleft palate only

Answer 23

25

Question 24

The ultrasound diagnosis relies on the presence of a _________ ______ to recognize the abnormality

Answer 24

Cleft lip

Question 25

What will cleft lip look like on ultrasound?

Answer 25

An interruption in the upper lip | this is why it is necessary to view the entire lip and Nares

Question 26

Don't mistake a cleft lip for a

Answer 26

Normal philtrum (dip in the skin above the lip)

Question 27

It is extremely difficult to recognize an ___________ ____________ __________ on ultrasound

Answer 27

isolated cleft palate

Question 28

Sagittal image of the midline of the face

Answer 28

Profile

Question 29

What are the two things that the profile image is used for finding

Answer 29

1. Micrognathia | 2. Frontal bossing

Question 30

an abnormally small jaw, associated with syndromes especially Trisomy 18

Answer 30

Micrognathia

Question 31

A prominent forehead due to an absent nasal bridge, associated with syndromes and skeletal dysplasia

Answer 31

Frontal bossing

Question 32

Facial masses

Answer 32

1. Epignathus 2. Cervical teratoma 3. Cystic hygroma

Question 33

Are facial masses common or uncommon

Answer 33

uncommon

Question 34

A rare pharyngeal teratoma which protude from the fetal mouth - looks like a large complex cystic and solid mass

Answer 34

Epignathus

Question 35

Epignathus is associated with ______________ because of ineffective fetal swallowing

Answer 35

Polyhydramnios

Question 36

May occur anywhere on or around the neck. It also appears as a complex solid or cystic mass near the fetal neck

Answer 36

Cervical teratoma

Question 37

A benign developmental anomaly of the lympthatic system in which single or multiple cystic areas are present around the neck

Answer 37

Cystic hygroma

Question 38

Cystic hygroma has a high association with

Answer 38

Chromosomal abnormalities especially Turner's syndrome and downs syndrome

Question 39

Large hygromas are often associated with

Answer 39

fetal hydrops

Question 40

What are the ultrasound findings with Cystic hygromas

Answer 40

- thin walled, multi septated mass at the posterior aspect of the neck - may see nuchal ligament extending posteriorly associated with hydrops fetalis which shows fetal ascites, body wall edema, pleural effusions