Fetal Face and Neck

Question 1

Anomalies of the face are discovered in what trimester

Answer 1

1st

Question 2

Fetal face development begins at what week

Answer 2

4

Question 3

Completion of major facial events happens when

Answer 3

by end of 1st trimester– week 12

Question 4

What are the 5 main tissue prominences that form the fetal face

Answer 4

frontonasal
lateral nasal
medial nasal
maxillary 
mandibular

Question 5

What does the frontonasal tissue prominence form

Answer 5

forehead

dorsum apex of nose

Question 6

What does the lateral nasal tissue prominence form

Answer 6

nasal ala

Question 7

What does the medial nasal tissue prominence form

Answer 7

nasal septum

Question 8

What does the maxillary tissue prominence form

Answer 8

upper cheeks

upper lip

Question 9

What does the mandibular tissue prominence form

Answer 9

lower cheek
lower lip
chin

Question 10

What are anomalies of the forehead?

Answer 10

frontal angle
encephalocele
proboscis

Question 11

What are anomalies of the eyes?

Answer 11

hypotelorism

hypertelorism

Question 12

What are anomalies of the nose?

Answer 12

hypoplasia

absent nasal bone

Question 13

What are anomalies of the mouth?

Answer 13

cleft lip
cleft palate
macroglossia

Question 14

What are anomalies of the chin?

Answer 14

micrognathia
retrognathia
agnathia

Question 15

What are anomalies of the ear?

Answer 15

low set

Question 16

What is the protocol for the measurement of the fetal facial angle?

Answer 16

gestational period 11-13wk 6d
magnify image for head and thorax occupy whole image
facial angle should be measured (another question on how)
if facial angle is increased, the risk of triploidy is increased

Question 17

How should the facial angle be measured?

Answer 17

between a line along the upper surface of the palate and a line along the upper corner of the anterior aspect of the maxilla extending to the external surface of the forehead, represented by frontal bones

Question 18

Encephalocele:

Answer 18

abnormal protrusion of the brain and/or meninges through a defect in skull or calvarium
associated with hypertelorism and midline facial clefting

Question 19

Proboscis:

Answer 19

a trunk like soft tissue appendage situated between orbits

associated with alobar holopresencephaly

Question 20

Hypotelorism:

Answer 20

small distance between the orbits

decreased inter-orbital diameter

Question 21

Hypotelorism is associated with what:

Answer 21

alobar holoproscencephaly
cyclopia
absence of nose
proboscis
tri13, 18 and 21

Question 22

Hypertelorism:

Answer 22

increased separation of the orbits
may result from abnormalities that interfere with the normal migration of the eyes from the lateral position to midline in embryonic development
abnormal increase in inter-orbital diameter
associated with anterior encephaloceles

Question 23

What is seen absent with an increased incidence of trisomy 21?

Answer 23

nasal bone

Question 24

Cleft lip/palate usually results from failure of

Answer 24

fusion of medial nasal prominences and maxillary prominences

Question 25

Cleft lip/palate is associated with:

Answer 25

Tri13/18 structural abnormalities including heart and CNS familial (child before, yourself)

Question 26

Cleft palate without cleft lip is difficult to diagnosis sonographically. True or false

Answer 26

True

Question 27

A child will always have both cleft palate and cleft lip. True or false

Answer 27

False-- can have cleft lip, palate or both

Question 28

Macroglossia:

Answer 28

enlarged tongue | may protrude from oral cavity and lack characteristic movement of tongue in relation to jaw

Question 29

What is macroglossia associated with:

Answer 29

*Beckwith-Wiedemann Syndrome | Tri21

Question 30

What do we see with Beckwith-Wiedemann Syndrome

Answer 30

macrosomia macroglossia omphalocele renal anomalies

Question 31

Retrognathia:

Answer 31

posteriorly displaced chin | associated with Tr13 and 18

Question 32

What are abnormalities of the neck?

Answer 32

increased NT NF thickening cystic hygroma cervical teratoma

Question 33

Thickened NT measurements in the 1st trimester are associated with:

Answer 33

fetal aneuploidy cardiac defects other major malformations adverse pregnancy

Question 34

Nuchal fold thickening should not increase _____mm from 15-22wks.

Answer 34

6mm

Question 35

What is an abnormal NT measurement?

Answer 35

>3mm

Question 36

How do we measure the nuchal fold thickening?

Answer 36

outer edge of occipital bone to outer edge of the skin

Question 37

Cystic Hygroma:

Answer 37

lymphatic malformation septated fluid collection behind the fetal neck associated with: turner syndrome, chromosomal abnormalities and cardiac structural abnormalities

Question 38

What's the most common tumor in neonates?

Answer 38

Cervical teratoma

Question 39

What percentage of teratoma's arise in the neck? Where's the most common location?

Answer 39

5% | sacrum or coccyx

Question 40

What are some sonographic appearances of cervical teratoma's?

Answer 40

``` cystic/solid components regions of calcifications may involved thyroid gland may impinge on airway, causing trouble swallowing polyhydraminos hyperextension of the neck protrude from mouth ```