Fetal Head/Brain Flashcards
1
Q
Greater than _______ multiples of the median MSAFP is abnormal
A
2.5
2
Q
What does MSAFP stand for?
A
Maternal
Serum
Alpha-FetoProtein
3
Q
An elevated MSAFP of 2.5x the median suggests:
A
An open neural tube defect (NTD)
4
Q
A ___________________ covering over an open neural tube defect allows excess ______ to enter maternal circulation.
A
Membranous covering
AFP
5
Q
Increased fundal height raises suspicion of:
A
Polyhydramnios
6
Q
Which bones are affected with a lemon shaped head?
A
Frontal bones of the skull
7
Q
What shape head is associated with spina bifida?
A
Lemon
8
Q
A flattened occiput and narrowed frontal part of the skull resembles a:
A
Strawberry
9
Q
Strawberry shaped skull is associated with?
A
Trisomy 18
10
Q
Brachiocephaly results in a what shaped head?
A
Rounded
11
Q
Cephalic index >85%
A
Brachiocephaly
12
Q
Brachiocephaly is associated with:
A
Chromosomal abnormalities and genetic syndromes
13
Q
Cephalic index <70%
A
Dolichocephaly
14
Q
Dolichocephaly is due to genetic abnormalities.
T/F
A
False, usually due to head molding in breech
15
Q
What is characterized by excessive CSF in the cerebral ventricles?
A
Ventriculomegaly
16
Q
Hydrocephalus is ventricular enlargement secondary to:
A
Increased intracranial pressure/head enlargement
17
Q
Atria of lateral ventricles should not exceed:
A
10 mm
18
Q
Examples of non communicating hydrocephalus
A
Aqueductal stenosis
Chiari II
Dandy Walker malformation
19
Q
What is the most common intraventrivular obstruction?
A
Aqueductal stenosis
20
Q
Where is the aqueduct of Sylvius located?
A
Between 3rd and 4th ventricles
21
Q
What is chiari II associated with?
A
Spina bifida
22
Q
What is a communicating hydrocephalus?
A
Arachnoid cyst
23
Q
What may cause an overproduction of CSF that is considered a pathogenesis of ventriculomegaly?
A
Choroid plexus papilloma
24
Q
Associated abnormalities with ventriculomegaly
A
Spina bifida Dandy-Walker syndrome Encephalocele Cardiac malformations Renal malformations Abnormal karyotypes
25
Sonographic findings associated with ventriculomegaly
```
Polyhydramnios
Abnormal fetal lie
Hepatomegaly
Fetal Ascites with associated infection
Meningomyelocele
```
26
Absence of skull and cerebral hemispheres
Anencephaly
27
Features seen with anencephaly
Bulging eyes
Macroglossia
Very short neck
Elevated AFP
28
With anencephaly, Face has what appearance?
Frog like
29
Other common findings with anencephaly
Polyhydramnios
| Talipes (club foot)
30
How early can anencephaly of can be diagnosed?
12 weeks
31
Alobar Holoprosencephaly is the _________________ form of Holoprosencephaly.
Most severe
32
Dandy Walker malformation is a:
Congenital brain malformation in which there is enlargement of cisterna magna, agenesis of cerebellar vermis, and dilation of fourth ventricle
33
Dangling choroid sign is associated with:
Ventriculomegaly
34
Scaphocephaly is another name for:
Dolichocephaly
35
Gastroschisis is a herniation of abdominal contents that has a membrane covering it.
T/F
False
36
Holoprosencephaly is a group of brain abnormalities that has varying degrees of:
Fusion of lateral ventricles, absence of midline structures and associated facial anomalies
37
Communicating hydrocephalus is an obstruction of cerebrospinal fluid from:
A source outside of the ventricular system like an arachnoid cyst
38
Hydrocephalus refers to ventricular enlargement due to:
increased cranial pressure, caused by increased volume of CSF
39
Fetal Hydrops must occur in at least:
2 body cavities
40
What is the term for “smooth brain” where there is little/no gyri or sulci?
Lissencephaly
41
Lobar Holoprosencephaly is the _____________ form of Holoprosencephaly.
Least severe
42
What are some associations with Meckel-Gruber syndrome?
Microcephaly
Occipital encephalocele
Polydactyly
Polycystic kidneys
43
Mega cisterna magna is when the CM measures larger than:
10 mm
44
What is an anterior abdominal wall defect where there is a herniation of bowel and organs into base of umbilical cord?
Omphalocele
45
Porencephaly is when a cyst, typically caused by intraparenchynal hemorrhage, communicates with:
A lateral ventricle
46
Schizencephaly is a cerebral malformation associated with:
Development of fluid filled clefts
47
Thanatophoric dysplasia is the most common lethal skeletal dysplasia characterized by:
Cloverleaf skull with frontal bossing and hydrocephalus
48
Vein of Galen aneurysms are arteriovenous malformations associated with:
Congestive heart failure
49
Cephalic index of less than _____ denotes Dolichocephaly and greater than _____ denotes Brachiocephaly.
70
| 85
50
Ventriculomegaly is when the atria of the lateral ventricles measure greater than:
10 mm
51
Anomaly associated with lemon shaped head
Chiari II malformation
| Spina bifida
52
Anomaly associated with a strawberry shaped head
Trisomy 18
53
Anomaly associated with a cloverleaf shaped head
Thanatophoric dysplasia
54
Anomaly associated with Microcephaly
TORCH/intrauterine infections
Trisomy 13 & 18, aneuploidy
Meckel-Gruber syndrome
Fetal alcohol syndrome
55
Microcephaly appears as:
Small BPD
decreased HC/AC ratio
Poor cranial growth on serial scans
No dip between nose and forehead
56
Macrocephaly is associated with:
```
Hydrocephalus
Hydranencephaly
Intracranial tumors
Familial inheritance
Beckwith-Wiedemann syndrome
```
57
Cisterna magna should not measure less than:
2 mm
58
The most common cause of non communicating hydrocephalus is:
Aqueductal stenosis
59
Ventriculomegaly may be seen as a normal variant later in second trimester in ________ fetuses and fetuses _______ for gestational age.
Male
| Large
60
Holoprosencephaly has a strong association with:
Trisomy 13
61
How many ventricles are typically seen with Holoprosencephaly?
1, a monoventricle
62
Alobar Holoprosencephaly has Sonographic traits that show:
```
Monoventricle
Fused echogenic thalami
Absence of falx, corpus callosum, CSP and interhemispheric fissure
Hypotelorism
Cyclopia
Midline clefts
```
63
Semilobar is associated with:
Cleft lip and palate
64
Semilobar may have:
Partial development of falx and interhemispheric fissure
65
Lobar Holoprosencephaly will have absence of:
Corpus callosum
| CSP
66
Dandy Walker variant is also known as:
Vermian hypoplasia
67
Dandy walker complex refers to
Congenital malformations of posterior fossa, dysgenesis of cerebellar vermis
68
When is the earliest vermian hypoplasia can be diagnosed?
After 18 weeks
69
How often is dandy walker malformation associated with CNS abnormalities?
50-70%
70
If cerebellar vermis is absent and the fourth ventricle is enlarged then ________ must be suspected.
Dandy Walker Malformation
71
What is colpocephaly?
Disproportionate enlargement of occipital horns
72
Ventricles may have what shape with agenesis of corpus callosum?
Tear drop shape
73
Third ventricle will be _______ and ________ with agenesis of corpus callosum.
Elevated and dilated
74
Porencephaly is most often unilateral.
| T/F
True
75
How can you tell the difference between an arachnoid cyst and a porencephalic cyst?
Arachnoid cysts will NOT communicate with the ventricular system
76
Cranial meningocele includes:
Meninges and CSF
77
Encephalocele contents include:
Brain tissue and CSF
78
Where is the most common site for Encephaloceles?
Occipital
79
Arnold Chiari II is displacement of :
Cerebellar vermis, fourth ventricle, and medulla oblangata through foramen magnum into upper cervical canal
80
What causes Arnold Chiari II?
Traction on hindbrain
81
What is Arnold Chiari II associated with?
Spina bifida
| Tethered spinal cord
82
Sono traits of Arnold Chiari II
Banana shaped cerebellum
Obliterated cisterna magna
Ventriculomegaly
Lemon shaped head
83
Microcephaly must measure more than ____ standard deviations below normal.
3
84
Agenesis of corpus callosum is associated with:
```
Trisomy 18 & 13
Holoprosencephaly
Median facial clefts
Dandy walker malformation
Schizencephaly
Lissencephaly
```
85
How can you confirm a vein of Galen aneurysm?
Using Doppler to demonstrate turbulence
86
What’s the most common cause of Hydranencephaly?
Occlusion of carotid arteries in 1st/2nd trimester
87
Hydranencephaly is the most severe degree of:
Porencephaly or brain destruction
88
Hydranencephaly causes total or near total absence of cerebrum but _________________ remain intact.
Cranial vault
Thalami
Lower brain centers
89
Hydranencephaly is difficult to distinguish from:
Severe hydrocephaly
