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SON 2122-DMS OB/GYN 2 > Fetal Head/face/neck > Flashcards

Fetal Head/face/neck Flashcards

1
Q

Anencephaly

A

No Brain,skull
Frog like face appearance
MOST COMMON NTD

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2
Q

Acrania (aka. Exencephaly)

A

No skull bones with presents of brain

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3
Q

Cephalocele

A

Protrusion of the meninges and/or brain through a defect in the cranium.
Most most often seen in the occipital region (80%)

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4
Q

Meningocele

A

Protrusion of the meninges (cystic looking)

Cephalocele

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5
Q

Encephalocele

A

Protrusion of brain tissue - complex structure

Cephalocele

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6
Q

Meningoencephalocele

A

Meninges and brain tissue - complex

Cephalocele

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7
Q

Meningoencephalocele

A

Protrusion of Meninges, brain tissue and ventricle - Complex

Cephalocele

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8
Q

Iniencephaly

A

Defect in the occiput, usually involves the foramen magnum.

-Retroflexion of the fetal head STAR GAZER

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9
Q

Spina Bifida>

  • Meningocele
  • Meningomyelocele
  • Open V.s. Close
A

Failure of the two halves of the vertebral arch to fuse. *73% lumbosacral region)

  • Meningocele = Herniation of meninges (cystic on US)
  • Meningomyelocele = meninges and spinal cord (complex cystic mass on US)
  • Open = open wound
  • Closed = Closed wound
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10
Q

Spina bifida on US

A

In transverse = splaying of the posterior ossification centers with V or a U configuration
In sag= “train track” will come to a stop

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11
Q

Cranial findings associated with spina bifida

A

~Lemon sign – anterior calvarium collapse (frontal)
~Banana sign – obliteration of the cisterna magna by cerebellum
~Ventriculomegaly- block of spinal fluid flow

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12
Q

Arnold-Chiari Malformation

A

Defects in the cerebellum and brainstem. A part of the cerebellum is located below the foramen magnum (normally located above the foramen magnum).

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13
Q

Arnold-Chiari Malformations Type 2

A

Associated with spina bifida, characterized by displacement of the cerebellum, brain stem, fourth ventricle, pons and medulla oblongata through the foramen magnum.

This is usually associated with hydrocephalus and meningomyelocele. (Cerebellum = banana (loss of dumbbell shape) Lemon (head resemble lemon), ventriculomegaly is seen.

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14
Q

Associated with Arnold-Chiari 2

A

Spina Bifida 80-90%

Trisomy 18

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15
Q

Dandy-walker

A
  • Agenesis of cerebellar vermis( Large midline cystic structure in posterior fossa).
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16
Q

Dandy-Walker malformation

A
  • *MOST SEVERE**
  • Complete/partial agenesis of cerebeller vermis
  • Dilation of fourth ventricle
17
Q

Dandy-Walker variant

A

Partial agenesis of cerebellar vermis
Normal forth ventricle
Key hole

18
Q

Posterior Fossa Arachnoid Cyst

A
  • Collection of CSF enclosed within the layers of the arachnoid that can displace adjacent normal brain parenchyma.
  • *Does not communicate with ventricles or subarachnoid spaces**
19
Q

Holoprosencephaly

A

BRAIN & FACE
Trisomy 13
ALOBAR - most severe
Several abnormalities of the brain and face resulting from incomplete cleavage (division) of the primitive prosencephalon portion of the brain (forebrain)

20
Q

Agenesis of the Corpus callosum

A

> DX before 20 wk may be difficult

> Sonographic appearance:

- Teardrop- shaped ventricle
- Absent cavum septi pellucidi
- Sunburst appearance of gyri and sulci
21
Q

Aqueductal Stenosis

A

> Obstruction, atresia, or stenosis of the aqueduct of sylvius causing ventriculomegaly.

> Sonographic appearance
Enlargement of the lateran ventricles and third ventricle in the presence of a normal forth ventricle.

22
Q

Vein of Galen Aneurysm- (AKA- A vein of Galen malformation)

A

> Rare AVM
• Cystic space that may appear irregular in shape and is located midline and posteriorsupesior to the third ventricle.
• Turbulent flow with color doppler evaluation

23
Q

Choroid plexus cyst

A

> Should resolve between 22-26 wks
Benign if no other anomalies found
Associated with Trisomy 18

24
Q

Porencephaly- (AKA Porencephalic cysts)

A

> Single of multiple cystic masses in the brain

> Communicate with the ventricular system of the subarachnoid space

25
Q

Hydranencephaly

A

> Water, No brain

> Destruction of the Cerebral hemispheres replaced with CSF by the occlusion of the internal carotid arteries.

26
Q

Schizencephaly

A

> Rare malformation by abnormal clefts in the cerebral hemispheres

Splits brain into anterior and posterior parts

27
Q

Lissencephaly

A

> The surface lacks the normal sulci and gyri, and appears smooth.
DX can not be made until the 3rd trimester

28
Q

Ventriculomegaly –&– Hydrocephalus

A

Ventriculomegaly - Increase in CSF in ventricles, Lateral ventricle >10mm, Main cause aqueductal stenosis

Hydrocephalus - ^ with enlargement of fetal head

29
Q

Microcephaly

A

Small head circumference, 3 standard deviations below normal.

30
Q

Skull shapes;

  1. Clover-leaf
  2. Lemon-shaped
  3. Strawberry-shaped
A
  1. Clover-leaf - Dwarfism
  2. Lemon-shaped - Seen often with banana shaped cerebellum due to open NTD, Arnold-Chiari 2, spina bifida
  3. Strawberry-shaped - Trisomy 18
31
Q

Frontonasal Dysplasia

A

Facial defect affecting midline of face.

-Midline cleft lip/palate-

32
Q

Cleft Lips/Palates

A
  • Most common
  • US appearance of Cleft Lip/Palate
    • Large gap in upper lip seen on coronal view of lip and nose
    • Mass effect formed by the upper lip bulging forward
    • Nose is usually flattened & widened
33
Q

Midline cleft lip/palate

A

-Frontonasal Dysplasia
The face predicts the brain
Search for coexisting brain anomalies

34
Q

Profile:

  • Absent/flattened nasal bone –
  • Forehead/Frontal bone -
  • Enlarged tongue –
  • Chin – Microgenathia (undersized jaw)
  • Epignathus. –
A
  • Absent/flattened nasal bone – Trisomy 21
  • Forehead/Frontal bone - slopping or bossing
  • Enlarged tongue – Macroglassia, Beckwith-Wiedemann syndrome
  • Chin – Microgenathia (undersized jaw). – chromosomal anomalies
  • Epignathus. – a teratoma arising from the oral/nasal cavity of pharynx
35
Q

Orbits:

  • Anopthalmis –
  • Micropthalmia –
  • Hypotelorism –
  • Hypertelorism. –
    *Dacryocystocele –
A
  • Anopthalmis – Absent eye of eyes
  • Micropthalmia – Small eyes
  • Hypotelorism –decrease distance between eyes
  • Hypertelorism. – increased distance between eyes
    *Dacryocystocele – Protrusion of the lacrimal sac
36
Q

Neck:

  • Nuchal Translucency
  • Nuchal fold
  • Cystic hygroma
  • Fetal thyroid goiter
A
  • Nuchal Translucency - Abnormal >3mm, measured between 11-14wks
  • Nuchal fold - Abnormal >6mm, measured between 15-21wks, Associated with Trisomy 21
  • Cystic hygroma- Lymphatic obstruction, Cystic, single/multiloculated fluid filled cavity, Posterior &/or lateral aspect of fetal neck, associated with Trisomy 21, Turners’s
  • Fetal thyroid goiter - Solid appearing mass, anteriorly located

SON 2122-DMS OB/GYN 2 (1 decks)

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