Module 11.1 : Spinal Pathology Flashcards
1
Q
Development of spine
A
- each vertebrae develop from 3 ossification centers
- centrum
- neural processes
2
Q
What does the centrum form
A
- central portion of vertebral body
3
Q
What does the neural processes form
A
- pedicles
- transverse processes
- laminae
- spinous process
- posterolateral part of vertebral body
4
Q
Ossification
A
- ossification is not complete in than laminae until 18 weeks
- can potentially miss a small spina bifida before the
5
Q
Risk of NTD increase with
A
- valproic acid (meds for seizures)
- maternal diabetes
+ type 1 or 2 - folic acid deficiency
- history of spinal defects
+ previous pregnancy
+ family history
6
Q
Spina bifida
A
- defect in bones structure of spinal canal that may result in Bernita ion of its content \+ meninges \+ CSF \+ neural tissue - neural tube defect (NTD)
7
Q
Other NTD
A
- encephalocele
+ brain herniation - anencephaly
+ missing all = brain and and skull
8
Q
Variations of spina bifida
A
Spina bifida occulta
Spina bifida Alperta
9
Q
Spina bifida Occulta
A
- involves only the deeper layers
- may only see a skin dimple or patch of hair on the skin
- closed defect
- less common
10
Q
Spina bifida aperta
A
- involves all layers from dura to skin
- open defect
- more often
- two types
+ meningocele
+ myelomeningocele
11
Q
Spina bifida aperta - meningocele
A
- contains meninges and CSF
12
Q
Spina bifida aperta - myelomeningocele
A
- contains meninges, CSF, and neural tissue
- more common
13
Q
Screening for NTD
A
- quad screen at 16 weeks
- maternal serum alpha fetal protein
- AFP produced by liver
- crosses placenta and varies with gestational age
- AFP is elevated with NTD not covered by skin
14
Q
Other causes of elevated AFP
A
- abdominal wall defects \+ omphalocele \+ gastrodchisis (bowel outside) - twins - fetal death - urinary obstruction - cystic hygroma - incorrect dates
15
Q
NTD in lumbar spine
A
- Meckel Gruber syndrome \+ encephalocele \+ polycystic kidneys \+ polydactyly - T18 - triploidy