Neonatal And Infant Head Flashcards
Located at the top of the neonatal head and felt as a “soft spot”
Anterior fontanelle
If hydrocephalus is present, anterior fontanelle is ____
Bulging
Spaces between the bones of the skull which allow for compression at birth and rapid brain growth after birth
Fontanelles
Fontanelles allow _____ at birth and ______ after birth
Compression
Rapid brain growth
Surrounds the brain and spinal cord and protects it from physical impact:
Cerebrospinal Fluid(CSF)
Approximately ___% of the CSF is formed by the choroid plexuses of lateral, third, and fourth ventricles
40%
CSF not produced by the choroid plexuses is produced by:
Extracellular fluid movement from blood through brain and into ventricles
Convolutions/folds on surface of brain causes by infolding of cortex
Gyri
Grooves/depressions on surface of brain separating gyri:
Sulcus/sulci
Sulci divide the hemispheres into:
Frontal, parietal, occipital, temporal lobes
Area in which the falx cerebri sits and separates two cerebral hemispheres
Interhemispheric fissure
Located along lateral most aspect of brain; area where middle cerebral artery(MCA) is located:
Sylvian fissure
Transducer used for neonatal head exam
Small footprint, high frequency
Sonography of the neonatal brain is initiated through the _____ fontanelle in transverse&long views to study the supratentorial and infratentorial compartments
Anterior fontanelle
The ______ should always be present in the standard images to ensure the entire brain is being visualized
Posterior cranial bones
The _______ is utilized to better visualize the cerebellum and infratenrorial compartment/posterior fossa in young infants
Mastoid fontanelle
If imagine is restricted by overlapping bones in the area of the anterior fontanelle, or if pathology is suspected in the choroid plexus & lateral ventricles, an alternative window to use is:
Posterior fontanelle
If a critical neonate is on ECMO, the _____ approach may be useful because the mastoid view is unattainable
Posterior fontanelle
To perform the coronal study, the transducer is placed on the ______ with the scanning plane following the ____ suture
Anterior fontanelle
Coronal suture
Skull bones and arteries should be the ______ bilaterally
Same size
Normal protocol for coronal images begins with the transducer angled toward the _________ skull, then angled to the ____, and finally angled towards the ____ occipital area of the skull
Anterior skull
Mid
Posterior occipital
The sagittal study is made by rotating the coronal plane approximately ____ degrees
90 degrees
The straight sagittal view is critical and can rule out many ____ anomalies
Midline
Parasagittal views are obtained by angling the transducer to the ____ of the skull
Right/left side
At least ___ parasagittal studies should be performed
3
The integration of the mastoid view of the posterior fossa in the routine neonatal head exam increases the detection of ____
Congenital anomalies in the 3rd, 4th ventricles and cerebellum
Posterior fossa study: the transducer is placed just being the ____
Ear
The most common disorder of the neonatal brain
Hydrocephalus/ventriculomegaly
Dilation of the ventricular system
Hydrocephalus/ventriculomegaly
3 mechanisms for development of hydrocephalus/ventriculomegaly
- Obstruction to outflow
- Decreases absorption of CSF
- Overproduction of CSF
Hydrocephalus/ventriculomegaly: Neonates may be diagnosed in utero, or may present clinically with a bulging _____ and/or _____
Bulging anterior fontanelle
Macrocephaly
The most common cause of both acquired and congenital hydrocephalus is:
Aqueductal stenosis
______ is at the greatest risk for intracranial hemorrhage(ICH) and is a major cause of mortality and morbidity
Premature neonate
The most common hemorrhagic lesion in preterm neonates
Intracranial hemorrhage/ Germinal Matrix-Intraventricular Hemorrhage(GM-IVH)
Intracranial hemorrhage/GM-IVH affect ____% of infants less than 34 weeks
40-70%
An even higher risk of intracranial hemorrhage/GM-IVH is associated with infants less than _______ or less than ____ birth weight
32 weeks
1500 grams
Subependymal Intracranial hemorrhage(SEH) or Intraventricular Hemorrhage(IVH) Grade 1:
Without ventricular enlargement
Subependymal Intracranial hemorrhage(SEH) or Intraventricular Hemorrhage(IVH)
Grade 2:
Minimal ventricular enlargement
Subependymal Intracranial hemorrhage(SEH) or Intraventricular Hemorrhage(IVH) grade 3:
Moderate or large ventricular enlargement
Subependymal Intracranial hemorrhage(SEH) or Intraventricular Hemorrhage(IVH) grade 4:
Worst, SEH/IVH with intraparenchymal hemorrhage
