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Summer 2014 - High Resolution ✔️ > Neonatal Head > Flashcards

Neonatal Head Flashcards

0
Q

what are the 3 sutures called

A

coronal

sagittal

lambdoid

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1
Q

what are the 2 fontanelle’s called

A

anterior (most commonly used for scanning) - soft spot

posterior

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2
Q

what does the foramen of Monro connect

A

lateral ventricles to the 3rd ventricle

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3
Q

what does the aqueduct of Sylvius connect

A

3rd ventricle to 4th ventricle

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4
Q

what are the 3 regions of the brain

A

forebrain

midbrain

hindbrain

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5
Q

what is the forebrain

A

Prosencephalon

mature

thalamus, epithalamus, hypothal, subthal, cerebral hemispheres, and olfactory system (senses)

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6
Q

what is the midbrain

A

Mesencephalon

mature

midbrain

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7
Q

what is hindbrain

example slide 6-7

A

Rhombencephalon

medulla

pons & cerebellum

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8
Q

what transducer would you use to scan a neonatal head

A

7-10 mhz linear

highest frequency with the smallest face

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9
Q

what is most important about scanning a neonatal head and following a protocol

A

it is important to follow the same protocol as the previous studies so that the doctor can compare them more easily

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10
Q

1st image TRV/coronal consists of what

A

anterior brain - show falx

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11
Q

2nd image TRV/coronal consists of what

A

anterior horns of lateral ventricles

contains anterior horn, caudate nucleus, corpus callosum, CSP

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12
Q

3rd image TRV/coronal consists of what

A

mid ventricles

contains sylvain fissure, MCA, foramen of monro connects to 3rd vent, 3rd vent, CSP, corpus callosum

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13
Q

4th image TRV/coronal consists of what

A

mid lateral ventricle

contains choroid plexus, lat vents, tail of caudate nucleus, corpus callosum, falx

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14
Q

5th image TRV/coronal consists of what

A

body of ventricles

choroid plexus in atria of lateral ventricles

occiput

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15
Q

6th image TRV/coronal consists of what

A

posterior brain

contains lat vents, falx, tentorium cerebelli

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16
Q

how do you image the neonates head coronally/TRV

A

place at the soft spot (fontanelle) and then sweep anterior to posterior without moving the transducer from the soft spot

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17
Q

how do you image the neonates head sagitally/LONG

A

place at the soft spot (fontanelle) and then sweep left to right without moving the transducer from the soft spot

medial, lateral x 3 left, medial, lateral x 3 right

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18
Q

1st sagittal image consists of what - medial

A 
3rd vent
aquaduct of sylvius
corpus callosum
4th vent
cisterna magnum
cerebellum
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19
Q

2nd sagittal image consists of what - lateral left or right

A

lat vents

choroid plexus

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20
Q

3rd sagittal image consists of what - lateral left or right

A 
lat vents
thalamus
caudate nucleus
caudate thalamus groove
show posterior horn
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21
Q

4th sagittal image consists of what - lateral left or right

A

lateral to ventricle
parietal lobe
temporal lobe

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22
Q

describe arnold-chiari malformation

A

associated with spina bifida

brain stem, cerebellum pulled toward spinal cord, absence of CSP

hydrocephalus

**“banana peel” sign of cerebellem

**frontal bossing - forehead comes to a point

23
Q

what are the 4 types of arnold-chiari malformation

A

type 1. downward displacement of cerebral tonsils
**type 2. MOST COMMON - associated with meningomyelocele
type 3. high cervical encephalomeningocele
type 4. severe hypoplasia of cerebellum

24
Q

what are the 3 types of holoprosencephaly

A

lobar

semilobar

alobar

25
Q

describe lobar holoprosencephaly

A

LEAST SEVERE

fused frontal horns
separate occipital horns
no facial anomaly

26
Q

describe semilobar holoprosencephaly

A

single ventricle

can separate temporal & occipital horns

mild facial anomaly

27
Q

describe alobar holoprosencephaly

A

MOST SEVERE

single midline cresent ventricle
fused thalami
absent 3rd vent
multiple facial anomalies - one eye, one nostril, nose off forehead, etc

28
Q

describe dandy-walker malformation

A

huge 4th ventricle cyst

with or without secondary dilatation of 3rd and lateral vents

found in the posterior fossa

29
Q

describe agenesis of the corpus callosum

A

absence of the corpus callosum (to any degree)

narrow frontal horns

marked separation of anterior horns and lateral vents

dilated occipital horns and 3rd vent.

“vampire wings” or “bat wings”

30
Q

what is hydranencephaly

A

brain cerebral hemispheres are absent and replaced by sacs filled with cerebrospinal fluid

extreme form of porencephaly which is characterized by a cyst or cavity in the cerebral hemispheres

31
Q

what is the progression of hydranencephaly

A

initally normally but after a few weeks irritable and increased muscle tone (hypertonia)

after several months, seizures & hydrocephalus - visual impairment, lack of growth, deafness, blindness, paralysis

prognosis is generally quite poor - death usually within the 1st yr

32
Q

what is hydrocephalus

A

enlargement of ventricular system - congenital or acquired

33
Q

what is congenital hydrocephalus

A

imbalance between production of CSP and reabsorption

present at birth

2 types are obstructive and comunicating

34
Q

what is obstructive hydrocephalus

A

interference of the circulation of CSF within vent system

35
Q

what is communicating hydrocephalus

A

CSF pathways in vent system open

decreased absorption

36
Q

what is aqueductal stenosis - Aqueduct of Sylvius

A

narrowed or obstructed by malformation of aqueduct or extrinsic pressure

sono - widening of the lateral and 3rd vent, normal sized 4th vent

treatment - shunts

37
Q

what is ventricular dilatation

know measurements

A

measured in sagittal plane (height at body mid thalamus) and axial plane (width at atrium, level of choroid)

mild =  8-10 mm
moderate = 11-14 mm
large = > 14 mm
38
Q

describe hemorrhage

A

classified by extent and location of hemorrhage and presence of hydrocephalus

intracranial hemorrhage more common with low birth weight, premature birth, 80% within first 3 days of life

39
Q

what is the MOST COMMON intraventricular hemorrhage

A

Subependymal hemorrhage pushes through ependyma into ventricle to form the hemorrhage

capillary bleeding in germinal matrix - most commonly seen at thalamic-caudate groove

40
Q

how many grades of hemorrhage are there

A

4

41
Q

what is hemorrhage grade I

A

SEH or IVH without ventricular dilatation

42
Q

what is hemorrhage grade II

A

SEH or IVH with mild ventricular dilatation

43
Q

what is hemorrhage grade III

A

SEH or IVH with moderate or large ventricles

44
Q

what is hemorrhage grade IV

A

SEH or IVH with intraparenchymal hemorrhage

45
Q

what is periventricular leukomalacia

A

necrosis of the brain tissue

deals with hypoxia and ischemia

cerebal palsy is a common result

46
Q

define hypoxia

A

lack of adequate oxygen to the brain

47
Q

define ischemia

A

lack of adequate blood to brain

48
Q

what is a definitive sign of hydrocephalus

A

gravity dependent

the choroid is going to dangle

49
Q

describe hypoxia/ischemic encephalopathy doppler

A

DOPPLER OF MCA OR ACA:

normal RI .65-.90

RI of .90 is indicative of immediate & long term poor outcome

doppler is not routine, must be ordered by physician

ACA obtained from anterior fontanelle, MCA obtained from temporal fontanelle

50
Q

what is a sign of down syndrome in utero

A

unilateral cyst that persists after 21 wks

51
Q

describe brain infections

A

serious complication - developmental delay, mental retardation, death

caused congenitally by TORCH infections

52
Q

what are TORCH infections

A 
T - toxoplasmosis/toxoplasma gondii
O - other infections (hep c, hiv, syphilis, etc)
R - rubella
C - cytomegalovirus
H - herpes simplex virus
53
Q

what does ECMO stand for

A

extracorporeal membrane oxygentation

54
Q

what is ECMO

A

support infants with underdeveloped or abn lungs, meconium aspiration, or congenital heart disease

causes sudden significant change in bp to brain

hemorrhage and ischemia are common

insert cannula into rt jugular vein and carotid

Summer 2014 - High Resolution ✔️ (7 decks)

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