Neonatal Spine

Question 1

Neural tube that becomes the spinal cord and brain

Answer 1

Ectoderm

Question 2

Neural tube that forms the bony spine, meninges, and muscle

Answer 2

Mesoderm

Question 3

Defects of the spine occur in the first ____ weeks

Answer 3

8.5 weeks

Question 4

Incomplete separation of the neural tube from the ectoderm:

Answer 4

Cord tethering
Diastematomyelia
Dermal sinus

Question 5

Premature separation of the neural tube from the ectoderm results in:

Answer 5

Lipomas

Question 6

Failure of the neural tube to fold and fuse in the middle:

Answer 6

Myelomeningocele

Question 7

Disorders of the distal cord:

Answer 7

Fibrolipomas of the filum terminale

Question 8

Total vertebrae:

Answer 8

33

Question 9

How many cervical, thoracic, lumbar, sacral, and coccygeal bones are there?

Answer 9

C-7
T-12
L-5
S-5
C-4

Question 10

Meninges layers:

Answer 10

• Dura mater(outer)
• arachnoid mater(middle)
• Pia(inner)

Question 11

Which meninges layer contains CSF?

Answer 11

Arachnoid mater

Question 12

Which meninges layer is the vascular layer?

Answer 12

Pia mater

Question 13

The spinal cord terminates at ____ in adults

Answer 13

Lower border of L1

Question 14

The spinal cord terminates at _____ in children

Answer 14

Upper border of L3

Question 15

Spinal cord: any termination(corpus medullaris) below _____ is abnormal

Answer 15

L3

Question 16

“Horse tail” part of spinal cord/lower nerve roots

Answer 16

Cauda equina

Question 17

How many nerve roots are there in the spinal cord?

Answer 17

31

Question 18

Indications for a spinal cord sonographic exam:

Answer 18

Sacral dimple

Lower extremity deformity

Question 19

Patient positions for exam:

Answer 19

Prone
Lateral decubitus
Upright

Question 20

Transducer for spinal exam

Answer 20

High frequency, linear

Question 21

Incomplete ossification of _____ spinal elements allows visualization

Answer 21

Posterior

Question 22

Where do you begin the exam?

Answer 22

1. Sacral area and follow spinal canal in a cranial direction
2. Count from lowest rib bearing vertebra(rib over kidney & follow medially)
3. Determine level of conus medullaris

Question 23

Sonographic appearance of vertebral bodies:

Answer 23

Echogenic, anterior

Question 24

Sonographic appearance of lamina:

Answer 24

Slight off midline (overlapping roof tiles)

Question 25

Sonographic appearance of spinous processes:

Answer 25

Inverted “U”

Question 26

Sonographic appearance of coccyx

Answer 26

Hypoechoic, don’t mistake for fluid

Question 27

Sonographic appearance of spinal cord

Answer 27

Hypoechoic with slightly echogenic borders and echogenic line extending along the middle

Question 28

Sonographic appearance of nerve roots

Answer 28

Echogenic | Move and change configuration during respiratory variations

Question 29

Sonographic appearance of conus medullaris

Answer 29

Normally above L3/L2.

Question 30

Fixation of cord @ abnormal caudal location (below L3)

Answer 30

Tethered cord

Question 31

- Diminished cord movement | - cord mechanical stretching, distortion, and ischemia with growth & activity

Answer 31

Tethered cord

Question 32

Tethered cord will sonographically show diminished cord ____

Answer 32

Pulsation

Question 33

Fatty masses that have connection with spinal cord

Answer 33

Lipomas

Question 34

Lipomas are frequently associated with _____

Answer 34

Tethered cord

Question 35

Dilation of central canal, diffuse or focal

Answer 35

Hydromelia

Question 36

Sonographic findings of hydromelia

Answer 36

Separation of echogenic linear structures of central canal

Question 37

Cord is split at one or more sites by a septum

Answer 37

Diastematomyelia

Question 38

Split segments(diastematomyelia) are best seen in _____ plane

Answer 38

Transverse

Question 39

Cysts on the spinal cord may be seen in ____ or ____

Answer 39

Cauda equina or filum terminale

Question 40

Small cysts in the filum terminale may be remnants of :

Answer 40

Terminal ventricle or an arachnoid pseudocyst

Question 41

Cysts on the spinal cord are related to ___

Answer 41

Tethered cord

Question 42

Protruding pouch containing CSF and nerves

Answer 42

Myelomeningocele spina bifida

Question 43

Sonographic appearance of myelomeningocele

Answer 43

Protruding pouch with flat, non-tubulated cord with nerve roots inside

Question 44

Small “dimple-like” opening in the midline of the spine connecting deep into the spinal cord

Answer 44

Dermal sinus tract

Question 45

The majority of dermal sinus tracts are located at the level of the _____ or ______

Answer 45

Sacrum or lumbar

Question 46

With a dimple sinus tract, communication with the spinal canal contents increases possibility of _____

Answer 46

Meningitis