Neonatal Spine Flashcards
Neural tube that becomes the spinal cord and brain
Ectoderm
Neural tube that forms the bony spine, meninges, and muscle
Mesoderm
Defects of the spine occur in the first ____ weeks
8.5 weeks
Incomplete separation of the neural tube from the ectoderm:
Cord tethering
Diastematomyelia
Dermal sinus
Premature separation of the neural tube from the ectoderm results in:
Lipomas
Failure of the neural tube to fold and fuse in the middle:
Myelomeningocele
Disorders of the distal cord:
Fibrolipomas of the filum terminale
Total vertebrae:
33
How many cervical, thoracic, lumbar, sacral, and coccygeal bones are there?
C-7 T-12 L-5 S-5 C-4
Meninges layers:
- Dura mater(outer)
- arachnoid mater(middle)
- Pia(inner)
Which meninges layer contains CSF?
Arachnoid mater
Which meninges layer is the vascular layer?
Pia mater
The spinal cord terminates at ____ in adults
Lower border of L1
The spinal cord terminates at _____ in children
Upper border of L3
Spinal cord: any termination(corpus medullaris) below _____ is abnormal
L3
“Horse tail” part of spinal cord/lower nerve roots
Cauda equina
How many nerve roots are there in the spinal cord?
31
Indications for a spinal cord sonographic exam:
Sacral dimple
Lower extremity deformity
Patient positions for exam:
Prone
Lateral decubitus
Upright
Transducer for spinal exam
High frequency, linear
Incomplete ossification of _____ spinal elements allows visualization
Posterior
Where do you begin the exam?
- Sacral area and follow spinal canal in a cranial direction
- Count from lowest rib bearing vertebra(rib over kidney & follow medially)
- Determine level of conus medullaris
Sonographic appearance of vertebral bodies:
Echogenic, anterior
Sonographic appearance of lamina:
Slight off midline (overlapping roof tiles)
Sonographic appearance of spinous processes:
Inverted “U”
Sonographic appearance of coccyx
Hypoechoic, don’t mistake for fluid
Sonographic appearance of spinal cord
Hypoechoic with slightly echogenic borders and echogenic line extending along the middle
Sonographic appearance of nerve roots
Echogenic
Move and change configuration during respiratory variations
Sonographic appearance of conus medullaris
Normally above L3/L2.
Fixation of cord @ abnormal caudal location (below L3)
Tethered cord
- Diminished cord movement
- cord mechanical stretching, distortion, and ischemia with growth & activity
Tethered cord
Tethered cord will sonographically show diminished cord ____
Pulsation
Fatty masses that have connection with spinal cord
Lipomas
Lipomas are frequently associated with _____
Tethered cord
Dilation of central canal, diffuse or focal
Hydromelia
Sonographic findings of hydromelia
Separation of echogenic linear structures of central canal
Cord is split at one or more sites by a septum
Diastematomyelia
Split segments(diastematomyelia) are best seen in _____ plane
Transverse
Cysts on the spinal cord may be seen in ____ or ____
Cauda equina or filum terminale
Small cysts in the filum terminale may be remnants of :
Terminal ventricle or an arachnoid pseudocyst
Cysts on the spinal cord are related to ___
Tethered cord
Protruding pouch containing CSF and nerves
Myelomeningocele spina bifida
Sonographic appearance of myelomeningocele
Protruding pouch with flat, non-tubulated cord with nerve roots inside
Small “dimple-like” opening in the midline of the spine connecting deep into the spinal cord
Dermal sinus tract
The majority of dermal sinus tracts are located at the level of the _____ or ______
Sacrum or lumbar
With a dimple sinus tract, communication with the spinal canal contents increases possibility of _____
Meningitis
