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neonatal spine Flashcards

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1
Q

When can we use sonography for evaluating the fetal spine?

A

infants under 6mo
surgical procedures
known spinal defects where an acoustic window is available

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2
Q

What is spinal dysraphism?

A

array of spinal abnormalities caused by inadequate or improper fusion of the NT in early fetal life
2 types: open + closed

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3
Q

Why would we need to perform an ultrasound on the spine?

A

spinal dysraphism: meningoceles, myelomeningoceles, lipomyelomeningoceles, lipomas
lumbosacral skin anomalies: pigmented spots, hairy nevus, dimples, hemangiomas, dermal sinuses

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4
Q

What is a syrinx?

A

a rare, fluid-filled cavity within the spinal cord

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5
Q

What patient position is used?

A

prone w/ towel or pillow under (rounds out back)

decub is also used “fetal position”

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6
Q

Slide 9-16

A

has stuff highlighted but it’s like labelling stuff

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7
Q

Spinal cord appears hypoechoic sonographically. T/F

A

true

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8
Q

The cord tapers to the

A

conus medullaris (L1 + L2)

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9
Q

What’s the measurement for filum terminale?

A

<2mm

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10
Q

What do nerve roots appear as sonographically?

A

small echogenic dots or clumps together

sometimes obscuring filum terminale

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11
Q

The cord is smaller in the cervical region, narrows in thoracic region and enlarges at the conus. True or false

A

False- it is larger in the cervical region and then narrows in the thoracic segment

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12
Q

When should the spinal cord terminate?

A

L1 + L2

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13
Q

What embryonic structure forms the spine?

A

ectoderm

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14
Q

Each end of the neural tube closes. If the anterior neuropore doesn’t close, what happens? The posterior neuropore?

A

anterior- anencephaly

posterior- spina bifida, p

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15
Q

Ventriculus terminalis is a normal variant. What is it?

A

a slight widening of the distal central canal
the echogenic walls of the central canal are slightly separated by anechoic fluid near the conus
doesn’t extend cranially into the the thoracic region

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16
Q

What is a filar cyst?

A

normal variant

ovoid midline anechoic structure just inferior to the tip of the conus

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17
Q

Where is spinal dysraphism most common?

A

lower spine

18
Q

Open spinal dysraphism:

A

neural tissue exposed without skin covering
myeloceles, myelomeningoceles
inc. AFP + maternal serum + amniotic fluid

19
Q

Closed spinal dysraphism:

A

skin covered spinal abnormality

can be with or without mass

20
Q

CSD with mass can be what? (3)

A

lipomyelocele
lipomyelomeningocele
myelocystocele

21
Q

CSD without a mass can be what? (4)

A

tethered cord
spinal lipoma
diastomyelia
dorsal dermal sinus

present as cutaneous markers (hair tufts, dimples or pits, hemangiomas, etc.)

22
Q

What’s the difference between a myelocele and a myelomeningocele?

A

myelocele is a herniation of the meninges through the dura mater and in an MMC it also includes the neural tissue

23
Q

What is more common, a myelocele or MMC?

A

MMC

24
Q

MMC is assoicated with?

A

Arnold Chiari II malformation

25
Q

What sonographic signs are seen with Arnold Chiari II malformation?

A

fruit sign

lemon + banana

26
Q

Banana shape refers to what structure?

A

cerebellum

27
Q

Tethered cords are almost always associated with?

A

dysraphic anomalies

28
Q

What symptoms does a child with a tetherd cord present ?

A

neurological symptoms- limb, bowel or urinary dysfunction

skin markers

29
Q

Sono appearance of tethered cord:

A

spinal cord in low lying postition (at or below L3)
conus is elongated and pulled dorsally
nerve roots have decreased movements
thick filum terminale

30
Q

What is diastomyelia?

A

separation of the spinal cord into two hemicords

split by a bony or fibrous septum

31
Q

Where does diastomyelia most often occur?

A

thoracolumbar region
usually has a cutaneous marker
usually reunite distally

32
Q

What is a dorsal dermal sinus?

A

a thin, epithelial lined tract that passes from the skin toward the spinal canal
mostly in lumbosacral region
at risk for meningitis

33
Q

What is the most common reason for an infant to be referred to US (for the spine)?

A

sacral dimple/pit

34
Q

Where is a sacral dimple located?

A

<2.5 from the anus

35
Q

What should a sacral dimple not be confused with?

A

DDS because it has no connection to the spine

36
Q

Intradural lipoma:

A

lies within the spinal cord and is completely confined by the dura

37
Q

Lipomas of the filum terminale:

A

presents as a thickened FT >2mm, or a small echogenic fatty mass in the FT

38
Q

Lipomyelocele protrudes out from spinal cord. True/false

A

False

39
Q

Terminal myelocystocele:

A

skin covered fluid filled lumbar mass protruding through a dysraphic defect

40
Q

What is a terminal myelocystocele associated with?

A

omphalocele, bladder exstrophy and imperforated anus

decreased function of lower extremity (bowel + bladder)

41
Q

What can be seen with terminal myelocystocele? What is it?

A

hydromelia– dilated central canal

Psychology (31 decks)

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