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1
Q

Name the six cranial bones? Which bone is a bat wing shaped bone?

A 
A. Frontal 
B. Temporal
C. ethmoid 
D. Parietal
E. occipital
F. sphenoid “bat wing shaped” bone
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2
Q

Name the five major sutures of the skull and what bones form them.

A

A. Coronal suture - formed by the frontal and parietal bones

B. Frontal/metopic suture - formed by the two frontal bones

C. Lambdoidal suture - formed by the occipital and parietal bones

D. Sagittal suture - formed by the two parietal

E. Squamosal suture -formed by the temporal and parietal bones

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3
Q

Describe the difference between craniosynostosis and cloverleaf skull.

A

A. Craniosynostosis - premature fusion coronal and sagittal suture‘s
i. May lead to microcephaly and secondary microencephaly

B. Clover leaf skull – premature fusion of the coronal and lambdoidal sutures

i. Trilobed school appearance
ii. Children die in infancy and have profound mental deficiencies

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4
Q

Name the fontanelles of the skull and where they are located.

A

A. Anterior fontanelle - junction of the two frontal bones and to parietal bones

B. Posterior fontanelle - junction of the two parietal bones and occipital bone

C. Mastoid fontanelle - junction of the temporal, parietal and occipital bone

D. Sphenoid fontanelle - formed by the frontal bone, anterior tip parietal bone and temporal bone and the Greater wing of the sphenoid bone

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5
Q

Name the divisions of the brain and the four major regions of the brain

A

Divisions of the brain:
1– Prosencephalon
i. telencephalon and diencephalon

2- mesencephalon

3- rhombencephalon
i. metencephalon, myelencephalon

4- spinal cord

Regions of the brain:
1- cerebrum
2- diencephalon
3-cerebellum
4- brain stem
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6
Q

Describe the differences between Gyri and sulci of the brain

A

Gyri– the folds/convolutions of the brain on the cerebrum
- They are hypoechoic sonographically

Sulci- the grooves that separate the gyri
-They are echogenic Sonographically

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7
Q

Describe the differences of the sulci and gyri in premature and term infants

A

A – the sulci and gyri are more prominent in term infants

B - premature infants have less sulci due to normal sulcal development occurring between 32 and 40 weeks gestation

C- Term infants with absence of sulci may have cerebral edema or an infection

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8
Q

Name of the major gyrus , it’s Location an appearance, and list the other important gyri

A

A. cingulate gyrus - major gyrus, hypoechoic, partially wrapped around the corpus callosum, posterior to the cingulate sulcus and a colossal marginal artery is within.

B. precentral, postcentral and hippocampal gyri

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9
Q

Name the major sulcus, its location and appearance, and list the other important sulci.

A

A. Central sulcus - main sulcus, AKA sulcus/fissure of Rolando, separates the frontal and parietal lobe‘s

B. Parietal – occipital sulcus – carries the PCA (posterior cerebral artery)

C. Cingulate sulcus - carries the colossal marginal artery

D. Calcarine sulcus

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10
Q

Describe and name the two main fissures of the brain.

A

A. Inter-hemispheric fissure - AKA longitudinal fissure, separates the right and left lobe of the brain

B. Lateral fissure- a.k.a. sylvian fissure, divides the frontal and parietal lobes from the temporal lobe, longer in the left hemisphere, carries the MCA (middle cerebral artery)

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11
Q

Name the three coverings of the brain and their location.

A

A. Dura Mater- outer most covering, toughest

B. Arachnoid mater – “spider web Dash like” membrane between the dura mater and the pia mater

C. Pia mater – delicate inner most layer of the brain

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12
Q

Name the three spaces of the meninges (brain covering)

A

A. Epidural space – between the Dura mater and the skull

B. Subdural space - between the Dura Mater and the arachnoid mater

C. Sub arachnoid space - area between the arachnoid and Pia mater

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13
Q

Name and describe the two main dural reflections.

A

A. Tentorium cerebelli - most important reflection, exist and separates the cerebellum and brainstem from the occipital lobe of the cerebrum, divides the cranial cavity into supra and subtentorial sections.

B. Falx cerebri- separates the two hemispheres of the brain, lies in the interhemispheric fissure, divides supratentorial compartment into a left and right side.

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14
Q

Name the 4 major subarachnoid cisterns.

A

A. Cisterna magna

B. Pontine cistern

C. Interpeduncular cistern

D. Quadrigeminal cistern

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15
Q

Which Cistern is the largest and what vessel runs through it.

A

A. Quadrigeminal cistern

B. Vein of Galen

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16
Q

In which cistern is a circle of Willis located?

A

Interpeduncular Cistern

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17
Q

Name the lobes of the cerebrum.

A

A. Frontal

B. Parietal

C. Temporal

D. Occipital

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18
Q

The M3 branch in the middle cerebral artery supplies what region of the brain?

A

A. The insula. This is an area within the cerebral cortex deep within the lateral sulcus. This area also contains Broca’s area (controls speech-reading – writing)

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19
Q

What is the largest white matter structure in the brain?

What purpose does this structure serve?

Describe its Sonographic appearance

A

A. Corpus callosum

B. It connects the right and left hemispheres of the brain

C. It is a midline, hypoechoic structure that forms the superior margin of the ventricles

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20
Q

What structure in the neonatal brain may be confused with a subependymal germinal matrix hemorrhage and what is its significance?

A

A. The caudothalamic groove may be mistaken for a SEH. ( subependymal hemorrhage )

B. It is a landmark used to assist in the detection of a SEH.

C. It is a landmark on the floor of the lateral ventricle formed by the white matter the internal capsule, which forms the groove between the caudate nucleus and the thalamus.

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21
Q

What is the purpose of the Massa intermedia and described its sonographic appearance?

A

The massa intermedia is tissue that connects the two thalamic bodies. It is only seen when the third ventricle is dilated and appears as a highly echogenic dot in a third ventricle.

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22
Q

What purpose does the hypothalamus serve?

A

It controls body temperature, hunger, thirst, fatigue, anger and circadian cycles.

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23
Q

Name the structures that make up the basal ganglia.

A

A. Caudate nucleus

B. Lentricular nucleus

C. Putamen

D. Globis pallidus

E. Subthalamic nucleus

F. Substantia nigra

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24
Q

What structure of the basal ganglia is concerned with learning and memory and where is it located?

A

A. Caudate nucleus

B. It lies below the floor of the frontal horn of the lateral ventricles and is superior and anterior to the thalamus.

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25
Q

Describe the location and function of the cerebellum

A

A. The cerebellum controls fine movement coordination, balance, and equilibrium and muscle tone. The cerebellum is located just above the brainstem, beneath the occipital lobe in the posterior fossa of the skull. The two cerebellar hemispheres are connected by the cerebellar vermis.

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26
Q

Name the cerebellar nerve tracks and what they control.

A

A. Dorso – spino-cerebellar tract: upper body impulses

B. Ventro -spino – cerebellar tract: lower body impulses

C. Vestibulo-cerebellar tract: inner ear impulses

D. Reticulo-cerebellar tract: spinal impulses to the brain stem and cortex

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27
Q

Name the parts of the brain stem and their neurological functions.

A

A. Midbrain

B. Medulla oblongata: relay station for the crossing of motor tracts between the spinal cord and brain; contains respiratory, vasomotor and cardiac centers, and reflects controls - coughing , gagging, swallowing, vomiting

C. Pons : relay station from the medulla to the higher cortical structures; contains the respiratory center, associated with arousal and autonomic functions of the heart and digestion.

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28
Q

What structures connect the pons to the cerebrum?

A

The cerebral peduncles

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29
Q

Name the four ventricles in the brain.

A

A. 2 lateral ventricles

B. Third ventricle

C. Fourth ventricle

30
Q

The latter ventricles are separated by a thin structure called the:

A

Septum pellucidum

31
Q

Name the four segments of the lateral ventricles.

A

Frontal horn

Body

Temporal horn

Occipital horn

32
Q

What structure divide the frontal horn of the lateral ventricles from the body of the lateral ventricles?

A

The foramen of Monro

33
Q

Describe the flow of CSF (cerebrospinal fluid) through the ventricles.

A

The framing of Monroe trains the lateral ventricles into the third ventricle.

Be. The aqueduct of Sylvia’s connect the third and fourth ventricle.

See. The fourth ventricle is trained by the foramina of Leska and

34
Q

Cerebrospinal fluid is produced by:

A

The choroid plexus and extracellular fluid movement.

35
Q

There is NO choroid plexus in what portion of the ventricular system?

A

The frontal and occipital horns.

36
Q

The terminal end of the spinal cord is called:

A

The conus medullaris

37
Q

What structure in the spinal cord secures its lower end?

A

The filing terminalis

38
Q

The nerve roots below the first lumbar vertebrae is called the:

A

Cauda equina

39
Q

When evaluating for extra axial fluid, what measurement should you take and what are the upper limits of normal values?

A

A. SCW: sinocortical width = 3 mm

B. CCW: cranialcortical width = 4 mm

C. IHW: interhemispheric width =6 mm

40
Q

What amount of extra axial fluid is a common and normal finding in a newborn?

A

3.3 mm in the SCW ( sinocortical) location

41
Q

Name the three stages of brain development

A

A. Cytogenesis – molecules into cells

B. Histogenesis - cells into tissues

C. Organogenesis – tissue into organs

42
Q

Name and describe the four grades of ICH – intracranial hemorrhage.

A

Grade I - subependymal/germinal matrix hemorrhage

Grade II– subependymal/germinal matrix or choroid hemorrhage with IVH (intraventricular hemorrhage) and no ventricular validation

Grade III – subependymal/germinal matrix or choroid hemorrhage with IVH (Intraventricular hemorrhage) with ventricular dilatation

Grade IV - subependymal/germinal matrix or choroid hemorrhage with IVH (intraventricular hemorrhage) and IPH (intraparenchymal hemorrhage)

43
Q

What is the cause of a subdural hemorrhage in a newborn?

A

Forceps or vacuum assistance during delivery

44
Q

Posterior fossa sub – dural hemorrhages/hematoma are a result of:

A

“shaken baby” syndrome

45
Q

Describe Hydrancephaly

A

A congenital anomaly of the brain thought to be caused by bilateral ICA occlusion during fetal development

46
Q

Describe the difference between hydrocephaly and ventriculomegaly

A

Hydrocephaly: increased ventricular size WITH increased head size and intracranial pressure

Ventriculomegaly: increase ventricular size WITHOUT increase head size or intracranial pressure.

47
Q

Describe the difference between cerebral edema and encephalitis

A

A . Edema: increased echogenicity of the brain with “slit– like“ ventricles

B. Encephalitis: overall increased echogenicity of the brain

48
Q

The TORCH infections can cause what abnormalities in the fetal/infant brain

A

A . Ventricular dilatation

B. Echogenic brain parenchyma

C. Encephalomalacia

D. Calcifications

E. Striatal densities

49
Q

Describe the sonographic appearance of a lipoma of the corpus callosum.

A

Highly echogenic fat mass with calcifications around the corpus callosum.

50
Q

What is Holoprosencephaly and describe the three types.

A

A. Holoprosencephaly is a failure of diverticulation of the prosencephalon

B. Alobar holoprosencephaly: most severe; no separation of the cerebral hemispheres.

C. Lobar holoprosencephaly: partial separation of the dorsal aspect of the brain

D. Semi lobar holoprosencephaly: more cerebral tissue

E. All forms have an absence of the septum pellucidum

51
Q

Why is the caudothalamic groove so important?

A

It is a landmark used to assist in the detection of a subependymal hemorrhage

52
Q

Which syndrome manifest with the webbed neck?

A

Turner’s syndrome

53
Q

What structure runs along the lateral margin of the thalami?

A

The sylvian fissure

54
Q

What vessel is seen pulsating in the sylvian fissure ?

A

MCA: middle cerebral artery

55
Q

Which syndrome is associated with aniridia (Absence of Iris)?

A

WAGR: Wilms Tumor, aniridia, GU Anomalies, Mental Retardation

56
Q

Which two vessels join to form the basilar artery?

A

That vertebral arteries

57
Q

What is the most common Arnold - Chiari malformation?

A

Chiari II

58
Q

What anomaly of the frontal horns of the lateral ventricle is seen with all of the Chiari malformation?

A

“Batwing “ configuration of the frontal horns

59
Q

What is a dilated, fluid – filled central sinus of the spinal cord called?

A

Hydromelia/ Syringomelia

60
Q

What is diastematomyelia?

A

A split cord malformation.

This anomaly can cause tethering of the spinal cord

61
Q

What is the difference between a fatty filum and a filar lipoma?

A

A. Fatty filum: normal variant; film should not measure more than 1-2 mm

B. Filum lipoma: filum measuring more then 1-2 mm causing a mass-like effect; associated with a tethered cord

62
Q

Name two types of caudal regression.

A

A. Sacral agenesis: mildest form

B. sirenomelia, most severe form

63
Q

Lissencephaly is called the “smooth brain“ condition due to:

A

Absent Gyri/sulci

64
Q

Which fontanelle is best for Imaging occipital parts of the lateral ventricles

A

The posterior fontanelle

65
Q

Where is germinal matrix in relation to the lateral ventricles

A

The floor of the lateral ventricles.

66
Q

What causes a dandy – walker malformation and what is the sonographic appearance?

A

Dandy– walker malformation is characterized by incomplete formation of the cerebellar vermis, dilation of the fourth ventricle in direct communication with the cisterna magna and an enlarged posterior fossa

67
Q

Which veins join to form the vein of Galen

A

The internal cerebral veins

68
Q

The sonographic sign of agenesis of the corpus callosum is called?

A

The classic “sunburst“ sign

69
Q

What is a thyroglossal duct cyst, where is it located and how does it occur?

A

A thyroglossal duct cyst is an anomaly that forms in the midline of the neck anterior to the trachea. It forms when the thyroglossal duct is not obliterate after the epithelial cells which, will form the thyroid, migrate from the pharyngeal floor.

70
Q

Describe the difference between a normal lymph node and a malignant lymph node.

A

A. A normal lymph node has a following characteristics, oval/bean-shaped; hypoechoic, homogenous; echogenic fatty hilum with central vascularity.

B. A malignant lymph node has the following characteristics: round, Hypoechoic, heterogenous, lots of echogenic fatty hilum, increase peripheral vascular disease.

71
Q

A Fetal persistence of the thyroglossal duct Causes?

A

A pyramidal lobe

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