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Pediatric and Superficial Structures > Spine Variants and Pathology > Flashcards

Spine Variants and Pathology Flashcards

1
Q

Where are filar cysts located?

A

Within midline terminale, inferior to the conus

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2
Q

T or F? Filar cysts are a normal variant?

A

True

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3
Q

Where are ventricular terminalis located?

A

Transition from tip of the conus to origin of filum terminale

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4
Q

What are ventricular terminalis also known as?

A

5th ventricle or persistent terminal ventricle

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5
Q

What is the ventricular terminalis?

A

Widening of the distal central canal

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6
Q

What are the two normal variants of the spine?

A
  1. Filar cyst
  2. Ventricular terminalis
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7
Q

By what week gestation is the neural tube formed?

A

8 weeks

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8
Q

The neural tube is formed by the closure of the?

A

Neural plate

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9
Q

Spinal dysraphism occurs when?

A

The neural plate fails to fuse completely

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10
Q

What is another term for OSD and CSD?

A

OSD - spina bifida aperta

CSD - spina bifida occulta

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11
Q

What is the difference between OSD and CSD?

A

OSP - Neural tissue communicates with the outside through a defect that does NOT include skin or tissue covering

CSD - Skin covered abnormality - usually seen as a dimple or tuft of hair in the lower back

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12
Q

What is a meningocele?

A

Protrusion of meninges without neural tissue (covered by a thin layer of skin)

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13
Q

What is a myelomeningocele?

A

Protrusion of meninges and neural tissue through a defect

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14
Q

What is a myelocele?

A

Protrusion of neural tissue without skin or meninges - shows as “flush” with the skin

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15
Q

How does spina bifida occulta present?

A

As a tuft of hair

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16
Q

What abnormality is a flat plate of neural tissue flush with the skin surface?

A

Myelocele

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17
Q

What 2 abnormalities are known as a herniation thru a defect in the dura mater?

A
  1. Myelomeningocele
  2. Myelocele
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18
Q

Is a meningocele classified as an open or closed spinal dysraphism?

A

Closed

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19
Q

Open and closed spina bifida are typically all associated with?

A

A tethered cord

20
Q

What is the definition of a tethered cord?

A

Low-lying cord with thickened filum terminale (< 2mm)

21
Q

What is almost ALWAYS associated with dysraphic spinal anomalies?

A

Tethered cord

22
Q

What are 3 complications of OPEN spinal dysraphism?

A
  1. Decreased limb function and paralysis
  2. Bladder and bowel dysfunction
  3. Hydrocephalus
23
Q

SF of open spinal dysraphism?

A
  1. Anechoic mass continuous with spinal cord
  2. Loss of normal conus
24
Q

SF of a tethered cord?

A
  1. Lack of movement of filum terminale and nerve roots
  2. Spinal cord low (conus terminates at L3 or after)
  3. Conus will be abnormally elongated and lack normal tapering
  4. Thickened filum terminale (>2mm)
25
Q

What is another name for diastomyelia?

A

Split cord malformation

26
Q

What is known as a longitudinal split of the spinal cord into 2 hemicords?

A

Diastomyelia

27
Q

Where in the spine does split cord normally occur?

A

Thoracolumbar region

28
Q

In what plane of imaging is a split cord diagnosed?

A

Transverse orientation

29
Q

What anomalies are associated with diastomyelia?

A
  1. Tethered cord
  2. Scoliosis
  3. Clubfoot
  4. Vertebral anomalies
  5. Dilation of central canal (hydromelia)
30
Q

What is known as a thin epithelial-lined tract that courses from the skin towards the spinal canal representing a focal disruption on the fusion of the spinal canal?

A

Dorsal dermal sinus (DDS)

31
Q

Where is DDS most common?

A

Lumbosacral region

32
Q

How do DDS clinically appear?

A

As deep midline dimples or pits

33
Q

What are patients at risk for developing with DDS?

A

Meningitis

34
Q

SF of DDS?

A

Midline tract from spinal cord to skin (most likely in the area of a skin marker)

35
Q

An abnormal focus of echogenicity within the canal of a DDS is visualized. What may be the most likely diagnosis?

A

Dermoid

36
Q

What is the most common reason an infant is referred for a spinal ultrasound?

A

Sacral dimple

37
Q

Sacral dimples may appear as one of two things, what are they?

A
  1. Blind ending
  2. As a pilonidal sinus - tract that leads to the coccyx
38
Q

Does a pilonidal sinus communicate with the spinal canal?

A

NO - do not confuse for DDS

39
Q

What are the three types of spinal lipomas?

A
  1. Lipomyocele/lipomyelomeningocele
  2. Intradural lipoma
  3. Lipoma of the filum terminale
40
Q

What is the most common spinal lipoma?

A

Lipomyocele/lipomyelomeningocele

41
Q

What is the difference between a lipomyocele and lipomyelomeningocele?

A

Lipomyocele - Stays within spinal canal

Lipomyelomeningocele - Enlarged subarachnoid space and a fatty mass extending through posterior defect

42
Q

Why are intradural lipomas and lipomas of the filum terminale different from lipomyocele/lipomyelomeningocele?

A

The first two DO NOT contain an associated subcutaneous mass and may or may not have a tethered cord

43
Q

What is known as an abnormal dilatation of the terminal ventricle that communicates with the central spinal cord but does not communicate with the subarachnoid space?

A

Terminal myelocystocele

44
Q

SF of terminal myelocystocele?

A
  1. Large, skin-covered, fluid filled mass in lumbar region
  2. Widened central canal of spinal cord with DIRECT communication with the cyst
  3. Hydromelia
45
Q

What are the 3 vertebral anomalies?

A
  1. Block vertebrae - incomplete separation of vertebral bodies
  2. Hemi-vertebrae - lack of formation of one vertebral body
  3. Butterfly vertebrae - failure of fusion of the lateral halves of the vertebrae
46
Q

What is the most common type of germ cell tumour occurring in the neonatal period?

A

Sacrococcygeal teratoma

Pediatric and Superficial Structures (23 decks)

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