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Test 2 Flashcards

1
Q

when does fetal face development begin?

A

week 4 of gestation

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2
Q

when does completion of major events occur with the face?

A

12 weeks gestation

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3
Q

what do the complex process involve in the fetal face?

A
  • ectoderm
  • mesoderm
  • endoderm
  • neural crest cells
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4
Q

what are the 5 prominences that form the fetal face?

A 
Frontonasal 
Lateral nasal 
Medial nasal 
Maxillary 
Mandibular
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5
Q

what is in the frontonasal prominence?

A

forhead and dorsum apex of nose

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6
Q

what is in the lateral nasal prominence?

A

nasal ala

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7
Q

what is in the medial nasal prominence?

A

nasal septum

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8
Q

what is in the maxillary prominence?

A

upper cheecks and upper lip

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9
Q

what is in the mandibular prominence?

A

lower cheeck, lower lip, and chin

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10
Q

what is seen on the sagital veiw of the fetal face?

A

nasal bone and madible

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11
Q

what is seen on the modified sagital veiw of the fetal face?

A

palate and ears

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12
Q

what is seen on the coronal veiw of the fetal face?

A

orbit and lens

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13
Q

what is seen on the modified coronal veiw of the fetal face?

A

nose and lips, palate

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14
Q

what is seen on the transverse veiw of the fetal face?

A

mandible, maxillary, orbits

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15
Q

what is in the profile image?

A 
Forehead
 Nasal Bone
 Nasal tip
 Upper lip
 Lower lip
 Chin
 Anterior neck
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16
Q

facial angle decreases with what?

A

an increase in CRL

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17
Q

when measuring fetal facial angle, how do we modify our image?

A

magnify so fetal head and thorax occupy the whole image

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18
Q

what is the mid-sagital view of the face defined by?

A
  • Presence of the echogenic tip of the nose
  • Rectangular shape of the palate anteriorly
  • Translucent diencephalon in the centre
  • Nuchal membrane posteriorly.
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19
Q

how is the facial angle measured?

A

Between a line along the upper surface of the palate and a line along the upper corner of the anterior aspect of the maxilla extending to the external surface of the forehead, represented by the frontal bones.

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20
Q

what does an increase in facial angle mean?

A

increased risk of triploidy

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21
Q

what is encephalocele?

A

Abnormal protrusion of the brain and/or meninges through a defect in the skull or calvarium

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22
Q

what is encephalocele associated with?

A

hypertelorism and midline facial clefting (an opening or gap in theface, or a malformation of a part of the face).

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23
Q

what is proboscis?

A

A trunk-like soft tissue appendage situated between the orbits

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24
Q

what is proboscic associated with?

A

alobar holoprosencephaly

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25
Q

what is cyclopia?

A

fetus has only one single orbital fossa

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26
Q

what is Dacryocystocele?

A

congenital obstruction of the nasolacrimal duct, resulting in cystic dilatation of the proximal part of the duct

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27
Q

what is hypotelorism?

A

Abnormally small distance between the orbits

-decreased inter-orbital diameter

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28
Q

what is hypotelorism associated with?

A
  • Alobar holoprosencephaly
  • Cyclopia (single midline eye)
  • Absence of the nose
  • Proboscis
  • Trisomy 13 (also 18 and 21)
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29
Q

what is hypertelorism?

A

Increased separation of the orbits

-Abnormal increase in inter-orbital diameter

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30
Q

what is hypertelorism associated with?

A

anterior encephaloceles

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31
Q

what is anophthalmia?

A

unilateral or bilateral absence of the eye

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32
Q

anophthalmia demonstrates an orbital diameter below what?

A

5th percentile for gestatonal age

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33
Q

hypoplastic or absent nasal bone is seen with increase of what?

A

incidece with trisomy 21

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34
Q

why does cleft lip and cleft palate happen?

A

Usually result from the failure of the fusion of the medial nasal prominences and the maxillary prominences

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35
Q

what is cleft lip and palate associated with?

A
  • chromosomal anomalies (trisomy 13 and 18)
  • structural abnormalties (heart, CNS)
  • familial (recurrance risk dependant on the number of family members affected)
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36
Q

what does a cleft lip involve?

A

opening from the upper lip to one or both nostrils

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37
Q

with a cleft in the palate, the opening in the roof of the mouth is__________

A

split

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38
Q

macroglossia

A

enlarged tongue

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39
Q

how may macroglossia appear?

A

protuberant extending from the oral cavity

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40
Q

what is macroglossia associated with?

A 
Beckwith-Wiedemann Syndrome
-Macrosomia
-Macroglossia
-Omphalocele
-anomalies
Trisomy 21
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41
Q

Micrognathia

A

small chin

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42
Q

Retrognathia

A

poorly displaced chin

-associated with trisomies 13 and 18

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43
Q

Agnathia

A

absence of the lower jaw

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44
Q

what is Agnathia associated with?

A

otocephaly

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45
Q

what are improper alignment of the ear associated with?

A
  • noonan syndrome

- trisomies

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46
Q

what are thickened NT in 1st trimester associated with?

A
  • Fetal aneuploidy
  • Cardiac defects
  • Other major malformations
  • Adverse pregnancy outcomes
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47
Q

what is nuchal fold thickening?

A

abnormal thickening of the fetal skin in the dorsal portion of the neck

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48
Q

how to meaure nuchal fold?

A

outer edge of occipital bone to the outer edge of the skin

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49
Q

what measurement is associated with increased risk of trisomy 21 with NF?

A

over 6mm

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50
Q

what kind of malformation is a cystic hygroma?

A

lymphatic malformation

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51
Q

what is a cystic hygroma?

A

septated fluid collecton behind the fetal neck

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52
Q

what is cystic hygroma associated with?

A
  • Turner Syndrome (XO)
  • Chromosomal abnormalities
  • Cardiac structural abnormalities
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53
Q

what is the most common tumour in neonates?

A

teratomas

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54
Q

where are most teratomas located?

A

sacrum or coccyx (5% arise in the neck)

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55
Q

what is a cystic teratoma?

A

Complex masses composed of both cystic and solid elements

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56
Q

what does a cystic teratoma look like?

A
  • May have regions of calcifications
  • Solid components are vascular
  • May involve the thyroid gland
  • May impinge on the airway, interfere with fetal swallowing and result in polyhydramnios
  • May cause hyperextension of fetal neck
  • May protrude from the mouth
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57
Q

Neural tube defects (NTD) may be either _________

A

open (increases Maternal Serum AFP and amniotic fluid AFP) or closed.

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58
Q

what is macrocephaly?

A

larger than expected head size

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59
Q

why may macrocephaly occur?

A

family history of large heads

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60
Q

what is the goal of macrocephaly when scanning?

A

Exclude any intracranial abnormalities that may cause an increase in fetal head size
Ex. hydrocephalus, intracranial tumour or macrosomia.

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61
Q

what is microcephaly?

A

smaller than expected head

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62
Q

what distinguishes microcephaly from anencephaly and encephalocele?

A

intact calvarium

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63
Q

what is microcephaly accociated with?

A

abnormal neurologic and subnormal intellectual development

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64
Q

what is the etiology of microcephaly?

A

Fetal infections
Anoxia
Chromosomal abnormalities

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65
Q

what are the key sonographic features of microcephaly?

A

-An abnormally small head size, defined as a BPD or HC 2 or 3 standard deviations below the mean expected for GA (usually 3 SD below the mean)
-Abnormal fetal biometric ratio (3 or more SD) may also be helpful for the sonographic diagnosis of microcephaly.
High FL/HC
Low HC/AC

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66
Q

what is brachycephaly?

A

head is rounder than usual

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67
Q

what is brachycephaly associated with?

A

multiple pregnancy (intrauterine crowding)

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68
Q

what is dolichocephaly?

A

-Narrow BPD and a long occipitofrontal diameter (OFD)

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69
Q

what is dolichocephaly associated with?

A

oligohydramnios but can be due to Breech position

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70
Q

what is the lemon sign?

A

Describes a fetal head with bilateral denting of the frontal bones

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71
Q

what is lemon sign associated with?

A

spina bifida

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72
Q

what is the clover leaf skull?

A

describes a tri-lobes appearance of the head

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73
Q

what is clover leaf skull associated with?

A
  • thanatophoric dysplasia

- homozygous achondroplasia

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74
Q

what is a strawberry skull?

A

describes a fetal head with a normal BPD and a narrow frontal diamter

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75
Q

how is strawberry shaped skull different from lemon sign?

A

Similar to Lemon Sign except for no obvious concavity to the frontal bones

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76
Q

what is strawberry shaped skull associated with?

A

Tri 18

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77
Q

what is spalding sign?

A

Describes a flattened and misshapen fetal head with overlapping of cranial bones

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78
Q

what is spalding sign associated with?

A

fetal demise

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79
Q

when may fetal demise happen with spalding sign?

A

estimates place the precise time of fetal death at about 4–7 days before overlapping and separation of the fetal skull bones appear.

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80
Q

what should the normal fetal scalp thickness be?

A

<3mm

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81
Q

what is scalp edema?

A

Manifestation of fetal hydrops and is seen as scalp thickening
(>3mm)

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82
Q

what are choroid plexus cysts?

A

Cysts arise from neuroepithelial folds in the choroid plexus

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83
Q

what is the most common site for chorios plexus cysts?

A

arterial region of lateral ventricle

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84
Q

what is the typical appearance of choroid plexus cysts?

A
  • Unilateral
  • Spherical anechoic
  • Relatively small (Range: 1 to 20 mm)
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85
Q

when are choroid plexus cysts usually seen?

A

16-24 weeks gestation

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86
Q

what is the treatment for choroid plexus cysts?

A

majortiy regress and disappear spontaneously

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87
Q

what may choroid plexus be associated with?

A

tri-18 and tri-21

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88
Q

true or false, agenesis of the corpus collosum is only complete?

A

false, can be partial or complete

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89
Q

what is agenesis of the corpus collosum most commonly associated with?

A

Dandy Walker Malformation (DWM)

90
Q

what are the key sonographic features of agenesis of the corpus collosum (ACC)?

A
  • Absence of cavum septum pellucidum

- Colpocephaly (Disproportionate prominence of the occipital horns of the lateral ventricles).

91
Q

what excludes ACC?

A

presence of CSP

92
Q

what is the best view to diagnose ACC?

A

midline sagital view

93
Q

what are intracranial calcifications (ICC) most commonly the result of?

A

Cytomegalovirus (CMV)

fetal viral infection

94
Q

where are ICC’s most often located?

A

bordering the wall of the lateral ventricles

95
Q

what are ICC’s associated with?

A

brain tumor-teratoma

96
Q

what do ICC’s appear as?

A

abnormal aggregates of high amplitude echoes with or without acoustic shadowing depending on beam resolution

97
Q

what is a frequent complication of brain tumors?

A

hydracephalus

98
Q

descrie teratoma

A
  • Most common
  • Contain a wide variety of tissue types
  • Benign but have malignant potential
  • May resemble a hemorrhage
99
Q

what is the vein of Galen or straight sinus?

A

major draining vein that lies in the transverse fissure within the subarachnoid space - posterior and slightly superior to the thalami.

100
Q

descrobe the vein of galen aneurysm?

A

A congenital aneurysm of the vein of Galen is a very uncommon anomaly but one with a pathognomonic sonographic and Doppler appearance. (if you see this sign, you know is the vein of galan anerysum)

101
Q

what is a pathognomonicsign?

A

a particular sign whose presence means that a particular disease is present beyond any doubt.

102
Q

how does a vein of galen aneurysm appear?

A
  • fusiform median cyst in the region of the transverse fissure immediately superior to the cerebellum
  • Doppler evaluation of the aneurysm demonstrates abnormal, turbulent Doppler signals within the aneurysm
103
Q

characteristic doppler signals associated with shunting?

A
  • turbulent
  • high velocity
  • low resistance flow between the feeding artery and the draining vein
104
Q

what is acrania?

A

Acrania is identified on U/S by absence of normal cranial vault with a normal appearing or disorganized brain above the orbits (Seen best: sagittal midline CRL view of the fetus).

105
Q

what are differential diagnosis of acrania?

A

conditions in which the cranial bones are absent or lack mineralization:

  • Amniotic band sequence
  • Large encephaloceles
  • Osteogenesis imperfecta
  • Hypophosphatasia
106
Q

what is anencephaly?

A

Absence of the cranial vault, cerebral hemispheres and diencephalic structures and replaced by a flattened amorphous vascular mass

107
Q

what is present in anencephaly?

A

facial structures and orbits

108
Q

what is the most reliable sonographic sign of anencephaly?

A

Failure to identify normal cranial morphology and brain tissue above the orbits

109
Q

what is a sign of anechaphy?

A

exophthalmos

110
Q

what is cephalocele?

A

herniation of intracranial structures through a defect in cranium

111
Q

what is a cranial meningocele?

A

If the cephalocele contains only meninges and CSF

112
Q

what is an encephalocele or meningoenceohalocele?

A

If the cephalocele also contains brain tissue

113
Q

do cephaloceles covered by normal scalp tissues cause an increase in maternal AFP?

114
Q

what is the sonographic feature of encephalocele?

A

cystic mass at the surface of the skull, typically in the midline.

115
Q

what are the differential diagnosis of Cephalocele and Encephalocele?

A
  • Cystic hygroma
  • Branchial cleft cyst (epithelial cyst that arises on the lateral part of the neck due to failure of obliteration of the second branchial cleft)
  • Epidermal scalp cyst
  • Cervical teratoma
  • Scalp edema or cephalohematoma (hemorrhageofbloodbetween theskulland theperiosteum)
  • Dacryocystocele: result of narrowing nasolacriminal duct
116
Q

what is Ventriculomegaly?

A

Dilation of the cerebral ventricles without defining the cause. Fetal head is normal, enlarged, or even small for GA

117
Q

what are the most common causes of ventriculomegaly (VM)?

A
  • Arnold-Chiari malformation (the 3rd and 4th ventricle and both lateral ventricles are dilated)
  • Open neural tube defects
  • Congenital double aqueductal stenosis (3rd ventricle and both lateral ventricles)
  • Dandy-Walker malformation
118
Q

is Ventriculomegaly usually bilateral or unilateral?

119
Q

what is the best indicator of VM?

A

atrial measurment

120
Q

what is Hydrocephalus or Hydrocephaly?

A

Increased intracranial pressure usually due to a lesion causing obstruction of the Cerebrospinal Fluid (CSF) pathway

121
Q

what is holoprosencephaly?

A

It is the failure of division of the prosencephalon (fore brain) resulting in varying degree of prosencephalon midline defects.
- Incomplete separation of the two hemispheres.

122
Q

what is the clinical presentation of holoprosencephaly?

A

It is usually obvious at birth even if antenatal diagnosis has not been made, due to associated midline facial anomalies including:

  • Proboscis
  • Cyclopia
  • Cleft lip and / or palate
  • Ocular hypotelorism
  • Solitary median maxillary central incisor
123
Q

what is holoprosencephaly associated with (aneuploidic)?

A
  • MOST COMMONLY trisomy 13

- trisomy 18

124
Q

what is holoprosencephaly associated with (non-aneuploidic)?

A
  • Congenital renal anomalies
  • Congenital cardiac anomalies
  • Diabetic embryopathy
  • Facial anomalies
  • Shprintzen syndrome
125
Q

describe what Alobar holoprosencephaly is?

A
  • Thalami are fused

- Single large posteriorly located ventricle

126
Q

what is alobar holoprosencephaly associated with?

A

facial abnormalities such as:

  • cyclopia
  • ethmocephaly
  • cebocephaly
  • median cleft lip.
127
Q

what is semi-lobar holoprosencephaly?

A
  • Basic structure of the cerebral lobes are present: most commonly fused anteriorly and at the thalami
  • Olfactory tracts and bulbs are usually not present
  • Agenesis or hypoplasia of the corpus callosum.
128
Q

what is Lobar holoprosencephaly?

A
  • Least affected sub type
  • More subtle areas of midline abnormalities such as: fusion of the cingulate gyrus and thalami
  • Olfactory tracts are absent or hypoplastic
  • May be hypoplasia or absence of the corpus callosum
129
Q

what is the prognosis of holoprosencephaly?

A

The prognosis is dependant on the type of holoprosencephaly - almost all alobar and semilobar forms incompatible with a extra uterine life.

130
Q

what is the most common holoprosencephaly?

131
Q

what does alobar holoprosencephaly have an absent of?

A

midline structures (falx cerebri, corpus collosum, septi pellucidi)

132
Q

what is alobar holoprosencephaly associated with?

133
Q

what is the sonographic findings of holoprosencephaly?

A
  • Enlarged monoventricular cavity with fused thalami with absence of the supra tentorial midline structure.
  • Choroid plexus is usually compressed and difficult to visualize.
134
Q

what is Hydranencephaly characterized by?

A

Gross ventriculomegaly due to complete or near complete absence of cerebral tissue

135
Q

is Hydranencephaly related to hyracephalus and anencephaly?

136
Q

what does Hydranencephaly appear as?

A

Absence of the cerebral hemispheres with an incomplete or absent falx and a sac-like structure containing cerebral spinal fluid surrounding the brainstem and basal ganglia.

137
Q

what is not affected in Hydranencephaly?

A
  • brain stem
  • cerebellum
  • cisterna magna
138
Q

what is the key sonographic feature for Hydranencephaly?

A

large cranial fluid collection lacking a mantle or rim of cerebral brain tissue (which is present in hydrocephalus).

139
Q

what is Schizencephaly?

A

Clefts in the cerebral mantle (usually bilateral), lined by pia-ependyma, with communication between the ventricles and subarachnoid space.

140
Q

what could Schizencephaly be the result of?

A

middle cerebral artery infarction or focal migration disorder

141
Q

what does Schizencephaly look like?

A

Pie-shaped areas of cystic necrosis extending to the calvarium

142
Q

what is Schizencephaly associated with?

A
  • absence of septum pellucidum
  • septo-optic displasia
  • dysgeneresis of corpus callosum
143
Q

what is dandy-walker malformation (DWM) and varients?

A

complete agenesis of cerebellar vermis resulting in a large central posterior fossa cyst, which communicates with the fourth ventricle (dilated).

144
Q

what is DWM associated with?

A

other CNC abnormalities including hydrocephalus (80% of cases) and agenesis of the corpus collosum

145
Q

what are the features of DWM?

A

A malformation of the roof of the fourth ventricle and of the cerebellum. The cerebellum is poorly developed and is displaced upwards and laterally.
-The enlarged fourth ventricle balloons out backward and is grossly misshapen

146
Q

what is DWM associated with?

A

atresia of the foramen of Magendie and, possibly, the foramen of Luschka

147
Q

what do true retrocerebellar arachnoid cysts do?

A

displace the fourth ventricle and cerebellum anteriorly and show significant mass effect

148
Q

what are retrocerebellar arachnoid cysts?

A

benign cysts that occur in the cerebrospinal axis in relation to the arachnoid membrane and that do not communicate with the ventricular system

149
Q

what are primary (congenital) arachnoid cysts?

A

result from benign accumulation of clear fluid between the dura and the brain substance throughout the CNS - related to the arachnoid membrane and do not communicate with the subarachnoid space

150
Q

what are secondary (aquired) arachnoid cyst?

A

result from haemorrhage, trauma, and infection and usually communicate with the subarachnoid space

151
Q

what are Porencephaly (Porencephalic Cysts)

A

Extremely rare congenital disorder

Results in cystic degeneration and encephalomalacia and the formation of porecephalic cysts

152
Q

what are what are Porencephaly (Porencephalic Cysts) caused by?

A

infarction or hemorrhage into brain parenchyma due to insult in utero (abruption, trauma, infection) causing focal or widespread ischemia

153
Q

Porencephaly (Porencephalic Cysts) are a less sever form of?

A

hydranencephaly

154
Q

what is arnold-chiari malformation characterized by?

A

prolapse of hindbrain structures below the level of the foramen magnum

155
Q

what is type 1 of arnold-chiari malformation?

A

just a lip of cerebellum is downwardly displaced with the tonsils, but the fourth ventricle remains in the posterior fossa. This is mainly an incidental CT discovery.

156
Q

what is type 2 of arnold-chiari malformation?

A

: usually involved in prenatal cases and is a congenital deformity characterized by displacement of cerebellar tonsils, parts of the cerebellum, fourth ventricle, pons, and medulla oblongata through the foramen magnum into the spinal canal

157
Q

in 95% of arnold-chiaari malformations what is it accompanied by?

A

hydrocephalus and myelomeningocele.

158
Q

what is type 3 of arnold-chiari malformation?

A

more severe form, with large herniation of the posterior fossa content and myelomeningocele and hydrocephalus.

159
Q

what is banana sign associated with?

A

arnold-chiari malformation

160
Q

what are associated anomalies for arnold-chiari malformation?

A
  • Hydrocephaly from obstruction of the foramina of Magendie
  • Syringomyelia
  • Diastematomyelia
161
Q

what are most congenital spinal problems a result of?

A

defective closure of the neural tube during 4TH WEEK of embryonic development

162
Q

what do neural tube defects (NTD’s) also involve?

A

tissues overlying the spinal cord:

  • meninges
  • vertebral arch
  • muscles
  • skin
163
Q

what do neural tube defects elevate?

164
Q

what is spinal dysraphism?

A

is a broad medical term given to a group of anomalies that relate to:

  • Malformations in the dorsum of the embryo.
  • Neurological disorders related to malformations of the spinal cord.
165
Q

what are some neurological disorders related to malformations of the spinal cord?

A
  • NTDs fall under this group.
  • Failed fusion of dorsal spinal elements.
  • The spinal cord may become excessively wide because of abnormal fat or fibrous tissue lying inside the spinal canal.
  • Leg, bladder, or bowel function may also be affected.
166
Q

open spinal dysraphism?

A
  • Meningocele

- Myelomeningocoele

167
Q

closed spinal dysraphism?

A
  • Spinal dermal sinus
  • Lipomyelomeningcoele
  • Diastematomyelia
  • Neurentric cysts
  • Thickened filum terminale
168
Q

Spinal dermal sinus

A

an epithelium-lined tract from the skin to the spinal cord, cauda equina, or arachnoid.

169
Q

Lipomyelomeningcoele

A

usually presents as a subcutaneous fatty mass just above the intergluteal cleft.

170
Q

Diastematomyelia

A

split cordmalformation

171
Q

Neurentric cysts

A

type offoregut duplication cyst, associatedeitherwith vertebral or CNS abnormalities. They most commonly occur in the thoracic region.

172
Q

Thickened filum terminale

A

thickened fatty filum terminale

173
Q

what is tight filum terminale syndrome caused by?

A

incomplete involution of the distal spinal cord during embryogenesis.

174
Q

what does tight filum terminale syndrome lead to?

A

development of an abnormally thickenedfilum terminale, which may be associated with lipomas or cysts within the filum

175
Q

what is tight filum terminale syndrome always associated with?

A

spinal cord tetheringand an abnormally positioned conus medullaris: below L2-3 (normal range: L1-L2)

176
Q

what are the clinical symtoms of tight filum terminale syndrome?

A

Neurologic deficiencies, pain or dysesthesia, and bladder or bowel dysfunction.
-Due to stretching of the spinal cord resulting in vascular insufficiency at the level of theconus medullaris.

177
Q

what are common findings for tight filum terminale syndrome?

A

associated verterbral body deformities and spina bifida

178
Q

what does tight filum terminale syndrome show on US?

A
  • abnormally thickened filum terminale

- the diameter of the filum terminale exceeds 2 mm (normal range, 0.5–2 mm) at the level of L5-S1

179
Q

what is tethered spinal cord a form of?

A

spinal dysraphism

180
Q

what happens in tethered spinal cord?

A

spinal cord is attached to surrounding tissue

181
Q

how is tethered spinal cord diagnosed?

A

detection of certain skin abnormalities along the midline of the back.

182
Q

what is spina bifida?

A

Neural tube defects (NTDs) involving the vertebral arches

183
Q

what are common to all types of spina bifida?

A

Non-fusion of the embryonic halves of the vertebral arches

184
Q

what is spina bifida occulta?

A

closed

  • Dorsal vertebrae not fused (but no underlying structures protrude through defect)
  • Often tuft of hair/dermal lesion over affeced area
185
Q

what is spina bifida aperta=cystica?

A

open

-defect of skin, underlying soft tissue, and vertebral arches

186
Q

Meningocele

A

meningeal membrane and CSF protrude through defect in vertebral arch (note: skin mostly intact)

187
Q

Myelomeningocele

A

meningeal membrane, CSF, and neural tissue (spinal cord) protrude through defect (note: skin partly covers defect)

188
Q

Myeloschisis

A

open, flattened spinal cord, exposed through a wide defect in the posterior neural arch + defect in musculature and skin (no skin or meningeal covering

189
Q

Rachischisis

A

Complete Spina Bifida) – cleft through entire spine from cervical to sacral region – open, flattened spinal cord (note: entire spinal cord is exposed)

190
Q

what is the indication if spina bifida occulta (closed)?

A

dimple, tuft of hair, or a red mark on the back

191
Q

what is the most severe and common spina bifida?

A

myelomeningocele

192
Q

Cystica

A

Involving protrusion of the meninges and spinal cord through the defect in the posterior vertebral arch.

193
Q

Spina Bifida with meningocele

A

If the mass contains only meninges with CSF

194
Q

what is the mildest form of spina bifida?

195
Q

where do the meninges protrude in cystica?

A

Meninges protrudeunder the skinthrough the cleft in the malformedvertebral arch

196
Q

Spina Bifida with meningomyelocele

A

If the spinal cord and/or nerve roots protrude in the mass

197
Q

what is the most severe form of myelomeningocele?

A

spina bifida with myeloschisis

198
Q

what does myeloschisis appear as?

A

a flattened, plate-like mass of nervous tissue with no overlying membrane.

199
Q

what can myeloschisis result in?

A

some degree ofparalysisand loss of sensation below the level of the spinal cord defect

200
Q

what is the most severe form of spina bifida aperta?

A

myeloschisis (rachischisis)

201
Q

how does myeloschisis (rachischisis)appear?

A

nerve tissue is fully bare and a dermal or meningeal covering is absent

202
Q

what do many individuals with spina bifida have?

A

an associated abnormality of thecerebellum, called theArnold Chiari II malformation.

203
Q

in 90% of people with myelomeningocele, what may occur with the brain?

A

hydrocephalus because of displaced cerebellum interfering with normal flow of cerebrospinal fluid

204
Q

with spina bifida the ___________ is abnnormally developed in 70-90% of individuas?

A

corpus collosum

205
Q

what are the sonographic signs of spina bifida?

A
  • Nonvisualization of cisterna magna
  • Deformation of cerebellum (banana sign)
  • Concave frontal bones (lemon sign)
  • Dilation of lateral ventricles
  • Chiari II malformation (97%)
  • Biparietal diameter lower than expected
206
Q

how does the banana sign happen?

A

produced by the caudal shift of the posterior contents of the skull, forcing the cerebellar hemispheres to wrap around the brain stems.

207
Q

what is spinal curvature most frequently associated with?

A

NTD and spinal bifida meningomyelocele

208
Q

scoliosis

A

lateral curvature of the spine

209
Q

Kyphosis

A

refers to an exaggerated rounding of the back in the sagittal plane.

210
Q

Hemivertebra

A

a type of vertebral anomaly and results from a lack of formation of one half of a vertebral body.

211
Q

what is a Sacrococcygeal Teratoma?

A

Tumours that arise from embryonic cells of the coccyx.

212
Q

what are the most common congenital tumors in the newborn?

A

Sacrococcygeal Teratoma

213
Q

what do Sacrococcygeal Teratoma appear as?

A

Most are large, external and solid or complex masses that extend outward from the lower part of the sacrum and buttock.

214
Q

are Sacrococcygeal Teratomas benign or malignant?

215
Q

what are Sacrococcygeal Teratomas not associated with?

A
  • Are not associated with a distinct vertebral abnormality

- Are not associated with cranial abnormalities

216
Q

what is caudal regression syndrome?

A

Spinal abnormalities include grossly distorted or absent vertebrae beginning at the thoracic level (sacral agenesis).

217
Q

what is caudal regression syndrome (CRS) strongly associated with?

A

poorly controlled diabetes

218
Q

what does sacral agenesis present as?

A
  • Caudal regression sequence or sacral agenesis (abnormal fetal development of the lower spine)
  • Sirenomelia sequence (legs are fused together)
  • Cloacal exstrophy sequence (defect of the ventral body wall)
  • VACTERL association
219
Q

what is vacterl associatation?

A
  • vertebral anomalies
  • imperforate anus
  • cardiac malformations
  • tracheoesophageal fistula
  • renal dysplasia
  • limb abnormalities
220
Q

spinal arachnoid cyst?

A

benign cystic lesions formed due to splitting of the arachnoid membrane

Abnormal OB (7 decks)

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