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OB/GYN pathology > head/brain > Flashcards

head/brain Flashcards

1
Q

what dies MSAFP stand for?

A

maternal serum alpha-fetoprotein

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2
Q

greater than 2.5 standard deviations from the median is abnormal & suggests what?

A

an open neural tube defect (NTD)

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3
Q

an increased fundal height raises suspicion for?

A

polyhydramnios

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4
Q

what is associated with a lemon shaped head?

A

spina bifida

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5
Q

a strawberry shaped head is associated with what?

A

trisomy 18

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6
Q

brachiocephy is a rounded head shape

true/false

A

true

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7
Q

what is brachiocephaly associated with?

A

chromosomal abnormalities

genetic syndromes

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8
Q

dolicocephaly is generally due to head molding in the vertex position
true/false

A

false; breech position

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9
Q

what is ventriculomegaly?

A

ventricular enlargement characterized by excessive CSF w/in cerebral centricles

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10
Q

what are some things that can cause ventriculomegaly?

A

obstruction to outflow (hydrocephalus)
decreased CSF absorption
overproduction of CSF

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11
Q

what is hydrocephalus?

A

term for ventricular enlargement secondary to increased intracranial pressure &/or head enlargement

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12
Q

the atrium of the lat vents shoukd not exceed:

A

10 mm

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13
Q

what is the most common type of intraventricular obstruction?

A

aqueductal obstruction (stenosis)

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14
Q

what are the other types of intraventricular obstructions?

A

chiari II malformation

dandy walker malformation

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15
Q

what is a cause for extraventricular obstruction?

A

arachnoid cyst

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16
Q

what are some additional anamalies that may be present with ventriculomegaly?

A 
spina bifida
dandy walker syndrome
encephalocele
cardiac malformations
renal malformations
abnormal karyotypes
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17
Q

what is the sonographic appearance of ventriculomegaly?

A

excess fluid in lateral & 3rd vents
atrium greater than 10mm
choroid plexus may dangle w/in CSF

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18
Q

what are some other associated so ographic findings of ventriculomegaly?

A

polyhydramnios
abnormal fetal lie
hepatomegaly & fetal ascites
meningomyelocele

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19
Q

what may be present with anencephaly?

A

portions of the midnrain & brain stem

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20
Q

what are some other features of anencephaly?

A

buldging eyes
macroglossia
very short neck
AFP will be elevated

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21
Q

with anencephaly, the face & orbits will be present, giving the face what type of appearance?

A

frog-like

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22
Q

what are some other sonographic findings associated with anencephaly?

A
  • major portions of cranium & intracranial strctures are absent
  • polyhydramnios
  • talipes (club foot) also a common finding

can be diagnosed as early as 12wks

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23
Q

a bony defect in the skull allows herniation of intracranial contents. what are those types of herniations called?

A

cranial meningocele

encephalocele

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24
Q

encephalocele contains only meninges & CSF

true/false

A

false; contents inclue brain & CSF

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25
Q

what is the most common site for a herniation of the skull? what are the other sites?

A

occipital

frontal
parietal

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26
Q

what could cause an encephalocele?

A

amniotic bands

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27
Q

what is the sonograhic appearance of an encephalocele?

A

may be cystic near the cranium

brain tissue may be present w/in the mass

28
Q

what is holoprosencephaly?

A

incomplete cleavage or diverticulation of primitive forebrain into 2 hemispheres

29
Q

what is holoprosencephaly strongly associated with?

A

trisomy 13

30
Q

what are the 3 classifications of holoprosencephaly?

A

alobar
semilobar
lobar

31
Q

which is the most severe form of holoprosencephaly?

a. semilobar
b. a bar
c. lobar
d. alobar

A

d. a lobar

* lacking 2 hemispheres*

32
Q

what brain structures are absent with alobar?

A

falx
corpus callosum
cavum septum

33
Q

what are the facial abnormalities associated with alobar?

A

hypotelorism
cyclopia
midline facial clefts

34
Q

semilobar resembles lobar

true/false

A

false; it resembles alobar

35
Q

what facial abnormality is associated with semilobar?

A

cleft lip/palate

36
Q

what is the least severe form of holoprosencephaly?

a. alobar
b. the bar
c. lobar
d. semilobar

A

c. lobar

* 2 hemispheres are present*

37
Q

what is dandy-walker complex?

A

congenital malformation of the posterior fossa, specifically the cerebellar vermis

38
Q

what is dandy-walker malformation?

A

small or absent cerebellar vermis

cisterna magna enlargement

39
Q

which of the following is a variant of dandy-walker?

a. arnold-walker
b. vermian hypoplasia
c. dandy hyperplasia
d. vermian hyperplasia

A

b. vermian hypoplasia

40
Q

why is it not possible to diagnose vermian hypoplasia until after 18wks?

A

vermis not developed until 18wks

41
Q

what are other associations of dandy-walker?

A

ventriculomegaly
agenesis of corpus callosum
spina bifida
microcephaly

42
Q

what is the sonographic appearance of dandy-walker?

A
  • complete or partial agenesis of the cerebellar vermis

* cisterna magna enlargement (>10mm)

43
Q

what is arnold chiari type II malfirmation?

A

displacement of cerebellar vermis, 4th ventricle, & medulla oblongata through the foramen magnum into the upper cervixal canal

44
Q

what is arnold chiari II frequently associated with?

A

spinal dysraphia

45
Q

cerebellum will be compressed against the back of the cranium demonstrating what sign?

A

banana sign

46
Q

what is microcephaly?

A

small head circumference measuring more than 3 standard deviations below the normal

47
Q

what is associated with microcephaly?

A

intrauterine infections
aneuploidy/syndromes
underlying CNS anomaly

48
Q

what is the sonographic appearance of microcephaly?

A 
small BPD
decreased HC/AC ratio
poor cranial growth in serial scans
no definitive nasal/forhead differentiation
high false positive rate
49
Q

the corpus callosum is the smalles neural tract connecting the cerebral hemispheres
true/false

A

false; it’s the largest

50
Q

what is agenesis of the corpus callosum (ACC)?

A

the failure of the development of the corpus callosum that may be partial or complete

51
Q

what other abnormalities are commonly associated with ACC?

A 
trisomies (especially 18 & 13)
holoprosencephaly
median facial clefts
dandy-walker
other syndromes or CNS anomalies (schizencephaly or lissencephaly)
52
Q

what are some clinical associations of ACC?

A

isolated ACC may be asymptomatic
low intelligence
seizures
poor motor coordination

53
Q

what is the sonographic appearance of ACC?

A
  • disproportionate enlargement of occipital horns (colpocephaly)
  • lateral displacement of both medial & lateral ventricular walls
  • widely separated lateral ventricular frintal horns
  • ventricles may demonstrate teardrop shape
  • absence of cavum septum pellucidi
54
Q

the vein of galen aneurysm is a true aneurysm

true/false

A

false

55
Q

what is hydranencephaly?

A

destructive process causing total or near total absence of cerebrum

it is the most severe degree of porencephaly or brain destruction

56
Q

what is the MOST common cause of hydranencephaly?

A

occlusion of the carotid arteries in the first or early second trimester

57
Q

what is the sonograohic appearance of hydranencephaly?

A
  • head size commonly normal but can be small or large
  • falx is present but may be displaced or hypoplastic
  • variable presence of 3rd vent
  • may be difficult to distinguish from a severe hydrocephaly
58
Q

what destructive process crates a cleft in the cerebral cortex?

a. hydrancephaly
b. lissencephaly
c. spina bifida
d. schizencephaly

A

d. schizencephaly

59
Q

what is the sonographic appearance of schizencephaly?

A

fluid-filled clefts in the cerebral cortex that can be uni/bi lat

60
Q

what is associated with schizencephaly?

A

midline brain defects
ventriculomegaly
septic optic dysplasia
agenesis or dysgenesis or the corpus callosum
absence of septum pellucidum
heterotopias (displacement of gray matter)
polymicrogyria (many folds on surface of brain)

61
Q

lissencephaly has a smooth brain surface with normal sulci & gyri
true/false

A

false; it does not have sulci & gyri

62
Q

when is lissencephaly usually diagnosed?

A

third trimester

63
Q

what is associated with lissencephaly?

A

agenesis of corpus callosum
dandy-walker
colpocephaly

64
Q

what are porencephalic cysts?

A

cysts filled with CSF that communicate w/ the ventricular system

65
Q

are choroid plexus cysts malignant or benign?

A

benign

OB/GYN pathology (7 decks)

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