Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

MIDS 187 > Ch 3 Head, Face, Neck > Flashcards

Ch 3 Head, Face, Neck Flashcards

1
Q

At approx. 6 menstrual weeks the neural tube differentiates into what 2 structures?

A

-Primitive brain
-Spinal cord

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Name the primary vesicles in the brain that occur at approx. 7-8 weeks?

A

-Prosencephalon (forebrain)
-Mesencephalon (midbrain)
-Rhombencephalon (hindbrain)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What weeks are defined as the critical period of brain development?

A

Between week 3-16 b/c many structures develop then

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

List 3 things that have impacts on brain development?

A

-Folic acid deficiency (moms should take 400-1000mg daily when expecting pregnancy)

-Toxoplasmosis (parasitic infection common in cat feces when scooping litter box + inhaling dusts)

-High radiation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is microcephaly?

A

Small head - based on biometry (not u/s appearance)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

The head perimeter for microcephaly is how many standard deviations below the mean for gest age?

A

2-3

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

With microcephaly, a qualitative evaluation of intracranial structures is used to supplement diagnosis in:

A

-Sloping forehead
-Macrogyria, microgyria (referring to size of cerebral brain folds)
-Enlarged ventricles (sometimes)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What virus can be responsible for microcephaly?

A

Zika virus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is macrocephaly?

A

Large head

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

With macrocephaly, the HC will be how many standard deviations above the mean?

A

2-3

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

M/C cause for macrocephaly?

A

Hydrocephalus, or other intracranial abnormalities

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Which artery is a major branch of the circle of Willis in the fetal brain?

A

Middle cerebral artery (MCA)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Which artery carries more than 80% of cerebral blood flow?

A

MCA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What would doppler on the main cerebral artery be useful in evaluating?

A

A growth restricted fetus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Is peak MCA velocity or an elevated pulsatility index better at predicting perinatal death?

A

Peak MCA velocity

(interrogate MCA at less than 15 degree angle)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

How many measurements should we take when interrogating the MCA?

A

At least 3, using highest as final value

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Normal measurement for cisterna magna?

A

Less than 10mm (inner to inner)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Where is the cisterna magna?

A

Anechoic space posterior to cerebellum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What is the vermis?

A

Echogenic area in center of cerebellum that divides the cerebellum into its 2 halves

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What kind of measurement is the cerebellum?

A

Outer to outer

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

During what week range does the TRV cerebellar diameter (in mm) correlate with gest age?

A

B/w 16-24 weeks there is a 1:1 ratio

(ex 19 week fetus will have a 19mm cerebellum)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

B/w what weeks do the lateral ventricles fill largely with choroid plexus?

A

12-13 weeks

(CP is echogenic + inside the anechoic ventricles)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Purpose of choroid plexus?

A

Produces + reabsorbs CSP

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Normal lateral ventricle measurement?

A

Less than 10mm (inner to inner)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

At what level do we measure the lateral ventricles?

A

Level of the atria of the ventricle

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

What are the segments of the lateral ventricles?

A

-Body
-Anterior, posterior + temporal horns

(remember can NOT be seen in a single plane)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Do we typically measure the inner orbital diameter (IOD) + outer orbital diameter (OOD)?

A

No, doctor would do this

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Why would we measure the IOD + OOD?

A

-To determine gest age for dating if there is malformed cranial structures
-To assess for hypotelorism + hypertelorism

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

What 2 structures outline the lens of the eye?

A

-Ciliaris muscles
-Zonular fibers

(looks like circular area on front of globe/eye)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Is the vitreous humor, extraocular muscles + ophthalmic artery and nerve always seen in the eye on u/s?

A

No, only sometimes seen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Do we typically measure the ears?

A

No, can use length as alternative biometric measurement if needed (b/c ear length follows a linear growth pattern)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

In early gestation, where do the primitive eye structures lie?

A

Lateral + dorsal, which then becomes the face

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

The facial structures + eyes migrate to midline to locate in the normal location by when?

A

End of 1st trimester

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Hypotelorism (decreased IOD) is almost always found with severe anomalies, m/c one is?

A

Holoprosencephaly

(when brain fails to separate into L/R hemispheres)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

What can extreme cases of hypertelorism (increased IOD) cause?

A

Significant mental development delays

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

What is micropthalmia + what is it caused by?

A

Decreased orbit size - due to chromosomal abnormalities or intrauterine infections

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

What is anopthalmia?

A

Absence of eyes (no orbit, optic nerves, chiasma or tracts)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

What is macroglossia?

A

Enlarged tongue (-glossia) extending past teeth or aveolar ridge

(profile view with trisomy 21 + beckwith-weidmann syndrome have this feature present)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

What is micrognathia?

A

Severely hypoplastic (underdeveloped) mandible/jaw

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

Is micrognathia usually an isolated finding?

A

No, only 40% of the time is

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

What syndromes + malformations are associated with micrognathia?

A

Syndromes:
-Pierre robin sequence
-Hemifacial microsomia (ex treacher collins)

Malformations:
-Skeletal dysplasias
-Trisomy 13 + 18

(also seen with alcohol exposure)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

What anomaly is often seen with alcohol exposure?

A

Micrognathia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

Fetuses with mandible anomalies like micrognathia are at risk for what?

A

Acute neonatal respiratory distress

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

What is cleft lip + palate?

A

-Lack of fusion of embryologic grooves in the maxillary OR intermaxillary segment
-Leads to unilateral OR bilateral cleft lip or palate

(palate is roof of mouth)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

What is the m/c craniofacial anomaly + 2nd m/c congenital malformation overall?

A

Facial clefts (13% of all anomalies)

46
Q

List the incidence rates for cleft lip/palate in various populations?

A

Whites: 1:1,000 (m/c males)
American Indians: 1:300
Asians: 1:600
Africans: 1:2,500

47
Q

Can an isolated cleft lip occur independently from chromosomal abnormalities?

A

Yes

48
Q

In cases of cleft lip + cleft palate, do most occur with other abnormalities?

A

Yes, usually part of a trisomy

49
Q

What anomaly is m/c found with an isolated CL or CP?

A

Clubfoot

50
Q

With combination of CL + CP, what is the m/c finding?

A

Polydactyly

51
Q

What disease is likely to occur with CL or CP?

A

Congenital heart disease

52
Q

What type of cleft lip is m/c?

A

Unilateral cleft lip (type 1)

53
Q

Classification of clefting defects depend on what?

A

Severity of the malformation

(m/c nostril + central posterior palate connect)

54
Q

If the CL/CP extends through the hard palate, alveolar ridge, involves the nasal cavity + orbit, this is classified as what?

A

A severe case

55
Q

What is meroanencephaly?

A

Partial development of the brain, fetus has some functioning brain tissue + a rudimentary brain stem

(anencephaly is when a fetus has no brain)

56
Q

What is the m/c neural tube defect?

A

Anencephaly

57
Q

Can fetuses live with meroanencephaly?

A

No, always lethal (deathly)

58
Q

How common is anencephaly?

A

1:1,000 (m/c females)

59
Q

What is acrania?

A

Absence of entire skull

(including skull base, therefore there is only a thin layer covering the brain, if that even)

60
Q

Sonographic diagnosis of anencephaly is usually possible during what gest age?

A

1st trimester b/w 10-14 weeks

(typically not before 12 weeks gestation b/c skull vault is not usually formed + seen until then)

61
Q

At what week does the skull vault form + become apparent?

A

12 weeks gestation

62
Q

In early 2nd trimester, rudimentary brain tissue is covered by a membrane (not bone) + may be seen protruding from the base of the skull with meroanencephaly, what happens afterwards?

A

It gradually degenerates until the appearance of the head is completely flattened behind the facial structures

63
Q

With anencephaly, what do the facial views reveal?

A

Prominent bulging eyeballs producing a froglike appearance

64
Q

Is high or low fetal activity often seen with anencephaly?

A

High b/c lacking brain control (appears spastic + lots of jerking movements)

65
Q

What is hydrancephaly?

A

-Near complete or complete absence of cerebral cortex (brain)
-Destruction of previously normal brain + replaced with fluid

66
Q

Is hydrancephaly common?

A

Rare, less than 1 in 10,000 births

67
Q

Cause of 3rd trimester brain destruction (hydrancephaly)?

A

-Maternal toxoplasmosis (cat litter box dusts)
-Cytomegalovirus
-Herpes simplex
-Carbon monoxide exposure

68
Q

What is holoprosencephaly?

A

-Abnormalities of brain + face
-Due to incomplete cleavage + rotation of embryonic forebrain (normally it rotates inwards)
-Resulting in a single central ventricle + a missing falx

69
Q

What anomaly is associated with holoprosencephaly?

A

Hypotelorism

70
Q

What 2 maternal factors can cause holoprosencephaly?

A

-Diabetes
-Teratogens (ex alcohol) which harms development in the 3rd week

71
Q

Is holoprosencephaly isolated + sporadic?

A

Yes, not likely going to occur again in next pregnancy

72
Q

Holoprosencephaly is separated into how many varieties?

A

3: alobar, semilobar + lobar

(alobar is worst form b/c no division of cerebral cortex into separate hemispheres)

73
Q

Which form of holoprosencephaly carries the worst prognosis?

A

Alobar

74
Q

What is the corpus callosum?

A

-Large neural commissure connecting 2 cerebral hemispheres
-Bundles of fibers connect the 2 hemispheres

75
Q

When does the corpus callosum start developing?

A

12 weeks gestation

76
Q

What is ACC?

A

-Rare congenital disorder with complete or partial absence of corpus callosum
-M/c associated with other anomalies

77
Q

What anomalies are associated with ACC?

A

-Trisomy 13 + 18
-Hydrocephalus
-DWC
-Arnold chiari
-Holoprosencephaly

78
Q

What only symptom may children with isolated ACC experience?

A

Seizures

79
Q

SF of ACC (agenesis of corpus callosum)?

A

Enlargement of occipital horns resulting in teardrop appearance of lateral ventricles (colpocephaly)

80
Q

What are arnold-chiari malformations?

A

Group of anomalies of hindbrain, below foramen magnum (there are 4 types of malformations)

81
Q

What is type 2 arnold-chiari?

A

Congenital deformity with displaced cerebellar tonsils, parts of cerebellum, 4th ventricle, pons + medulla oblongata through the foramen magnum into the spinal canal

82
Q

What is the banana sign with type 2 arnold-chiari?

A

The displacement of the cerebellum inferiorly changes its shape + wipes out the cisterna magna, causing it to look like a banana

(cerebellum normally looks like a dumbbell)

83
Q

Type 2 arnold-chiari are found exclusively in fetuses with what?

A

Myelomeningocele (type of spina bifida)

84
Q

What is dandy-walker?

A

-Abnormalities of posterior fossa, that may not be possible to differentiate on imaging

85
Q

List the 3 forms of dandy-walker?

A

-Dandy walker malformation (end in termination)
-Dandy walker variant (end in termination)
-Mega cisterna magna (good prognosis if isolated finding)

86
Q

What is dandy-walker malformation?

A

-Most severe form
-Cystic dilatation of 4th ventricle which may fill posterior fossa up
-Complete or partial agenesis of cerebellar vermis
-Elevated tentorium

87
Q

What is dandy-walker variant?

A

-Less severe
-Partial agenesis of vermis
-No large dilated cystic 4th ventricle

88
Q

What is mega cisterna magna?

A

-Normal cerebellar vermis + 4th ventricle
-Enlarged cisterna magna

89
Q

What is ventriculomegaly?

A

-Enlarged brain ventricles
-Several causes
-Nonspecific finding

90
Q

Possible causes of ventriculomegaly?

A

-Intraventricular or extraventricular obstruction
-Decrease in brain substance
-Increase in CSP production (rarely)

91
Q

What is hydrocephalus?

A

Ventriculomegaly with increased intracranial pressure + head size

(often associated with spina bifida)

92
Q

What is “dangling choroid plexus”?

A

Enlarged ventricles + CSP displacement of choroid plexus

(slide image can see large ventricle with CP dangling in it)

93
Q

Normal, mild + severe lateral ventricle measurement?

A

Normal: <10mm
Mild: 10-15mm
Severe: >15mm

94
Q

Are choroid plexus cysts common?

A

Yes, found in 1-6% of all fetuses

95
Q

Should we be worried if we see CP cysts?

A

-Not necessarily, usually w/o significance + resolves by end of 2nd trimester
-However, they have an association with trisomy 18 + other chromosomal abnormalities

96
Q

Where do CP cysts develop?

A

In atria of lateral ventricles

(can mimic ventriculomegaly if large)

97
Q

Measurement of CP cysts?

A

Must be over 2mm

98
Q

Landmarks for our nuchal fold measurement?

A

-Cerebellar vermis
-CSP
-Thalamus

(outer skull to outer skin)

99
Q

What is the upper limit of normal for nuchal fold thickness?

A

Less than 6mm

(>6mm abnormal on u/s at 18-22 weeks)

100
Q

We measure the NF b/c it is a soft marker for?

A

Aneuploidy, m/c down syndrome

101
Q

What is a soft marker?

A

U/s feature seen mid pregnancy that may indicate an increased chance of a fetal chromosomal abnormality

102
Q

What is a cystic hygroma?

A

-Fluid filled bump on the back of the fetuses neck
-Occurs when the jugular lymph sacs fail to communicate with venous system, they fill with lymph + enlarge, then form cystic hygromas

103
Q

What do normal fetal lymphatic vessels drain into?

A

2 large sacs lateral to jugular veins

104
Q

Are cystic hygromas m/c single or multiloculated fluid filled cavities?

A

Multiple, but can be either

105
Q

What conditions cause an increased chance of hygromas in 1st trimester?

A

Autosomal trisomies + trisomy 21

106
Q

In midpregnancy, what syndrome is a predominant finding with hygromas?

A

Turner syndrome (chromosomal abnormality)

107
Q

A hygroma with nonimmune hydrops has a strong association with abnormal karyotypes, can the fetus still live?

A

No, mid pregnancy mortality rate close to 100%

108
Q

If a fetus has an isolated hygroma, can it still live?

A

Yes, good outcome

109
Q

Which abnormality has 3 variations?

A

Dandy walker malformation

110
Q

What mineral has an affect on brain development?

A

Folic acid

111
Q

Meroencephaly is also known as?

A

Anencephaly

MIDS 187 (19 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions