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Chapters 25-29 > Fetal Spine and Musculoskeletal System > Flashcards

Fetal Spine and Musculoskeletal System Flashcards

1
Q

Axial skeleton begins to form between __________ menstrual weeks

A

6-8

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2
Q

The axial skeleton consists of the bones of the _______ and _________

A

cranium and spine

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3
Q

As pregnancy progresses, the skull and skeletal bones become more:

A

echogenic

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4
Q

The spine consists of five sections:

A

cervical, thoracic, lumbar, sacrum, and coccyx

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5
Q

Each fetal vertebra consists of 3 echogenic ossification centers:

A

one centrum and 2 neural processes

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6
Q

The centrum will eventually form the :

A

vertebral body

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7
Q

The neural process of each vertebra will become :

A

lamina, pedicle, transverse process, spinous process, and articular process.

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8
Q

The structure that runs the length of the spine and contains the spinal cord:

A

vertebral column

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9
Q

The echogenic laminae are normally angled:

A

inward

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10
Q

With spina bifida the echogenic laminae will be angled:

A

outward or be splayed

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11
Q

The spinal cord appears as a ________ linear structure.

A

hypoechoic

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12
Q

The most common neural defects:

A

anencephaly and spina bifida

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13
Q

Helpful for detecting neural tube defects is the _______ component of the test

A

MSAFP

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14
Q

AFP exits the fetus through an opening in the ____________ if one is present, such as with open spina bifida.

A

neural tube

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15
Q

______________ bifida is not associated with elevated MSAFP

A

closed spina

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16
Q

A supplement of 4 mg of _____ in a woman’s diet significantly reduces the likelihood of the fetus developing spina bifida

A

folate (folic acid)

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17
Q

_____________ neural tube defect that occurs when the embryonic neural tube fails to close.

A

Spina Bifida

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18
Q

Spina bifida may also be referred to as :

A

spinal dysraphism, meningocele, and meningomyelocele (myelomeningocele)

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19
Q

Spina bifida can be subdivided into two types:

A

Spina bifida occulta (closed) and Spina bifida aperta (open)

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20
Q

Occult (closed) lesions are completely covered by _______

A

skin

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21
Q

With spina bifida _____, the vertebrae fail to close, there is no herniation of the spinal contents outside of the spinal column.

A

occulta

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22
Q

In the postnatal period, spina bifida occulta is suspected when a _________, __________, ___________ or excessive __________ is identified directly over the distal spine.

A

sacral dimple, hemangioma, lipoma, excessive hair

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23
Q

_________________, an open lesion, is the most common form of spina bifida and the type more frequently recognized in utero

A

spina bifida aperta

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24
Q

____________ and __________ are forms of spina bifida aperta.

A

meningocele and meningomyelocele

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25
Q

Meningocele and meningomyelocele are specifically referred to as

A

spina bifida cystica

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26
Q

Meningocele’s contain:

A

meninges only

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27
Q

Myelomeningocele, contain:

A

meninges and nerve roots

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28
Q

The most common location of Spina bifida:

A

lumbosacral area

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29
Q

The _______ the location of the spina bifida, the greater the neurologic impairment.

A

higher

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30
Q

Spina bifida is often initially recognized by its associated cranial findings, a group of abnormalities referred to as :

A

Arnold-Chiari II malformation

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31
Q

The pressure of a large mass in the distal spine pulling on the spinal cord causes malformations of the cranium and intracranial contents. The frontal bones become flattened and will yield a _________ shaped cranium.

A

lemon

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32
Q

The “lemon sign” is often described as :

A

scalloping of the frontal bones

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33
Q

It is most helpful to analyze the _______ fossa of the cranium for abnormalities when a “lemon sign” is suspected.

A

posterior

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34
Q

The cerebellum will become displaced inferiorly and posteriorly and appear curved in the presence of spina bifida. This is referred to as:

A

banana sign

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35
Q

When the cerebellum is displaced inferiorly due to spina bifida, the cisterna magna is:

A

completely obliterated or non-existent

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36
Q

The lateral ventricles will appear _______ with spina bifida.

A

enlarged and distorted in shape

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37
Q

With spina bifida the frontal horns will be small and slitlike, while the occipital horns will be enlarged, a condition is known as:

A

colpocephaly

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38
Q

In the presence of spina bifida, the posterior ossification elements or laminae will often appear:

A

splayed in the transverse plane

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39
Q

A meningocele will appear as a ______ mass protruding from the spine.

A

simple cystic

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40
Q

A meningomyelocele tends to appear more ______

A

complex

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41
Q

Differential diagnosis of meningocele/meningomyelocele:

A

sacrococcygeal teratoma

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42
Q

A fetus with ______ _____ will most likely have normal head and intracranial anatomy, while the intracranial anatomy of a fetus with spina bifida is often altered.

A

sacrococcygeal teratoma

43
Q

Fetal surgery can be performed on the fetus with spina bifida when a mass is identified on spine, as early as :

A

16 weeks

44
Q

A deformity of the spine in which there is an abnormal lateral curvature:

A

scoliosis

45
Q

The spine will appear ___ shape in the affected region of scoliosis.

A

S

46
Q

An abnormal posterior curvature of the spine:

A

kyphosis

47
Q

When there is an abnormal of both the lateral and posterior curvature of the spine it is termed:

A

kyphoscoliosis

48
Q

___ referred to as body stalk anomaly, is a rare group of fetal defects.

A

LBWC - limb body wall complex

49
Q

The most common sonographic findings of LBWC are :

A

short or absent umbilical cord, ventral wall defects, limb defects, craniofacial, (exencephaly or encephalocele), and scoliosis

50
Q

The fetus with Limb body wall complex will appear:

A

closely connected with the placenta and will have marked scoliosis.

51
Q

With limb body wall complex, because of the opening in the ventral wall, elevated levels of ____ can be detected in the second trimester.

A

MSAFP

52
Q

___________ has very similar sonographic findings and may be seen simultaneously with limb body wall complex.

A

Amniotic band syndrome

53
Q

________ denotes the abnormal development of a structure.

A

dysplasia

54
Q

Four most common skeletal dysplasias :

A

achondroplasia, achondrogenesis, osteogenesis imperfecta, and thanatophoric dysplasia

55
Q

_______ is the most common non-lethal skeletal dysplasia.

A

heterozygous achondroplasia

56
Q

Heterozygous achondroplasia is a type of _____

A

dwarfism

57
Q

Proximal portions of limbs, the humeri, and femurs, are much shorter than the distal portion of the limbs, a condition known as :

A

rhizomelia

58
Q

Achondroplasia can also be _______ this is fatal and occurs when both parents are dwarfs.

A

homozygous

59
Q

Rhizomelia is typically not detected until after ____ weeks gestation

A

24

60
Q

When rhizomelia is detected there is a notable difference in the gestational age measurements between the:

A

BPD and femur length

61
Q

Sonographic findings of achondroplasia include:

A

micromelia, macrocrania, frontal bossing, flattened nasal bridge, and trident hand

62
Q

Achondrogenesis is a rare, lethal condition resulting in:

A

absent mineralization of the skeletal bones

63
Q

________ is apparent when there is deficient ossification of the fetal spine, pelvis, and cranium, ultimately leading to stillbirth or early death.

A

achondrogenesis

64
Q

With achondrogenesis the fetus will suffer from :

A

severe limb shortening and may have rib fractures

Polyhydramnios is often present as well

65
Q

Commonly known as brittle bone disease, is a group of disorders that results in multiple fractures that can occur in utero:

A

osteogenesis imperfecta

66
Q

There are ___ different types of osteogenesis imperfecta:

A

4

67
Q

The uniformly fatal form of osteogenesis imperfecta is:

A

type II - is the most severe type of the disease

68
Q

Osteogenesis imperfecta type II results in :

A

multiple fractures in utero, skull demineralization, bell-shaped chest, and decreased fetal movement

69
Q

One distinctive finding of osteogenesis imperfecta type II is that when the transducer pressure is applied the skull, the shape of the :

A

soft skull can be distorted

70
Q

“death bearing” dysplasia is the most common lethal skeletal dysplasia

A

thanatophoric

71
Q

The fetus with thanatophoric dysplasia will have a ____ skull with _______ and _______

A

cloverleaf, frontal bossing, and hydrocephalus

72
Q

The shortened long bones of a fetus with thanatophoric dysplasia take on a _______ shape

A

telephone receiver

73
Q

The diaphysis of the long bones, of the fetus with thanatophoric dysplasia, will be _____ and have prominent metaphyseal ends.

A

bowed

74
Q

The ____ and ____ circumference will be remarkably dissimilar, leading to a bell-shaped chest. (thanatophoric dysplasia)

A

thoracic and abdominal

75
Q

With thanatophoric dysplasia the thorax will be remarkably narrow, resulting in _____ of the lungs.

A

hypoplasia

76
Q

Fetuses with thanatophoric dysplasia typically die shortly after birth, succumbing most often to _________ _____ as a result of pulmonary hypoplasia.

A

respiratory distress

77
Q

May also be referred to as sacral agenesis.

A

caudal regression syndrome

78
Q

Sonographic findings of caudal regression syndrome:

A

absence of sacrum and coccyx

79
Q

___________ _____ ______ has a strong associated with caudal regression syndrome.

A

Uncontrolled maternal diabetes

80
Q

Also referred to as mermaid syndrome because of the fusion of the lower extremities that occurs.

A

sirenomelia

81
Q

Bilateral _______ _____ often accompanies sirenomelia.

A

renal agenesis

82
Q

What else may be seen with sirenomelia:

A

oligohydramnios, cardiac anomalies, genital absence, and two-vessel cord.

83
Q

Like caudal regression syndrome, ____ _______ ________ seems to pay a role in the development of this disorder.

A

uncontrolled maternal diabetes

84
Q

A germ cell tumor, that has been cited as the most common congenital neoplasm and is more frequently found in females:

A

sacrococcygeal teratoma, SCT

85
Q

A SCT will appear ______ or ______ extending posteriorly and inferiorly from the distal fetal spine.

A

complex / solid mass

86
Q

A SCT has the potential to grow inside of the pelvis and may cause destruction of the :

A

sacrum and pelvic bones

87
Q

The appendicular skeleton begins to form between ____ and ___ menstrual week.

A

6-8

88
Q

The appendicular skeleton includes the bones of the :

A

upper extremities, lower extremities, and pelvic girdle

89
Q

The first sonographic appearances of the fetal limbs are referred to as:

A

limb buds

90
Q

During the second trimester the fetal limb bones take on more of an adult appearance and appear ____

A

echogenic

91
Q

The femur, tibia, fibula, humerus, radius and ulna can be measured as early as

A

12 weeks

92
Q

The measurement of the long bones should include:

A

the diaphysis of the bones and not the hypoechoic cartliginous ends

93
Q

The sonographic determination of the shortening of a limb is made when the long bones measure more than _______ deviations below the norm for gestational age.

A

4 standard

94
Q

Described as the absence (aplasia) or underdevelopment (hypoplasia) of the radius.

A

radial ray defect

95
Q

Radial ray defect can be seen in the presence of:

A

trisomy 13, trisomy 18, cardiac abnormalities, and an associated with VACTERL

96
Q

Referred to as talipes:

A

clubfoot

97
Q

With clubfoot the foot is most often :

A

inverted and rotated medially

98
Q

Sonographic diagnosis of clubfoot can be made when:

A

the metatarsals lie in the same plane as the tibia and fibula

99
Q

Limb reduction Is often caused by :

A

amniotic band syndrome

100
Q

_______ _____ result from the rupture of the amnion.

A

sticky bands

101
Q

The amniotic bands can entrap fetal parts and cause:

A

amputation of digits, limbs, and even the skull

102
Q

Amniotic bands can also lead to :

A

peculiar facial clefting

103
Q

Amniotic Bands should not be confused with:

A

uterine synechaie

104
Q

Uterine synechiae may be recognized as:

A

linear, thick membranes with a broad base crossing the amniotic sac.

Chapters 25-29 (6 decks)

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