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OBGYN 2 > M11: Face And Neck > Flashcards

M11: Face And Neck Flashcards

(73 cards)

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1
Q

When does development of the face occur, when is it complete

A

5 wks LMP

10 wks

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2
Q

What does the face develop from

A

5 main facial processes that move together and fuse:

1 frontonasal process
2 maxillary prominences
2 mandibular prominences

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3
Q

How does the frontonasal process of the face develop

What does it form

A

Starts superior and move inferiorly

Mid forehead, nose, central upper lip, central maxilla and anterior palate

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4
Q

Another name for anterior palate

A

Primary palate

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5
Q

How does the maxillary and mandibular prominences of the face develop

What do they form

A

Maxillary moves medially And fuse to form:

Cheeks
Lateral upper lip
Maxilla
Secondary palate

Mandible fuse to form the mandible

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6
Q

Another name for Secondary palate

A

Posterior palate

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7
Q

Describe the migration of the nose where does it start

A

Starts above the orbits as 2 widely spread nasal placodes that move medially and inferiorly

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8
Q

Define placodes

A

Areas of ectoderm tissues that form the sense organs

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9
Q

Describe the migration of the eyes

Where do they start

A

Start laterally and move medially

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10
Q

Describe the migration of the ears

Where do they start

A

Below the mandible and move laterally and upwards

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11
Q

Are facial anomalies common

What do they often cause

A

Yes

Polyhydramnios

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12
Q

facial anomalies are associated w/ what other anomalies

A

Other non-facial anomalies due to chromosomal abnorm.

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13
Q

What drugs/teratogens can affect the development of the face

A

Alcohol
Codeine
Valium
Anti-epileptics

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14
Q

Which chromo abnorm is commonly associated w facial anomalies

A

T13, then T18

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15
Q

What view do we assess the orbital distance, the lens and binocular distance

A

Axial view/BPD with the orbits and cranium in view

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16
Q

Which view is used to assess the nose/lips

What are we assessing for

A

Tangential coronal… important to have the soft tissues, not the bone

Intact upper lip
Presence of 2 nostrils

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17
Q

What do we asses for when scanning the profile

A

Prominence of chin and forehead
Protruding tongue or flattened nose
Assess for nasal bone

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18
Q

How should the alignment of the bones appear in the profile image

What about the forehead

A

Maxilla, nasal bone, chin

Forehead shouldn’t extend out to the same level of the other bones

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19
Q

When assessing the profile, how should the chin be positioned

A

Off the chest

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20
Q

Propose of 3D imaging

A

Give parents and surgeons an idea of what to expect at birth

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21
Q

How far apart should the orbits be

A

Separated by a distance of 1 orbit

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22
Q

Which measurement for the orbits can be used to date preg when BPD cant be obtained

A

Outer orbital distance

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23
Q

Describe anophthalmia

A

Congenital absence or severe hypoplasia or the eyes

LOOK FOR LENS

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24
Q

anophthalmia is associated w/ which chromo abnorm

A

T13

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25
Describe micophthalmia Which measurement is important
Small eyes Interocular measurement
26
micophthalmia is associated w/ which chromo abnorm
T13
27
Describe hypertelorism What commonly causes it Other causes
Widely spread eyes Mass blocking anterior migration of the eyes Craniosynostoses , eyes cant migrate
28
Describe hypotelorism Which measurement if important Associated w/ which chromo abnorm
Eyes close together Binocular measurement T13
29
Describe cyclopia Associated w/ which abnorm of the nose Asssociated w/ which chromo abnorm
Fusion of eyes into one orbit supraorbital proboscis T13
30
Describe ethmocephaly
2 closely spaced but separate eyes w/ a supraorbital proboscis
31
Describe cebocephaly
2 closely spaced but separate eyes w/ a centrally placed nose w/ only one blind ended nostril
32
What is a proboscis
Tuft of tissue, usually above the eyes... no normal nose
33
5 patterns of cleft lip and palate more cases are what type
``` isolated cleft lip unilateral cleft lip and palate bilateral cleft lip and palate midline cleft lip and palate facial defects associate w/ amniotic bands ``` cleft lip and palate together
34
is US better at detecting cleft lip or palate
lip, palate is hard to see on US and often missed
35
which type of cleft lip is more likely to be associated w/ additional anomalies
isolated cleft lip
36
2 abnormalities often seen w/ clefting
polyhydramnios and sm stomach b/w the defect can disturb swallowing
37
cleft lip should not be confused w/ which normal anatomy
philtrum
38
lateral cleft lip is associated w/ which chromo abnormality
T18
39
US appearance of bilateral cleft lip
snout like appearance b/c upper lip isn't attached on either side on the mouth so 'floats' in the amniotic fluid
40
median cleft face has a stronger association w/ which chromo abnorm
T13
41
describe median cleft face which structures didn't fuse to cause this
cleft in the middle of the nose and including the nose (missing the septum) nasal and maxillary structures failed to fuse
42
best view to assess for cleft palate look around which area in the mouth?
TRX around tooth buds
43
cleft palate can be mistaken for which normal facial structures
oral cavity or ethmoid sinuses
44
describe macroglossia associate w/ which chromo abnorm
abnormally large protruding tongue beyond the lips T21 and beckwith-wiedemann syndrome
45
abnormalities seen w/ beckwith-wiedemann syndrome
``` macroglossia macrosomia (big baby) omphalocele renal hyperplasia or dysplasia increased risk of wilms tumor and hepatoblastoma ```
46
# define micrognathia retrognathia
small chin receding chin
47
what is frontal bossing associated w/ what anomalies
protruding forehead skeletal dysplasia
48
low set and/or small ears are associated w/ which abnormalities
T21, 18 or 13
49
when does the thyroid start to function what abnormalities can occur
12 wks hyper or hypothyroidism
50
maternal causes of hyperthyroidism in the fetus
maternal graves disease
51
Us appearance of hyper or hypothyroidism
- thyroid would be enlarged, neck mass is seen that may cause the fetal neck to be hyperextended - polyhydramnios due to obstruction
52
what can fetal thyroid dysfunction lead to treatment
IUGR oligohydramnios tachycardia thyroid medicaltion administered to mom
53
what is a nuchal cord
umbilical cord wrapped 2 or more times around the neck... more likely to be a poor prognosis if the cord it wrapped multiple times and tightly... loose wrapping or 1 loop is insignificant
54
best plane to assess nuchal cord
TRX
55
describe cystic hygroma prognosis
separated nuchal fluid located posterior and lateral to the neck... usually multiocular lymph fluid lined by lymphatic endothelium poor
56
how does a cystic hygroma arise
thought to arise due to a failure of the lymphatic sys to develop a communication to the venous sys of the neck.... so lymph can't drain properly.
57
are all cystic hygromas lymphatic in origin
no
58
cystic hygroma associations
``` hydrops chromo abnormalities (>60%) cardiac abnormalities fetal alcohol syndrome can be seen after IUD ```
59
cystic hygroma is associated w/ which chromo and genetic abnorm
turners T21 noonan syndrome
60
US appearance of cystic hygroma when can they be seen
hypo fluid w/ random septations as early as 10 wks
61
cystic hygroma can be mistaken of which normal anatomy
nuchal translucency
62
Ddx for cystic hygroma
poster encephalocele, but brain, skull, spine are all normal w/ cystic hygroma
63
when is the nuchal translucency seen how big is the CRL at this time normal value
11-13 wks and 6d gestation 45-84 mm < 3mm but depends on maternal age
64
increased size of nuchal T associated w/ abnormalities
chromosomal and other abnormalities
65
how do you measure a NT
``` zoom, only head and fetal chest on the screen perfect midline sag neutral spinal/chin position decrease compression measure on to on ```
66
when is the nuchal fold (NF) assessed what causes it to be thick
16-24 wks for T21 subcutaneous edema
67
when do we stop measuring nuchal fold
24 weeks, after this babies have different growth curves so could be larger but norm
68
what positioning can help visualize the NF better
tip posterior of babies head anteriorly
69
what are teratomas composed of can they obstruct swelling
3 germ cell layers yes
70
what is dystocia? what can cause it
difficult labor/birth teratoma
71
what affects can a teratoma have after birth
compromised breathing and swallowing
72
US appearance of teratoma
solid mass, hyperextension of the fetal neck if the mass is big
73
With hypertelorism, which eye measurements are normal and which are abnormal
N: OOD AB: IOD

OBGYN 2 (15 decks)

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