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DMST 244 OBGYN 1 > Module 11.1 Fetal spinal pathology > Flashcards

Module 11.1 Fetal spinal pathology Flashcards

(58 cards)

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1
Q

Each vertebra will develop how many ossification centers?

A

Three

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2
Q

The centrum forms the ______ portion of the vertebral body

A

Central

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3
Q

The two neural processes will form what 5 things?

A
  1. Peduncles
  2. Transverse processes
  3. Laminae
  4. Spinous process
  5. Posterolateral part of the lateral body
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4
Q

Ossification is not complete until which weeks?

A

18 weeks

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5
Q

Potentially a small spinal bifida could be missed prior to what week?

A

18

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6
Q

How many will be at risk for NTD?

A

1/1000

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7
Q

What increases risk of NTD? 4

A
  1. Valproic acid
  2. Maternal diabetes
  3. Folic acid deficiency
  4. History of spinal defects
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8
Q

In terms of spinal bifida, Defects in the boney structure of the spinal canal may result in the herniation of what contents? 3

A
  1. Meninges
  2. CSF
  3. Neural tissue
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9
Q

What are other forms of NTD? 2

A
  1. Encephalocele: Brain herniation through defect in skull
  2. Anencephaly: Missing all brain and skull
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10
Q

What does this picture demonstrate?

A

Encephalocele

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11
Q

What does these two images demonstrate?

A
  1. Left normal spine
  2. Right Spina bifida occulta
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12
Q

What does these two pictures demonstrate?

A
  1. Left Spina bifida with meningocele
  2. Spina bifida with myelomeningocele
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13
Q

What is spinal bifida occulta? what does it involve? What might we see?

A
  1. Involves only the deepest layers
  2. May only see skin dimple or patch of hair on the skin
  3. Closed defect
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14
Q

How many spinal bifida cases are occult?

A

15-20%

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15
Q

What is involved with Spina bifida aperta? What kind of defect is it? And what are the percentage of cases?

A
  1. Involves all layers from dura to skin
  2. Open defect
  3. 80-85% of cases
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16
Q

Which is the most intense case of spina bifida?

A

Myelomeningocele with meningocele coming in second

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17
Q

What does meningocele contain?

A

Meninges and CSF

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18
Q

What does myelomeningocele contain? 3

A
  1. Meninges
  2. CSG
  3. Neural tissue
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19
Q

When is screening done for spina bifida? What is abnormal?

A

1.16 weeks
2. AFP is elevated

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20
Q

What are other causes of elevated MS AFP? 6

A
  1. Abdominal wall defects
  2. Multiple fata pregnancies
  3. Fetal death
  4. Urinary obstruction
  5. Cystic hygroma
  6. Incorrect dates
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21
Q

What is the most common location for NTD?

A

Lumbosacral spine

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22
Q

What is NTD usually associated with? 6

A
  1. Meckel gruber syndrome
  2. Encephalocele
  3. Polycystic kidneys
  4. Polydactyly
  5. Trisomy 18
  6. Triploidy
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23
Q

What is spinal dysraphism?

A

Abnormal closure of the spine

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24
Q

What is rachischisis? What is it another name for?

Study These Flashcards
A
  1. Another name for spinal dysraphism
  2. Failure of fusion of the vertebral arches
25
What are radiological landmarks for NTDs? 3
1. t12 most distal rib 2. L5 superior margin of iliac wing 3. S4 most caudal ossification center in 2nd trimester
26
What are some other systems affected by NTD?
lefts (clubfoot, hip dislocation)
27
Legs are affected by NTD how? 2
1. Imbalance of muscular activity due to nerve involvement 2. Nerves exposed to amniotic fluid results in damage to these nerves
28
What should look for on U/S for NTD? 5
1. Obliterated cisterna magna 2. Banana sign with cerebellum 3. Lemon sign 4. **Splayed laminae** 5. **Protruding mass or cyst**
29
What does this image demonstrate?
Spinal NTD
30
Where is the best plane to do an assessment of meningocele?
Transverse
31
When assess Meningocele what must we ensure we do?
Assessment of the skin surface away from the uterine wall
32
What is the prognoses of NTD? 2
1. Depends on location 2. More superior = greater disability
33
What is Iniencephaly?
Special case of dysraphism involving the back of the cranium and c- spine
34
What is iniencephaly also known as?
Star gazing position
35
What cerebral condition can inencephaly also be associated with?
Anencephaly
36
What are some segmentation errors of iniencephaly?
Shortens neck and head becomes dorsiflexed
37
What is scoliosis?
Lateral curvature of the spine
38
What kyphosis?
Exaggerated curvature of the spine in the sagittal plane
39
What does this image demonstrate?
Scoliosis
40
What is the VACTERL sequence?
Vertebral Anal Cardiovascular Tracheo- Esophageal Renal Limb
41
What is VACTERL sequence often associated with ?
Caudal regression
42
What is the prognosis of VACTERL sequence?
Depends on severity and extent of involvement
43
What is caudal regression?
Range of anomalies of the spine
44
What maternal condition increases the risk of caudal regression?
Maternal diabetes
45
What is sirenomelia?
1. Absence of sacrum 2. Fusion of legs 3. Rectal atresia 4. Renal dysgenesis or agenesis 5. Oligohydraminos
46
What is the prognosis of sirenomelia?
1. All die in infancy
47
What is the most severe form of caudal regression?
Sirenomelia (mermaids syndrome)
48
What is a sacrococcygeal teratoma? What elements does it contain?
1. Mass adjacent to distal spine 2. Contains elements of many tissues
49
How rare is sacrococcygeal teratoma?
1/ 35,0000 births (very rare)
50
Teratomas can arise from what areas? 4
1. Sacrum 2. Coccyx 3. Brain 4. Gonads
51
What are four types of sacrococcygeal teratomas?
By location 1. External mass predominant 47% 2. External mass with internal components 34% 3. Internal mass predominant with smaller external component 5% 4. Presacral mass (internal only) 10%
52
What is this an image of?
Type 1 Sacrococcygeal Teratoma
53
What is this an image of?
Type 2 Sacrococcygeal teratoma
54
What is this an image of?
Type 3 Sacrococcygeal teratoma
55
What is this an image of?
Type four sacrococcygeal teratoma
56
What is this an image of?
Sacral teratoma
57
What is the prognosis of sacral teratoma? What of a solid one? What happens if it is >4.5 cm?
1. Depends on size of mass and severity of structure displacement 2. Solid mass has a malignant tendency 3. If >4.5 cm C section is indicated
58
What is the DDX for sacral teratoma? 3
1. Rectal duplication 2. Anterior myelomeningocele 3. Sarcoma

DMST 244 OBGYN 1 (22 decks)

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