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Eval. the Fetal Neural Axis
OB/GYN Sonography
80
Medical
Undergraduate 4
02/19/2009

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Term
First organ system to be investigated in utero.
Definition
central nervous system
Term
First structure of the CNS seen by ultrasound.
Definition
rhombencephalon
Term
The only organ system that continues to develop throughout gestation.
Definition
central nervous system
Term
Lack of knowledge in the development of the CNS will result in:
Definition
overcalling pathology and missing defects all together
Term
Cystic single ventricle seen 7 wks LMP; appears to have very little surrounding brain tissue.
Definition
rhombencephalon
Term
The rhombencephalon is the precursor to which section of brain development?
Definition
hind brain
Term
The prosencephalon is the precursor to which section of brain development?
Definition
fore brain
Term
At what age LMP is the midline falx anf the choroid plexus seen?
Definition
10 weeks
Term
When does the cranium begin to ossify?
Definition
10 weeks LMP
Term
When and how can the best diagnosis of acrania be made?
Definition
12 weeks LMP transvaginally
Term
Nuchal translucency is highly associated with which trisomy?
Definition
21 (Down's syndrome)
Term
Posterior/lateral accumulation of subcutaneous fluid due to back-up of lymphatic system.
Definition
cystic hygroma
Term
Which aneuploidies are associated with cystic hygromas?
Definition
Turner's syndrome and Down's (trisomy 21)
Term
Absence of a sex chromosome, usually in female fetuses.
Definition
Turner's Syndrome
Term
Do babies with Turner's Syndrome usually survive?
Definition
no
Term
At what age LMP does choroid plexus seem to fill the cranium?
Definition
12-13 weeks LMP
Term
Spaces that house cerebral spinal fluid.
Definition
ventricles
Term
Midline space bound by corpus callosum that houses CSF.
Definition
cavum septum pellucidum
Term
Structure that connects two hemispheres of the cerebellum.
Definition
vermis
Term
The cisterna magna and the lateral ventricles should have what measurement?
Definition
2-10 mm
Term
When can the CSP first be visualized?
Definition
18-20 weeks
Term
What structure separates cerebellum from the upper brain?
Definition
tentorium
Term
Which lateral ventricle should be measured and why?
Definition
The one furthest from the transducer because of near field reverberation
Term
Edge of the choroid plexus.
Definition
glomus
Term
When can you start measuring the atria?
Definition
15 weeks LMP
Term
Diagnosed when a ventricle is greater than 10 mm.
Definition
ventriculomegaly
Term
Diagnosed when a venticle measures greater than 15 mm (aka severe ventriculomegaly).
Definition
hydrocephalus
Term
What type of ventriculomegaly is caused by agenesis of part of the brain or underdevelopment of a structure?
Definition
passive
Term
What type of ventriculomegaly is caused by a pathology obstructing the CNS system?
Definition
obstructive
Term
The most common cause of ventriculomegaly.
Definition
aqueductal stenosis
Term
Narrowing or occlusion between the 3rd and 4th ventricles at the level of the aqueduct of Sylvius (aka aqueductal obstruction).
Definition
obstuctive hydrocephalus
Term
Best diagnostic clue for aqueductal stenosis.
Definition
hydrocephalus with normal posterior fossa
Term
When do choroid plexus cysts typically resolve?
Definition
19 weeks
Term
Choroid plexus cysts are soft chromosomal markers for what?
Definition
trisomy 18
Term
A tear-drop shaped ventricle and failure to see the CSP are clues to what pathology?
Definition
agenesis of the corpus callosum
Term
Which artery wraps around the corpus callosum?
Definition
pericallosal
Term
When can a nuchal fold measurement be taken?
Definition
15-22 weeks
Term
The size of the cerebellum should equal what?
Definition
gestational age +/- 2mm
Term
Name for the wrinkles of the cerebellum.
Definition
cerebellar sulci
Term
A nuchal fold greater than or equal to _______ is a chromosomal marker for _______.
Definition
6 mm; trisomy 21 (Down's)
Term
What is the max nuchal fold measurement in an AMA patient?
Definition
5 mm
Term
Another name for spina bifida.
Definition
myelomeningocele
Term
What happens to the cerebellum in a baby with spina bifida?
Definition
The defects tugs and pulls the brain downward; the cerebellum fills the cisterna magna and loses its peanut shape
Term
Most common area for spina bifida.
Definition
lumbar-sacral
Term
Symptomatic herniation of the hindbrain, 100% assoicated with ONTD.
Definition
Arnold-Chiari Malformation
Term
Dysgenesis of the cerebellar vermis and cystic dilation of the 4th ventricle.
Definition
Dandy-Walker Malformation
Term
Sonographic appearance of Dandy-Walker Malformation.
Definition
vermis formation variable, communication of the 4th ventricle with PF cyst or CM, enlarged CM
Term
What is a mega cisterna magna?
Definition
enlarged CM, but vermis is intact
Term
Infarct or hemorrhage into brain parenchyma resulting in cystic resolution; may communicate with ventricular system.
Definition
porencephalic cyst
Term
Clefting through the cerebral hemisphere resulting in free communication between the ventricular system and arachnoid space.
Definition
schizencephaly
Term
Rare, solid tumor of the brain.
Definition
craniopharyngioma
Term
Failure of the prosencephalon to divide properly, resulting in a single lobe brain.
Definition
holoprosencephaly
Term
Most common chromosomal association of HPE.
Definition
trisomy 13
Term
Is trisomy 13 compatible with life?
Definition
no
Term
Most pronounced form of HPE. Single ventricle with fissure, falx, and CC totally absent.
Definition
alobar
Term
Type of HPE with two interhemispheres partially separated yet single ventricle cavity.
Definition
semilobar
Term
Type of HPE that is mild; interhemisphere fissure well developed yet there is fusion of the ventricles with absence of CSP.
Definition
lobar
Term
When eye spacing is too close.
Definition
hypotolerism
Term
When eye spacing is too far apart.
Definition
hypertolerism
Term
Only aneurysm of the brain.
Definition
vein of galun
Term
absence of crainal vault and varying amounts of supertentorial brain. No neural tissue present.
Definition
Anencephaly
Term
In what gender is anencephaly 5x more common?
Definition
female
Term
Absent calvarium above the orbits with exposed brain.
Definition
acrania
Term
What are encephaloceles, cephaloceles, or cranial meningoceles?
Definition
herniation of cranial structures through skull defect
Term
Encephaloceles, cephaloceles, or cranial meningoceles are mostly seen where and with what syndrome?
Definition
occipital region; Meckel-Gruber syndrome
Term
What trisomy has a strawberry head shape?
Definition
18
Term
Lacking calcification showing brain parenchyma too well.
Definition
hypomineralization
Term
Another term for recessed chin.
Definition
micrognathia
Term
What is frontal bossing?
Definition
prominent protruding forehead
Term
Condition in which frontal bone is sloped, not prominent enough.
Definition
microcephaly
Term
Which artery feeds the lens of the eye?
Definition
hyaloid artery
Term
What type of head shape has an increased BPD?
Definition
brachycephalic
Term
What type of head shape has an decreased BPD?
Definition
dolicephalic
Term
Overlapping of the fetal skull bones and sutures which strongly suggests fetal demise.
Definition
spalding sign
Term
Complete destruction of cerebral hemispheres; occurs when hemispheres are replaced with CSF in a normally developed skull.
Definition
hydrancephaly
Term
What type of cyst does not communicate with the ventricular system?
Definition
arachnoid
Term
CSF collection enclosed within the layers of the arachnoid membrane.
Definition
arachnoid cyst
Term
Most common fetal mass.
Definition
teratoma
Term
How does CSF made in the choroid plexus flow through the brain?
Definition
lateral ventricles > foramen of Monro > 3rd ventricle > aqueduct of Sylvius > 4th ventricle > foramen of Magendie and foramina of Luschka > subarachnoid space
Term
TORCH exposure leads to what in the brain?
Definition
calcifications
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