Ch 59

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rbeacr
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145355
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Ch 59
Updated:
2012-04-02 20:57:28
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Fetal Neural Axis
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fetal neural axis
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  1. forebrain develops into
    prosencephalon
  2. midbrain develops into
    mesencephalon
  3. hindbrain develops into
    rhombencephalon
  4. neuro tube closes at what days
    24-26
  5. prosencephelon divides into two parts
    • telencephalon- cerebral hemispheres
    • diencephalon- epithalamus, thalmus, hypothalamus, infundibulum
  6. rhombencephalon divides into
    metencephalon- cerebellum and pons

    myelencephalon- medulla
  7. two parts of spinal cord
    • alar plate- sensory region
    • basal plate- motor region
  8. spinal cord at birth terminates?


    at adulthood?
    at 3rd lumbar vertebra


    adult- 2nd lumbar vertebra
  9. anencephaly stats
    • aka aprosencephaly or atelencephaly
    • most common
    • 1 in 1000
    • females 4:1
    • white to black 6:1
  10. anencephaly definition
    • absense of the brain and is caused by failure of closure of the neural tube at the cranial end
    • absense of the crainial vault
    • complete or partial absense of the forebrain
    • presense of the brain stem, midbrain, skull base, and facial structures
  11. angiomatous stroma or cerebrovasculosa
    remnant brain covered by a thick membrane
  12. Anencephaly outcome
    • 50% fetal demis
    • remainder die at birth of shortly after

    High AFP
  13. Teratogens associated with neurptube defects
    • valporic acid
    • methotrexate
    • amniopterin
  14. anencephaly detected when
    • 10-14 weeks
    • more obvious in second trimester
  15. anaencephaly sonographic findings
    • no brain or cranial vault
    • bulging orbits
    • poly or oligohydraminos
    • cleft lip/palate
    • hydronephrosis
    • diaphragmatic hernia
    • cardiac defects
    • ompalocele
    • gi defects
    • talpies
  16. Acrania definition
    • absense of cranial bones
    • complete but abnormal cerebral hemispheres
  17. acrania stats
    • rare
    • lethal
    • begins at 4th week
  18. acrania sonographic appearance
    • brain without calvarium
    • disorganized brain tissue
    • prominent sulci markings
    • no frog eyes- anencephaly
  19. acrainia associated with
    • spinal defects
    • cleft lip/palate
    • talpies
    • cardiac defects
    • omphalocele
  20. Cephalocele
    meninges or meningies and brain herniate through calvarium defect
  21. Encephalocele
    herniation of menengies and brain
  22. cranial meningocele
    herniation of only meninges
  23. Cephalocele stats
    • 1 to 3 in 10,000
    • 75% occipital
    • 25% parietal, frontal, temporal
    • If brain involved a poor outcome- meninges can be fixed
  24. Cephalocele sonographic appearance
    • extracranial mass- fluid (meninges) or solid (brain)
    • bony skull defect
    • ventriculomegaly (encephalocele)
    • polyhydraminos
  25. cephalocele can be confused with cystic hygroma but the difference is..
    cystic hygroma is on the neck
  26. Spina bifida definition
    • Wide range of vertebral defects from failure of neural tube closure
    • cleft or opening in spine
    • meningies an neural elements protrude- can be anywhere along cord- usually lumbar/sacral

    increase folic acid helps
  27. spina bifida occulta
    • covered with skin or hair
    • difficult to detect in fetus
    • AFP normal
  28. meningocele
    meningies protrude through defect- spina bifida
  29. meningomyelocele
    protrusion of meningies and neural elements
  30. rachischisis
    • large severe defect of spinal cord
    • high AFP
    • lethal
  31. bannana and lemon sign
    • myelomengingoceles- present with cranial defects associated with Arnold-Chiari (type II)
    • 90%
  32. Arnold Chiari Type II
    • 90% with spina bifida
    • hydrocephalous
    • bananna appearing cerebellum
    • displacement of cranial structures- lemon
  33. spina bifida sonographic
    • flattening of frontal bones- lemon shape
    • obliteration of cisterna magna
    • inferior displacement of cerebellum- banana
    • ventriculomegaly

    • talpies
    • cephaloceles
    • cleft palate/lip
    • hypotelerism
    • heart defects
    • genituri anomolies
  34. Dandy walker malformation definition
    • varying degrees of severity
    • agenesis or hypoplasia of cerebellar vermis with dilitation of 4th ventricle and enlargement of posterior fossa
  35. DWM stats
    • 1 in 25,000-35,000
    • 4% of hydrocephalus infants
    • associated with other cranial anomolies 50% of the time

    may have normal function and sub IQ
  36. three types of DWM
    • DWM-
    • DWV- dandy walker variant- cystic dilitation of 4th vent- no enlarged posterior fossa
    • MCM- Megacisterna magna- enlaraged cist. magna
  37. DWM sonographic
    • cardiac anomolies
    • polydactyly
    • facial clefts
    • urinary tract anomolies
    • post fossa cyst
    • splaying of hemispheres
    • enlarged cisterna magna
    • ventriculomegaly
  38. Holoprosencephaly definition
    range of abnormalities resulting from abnormal cleavage of prosencephalon (forebrain)
  39. Holoprosencephaly stats
    • 1 in 10,000 to 1 in 20,000
    • assosciated chrom anomolies in 50% of cases
    • ( Trisomy 13)
  40. 3 forms of holoprosencephaly
    • alobar
    • smilobar
    • lobar
  41. Alobar holoprosencephaly
    • singular monoventricle brain ( cup, ball, pancake)
    • fusion of thalamus
    • absent interhemisphere fissure, cav sept pelluc, corpus calosum, optic tracts, olfactory bulbs

    • not many surviovors
    • worst oucome
  42. semilobar holoprosencephaly
    • single ventricle cavity with partial occipital hroms, partial or complete thalamus, rudiment. falx, and interhemispheric fissure
    • absent corpus call. ca sept pellu, and olfactory bulbs
  43. lobar holoproosencephaly
    • almost complete division of ventricles
    • normal corpus callos
    • cav sept pellu absent
  44. holoprosencephaly sonographic
    • common c-shaped ventricle
    • horse shoe shaped brain tissue
    • fusion of thalmus (no 3rd vent)
    • Absent interhemisphere fissure
    • no corpus callosum
    • no cav sept pelluc

    • cyclopia
    • hypotelerism
    • no nose
  45. cebocephaly
    hypotelorism with normal nose with single nostril
  46. ethmocephaly
    • severe hypotelerism
    • nose proboscis superior to eyes
  47. corpus callosum definition
    fibrous tract that connects the cerebral hemispheres and aids in learning and memory

    caused by vascular disruption or inflammatory lesions before 12 weeks

    • associated with trisomy 21 13 18 triploidy
    • X linked syndrome
  48. corpus callosum stats
    • 1 to 3 in 1000 births
    • starts developing at 12 weeks completes at 20
  49. corpus callosum sonographic
    • wide amount of outcomes
    • absense of corpus callosum
    • elevated and dilated third vent

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