neonatal/msk exam review guide

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why ICH common in preterm infants

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1

why ICH common in preterm infants

low birth weight

<34 wks

fragile & not developed blood vessels

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2

US appearance of ganglion cyst

cystic (simple) on wrist

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3

when does ant. fontanelle close

9-15 mnths

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4

another name for mastoid fontanelle

posterolateral fontanelle

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5

where is largest part of choroid plexus located

lateral ventricle

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6

leukomalacia definition

CNS dysfunction bc hypoxic ischemia or infection

white matter softens

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7

leukomalacia presents…

limp & pale at birth

seizures

hypotonia

poor prognosis

neurological deficits

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8

IVH grade 0

no hemorrhage

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9

IVH grade I

(SEH) blood only in germinal matrix

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10

IVH grade II

(w/out dilation) SEH breaks thru ependymal into ventricle

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11

IVH grade III

(w/ dilation) motor problems & mental retardation

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12

3 segments of the brain

cerebrum

cerebellum

brain stem

<p>cerebrum</p><p>cerebellum</p><p>brain stem </p>
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13

most common neonatal congenital infection

cytomegalovirus cmv

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14

hydrocephalus

dilation of ventricle bc CSF obstruction

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15

SAG neonatal head

corpus collosum

4th ventricle

cavum septum pellucidum (anechoic)

3rd ventricle

cerebellum

<p>corpus collosum </p><p>4th ventricle </p><p>cavum septum pellucidum (anechoic)</p><p>3rd ventricle </p><p>cerebellum </p>
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16

COR neonatal head image

frontal horns of lateral ventricle *always in image*

sylvian fissure (bright spot)

cavum septum pellucidum

<p>frontal horns of lateral ventricle *always in image*</p><p>sylvian fissure (bright spot)</p><p>cavum septum pellucidum </p>
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17

what lumbosacral anomaly is indication for neonatal spine US

sacral dimple/pilonidal sinus

skin anomalies (hair, dimple, pigment)

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18

until when is spinal US helpful on newborns

<6 mnths bc post. spinous process not yet ossified

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19

US appearance of spinal canal

anechoic

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20

spinal dysraphism

inadequate neural tube fusion

open-spinal dysraphism (neural tissue exposed to skin)

closed-spinal dysraphism (neural tissue covered by skin)

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21

myelocele

myelomeningocele

OSD

herniated meninges

herniated meninges & nerve roots

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22

tethered cord

CSD

low, thick filum terminal; below L3

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23

diastomyelia

CSD

seperation of spinal cord into two; thoracolumbar

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24

dorsal dermal sinus

CSD

thin, epithelial tract from skin to spinal canal; deep midline dimple

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25

sacral dimple/pilonidal sinus

CSD

m.c. reason for neonatal spinal US; dimple w/ tract

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26

spinal lipoma

CSD

fat & connective tissue connected w/ spinal cord; skin covered back mass; lumbar

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27

terminal myelocystocele

CSD

skin covered, fluid filled, lumbar mass; CSF accumulation; omphalocele

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28

where does conus medullaris terminate when tethered

L3 or below

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29

transducer for neonatal spine

8-15 mhz; high frequency; linear/sector

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30

where does diastomyelia occur

thoracolumbar

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31

dorsal dermal sinus

thin, epithelial lined tract that passes from skin to spinal canal; CSD; lumbosacral; deep midline dimple

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32

most common methods for DDH

clinical assessment

sonography

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33

types of hip displacement

instability

subluxation

dislocation

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34

normal value of hip displacement

alpha >60°

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35

scanning planes for femoral head

COR, neutral: how well femoral head is in acetabulum (>50%)

COR, flexion: same as COR but hold hip at 90°; w/ stress

TRANS, flexion: rotate probe 90°; flexed femur at 90°; w/ stress (look for ‘U’)

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36

hip effusion

swelling of hip joint bc increased synovial fluid around joint

pain, limping, no weight bearing, fever

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37

DDH risk factors

breech

family history

cultural swaddle

abnormal physical

female

1st pregnancy

oligohydramnios in utero

high birth weight

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38

bursa definition

closed connective & synovial sacs w small amount of fluid

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39

what does bursa do

gliding at high friction points

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40

bursa US appearance

small, hypoechoic, flat sac; hyperechoic wall; fluid

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41

most common joint injury

ankle (complex diarthrosis joint)

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42

plantar fasciitis

inflammation of plantar fascia (>4mm)

thick, medial, central, & lateral cords

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43

msk image

skin

fat

muscle

tendon

<p>skin</p><p>fat</p><p>muscle</p><p>tendon </p>
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44

what shares insertion point with supraspinatus at tendon

infraspinatus

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45

what is elevated with rotator cuff imaging

subscapular nerves (C5, C6, C7)

suprascapular nerves (C4, C5, C6)

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46

minor rotator cuff tear criteria

subdeltoid bursal effusion

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47

major rotator cuff tear criteria

focal, nonvisualized cuff

localized absence of cuff

abnormal echogenicity

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48

periosteum US appearance

thin, bright line parallel to cortex of bone

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49

tendons

bone to muscle

flexion & extension

type II collagen & water

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50

ligaments

bone to bone

stability & strength

type I collagen & water

‘basket weave’

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51

muscle

smooth, cardiac, skeletal

contract & extend

US sees mostly skeletal muscle

fibers...fascicles…muscle group…endomysium…perimysium…epimysium (muscle to bone)

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52

what is a sign of full thickness tear

complete tendon interruption

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53

compartment syndrome

compression of blood vessels & nerves stops blood flow to that compartment

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54

what nerve is compressed w/ carpal tunnel

median nerve

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55

retinaculum

band of thick, deep fascia around tendons to hold them in place

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56

anisotropy

change in properties of structure when evaluated in different directions

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