Neonatal Study Guide

The brain and the spinal cord developed from a structured called

Neural tube

Early in the development of the brain the three primary vesicles are

1. The prosencephalon (forebrain) 2. Mesencephalon (midbrain) 3. Rhombencephalon (hindbrain)

From the 3 primary vesicles of the brain the one that is identified in the first trimester is called — and it appears by us as

Rhombencephalon, anechoic

Skull bone (bony part) also called

Calvarium

is spaces that exist between the forming fetal bones are called

Fontanelles, or “soft spots”

Fontanelles, or “soft spots” usually closed

About 18-24 months

The 3 parts of the brain are

1. The cerebrum (the largest) 2. Mid brain (the smallest) and 3. The cerebellum(posterior)

The six cerebral lobes are

1. 1 Frontal 2. 1 Occipital 3. 2 Parietal 4. 2 Temporal

The u/s appearance of the cerebrum is

Hypoechoic

The cerebrum is divided into a right and left hemisphere by the

Interhemispheric fissure/ the falx cerebri

The u/s appearance of the interhemispheric fissure/ the falx cerebri is

Echogenic linear structure

— Are elevated folds on the surface of brain caused by in folding of the cortex

Gyri

— are groove or depression on the surface of the brain separating the gyri

Sulci

The u/s appearance of the gyri is

Hypoechoic

The u/s appearance of the sulci is

Echogenic

— appear fewer in number in premature neonate

The sulci

Sylvain fissure is a landmark to identify —

Middle cerebral artery

The cerebral hemispheres connected or communicate through

Corpus callosum

The sonographic appearance of the corpus callosum is

It has an echogenic “double-walled”-like appearance. The parenchyma appears mid gray or as medium-to-low-level echoes

The four parts of the corpus callosum are

1. Rostrum 2. Genu 3. Body 4. Splenium

— Is a midline brain structure that can be identified in the anterior portion of the brain between the frontal horns of the lateral ventricles

Cavum septum pellucidum

The us appetence of the cavum septum pellucidum is

Anechoic inside and echogenic walls

The two egg-shaped thalami lie on each side of the third ventricle is —

Thalamus

The us appetence of the thalamus is

Hypoechoic

— connect the two lobes of the thalamus

The massa intermedia or interthalamic adhesion

— can be confused as thalamus

Cerebral peduncles

Cerebral peduncles are located between — and —

Thalamus and cerebellum

The us appearance of the cerebral peduncles is

Hypoechoic

— Brain stem connects forebrain and spinal cord

Brain stem

The 3 parts of the brain stem are

1. Midbrain 2. Pons 3. Medulla oblongata.

The us appearance of the

Midgray or as medium-to low-level echoes

The cerebral peduncles are located within

Midbrain

Cerebral peduncles are larger than thalamus. T/F

False

The ventricular system is composed of — ventricles

Four

— ventricles are located on both sides of the falx cerebri within the cerebral hemispheres

The paired lateral

Is the site where frontal, temporal and occipital horns meet

The trigone or the atrium

— & — are midline ventricles

3rd & 4th

The lateral ventricle are connected to the 3rd ventricle by

Foramen of Monro, or interventricular foramina

The third ventricle is located between the two lobes of the —

Thalamus

The third ventricle connects to the fourth ventricle inferiorly by the

Aqueduct of Sylvius, or the cerebral aqueduct

Normally — and — are not seen by ultrasound because of their size

3rd & 4th

The 4th ventricle is located

Anterior to the cerebellum

The ultrasound appearance of the ventricles is

Anechoic inside and echogenic walls.

— lies anterior to the thalamus

The caudate nucleus

The 3 parts of the caudate nucleus are

1. Head 2. Body 3. Tail

— is a common site for hemorrhage

The head of the caudate nucleus

The ultrasound appearance of the caudate nucleus is

Hypoechoic

— it is located between the caudate nucleus and thalamus, and is a shallow groove projecting from the floor of the lateral ventricle

Germinal matrix/caudothalamic groove

— the most common location of germinal matrix hemorrhage and it is due to

Germinal matrix/caudothalamic groove because of the germinal matrix contains a rich network of fragile thin-walled blood vessels

The ultrasound appearance of the germinal matrix/caudothalamic groove is

When visualized, it appears small and echogenic

Choroid plexus is found with in which structure

Within the ventricles, most of it in the lateral ventricles

The function of choroid plexus is

The cerebrospinal fluid production

US appearance of Choroid plexus is

Echogenic area

Map out the flow of CSF

Lateral ventricles — foramen of Monro — third ventricle — aqueduct of sylvius — 4th ventricle — foramen of magendie and lusaka

— are space surrounding the brain and spinal cord contains a small amount of fluid

Cisterns

Is the largest cistern in the head is

The cisterna magna

The cisterna magna is located

Posterior to the cerebellum

On sonography, the cisterna magna appears as

An anechoic, fluid-filled space

The two hemispheres cerebellum, right and left, that are connected at the midline by the

Cerebellar vermis

The ultrasound appearance of the vermis or cerebellar vermis is

Echogenic

— Is an echogenic structure that separates the cerebrum from the inferior cerebellum

Tentorium

— are the protective tissues layers that cover the brain and the spinal cord

The meninges

The layers pf the meninges are

1.The pia mater - innermost layer 2. the arachnoid membrane - middle layer 3. the dura mater - the dense outermost layer

The anterior and the middle part of the brain is supplies by

Internal carotid arteries

The posterior part of the brain is supplies by

Vertebral Artery

For the anterior circulation the internal cerebral artery divides into

1. Anterior cerebral artery 2. Middle cerebral artery

For the anterior circulation the posterior circulation the two vertebral arteries combine to form —

Basilar artery

The basilar artery once it enters the skull it divided into

Two posterior cerebral arteries

Indications for the exam include

1. Brain maturation 2. Structural brain abnormalities and/or brain injury 3. Hydrocephalus 4. Bleed 5. Flow up

The transducer choice for scanning the neonatal head is

1. 7.5 MHz sector. For premature infants less than 32 weeks’ gestation or less than 1500 g. 2. 5.0 to 3.0 sector MHz sector for term and older infants with open anterior fontanelle

What are the 8 midline structures of the brain

1. Interhemispheric fissure/ the falx cerebri 2. Corpus callosum 3. Cavum septum pellucidum 4. 3rd ventricle 5. 4th ventricle 6. Foramen of monro (interventricular foramen) 7. Aqueduct of sylvius 8. The vermis