Week 8- DMS 241 Neonatal Brain and Pediatric Spine

the prosencephalon contains the:

telencephalon and diencephalon

the telencephalon contains the:

cerebral cortex

corpus striatum

the diencephalon contains the:

thalamus

hypothalamus

optic stalk

the telencephalon and diencephalon make up the:

cerebral hemispheres

mesencephalon is made of up:

midbrian

rhombencephalon contains the:

metencephalon and myelencephalon

the metencephalon is made up of:

pons and cerebellum

the myelencephalon is made up of:

medulla oblongata

when does the posterior fontanelle close:

1-2 months

when does the anterior fontanelle close:

9-18 months

all sutures should be closed by:

2 years old

what are the functions of the meninges:

protect CNS

enclose CSF

exchange substances with body

what are the layers of the meninges from outer to inner:

dura mater

arachnoid

pia mater

what do you need to do in order to enter the NICU:

scrub up to the elbow and under the nails for 3 min

wear gloves

wear gown

use port holes when scanning

turn the lights down

if baby is less than 1500g you must:

wear sterile gloves

frontal lobe of the brain controls:

personality

motor function

speech

parietal lobe of the brain controls:

perception

spatial location

mathematical concepts

temporal lobe controls:

sensory

memory

emation

occipital lobe controls:

visual

color discrimination

cerebellum controls:

coordination

-balane

-equilibrium

-tone

the two hemispheres are separated by:

corpus callosum

the main area where we will scan is the:

anterior fontanelle

list some indication for brain US:

prematurity

screening

ICH

seizures

hydrocephalus

infection

hypoxic ischemic events

list some scanning techniques used for brain US:

highest FRQ possible

multiple focal zones

small footprint probe

patient care

infection control

clean machine

light pressure

measurement of the lateral ventricle in neonates:

more than 4mm

ventriculomegaly in neonates:

5-10mm

the _____________________ artery border the corpus callosum

pericallosal

what is the greatest rick factor for IVH?

prematurity

list some other risk factors for IVH:

ges age less than 30wks

less than 1500g

immature germinal matrix

neonates of ECMO

list the clinical signs of IVH:

seizures

apnea

hypotonia

abnormal posturing

diminished consciousness or coma

Grade 1 IVH:

confined to germinal matrix

Grade 2 IVH:

intraventricular with NO ventricular dilation

Grade 3 IVH:

intraventricular with ventricular dilation

when imaging the brain you will take images in what two planes?

sagittal

coronal

Grade 4 IVH:

infarction of periventricular parenchyma

when hemorrhage is resolving it may appear as:

hyperechoic and heterogenous

a ____________ may be used to reduce ventriculomegaly

shunt

cerebellar hemorrhage risk factors:

prematurity

cerebellar hemorrhage is best seen through the __________________ fontanelle

mastoid

periventricular leukomalacia (PVL)

infarction of deep white mater

the first place you may see fluid in the brain is the

caudate thalamic groove

sono appearance of PVL:

more echogenic than choriods

PVL may undergo ____________________ changes

cystic

vessels of the ___________________ tend to be fragile and bleed

caudate nucleus

what is the clinical concern of a vein of galen AV malformation?

venous overload back to RA, creating right side volume overload

complete agenesis of CC occurs prior to week _______________ of gestation

12

agenesis of CC may indicate:

dandy-walker

holoprosencephaly

septo-optic dysplasia

aicardia syndrome

sono findings of agenesis of CC:

absence of CC

absence of pericallosal artery

splayed lateral ventricles

elevated 3rd ventricle

colpocephaly

straight gyri

hydrancephaly

cerebral hemispheres replaced by fluid filled sac

etiology of non-comm hydrocephalus:

stenosis of cerebral aqueduct

cisterna magna measurement

less than 10mm

occipital horn measurement

5-9mm

frontal horn measurement

less than 4mm

hydrocephalus

progressive dilation of ventricles

closure of anterior fontanelles begin closing at _____ months

9

the primary acoustic window for brain US is:

anterior fontanelle

the CC is an important midline structure to visualize

true

coronal eval of the brain should include images of:

frontal to occipital

sagittal eval of the brain should include images of:

right

midline

left

lack of fusion of the lamina results in:

open spina bifida

technique for spinal US:

5-12 MHz TDR

counting method

indications for spinal US:

sacral dimple

congenital anomalies

sinus tract

mass

post-op

you will see the entire lateral ventricle and thalamus in the _____________________ view

parasagittal

you will not see the thalamus in the midline view

true

what should be documented in a spinal US?

long and trans images of spine

level of conus medullaris

position of spine

cord and nerve root motion

lesions

the ____________________ connects the lateral ventricles to 3rd ventricle

foramen monroe

the spinal cord tapers caudally at the _________________

conus medullaris

how many cervical vertebrae?

7

how many thoracic vertebrae?

12

how many lumbar vertebrae?

5

how many sacral vertebrae?

5

how many coccygeal vertebrae?

4 fused

you should start counting at the ___________________ region

sacrococcygeal

filar cyst

ovoid midline anechoic structure just inferior to the tip of the conus medullaris

a SHE is a ____________________ IVH

grade 1

a SHE is confined to the caudothalamic groove

true

spina bifida occulta

covered by skin

PVL is caused by:

necrosis due to lack of oxygen

the cystic changes in late stage PVL are due to:

necrosis

if you see calcs in the brain think of:

TORCH -- infection in utero