Fetal Face And Neck

Front 1

look at ian suchet dvd

Back 1

normal face
frontal bossing
cleft lip and palate
nasal bone
nasal proboscis

Front 2

when is the fetal face identified sonographicallY? when can a fetal profile be seen?

Back 2

identified 10-12 wks
profile=13-14 wks

Front 3

what are some causes of facial anomolies?

Back 3

-developmental/inherited
-affected by drugs/alcohol
-chomosomal aberation

Front 4

what drugs may affect facial developing?

Back 4

-alcohol
-codine
-diazepam(valium)
-retin A
-antiepileptric drugs

Front 5

what are some limitations for facial visualaization?

Back 5

-materal obesity
-fetal position
-oligo

Front 6

hyaloid artery

Back 6

visualized 16-30 wks
-echogenic line coursing from posterior globe through back of lens
-regresses during pregnancy

Front 7

what is the most valuble way of measuring the eyes?

Back 7

OOD(outer orbital diameter)-because of the increased range of normal variation
-it may be used to date pregnancey when BPD cannot be measured
-useful when there is severe distortion of other biometric parameters(ie. cloverleaf skull, micromelia, etc.)

Front 8

how far apart should orbits be? what does this indicate?

Back 8

should be separated by 1 globe w/ a general rule
-eye spacing abnormalities usually associated w/ other anomolies

Front 9

when measuring orbits, how should they be seen?

Back 9

change axis until orbits appear the larges and the intraorbital distance is the greatest(can use transverse, coronal, or coronal oblique planes for measureing orbits)

Front 10

hypotelorism

Back 10

-decreased intraorbital distance
-assoc. w/ holoprosencephaly(most common)
-associated w/ microcephaly, trisomy 21, and 13
-best scan plane=coronal oblique

Front 11

hypertelorism

Back 11

-increased intraorbital distance
-may be isolated or part of a syndrome
-assoc. anomolies:
-craniosynostosis
-anterior cephalocele
-median cleft syndrome

Front 12

name and explain some rare eye anomolies?

Back 12

-anopthalmia-absence of one or both eyes
-micropthalmia-abnormally small eyes
-cataracts-abnormally echogenic lens
-dacrocystocele-lacrimal duct cyst located inferomedial to orbit.

Front 13

MEDIAN cleft face syndrome

Back 13

-aka frontal nasal dysplasia malformation complex
-hypertelorism
-median clefting of the nose
-varying degrees of palate cleftin
-V shaped arterior hairline

Front 14

Explin the embryology of the nose, eyes, and ears

Back 14

Nose-starts above the orbits as widely space entities(placodes) that move medialy and inferiorly
Eyes-start laterally and move medialy
-ears-start velow the mandible and move laterally and upward

Front 15

fetal nose

Back 15

-imaged coronally to visualize nares
-imaged midline sagital(profile) to measure nasal bone
-absence of nasal bone at 11-14 wks is associated w/ downs syndrome
-small or hypoplastic nose is seen w/ trisomy 18, apert's syndrome, de lange syndrome, and fetal toxins

Front 16

scanning criteria for nasal bone measurment

Back 16

-midline sagital profile
-magnify image to display only head and uppper thorax
-profle/transducer angle=45 degrees
-obtain 3 lines in nasal region
-=sign represents sline line, and nasal bone(inner)
-3rd line is tip of nose`

Front 17

diprosopus

Back 17

-duplication of craniofacial structures
-from isolated duplication to completer facial duplication
-single neck and body
-rare form of conjoined twins

Front 18

otocephaly

Back 18

absence of eyes and forerain
-possible absence of mouth
-incompatable w/ life

Front 19

cyclopia

Back 19

-single median orbit w/ various degrees of ocular fusion
-absent nose
-proboscus from lower forehead
-abscent facial bones
-absent philtrum of upper lip
-low set ears
-assoc. w/ holoprosencephaly

Front 20

cebocephaly

Back 20

-flat and rudimentry nose
-hypotelorism
-single flat nostril
-absent philtrum of upper lip
-assoc. w/ holoprosencephaly

Front 21

anopthalmia

Back 21

-congenital absence or severe hpoplasia of the eyes

Front 22

ethmocephaly

Back 22

-extreme hypotelorism w/ supraorbital proboscis or absent nose
-assoc. w/ holoprosencephaly

Front 23

where is the proboscus seen with ethmocephaly, cebocephaly, and cyclopia?

Back 23

cyclo=most superior
ethmo=btw eyes
cebo=most inferior

Front 24

why is a cleft lip/palate devastating for newborns?

Back 24

because they can't feed becuase they will inhale the food.

Front 25

cleft lip and palate

Back 25

-most common facial deformity at birth-lack of fusion of facial grooves
-fissure results in communication btw mouth and nasal cavity
-best visualized in coronal oblique
-incomplete cleft involves upper lip
-2/3 patiens w/ cleft lip have cleft palate
-congenital anomolies occur in more than 50% of fetuses w/ facial clefts
-

Front 26

what are the forms of cleft palate/lip

Back 26

-complete or incomplete
-unilateral/bilateral
-symmetric/assymetric

Front 27

unusual clefting may be the result of what?

Back 27

amniotic band syndrome

Front 28

what is the sonographic appearance of cleft lip?

Back 28

-anechoic region in the upper lip lateral to midline and extending into the nose

Front 29

what is hairlip(cleft lip) often associated w/

Back 29

club foot

Front 30

why should a thorough facial scan be done w/ polyhydramnios and a small stomach?

Back 30

because clefting may interfere w/ swallowing.

Front 31

what are some associated anomolies w/ cleft lip?

Back 31

-skeletal anomolies(most common)
-CVS-2nd common
-trisomy13
-triploidy(69 chromosomes)
-multiple syndromes
-anencephaly
-holoprosencephaly

Front 32

when should tooth buds be seen by?

Back 32

-15/16 wks

Front 33

what should be done when scannign for facial clefts?

Back 33

-frontal scans provide optimal view
-place transducer beneath chin, above forehead, or lateral to cheeks
STRUCTURES VISUALIZED:
-lips
-chin
-alveolar ridge
-nose
-normal philtrum(midline groove of upper lip)

Front 34

macroglossia

Back 34

-enlarged tounge prenatally
-often protruding
-beckwith-wiedemann syndrome
-hypothyroidism

Front 35

micrognathia(retrognathia)

Back 35

-shortening of the mandible
-small receeding chin
-overbite
-assoc. w/ trisomy 13 and 18

Front 36

prognathism

Back 36

large forward jutting jaw

Front 37

epignathus

Back 37

-rare pharyngeal tuor that arises from the palate
-extends through the mouth ad creats an anterior mass
-caries greatly in size and texture

Front 38

ears

Back 38

-rarly provide useful info
-low set ears=assoc w/ multiple syndromes
-look for gross deformities
-ears not always visualized due to:
-oligo
-fetal position
-maternal obesity

Front 39

nuchal thickening

Back 39

-thickening of skin on back of neck seen on the cerebellar veiw
->6mm@16-20wks=abnormal
-outer edge of bone to outer skin edge
-downs syndrome in 20-40%

Front 40

fetal thyroid

Back 40

-functions by 12 wks
-thyroid enlargement or goiter may be seen with hypo/hyperthyroidism

Front 41

goiter

Back 41

-thyroid enlargement
-impared swallowing=polyhdramions
-may be seen w/ fetal hyper/ hypothyroidism
-small percentage of mothers w/ grave's disease have hyperthyoid fetus

Front 42

what are the fetal manifestations w/ a goiter?

Back 42

-IUGR
-oligo
-tachycardia
-polyhadramnios
-hyperextension of the neck

Front 43

what should mothers with thyroid disease be monitored for?

Back 43

-fetal goiters as it can be treated in utero

Front 44

cystic hygroma

Back 44

-aka nuchal cyst syndrom
-large septated nuchal fluid collection

Front 45

give examples of giant neck masses

Back 45

-cervical teratomas
-orthopharyngeal

Front 46

give examples of other neck masses

Back 46

--hemangioma
-lyphangioma
-teratoma:
these are all differentials for eachother

Front 47

Micropthalmia

Back 47

abnormally small eyes

Front 48

cataracts

Back 48

appear as an abnorally echogenic lens

Front 49

Dacrocystocle

Back 49

lacrimal duct cyst located infromedial to orbit

Front 50

when scanning for facial clefts, what structures should be visialized

Back 50

-lips
-chin
-alveolar ridge
-nose
-philtrum(midline groove of upper lip)

Front 51

what are wourmian bones? Where are they located?

Back 51

Extra ossification center is identified btw frontal bones
If there is <3, they are called sutural bones. 36-8

Front 52

wourmian bones

Back 52

extra ossification center identified btw frontal bones
-<3=suteral bones
-associated with wild chromosomal anomolies

Front 53

describe the correct way to measure fetal nasal bone

Back 53

-midsagital profile
-image magnified
-45 degree angle
-must see equals sign, and tip of the nose
-

Front 54

what are some other possible neck masses?

Back 54

hemangioma
lyphangioma
teratoma