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Spring '14-127 (Exam 1) > 2/17/14-Surgery > Flashcards

2/17/14-Surgery Flashcards

1
Q

What are nostrils also known as?

A

Nares

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2
Q

What is a feature of the upper lip?

A

Philtrum

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3
Q

What are the palatine processes a part of?

A

Maxilla

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4
Q

What does the Eustachian tube connect the pharynx with?

A

Middle Ear

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5
Q

What is the primary muscle of velar movement?

A

The Levator Levi Palatini

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6
Q

What are the muscles of the faucial pillars?

A

Palatoglossus & Palatopharyngeus

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7
Q

What are the rugae?

A

Transverse palatal ridges of mucosa

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8
Q

What teeth are contained in the pre maxilla?

A

central and lateral incisors

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9
Q

Where are the bones of the hard palate joined at?

A

the Midline raphe

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10
Q

What is the primary innervation of velopharyngeal closure from?

A

CN X

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11
Q

What is the purpose of a genetics evaluation?

A
  • make a diagnosis
  • determine the course of a disorder
  • Determine the risk of recurrence
  • provide psychological counseling
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12
Q

What is the most important aspect of a genetics evaluation?

A

-getting a complete history

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13
Q

Why are trisomy or monosomy very serious in terms of infant mortality?

A

more genetic information is wrong

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14
Q

Van Der Woude Syndrome is most common in CL/P. The chromosome involved and the most common symptoms is… ?

A

Chromosome 1; Lip Pits

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15
Q

Pierre Roban is a _______ not a _______.

A

Sequence, Syndrome

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16
Q

Classic presentation of stickler syndrome includes early onset of.. ?

A

Osteoarthritis and Myopia

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17
Q

22q11 Syndrome is also known as…?

A

Velocardiofacial Syndrome

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18
Q

One of the most distinguishing features of Apert’s Syndrome is What?

A

Syndactyly

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19
Q

What is the primary feature of Hemifacial Microsomia?

A

Facial Asymmetry

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20
Q

Is autosomal dominant MORE or LESS likely to be inherited?

A

More likely to be inherited

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21
Q

What is resonance determined by?

A

size and shape of the vocal tract

function of the velopharyngeal valve or port

vocal quality

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22
Q

When pitch rises, so does the… ?

A

larynx

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23
Q

Hypernasality is what kind of a disorder?

A

Resonance disorder

24
Q

Hyper nasality is due to abnormal coupling of the what?

A

Oral and Nasal Cavities

25
Q

What is hypo nasality the result of?

A

Blockage of resonance in the nose

cold, allergy swelling nasal passages

physical obstruction in the nose

26
Q

Nasal air emission occurs when there is a failure to build up…?

A

Intraoral pressure

27
Q

NAE often results in?

A
  • short utterance of length
  • nasal grimace
  • weak or omitted consonants
28
Q

Hypernasality and NAE often cause a child to resort to.. ?

A

Compensatory-obligatory articulation errors

29
Q

People with resonance disorders often try to compensate with the voice by using….?

A

hyper functional voice production

30
Q

Obligatory arctic errors are_____ and compensatory errors are_____.

A
  • On accident; on purpose

- flaws; substitutions

31
Q

Is it ethical to do suck and plow exercises in speech therapy?

A

No. Because they are absolutely useless due to speech being voluntary where suck and blow are biological functions.

32
Q

What are the three types of lip repairs?

A
  • Straight line repair
  • Tennison-Randall (triangular flap)
  • Milard Rotation-Advancement technique
33
Q

Why is surgery done on the lip first? and what is the rule that dictates when it can be done?

A

Surgery si done on the lip to repair the muscular continuity on the upper lip (orbicular is iris) it’s about making it aesthetically pleasing. They end up repairing again in the teen years.

Rule of 10s, 10 lbs, 10 grams of hemoglobin (02 in the blood) to tolerate the effects of anesthesia and about 10 weeks of age.

34
Q

What is another procedure to bring the cleft segments together other than taping?

A

-Nasal Alveolar Molding (NAM)

35
Q

Describe the straight line repair.

A

The problem with straight line repair is that it’s too tight and it tends to impede the growth of the maxilla. Pulls down the nose/nare

they just aren’t done anymore b/c they require another surgery alter on.

36
Q

Describe the triangular flap/Tennison-Randall.

A

This surgery cuts out a section of tissue on both sides and then the lip can be pulled down, so you can lengthen the lip a little bit.

The tennis on randall removes some tissue so although you get some lengthening you also get some tightening

37
Q

Describe the Millard Rotation technique

A
  • Lip repair that is most commonly done now!
  • in this one you’re not losing tissue, in order to get lengthening of the lip & no tissue being removed you get this geometric cut.
  • Although the milard and tennis on randall are both used in unilateral cleft, the millard is better for the bilayer b/c there’s no loss of tissue!
38
Q

So again, what are the three types of lip repairs?

A

Straight line

millard rotation

tennison randall

39
Q

What is one stage closure?

A
  • most common surgical procedures
  • done around 10-24 months of age (10 is still considered too young, usually between 14-16 months)
  • if you cut the bone you will scar the bone and there won’t be any bone growth, leading to weird facial growth.
  • The tissue has to be taken off from surrounding structures. The tissue is cut from the palatal shelves that are present. Remember, the tissue that is not severed will continue to receive blood supply
  • Also, remember that if you’re talking about the palatal shelves you have an oral and a nasal surface.
40
Q

What are the different type of palatal repairs (these are all one stage closure repairs!)?

A
  • Free flap repair
  • furlow z-plasty for the soft palate
  • von langenbeck
  • V-Y Retroposition Procedure, AKA Wardill Pushback Procedure
  • Vomer Flap
41
Q

Describe the free flap repair

A
  • a free flap is tissue taken from some place else and transplantation. The problem with this is establishing blood supply, and there is hair growth.
  • if the palatal shelves really haven’t developed, then sometimes you don’t have a choice, and MUST do a free flap repair
42
Q

Describe the Furlow Z-plasty for the soft palate?

A

tissue is removed from the .. listen! missed this.

  • this is a velum repair
  • a furlow Z may be a revision of a palatal repair when there isn’t enough length
43
Q

Describe the Von Langenbeck?

A

This is a typical hard palate repair. They are pulling up flaps of tissue, not removing it, and moving it towards the center.

  • this can be done on the oral and nasal surface of the palatal shelves. you pull that tissue so that the hard palate edges together. And then threading them and papering over with tissue. You’re not actually moving the bone.
  • In this particular picture the cleft hasn’t gone through the alveolus (check pic!)
44
Q

Describe the VY Retroposition Procedure/Wardill Pushback procedure

A
  • there is no bone graft in this
  • they are cutting these slits (almost like vents or darts, that end up healing on their own cause they are not deep) in the tissue. A pushback will give you more length in the tissue, opening a flap, cutting a hole, and then pulling it backwards
  • you’re lengthening your repair therefore lengthening the velum

NO BONE JUST A SOFT TISSUE CLOSURE

45
Q

Describe the Vomer flap

A

May be used with the Wardill Pushback to close the large gap of the superior position (nasal septum)

46
Q

What is a two-stage surgical repair?

A

done around 12 and then 24 months

-surgical procedures are the same in two stage, but close velum first then wait for facial growth and then the hard palate.

this is kind of going out of style b/c it makes no difference, there is no advantage to it!

47
Q

What is a fistulae?

A

holes that develop after surgical repair, at some point there is tissue dehissance.

48
Q

How do you know a fistula is said to be functional?

A

-if a fistula has an effect on speech, eating, or drinking, as in air, food, or liquid gets into the nose, the fistula is said to be functional

the effect of a fistula is dependent on its size and location (e.g., a fistula in the alveolar ridge would have close to no effect, whereas a posterior fistula, eve if it’s tiny, will have a big effect.

Functional fistula: air, food, water, can pass through it!

49
Q

What is orthognathic surgery?

A

jaw surgery, it may occur later in life, ti is most commonly the bone graft to the alveolus. The fistula pictures would need an alveolus bone graft.

50
Q

When is orthognathic surgery done?

A
  • done when the cleft is in the alveolus
  • timing of the bone graft is controversial.
  • usually comes between 9-10 years of age, but you have to take into account the development of each individual child. the issue of orthodontia is that the bones need to be put in place so that when the adult teeth come into place, the bone is where it should be.
51
Q

Describe orthognathic surgery

A

-they transplant the bone from the hip or rib and sometimes it can be taken from the skull (calvarial). Most often done front he Iliac crew.

when the alveolus is closed, a surgeon may do the fistula repair @ the same time to avoid anesthesia over and over.

generally attempts are made to close fistulae at this time.

52
Q

Describe Maxillary osteotomies..

A

Surgical repairs probably disrupt blood supply, nerve supply, growth.

surgical repairs disrupt growth, so palate repair, regardless of the type of repair, may later require corrective surgery to approximate a normal growth pattern .you want to normalize bite and profile.

these surgeries are called Le Fort surgeries!

53
Q

Who are Le Fort I & II procedures done by?

A

an oral-maxillary surgeon

54
Q

Describe a LeFort I procedure

A

the upper alveolar arch is brought forward

usually the maxilla is advanced to correct mid faced hypoplasia–the lack of mid face growth.

-for this surgery the skin is pulled up, the upper jaw moves forward, and then sew things back on.

55
Q

Describe a LeFort II procedure

A

a much bigger section of the maxilla is advanced. this includes the bridge of the nose.

skin is peeled away front he mouth. Still done by an oral maxillary surgeon

56
Q

Describe a LeFort III procedure

A
  • done by a cranial surgeon
  • means a whole lot more of the face is pulled forward. this includes the eye sockets!
  • for this surgery the skin is peeled off from the skull. the whole face is pulled down and forward
57
Q

What can maxillary advancement create?

A

velopharyngeal dysfunction..

VPI occurs as a result of LeFort I, II, or III surgeries. It’s cause you pull the structure from the velopharyngeal wall.

Spring '14-127 (Exam 1) (5 decks)

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