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Paediatrics > 2. Growth and development > Flashcards

2. Growth and development Flashcards

1
Q

What is the bilaminar disc?

A
  • ectoderm and endoderm
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2
Q

What is the trilaminar disc?

A
  • endoderm, ectoderm and mesoderm
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3
Q

What does the ectoderm form?

A
  • skin, nails, teeth etc
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4
Q

What does the mesoderm form?

A

Muscles, bone

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5
Q

What does the endoderm form?

A
  • gut
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6
Q

What symptoms are present in ectodermal dysplasia?

A
  • problem with ectoderm
  • sparse hair
  • periorbital wrinkling
  • dysplastic nails
  • congenitally absent teeth
  • peg shaped teeth
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7
Q

What forms on the 26th day?

A
  • frontal prominence
  • maxillary process
  • mandibular process
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8
Q

What forms on the 27th day?

A
  • odontogenic epithelium
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9
Q

What forms on the 34th day?

A
  • lateral nasal process
  • medial nasal process
  • nasal pit
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10
Q

What happens on 36th and 38th day?

A

Fusion of processes, eg. maxillary and mandibular process. And medial and lateral nasal process.

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11
Q

What happens in the 7th, 8th and 9th week?

A
  • in the 7th week, the tongue is meant to drop down to allow the shelves to fuse correctly
  • the primary palate is formed from the frontonasal processes, forming the premaxilla and fusing with the maxillary processes posteriorly
  • the secondary palate is formed by fusing of the right and left palatal shelves of the maxilla
  • failure of these processes to fuse gives rise to cleft lip/alveolus/palate
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12
Q

How does the mandible form?

A

from fusion of the bilateral prominences

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13
Q

What cartilage is the mandible made from?

A
  • meckel’s cartilage forms the basis of the mandible as well as the structures of the inner ear
  • therefore aberrations of the mandible can therefore lead to hearing difficulties and should be considered when faced with poorly developed mandible
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14
Q

How does a child’s mandible differ from adults?

A

Child’s mandible is smaller with a far shorter ramus

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15
Q

PHARYNGEAL ARCHES SLIDE 14

A
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16
Q

What is Treacher Collins syndrome?

A

Problem with the first pharyngeal arch
- eyes with downward slant
- small flattened cheekbones
- small steeply angled jaw
- small oddly shaped ears
- may have cleft palate

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17
Q

Where can clefts affect?

A
  • the lip, alveolus and palate. If it affects the alveolus, the child may not have the full complement of teeth as the bone has not fused
  • clefts of the mandible and face are very rare
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18
Q

What is the definition of a cleft?

A

Failure of developing palatal shelves and/or frontonasal prominence to fuse together

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19
Q

What is the incidence of clefts?

A

CLP- 1 in 7000 live births
Palate- 1 in 200

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20
Q

Who and where are clefts most common in?

A

Males and left hand side

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21
Q

What are associated syndromes with clefts?

A
  • Downs syndrome
  • Treacher Collisns
  • Pierre Robin
  • Klippel-Fiel
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22
Q

How does the mandible join and as a result which tooth is most likely to be missing?

A
  • the mandible joins along the symphisis with left and right sides coming together. If there is a disruption in the union, it may cause absence of lower anterior 1
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23
Q

How does the maxilla join and as a result which tooth is most likely to be missing?

A
  • the premaxilla joins the posterior maxilla at a region where the lateral incisors are
  • so lateral incisor most likely to be missing if there is disruption in the union
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24
Q

What are morphogenetic fields?

A
  • the arch is divided into segments
  • the most anterior tooth in each segment is the key tooth, most stable
  • eg, molars=6, premolars=4, anterior=1
  • stability is in terms of reliable size and occurence
  • this theory supports common patterns of hypodontia
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25
Q

What is the cranium like at birth?

A
  • 60-65% of adult volume
  • has sutures open
  • has 6 fontanelles
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26
Q

What are the teeth like at birth?

A
  • primary teeth are partly calcified
  • teeth present at or very shortly after birth are called natal teeth
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27
Q

How does the mandible and maxilla grow?

A

In a downwards and forwards direction

28
Q

When does the cranial base grow till and how?

A
  • cranial base continues to enlarge at spheno-occipital synchrondosis
  • till 15 years
  • through endochrondral ossification
29
Q

How does the maxilla grow?

A

By intramembranous ossification by enlargement of the sinuses

30
Q

How does the mandible grow?

A

By intramembranous ossification as a result of muscle action and tooth development

31
Q

What does a diolocephalic head shape form?

A
  • face which is longer and thinner
  • associated with high mandibular plane angle
32
Q

What does brachycephalic head shape form?

A
  • rounder faces more like a child
33
Q

What is plagiocephaly?

A

Due to the result of premature fusion of one side of the cranium, giving lopsided growth

34
Q
A
35
Q

What are features of the primary occlusion?

A
  • develops continuously from 7 to 29 months
  • spaced incisors
  • anthropoid spaces between b’s and c’s
  • flush terminal plane
  • primary teeth are whiter and more susceptible to erosion than the permanent dentition
35
Q

What is the eruption sequence for primary teeth?

A
  • lower A
  • upper A, upper B, lower B
  • D
  • C
  • E
36
Q

What dates do A and B erupt?

A

6-9 months

36
Q

What dates do D erupt?

A

12-14 months

36
Q

What dates do C’s erupt?

A

16-18 months

37
Q

What dates do E’s erupt?

A

20-30 months

38
Q

What is the definition of the leeway space?

A

the difference between the sum of the mesiodistal crown widths of the primary canines and molars and that of their successors, the permanent canines and premolars.
- the difference in width between the distal aspect of E and mesial aspect of CW

39
Q

What is the upper leeway space?

A

1.5mm

40
Q

What is the lower leeway space?

A

2.5mm

41
Q

What is the gingivae around primary teeth like?

A
  • gingivae around primary dentition has pocket depth of around 3mm compared to 2mm for permanent
42
Q

What are the soft tissues in the primary dentition like?

A
  • epithelia thinner with less keratinisation
  • sulci deepen from birth till adulthood
  • fraenae become less prominent
43
Q

Which layer is soft tissues of the mouth derived from?

A

ectoderm

44
Q

When does post natal growth occur most?

A

0-5 years marks the greatest growth
- second growth spurt at onset of puberty

45
Q

What are the symptoms of Goldenhar syndrome?

A
  • tags on ears
  • flat nasal bridge
  • facial asymmetry
  • midface deficiency
  • deviated angle of mouth
  • canting
  • loss of xygomatic and malar prominence
46
Q

When is growth of the brain and cranium complete by?

A

5 years

47
Q

Which permanent teeth calcify at birth?

A

first permanent molars and incisors

48
Q

When does the face stop growing?

A

Face grows forwards and downwards till the early 20’s

49
Q

What drugs should you avoid in pregnancy?

A
  • NSAID’s and benzodiazepines
50
Q

How long is pregnancy?

A

38 weeks
Smoking, drinking alcohol and taking recreational drugs is strongly discouraged

51
Q

What is prescribed during pregnancy?

A

Folic acid to prevent spina bifida and similar diseases

52
Q

What is given parentrally in the neonate and at what time point?

A

Vitamin K parentral
0-4 weeks

53
Q

What is screened 0-4 weeks in a baby?

A
  • rhesus test of the umbilical cord
  • hearing test
54
Q

What is physically examined at 0-4 weeks in baby?

A
  • eyes, heart, hips, testes
55
Q

What is the heel prick test/blood test done for?

A

Done at 0-4 weeks
- to test sickle cell
- cystic fibrosis
- congenital hypothyroidism
- inherited metabolic disease

56
Q

What is prematurity?

A
  • when a baby is born less than 34 weeks gestation
  • more than 32 weeks have excellent outcomes
  • 23-26 weeks have significant problems
57
Q

What 3 common problems occur in prematurity?

A
  • respiratory distress syndrome
  • hypotension
  • patent ductus arteriosis
58
Q

When do children in the uk have health visitors?

A
  • up until 5 years old
  • supports family and monitors growth of the child
59
Q

Which medical interventions and people help with the child?

A
  • health visitor
  • vaccinations
  • school nurse
  • social worker
  • paediatrician
  • dietician
  • speech and language therapist
60
Q

What is failure to thrive?

A
  • failure of the baby to put weight on and grow
  • most often linked with feeding difficulties, absorption difficulties
61
Q

What 3 things do you use to diagnose failure to thrive?

A
  • growth that has dropped over 2 or more percentiles
  • persistently below the third or fifth percentile
  • less than 80% percentile for median weight for height measurement
62
Q

41-49

A

Paediatrics (8 decks)

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