CFD9- Skull growth Flashcards

1
Q

what is the need to understanding facial growth?

A
  • aetiology of malocclusion
  • recognise abnormal growth patterns
  • Best plan of treatment: functional appliances vs orthognathic surgery
  • Understand factors that influence treatment stability
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2
Q

Name the primary cartilages.

A
  • meckel’s cartilage : contribute to mandible development
  • Reichert’s cartilage the 2nd arches cartilage
  • nasal capsule
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3
Q

what is the role of primary cartilages?

A

Primary skeletal support of developing structures

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4
Q

what is the structure of primary cartilage?

A
  • hyaline cartilage

- interstitial growth

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5
Q

what is the fate of primary cartilages

A
  • ossify e.g. part of nasal capsule (some remain)

- disappear e.g most of meckel’s cartilage

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6
Q

what are the 2 craniums of the skull?

A
  • neurocranium

- viserocranium

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7
Q

what is the bones that hold the brain (brain case)?

A

neurocranium

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8
Q

what is the bones that form the facial skeleton?

A

viserocranium

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9
Q

what are the 2 divisions of the neurocranium?

A
  • Dermatocranium : cranial vault (intramembranous formed bones)
  • Chondrocranium : cranial base (cartilage forms bone)
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10
Q

when do the primary cartilages appear?

A

7 weeks IU

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11
Q

name some primary cartilages.

A
  • trabeculum
  • parachordal cartilages
  • occipital somites
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12
Q

what happens to the primary cartilages?

A

cartilages fuse together and from a network of primary cartilages

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13
Q

what are the bones of the cranial base?

A
  • sphenoid bone
  • occipital bone
  • Temporal bone-petrous part
  • ethmoid bone
  • frontal bone
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14
Q

what type of ossification forms the cranial base?

A
  • ossification centres

- endochondral ossification (cartilage converts to bone)

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15
Q

what are the dermal/membranous bones of the cranial vault?

A
  • frontal
  • parietal
  • squamous part of temporal and occipital bones
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16
Q

what ossification forms the cranial vault?

A

intramembranous

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17
Q

what are the bones from anterior to the coronal suture derived from?

A

ectomesenchyme (neural crest)

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18
Q

what are the bones posterior to the coronal suture derived from?

A

mesenchyme (mesoderm) derived

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19
Q

what does ectomesenchyme/ mesenchyme differentiate into?

A

osteoblasts

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20
Q

when does bone formation of cranial vault start?

A

8 weeks in utero

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21
Q

where do bones meet?

A

sutures

22
Q

what occurs at sutures?

A

growth

23
Q

what are synchondroses?

A

cartilage joints at the base of the skull

24
Q

what is the difference in neural and somatic growth?

A
  • Neural growth happens quickly so dermatocranium almost fully formed by the age of 12
  • Somatic growth is slower- reaches full size at around age 20
25
Q

what is sutural growth due to?

A

expansion of underlying structures (i.e brain)

  • osteoblasts on surface lay down bone
  • brain expands and the suture is stretched and causes tension between the 2 areas
  • osteoblasts need to work harder to lay down more bone
26
Q

what are fontanelles?

A
  • Soft spots- in a new born skull the sutures are wide open - fibrous tissue over the brain
  • gradually close up
27
Q

what are fontanelles for?

A

skull is flexible so when the baby is born , the head is squished and bones are compressed and overlap

28
Q

How long do the fontanelles take to close?

A
  • anterior (closes 6-18 months)
  • posterior (closes 1-3 months)
  • anterolateral (closes 6 months)
  • posterolateral (closes 6-18 months)
29
Q

what is a sychondrosis?

A
  • Immovable cartilage joint
  • active growth sites
  • interstitial growth
  • pushes bones apart
30
Q

Name the 2 synchondrosis’s.

A
  • spheno-ethmoidal

- spheno-occipital

31
Q

when does sphenoid-ethmoidal fuse?

A

around birth

32
Q

what is the main site of elongation of the cranial base?

A

spheno-occipital

33
Q

when does the spheno-occipital fuse?

A

age 12 (female) and 14 (male)

34
Q

what is achondroplasia ?

A
  • impaired cartilaginous growth

- FEATURES: facial shape is concave (don’t have any growth at spheno-occipital synchondrosis)

35
Q

what is involved in remodelling of bone?

A
  • surface deposition -ostepblasts

- surface resorption -osteoclasts

36
Q

what is surface deposition?

A

adding of bone (on the outside)

37
Q

what is surface resorption?

A

bone taken away (on the inside)

38
Q

when does the maxillary air sinus form?

A

10 weeks

39
Q

what is primary pneumatisation?

A

forms pouches in walls of nasal cavity

40
Q

what is secondary pneumatisation?

A

expansion by resorption of lateral and inferior walls ( not medial)

41
Q

what is the clinical relevance of maxillary air sinus?

A
  • tooth can grow into sinus

- oral antral fistula connection

42
Q

what happens to the sinus during a removal of a tooth?

A
  • sinus enlarges
  • alveolar height reduces
  • thin bone
43
Q

Describe secondary cartilages.

A
  • fibrocartilage
  • not part of the primary skeleton
  • appositional growth
44
Q

what are the stages of appositional growth in secondary cartilages (endochondral ossification) ?

A

– Surface deposition of new cartilage
– Calcification of sub‐surface cartilage
– Resorption of calcified cartilage
– Replacement of calcified cartilage with bone

45
Q

Name 3 secondary cartilages.

A
  • symphyseal
  • coronoid
  • condylar
46
Q

when does symphyseal cartilage appear and disappear?

A
  • appear : 16 weeks i.u.l

- disappear : 1st year after birth

47
Q

when does coronoid cartilage appear and disappear?

A
  • appear : 14-16 weeks i.u.l

- disappear : before birth

48
Q

when does condylar cartilage appear and disappear?

A
  • appear : 10-12 weeks i.u.l

- disappear : 20 years of age

49
Q

what is the evolution of the mandible?

A
  • birth (small ramus)
  • Deciduous dentition
  • Permanent eruption
  • maturity
  • partially dentate
  • edentulous
50
Q

what factors control growth patterns?

A

1) hormonal -growth spurts
2) intrinsic - within the bone or cartilage (genetic)
3) Extrinisc :
- Neural -brain growth
- special sense - eyeball
- muscle activity
- air sinuses
- nasal septum growth
- soft tissues - cheeks -thumb sucking
4) teeth :
- presence
- removal
- implants
- orthdontics (expand plate)