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Cleft Palate > Ch. 2 > Flashcards

Ch. 2 Flashcards

1
Q

What is a cleft?
-Abnormal _______ or fissure in an anatomical structure
-Usually a _______ _______ due to abnormal fusion of parts during embryological development
-Can be due to ________ surgery
-Vary in ________ and __________
-Follow _________ __________ lines
Length of ____________ suture line.

A

-Abnormal opening or fissure in an anatomical structure
-Usually a congenital malformation due to abnormal fusion of parts during embryological development
-Can be due to ablative surgery
-Vary in type and severity
-Follow embryological suture lines
Length of medial suture line.

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2
Q

Embryological Development is dependent on the formation of _______________.

A

neural crest cells in embryo

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3
Q

Where are neural crest cells found?

A

between the neural tube and the epidermis of an embryo

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4
Q

Cells migrate to form ______.

A

skull and face

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5
Q

Causes of clefts:

  • _________ or ________ factors delay cell ___________ and palatal shelf movement.
  • This can cause the embryo to miss the period of _________ _________fusion.
A
  • Genetic or environmental factors delay cell migration and palatal shelf movement.
  • This can cause the embryo to miss the period of epithelial cell fusion.
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6
Q

Multifactorial Inheritance: Endogenous (internal) factors

A

Chromosomal disorders

Genetic disorders

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7
Q

Multifactorial Inheritance: Exogenous (external) factors

A

Drugs: phenytoin (Dilantin), valium, and corticosteroids
Viruses (rubella, influenza)
Teratogens (smoking, lead)
Nutritional deficiencies or maternal obesity
Mechanical interference

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8
Q

Lip (primary palate) begins at

A

7 weeks

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9
Q

Palate (secondary palate) begins at

A

9 weeks

should be finished by 12 weeks

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10
Q

Embryological closure begins at
_______ ___________ and “zips” …
-____________ to form the alveolar ridge and then lip
-____________ to form the hard palate and velum

A

incisive foramen and “zips” …

  • forward to form the alveolar ridge and then lip
  • backward to form the hard palate and velum
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11
Q

Clefting Severity occurs from
the _______ in to the incisive foramen
the ________ in to the incisive foramen

A

the lip in to the incisive foramen

the uvula in to the incisive foramen

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12
Q

right side of the lip

A

may close first.

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13
Q

Oral surface of the velum

A

Oral surface of velum may close first.

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14
Q 
Primary Palate (Cleft Lip)
Fuses around \_\_\_ weeks of gestation
  \_\_\_\_\_\_\_\_ to incisive foramen
  Includes \_\_\_\_\_\_\_ and \_\_\_\_\_\_\_\_\_
  Clefts include:
\_\_\_\_\_\_\_\_ or \_\_\_\_\_\_\_\_\_\_\_
\_\_\_\_\_\_\_\_ or \_\_\_\_\_\_\_\_\_\_\_
A 
Fuses around 7 weeks of gestation
  Anterior to incisive foramen
  Includes lip and alveolus
  Clefts include:
Complete or incomplete
Unilateral or bilateral
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15
Q 
Secondary Palate (Cleft Palate
Fuses around \_\_\_ weeks of gestation
  \_\_\_\_\_\_\_\_ to incisive foramen
  Includes \_\_\_\_\_\_\_\_\_\_\_ and \_\_\_\_\_\_\_\_
  Clefts include:
\_\_\_\_\_\_ or \_\_\_\_\_\_\_\_\_\_\_\_\_\_
A 
Fuses around 9 weeks of gestation
  Posterior to incisive foramen
  Includes hard palate and velum
  Clefts include:
Complete or incomplete
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16
Q

identify cleft lips and palates

A

see photos from powerpoint

17
Q

Simonart’s Band

A

band of soft tissue that bridges a cleft of the lip

May be due to amniotic bands

18
Q 
Primary Palate: effect on structure
Cleft \_\_\_\_\_\_ and orbicularis oris
Wide, \_\_\_\_\_\_\_ nose with spreading nasal ala
Short \_\_\_\_\_\_\_\_\_
Abnormal \_\_\_\_\_\_\_
A

Cleft lip and orbicularis oris
Wide, flat nose with spreading nasal ala
Short columella
Abnormal dentition

19
Q

Primary Palate: effect of Function
Specific ________ errors
_________ affected

A

Specific articulation errors

Resonance affected

20
Q

Secondary Palate: effect on structure
Absent ____ _________
Altered ______ of the levator velar muscles (cleft muscles of Veau)
Abnormalities in ______ _________

A

Absent velar aponeurosis
Altered insertion of the levator velar muscles (cleft muscles of Veau)
Abnormalities in nasal septum

21
Q

Secondary Palate: effect on Function
_________ ____________ (speech and resonance affected)
Feeding problems and ______ ________
_______ _________ malfunction

A 
Velopharyngeal insufficiency (speech and resonance affected)
Feeding problems and nasal regurgitation
Eustachian tube malfunction
22
Q

Submucous Cleft: Overt

A

visible from oral surface

23
Q

Submucous Cleft: occult

A

normal on the oral surface, abnormal on the nasal surface

24
Q

Classic Stigmata of an overt sub mucous cleft

  • _______ or hypoplastic (small and underdeveloped) uvula
  • ______ _________—thin, bluish area in middle of the velum
  • _______ in the hard palate where the posterior nasal spine should be, if the submucous cleft extends that far
  • Muscles often ______ in the same way as a complete cleft palate
A
  • Bifid or hypoplastic (small and underdeveloped) uvula
  • Zona pellucida—thin, bluish area in middle of the velum
  • Notch in the hard palate where the posterior nasal spine should be, if the submucous cleft extends that far
  • Muscles often affected in the same way as a complete cleft palate
25
Q

Submucous cleft:
Affects _______ of the levator veli palatini muscle
Levator muscle inserts on the _____ ______ of hard palate rather than in the _____ of the ______

A

Affects interdigitation of the levator veli palatini muscle

Levator muscle inserts on the posterior border of hard palate rather than in the middle of the velum

26
Q

Submucous Cleft effects on structure
Depends on the ______
May have virtually ___ ______
May have the same effects as an _____ cleft palate as follows:
Structure
Altered ______ of the levator velar muscles (cleft muscles of Veau)

A

Depends on the extent
May have virtually no effect
May have the same effects as an overt cleft palate as follows:
Structure
Altered insertion of the levator velar muscles (cleft muscles of Veau)

27
Q 
Submucous Cleft effects on function
\_\_\_\_\_\_\_\_\_ \_\_\_\_\_\_\_\_\_\_\_ (speech and resonance affected)
Feeding problems and \_\_\_\_\_\_\_ \_\_\_\_\_\_\_\_\_
\_\_\_\_\_\_\_ \_\_\_\_\_\_\_\_\_ malfunction
A 
Velopharyngeal insufficiency (speech and resonance affected)
Feeding problems and nasal regurgitation
Eustachian tube malfunction
28
Q

Holoprosencephaly: failure of the ____________ (the embryonic forebrain) to divide into _______ ________ of the cerebral hemispheres. The result is a _______-________ brain structure.

A

failure of the prosencephalon (the embryonic forebrain) to divide into double lobes of the cerebral hemispheres. The result is a single-lobed brain structure.

29
Q

Facial Clefts can be caused by

A

genetic defects

amniotic bands

30
Q

Two types of facial clefts

A

Oblique: slanting
Midline: middle of the face

31
Q

Facial clefts effects on structure and function
Structural abnormalities on the ______ the head (face or skull) usually suggest abnormalities on the ______ of the head (face or skull).
Abnormalities on the ______ the head (face or skull) usually affect function of the following:
_________
_________
_________
_________
_________
_________/___________

A 
Structural abnormalities on the outside the head (face or skull) usually suggest abnormalities on the inside of the head (face or skull).
Abnormalities on the inside the head (face or skull) usually affect function of the following:
cognition
language
speech
resonance
hearing
feeding/swallowing
32
Q

Cleft lip occurs…

A

twice as often in males (with or without cleft palate

33
Q

Cleft palate occurs…

A

twice as often in females

34
Q

Submucous cleft prevalence

A

Essentially unknown
May not cause problems with speech
May become symptomatic after adenoidectomy

35
Q

Facial Cleft prevalence

A

very rare

36
Q

TX of clefts: cheiloplasty

A

to close the lip

37
Q

TX of clefts: palatoplasty

A

to close the palate

38
Q

TX of velopharyngeal insufficiency affecting speech

A

pharyngeal flap or sphincter pharyngoplasty

Cleft Palate (7 decks)

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