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Cleft Palate > Chapter Two > Flashcards

Chapter Two Flashcards

1
Q

What Is a Cleft?

Usually a _______
malformation due to abnormal fusion of parts during _______

Can be due to ______

A

Abnormal opening or fissure in an anatomical structure

congenital; embryological development

ablative surgery

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2
Q

Clefts

Vary in ___and _____

Follow embryological _____lines

A

type

severity

suture

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3
Q

Embryological Developmentof the Lip and Palate

Embryological development is dependent on formation of ______ cells in embryo.

Through the process of _______

Neural crest cells are found between the ____and the ____ of an embryo.

Cells migrate to form ______

A

neural crest

organogenesis

neural tube and epidermis

skull and face.

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4
Q

Causes of Clefts

_____or ______factors delay cell migration and palatal shelf movement.

This can cause the embryo to miss the period of ______

A

Genetic or environmental

epithelial cell fusion.

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5
Q

Causes of Clefts

Multifactorial Inheritance: Endogenous (internal) factors

Exogenous (external) factors (e.g., teratogens)

A

Chromosomal disorders
Genetic disorders

Drugs: phenytoin (Dilantin), valium, and corticosteroids

Viruses (rubella, influenza)

Teratogens (smoking, lead)

Nutritional deficiencies or maternal obesity

Mechanical interference

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6
Q

Embryological Development***

Lip (primary palate)

Palate (secondary palate)

Development is _______.

A

begins at 7 weeks.

begins at 9 weeks.

independent

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7
Q

Embryological closure begins at incisive foramen and “zips” …

Structures closest to the incisive foramen…

A

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

fuse first

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8
Q

Embryological Development
Clefting severity occurs from…

____side of lip may close first.

_______ may close first.

Clefting starts in the strictures that are _____from the incisive foramen.

A

the lip in to the incisive foramen
the uvula in to the incisive foramen

Right

Oral surface of velum

farther

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9
Q 
Classification of Clefts
Primary Palate (Cleft Lip)

Fuses around ___weeks of gestation

______to incisive foramen

Includes ___and ____*** (can be one or both)

Clefts include:

A

7

Anterior

lip and alveolus

Complete or incomplete
Unilateral or bilateral

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10
Q 
Classification of Clefts
Secondary  Palate (Cleft Palate)

Fuses around ___weeks of gestation

_____to incisive foramen

Includes ___________

Clefts include:

A

9

Posterior

hard palate and velum

Complete or incomplete

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11
Q

Unilateral incomplete cleft lip

A

Image

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12
Q

Unilateral complete cleft lip

A

Image

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13
Q

Bilateral incomplete cleft lip

A

Image

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14
Q

Bilateral complete cleft lip

A

Image

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15
Q

Clefts of the Primary Palate:Types and Severity

Simonart’s Band—

May be due to _____

A

band of soft tissue that bridges a cleft of the lip

amniotic bands

(Image)

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16
Q

Clefts of the Primary Palate: Effects on Structure and Function

Structure
1.
2.
3.
4.

Function
1.
2.

A
  1. Cleft lip and orbicularis oris
  2. Wide, flat nose with spreading nasal ala
  3. Short columella
  4. Abnormal dentition
  5. Specific articulation errors
  6. Resonance affected
17
Q

Cleft palate

A

Image

18
Q

Cleft palate with Pierre Robin sequence

A

Image

19
Q

Bilateral complete cleft lip and palate

A

Image

20
Q

Fistula

Palatal (oronasal) fistula

A

Image

21
Q

Clefts of the Secondary Palate:Effects on Structure and Function

Structure

  1. Absent _____
  2. Altered insertion of the ________(cleft muscles of Veau)
  3. Abnormalities in _____

Function

  1. ______ insufficiency (speech and resonance affected)
  2. _______problems and ____regurgitation
  3. _______malfunction
A
  1. velar aponeurosis
  2. levator velar muscles
  3. nasal septum

function

  1. Velopharyngeal
  2. Feeding; nasal
  3. Eustachian tube
22
Q

Submucous Cleft Palate:Types and Severity

Overt—

Occult (hidden)—

A

visible from the oral surface

normal on the oral surface, abnormal on the nasal surface

23
Q

**Classic stigmata of an overt submucous cleft:

Bifid or hypoplastic:

Zona pellucida—

Notch in the hard palate where the posterior nasal ____should be, if the submucous cleft extends that far

Muscles often affected in the same way as a ______palate

A

Bifid or hypoplastic:(small and underdeveloped) uvula

Zona pellucida—thin, bluish area in middle of the velum

spine

complete cleft

24
Q

Submucous Cleft Palate

A

Image

25
Q

Submucous Cleft:

Affects ______of the_______muscle

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

A

interdigitation and levator veli palatini

posterior

(Image)

26
Q

Submucous Cleft: Effects on Structure and Function

Depends on the ____

May have virtually no ____

May have the same effects as an overt cleft palate as follows:

Structure
Altered insertion of the ________ (cleft muscles of Veau)

A

extent

effect

levator velar muscles

27
Q

Function

Velopharyngeal ______(speech and resonance affected)

Feeding _____and nasal regurgitation

Eustachian tube ______

A

Insufficiency

problems

malfunction

28
Q

Clefts of the Primary Palate:Types and Severity
Midline cleft with holoprosencephaly

Holoprosencephaly—

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.

Image

29
Q

Facial Clefts: Type and Severity

Can be caused by:

A

Genetic defects

Amniotic bands

30
Q

Two types of facial clefts:

A

Oblique

Midline (median)

31
Q

Facial Clefts: Effects on Structure and Function

Structural abnormalities on the outside the head (face or skull) usually suggest abnormalities on _________(face or skull).

A

the inside of the head

32
Q

Abnormalities on the inside the head (face or skull) usually affect function of the following:

A 
cognition
language
speech
resonance
hearing
feeding/swallowing
33
Q

Prevalence of Clefts***

Cleft lip occurs twice as often in ____(with/without cleft palate).

Cleft palate occurs twice as often in ______.

A

males

females

34
Q

Submucous cleft

Facial cleft

A

Essentially unknown

May not cause problems with speech

May become symptomatic after adenoidectomy

very rare

35
Q

Treatment of Clefts

A

Cheiloplasty to close the lip

Palatoplasty to close the palate

Usually pharyngeal flap or sphincter pharyngoplasty if there is velopharyngeal insufficiency affecting speech

36
Q

Clefts are a common _________

Proper intervention is important.

A

birth defect.

37
Q

Velopharyngeal insufficiency*

A

VP closure is not achieved due to an anatomical

In cleft palate, this is what we are talking about**

38
Q

VP incompetency*

A

results from a functional problem

39
Q

VP mislearning*

A

person incorrectly learns how to use sounds; anatomy and function are fine

Cleft Palate (19 decks)

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