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AU '18 - Peds III exam III > Cleft Lip and Palate > Flashcards

Cleft Lip and Palate Flashcards

1
Q

what is the jxn between lip and palate?

A

incisive foramen

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2
Q

T/F: cleft lip is always anterior

A

true

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3
Q

T/F: cleft palate is always posterior

A

false, may be anterior or posterior or both

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4
Q

class I Veau cleft of LIP

A

unilateral notching of the vermillion border, not extending into lip (microform)

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5
Q

class II Veau cleft of LIP

A

unilateral cleft extending into lip (incomplete)

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6
Q

class III Veau cleft of LIP

A

unilateral cleft involving the floor of the nose (complete)

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7
Q

class IV Veau cleft of LIP

A

any bilateral cleft of the lip

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8
Q

class I Veau cleft of PALATE

A

isolated soft palate cleft only

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9
Q

class II Veau cleft of PALATE

A

unilateral soft and hard palate cleft

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10
Q

class III Veau cleft of PALATE

A

unilateral cleft involving soft/hard palate thorugh the alveolus (usually involves lip too)

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11
Q

class IV Veau cleft of PALATE

A

same as class II but BILATERAL

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12
Q

what causes cleft lip?

A

caused by partial or complete lack of fusion of maxillary prominence with the medial nasal prominence

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13
Q

what causes cleft palate?

A

lack of fusion of the palatine shelves

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14
Q

what are some reasons why palatine shelves didn’t fuse?

A
  1. smallness of shelves
  2. failure of shelves to elevate
  3. inhibition of shelf fusion
  4. failure of tongue dropping (micrognathia)
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15
Q

etiology of cleft lip palate

A
  1. environmental
  2. genetic
  3. mixed of environmental and genetic
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16
Q

environmental causes of cleft lip palate

A
  1. maternal smoking
  2. teratogens (i.e. EtOH, anticonvulsants)
  3. maternal obesity, nutrition, infection, hyperthermia, exposure to ionizing radiation (suspected)
17
Q

genes that cause cleft lip palate

A
  1. IRF6
  2. 8q24 locus
  3. VAX1
18
Q

cause of isolated (non-syndromic) cleft lip palate

A

multifactorial, environmental and genetic factors but known teratogens as well

19
Q

chromosomal anomalies that cause Syndromic Cleft Lip +/- Palate

A
  1. trisomy 13 (Patau)
  2. 18 (Edwards)
  3. 21 (Downs)
  4. 22q11 deletion syndrome (velocardiofacial)
20
Q

inherited syndromes that cause Syndromic Cleft Lip +/- Palate

A
  1. Sticklers (AD)
  2. Treacher Collins (AD)
  3. Van de Woude (AD)
21
Q

non-inherited syndromes that cause Syndromic Cleft Lip +/- Palate

A

Pierre Robin Sequence

22
Q

how many CLP cases are associated with syndromes?

A

1/3rd

23
Q

how many syndromes have CLP as a primary feature?

A

over 400 (1/2 due to Mendelian inheritance)

24
Q

list the order of races that has the highest to least number of incidence of CLP

A

American Indian/Asian > Caucasian > African descent

25
Q

cleft lip is more frequent in which sex?

A

males

26
Q

isolated cleft palate is more frequent in which sex?

A

females

27
Q

surgeries for CLP

A
  1. lip adhesion: 1-2 months
  2. lip repair: ~3-4 months
  3. palate repair: ~8-12 months
  4. tympanostomy tubes: 1-6 years
  5. posterior pharyngeal flap: 6-18 years
  6. alveolar bone graft: ~10 years
  7. orthognathic surgery
  8. alveolar grafting/block grafts
  9. dental implants
28
Q

pre-lip repair care

A
  1. dynacleft taping
  2. nasoalveolar molding appliance (NAM)
  3. lip adhesion surgery
29
Q

lip adhesion surgery reduces what?

A

tension on final scar after definitive repair

30
Q

why is alveolar bone grafting indicated?

A

clefts through the alveolar ridge, may have residual oronasal fistula and bony defect through the ridge, nose and palate

31
Q

T/F: alveolar bone grafting may be required even after successful lip and palate repair

A

true

32
Q

T/F: children with CLP are at a higher risk for caries

A

true

33
Q

in what area are caries higher in CLP pts?

A

max anterior regions and bilateral clefting

34
Q

T/F: children with CLP have good OH

A

false, poor

35
Q

T/F: children with CLP have perio disease and progression is faster than general population

A

true

36
Q

T/F: CLP care REQUIRES coordination fro ma large multidisciplinary team

A

true

AU '18 - Peds III exam III (12 decks)

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