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Genetics > Cleft Palate and ID > Flashcards

Cleft Palate and ID Flashcards

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1
Q

When does the primary palate form?

A

6-8 weeks

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2
Q

When does the secondary palate form?

A

10th week

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3
Q

What are the classifications of clefts?

A

Unilateral-one side
Bilateral-both side
Complete cleft- opening from the periphery completely through the incisive foramen
Incomplete cleft- only a slight cleft on the periphery or a cleft through to the incisive foramen w/ minimal band or bridge of tissue at some pt along the cleft

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4
Q

Causes of cleft lip and palate

A

Unknown
Genetic
Environmental
Multifactorial

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5
Q

issues with cleft lip and palate

A

Feeding difficulties
Otitis media and HL
Speech and Language delay
Dental problems

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6
Q

Cleft team members

A 
Plastic surgeon
Pediatrician
SLP
Audiologist
ENT
Genetic counselor
Nurse practioner
Dentist
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7
Q

What are some syndromes associated with cleft lip and palate?

A 
Van der Woude - autosomal dom
Opitz- auto dom, x-linked rec.
Pierre robin sequence- interference w/ mandible development in 9th week
Stickler- auto dom
Velocardiofacial- auto Dom
FAS
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8
Q

First region inspected when meeting a client face to face.

A

Impression of face
Evaluation of facial type
Evaluation of facial expression
Then, body type, posture and interpersonal skills

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9
Q

Why do cleft palate children develop more ear infections?

A

Levator Palatini is not aligned correctly, therefor does not properly pull on eustachian tube to open it up. Ears will remain “plugged” causing infection.

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10
Q

What is the incidence that a second child will have cleft lip/palate if the first child was affected?

A

Incidence in general pop is about 1:750, it DOUBLES for next child to about 1:375.

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11
Q

What causes cleft palate?

A

Improper migration of the lateral lip segment in utero. It is a complex process and sometimes malfunctions.

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12
Q

Cleft Palate/Lip and Speech

A
  • velopharyngeal closure problems result in hyper nasal speech.
  • recurrent otitis media may cause phonological and articulation problems
  • those with cleft lip alone do not typically experience speech problems..
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13
Q

Cleft Palate/Lip and Language

A

-Recurrent Otitis Media may cause language delays

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14
Q

Cleft Palate/Lip and Language

A
  • Increased risk for HL
  • Increased risk for conductive HL if persistent otitis media
  • muscles (levator palatini) used to open and close the eustachian tube do not work properly with cleft palate.
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15
Q

Cleft Lip alone-prevalance

A

Twice as common in males

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16
Q

Cleft Palate alone- prevalance

A

Twice as common in females

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17
Q

Cleft Palate/Lip- prevalance

A

more prevalent in certain ethnicities

18
Q

Other issues associated with Cleft Palate/lip (not medical)

A

-Social, Emotional, Behavioral problems due to appearance and stress of medical care.

19
Q

Cleft Palate/Lip Feeding Issues

A
  • Breast feeding is allowed
  • Special bottles and nipples available for use
  • larger openings in nipples to help with weak suction
  • syringes available for post-op feeding
20
Q

Cleft Palate/Lip and Articulation

A
  • Poor Velopharyngeal structure and function
  • –Nasal Emission
  • –Weak-pressure consonants
  • –Compensatory articulation
21
Q

Cleft Palate/Lip and Resonance

A
  • Resonance= perceived quality of the voice
  • –hypernasality
  • –hyponasality
22
Q

Cleft Palate/Lip and Voice

A
  • Soft, breathy voice due to lack of pressure

- hoarse or harsh voice due to strain put on vocal mechanism

23
Q

Cleft Palate/Lip and Dental

A
  • at risk for abnormalities of the teeth and jaw
  • missing, crowded, or rotated teeth
  • underdevelopment of midface region
24
Q

Role of the SLP with Cleft Palate/Lip

A
  • Assessment
  • —Clinical History
  • —Orofacial Examination
  • —Resonance
  • —Articulation
  • —Voice
25
Q

Specific treatment for Cleft Lip and Palate is determined by child’s physician based on what?

A
  • Child’s age, overall health, and med history
  • specific qualities of child’s abnormality
  • child’s tolerance for specific meds, procedures, or therapies
  • involvement of other body parts or systems
  • family input
26
Q

Treatment of Cleft Lip?

A
  • repaired within first several months (rule of 10)
  • surgeon decides when
  • goal of surgery is to fix separation in lip
  • 2nd surgery sometimes needed
27
Q

Treatment of Cleft Palate?

A
  • Repairs usually done between 9-18 months, but before age 2.
  • Physician decides when.
  • Goal of surgery is to fix roof of mouth so child can eat and learn to speak normally.
  • 2nd surgery sometimes needed
28
Q

Cleft Lip/Palate Surgery Timeline

A

Cleft Lip- Primary and secondary surgery between 1-3 months (rule of 10)
Cleft Palate-Primary surgery 6-18 months.
-Veloplasty @ around 4-5 years to allow midfacial growth.

29
Q

Terms reminder- Syndrome?

A

Cluster of anomalies that occur together and have a single known or suspected cause.

30
Q

Terms reminder- Sequence?

A

A series of secondary anomalies resulting from one initial anomaly.

31
Q

Define Cleft Lip

A

abnormality in which the lip does not completely form during fetal development. Degree can vary greatly from mild (notch in lip) to severe (large opening from lip up through the nose).

32
Q

Embryo 3-4 Weeks

A

-doesn’t have face; head composed of a brain covered with a membrane, eyes represented by optic vesicles are lateral on the head (like a fish); future mouth represented by stomodeum; later part of this period nasal pits emerge.

33
Q

Embryo 5-6 Weeks

A

-general shape of face begun to develop; frontonasal process is prominent; nasal pits are forming laterally, with increase in size of the first and second bronchial arches (idea of a mouth)

34
Q

Embryo Subsequent Weeks

A

-structure that we associate with the human face- jaws, nose, eyes, ears, and mouth will take on human configurations

35
Q

End of Embryo Phase 8 Weeks

A

-Facial features are characterized by the appearance of hypertelorism (excessive width between two bodily parts or organs). During continued growth it will appear as though the eyes are moving closer together – they are not they will continue to move farther apart BUT the remainder of the face is growing at a much more rapid rate and thus it appears the eyes are moving closer together. The hypertelorism is actually decreasing as a result of differential development.

36
Q

Define Proliferation

A

the growth or production of cells by multiplication of parts.

37
Q

Define Migration

A

Movement of Cells during growth.

  • migration different for development of different processes.
  • cells that migrate from forebrain fold to frontonasal process much shorter than forebrain to maxillary process.
  • These cells of mesodermal origin are capable of developing into connective tissues, blood, and lymphatic and blood vessels.
38
Q

Formation of Blood Supply

A
39
Q

Blood Supply 6 Weeks

A

-first and second aortic arches and their arteries formed; face continues to develop; vessels disappear; facial muscles are beginning to develop in a laminar fashion (A thin plate, sheet, or layer).
Nerves are beginning to develop as outgrowths of the CNS; skull base forms; 5th cranial nerve (trigeminal) – supply sensation to the face; 7th CN nerve supple to the second branchial arch begun to dev.

40
Q

Define Growth

A

Increase in dimension and mass

41
Q

Define Development

A

progression to more adult characteristics

42
Q

Factors affecting craniofacial growth and development

A
  • Nutrition -Genetic
  • Nervous System -Disease
  • Emotion -Socioeconomic status

Genetics (2 decks)

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