Congenital Genetic Disorders Flashcards
Set of medical signs and symptoms that are correlated with each other.
Syndrome
Many syndromes are autosomal dominant or recessive?
Dominant
Second most common congenital physical birth defect (approx 1 in 800 births).
Cleft lip and palate
Chances of cleft palate in Asians
2 in 1000
Chances of cleft palate in Caucasians
1 in 1000
Chances of cleft palate in Blacks
0.5 in 1000
This is more commonly associated with syndromes.
Isolated cleft palate
Sex predilection of cleft lip and palate.
Males > F
Sex predilection of cleft palate ONLY.
F > M
One child with cleft palate = ____% chance another child will have it.
4
Two children with cleft palate = ____% chance another child will have it.
9
Mother and child with cleft palate = ____% chance another child will have it.
15
When does lip and palate development occur in utero?
4-8 weeks
What gives rise to the medial and lateral nasal prominences?
Frontonasal prominence
These form from neural crest cells migrating from the first pharyngeal arch.
Maxillary (2) and Mandibular (2) prominences
Houses the incisors in a developing fetus.
Premaxilla
Anterior to the incisive foramen
Premaxilla/Primary palate
Premaxilla AKA
Primary palate
What weeks does the secondary palate form?
6-12
When the maxillary prominence and medial nasal prominence don’t fuse.
Cleft lip
When the lateral palatine processes don’t fuse.
Cleft palate
When the medial and lateral palatine processes don’t fuse.
Cleft alveolus
What class (Veau)?
Unilateral notching of the vermillion not extending into the lip.
1
What class (Veau)?
Extending into the lip, but not the floor of the nose.
2
What class (Veau)?
Goes through the floor of the nose.
3
What class (Veau)?
Any bilateral clefting.
4
What class (Veau)?
Only soft palate involvement.
1
What class (Veau)?
Soft and hard palate involvement.
2
What class (Veau)?
Class 2 + unilateral alveolar process involvement.
3
Bilateral alveolar process involvement.
4
What age is the primary lip repaired?
0-6 months
When is the primary palate repaired?
12-18 months
- Est. a dental home.
- Routine prophy and exam.
- Speech surgery?
- Secondary lip/nose/scar revision surgery?
18 months - 6 years
Premature closing of one or more cranial sutures.
Craniosynostosis
Sagittal suture premature closing.
Scaphocephaly
Premature fusing of the metopic (median frontal) suture.
Trigonocephaly
When the coronal or lamboid sutures fuse.
Plagiocephaly
Both sides of the coronal sutures fuse.
Brachycephaly
Asymmetrical head shape due to external factors (cranial sutures are normal).
Deformational plagiocephaly.
Tx for deformational plagiocephaly
Helmet molding.
Most common syndrome associated with craniosynostosis.
Crouzon Syndrome
What percent of craniosynostoses are Crouzon Syndrome?
4.5%
Cloverleaf skull/Kleeblattschadel is associated with what syndrome?
Crouzon’s
Mental deficiency common or rare with Crouzon ?
Rare
Associated with that Syndrome?
Maxillary hypoplasia
Narrow palate
Class III malocclusion
Crouzon
Genes associated with Crouzon’s that play a role in bone growth, especially during embryonic development.
FGFR2/3
Genes associated with Apert Syndrome that play a role in bone growth, especially during embryonic development
FGFR2
Cephaly associated with Apert Syndrome.
Acrobrachycepahy (Tower skull).
Premature closing of the coronal suture.
Acrobrachycephaly
Syndactyly with Apert involves which digits?
2,3,4
Mental diability common or uncommon with Apert?
Common
Abnormally increased distance between two organs.
Hypertelorism.
Which Syndrome is this?
Hypertelorism
Proptosis
Down-slanting palpebral fissures
-Cleft palate common
Apert
Which syndrome?
- Class 3 malocclusion
- Anterior open bite
- V shaped maxilla
- Delayed dental eruption
- Crowding
Apert syndrome
Mandibulofacial dysostosis AKA
Treacher Collins Syndrome
Notch on the outer portion of the lower eyelid.
Coloboma
Which syndrome?
- Hypolastic zygoma and mandible.
- Coloboma
- Ear anomalies/hearing loss
- Mandible hypoplasia
- Cleft palate common
- Infants may expereince respiratory/feeding difficulties due to airway hypoplasia
Mandibulofacial dysostosis/Treacher Collin’s Syndrome
Cleft palate is common in these syndromes/diseasea.
Apert’s
Treacher Collins
Pierre Robin Sequence
DiGeorge Syndrome
This syndrome has defects of structures that derive from the first and second pharyngeal arch.
Treacher Collins/Mandibulofacial Dysostosis
Second most common facial birth defect.
Craniofacial (hemifacial) microsomia
Which syndrome?
- 1st/2nd pharyngeal arches.
- Assymmetrical presentation
- Usually spontaneous mutation
- Hearing loss common
- OMENS classifications:
Orbit Mandible Ear Nerve Soft tissue
Craniofacial/Hemifacial Microsomia
Theory of craniofacial/hemifacial microsomia.
Vascular deficiency leads to poor formation of the fetal face.
- Micrognathia
- Cleft palate
- Glossoptosis
Pierre Robin Sequence
Pierre Robin is NOT a syndrome!
True
The primary pathogenic event in Pierre Robin sequence.
Absent or delay in lowering of the embryonic tongue.
-Respiratory difficulties at birth and may have congenital heart disease.
Pierre Robin sequence
Tx for Pierre Robin sequence.
Mandibular distraction or advancement.
- Large head
- Frontal/Parietal bossing
- Small face (hypoplastic maxilla and zygoma).
- Hypertelorism, broad nose
- Short stature
- Multiple unerupted and supernumerary teeth.
Cleidocranial Dysplasia
Syndrome with multiple unerupted and supernumerary teeth.
- Distorted crown/root shapes.
- Lack cementum.
Cleidocranial Dysplasia
-Muscles on half the face atrophy.
Parry Romberg/Progressive Hemifacial Atrophy
- Unknown cause (maybe autoimmune).
- Onset age 5-15.
- Progresses for 2-10 years, then stabilizes.
- Seizures
- Skin pigmentation
- Vitiligo
- Eye problems
- Trigeminal neuralgia
- No know tx
Parry Romberg/Progressive Hemifacial Atrophy
Most common syndrome associated with cleft palate.
DiGeorge/Velo-Cardio- Facial/ 22q11.2 deletion syndrome.
- Long face
- Underdeveloped lower jaw
- Hearing loss
- Heart abnormalities
- Learning disabilities
- Thymic hypoplasia
DiGeorge/Velo-Cardio- Facial/ 22q11.2 deletion syndrome.
Which syndrome is this?
- Hypoplastic zygoma
- Coloboma
- Mandibular hypoplasia
- Cleft palate commcon
Treacher Collins Syndrome or Mandibulofacial Dysostosis