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Head and Neck > Development of the Head, Neck and Face. > Flashcards

Development of the Head, Neck and Face. Flashcards

1
Q

What are the pharyngeal arches?

A

A sequence of ridges that form in the lateral wall of the embryonic pharynx, towards the cranial end of the neural tube. They form structures of the future head and neck.

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2
Q

When do the pharyngeal arches become apparent?

A

~4 weeks.

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3
Q

Describe the structure of the pharyngeal arches.

A

There are 5 arches (1,2,3,4,6). Each arch has a large mesenchyme core with some neural crest cells that migrate in. Pharyngeal arches are covered by ectoderm on their external surface and endoderm on their internal structure. Between each arch on the external surface there are pharyngeal grooves and the internal structure has pharyngeal pouches.

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4
Q

What is the external surface between each arch called?

A

Pharyngeal grooves.

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5
Q

What is the internal surface between each arch called?

A

Pharyngeal pouches.

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6
Q

What happens to the pharyngeal grooves?

A

The first groove persists to become the external auditory meatus. The 2nd arch grows down to cover the other grooves.

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7
Q

What is the embryological defect occurring when the pharyngeal grooves persist?

A

Branchial Cysts (enclosing fluid filled remnant) or a Branchial Fistula (abnormal connection or opening).

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8
Q

Describe the Clinical Presentation of a Branchial Cyst or a Branchial Fistula.

A

The embryological defects are usually found anterior to sternocleidomastoid. A fistula will be leaking as there is an opening but a cyst will just be a serous lump.

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9
Q

What arises from the Pharyngeal Pouches?

A

A number of important glandular structures including the parathyroids, thymus and palatine tonsils.

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10
Q

What is a Pharyngeal Apparatus?

A

The pharyngeal arches, pharyngeal pouches and pharyngeal grooves collectively are called the pharyngeal apparatus.

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11
Q

Describe the pharyngeal arches in terms of size.

A

The first is the largest and then the arches get progressively smaller in size,

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12
Q

What is associated with each arch?

A
  1. Cartilage,
  2. Nerve,
  3. Artery.
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13
Q

What constitutes the building blocks for the head and neck region?

A

The Pharyngeal Arches and the Frontonasal Prominence (FNP).

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14
Q

What does the cartilaginous bar do?

A

This is where the cartilage arises in each pharyngeal arch and becomes a skeletal element of the head and neck.

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15
Q

Which cranial nerves are associated with the pharyngeal arches?

A

V, VII, IX and X.

Trigeminal, Facial, Glossopharyngeal and Vagus Nerves.

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16
Q

How are the cranial nerves associated with the pharyngeal arches?

A

The cranial nerves arises from the lower part of the brainstem and so innervate the pharyngeal arches.

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17
Q

Describe the pharyngeal arches association with the aortic arch blood vessels.

A

The aortic arch blood vessels run through the mesenchyme of each pharyngeal arch. Order is loss as the embryo continues to develop.

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18
Q

Explain why the recurrent laryngeal nerve becomes looped under the arch of the aorta on the left and the subclavian artery on the right.

A

The pharyngeal arches are first orderly associated with the aortic arch blood vessels but as the embryo develops and the structures start to derive from the pharyngeal arches much of this structure is lost and this can explain the seemingly random arrangement here.

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19
Q

Which Cranial Nerves are associated with Pharyngeal Arch 1?

A

Trigeminal (V), Facial (VII) and Glossopharyngeal (IX) Nerves.

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20
Q

Which Cranial Nerves are associated with Pharyngeal Arch 2?

A

Trigeminal (V), Facial (VII) and Glossopharyngeal (IX) Nerves.

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21
Q

Which Cranial Nerves are associated with Pharyngeal Arch 3?

A

Trigeminal (V), Facial (VII) and Glossopharyngeal (IX) Nerves.

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22
Q

Which Cranial Nerves are associated with Pharyngeal Arch 4?

A

The Vagus (X) Nerve.

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23
Q

Which Cranial Nerves are associated with Pharyngeal Arch 6?

A

The Vagus (X) Nerve.

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24
Q

Which Arteries are associated with Pharyngeal Arch 1?

A

Common External and Internal Carotid Arteries and their branches.

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25
Q

Which Arteries are associated with Pharyngeal Arch 2?

A

Common External and Internal Carotid Arteries and their branches.

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26
Q

Which Arteries are associated with Pharyngeal Arch 3?

A

Common External and Internal Carotid Arteries and their branches.

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27
Q

Which Arteries are associated with Pharyngeal Arch 4?

A

Aortic Arch (on the left) and the Subclavian Artery (on the right).

28
Q

Which Arteries are associated with Pharyngeal Arch 6?

A

Pulmonary Arteries.

29
Q

Which Muscles are associated with Pharyngeal Arch 1?

A
  1. Muscles of Mastication.
  2. Mylohyoid.
  3. Anterior belly of digastric.
  4. Tensor Tympani.
  5. Tensor Veli Palatine.
30
Q

Which Muscles are associated with Pharyngeal Arch 2?

A
  1. Muscles of Facial Expression.
  2. Stapedius.
  3. Stylohyoid.
    Posterior belly of digastric.
31
Q

Which Muscles are associated with Pharyngeal Arch 3?

A
  1. Stylopharyngeus.
32
Q

Which Muscles are associated with Pharyngeal Arch 4?

A
  1. Constrictor muscles of pharynx.
  2. Muscles of soft palate (levator veil palatine).
  3. Muscles of larynx.
  4. Striated muscles of oesophagus.
33
Q

Which Muscles are associated with Pharyngeal Arch 6?

A
  1. Intrinsic muscles of the larynx.
34
Q

Which Skeletal/Cartilage Elements are associated with Arch 1?

A
  1. Maxillae and Zygomatic bones.

2. Meckel’s Cartilage: malleus and incus and template for mandible to form via intramembranous ossification.

35
Q

Which Skeletal/Cartilage Elements are associated with Arch 2?

A

Reichert’s Cartilage:

  1. Stapes,
  2. Upper part of Hyoid Bone,
  3. Stylohyoid Process.
  4. Stylohyoid Ligament.
36
Q

Which Skeletal/Cartilage Elements are associated with Arch 3?

A
  1. Inferior part of Hyoid Bone.
37
Q

Which Skeletal/Cartilage Elements are associated with Arch 3-4?

A
  1. Epiglottis.
38
Q

Which Skeletal/Cartilage Elements are associated with Arch 4-6?

A
  1. Cartilage of Larynx.
39
Q

Describe the 1st and 2nd Pharyngeal Arches in association with the Aortic Arches.

A

Arteries disappear.

40
Q

Describe the 3rd Pharyngeal Arch in association with the Aortic Arches.

A

Internal Carotid Artery.

41
Q

Describe the 4th Pharyngeal Arch in association with the Aortic Arches.

A

Arch of the Aorta on the left and the Brachiocephalic on the right.

42
Q

Describe the 6th Pharyngeal Arch in association with the Aortic Arches.

A

Pulmonary Arch.

43
Q

What drives the development of the face?

A
  1. Expansion of the cranial neural tube.
  2. Appearance of complex tissue systems associated with the cranial gut tube and the outflow of the developing heart.
  3. Development of the sense organs.
  4. The need to separate the respiratory tract and the GI tract.
44
Q

What makes up the facial primordia?

A
  1. First pharyngeal Arch (maxillary and mandibular prominence).
  2. Frontonasal Prominence (surrounds the venture-lateral part of the forebrain).
45
Q

What is the Derivatives of the first pharyngeal pouch?

A
  1. Pharyngotympanic tube (tube that links the nasopharynx to the middle ear).
  2. Middle ear cavity.
46
Q

What is the Derivatives of the second pharyngeal pouch?

A

Palatine tonsils.

47
Q

What is the Derivatives of the third pharyngeal pouch?

A
  1. Inferior parathyroid.

2. Thymus.

48
Q

What is the Derivatives of the fourth pharyngeal pouch?

A
  1. Superior parathyroid.

2. C cells of Thyroid.

49
Q

What makes up the Frontonasal Prominence?

A
  1. Forehead.
  2. Bridge of nose.
  3. Nose.
  4. Philtrum.
50
Q

What makes up the Maxillary proportion of the face?

A
  1. Cheeks.
  2. Lateral upper lip.
  3. Lateral upper jaw.
51
Q

What makes up the Mandibular proportion of the face?

A
  1. Lower lip.

2. Lower jaw.

52
Q

What are the major facial features?

A
  1. Palpebral fissures (round eye).
  2. Oral fissure.
  3. Nares.
  4. Philitrum.
53
Q

What are the components of the face embryologically?

A
  1. FNP.
  2. 1st pharyngeal arch (maxillary/mandibular).
  3. Stomatoduem-> the future mouth, covered by the buccopharyngeal membrane.
54
Q

What membrane separates the stomatodeum to the outside?

A

Buccopharyngeal Membrane.

55
Q

Describe the development of the nose.

A
  1. Nasal placodes appear on the frontonasal prominence
  2. Nasal placodes sink to become the nasal pits.
  3. Medial and lateral nasal prominences form on either side of the pits.
  4. The maxillary prominence grows medially pushing the nasal prominences closer together in the midline.
  5. The maxillary prominences fuse with the medial nasal prominences.
  6. Medial nasal prominences then fuse in the midline.
56
Q

What is a placode?

A

Area of ectoderm that starts to thicken and differentiate itself from its surrounding tissue to give rise to sensory structures. E.g. Otic placode from which the future ear develops.

57
Q

How does separation of the nasal and oral cavities occur?

A
  1. Fusion of the medial nasal prominences creates the intermaxillary segment (made up of the labial component of the philitrum, upper jaw 4 incisors and the palates primary palate). The main part of the definitive palate is the secondary palate derived from the palatal shelves from the maxillary prominence.
  2. The maxillary prominence gives rise to 2 palatal shelves
  3. The shelves grow vertically downwards onto the oral cavity on each side of the developing tongue.
  4. The mandible grows large enough to allow the tongue to drop.
  5. The palatal shelves then grow towards each other and fuse in the midline.
  6. The nasal septum develops as a midline down-growth and fuses with the palatal shelves.
58
Q

What makes up the intermaxillary segment?

A
  1. Labial component of the philitrum.
  2. Upper jaw: 4 incisors.
  3. Palate= primary plate.
59
Q

How do the deepening nasal pits lie in relation to the stomodaeum?

A

Deepening nasal pits lie dorsal to the stomodaeum, separated by only a thin sheet of cells, the oronasal membrane. This membrane disappears to become one space.

60
Q

How does the Lateral Cleft Lip Form?

A

Failure of fusion of medial nasal prominence and the maxillary prominence.

61
Q

How does the Cleft Lip and Cleft Palate Form?

A

Failure of fusion of medial nasal prominence and maxillary prominence combined with failure of palatal shelves to meet into midline.

62
Q

Describe the formation of the back of the ear.

A

The external auditory meatus develops from the first pharyngeal groove.
The middle ear cavity and ossicles develop from the first pharyngeal pouch and cartilages of the first and second arches respectively.
The auricles develop from proliferation within the first and second pharyngeal arches surrounding the meatus.

63
Q

How do the auricles develop?

A

From proliferation within the first and second pharyngeal arches surrounding the meatus.

64
Q

Describe the positioning of the ears.

A

External ears develop initially in the neck.
As the mandible grows the ears ascend to the side of the head to lie in line with the eyes.
All common chromosomal abnormalities alibis have associated external ear abnormalities.

65
Q

What is Fetal Alcohol Syndrome?

A

There is no known safe level of alcohol consumption during pregnancy.
The facial skeleton is derived from neural crest cells populating the pharyngeal arches.
Neural crest migration as well as development of the brain are very sensitive to alcohol.

66
Q

How would Fetal Alcohol Syndrome present?

A
  1. Small head.
  2. Local Nasal Bridge.
  3. Small eye openings.
  4. Short nose.
  5. Thin upper lip.
  6. Underdeveloped jaw.
  7. Smooth philtrum.
  8. Flat midfacxe.
  9. Epicanthal folds.
67
Q

What its the incidence of Fetal Alcohol Syndrome?

A

1/100.

Head and Neck (6 decks)

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