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BDS2 BAMS > Face and Palate > Flashcards

Face and Palate Flashcards

1
Q

time of development of the face

A

4-8 weeks in utero

  • eyes, ears, nose
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2
Q

time of formation of palate

A

6-10 weeks in utero

  • soft palate developing till 12 weeks
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3
Q

what is the earliest bone laid down in the skull

A

the mandible (approx 6-7 weeks)

one of the earliest in the skeleton

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4
Q

what are the 2 severities of defects in face and palate formation

A

can be major defects
- are incompatible with life

can be minor defects
- can be surgically corrected

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5
Q

the process of face and palate formation is

A

Highly coordinated and pre-programmed

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6
Q

how common are face and palate development abnormalities

A

1 in 700 births have some form of congenital malformation

More severe defects tend to occur 4-8 weeks (early facial developments)

Relatively minor problems develop later (8-12 weeks)
- Cleft lip and palate

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7
Q

what do the frontal nasal processes develop from

A

tissues surrounding forebrain

Develop separately from 1st pharyngeal arch (tissue around maxilla and mandible)
- Usually defects affect one or the other but not both at the same time

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8
Q

what are pharyngeal arches

A

ridges/outgrowths of tissues

devolved from gills of fish
- common in embryogenesis of all vertebrates

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9
Q

pharyngeal arches in humans

A

4 pairs of well developed arches

  • 5 is short ridge
  • 6 is debatable

Mesenchymal core (mesoderm and neural crest) covered ectoderm, separated by clefts and inside has endoderm separated by pouches

Each arch has a central rod of pre-cartilaganous/ cartilaginous mesenchyme then transformed into adult skeletal structures
- Striated muscles transformed into muscles of face

Each arch supplied by major artery and has specific CN nerve derived from

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10
Q

pharyngeal arch structure

A

Mesenchymal core (mesoderm and neural crest) covered ectoderm, separated by clefts and inside has endoderm separated by pouches

Each arch has a central rod of pre-cartilaganous/ cartilaginous mesenchyme then transformed into adult skeletal structures
- Striated muscles transformed into muscles of face

Each arch supplied by major artery and has specific CN nerve derived from

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11
Q

1st pharyngeal arch

A

Mandibular

Trigeminal Nerve CNV, Muscles of Mastication, Malleus, Incus, Meckel’s Cartilage

  • Forms mandible
  • – Second bone to start to ossify in skeleton
  • — Intramembranous ossification – bone laid down in mesenchyme around it

Mandibular, part maxilla, ear

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12
Q

2nd pharyngeal arch

A

facial nerve CNVII, muscles of facial expression, hyoid

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13
Q

3rd pharyngeal arch

A

glossopharyngeal Nerve CNIX, Stylopharyngeus, Common Carotid Artery, Hyoid

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14
Q

4th and 6th pharyngeal arches

A

Vagus Nerve CNXII, Muscles of Pharynx and Larynx, Aortic Arch, Laryngeal Cartilages

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15
Q

how many prominences does the face develop from

A

5 prominence surrond stomadaeum

grow and develop and fuse in midline to form face

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16
Q

what is the stomadaeum

A

central depression in developing skull which leads on to be the mouth

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17
Q

what are the 5 prominences of facial development

A

frontnasal
- overlies developing forebrain

paired maxillary
- from 1st pharyngeal arch

paired mandibular
- from 1st pharyngeal arch

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18
Q

what does the frontal nasal prominence develop into

A

Forehead; bridge of nose
- Lateral aspects – circles – nasal placode

Grow and enlarge in fifth embryonic week
Olfactory epithelium

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19
Q

what does the medial nasal prominence develop into

A

Midline nose (grow towards midline and form septum)

philtrum upper lip (fuse with maxillary prominences that are going towards midline)

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20
Q

what does the lateral nasal prominence develop into

A

Alae (wings/lateral aspect) of nose (fuse to form)

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21
Q

what does the maxillary prominence develop into

A

Cheeks

lateral upper lip (corners of mouth – where fuse with mandibular prominence)

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22
Q

what does the mandibular prominence develop into

A

Lower lip and jaw (fuse in midline, location where they fuse – chin can lead to cleft or dimple in chin not fused)

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23
Q

what forms the nasal lacrimal duct and lacrimal sac

A

6th week – groove between lateral nasal prominence and maxillary process

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24
Q

what term is used for the precursor of the ear

A

auricular helix

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25
how many parts does the palate form from
2
26
process of developing palate (5)
at 6 week the nasal and oral cavities are continuous - open space end of 7 weeks – Medial nasal processes expand inferiorly to join to form form intermaxillary process - gives rise to philtrum of lip and primary palate - --contains 4 incisor teeth - ---premaxilla ``` palatal shelves (7-8 weeks) separate them - derive from Maxillary prominences, from 1st Pharyngeal arch (lateral palatal shelves form secondary palate) ``` Thin palatal shelves grown downwards from maxillary prominences (approx. 7 weeks) - Then rotate up towards midline – go horizontal - --Fuse around midline - ---Can see primary palate (premaxillary) and secondary palate - ---Maxilla and palatine bones laid down in tissue Growth and expansion of mandible to accommodate tongue
27
basics of how nasal septum formed
Downgrowths of frontal nasal prominence - Fuse in midline Divide into L and R nasal cavities
28
stomadaeum
Primitive mouth Structure 5 prominences form around
29
medial nasal prominences develop into
philtrum of upper lip and tip of nose
30
what forms the alae of nose
maxilla fused with lateral nasal prominences
31
5 prominences of facial development and 2 additional features used to show stage
frontal nasal prominence mandibular prominence maxillary prominence medial nasal prominence lateral nasal prominence nasal pits and developing eye
32
what do the lateral palatal shelves come from
maxillary process | - open space between them can see into nasal cavity from oral cavity
33
what fuse to form the inter-maxillary process (distal to the primary palate)
medial nasal processes
34
stages in palatine development
palatal shelves grow down, towards you palatal shelves begin to fold up horizontally - coming closer together palatal shelves nearly at midline palatal shelves start to fuse in midline - incisive foramen where they fuse together towards the primary palate/premaxilla region
35
where could palatal development go wrong
fusion not occur - cleft palate can be linked to mandible growth as it's growing simultaneously
36
complete or partial failure of facial development can lead to
facial cleft
37
facial cleft affecting one side
unilateral
38
facial cleft affecting both sides
bilateral
39
4 impacts of life facial clefts can impact
Feeding Speech Hearing Social integration
40
how common is facial clefts
1 in 700 births can be connected to a syndrome (300 syndromes) most oro-facial clefts are not
41
cleft lip
Failure of fusion of maxillary prominence with the mesial nasal processes - Maxillary prominence coming in to form the secondary palate - Medial nasal process forms the primary palate and philtrum of lip - -See cleft formed in between Uni or Bi lateral Can extend to incisive foramen
42
medial cleft lip
Failure of the two medial nasal processes to fuse with each other - rare
43
cleft palate
Failure of 2 palatal shelves fuse together in midline
44
what can effect the distribution of cleft lip and palate
sex, familial distribution, geography
45
isolated cleft lip prevalence
more common on left more prevalent in males
46
isolated cleft palate prevalence
more in females | - later elevation of palatal shelves in females (week 8 over 7)
47
cause of oro-facial clefts
Multi-factorial - Identical twins don’t form the same Related factors - Environment - Smoking - Alcohol - Viral infection - Certain drugs - Some vitamin A analogues
48
diagnosis of cleft lip
ultrasound from week 13 usually picked up in 20 week midterm scan - and definitely picked up 72hrs post-partum
49
diagnosis of cleft palate
harder to see on ultrasound pre birth
50
treatment of cleft lip and palate
Can be repaired surgically cleft lip surgery - 3-6 months cleft palate surgery - 6-12 months
51
advise on cleft lip/palate treatment
Advised early on - Feeding issues – unable to form seal - Hearing issues – higher ear infections chance - Dental development – can have impact - Speech development
52
time of cleft lip surgery
3-6 months
53
time of cleft palate surgery
6-12 months
54
additional treatment that might be required for cleft lip and palate babies (2)
Speech and language therapy Orthodontic treatment depending on the development of adult dentition
55
sutures
joints between bones in skull - juvenile further apart strong fibrous joints limited to no movement
56
ossification of bones of calvarium
intramembranous ossification
57
intramembranous ossification
laid down directly into membrane grow and start to replace the membranes
58
fontanelles
membrane tissue remains (yet to be ossified) movement/flexibility can happen here - will continue to grow and replaced by sutures - -- fibrous bone connections
59
mental symphysis
2 forming sides of mandible can start to fuse but see split still
60
closed mental symphysis
single mandible symphysis completely closed - one mandible by one year old
61
open mental symphysis
see 2 parts of mandible visible split in middle
62
what can happen to sutures with advanced age
Sutures can fuse completely and disappear
63
antemortem tooth loss
Evidence of healing Tooth sockets filling in, alveolar bone removed with tooth
64
post mortem tooth loss
No healing/turnover of bone Open tooth socket
65
denture pain if most alveolar bone is lost
dentures sit close to mental foramen | - sit on nerve = pain
66
bone in life
Constant turn over - Old removed - New laid down Micro fractures repaired Don’t use it you lose it - Astronauts/bed ridden lose bone density and resor No mechanical stimulation as loss of teeth - Alveolar bone resorbed
67
why wide obtuse angle of mandible in juvenile
Wide obtuse angle in juvenile - Ramus not finished growing Need to widen to accommodate adult dentition - To create space for developing adult teeth
68
angle of mandible comparison between males and females
females More obtuse than males ``` Changes in puberty - Males undergo larger growth spurt -Larger muscle mass ----Pull more on bone More robust mandible ``` Mandible grows more in men - Square chin and jaw - Ridges on bone due to enlarge muscles of mastication

BDS2 BAMS (54 decks)

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