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BDS2 - Anatomy > face and palate development > Flashcards

face and palate development Flashcards

1
Q

when does development of the face occur

A

4-8weeks in utero

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2
Q

when does formation of the palate happen

A

6-10 weeks in utero

soft palate developing until around 12 weeks in utero

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3
Q

when is the earliest bone laid down in the skull and where

A

6/7 weeks

in mandible

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4
Q

when do more severe congenital problems generally occur during facial development

A

between 4-8 weeks

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5
Q

when do more minor problems like cleft lip and palate develop during development

A

around 8-12 weeks

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6
Q

what is the first pharyngeal arch also called and what does it contribute

A

the mandibular arch

Involved in contributing to structures of the face both maxillary and mandible parts of the face as well as the ear

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7
Q

what are pharyngeal arches

A

= ridges or out growths of tissue

These arches are formed during the embryogenesis of all vertebrates

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8
Q

how many pairs of well developed pharyngeal arches do human embryos have

A

4 pairs

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9
Q

what is the problem with arch 5 in humans

A

Arch 5 either never forms in humans or if it does form it is very short lived

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10
Q

what is the problem with arch 6

A

There is a question mark to whether not there is a true 6 pharyngeal arch

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11
Q

what do pharyngeal arches consist of

A

consist of a mesenchymal core so the centre is made from mesoderm and neural crest cells
covered on the outside by ectoderm and separated by a series of clefts
on the inside they are covered endoderm and separated by pouches

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12
Q

what are pharyngeal arches formed from

A

Formed from early embryonic tissues

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13
Q

what are the structures that are found within each arch

A

Within each arch there is some striated muscle which will go on to form some of the muscles of the face
Each arch is also supplied by a major artery and has a specific cranial nerve derived from it
(important because some of the structures formed in these arches will migrate to other areas of the head and neck but they generally maintain the nerve supply that originates with them)

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14
Q

what cranial nerve and muscles is the first pharyngeal arch associated with

A

trigeminal

muscles of mastication

malleus and incus

meckel’s cartilage

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15
Q

what cranial nerve and muscles is the second pharyngeal arch associated with as well as bone

A

facial

muscles of facial expression

part of the hyoid bone

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16
Q

what cranial nerve and muscles is the third pharyngeal arch associated with as well as major artery and bone

A

glossopharyngeal nerve

stylopharyngeus muscle

common carotid artery

parts of the hyoid bone

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17
Q

what cranial nerve and muscles are the fourth (and 6th) pharyngeal arch associated with as well as other features

A

vagus nerve

muscles of pharynx and larynx

aortic arch

laryngeal cartilages

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18
Q

what is the rod of cartilage within the first arch and why is it important

A

Rod of cartilage = Meckel’s cartilage

Important because the mandible forms around this cartilage

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19
Q

how does the mandible form

A 
intramembranous ossification
(although we have this meckel's cartilage the bone of the mandible is laid down in the mesenchyme around it)
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20
Q

what else is formed from meckel’s cartilage (other than the mandible)

A

2 of the inner bones

  • malleus
  • incus
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21
Q

what does the face develop from

A

5 prominences (or swellings) which surround a central depression - the stomodeum

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22
Q

what is the stomodeum

A

the future mouth and separated from the GI tract by the oropharyngeal membrane

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23
Q

name the 5 prominences

A

frontonasal
paired maxillary
paired mandibular

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24
Q

what does the central frontal nasal prominence over lie

A

the developing forebrain

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25
Q

what does the paired maxillary and mandibular promiences derive from

A

from the first pharyngeal arch

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26
Q

what does the frontal portion of the frontal nasa promience form

A

the forehead

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27
Q

at the lateral aspects of the frontal nasal prominences what can be seen

A

nasal placodes
these start to grow and enlarge in the 5 th embryonic week
eventually go on to form the olfactory epithelium which is involved in smell

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28
Q

what is the name of the swellings around the placodes

A

nasal prominences (medial and lateral)

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29
Q

what do the placodes form

A

they start to invaginate - start to depress into the tissues and form a pit
the pit then goes on to form the nostrils
the formation of this pit separates the nasal prominences into medial and lateral portions

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30
Q

what does the little groove between the lateral nasal prominence and the maxillary prominence form in the 6th week

A

the nasolacrimal duct and lacrimal sac

Start to invaginate and form a tubular structure

Surrounded by bone in the adult and form a passage for draining tears from the eye into the nasal cavity

As this invaginates and the lateral nasal process and maxillary process fuse they will form the alae / wings of the nose (lateral aspect of the nose surrounding the nostril)

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31
Q

what happens to the medial nasal prominences in the 6th week

A

they will start to grow towards one another
They grow towards the midline and fuse to form the bridge and part of the septum of the nose

Also fuse with the maxillary prominences (which still grow towards the midline) to form the majority of the upper jaw

The medial nasal prominence will fuse to one another to form the philtrum and tip of the nose and upper lip

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32
Q

what happens to the mandibular processes

A

Fuse in the midline - where they fuse is the position of the chin

Form the lower lip and jaw
If they don’t fuse or only partially fuse = cleft chin or a dimple in the chin

Mandibular and maxillary processes will form the cheek region (maxillary forming the majority of the upper cheeks)
Where mandibular and maxillary processes fuse will form the corners of the mouth

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33
Q

what happens in the development of the eye

A

Eyes start off very laterally

Eye lids form around 6 weeks in embryonic development (also start to get the precursors to the ears)

the eyes are open but by around week 10 the eyelids will grow rapidly together and will fuse and won’t open until 7 months of foetal development

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34
Q

what are the 6 little bumps in the neck region called around week 7 of development

A

auricular hillocks

35
Q

when do the ears form and how

A

The ears are starting to form their adult external form by around week 7 or week 8
still appear in neck region
the ears don’t move up - the jaws instead will continue to grow and expand inferiorly so it looks like the ears are rising up towards the position of the eyes

36
Q

what does the foetus look like around week 8

A

Mandible small

Stomodeum (future mouth) still taking up a large portion of the face

It is recognisable, can see features but the face itself does not start to look “human” in appearance until around 4 months of development

37
Q

what adult facial feature does the frontonasal prominence make

A

forehead

bridge of nose

38
Q

what adult facial feature does the medial nasal prominence make

A

midline nose

philtrum upper lip

39
Q

what adult facial feature does the lateral nasal prominence make

A

alae of nose

40
Q

what adult facial feature does the maxillary prominence make

A

cheeks

lateral upper lip

41
Q

what adult facial feature does the mandibular prominence make

A

lower lip

jaw

42
Q

what does the medial nasal processes form

A

intermaxillary process
which gives rise to the philtrum of lip and primary palate

they expand inferiorly by the end of the 7th week of embryonic development

43
Q

what does the maxillary prominences give rise to in the palate

A

lateral palatal shelves

secondary palate

44
Q

what does the intermaxillary process give rise to

A

to the philtrum of the upper lip and also the primary palate which contains the 4 incisal teeth
= primitive pre-maxilla

45
Q

at 6 weeks what is the realtionship between the oral and nasal cavities

A

the nasal and oral cavities are continuous so there is an open space between them

These will then be separated into their individual cavities during the 7th and 8th weeks by formation of the palatal shelves

46
Q

what are the palatal shelves derived from

A

maxillary prominences

47
Q

when the palatal shelves fuse what do they form

A

secondary palate (at the back)

48
Q

what bones are within the tissues of the palate

A

maxilla and palatine

49
Q

at 9 weeks what happens to the secondary palate

A

they are starting to fuse in the midline and they will also fuse with the primary palate around the region of the incisive foramen

50
Q

what does the nasal septum form from

A

The nasal septum will form from down growths of the frontal nasal prominence and the medial nasal processes and will fuse with the surfaces of the primary and secondary palates in the midline

51
Q

what do the medial nasal processes fuse to from

A

fuse in the midline to form the inter-maxillary process = primary palate

52
Q

where does the lateral palatal shelves come from

A

maxillary process

53
Q

what can cause a facial clefr

A

Complete or partial failure of fusion between any of the swellings that develop around the primitive mouth

54
Q

what do facial clefts affect

A

feeding,
speech,
hearing
social integration

55
Q

what are the 2 most common types of facial clefts

A
  • cleft lip

- cleft palate

56
Q

where can a cleft lip extend to

A

incisive foramen

57
Q

what is a median cleft lip

A

results from the failure of the 2 medial nasal processes to fuse with each other
but that is much more rare

58
Q

what do cleft lip and cleft palate defects differ in

A

differ in their distribution with respect to things like sex, familial association, population and geography

it is suggested that they may have different aetiology or different causes

59
Q

what cleft lip usually result from

A

results from failure of fusion of the maxillary prominence with the medial nasal processes
Can be unilateral or bilateral

60
Q

what does cleft palate result from

A

results from the failure of the 2 palatal shelves to fuse together in the midline

61
Q

is cleft lip more frequent on the left or right

A

left

62
Q

is cleft lip more prevalent in males or females

A

males

63
Q

is isolated cleft palate more frequent in males or females

A

females
this is suggested to be related to their slightly later elevation of the palatal shelf as this occurs more towards week 8
(in males it tends to occur around week 7)

64
Q

what are the causes of oral-facial clefts

A 
multi-factorial
we dont know exactly
these things are related
• Environmental factors;
○Smoking 
○ Alcohol
○ Viral infection
○ Certain drugs are thought to have an impact
○Some vitamin A analogues

The reason it is thought to be multifactorial is emphasised as well by the fact that in twins that cleft lip and palate in identical twins does not occur the same

65
Q

how do you diagnose a cleft lip

A

○ can be seen in ultrasound from about week 13
○ But is usually picked up in the 20 week mid term scan
○ Certainly is identified directly following birth - within the first 72 hours

66
Q

how do you diagnose a cleft palate

A

○ Can be more difficult to see from an ultrasound

67
Q

how can cleft lip and palate be repaired

A

surgically

better to be repaired early on

68
Q

what may babies with cleft lip or palate struggle to do

A

may struggle to breast feed or feed from a bottle because they can’t form a seal from their mouths

69
Q

what are babies with cleft palate more vulnerable to

A

ear infections

hearing issues

70
Q

what dental issues arise from cleft lip / palate

A

teeth will potentially not develop correctly depending on location and severity of the cleft

71
Q

when are cleft lip repairs usually done

A

3-6months

72
Q

when are cleft palate repairs usually done

A

6-12 months

73
Q

what treatment may be requried alongside surgery

A

Some speech and language therapy is also required

Potentially orthodontic treatment - depending on the development of the adult dentition

74
Q

throwing in a few questions from the anatomy zoom Q&A so they might not be from this practical but it is all relevant for revision and cant be bothered adding them to the correct ones x x x

A

sorry
love u
miss u
xxxxxx

75
Q

what are suture

A

sutures are tough fibrous joints between cranial bones - with little to no movement between bones

76
Q

what are fontanelles

A

fontanelles are membranes covering the brain that haven’t yet turned to bone (ossified) - they allow movement / overlapping of the bones during birth and rapid expansion of the brain and skull following birth
when the bones grow together and fuse, they are replaced by sutures

77
Q

how can you tell if a symphysis is open or closed

A

if it is completely open you will be able to see the separation between the 2 bones

when it is completely closed the line between the 2 joining parts will have disappeared

78
Q

when does the mandibular / mental symphysis close

A

around 1 year after birth

79
Q

how do you tell the age of someone from a radiograph if they dont develop wisdom teeth or have their wisdom teeth removed

A

if 3rd molars are not present and obvious that removed / absent then you would use alternative methods of age estimation

age estimation is more accurate in younger individuals - becomes more difficult once growth and development end

80
Q

how can you tell which teeth have been lost antemortem and post mortem

A

teeth lost prior to death will display evidence of healing and the tooth socket will eventually be filled in with bone
there will also be resorption of the alveolar bone in the region of the missing tooth

perimortem / postmortem will be no healing and the open tooth socket will be visible

81
Q

why does bone resorb when you lose teeth

A

if you dont use bone you lose it

if you lose teeth there is no mechanical stimulation so the bone starts to resorb and be removed

82
Q

what problems does alveolar bone resorption cause in relation to dentures

A

bone loss can nearly reach the mental foramen in the mandible
the patient is quite close to the nerve so there can be associated pain and there is potential for it to continue to resorb right down to the mental foramen and expose the nerve

83
Q

what are sutures like in children’s skulls

A

sutures are a little further apart as the bones are still growing together

BDS2 - Anatomy (4 decks)

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