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Ortho > Facial growth 1 > Flashcards

Facial growth 1 Flashcards

1
Q

LIfe in utero consists of what 2 phases

A

embryonic – 1-8 weeks
foetal – 8 weeks to term

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2
Q

What has formed in first 2 months of pregnancy

A

All of the limbs and organs including the face

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3
Q

External enviroment influnces what in early stages of pregnancy

A

cranio-facial abnormalities

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4
Q

What is a very important stage in development of the face in embryology

A

Neural crest migration

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5
Q

what happens near the end of week 3 of embryology

A

The neural folds fuse to form the neural tube

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6
Q

What does failure in the formation of the nueral tube lead to

A

Spina Bifida

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7
Q

What does the neural tube develop into

A

Brain and spinal cord

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8
Q

what does failed development of the neural tube lead to

A

anencephaly

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9
Q

What happens in the folding of the neural plate

A

cells develop from the ectoderm along the edge
of the groove, termed neural crest cells

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10
Q

What happens to neural crest cells

A

undergo extensive migration within the developing embryo and ultimately
differentiate into many cell types e.g. spinal and autonomic ganglia; Schwann cells, adrenal medulla, meninges of the brain

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11
Q

What do nueral crest dervided ectomesenchyme contribute to

A

branchial arch cartilage, bone and connective tissue
proper, as well as dental tissues - pulp, dentine, cementum and periodontal
ligament

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12
Q

What day does the maxilla nd mandible start to form

A

46th

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13
Q

When does ossification of the face and skull start

A

7-8 weeks

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14
Q

During formation of face what may lead to significant malformations during this early period

A

Environmental factors

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15
Q

Defects of the face, particularly in the midline, may be closely related to what

A

defects of the anterior parts of the brain

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16
Q

What is most of the face formed by

A

Migrating neural crest cells

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17
Q

What causes major facial deformaties

A

Interference with neural crest cell migration

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18
Q

What leads to cleft formation

A

Failure of fusion between the various facial processes or between the palatine
processes

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19
Q

What has different embryological origins

A

The upper lip and anterior part of the palate

and

the posterior palate

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20
Q

What does the different embryological origins and different fuse times of the upper lip and anterior part of the palate and the posterior palate mean?

A

cleft lip and alveolus can occur independently of cleft palate

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21
Q

What happens week 4

A

Migrating neural crest cells form the frontonasal
process and laterally the branchial arches

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22
Q

What happens week 5-7

A

extension and fusion of the facial processes

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23
Q

The skull can be divided into what two parts

A

Neurocranium and viscerocranium

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24
Q

What is the neurocranium

A

Part of the skull that which forms a protective
case around the brain

25
Q

What is the viscerocranium

A

Part of the skull which forms the skeleton of the face

26
Q

How is intramembranous bone formed

A

Bone is deposited directly into primitive mesenchymal tissue

Needle-like bone spicules form, which progressively radiate from the primary
ossification centres to the periphery. Progressive bone formation results in the
fusion of adjacent bony centres

27
Q

What is made of intramembraneous bone

A

vault of the skull, the maxilla and most of the mandible

28
Q

How is endochondral bone formed

A

bones are preceded by a hyaline cartilage ‘model’

Several centres of ossification which eventually fuse

29
Q

What does endochondral bone form

A

base of the skull

30
Q

How is base of skull made

A

series of cartilages forms the base of skull.

They undergo endochondral
ossification from multiple
centres, starting with the
basi-occiput at 10-12
weeks.

At birth cartilagenous
growth centres remain
between the sphenoid and
occipital bones and in the
nasal septum.

31
Q

The neurocranium can be divided into what

A

flat bones of the vault which develop intramembranously and the endochondral elements of the base of the skull

32
Q

What age does skull stop growing

A

7

33
Q

What occurs at the 3 month in vault of the skull

A

Intramembranous ossification of the vault in several centres

34
Q

When do fontanelles close

A

anterior fontanelle closes at about 2 years of age
the posterior at about 1 year

35
Q

how does the maxilla and mandible form

A

intramembranously

36
Q

What do the mandible and maxilla develop adjacen to

A

pre-existing cartilaginous
skeletons - the nasal
capsule and Meckel’s
cartilage

37
Q

How does the different parts of the mandible form

A

They form as several units all responding to different growth stimulate

A condylar unit which forms the articulation
and contains the largest secondary
cartilage formation.

An angular unit which forms in response to
the lateral pterygoid and masseter muscles;

A coronoid unit which responds to
temporalis muscle development (muscular processes).

An alveolar unit which forms only if teeth
are developing.

The body of the mandible forms in
response to the inferior dental nerve

38
Q

what are the 3 main sites secondary cartlidge formation of the mandible

A

the condylar cartilage, the coronoid cartilage and at the symphyseal end of
each half of the bony mandible. The cartilages appear between 12 and 14
weeks I.U.

39
Q

When do the cartilidges dissapear of the mandible

A

coronoid cartilage disappears long before birth and the symphyseal just
after birth. Growth continues at the condylar cartilage until about 20 years of age.

40
Q

What precedes the growth of the mandible

A

Meckels cartiliage

41
Q

What is the primary skeleton of the upper face

A

Nasal capsule

42
Q

What does primary abnormality mean and give examples

A

Defect in the structure of an organ or part of an organ that can be traced back to an anomaly in it’s development

spina bifida, cleft lip, CHD

43
Q

What does secondary abnormality mean and give examples

A

Interruption of the normal development of an organ that can be traced back to other influences

Teratogenic agents; infection (rubella virus), chemical
(thalidomide), chemical (lithium)

Trauma; amniotic bands

44
Q

What does deformation mean

A

Anomalies that occur due to outer mechanical effects on
existing structures

45
Q

What does Agenesia mean

A

Absence of an organ due to failed development during
embryonic period

46
Q

What does Sequence mean

A

Single factor results in numerous secondary effects (PierreRobin)

47
Q

What does Syndrome mean

A

Group of anomalies that can be traced to a common origin (Trisomy 21 in Down’s Syndrome)

48
Q

Give examples of some maxillary hypoplasia facial syndromes

A

-Apert’s Syndrome (acrosyndactyly)

-Crouzon’s Syndrome(craniofacial dysostosis)

-Oral-Facial Digital Syndrome

-Binder’s Syndrome

  • Achondroplasia

-Down’s Syndrome

-Cleidocranial dysostosis

-Foetal Alcohol Syndrome

-Cleft lip/palate

49
Q

Give examples of some maxillary hypoplasia facial syndromes

A

Treacher Collin’s Syndrome
(mandibulofacial dysostosis)

Pierre-Robin

Stickler’s Syndrome

Van der Woude Syndrome

Turner’s Syndrome

Hemifacial Microsomia

50
Q

Give examples of facial syndromes arrising from early problems with facial development

A

Enviromental- Foetal Alcohol Syndrome

genetic

Mulitifactorial-

Hemifacial microsomia

Treacher Collins syndrome (mandibulofacial dysostosis)

Clefts of lip and palate

51
Q

What day can foetal syndrome ocur

A

17 days+

52
Q

What are signs of foetal alcohol syndrome

A

microcephaly (small head)
typical faces having:

short palpebral fissures,
short nose,
long upper lip with deficient
philtrum,
small midface
small mandible.

53
Q

What is the possible cause and signs of hemifacial microsomia

A

Neural crest migration disrupted (days 19-28)

Unilateral mandibular hypolasia, zygomatic arch
hypoplasia, high arched palate, malformed pinna

1:3500 Live births

54
Q

Causes of mandibulofacial dysostosis and signs

A

Deformity of 1st and 2nd branchial arches

-Anti-mongoloid slant palpebral fissures
-Colomboma of lower lid outer 1/3rd
-Hypoplastic or missing zygomatic arches
-Hypoplastic mandible with antigonial notch
-Deformed pinna, conductive deafness

1;10,000 Live births

55
Q

What is the Aetiology of Cleft lip and palate

A

Genetic:

Monozygotic twins
Syndromes
Familial pattern

Enviroment

Social deprivation
Smoking (2.5x)
Alcohol
Anti-epileptics
Multivitamins (25% down)

56
Q

Dental features of cleft lip and palate

A

Impacted Teeth
Crowding
Hypodontia
Supernumeraries
Hypoplastic teeth
Caries

57
Q

Achondroplasia cause and effects

A

Problem with endochondrial ossification

Defects in base of the skull, retrusive
middle third of the face, frontal bossing,
depressed nasal bridge

58
Q

Crouzon’s (craniofacial dysostosis) cause and effects

A

Premature closure of cranial sutures (esp coronal and lamdoid)

Proptosis (shallow orbits), orbital dystopia, mild hypertelorism

Retusion and vertical shortening of midface

Prominent nose

Class III malocclusion
Narrow spaced teeth

Ortho (7 decks)

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