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Ortho > Growth and Development > Flashcards

Growth and Development Flashcards

1
Q

anatomic phenomenon

A

growth – change in size or nuber and largery anatomic phenom.

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2
Q

physiologic and behavioral phenomenon

A

development – increase in complexitey

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3
Q

concept 1

A

pattern –> patterns REPEAT and refers to COMPLEX SET OF PROPORTIONS

  • these PROPORTIONS CAN CHANGE over time

LIKE AT BIRTH HEAD IS 50% of body but then at full growth may be like 25% or less of growth

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4
Q

scammon’s curves looks at what

A
  1. lymphoid
  2. neural
  3. general
  4. genital

patterns of growth in these areas represented by a % of adult size in relation to age

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5
Q

neural tissue growth?

A

complete by age 6-7 usually

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6
Q

lymphoid tissue growth?

A

grows beyond adult size and then involutes and puberty commences

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7
Q

concept # 2

explain

A

VARIABILITY
- patterns repeat reliably, but still everyone is different

*important to clinically differentiate individuals that ay be extremes of NORMAL variations, from those OUTSIDE this NORMAL range

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8
Q

concept #3

A

Timing

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9
Q

explain timing

A

same event happens for different individuals at different times

biologic clocks of different individuals are set differently

variations in timing aremost obvious in adolescence

because of this variability– chronologic age is often not a good indicator of growth status

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10
Q

chronological age good indicator of growth status?

A

NO – b/c of variability

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11
Q

craniofacial pattern change

A

see a clockwise end to growth a- e
a= cranial base (stops growing first)

then frontal then maxilla then mandible then ramus

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12
Q

growth pattern seen in neural tissue vs general

A

neural early jump then plateus

general - S shaped curve spike, plateu, and increase at puberty agian then plateus

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13
Q

T/F patterns repeat

A

TRUE - but variablity in these patterns

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14
Q

sign of alarm in standard growth charts - check up?

A

if child over 2 consectutive periods of time - like 2 checkups in a row child is falling or rising 2 percentile in change – sign of alarm

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15
Q

calander or clock good indicator for concept of timing?

A

NO - the SAME event happens at DIFFERENT TIMES for different people

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16
Q

chronological growth?

A

not a good indicator of timeline

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17
Q

craniometry growth study model
Pro
con?

A

pro= precise

only cross sectional – so person is not alive

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18
Q

Anthropometry growth study model
Pro
con?

A

pro- longitudinal

measuring external body

con- less precise on bony structures - like what is inside

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19
Q

cephalometric radiology growth study model
Pro
con?

A

pro = longitudinal possible, relatively precise

con- not all measurements possible

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20
Q

cone bean technology growth study model
Pro
con?

A

pro - low dose 3-D precidse

cons - expensive

can see a lot of structures

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21
Q

hand wrist radiography?

A

growth study model
- can capture when puberty should be starting and timing of it when looking at development or fusing of certain anatomical aspects of the hand

fully fused? – then height probably wont increase

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22
Q

increase in size independentof number or size of cells?

A

secrete extracellular material

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23
Q

hypertrophy

A

increase in size of cells

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24
Q

hyperplasia

A

increase in NUMBER of cells

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25
Q

interstitial growth

A

growth from WITHIN

a combination of hyperplasia and hypertrophy

characteristic of soft tissues and uncalcified cartilage

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26
Q

appositional growth

A

increase in sie by surface addition

mainly through extracellular secretions

characteristic of hard tissues (bone and teeth) and calcified cartilage

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27
Q

formation of cartilage

A

chondrogenesis

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28
Q

chondrogenesis details

A
  1. chondroblasts produce matrix
  2. cells are encased in matrix and become chondrocytes
  3. chondrocytes enlarge, divide, and produce more matrix
  4. matrix remains uncalcified
  5. a cell membrane covers the tissues but is not essential for further growth
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29
Q

intramembraneous bone foramtion

A

thisi type of bone is derived from neural crest cells due to mild tension forces

30
Q

evidence of intramembraneous bone formatin?

A

first evidence is IN MANDIBLE at the 6th PRE-NATAL week and by the 8th week many centers of ossification can be seen throughout the head

this type of ossification occurs in the cranial vault and both jaws for further growth

31
Q

growth occuring a lot in the cranial vault and the jaws?

A

intramembraneous bone formation

32
Q

membrane more important in what type of growth?

A

INTRAMEMBRANEOUS GROWTH AND

33
Q

INTRAMEMBRANEOUS BONE FORMATION STEPS

A
  1. osteoblasts produce osteoid
  2. cells and blood vessels are encased in osteoid and become osteocytes
  3. osteoid is produced by membrane cells - osteocytes are not longer contributing to growth
  4. osteoid calcifies
  5. a cell Membrane – PERIOSTEUM covers the bone and i ESSENTIAL for further growth
34
Q

osteoid produced by?

A

membrane cells

35
Q

what is essential for further intramembraneous bone formatino?

A

periosteum (cell membrane ) covering the bone

  • SAME FOR ENDOCHONDRLA – once osteoid calcifies the periosteum covers and is essential for further growth as well
36
Q

bone forming from cartilage is termed

A

endochondral bone formation

37
Q

endochondral bone formation occurs when

A

starts to occur as early as the 8th PRENATAL WEEK

only the bones of the cranial base and portions of the calvarium are derived from this method

38
Q

from endochondal bone formation?

A

only the bones of the cranial base and portions of the calvarium are derived from this method

39
Q

difference in quality of endochondrla vs intramembraneous once formed?

A

no

40
Q

steps in endochondral bone formation

A
  1. hypertrophy of chondrocytes and matrix calcifies
  2. blood vessels and connective tissue invade
  3. osteoblasts differentiate into osteoid
  4. osteoid calcifieis
  5. cell membrane – periosteum covers the bone and is essential for further growth
41
Q

bone vs cartilage with rigidity

A

bone - rigid

cartilage – flexible

42
Q

bone vs cartilage with calcificationo

A

bone - calcified

cartilage - uncalcified

43
Q

bone vs cartilage with vascularity

A

bone- vascular

cartilage - avascular

44
Q

bone vs cartilage with membrane

A

bone - ESSENTIAL

cartilage – non- essential

45
Q

bone vs cartilage with resistence

A

bone - pressure SENSTITIVE

cartilage – pressure TOLERANT (think because it is more flexible - more tolerant to pressure and resistiance )

46
Q

implication of bone being sensitivie to pressure

A

like tongue sucking and implications on bone movement in the oral cavity

47
Q

growth in the cranial vault by

A

intramembraneous growth

with remodeling occurs primarily at periosteum lined surfaces called sutures – and at inner and outer surfaces

48
Q

growth of cranial base

feature of this

A

endochondral growth

as the ossification continues – bands of cartilage remain between bones – called synchondroses

49
Q

premature fusoin of all sutures will show? - general

A

downward grwoth and bulging of eyes as the brain and tissue need to continue to develop and if sutures closed – will take path of least resistance

50
Q

craniosynostosis

A

pre-mature fusion of sutures

51
Q

pre-mature fusion of sutures termed

A

craniosynostosis

52
Q

coronal suture prematurely closes?

A

brachycephalic – short front to back , wide left to right

53
Q

sagittal suture prematurely closes?

A

dolichocephalic – long front to back, narrow left to right

54
Q

coronal and sagittal suture prematurely closes?

A

oxycephalic - long vertical , with short and narrow head

55
Q

metopic suture prematurely closes?

A

trigonocephaly – triangular shaped head

56
Q

allsuture prematurely closes?

A

microcephaly – small cranium

57
Q

any unilateral suture prematurely closes?

A

plagiocephaly – unilateral decrease on fused side and increase on other

58
Q

important synchondroses and age

A

inter-sphenal – fuse by age 6

spheno-ethmoidal – fuse by age 6

spheno-occipital – remains active until after puberty

59
Q

inter-sphenal synchondroses

A

fuse by 6

Anterior portion of the cranial base - relaibel structure not changing over time – good landmark to compare over time

Determine or predict growth

same with spheno-ethmoidal

60
Q

growth of maxilla

A

develops postnatally entirely by INTRAMEMBRANEOUS OSSIFICATION

DOWN AND FORWARD

growth occurs in 2 ways

  1. apposition of bone at cranial sutures
  2. surface remodeling on the anterior and palatal regions

where there is direction of growth -and displacement there is resorption and apposition

61
Q

growth of the mandible

A

1/ intramembraneous growth accounts for the main body of the mandible

endochondral growth is important at the CONDYLE

62
Q

condyle growth?

A

endochondral growth is important here

63
Q

theories of growth

A
  1. bone is the primary determinant of its growth
  2. cartilage is the primary determinant of skeletal growth , while bone responds
  3. soft tissue matrix is the primary determinant of growth and both bone and cartilage respond to its growth
64
Q

growth site vs center

A

site: A location at which growth occurs

center– a location at which independent, genetically controlled growth occurs

65
Q

all centers are ___ but not all ___ are ___

A

all centers are sites but not all sites are centers

sites – occur in that area only but if remove center and place somewhere else can still grow??

66
Q

bone as a determinant?..

A
  1. growth occurs at the sutures and along the periosteum covered surface
    - cranial base is example of this
  2. this growth is REACTIVE to surrounding changes
  3. tension enhances growth - stimukate apposition
  4. pressure impedes growth
  5. BONE IS NOT a primary growth center
67
Q

cartilage as a determinant of growth

A

cartilage grows in many bones, and then gets replaced by bone

only certain cartilage areas serve as growth centers

  • epiphyseal cartilage of long bones
    2. cranial base synchondroses
    3. nasal septum
68
Q

soft tissue as a determinant?

A

theorized by dr. moss in 1960’s

grants epiphysieal cartilage of long bones as growth center, but not cartilage in the head

growth of the face occurs as a response to functinal needs and neurotrophic influences, mediated by the soft tissues

69
Q

functional matrix theory

A

functinal determinant of heaf growth

  • expanding brain leads to forces on the calvarium, and leads to its growth

major reason for growth of maxilla and mandible is the enlargment of nasal and oral cavities iin respones to functional needs

70
Q

___ as a functinal matrix

A

brain

71
Q

brain as a functinal matrix

A
  1. brain expands with growth
  2. pressure on the surrounding bones
  3. tension at the sutures between the bones
  4. grwoth to accomodate the brain growth

*the sutures allow displacement of vault bones and fossa configuration necessitates drift

Ortho (19 decks)

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