growth patterns/timings of head and neck, clinical relevance Flashcards

1
Q

bones in human head

A

28 bones

  • 8 cranial
  • 14 facial
  • 6 auditory
  • 1 hyoid
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2
Q

head to body ratio proportions

A
  • 1:4 @ birth (large proportion at birth due to the growth of the brain)
  • 1:8 adults
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3
Q

when do sutures fuse

A

7 yeras

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4
Q

what type of growth are surtures

A

secondary

- repsonding to the brain growing

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5
Q

early fusuon of sutures

A
craniosynotosis
syndromes
- crouzon
- apert
- pfeiffer
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6
Q

development of the lower 2/3 face

A
  • downward and downward growth of maxilla and mandible

- elongation of nose

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7
Q

what is found at the base of the skul

A

cranial base synchrondroses

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8
Q

crainial base synchondroses

A

spheno ethmoidal

spheno occuipital

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9
Q

spehno ethmpidal

A

anterior cranial base

follows neurla growth pattern

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10
Q

neural growth pattern

A

rapid growth early on which then slows, follows growth pattner of briain

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11
Q

spheno occipital

A

posterior cranial base

somatic growth pattern (much later on)

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12
Q

what is it when synchondroses dont grow

A

achrondroplasia (dwafism)

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13
Q

achrondroplasia

A
  • short stature
  • large head as a proportion
  • prominent forehead (frontal bossing)
  • small midface
  • flattened nasal bridge
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14
Q

what is responsible for achrondroplasia

A
  • changes in the genes
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15
Q

how does the maxilla grow

A

downwards and forwards through growth in the cranial base

  • new bone added to both sides of sutures
  • possible secondary growth site following soft tissue growth
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16
Q

sycondroses growth site type

A

primary

- growht of the cartilage is the driving force pushing the face downwards and forwards

17
Q

why does the maxialla grow width ways

A

due to mid palatal suture
fuses around puberty
- areas of new bone addition and resportion

18
Q

maxilla bone shaping

A

floor of nose resorbs
bone added to floor of mouth
appears to move more downwards than forwards
- surface remoddeling occurs in opposite direction to bone translation
reshaping of face as bone moves downwards and forwards

19
Q

how can orthodontics be used to influence growth of mx

A

push apart suture to grow the middle of the suture

20
Q

md growth

A

grows in height and length

21
Q

role of conyde in md growth

A

get longer and remodels
growth in length by cartilage replacement in the condyle
unsure if 1/2 growth site

22
Q

condylar cartilage

A

resembles epiphyseal plate cartilage of long bones
- proliferative cell can differentiate into chrondroblasts
appositional, not proliferative
not organised into parallel colums

23
Q

remodelling involved in md formation

A

resoprtion from the anterior surface
deposition on the posteiror surface
remodeling of the glenoid fossa
growht in height continutes throughout life, lenght ceaces in teens

24
Q

rotation upon growing in md

A
  • remodelling of surfaces of the mandible masks the rotation (masked by surface apposition and resorption)
  • due to differential growth in anterior and posterior face heights
  • internal rotation in core of mandible relative to the cranial base (forwards and upwards)
  • seen by superimposing serial radiographs with implants
25
greater growth in one side of the condyl can lead to
facial asymmetry
26
mx rotation
small but variable rotation | mean 3 degrees anterior, but can be backwards
27
when is soft tissue growth most rapid
around puberty
28
attemtpted mechancisms that control head and face growth
1) Remodelling theory 2) sutural theory 3) cartilaginous theory 4) functional matrix theory 5) part counterpart principle 6) servo system theory non proven
29
when should you fit functional applicances
when puberty growth occurs
30
how can you predict when puberty growth will occue
Can use hand wrist radiographs - ulnar sesamoid graph ossifies at start of pubertal growth spurt Cervical spine maturation - undertaken on lateral cephalometric radiograph