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Plastic Surgery - Craniofacial > Head and Neck Embryology > Flashcards

Head and Neck Embryology Flashcards

1
Q

Ectoderm

A

nervous system, skin (epidermis and appendages), neural crest cells and derivatives

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2
Q

Mesoderm

A

bone, cartilage, muscles, connective tissue (dermis), dura mater, heart, vessels, blood, reproductive organs, genitourinary system

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3
Q

Endoderm

A

GI and respiratory lining, digestive organ parenchyma

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4
Q

Neural crest cells

A

Ectodermal origin; pluripotent; migrate along cleavage planes, differentiate into connective, muscle, nervous, endocrine, and pigmentary tissues, induce differentiation of the tissue they invade

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5
Q

Pharyngeal (branchial) arches (definition and origin, not specific derivations)

A

from migrating NCCs and surrounding pharyngeal endoderm and mesoderm; different from somites; separated by pharyngeal grooves on the external surface and pharyngeal pouches on the internal surface; grooves and pouches are separated by mesoderm; each arch has nervous, arterial, muscular and bony components

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6
Q

Somites

A

mesodermal swellings around the neural tube

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7
Q

Pharyngeal/Branchial Arch I

A

N: CN V
A: Maxillary artery
B: Greater wing of sphenoid, malleus, maxilla, zygomatic, temporal (squamous), mandible
M: Muscles of mastication, anterior digastric, mylohyoid, tensor tympani, tensor veli palatini
Ear: forms anterior hillocks (tragus, root of helix, superior helix)

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8
Q

Pharyngeal/Branchial Arch II

A

N: CN VII
A: Stapedial artery (corticotympanic)
B: Stapes, styloid process, stylohyoid ligament, lesser horn and upper body of horn
M: Muscles of facial expression, posterior digastric, stylohyoid, stapedius
Ear: posterior hillocks (antitragus, antihelix and lobule)

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9
Q

Pharyngeal/Branchial Arch III

A

N: CN IX
A: Common carotid, proximal internal carotid
B: Greater horns and lower body of hyoid
M: Stylopharyngeus

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10
Q

Pharyngeal/Branchial Arch IV/VI

A

N: CN X
A: Aortic arch, right subclavian, origin of pulmonary arteries, ductus arteriosus
B: laryngeal cartilages
M: Pharyngeal constrictors, levator veli palatini, palatoglossus, striated upper esophageal muscles, laryngeal muscles

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11
Q

Pharyngeal Groove(Cleft) I

A

becomes external auditory canal, mesoderm becomes tympanic membrane

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12
Q

Pharyngeal Groove II-IV

A

operculum flap grows downward from arch II and fuses below cleft IV to create cervical sinus
Anomalies from groove II are the most common

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13
Q

Pharyngeal grooves (clefts)

A

Failure to obliterate can lead to cysts (sealed in neck), sinuses (end in blind sac) or fistulas (connect with pharynx; often detected in the second decade of life and palpable at the anterior border of the SCM

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14
Q

Pharyngeal Pouch I

A

Internal auditory canal

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15
Q

Pharyngeal Pouch II

A

Palatine tonsil

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16
Q

Pharyngeal Pouch III

A

inferior parathyroid and thymus

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17
Q

Pharyngeal Pouch IV

A

Superior parathyroid (migrates above pouch III)

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18
Q

Pharyngeal Pouch V

A

Ultimobranchial body (thyroid C cells)

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19
Q

Intramembranous ossification

A

cartilaginous precursors resorb; mesenchymal cells directly differentiate into osteoblasts without cartilaginous intermediate

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20
Q

Endochondral ossification

A

cartilaginous template is directly and gradually replaced with a bony matrix

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21
Q

Neurocranium

A

portion of the skull encasing and protecting the brain

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22
Q

Membranous neurocranium

A

forms via intramembranous ossification of neural crest origin, includes paired frontal, squamosal, and parietal bones, and upper occipital bone

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23
Q

Cartilaginous neurocranium

A

forms via endochondral ossification of mesodermal origin, includes sphenoid and ethmoid bones, mastoid and petrous temporal bone, and the base of the occipital bone

24
Q

Viscerocranium

A

bones of the facial skeleton; forms via intramembranous ossification of pharyngeal arch I, except for Meckel’s cartilage (which forms the malleus and mandibular condyles)

25
Q

Craniosynostosis

A

sutures fuse prematurely, associated with FGFR and TGFßR and TWIST and Wnt pathways

26
Q

Virchow’s Law (of skull)

A

After suture fusion, growth proceeds parallel to suture instead of perpendicular

27
Q

Five Prominences of the Face

A

Frontonasal (1), Maxillary (2), Mandibular (2)

28
Q

Frontonasal prominence

A

pulled ventrally and caudally, forming the forehead, nasal dorsum (apex), and medial and lateral nasal prominences

29
Q

Maxillary prominence

A

Migrate medially to form the secondary palate, lateral maxilla, and lateral lip

30
Q

Tessier number 3

A

Oblique facial cleft; Failure of fusion of the junction with the lateral nasal prominences forms the nasolacrimal groove and nasolacrimal duct system

31
Q

Mandibular prominence

A

Forms mandible, lower lip, and lower face

32
Q

Prominent growth factors and signaling pathways

A

TGFß, BMP, FGF, IRF, Wnt, FOXe1

33
Q

Teratogens affecting Sonic Hedgehog Pathway

A

retinoids, alcohol, drugs that affect cholesterol synthesis and transport

34
Q

Stomodeum

A

primitive mouth forms at 3-4 weeks from invagination of the ectoderm around the buccopharyngeal membrane

35
Q

Unilateral cleft lips

A

result from failure of fusion of the medial nasal prominence and a maxillary prominence

36
Q

Tessier Cleft 7

A

Cleft at the lateral oral commissure, results from failure of fusion of the maxillary and mandibular prominences

37
Q

Tessier Cleft 0

A

median cleft lips are rare and result from failure of the medial nasal prominences to fuse

38
Q

Tessier Cleft ?

A

central defects of the lower lip and chin result from failure of the mandibular processes to fuse

39
Q

Primary Palate and Cleft

A

5-6 weeks, medial nasal prominences come together to form the primary palate, midmaxilla, and septum; cleft results from failure of fusion of the medial and lateral palatine processes

40
Q

Secondary Palate and Cleft

A

9-12 weeks, lateral palatine shelves initially hang vertically but assume a horizontal position as the tongue drops with mandibular growth; right palate drops first, which explains higher incidence of cleft palate on the left side; cleft results from failure of fusion of the lateral palatine process with the nasal septum

41
Q

Incisive foramen

A

Lies between the primary and secondary palate

42
Q

Epstein pearls

A

along the median raphe or junction of the hard/soft palates result from cystic degeneration of epithelial lining at edges

43
Q

Nasopalatine duct cysts

A

at the incisive foramen result from epithelial entrapment at the junction of developing primary/secondary palates

44
Q

Thyroid

A

from endodermal proliferation at foramen cecum of tongue, descends with a trailing diverticulum to final position distal to cricoid cartilage

45
Q

Thyroglossal duct cysts

A

may form anywhere along the path of the thyroid, presenting as painless midline (or near midline) neck mass, may rupture and result in sinus or fistula formation; treat with sistrunk procedure (removal of cyst and central hyoid bone)

46
Q

Lingual thyroids

A

result from failure of thyroid descent

47
Q

Anterior 2/3 of tongue

A

Originates from pharyngeal arch I and is innervated by lingual nerve CN V3

48
Q

Posterior 1/3 of tongue

A

Originates from arches III and IV (these overtake arch II) and is innervated by CN IX and X

49
Q

Tongue muscles

A

Arise largely from occipital myotomes (CN XII) except for palatoglossus (CN X)

50
Q

External Ear

A

Forms at interface between pharyngeal arches I and II

51
Q

Arch I

A

Forms anterior hillocks (tragus, root of helix, and superior helix)

52
Q

Arch II

A

Forms three posterior hillocks (antitragus, antihelix, lobule)

53
Q

Groove I

A

lies between arches I and II and forms external auditory canal

54
Q

Medial nasal prominence

A

Primary palate, midmaxilla, midlip, philtrum, central nose, and septum

55
Q

Lateral nasal prominence

A

Nasal ala

Plastic Surgery - Craniofacial (7 decks)

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