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Pedo/Ortho > Lecture 2 > Flashcards

Lecture 2 Flashcards

1
Q

Klinefelter Syndrome

A

Males that have an extra x in most of their cells, the more x’s the more severe, 1:500-1,000. Penetrance, women over 35 have a higher incidence

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2
Q

Klinefelters clinical appearance:

A

Gynecomastia (man boobs),max and mand prognathism (causes cross bits and malocclusion). Permanent crowns larger than usual. Inc pulmonary and autoimmune disorders, diabetes mellitus in 8%, high incidence of cleft palate.

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3
Q

Klinefelters clinical management:

A

Bolton discrepancy (tooth size ration wont accommodate a proper occlusal relationship) growth abnormalities, max and mand prognathism, Taurodontism (extension of pulp chamber below alveolar crest, failure of hertswig epithelial shift to invaginate at proper level, enlarged pulp chamber, apical displacement, no constriction at CEJ, caries control important (due to potential calcification and extra canals)

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4
Q

Turners Syndrome:

A

One normal x and the other missing/altered. 1:2,500 females. Webbed neck, low hairline on back of neck, lymphedema, early loss of ovarian function, 1/3-1/2 with heart defect. Short stature defect on SHOX gene (essential for skeletal development especially in arms and legs.

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5
Q

Clinical management of syndromic patients

A

Good understanding of the syndrome is important, congenital heart defects so consult with cardiologist, mental handicaps, need realistic goals for oral problems,

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6
Q

Cleavage

A

Subdivides zygote without increasing in size. Starting at 8 cell size, blastomere begins to flatten. Outer surface become convex and inner surfaces become more concave. Called compaction and involves changing the blastomere cytoskeleton.

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7
Q

Preimplantation genetic diagnosis (PGD)

A

Remove a blastomere and screen for aneuploidy or translocation with karyotype analysis. Done on old pts and high risk

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8
Q

Trophoblast

A

part of the cleaving embryo, peripheral outer cell mass, placenta and associated membranes

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9
Q

embryoblast

A

part of cleaving embryo, inner cell mass that gives rise to embryo proper

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10
Q

day 4

A

morula consist of 30 cells. Trophoblast has a sodium potassium ATPase pump that pumps in ions and water follows. Fills a large cavity called the blastocyst cavity

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11
Q

blastocyst

A

has the fluid filled cavity. The inner cell mass forms the embryonic pole and the other end is abembryonic pole.

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12
Q

Zona hatching

A

Blastocyst’s zona pellucida degenerates and replaced by a underlying layer of trophoblast cells called the cytotrophoblast

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13
Q

Syncytiotrophoblas

A

Trophoblast cells in contact with uterine wall lose cell membrane coalesce to form syncytium and implants into the uterine wall

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14
Q

Bilaminar embryonic disk

A

During the second week the embryoblast splits into epiblast (primary ectoderm) and hypoblast (primary endoderm)

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15
Q

Amniotic cavity

A

Appears day 8 as fluid collects between cells of epiblast and overlying trophoblast. A layer of epiblast cells expands toward the embryonic pole and differentiates into a thin membrane (amnion) separating the new cavity and from the cytotrophoblast. Remainder of epiblast and hypoblast now constitute a bilaminar disk which develops into embryo proper

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16
Q

Coagulation plug

A

Acellular material that seals the small hole where the blastocyst implanted.

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17
Q

Extraembryonic endoderm:

A

day 9 the hypoblast sends out a proliferation of cells that lines the cytotrophoblast. Completely surrounds the former blastocyst and is called the Heuser’s membrane

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18
Q

extra embryonic mesoderm

A

filling in between heusers membrane and the cytotrophoblast with loosely arranged cells

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19
Q

primary yolk sac

A

blastocyst cavity after heusers membrane is formed

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20
Q

cytotrophoblastic lacunae

A

day 11-13 anastamose with maternal capillaries and become filled with blood

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21
Q

extraembryonic coelom or chorionic cavity

A

12-13 days. extraembryonic mesoderm splits into two layers. seperates the embryo with its attached amnion and yolk sac from the outer wall of the blastocysts

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22
Q

endodermal lining of the definitive yolk sac

A

breaks up the primary yolk sac, happens on day 12, migrates over the inside of the extraembryonic mesoderm

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23
Q

major structure associated with the developing embryo throught eh 4th week

A

definitive yolk sac-primordial germ cells first identified in this wall

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24
Q

primitive streak

A

primitive groove, pit, and node. beginning of third week

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25
Q

gastrulation

A

cell migration, invagination and ingress. day 16 the epiblast cells near the primitive streak begin to proliferate, flatten, and lose their connections with each other. develop long flat foot like processes (pseudopodia) which allow them to migrate through primitive streak

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26
Q

definitive endoderm

A

invading epiblast cells replace the hypoblast- gives rise to gut and gut derivatives

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27
Q

intraembryonic mesoderm

A

invading epiblast cells form a middle layer. migrate laterally (somites= vertebral column, skeltal muscle, and dermis) and cranially

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28
Q

notchordal process

A

hollow, mesodermal cells migrates cranially on day 17.

29
Q

prechordal plate

A

thickening of endodermal layerwhich is formed my mesodermal cells. gives rise to the endodermal layerof the orppharyngeal membrane (forms the mouth and participates in patterning of the cranial nerve tube.

30
Q

ectoderm

A

once ingress of epiblast is complete its called ectoderm and bilaminar disk is now trilaminar

31
Q

bilaminar membrane

A

fusion of ectoderm and endoderm. 3rd week.

32
Q

buccopharyngeal membrane

A

cranial membrane

33
Q

cloacal membrane

A

caudal membrane

34
Q

caudal eminence

A

day 26 the remnants of primitive streak leave behind a caudal midline mass of mesoderm

35
Q

notochordal plate

A

days 16-22 the hollow notochordal process fuse with the underlying endoderm in a caudal to cranial manner. disengages from the endoderm to form notochord

36
Q

neural plate

A

thickening of the ectoderm on either side of the midline, cranial to the primitive node.wider at cranial portion (for brain) day 22 the neural plate represents about 25% of the length it will be. day 23-24 its 50%.

37
Q

neurulation

A

fourth week, converts neural plate into a hollow tube which sinks and differentiates into brain and spinal cord

38
Q

neural groove

A

crease above the notochord. crease ventrally to form the neural tube and canal

39
Q

neural crest cells

A

day 24. detach from neural tube and undergo epithelial to mesenchymal transformation, and migrate to different parts of the body where they make up a variety of structures. the route and where they stop migrating determines what they become.

40
Q

day 22

A

neural groove begins to close, starts in middle and goes laterally. 24 cranial closes and 26 caudal closes. then neural tube is covered dorsally by mesenchyme

41
Q

main force for folding

A

growth of different embryonic structures. embryonic disc and amnion grow while yolk sac says the same. notochord, neural tube, and somites stiffen so the main force is on the thin flexible disc.

42
Q

oropharyngeal membrane

A

cranial rim of embryonic disc, future mouth

43
Q

cardiogenic area

A

horshoe shaped, cranial to oropharyngeal membrane. gives rise to heart

44
Q

septum transversum

A

day 22, thickened bar of mesoderm, just caudal to cranial margin of embryonic disc, diaphragm, stomach, duadenum

45
Q

cranial rim

A

face, neck, chest

46
Q

caudal rim

A

contains coacal membrane, folds ventrally

47
Q

body folding result

A

tube inside a tube is established. ectoderm on outside and endoderm on inside

48
Q

anencephaly

A

upper part of neural tube fails to close- neural tube defect. missing forebrain, cerebrum, skull and skin of head

49
Q

spina bifida

A

lower portion of neural tube fails to close, physical and mental disabilities. genetic, nutriotional, environmental. folic acid/ vit b

50
Q

encephalocele

A

failure of skull to close completely, brain squishes out somehwere on head. rare 1;500. girls more likely occcipital, boy more likely front of skull, north america more common back, SE asia more comman front. if meninges involved its an miningoencephalocele. with CSF its meningiohydroencephalocele. tx: surgery

51
Q

myelomeningoecele

A

most serious type of spina bifida, sac of fluid with spine and nerves out the opening, moderate to sever disabiltes,

52
Q

meningiocele

A

spina bifida, just sac of water, minor disabilties

53
Q

spina bifida occulta

A

small gap but no pouch, no disabilites

54
Q

pharyngeal arches

A

1,2,3,4,6. internal endoderm pouch (4), external ectoderm cleft (4), mesenchymal core (somatic mesoderm (artery and muscle) and neural crest mesencyme(bone cartilege and CT)

55
Q

pharyngeal membrane

A

area between clefts and pouches, both endoderm and ectoderm

56
Q

1st pharyngeal arch

A

4th week. maxx and mand process. max: cartilage= palatopterygoquadrate forms incus and alisphenoid (eye)
mandible cartilege (meckels) neural crest, malleous.
Somatic mesoderm: maxillary artery and muscles of mastication
pharyngea membrane: tympanic membrane
NC mesenchyme; max, mand, zygomatic, squamous.
trigeminal nerve 5

57
Q

2nd pharyngeal arch

A

cartilege= stapes, styloid process, stylohyoid, lesser horn and upper rim of hyoid.
stapedial artery
muscles of facial expression, digastic (posterior), stylohyoid, stapedius muscles
facial nerve 7
failure of the sinus to obliterate leaves cervical cyst

58
Q

3rd pharyngeal arch

A

cartilage: lower rim of hyoid bone (body) and greater horn
somatic mesoderm: stylopharyngeous muscle
common and internal corotid artery
glossophayrngeal nerve 9

59
Q

fourth arch

A

arch of aorta, right subclavian, initial pulmonary arteries.

constrictors of pharynx, cricothyroid, and levater veli palatini

60
Q

sixth arch

A

ducctus arterious, definitive pulmonary arteries.

intrinsic muscles of larynx

61
Q

cranial nerves and arches

A

5,7,9,10 (superior laryngeal branch), 10 (recurrent laryngeal branch)

62
Q

pharyngeal cleft 1

A

external auditory canal, preauricular cysts and fistulas. may threaten facial nerve

63
Q

2,3,4 pharyngeal clefts

A

obliterated, can form cysts of fistulas along the anterior border of the sternocleidomastoid muscle

64
Q

1 pharyngeal pouch

A

eustacian tube and middle ear cavity

65
Q

2 pharyngeal pouch

A

crypts of the palatine tonsil, lymphocytes form the actual tonsil

66
Q

3 pharyngeal pouch

A

dorsal/superior form inferior parathyroid glands

ventral/inferior form thymus

67
Q

4 pharyngeal pouch

A

dorsal= superior parathyroid.

ventral=ultimobranchial body (induces migration of nearby NC cells into parafollicular cells of thyroid

68
Q

thryoid gland

A

late 4 week. proliferate at foremen cecum, descends through thyroglossal duct, duct breaks down in 5 week. migrates till week 7. not from any arch, arises from midline thyroid diverticulum (endoderm) endoderm differentiate into follicular cells
issues: ectopic thyroid or MIDLINE cysts

Pedo/Ortho (3 decks)

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