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Fundamentals of Patient Management > Maxillofacial Embryology > Flashcards

Maxillofacial Embryology Flashcards

1
Q

how many prominences develop on the human face

A

5

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2
Q

what are terms interchangeable with prominences

A

swelling or process

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3
Q

what do facial prominences predominantly consist of

A

*neural crest derived mesenchyme from first pharyngeal arches

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4
Q

what happens at week 4 in relation to the prominences

A

5 prominences surrounds the stomodeum

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5
Q

what and where are prominences 1&2

A

maxillary prominences, lateral to the stomodeum

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6
Q

what and where are prominences 3&4

A

mandibular prominences, caudal to the stomodeum

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7
Q

what and where is prominence 5

A

frontonasal prominence, rostral to the stomodeum

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8
Q

where are the nasal (olfactory) placodes*

A

on both sides of the frontonasal prominence, thickenings of surface ectoderm

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9
Q

what is the stomodeum*

A

precursor to the mouth

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10
Q

what occurs during week 5

A
  • *nasal placodes invaginate from nasal pits
  • *nasal prominences
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11
Q

what forms on the nasal pits during week 5

A
  • a new ridge of tissue forms on each side of the pits
  • this forms the *medial nasal prominence and *lateral nasal prominence
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12
Q

what happens for weeks 6-10 for the lips

A

*maxillary prominences increase in size and grow medially compressing the *medial nasal prominences toward the midline
*the lower lip& mandible are formed

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13
Q

what occurs during weeks 6-10 to the maxillary and medial nasal prominences? what does this form?

A
  • clef between the *medial nasal prominence and maxillary prominence should be LOST and 2 structures fuse
  • *upper lip is formed by *2 medial nasal prominences and *2 maxillary prominences
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14
Q

what is the nasolacrimal groove*

A

deep furrow separating maxillary and lateral nasal prominences

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15
Q

what is the nasolacrimal duct*

A

ectoderm forms a canal at the base of the groove

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16
Q

what forms the nasolacrimal sac

A

upper end of the duct forms this structure

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17
Q

what occurs once the duct of the nasolacrimal sac forms

A

*maxillary and lateral nasal prominences merge (supposed to)

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18
Q

where is the duct near the nasolacrimal sac located

A

duct runs from the *medial corner of the eye to the *inferior meatus of the nasal cavity

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19
Q

what happens to the maxillary prominences during week 6-10

A

*they enlarge to form the cheeks and maxillae

20
Q

what is the nose formed by during weeks 6-10*

A

formed from 5 facial prominences

21
Q

what are the 5 facial prominences that form the nose

A

1) *frontonasal prominence forms the bride
2&3) *merged medial prominences form the crest and tip
4&5) lateral nasal prominences form the alae

22
Q

by week 7 what has merged? what structure has been created?

A

-merging of the maxillary prominences and medial nasal prominences
- creates the *INTERMAXILLARY SEGMENT
- secondary palate begins to fuse

23
Q

what are the 3 components of the intermaxillary segment

A

1) * labial component = philtrum of the upper lip
2) * upper jaw component = four incisor teeth
3) * palatal component= triangular *primary palate

24
Q

what is the I.S. continuous with?

A

w/ the rostral portion of the *nasal septum which is formed by the frontal prominence

25
Q

how do the primary and secondary palates compare?

A
  • primary palate is relatively small compared to secondary
  • secondary becomes the main part of the definitive palate
26
Q

what forms the secondary palate

A

two shelf-like outgrowths from the maxillary prominences called the *palatine shelves

27
Q

how does fusion of the palatal shelves take place*

A
  • begins in the anterior palate and progresses posteriorly
  • also ascend to horizontal position above the tongue and fuse
  • nasal septum grows down and joins the newly formed palate
28
Q

what is the incisive foramen*

A

midline landmark between the primary and secondary plates

29
Q

what 5 changes occur to the nasal cavity during weeks 6-9

A

1) nasal pits deepen
2) growth of surrounding tissue
3) penetration into the underlying mesenchyme
4) oronasal membrane
5) definitive choanae once palate forms and nasal chambers develop

30
Q

what is the oronasal membrane

A
  • separates the pits from the primitive oral cavity via the foramina named *primitive choanae
  • lie on each side of the midline immediately behind the primary palate
31
Q

where are definitive choanae

A

lie at the junction of the nasal cavity and pharynx

32
Q

how do paranasal air sinuses develop

A

as diverticula of the lateral nasal wall and extend into the maxilla, ethmoid, frontal, and sphenoid bones, reaching definitive size at puberty

33
Q

what are 4 leading reasons why structures don’t fuse

A

1) maternal use of valproic acid (anticonvulsant med)
- 10x greater frequency of clefting
2) maternal smoking
- doubles the frequency of clefting
3) maternal alcohol
4) syndromic

34
Q

what is the most common syndrome associated with clefting*

A

van der woude syndrome
- cleft lip w/ or w/o cleft palate
- paramedian lip pits

35
Q

what is pierre robin sequence

A
  • cleft palate, one of the syndromes where structures don’t fuse
  • mandibular micrognathia
  • glossoptosis
36
Q

what is treacher collins syndrome? the alternate name?

A
  • one of the syndromes where structures don’t fuse
  • 1st and 2nd branchial arch defects
    -> cleft palate, narrow cheeks, underdeveloped mandible, lateral facial clefting
  • mandibulofacial dysostosis
37
Q

what is the origination of cleft lip

A

defective fusion of the *medial nasal process with the *maxillary process

38
Q

what is the origination of cleft palate

A

failure of the *palatal shelves to fuse (secondary palate)

39
Q

what demographic has cleft palate only

A

30% of people affected have CPO
- female predominance*

40
Q

what demographic has CL+/-CP

A

70% overall
-male predominance*

41
Q

how does race play into cleft palate

A

NA 2x more than Asians
Asians 1.5x more than white
white 2x more than black

42
Q

where is an oblique facial cleft? what is it?

A
  • along the nasolacrimal groove
  • failure of the maxillary prominence to merge with the lateral nasal prominence
43
Q

what is median cleft lip

A
  • failure of the medial nasal prominences to merge
  • holoprosencephaly: spectrum w/ most severe being loss of midline structure & fusion of lateral ventricles of brain
44
Q

what are important features of commissural lip pits

A
  • failure of normal fusion of the maxillary and mandibular processes
  • NOT associated with facial or palatal clefts
  • corners of mouth, can develop later in life
45
Q

what are important features of paramedian lip pits

A
  • rare congenital invaginations of lower lip from persistent lateral sulci on embryonic mandibular arch, usually disappear by week 6
  • usually inherited as an autosomal dominant trait (e.g. van der woude syndrome)
46
Q

what is double lip

A
  • congenital- approx., 3rd month of gestation
  • acquired- ascher syndrome
47
Q

what are important features of palatal cysts of the newborn

A

-trapped islands of epithelium when palatal shelves fuse
- epstein perals, bohn nodules

Fundamentals of Patient Management (10 decks)

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