Mechanisms of Post-Natal Growth Flashcards

1
Q

How many fontanelles are present at birth?

A

6

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2
Q

What is the cranial vault to face ratio in newborns compared to adults?

A

8:1 in newborns vs 3:1 in adults

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3
Q

What parts of the skull follow a neural growth pattern?

A

Cranial vault and structures associated with sense organs

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4
Q

Why does the cranial vault follow a neural growth pattern?

A

Grows in response to developing brain

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5
Q

Which of the neural or somatic growth patterns is faster?

A

Neural

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6
Q

By 10yo how much of the brain is developed?

A

95%

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7
Q

What growth pattern does the face follow?

A

Somatic

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8
Q

When is face growth complete?

A

With eruption of third molars (18-25yo)

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9
Q

What growth pattern does the cranial base have?

A

Intermediate - early is neural then later childhood is somatic

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10
Q

What areas in the head have endochondral origin? (3)

A

Cranial base

Pharyngeal arch cartilages

Otic and nasal capsule

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11
Q

What is the main difference between endochondral and intramembraneous ossification?

A

Endochondral has a hyaline cartilage precursor

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12
Q

Why does secondary cartilage form?

A

In response to pressure/force

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13
Q

What are the three embryonic origins of the bones in the head?

A

Neural crest cells - most skeletal structures

Unsegmented paraxial cranial mesoderm - back of cranial vault and back of cranial base

Segmented paraxial cranial mesoderm - occipital bone

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14
Q

What are the remnants of Meckel’s cartilage?

A

Incus and malleus in the inner ear

Perichondrium of sphenomandibular and sphenomalleolar ligaments

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15
Q

How do neural crest cells form?

A

Epithelial to mesenchymal transformation

Lose adherens junctions and become migratory

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16
Q

What is the function of Meckel’s cartilage? (2)

A

Act as a support on which the mandible is formed

Required for downward growth of mandible

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17
Q

Where is primary cartilage found in the head?

A

Growth plates of cranial base

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18
Q

What type of growth occurs in growth plates?

A

Interstitial

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19
Q

How can ossified primary cartilage be remodelled?

A

Appositional growth

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20
Q

What is an example of secondary cartilage in the head?

A

Condylar cartilage

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21
Q

Why is the cranial vault remodelled?

A

Reduce weight

Flatten

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22
Q

Give two conditions where brain defects have affected skull growth.

A

Microcephaly (eg. zika virus) - underdeveloped skull

Macrocephaly (eg. hydrocephaly) - enlarged skull

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23
Q

What three cartilages form the cranial base?

A

Prechordal - ethmoid

Hypophyseal - sphenoid

Parachordal - occipital

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24
Q

Which cartilages are associated with sense organs?

A

Greater and lesser wings of sphenoid

Periotic capsule (temporal)

25
Name the synchondroses of the cranial base.
Spheno-ethmoidal (ethmoid and presphenoid) Intersphenoid (presphenoid and basi-sphenoid) Spheno-occipital (basi-sphenoid and basi-occipital)
26
When are each of the synchondroses of the cranial base fused?
Intersphenoid - at birth Spheno-ethmoidal - 3-5yo Spheno-occipital - 12-16yo
27
How could achondroplasia affect occlusion? (3)
Defects in cranial base development Cranial base linked to maxilla No space for third molars, class III occlusion
28
How does the mandible change from birth to adulthood? (3)
Increases in width, length, height Angle decreases from 140° to 115°/120° Relative sizes of condylar and coronoid processes change from even to a dominating condylar
29
Which pharyngeal arch is the mandible derived from?
First
30
What are features of the Pierre Robin Sequence?
Micrognathia Glossoptosis Airway obstruction
31
How might defects in Meckel's cartilage cause Pierre Robin Sequence?
No lowering of lower jaw
32
By when is the lower jaw ossified?
10 weeks i.u.
33
When and where does ossification of the lower jaw begin?
6 weeks i.u. At incisive and mental branch tributary (from inferior alveolar nerve)
34
When does the mandibular secondary cartilages start to form?
10 weeks - condylar 11 weeks - coronoid 12 weeks - symphysial
35
Where do the cells giving rise to chondrocytes for secondary cartilage come from?
Periosteum
36
When does the symphysial cartilage ossify and why is this important?
By the end of year 1 Limits growth in width of mandible
37
When does the condylar cartilage stop growing?
20yo
38
Which mandibular secondary cartilage disappears by birth?
Coronoid cartilage
39
What is the result of mandibular remodelling from child to adult? (3)
Lengthen body Strengthen chin Widen mandible at back
40
Why does loss of dentition result in a thinner mandible?
Loss of alveolar bone
41
How is room made for the permanent mandibular dentition? (3)
Remodelling Size difference between deciduous molars and their successors Forward movement of lower teeth through alveolar bone
42
What parts of the upper jaw are endochondral?
Nasal capsule and septum
43
Describe the upper jaw at birth. (3)
Large frontal process No alveolar bone No anterior nasal spine
44
What occurs during the growth of the upper jaw? (3)
Displacement at sutures Dentition and alveolar bone develop Remodelling forms maxillary sinuses and makes room for third molars
45
Which sutures are growing post-natally in the palatal shelves and until when?
Intermaxillary/median palatine - increase width up to 2 yo Palatomaxillary/transverse palatine suture - increase length up to 7yo
46
What causes displacement at the sutures for upper jaw growth? (3)
Expanding brain Expanding sense organs Muscle forces
47
When is the septal cartilage ossified?
7yo
48
How does the septal cartilage help upper jaw growth?
Pushes down on palatal shelves causing a forward and downward movement to develop the arched shape
49
What region of the skull is the septal cartilage a part of?
Cranial base
50
When does the cartilage between the greater wings and body of sphenoid ossify?
By the end of year 1
51
What region of the skull are the greater wings and body of sphenoid part of?
Cranial base
52
When is the cribriform plate of the ethmoid ossified?
By the end of year 3
53
When is the midline of the face completely fused?
By the end of year 3
54
By when are all the upper jaw sutures fused?
10yo
55
By when is all the upper jaw endochondral growth complete?
7yo
56
At birth, what percentage of the final width, height and depth is the face?
60% width 45% height 35% depth
57
When is the metopic suture fused?
By the end of year 1
58
Why is there less growth in the width of the face than height and depth?
Midline is fused by 3yo