NB2 10+11

Question 1

Clefts

Answer 1

can occur on its own or part of a syndrome

usually multifactorial

can be anterior or posterior

Question 2

clefts of the anterior palate

Answer 2

Anterior to the incisive fossa

Results from failure of the fused lateral palatine processes (secondary palate) to meet and fuse with the primary palate

Question 3

clefts of the posterior palate

Answer 3

posterior to the incisive fossa

Results from failure of the lateral palatine processes to meet and fuse with each other and the nasal septum

Question 4

cleft of the anterior and posterior palate

Answer 4

Results from failure of the lateral palatine processes to meet and fuse with the primary palate, with each other, and the nasal septum

Question 5

cleft lip

Answer 5

Cleft lip can occur independently from underlying bony deformities

can be unilateral or multilateral

Failure of maxillary prominence to fuse with the fused medial nasal prominence(intermaxillary segment) on one or both sides

Question 6

Unilateral Cleft Upper Lip

Answer 6

Failure of fusion of left maxillary prominence with the fused medial nasal prominences (intermaxillary segment)

Question 7

Bilateral Cleft Upper Lip

Answer 7

Failure of both maxillary prominences to fuse with the intermaxillary segment

Question 8

Median Cleft Upper Lip

Answer 8

Failure of fusion of the two medial nasal
prominences to form the intermaxillary segment

usually seen with other morphologies

rare

Question 9

Median Cleft Lower Lip

Answer 9

rare

Failure of fusion of the mesenchyme of the
mandibular prominences

Question 10

Oblique Facial Cleft

Answer 10

Failure of maxillary prominence to fuse with lateral nasal prominence

Nasolacrimal duct is visible

Question 11

First arch syndrome - Treacher Collins Syndrome

Answer 11

failure of NCS migration into the first arch

underdeveloped jaw (micrognathia) 
cleft palate (50%) 
conductive hearing loss
pinna malformation 
drooping eyelid (lower)

Question 12

First arch syndrome - Pierre Robin Sequence

Answer 12

1. Micrognathia or retrognathia
2. glossoptosis (retraction of tongue)
3. cleft palate

Question 13

cervical (branchial) sinus

internal and external??

Answer 13

external:
Open externally along ant. border of SCM

Failure of the second pharyngeal groove and cervical sinus to obliterate

internal:
Opens internally into the tonsillar fossa or near the palatopharyngeal arch

Most result from persistence of the proximal part of the
second pouch (more rare)

Question 14

CERVICAL (BRANCHIAL) FISTULA

Answer 14

Persistence of the 2nd pouch and cervical sinus

Abnormal tract passing between external and
internal carotid arteries

opening on the side of neck externally & in the
tonsillar sinus internally.

Question 15

cervical (branchial) cysts

Answer 15

persistence of parts of cervical sinus and /or 2nd pharyngeal groove with no internal or external communication

Cystic swelling along anterior border of the sternocleidomastoid

slowly will enlarge with fluid and cells
painless
late childhood

Question 16

Thyroglossal Duct Cyst and Sinus

Answer 16

Cystic remnant of the thyroglossal duct

usually in the midline

may develop anywhere along the pathway of the duct

painless, enlarging, movable

Infection can cause perforation unto to skin of the neck leading to development of a thyroglossal duct sinus

Question 17

Craniopharyngiomas

Answer 17

usually benign and sometimes functional tumors may develop from minor epithelial remnants of the hypophyseal diverticulum

Question 18

parathyroid anomalies

Answer 18

Supernumerary parathyroid glands – early
division of the primordium of the gland

Absence of the parathyroid gland – atrophy or
failure of differentiation of the primordium

Ectopic parathyroid glands – usually within the
thyroid gland or thymus