QUIZ 2 Embryology of the Head, Face, and Oral Cavity

Question 1

orofacial development begins at ___ weeks in utero

Answer 1

4

Question 2

once the olfactory placodes develop, what happens?

Answer 2

ectomesenchyme proliferates on both sides of each placode, resulting in medial and lateral nasal processes

Question 3

what merges to form the upper lip?

Answer 3

medial nasal processes merge with each other, as well as the maxillary processes of the first branchial arches

Question 4

upper lip formation occurs from weeks ___ to ___

Answer 4

6-7

Question 5

what merges to form the primary palate?

Answer 5

medial nasal process

Question 6

the secondary palate is formed from the ___ processes of the first ___ arches

Answer 6

• maxillary
• branchial

Question 7

what makes up 90% of the hard and soft palates?

Answer 7

secondary palate

Question 8

what are the developmental conditions that can affect orofacial development?

Answer 8

• developmental
  
  • anomaly of development
• hereditary/genetic
  
  • familial - runs in families
  • congenital - present at birth

Question 9

a cleft lip is the result of the defective fusion of which two processes?

Answer 9

medial nasal process and the maxillary process

Question 10

what percent of cleft lip cases are unilateral?

Answer 10

80%

Question 11

cleft palate is the failure of what to fuse?

Answer 11

the palatal shelves

Question 12

the minimal manifestation of cleft palate is a ___

Answer 12

bifid uvula

Question 13

describe treatment of cleft lip

Answer 13

rule of 10

• 10 weeks old
• 10 lbs
• 10 grams % hemoglobin

Question 14

describe treatment of cleft palate

Answer 14

about 1 1/2 years

Question 15

what % of orofacial clefts are cleft lip and palate?

Answer 15

45%

Question 16

what % of orofacial clefts are cleft palate only?

Answer 16

30%

Question 17

what % of orofacial clefts are cleft lip only?

Answer 17

25%

Question 18

what percent of syndromic patients have cleft lip AND cleft palate?

Answer 18

30%

Question 19

what percent of syndromic patients have cleft palate only?

Answer 19

50%

Question 20

describe Pierre Robin sequence

Answer 20

• cleft palate
• mandibular micrognathia
• glossoptosis (downward displacement of the tongue)

Question 21

describe environmental factors of nonsyndromic clefts

Answer 21

• maternal alcohol or cigarette use
• folic acid deficiency
• corticosteroid use
• anticonvulsant therapy

Question 22

what type of cleft is described as a lack of fusion of the maxillary and mandibular processes?

Answer 22

lateral facial cleft

Question 23

what type of cleft is described as failure of fusion of the lateral nasal processes with maxillary process?

Answer 23

oblique facial cleft

Question 24

what type of cleft is described as failure of fusion of the medial nasal processes?

Answer 24

median cleft of the upper lip

Question 25

what type of cleft is more common in males?

Answer 25

CL + CP

Question 26

what type of cleft is more common in females?

Answer 26

cleft palate only

Question 27

describe the prevalence of orofacial clefts among native americans, asians, caucasians, and african americans

Answer 27

* native americans: 1/250 * asians: 1/300 * caucasians: 1/700 * african americans: 1/1500

Question 28

how can a submucous palatal cleft develop?

Answer 28

* surface is intact, but defect exists in the underlying musculature of the soft palate * epithelium seals off cleft, but bones are still separated * a bone notch will be present on the posterior hard palate margin * appears as a bluish midline discoloration

Question 29

name the 9 individuals that can be involved in management of orofacial clefts

Answer 29

* pediatrician * OMFS * ENT * plastic surgeon * pediatric dentist * orthodontist * prosthodontist * speech pathologist * geneticist

Question 30

describe commissural lip pits

Answer 30

* angle of the mouth * mucosal invaginations that occur at the corners of the mouth on the vermillion border * not associated with facial or palatal clefts

Question 31

describe paramedian lip pits

Answer 31

* congenital invaginations of the lower lip * usually bilaterally located * no treatment except evaluate for syndrome

Question 32

describe van der woude syndrome

Answer 32

* greatest significance of paramedian lip pits * cleft lip and cleft palate * most common form of syndromic clefting

Question 33

what is microglossia?

Answer 33

* abnormally small tongue * usually syndromic

Question 34

what is aglossia?

Answer 34

missing tongue

Question 35

microglossia is frequently associated with what?

Answer 35

hypoplasia of the mandible

Question 36

what may be missing in microglossia?

Answer 36

lower incisors

Question 37

what is ankyloglossia?

Answer 37

developmental tongue abnormality characterized by a short, thick lingual frenum resulting in limitation of tongue movement aka tongue tied

Question 38

akyloglossia may cause problems with what?

Answer 38

speech and breastfeeding

Question 39

what are the treatment options for ankyloglossia?

Answer 39

frenotomy or frenuloplasty around age 4-5