Quiz 2 - Trump - Embryology Of Head, Face, And Oral Cavity Flashcards

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1
Q

When does central face development begin?

A

Week 4

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2
Q

Where does central face development happen?

A

Nasal placodes

-Placodes = thickening

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3
Q

Upper lip formation, when?

A

Weeks 6-7

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4
Q

Upper lip formation, where?

A

Medial nasal processes merge w/ each other as well as the maxillary processes of the first branchial arches

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5
Q

The primary palate is made from what?

A

Merger of the medial nasal process

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6
Q

The secondary palate is formed from what?

A

Formed from the maxillary processes of the first branchial arches

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7
Q

What is the primary palate? What is the secondary palate?

A

Primary - Right around the central incisors

Secondary - The rest of the hard palate (90% of it)

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8
Q

Two types are conditions, what are they?

A

Developmental

Hereditary/Genetic

  • Familial
  • Congenital
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9
Q

Cleft lip is what?

A

Defective fusion of the medial nasal process with the maxillary process

80% of cases are unilateral

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10
Q

Treatment for cleft lip?

A

Rule of 10

  • 10 weeks
  • 10 lbs
  • 10 gm %Hemoglobin
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11
Q

What happens with cleft palate?

A

Failure of the palatal shelves to fuse

-Minimal manifestation of cleft palate is bifid uvula

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12
Q

What about treatment for cleft palate?

A

Start only after 1.5 yrs of life

  • 45% of cases are cleft lip and cleft palate
  • 30% are only cleft palate
  • 25% are cleft lip
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13
Q

Some clefting is due to what?

A

Syndromic

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14
Q

With syndromic clefting, ____% of pts have cleft palate only.

A

50%

  • Most cases in syndromic clefting are cleft palate only
  • Most cases in overall clefting are both cleft lip and cleft palate
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15
Q

Tell me about clefting with Pierre Robin.

A

Cleft palate only

Mandibular micrognathia - small mandible

Glossoptosis - Downward displacement of tongue

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16
Q

Clefting can also occur in a non-syndromic way. Name some environmental factors.

A

Maternal alcohol or cigarette use

Folic acid deficiency

Corticosteroid use

Anticonvulsant therapy

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17
Q

A lateral facial cleft happens when?

A

Lack of fusion of the maxillary and mandibular processes

-Very rare

18
Q

An oblique facial cleft happens when?

A

Failure of fusion of the lateral nasal processes with maxillary process

  • Upper lip to the eye
  • ALMOST ALWAYS ASSOCIATED WITH CLEFT PALATE
19
Q

When does median clefting happen?

A

Failure of fusion of the medial nasal processes

-Very rare

20
Q

T/F - One of the most common major congenital defects.

A

TRUE

21
Q

Prevalence of clefting?

Native Americans

Asians

Whites

Blacks

A

1 in 250

1 in 300

1 in 700

1 in 1500

22
Q

T/F - Cleft lip and cleft palate is more common in males.

A

TRUE

23
Q

T/F - Cleft palate only is more common in females

A

TRUE

24
Q

What is a submucous palatal cleft?

A

Surface is intact, but defect exists in the underlying musculature of the soft palate

-Bone notch will be present on post hard palate and appears as a bluish midline discoloration

25
Q

What are lip pits?

A

Occur in commissures

  • Mucosal invaginations that occur at the corners of the mouth on the vermilion border
  • NOT CLEFTING, but an issue with deposition of collagen
26
Q

What are paramedical lip pits?

A

Congenital invagination of the lower lip

-Usually bilateral

27
Q

What syndrome is associated with lip pits?

A

Van der Woude Syndrome

  • Greatest significance of paramedian lip pits
  • With cleft lip and cleft palate
28
Q

What is microglossia?

A

Abnormally small tongue

  • Usually syndromic
  • Rarely, the entire tongue may be missing (Aglossia)
  • Associated with hypoplasia of the mandible (micrognathia)
  • Lower incisors may be missing
  • Tx depends on nature and severity of condition
29
Q

What is ankyloglossia?

A

Developmental tongue abnormality characterized by a short, thick lingual frenum, which limits tongue movement

  • This is called tongue-tied*
  • 4% of neonates
  • May cause problems with speech and breastfeeding
  • No tx req’d if asymptomatic, or may be self-correcting
  • Frenotomy or frenuloplasty - wait until age 4-5
30
Q

Where does the thyroid gland begin?

A

Foramen cecum - Begins as an epithelial proliferation in the floor of the pharyngeal gut during week 3-4 of embryogenesis

During week 7, the thyroid bud normally descends into the neck, ant to trachea and larynx

31
Q

Site where the descending bud invaginates later becomes the?

A

Foramen cecum

-Located at junction of ant 2/3 and post 1/3 of the tongue in midline

32
Q

If primitive gland doesn’t descend normally, then ectopic thyroid can be found b/t what?

A

Foramen cecum and the epiglottis

-90% of ectopic thyroids (also called lingual thyroids) are found here

33
Q

T/F - Lingual thyroid is 7x more common in females.

A

TRUE

34
Q

What are some symptoms with lingual thyroid?

A

Arise during puberty, adolescence, pregnancy, or menopause

-Dysphagia, dysphasia, dyspnea

35
Q

T/F - 1/3 of lingual thyroid pts have hypothyroidism.

A

TRUE

36
Q

How to diagnose lingual thyroid?

A

Via thyroid scan using iodine isotopes or technetium-99m), CT, and/or MRI

-Biopies are avoided

37
Q

What is a thyroglossal duct cyst?

A

Develop from epithelial remnants of the thyroglossal tract

  • 50% are diagnosed before age 20
  • Painless, fluctuating, movable swelling at or near midline, usually inferior to the hyoid bone
  • Tx - surgical removal - 10% recurrence
  • 1% carcinoma
38
Q

What is hemihyperplasia?

A

Rare developmental anomaly

Asymmetric growth of one of more body parts (unilateral macroglossia)

**Hyperplasia - Increase in cell NUMBER

39
Q

What is craniosynostosis?

A

Premature closing of the cranial sutures

  • Brachycephaly (short head), scaphocephaly (boat-shaped head), trigonocephaly (triangle head)
  • Cloverleaf skull (KLEEBLATT-SCHADEL deformity)
  • Underdeveloped maxilla
  • Skull X-ray shows beaten-metal pattern
40
Q

What is apert syndrome (acrocephalosyndactyly)?

A

Ocular proptosis - Eyes sticking out

Hypertelorism

Downward slant of lateral palpebral fissures

Webbing of 2nd, 3rd, and 4th digits of hands and feet

Mental retardation

75% have cleft soft palate or bifid uvula

41
Q

Treacher-Collins Syndrome?

A

Defects of structures derived from 1st and 2nd branchial arches

Hypoplastic zygoma, coloboma (notch on outer portion of lower eyelid), underdeveloped mandible

42
Q

What is Stafne defect?

A

AKA Lingual mandibular salivary gland depression

Focal concavity of the cortical bone in the lingual surface of the mandible

**Classically presents as an asymmptomatic, well-circumscribed radiolucency below the mandibular canal in the posterior mandible b/t the molar teeth and the angle of the mandible

-No treatment