Facial growth 1 Flashcards

(58 cards)

1
Q

LIfe in utero consists of what 2 phases

A

embryonic – 1-8 weeks
foetal – 8 weeks to term

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2
Q

What has formed in first 2 months of pregnancy

A

All of the limbs and organs including the face

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3
Q

External enviroment influnces what in early stages of pregnancy

A

cranio-facial abnormalities

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4
Q

What is a very important stage in development of the face in embryology

A

Neural crest migration

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5
Q

what happens near the end of week 3 of embryology

A

The neural folds fuse to form the neural tube

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6
Q

What does failure in the formation of the nueral tube lead to

A

Spina Bifida

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7
Q

What does the neural tube develop into

A

Brain and spinal cord

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8
Q

what does failed development of the neural tube lead to

A

anencephaly

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9
Q

What happens in the folding of the neural plate

A

cells develop from the ectoderm along the edge
of the groove, termed neural crest cells

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10
Q

What happens to neural crest cells

A

undergo extensive migration within the developing embryo and ultimately
differentiate into many cell types e.g. spinal and autonomic ganglia; Schwann cells, adrenal medulla, meninges of the brain

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11
Q

What do nueral crest dervided ectomesenchyme contribute to

A

branchial arch cartilage, bone and connective tissue
proper, as well as dental tissues - pulp, dentine, cementum and periodontal
ligament

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12
Q

What day does the maxilla nd mandible start to form

A

46th

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13
Q

When does ossification of the face and skull start

A

7-8 weeks

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14
Q

During formation of face what may lead to significant malformations during this early period

A

Environmental factors

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15
Q

Defects of the face, particularly in the midline, may be closely related to what

A

defects of the anterior parts of the brain

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16
Q

What is most of the face formed by

A

Migrating neural crest cells

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17
Q

What causes major facial deformaties

A

Interference with neural crest cell migration

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18
Q

What leads to cleft formation

A

Failure of fusion between the various facial processes or between the palatine
processes

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19
Q

What has different embryological origins

A

The upper lip and anterior part of the palate

and

the posterior palate

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20
Q

What does the different embryological origins and different fuse times of the upper lip and anterior part of the palate and the posterior palate mean?

A

cleft lip and alveolus can occur independently of cleft palate

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21
Q

What happens week 4

A

Migrating neural crest cells form the frontonasal
process and laterally the branchial arches

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22
Q

What happens week 5-7

A

extension and fusion of the facial processes

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23
Q

The skull can be divided into what two parts

A

Neurocranium and viscerocranium

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24
Q

What is the neurocranium

A

Part of the skull that which forms a protective
case around the brain

25
What is the viscerocranium
Part of the skull which forms the skeleton of the face
26
How is intramembranous bone formed
Bone is deposited directly into primitive mesenchymal tissue Needle-like bone spicules form, which progressively radiate from the primary ossification centres to the periphery. Progressive bone formation results in the fusion of adjacent bony centres
27
What is made of intramembraneous bone
vault of the skull, the maxilla and most of the mandible
28
How is endochondral bone formed
bones are preceded by a hyaline cartilage ‘model’ Several centres of ossification which eventually fuse
29
What does endochondral bone form
base of the skull
30
How is base of skull made
series of cartilages forms the base of skull. They undergo endochondral ossification from multiple centres, starting with the basi-occiput at 10-12 weeks. At birth cartilagenous growth centres remain between the sphenoid and occipital bones and in the nasal septum.
31
The neurocranium can be divided into what
flat bones of the vault which develop intramembranously and the endochondral elements of the base of the skull
32
What age does skull stop growing
7
33
What occurs at the 3 month in vault of the skull
Intramembranous ossification of the vault in several centres
34
When do fontanelles close
anterior fontanelle closes at about 2 years of age the posterior at about 1 year
35
how does the maxilla and mandible form
intramembranously
36
What do the mandible and maxilla develop adjacen to
pre-existing cartilaginous skeletons - the nasal capsule and Meckel’s cartilage
37
How does the different parts of the mandible form
They form as several units all responding to different growth stimulate A condylar unit which forms the articulation and contains the largest secondary cartilage formation. An angular unit which forms in response to the lateral pterygoid and masseter muscles; A coronoid unit which responds to temporalis muscle development (muscular processes). An alveolar unit which forms only if teeth are developing. The body of the mandible forms in response to the inferior dental nerve
38
what are the 3 main sites secondary cartlidge formation of the mandible
the condylar cartilage, the coronoid cartilage and at the symphyseal end of each half of the bony mandible. The cartilages appear between 12 and 14 weeks I.U.
39
When do the cartilidges dissapear of the mandible
coronoid cartilage disappears long before birth and the symphyseal just after birth. Growth continues at the condylar cartilage until about 20 years of age.
40
What precedes the growth of the mandible
Meckels cartiliage
41
What is the primary skeleton of the upper face
Nasal capsule
42
What does primary abnormality mean and give examples
Defect in the structure of an organ or part of an organ that can be traced back to an anomaly in it’s development spina bifida, cleft lip, CHD
43
What does secondary abnormality mean and give examples
Interruption of the normal development of an organ that can be traced back to other influences Teratogenic agents; infection (rubella virus), chemical (thalidomide), chemical (lithium) Trauma; amniotic bands
44
What does deformation mean
Anomalies that occur due to outer mechanical effects on existing structures
45
What does Agenesia mean
Absence of an organ due to failed development during embryonic period
46
What does Sequence mean
Single factor results in numerous secondary effects (PierreRobin)
47
What does Syndrome mean
Group of anomalies that can be traced to a common origin (Trisomy 21 in Down’s Syndrome)
48
Give examples of some maxillary hypoplasia facial syndromes
-Apert’s Syndrome (acrosyndactyly) -Crouzon’s Syndrome(craniofacial dysostosis) -Oral-Facial Digital Syndrome -Binder’s Syndrome - Achondroplasia -Down’s Syndrome -Cleidocranial dysostosis -Foetal Alcohol Syndrome -Cleft lip/palate
49
Give examples of some maxillary hypoplasia facial syndromes
Treacher Collin’s Syndrome (mandibulofacial dysostosis) Pierre-Robin Stickler’s Syndrome Van der Woude Syndrome Turner’s Syndrome Hemifacial Microsomia
50
Give examples of facial syndromes arrising from early problems with facial development
Enviromental- Foetal Alcohol Syndrome genetic Mulitifactorial- Hemifacial microsomia Treacher Collins syndrome (mandibulofacial dysostosis) Clefts of lip and palate
51
What day can foetal syndrome ocur
17 days+
52
What are signs of foetal alcohol syndrome
microcephaly (small head) typical faces having: short palpebral fissures, short nose, long upper lip with deficient philtrum, small midface small mandible.
53
What is the possible cause and signs of hemifacial microsomia
Neural crest migration disrupted (days 19-28) Unilateral mandibular hypolasia, zygomatic arch hypoplasia, high arched palate, malformed pinna 1:3500 Live births
54
Causes of mandibulofacial dysostosis and signs
Deformity of 1st and 2nd branchial arches -Anti-mongoloid slant palpebral fissures -Colomboma of lower lid outer 1/3rd -Hypoplastic or missing zygomatic arches -Hypoplastic mandible with antigonial notch -Deformed pinna, conductive deafness 1;10,000 Live births
55
What is the Aetiology of Cleft lip and palate
Genetic: Monozygotic twins Syndromes Familial pattern Enviroment Social deprivation Smoking (2.5x) Alcohol Anti-epileptics Multivitamins (25% down)
56
Dental features of cleft lip and palate
Impacted Teeth Crowding Hypodontia Supernumeraries Hypoplastic teeth Caries
57
Achondroplasia cause and effects
Problem with endochondrial ossification Defects in base of the skull, retrusive middle third of the face, frontal bossing, depressed nasal bridge
58
Crouzon’s (craniofacial dysostosis) cause and effects
Premature closure of cranial sutures (esp coronal and lamdoid) Proptosis (shallow orbits), orbital dystopia, mild hypertelorism Retusion and vertical shortening of midface Prominent nose Class III malocclusion Narrow spaced teeth