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Chiro Pediactric Diplomate > M1.1 — 2 Skull 0-4 > Flashcards

M1.1 — 2 Skull 0-4 Flashcards

(62 cards)

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1
Q

What is the process of intramembranous ossification?

A

Mesenchymal cells differentiate into osteoblasts which deposit matrix that becomes mineralized and develop into interwoven trabecula where primary spongiosa is deposited. Primary spongiosa is replaced with secondary bone, bone marrow forms and primary cortical bone

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2
Q

What bones are formed by intramembranous ossification?

A

frontal, parietal, mandible, maxilla, portions of occiput and temporal bones

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3
Q

What is the process of endochondral ossification?

A

chondrocytes make cartilagenous template –> osteoblasts and clasts fill it up to make woven bone –> lamellar bone takes its place

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4
Q

Where are the secondary ossification centers of endochondral ossified bones?

A

epiphysis and apophysis

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5
Q

how many bones form the skull?

A

22, 8 cranial 14 facial

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6
Q

What are the 14 facial bones?

A

nasal (x2), lacrimal (x2), maxilla (x2), zygomatic (x2), vomer, mandible, palatine (x2), inferior nasal conchae (x2)

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7
Q

What are the 8 cranial bones?

A

frontal, parietal (x2), occipital, temporal (x2), sphenoid, ethmoid

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8
Q

ethmoid bone - ossification type?

A

endochondral

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9
Q

ethmoid bone - ossification centers? ossification timeline? fusion timeline?

A

3 ossification centers = perpendicular plate and crista galli, paired bony labyrinth

ossification starts 4 months in utero
- bony labyrinth ossified at birth
- septum remains cartilaginous throughout first year

fusion of all 3 during second year

nasal concha - appears 4-5 fetal months and rapidly ossifies

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10
Q

sphenoid bone - ossification type?

A
  • endochondral - body, lesser wings, medial portion of greater wings
  • intramembranous - everything else
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11
Q

Sphenoid bone - ossification centers? fusion timeline?

A
  • up to 19 individual centers of ossification
  • presphenoid and postsphenoid fuse shortly free birth
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12
Q

Occipital bone - ossification type?

A

intramembranois - superior to nuchal line
endochondral - everything else

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13
Q

Occipital bone - ossification centers? ossification timeline? fusion timeline?

A
  • intramembranous - superior to nuchal line = 2 centers - appear 8 weeks in utero
  • endochondral - everything else = 4 centers = squamous, exocipital and basilar portions fuse to form a single occipital bone by 7 years
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14
Q

when is spheno-occipital synchondrosis?

A
  • begins to fuse at 12-13 in F and 14-15 in M
  • complete fusion does not occur until age 20
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15
Q

temporal bone - ossification type?

A

-intramembranous - squamous and tympanic portion
- endochondral - petrous and styloid portions

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16
Q

temporal bone - ossification centers? ossification timeline? fusion timeline?

A
  • squamous part = single ossification center
  • tympanic portion = 4 ossification centers
  • petrous and styloid portions = up to 22 ossification centers
  • styloid process - 2 ossification centers fuses to temporal bone in middle age
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17
Q

Where are the primary ossifications centers of endochonral ossified bones?

A

central portion of bone

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18
Q
A
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19
Q

Hyoid bone - ossification centers?

A

6 centers of ossification
- 2 for body, 2 for lesser horns, 2 for greater horns

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20
Q

Frontal bone - ossification centers? ossification timeline? fusion timeline?

A

2 primary ossification centers
- appear 8 weeks in utero

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21
Q

what separates the frontal bone in utero?

A

metopic suture

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22
Q

parietal bone - ossification centers? what part of the newborn skull do they help create?

A

2 centers of ossification each
- 4 corners remain unossified at birth = fontanelles

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23
Q

Maxilla - ossification centers? timeline?

A

1 primary ossification center
- appears 7 weeks in utero

5 secondary ossification centers

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24
Q

what is the maxillary sinus? when does it appear and form?

A

depression in the wall of the maxilla
- 4 months in utero, well formed by birth

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25
26
When does the maxilla grow until
until the eruption of the third molars (wisdom teeth)
27
Palatine, zygomatic, nasal, lacrimal bones - ossification centers?
each from a single ossification center
28
Vomer bone - ossification centers? where does it form?
2 centers of ossification - forms on either side of the cartilaginous nasal septum
29
When no where does the mandible appear? and how does it ossify?
6 weeks in utero lateral to Meckel’s cartilage at the location of the future manual foramina ossification invades Meckel’s cartilage. The cartilage that persists becomes the incus and malleus
30
when does the mandible fuse?
2 halves fuse early in the 2nd year
31
What kind of joints are the skull sutures? what make up the internal and external layer?
fibrous dura matter internally periosteum externally
32
why are the skull sutures wavy?
for added strength
33
skull sutures don’t fuse until ________ is complete
brain growth
34
what are the 5 major skull sutures?
coronal, saggital, lambdoid (occipitomastoid), squamosal, metopic
35
what bones line the coronal suture? when does it fuse?
frontal and 2 parietal around 24 years
36
what are the types of premature fusion (craniosynostosis) of the coronal suture?
oxycephaly plagiocephaly brachycephaly
37
What is the most severe type of craniosynostosis? which sutures are involved? what is the nickname?
oxycephaly (aka turricephaly) - ALL sutures - “tower-like” skull
38
What is asymmetric premature closure of the coronal and/or lambdoid sutures?
plagiocephaly - single or asymmetric multiple sutures
39
what symmetric craniosynostosis includes the coronal and/or lambdoid sutures and is associated with numerous syndromes?
brachycephaly
40
What does the skull shape look like with brachycephaly?
shortened AP length, increased skull width
41
what causes brachycephaly?
positional or synostotic
42
what is positional brachycephaly/plagiocephaly?
calvcarial deformation from external pressure after birth - infant is consistently placed in the same position for rest and sleep no cranial synostosis
43
ipsi or contra lateral? in positional brachycephaly/ plagiocephaly the ipsilateral ear is displaced _______(anteriorly/posteriorly?), frontal bossing occurs ___lateral, ___lateral occipital flattening, ___lateral occipitoparietal bossing
ipsilateral ear anterior ipsilateral frontal bossing ipsilateral occipitoparietal flattening contralateral occipital bossing
44
ipsi or contra lateral? in synostosis type brachycephaly/ plagiocephaly the ipsilateral ear is displaced ________(anterior/posterior?), frontal bossing occurs ___lateral, ___lateral occipital flattening, ___lateral occipitoparietal bossing
ipsilateral ear posterior contralateral frontal bossing ipsilateral occipitoparietal flattening contralateral occipital bossing
45
what bones line the saggital suture? when does fusion occur?
2 parietal bones around 22 years
46
What is premature fusion (craniosynostosis) of the saggital suture?
scaphocephaly (aka dilochocephaly)
47
what is the most common form of craniosynostosis? what suture(s) involved? what does it look like? M:F?
scaphocephaly (aka dolichocephaly) - sagittal suture - elongated, narrow skull M:F 3:1
48
what bones line the lambdoid suture? when does it fuse
superior border of occipital bone and posterior border of parietal bones - around 26 years
49
What is premature fusion of just the lambdoid suture called? how common is it?
posterior plagiocephaly one of the rarest craniosynostosis
50
What bones line the metopic suture?
vertical fibrous joint that divides the two halves on the frontal bone from the nasion to bregma
51
what is the timeline of the metopic suture?
- present in newborn - should fuse by 9 months, may fuse as early as 3 months - usually obliterated by 7 years - if persists = anatomical variant of little clinical significance
52
what is synostosis of the metopic suture called? what does it look like? how common is it?
trigononcephaly - triangular share of frontal bone - 5% of craniosynostosis
53
what is orbital hyportelorism? what can cause it?
abnormal closeness of the eyes - trigononcephaly = synostosis of frontal bone
54
what bones line the squamosal suture? what is at the start of it? when does it fuse?
temporal and parietal bilaterally - starts at the pterion - may not completely close until 60 years
55
What 4 things are the fontanelles used for clinically?
-assessment of calvarial growth -assessment of hydration status -assessment of intracranial pressure -provides window for neonatal head ultrasound
56
what are the 4 fontanelles?
anterior, posterior, anterolateral (sphenoid), posterolateral (mastoid)
57
how long does the anterior fontanelles persist? what does it become once it closes?
18-24 months (some say 12-18 months) bregma
58
how long does the posterior fontanelles persist? what does it become?
2-3 months (some say 6-8 weeks) lambda
59
how long does the sphenoidal (anterolateral) fontanelles persist? what does it become?
6 months pterion
60
how long does the mastoid (posterolateral) fontanelles persist? what does it become?
2 years (some say 6-18 months) asterion
61
what is the third fontanelle? what two conditions is it associated with?
generally abnormal fontanelle (6.4% of population) between the anterior and posterior fontanelles - down syndrome - congenital infections - rubella
62
what % does the saggital, coronal, lambdoid and metopic sutures make up for craniosynostosis?
saggital = 50% coronal = 20% lambdoid = 5% metopic = 5%

Chiro Pediactric Diplomate (15 decks)

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