Craniofacial dev final 2

robbypowell's version from 2015-04-27 15:42


Question Answer
Does a small brain mean mental retardation?NO, not definitively. it is often fine.
The pull of what muscle creates the Mastoid process?Sternocleidomastoid muscle
Muscular pull creates what 3 features/processes of cranium? (e.g.)Mastoid process, Temporal lines, Nuchal lines
Muscular pull creates what 3 features/processes in the Infratemporal Fossa? (e.g)Lateral Pterygoid plate, Coronoid Process, Angle of Mandible
What are cranial sutures composed of?several layers of intravenous MESENCHYMAL fibers between islands of bone (vascular loose connective tissue)
What are the 2 Serrate (saw-like) sutures?Sagittal & Coronal sutures
What suture is Denticulate (dove-tailed)?Lambdoid suture
What suture is a Squamos (beveled) suture?Temporo-parietal
What suture is a Plane (butt-end) suture?Palatal
The mesenchymal fibers of cranial sutures are continuous with what above and what below islands of bone?Pericranium above, Dura Mater below
SECONDARY CARTILAGE is a component of what 3 sutures?Metopic (Frontal), Sagittal, & Mid-Palatal
What is the difference between CRANIAL sutures and FACIAL sutures?Facial sutures have no fibers connecting bone, and no DURA mater below
T/F: The Zygomo-frontal suture has an underlying matrix whose growth is determined by tensile strainFALSE (Cranial sutures have this feature, NOT facial sutures)
T/F: There are no Intramembraneous cranial bones with Secondary cartilageFALSE (there are at least 3 sutures that have secondary cartilage components... another question will ask which)
Without exception, suture fusion occurs by ____ ossificationINTRAMEMBRANEOUS
What 5 mutations have are associated with Craniostenosis?FGFR-1, FGFR-2, FGFR3, TWIST & MSX-2
Suture fusion starts in both cortical plates, but the ___ is slower, more variable, & less completeOUTER CORTICAL PLATE
Suture fusion starts in both cortical plates, but the ___ is more rapid, less variable & more completeINNER CORTICAL PLATE
T/F: Sutural Fusion is a RELIABLE determinant of skull ageFalse! timing of sutural fusion is HIGHLY VARIABLE
Hypothetically, the mid-face development is driven by the growth of the ___ ___ ___Nasal Septal Cartilage
Mandibular Condylar cartilage is a ____ cartilageSECONDARY
The body of the mandible is formed via ____ ossificationINTRAMEMBRANEOUS
Maxillary development, or mid-face development progresses in what vectoral direction?Forward & Downward
The Metopic (Frontal) suture starts fusing during the ___ year and is completely fused by the ___ year.2nd year starts, fused by 7th (in 10-15% of people it persists into adulthood)
Sagittal, Lambdoidal, & Coronal sutures fuse during late ____ or early ____late 20's, early 30's
Ridge in midline that shows up in some, not allMetopic ridge (frontal suture feature)
What is sequence of Fontanelle closure?Lambda, Pteryion, Asterion, Bregma (LPAB)(Little Pretty Asian Babies) (Lumpy Purple Angry Babies)
What fontanel closes around 1-3 months after birth?Lambda (posterior)(first)
What fontanel closes around 6 months after birth?Pterion (sphenoidal fontanelle)(second to close)
What fontanel closes around 6-18 months after birth?Asterion (Mastoid fontanel) (third to close)
What fontanel closes around 7-19 months after birth? (with a median of 14 months)Bregma (anterior)(last to close)
What is the LARGEST and most CLINICALLY IMPORTANT fontanel?Bregma (anterior) (last to close)
Posterior fontanel is usually ___ cm at birth (caucasian)0.6 cm
Anterior fontanel is usually ___ cm at birth (caucasian)2.1 cm median
Fontanelles are LARGER in children of ____ descentAfrican
Fontanelles usually close EARLIER in ____ than in ____earlier in BOYS than in GIRLS
Intracranial pressure is normally within the range of ___ to ___ mmHg, treatment is may be needed once the intracranial pressure reaches ___ mmHg7-15 normal, 20 mmHg treatment necessary
How many cranial primary OSSIFICATION CENTERS are there?112
How many cranial bones are there IN UTERO?45
How many cranial bones are there in adults?22
Which of the following bones does not originate from NEURAL CREST: Petrous Temporal, Zygomatic, MandiblePETROUS TEMPORAL comes from Paraxial Mesoderm
Which of the following bones does not originate from NEURAL CREST: Maxilla, Lacrimal bone, Nasal Bone, Occipal boneOCCIPITAL comes from Paraxial Mesoderm
What 6 bones should you remember come from the NEURAL CREST?Lacrimal, Nasal, Squamos temporal, Zygoma, Maxilla, Mandible
Earliest sign of skull formation is in the ___ week, and is the development of the ____-ocraniumCHONDROCRANIUM
Important feature between the Anterior and Middle Cranial Fossa for Lat Ceph analysisChondro-cranial angle
The LOWER angle of the CHONDROCRANIAL ANGLE is initially OBTUSE ___ (what deg are angle), in the 7th or 8th week it flattens out to ____ degrees, then in the 10th week it is ___ degrees150; (7-8 wk) 120 deg; (10th week) 130 deg
During Ossification, the Chondrocranial angle is ____ degrees125-130 degrees
The Chondrocranial angle is the angle between lines connecting ___ to the ___ ___ & the ___ ___ to ____Nasion to Sella Turcica; Sella Turcica to Basion
Development of the chondrocranium, while genetically controlled and largely in variable, is dependent on what 3 factorsPRESENCE OF BRAIN, other neural structure (unspecified), & STAGED INJUNCTION by adjacent EPITHELIA (oral epithelia)
Signalling center of neural developmentRostral end of NOTOCHORD
Important fibers between the BASIOCCIPITAL and POST-SPHENOIDAL neonate cartilages?Spheno-Occipital Synchondrosis
Important Double Epiphyseal PRIMARY cartilage that is MAJOR DRIVING FORCE for development of MIDFACESOS, SPHENO-OCCIPITAL SYNCHONDROSIS
Spheno-Occipital Synchondrosis is important for the development of the ______MIDFACE
Major Driving Force for the ANTERIOR EXTENSION of the MAXILLASpheno-Occipital Synchondrosis (SOS)
During development of the skull, the SYNCHONDROSES are ___ cartilagePRIMARY
What is the difference between mandibular condylar cartilage and cranial synchondroses?Condyle SECONDARY, synchondroses PRIMARY
The SOS has both superior and inferior surfaces... the first to fuse is the ____, afterward the ___ continues to growfirst to close SUPERIOR; continued growth in INFERIOR
What are the 3 mechanisms of growth in the CRANIO-FACIAL SKELETON?Apposition, Remodeling, Displacement


Question Answer
Expansion and thinning of neurocranium due to excessive accumulation of CSFHydrocephalus
Impaired bone growth leads toMicrocephaly
Blocked drainage of the CSF in the developing Neurocranium will cause what condition?Hydrocephalus
Premature fusion of cranial sutures (before brain is finished growing)Craniosynostosis (or craniostenosis)
CranioSTENOSIS is synonymous with what term?CranioSYNOSTOSIS
Anything that interferes with OSTEOCLAST activity during the period of neurocranial development will causeCraniostenosis (Craniosynostosis)
Problem associated with mutation in TCOF1Treacher Collins Syndrome
Problem associated with mutation in FGFR (1,2, and/or 3)Craniostenosis
Problem associated with mutation in TWISTCraniostenosis
Problem associated with mutation in MSX-2Craniostenosis
Because development is highly variable, what must be proved for a diagnosis of Craniostenosis (Craniosynostosis)Brain is still trying to grow, and cannot b/c it is impeded by fusion of cranial sutures (manifesting as deformation or excessive intra-cranial pressure)
Apparent lack of head circumferential growth, bulging cranial veins, and fussiness of developing child are strong indicators ofCraniostenosis (Craniosynostosis)
5 Most common causes of DELAYED BREGMA CLOSURE (anterior fontanel)Achondroplasia (dwarfism), Down Syndrome, increased Intracranial Pressure, HYPOthyroidism, & Rickets (vitD problem)
A BULGING anterior fontanel is an indicator ofIncreased cranial pressure
A sunken anterior fontanel is an indicator ofDEHYDRATION
Premature closure of the Coronal suture & Delayed closure of the Anterior Fontanel & Sagittal suture is associated with what?Down's Syndrome
Down's syndrome is associated with the PREMATURE closure of the ____ ____ & the DELAYED closure of the ___ ___ & ___ ___premature, CORONAL SUTURE; delayed, ANTERIOR FONTANEL & SAGITTAL SUTURE
A third mid-line fontanel is associated with what two conditions?Down's Syndrome & HYPOthyroidism
An abnormally large anterior fontanel in conjunction with with an open posterior fontanel would indicate a pediatrician should test the levels of what hormone, elevated levels would indicate what condition?TSH (thyroid stimulating hormone), HYPOthyroidism (if levels are elevated)
The sutural and fontanel problems associated with down's syndrome lead to the development of a _____ headBRACHICEPHALIC (widened, box-like)
recoil of cranial bones under pressure is called ____, and is a sign of what condition after 6 months of age?CRANIOTABES, sign of RICKETS after 6 months
Craniostenosis (craniosynostosis) can be idiopathic or caused by what 4 syndromesHYPERthyroidism, HyperPARAthyroidism, Rickets, or HYPOphosphatasia
Which of the following conditions does NOT cause Craniostenosis: Hyperthyroidism, Hypothyroidism, Hyperparathyroidism, RicketsHYPOthyroidism DOES NOT cause CRANIOSTENOSIS (rather it could cause delayed fusion of fontanelles, or the appearance of 3rd midline fontanel)
Asymmetric flattening of the head due to unilateral sutural fusionunilateral PLAGIO-cephaly (can be anterior or posterior)
Deformation of skull not caused by premature fusionDeformational Plagiocephaly
Hernia of brain through skull openingEncephalocele
Most common herniation of the brain through skull opening, through foramen cecum (ethmoid-frontal junction)Nasal Encephalocele