Questions and Answers
Which of the following are classification systems of cleft palate? (Select all that apply)
What are the four groups in the Veau Classification?
I. Defect of the soft palate clefts only; II. Soft and hard palate involved up to the incisive foramen; III. Complete, unilateral cleft that involved the soft and hard palate including alveolar ridge and lip; IV. Bilateral cleft from soft through hard palate, alveolar ridge, and lip.
What are the two categories in the Kernahan and Stark Classification?
Cleft of primary palate (anterior to the incisive foramen) and Cleft of secondary palate (posterior to the incisive foramen - hard and/or soft palate).
Describe Kernahan's Striped Y.
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What is the focus of the American Cleft Palate Association Classification?
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What structures are included in the primary palate?
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What does the secondary palate consist of?
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What does 'the great coming together' refer to in the formation of the secondary palate?
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What is quasi-continuous variation?
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Define a submucous cleft.
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What is endogenous etiology of cleft?
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What are teratogens?
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What is the prevalence of submucous cleft?
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Which of the following statements about demographic factors of cleft palates is true? (Select all that apply)
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What is multifactorial inheritance?
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Study Notes
Classification Systems of Cleft Palate
- Various classification systems include Veau, Kernahan and Stark, Kernahan's Striped Y, and the American Cleft Palate Association System.
Veau Classification
- Divided into four groups:
- Group I: Soft palate clefts only.
- Group II: Involves both soft and hard palate up to the incisive foramen.
- Group III: Complete unilateral cleft affecting soft and hard palate, alveolar ridge, and lip.
- Group IV: Bilateral cleft from soft palate through hard palate, alveolar ridge, and lip.
Kernahan and Stark Classification
- Categorized into two types:
- Cleft of the primary palate: Anterior to the incisive foramen.
- Cleft of the secondary palate: Posterior to the incisive foramen, involving hard and/or soft palate.
Kernahan's Striped Y
- Visual classification system depicting cleft lip and palate using a Y-shaped diagram.
- Stem represents secondary palate; arms illustrate primary palate with shaded areas indicating the affected regions.
American Cleft Palate Association Classification
- Highly detailed classification for primary and secondary palate structures, dividing most into thirds.
- One of the most widely used systems due to its comprehensive detail.
Primary Palate
- Defined as the area anterior to the incisive foramen, including alveolar ridge, alveolus, and lips.
Secondary Palate
- This includes both the hard palate (90%) and soft palate, located posterior to the incisive foramen.
Formation of the Secondary Palate
- Key stages:
- 4 weeks: Tongue expands into the oral cavity and nasal cavity; maxillary palatine shelves begin to descend.
- 6-8 weeks: Growth of the mandibular arch allows tongue dropping and the elevation of palatine shelves toward the midline for fusion.
- 12 weeks: Nasal septum descends and fuses with palatine shelves.
Quasi-continuous Variation
- Traits present only when a sufficient number of factors reach a critical threshold.
Submucous Cleft
- A congenital defect where the underlying palate structures are affected, while the oral surface remains intact.
Endogenous Etiology of Cleft
- Factors originating from within the organism, such as genetic and chromosomal disorders.
Genetic Disorders
- Disorders resulting from specific gene properties.
Chromosomal Disorders
- Occurs due to alterations in chromosome numbers or structures.
Exogenous Etiology of Cleft
- Factors developing outside the organism, including teratogens and mechanical factors during gestation.
Teratogen
- Chemical or physical agents that disrupt embryonic development, leading to congenital anomalies.
Conceptualizations of Oral-Facial Cleft Formation
- Includes threshold, continuum, and post-fusion rupture conceptualizations to understand cleft formation.
Threshold Conceptualization
- Structures must be appropriately positioned and sized; any deviation can compromise fusion.
Continuum Conceptualization
- Earlier interfering factors have a greater effect on structure development than those occurring later.
Post-Fusion Rupture Conceptualization
- Interference at fusion time may lead to a later rupture or tear as the embryo grows.
Morphogenesis
- Process of forming an adult from a ball of cells post-fertilization.
Embryogenesis
- Development from fertilized egg to the end of the embryonic stage.
Determining Severity of Cleft Palate or Lip
- Factors include unilateral vs. bilateral, complete vs. incomplete, length, width, and depth.
Prevalence
- The proportion of a population displaying a particular disorder at a specific time.
Incidence
- Rate of new cases of a condition occurring in a defined period.
Cleft Muscle of Veau
- Abnormal velar muscle insertion due to cleft palate; levator veli palatini fails to interdigitate.
Simonart's Bar/Band
- A strand of soft tissue across a cleft, classifying it as incomplete.
Rates of Cleft Palate Incidence
- Isolated secondary cleft palate: 25%
- Isolated primary cleft palate: 25%
- Mixed cleft palate: 50%
Prevalence of Submucous Cleft
- Occurs in less than 1% of live births, approximately 1 in 1200.
General Incidence of Cleft Palate
- Affects 1 in 750 live births.
Congenital Palatopharyngeal Dysfunction
- Velopharyngeal dysfunction from birth without overt or submucous clefts; includes velar insufficiency and incompetence.
Epidemiology
- Studies the incidence and distribution of diseases and health factors.
Classic Stigmata
- A triad of symptoms including bifid uvula, zona pellucida, and bony notch.
Microform
- Minimal defect form.
Forme Fruste
- Partial cleft lip where the lip is attached but underlying structures are affected.
Multifactorial Inheritance
- Clefts arise from various factors including genetic and environmental components.
Males and Clefts
- Higher incidence of isolated cleft primary palate and submucous cleft.
Females and Clefts
- Higher incidence of isolated cleft of the secondary palate.
Prolabium
- Tissue found between complete bilabial clefts of the philtral ridges.
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Description
Explore various classification systems for cleft palate, including the Veau Classification and the American Cleft Palate Association System. This quiz covers essential concepts such as different types of clefts and their classifications. Test your knowledge on these critical pediatric topics.
