Kafa Yüz Çene Prenatal Gelişimi Öğrenci Notu PDF

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Doç. Dr. Şirin Hatipoğlu

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prenatal development head and facial anatomy embryology science

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Bu belge, doğuma kadar kafa, yüz ve çene iskeletinin prenatal gelişimini kapsamaktadır. Doç. Dr. Şirin Hatipoğlu tarafından hazırlanmıştır. Kraniofasiyal gelişim, intramembranöz ve endokondral kemikleşme, ve sinkondrozlar gibi konular ele alınmaktadır.

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Slayt 1 Doç. Dr. Şirin Hatipoğlu __________________________________________________________________________________ __________________________________________________________________________________ ______________________________________________________________________________...

Slayt 1 Doç. Dr. Şirin Hatipoğlu __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ ________________________________________ Slayt 2 Neurocranium Viscerocranium: Yüz İskeleti __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ ________________________________________ Slayt 3 Kafa Kubbesi CRANIAL VAULT (Calvarium) Neurocraniu Membra nous m Kraniyal Taban CRANIAL BASE (Chondrocranium) Cartilaginous __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ ________________________________________ Slayt 4 Embriyolojik olarak Prenatal Dönem  Ovum Dönemi (0 - 14. günler)  Embriyo Dönemi (14 - 56. günler)  Fetüs Dönemi (56. gün - doğum) KraniofasiyalKompleks 4’e ayrılır;  Kafa Kubbesi  Kafa Kaidesi  Nazomaksiller Kompleks  Mandibula **Kranial, Fasiyalve oral dokuların gelişimi intrauterin hayatın 21. günde başlar. __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ ________________________________________ Slayt 5 A. Kondrokranium’un Oluşması B. Kafa Kaidesinin Prenatal Gelişimi C. Kafa Kubbesinin Prenatal Gelişimi D. Maksillanın Prenatal Gelişimi E. Mandibulanın Prenatal Gelişimi __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ ________________________________________ Slayt 6  Kafa kaidesinioluşturankemiklerçoğunlukla «Endokondral»,  Kafa kubbesini, yüz ve çeneleri oluşturan kemikler ise «Membranöz» kemikleşmeilemeydana gelirler.  Başı oluşturan kemikler hangi yolla kemikleşirse kemikleşsin «Kondrokranium» destek vazifesi görmektedir. __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ ________________________________________ Slayt 7 KONDROKRANIUM NEDIR ? kıkırdak halindeki embriyonik kafatası kafa kemikleri sınırlarının henüz belli omadığı, kemiklerin kıkırdak yapı gösterdiği devredeki embriyonun kafatasıdır. __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ ________________________________________ Slayt 8 Kraniyal tabanın bir parçasıdır __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ ________________________________________ Slayt 9 ‘KARTILAJ NÖROKRANYUM’ Fetus kafatasının kıkırdak (kartilaj) bir yapısı olan kondrokranium, hızlı büyüyen embriyo beynini saran bir yapıdır. __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ ________________________________________ Slayt 10 KONDROKRAN IUMUN OLUŞUMU  Embriyonun Sefalik ucunda baş ile ilgili sert dokulara ait ilk oluşumdur.  Başın ilkkıkırdaksal iskelet taslağıdır.  Fötal hayatın 4. haftasından sonra (ikinci ay içerisinde) oluşmaya başlar. __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ ________________________________________ Slayt 11 Kondrokranium içerisindeki kemikleşme ile KAFA ve YÜZÜN bazı kemiksel yapıları oluşurken, diğer taraftan kondrokranyum çevresindeki mezenkimal doku içerisindeki kemiksel organlar direkt olarak(zarsal)kemikleşmeyebaşlar. Bu kemiksel yapılar için kondrokranyum destek işlevi de görür. __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ ________________________________________ Slayt 12  Fötal hayatın dördüncü haftasına doğru Hipofizo-pitüiter kompleksin altında bulunan mezenkim dokusunda yoğunlaşma meydana gelir.  Bu doku kafa skleroblastemi olarak adlandırılır ve ileride sfenoidkemiğinkorpusunumeydana getirir. __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ ________________________________________ Slayt 13  Kafa skleroblastemi oluştuktan sonra öne ve arkaya doğru gelişim gösterir.  Orta kısmı: kondro-sfenoid’i meydanagetirir. (Sfenoidkemiğin korpusununkıkırdaksaltaslağı)  Öne doğru gelişen kısmı: medial ethmoid çıkıntı adı verilen bir uzantı meydana getirir. Daha sonra kıkırdaklaşarak kondro- ethmoidi meydanagetirecektir. __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ ________________________________________ Slayt 14  Ethmoidal çıkıntı sağ ve sol taraflara doğru birer yan çıkıntı oluşturur: - Bunlar sağ ve sol orbito-temporale çıkıntılar olarak adlandırılır.  Lateral orbital çıkıntılarda birisi önde diğeri arkada iki çıkıntı oluşturur: -Öndebulunana orbitalkanat -Arkada bulunanatemporalkanat adı verilir. __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ ________________________________________ Slayt 15  Lateral orbital çıkıntılarda birisi önde diğeri arkada iki çıkıntı oluşturur: -Öndebulunana orbitalkanat -Arkadabulunana temporalkanat adıverilir.  Kondro-ethmoidin yan çıkıntıları olan orbito-temporal çıkıntıların ön (orbital) ve arka (temporal) kanatları ileride birleşerek kıkırdaksal ilkel orbitayı meydana getirirler. __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ ________________________________________ Slayt 16  Ethmoidal çıkıntının alt yüzünden orta çizgi boyunca dik olarak aşağıya doğru ilerleyen bir çıkıntı oluşur. Bu çıkıntı burun septumunu teşkil eden yumuşak doku içerisinde ilerleyerek kıkırdaksal burun septumunu meydana getirir. __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ ________________________________________ Slayt 17  Kondro-ethmoidin sağ ve sol kenarlarından çukurluğu içe bakan, kiremit şeklinde, aşağı doğru saçak tarzında inen iki çıkıntı meydanagelir.  Bu yapılar kıkırdaksal burun kapsülünü meydana getirirler. Bu kapsül arkada kondro-sfenoid ile üst kenarında kondro-ethmoid ile devamlılık göstermektedir. Alt kenarları içeri doğru bükülerek alt konkalarımeydanagetirir. __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ ________________________________________ Slayt 18 Kondrokranyumda yer alan: Kondro-sfenoid, Kondro-etmoid, Orbital ve Temporal kıkırdaksal kanatlar ağız ve burun boşluğunun kıkırdaksal taslağını da yapmış olurlar. __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ ________________________________________ Slayt 19  Kafa skleroblastemi oluştuktan sonra öne ve arkaya doğru gelişim gösterir.  Orta kısmı: kondro-sfenoid’i meydanagetirir. (Sfenoidkemiğin korpusununkıkırdaksaltaslağı)  Öne doğru gelişen kısmı: medial ethmoid çıkıntı adı verilen bir uzantı meydana getirir. Daha sonra kıkırdaklaşarak kondro- ethmoidi meydanagetirecektir. __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ ________________________________________ Slayt 20  Kafa skleroblastemi oluştuktan sonra öne ve arkaya doğru gelişim gösterir.  Kafa skleroblasteminin arkaya doğru gelişen kısmı oksipito vertebral blastem adını alır. Bu blastemin oksipital kısmı ön tarafa doğru bir çıkıntı vererek oditif blastemi yapar. Oditif blastem kıkırdaklaşarakoditif kapsülü meydanagetirir. __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ ________________________________________ Slayt 21  Oditif blastem öne doğru birisi büyük diğeri küçük iki uzantı verir. Büyük olan uzantı Meckel Blastemi küçük olanıiseStiloid Blastemdir.  Meckelblastemi kıkırdaklaşarakMeckelkıkırdağını,  Stiloid blastem kıkırdaklaşarak Reichert kıkırdağını meydanagetirirler. __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ ________________________________________ Slayt 22 MECKEL KIKIRDAĞI kondrokranyumdan uzantı şeklinde oluşur. __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ ________________________________________ Slayt 23 MECKEL KIKIRDAĞI Mandibulanın oluşumundaçokönemli birrol oynar. İki ayrı kısma ayrılarakincelenebilir. 1. Dorsalveya Timpanikkısım 2. Ventralya da Mandibülerkısım __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ ________________________________________ Slayt 24  DORSAL (Timpanik) bölüm: Bu bölge otik kapsülün dışında, kafa kaidesine yakın bulunur. Kulak kemikçiklerinden çekiç kemiğinin korpusunu ve Dış kulak yolunu oluşturur.  VENTRAL (Mandibüler) bölüm: Karın tarafına yakın, üç ayrıbölümeayırarakinceleyebiliriz. 1. Kondil bölümü 2. Mandibula bölümü 3. Simfiz bölümü __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ ________________________________________ Slayt 25 Meckelkıkırdağının görevi çoğunluğu zarsal olarak kemikleşen mandibula için destek vazifesi görmektir. __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ ________________________________________ Slayt 26  Mandibula esas olarak Meckel kıkırdağının dış yüzeyinde oluşur.  Meckel kıkırdağının hiçbir bölgesi kemikleşerek mandibulanın herhangi bir bölgesini oluşturmaz. Sadece simfiz bölgesinde ve kondil bölgesinde zarsal kemik içerisindekalır. __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ ________________________________________ Slayt 27 Kafa kaidesi kemikleri önden arkaya doğru;  Frontal kemik: Orbita tavanını yapan yatay kısmı  Ethmoid kemik: Kribriform laminası  Sella turcica dahil Sfenoid kemiğin korpusu  Clivus: Oksipital kemiğin basilarparçasının üst yüzü.  Temporal kemiğin pars petrosası  Oksipital kemiğin foramen magnumunetrafını çeviren yatay kısmı __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ ________________________________________ Slayt 28 Kafa Kaidesi Kraniyal Orta Şeridi Fossalar __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ ________________________________________ Slayt 29 KAFA KAİDESİ ORTA ŞERİDİ Ön: Nasal Kemik- ForamenCaecum Orta: ForamenCaecum - SellaTurcica Arka: SellaTurcica – F.Magnum __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ ________________________________________ Slayt 30 Os frontale ForamenCaecum __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ ________________________________________ Slayt 31 KRANİYAL FOSSALAR Ön Orta Arka __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ ________________________________________ Slayt 32 1. ÖN Frontal kemiğin orbital laminaları, Etmoidkemiğin kribriform laminası, Sfenoidkemiğin küçük kanatları tabanını oluşturur. __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ ________________________________________ Slayt 33 2. ORTA Sfenoid kemiğin korpusuvebüyük kanatları, temporal kemiğin pars petrozasının üst kısmı. __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ ________________________________________ Slayt 34 3. Arka Tabanını oksipital kemikoluşturur. __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ ________________________________________ Slayt 35 __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ ________________________________________ Slayt 36  Kafa kaidesi Endokondral kemikleşmektedir. (SfenoidkemiğinBüyükkanatlarıhariç)  İlkoluşan kartilaj yapı IU 6.haftada parakordalkıkırdaktır.  Ossifikasyon ise IU 9.Haftada parakordal kıkırdaktan başlayarak anteriora doğru ilerler ve en son ossifiye olan kemik ise Ethmoid kemiktir. __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ ________________________________________ Slayt 37 KONDROKRANİUMU OLUŞTURAN PRİMORDİAL KIKIRDAK KÜTLESI IÇINDE BELIREN KEMIKLEŞME MERKEZLERI, ZAMANLA KEMIK ADACIKLARI ŞEKLINDE YAYILARAK BIRLEŞIRLER. ▪ Böylece kondrokraniumun bir bölgesi olan kıkırdaksal kafa kaidesi kemiğe dönüşür. __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ ________________________________________ Slayt 38  Kondrokraniumu oluşturan kemik taslakları içerisinde kalan ve doğumdan sonrada kafa gelişimine katkıda bulunan primordial kıkırdak kalıntılarına sinkondrosislerdenir. ▪ Bu sinkondrosisler; - prenatal ve - erken postnatal dönemlerde faaliyet gösterirler. __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ ________________________________________ Slayt 39 1. Sfeno-oksipital sinkondrosis: Oksipital kemiğin bazal kısmı ile sfenoid kemiğin korpusu arasında bulunur (15-16 yaş). 2. Sfenoidal sinkondrosis: Sfenoid kemiğin korpusunun iki ayrı kemikleşme noktasından gelişen kısımlarıarasında bulunur. (Doğumdanöncekapanmış olur) 2. 1. __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ ________________________________________ Slayt 40 3. Bilateral Sinkondrosis: Sağda ve solda sfenoidin korpusu ile büyük kanatları arasında bulunur. Membranöz ve kondral kemikleşen iki kütle arasında yeralır. Sadece prenatal devrede gelişim faaliyetine katılır, doğum çağında kapanır. __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ ________________________________________ Slayt 41 Oksipital Kemiğin: 4. Bazal ve kondiler kısımları arasında bulunan kıkırdaklar. Doğumdan sonraki devrede 4-6 yıl faaliyetlerinedevamederler. 5. Kondiler ve squamal kısımları arasında bulunan kıkırdak. Doğumdan sonra2-3 yıl faaliyetinedevameder. __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ ________________________________________ Slayt 42 ▪ Sfenoidalvebilateralsinkondrosisdoğumdan önce, ▪ Oksipital kemikte yeralan sinkondrosisler doğumdan sonra ilk yıllar içindekapanmış olurlar. __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ ________________________________________ Slayt 43 Sfenooksipital Sinkondrozis, çocukluk döneminde kafa kaidesinde büyüme kıkırdağı olarakrol oynar. __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ ________________________________________ Slayt 44 SfenooksipitalSinkondrozis, kafa kaidesinin uzunluk artışını sağlar. __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ ________________________________________ Slayt 45 SFENOOKSİPİTAL SİNKONDROZİS KAFA KAİDESİ GELİŞTİĞİ SÜRE BOYUNCA VARLIĞINI SÜRDÜRMEKTEDİR. __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ ________________________________________ Slayt 46 Sfenooksipital Sinkondrozis aktivasyonu 15-16 yaşlararasındasona ermekte, 20 yaşından önce ise tamamen kemikleşmektedir (Thilander ve Ingerval, 1973). Bireysellik gösterebilir! __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ ________________________________________ Slayt 47 ▪ Orta kafa kaidesinde: Sfenoid, Etmoid ve Frontal kemiklerin belirlibölgeleri 4 - 7 yaşından sonra yer değiştirme ve yeniden şekillenmeiledeğişikliğe uğramamaktadır. (Thilander veIngerval, 1973, Melsen,1974). __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ ________________________________________ Slayt 48 BU YAPILAR 7 YAŞINDAN SONRA BÜYÜME ANALİZİ İÇİN İYİ BİR ‘SABİT REFERANS’ OLARAK KULLANILABİLİR. Cranial base development: A follow-up x-raystudyof the individualvariation in growth occurring between the ages of 12 and 20 years andits relation to brain caseand face development Arne Björk, D. Odont. (Professor) Copenhagen, Denmark American Journal of Orthodontics Volume41, Issue3 , Pages 198-225, March 1955 > 400 atıf __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ ________________________________________ Slayt 49 __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ ________________________________________ Slayt 50 Kafa Kubbesini oluşturan kemikler;  Frontal- pars parietale  Parietal  Oksipital –pars squamoza  Sfenoid –ala majoris  Temporal –pars squamoza’sıdır. __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ ________________________________________ Slayt 51  Kafa kubbesini oluşturan kemikler intramembranöz kemikleşmektedirler ve kalsifikasyonları IU 8.haftada başlamaktadır.  Kafa kubbesi kemikleri kıkırdaksal kafa kaidesine nazaran daha geç bir devrede gelişmekte olan beynin etrafında bulunanmezankimdoku içerisindeoluşmayabaşlarlar. Frontal  Temporal  Parietal  Oksipital __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ ________________________________________ Slayt 52 Sutura:  Kafa kubbesini oluşturan kemiklerin büyük çoğunluğu ossifiye olduktan sonra kemiklerin arasında ossifiye olmadan kalan alanlarbulunmaktadır.  Suturalar bir çeşit İntramemranöz ossifikasyon ile kemikleşirler.  Frontal kemik doğumda iki parça halindedir. Bu iki parça arasında ve orta çizgi üzerinde metopik sutura denilen bir sutura bulunur. Bu sutura ikinci yaş içinde kapanmaya başlar ve sekiz yaşında tamamenortadankalkar. __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ ________________________________________ Slayt 53 Bıngıldak:  Doğumda bu kemik kısımlar oldukça gelişmiş ve birbirleri ile karşılaştıkları sahalarda suturaları meydana getirmiş olmakla birlikte, aralarında oldukça büyük kemikleşmemiş zarsal sahalar da vardır. Bu sahalara bıngıldak(fonticulus-fontanelle) adıverilir. __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ ________________________________________ Slayt 54  Fonticulus Major veya Fonticulus Frontalis (Anterior Fontanel): Koronal, sagital ve metopik suturların birleşme yerinde bulunur. Doğumdan sonra 3. yılda tamamen kapanmış olur.  Fonticulus Minor (Posterior Fontanel): Sutura Lambdoideanın iki kolu ile sutura sagittalis arasında bulunur. Birinci yaşın sonuna doğru kapanır. __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ ________________________________________ Slayt 55  Fonticulus Sfenoideus (Antero lateral fontanel): Frontal, Sfenoidin büyük kanadı, parietal ve temporal kemiklerin birleştikleri yerde bulunur. Doğumdan iki-üç ay sonra kapanır. Sağda vesolda birertanedir.  Fonticulus Mastoideus (Postero lateral fontanel): Mastoid çıkıntı, parietal ve oksipitalin squamal kısımları arasında bulunur. Sağda vesolda birertanedir. __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ ________________________________________ Slayt 56 Bu kompleksi oluşturan kemikler;  Maksilla  Nazal  Zygomatik  Lacrimal  Palatinal  Vomer  Nazal Konkalar __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ ________________________________________ Slayt 57  Bu kompleksi, mandibula ve yüzü oluşturan yapılar brankial arklardan köken almaktadır. __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ ________________________________________ Slayt 58 Baş-boyun bölgesinde prenatal dönemde 6 adet brankial ark bulunmaktadır  5.brankialarkrudimenter  5. ve6. farengeal arklariseeksternalolarakizlenemez.  Dış yüzeyi ektoderm, iç yüzeyi endoderm, merkezde ise mezodermdençekirdek __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ ________________________________________ Slayt 59 Birinci faringeal ark (mandibular ark); embiriyolojik olarak ilkoluşanfarengeal arktır(IU 4.Hafta). İki bölümde incelenmektedir;  Palatopteryquadrate kıkırdağının bulunduğu dorsal kısım (Maksillaoluşumuna destek)  MECKEL kıkırdağının bulunduğu ventral kısım (Mandibulaoluşumuna destek) __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ ________________________________________ Slayt 60  İkinci farengial ark (Hyoid ark): Birinci arkı takiben oluşur. Spesifik kıkırdağı REICHERT.  Üçüncü farengialark; hyoidbüyükboynuzu vealt kenarı. __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ ________________________________________ Slayt 61 Farengial Ark İskelet Kas 1. Farengialark Palatopterygoquadrate Çiğneme Kasları MeckelKıkırdağı CN V (trigeminus) MaksillerProses Mandibularproses ZygomatikKemik TemporalKemik - (Pars Squamoza) 2. Farengialark Reichert Kıkırdağı Fasiyal Kaslar Hyoidkemik- (küçük boynuz, üst kenarı) CN VII Stapes TemporalKemik - (StyloidProses) 3. Farengialark HyoidKemik- (alt kenar,büyükboynuz) M. Stylopharyngeus CN IX __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ ________________________________________ Slayt 62  Maksilla, direk kemikleşme ile meydana gelen bir membran kemiğidir.  Maksilla da iki adet kemikleşme merkezi bulunmaktadır. Bu kemikleşmenoktaları büyürler vebirbirleriilebirleşirler. A: Ön kemikleşme noktası (Premaksiller) B: Arka kemikleşme noktası (Post maksiller) __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ ________________________________________ Slayt 63 A. Premaksiller kemikleşme merkezi; Ön kemikleşme noktası nazal kavitenin ön alt kısmında sağda ve solda olmak üzere birer tanedir. Premaksilla, Keser bölgesi dış alveolar laminası, Spina nazalis anterior ve Maksillanın processus frontalisinin ön kenarını meydana getirir. __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ ________________________________________ Slayt 64 B. Posterior Kemikleşme merkezi; Orbita boşluğununaltındadır. Buradan gelişen kemik dokusu, aşağıya doğru yayılarak; Kaninden itibaren tüm dişleri içeren dış alveolarlamina, Yukarıya 2 kol üzerinden gelişerek; Ön kol: Orbita tabanın bir kısmı, Processus Frontalis’in arka kısmını, Arka kol: Orbita tabanının kalan kısmı, Processus Zygomaticus’u oluşturur. __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ ________________________________________ Slayt 65  Her iki kemikleşme noktasının gelişimi önce dış yüzey üzerinde olur. İç yapıların gelişimi ise diş germlerinin etrafında kemik trabeküllerininyayılmasıilemeydana gelir.  Diş folüküllerinin tamamen dış tarafını kuşatan kemik laminaları daha sonra foliküllerin arasından derine doğru ilerler. Diş folikülleri arasına giren bu uzantılar, kanin ile yan kesici diş folikülleri arasında birboşlukbırakırlar.  Bu boşluk kemik devamlılığının kesildiği bir bölgedir ve ara yerde bir bağ dokusu mevcuttur. Ön ve arka kemikleşme noktalarından gelişen kemik kütleleri arasındaki bu boşluğa sutura incisivo-kanin adıverilir. __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ ________________________________________ Slayt 66  Buna benzer şekilde sağ ve sol ön kemikleşme noktalarından gelişen kemik kütleleri de orta çizgi üzerinde yine içi bağ dokusu ile dolu bir boşluk bırakırlar ki buna da sutura palatina media denir.  Sutura palatina media'nın iki yanından, ön kemikleşme noktasından meydana gelmiş kemikten arkaya doğru uzanan iki çıkıntıya processuspalatina media adı verilir.  Ön kemikleşme ve arka kemikleşme noktalarından meydana gelmiş kütleler arasında derin kısımlarda ilk birleşme, prosessus palatina media vasıtasıyla olur. __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ ________________________________________ Slayt 67  IU 4. haftada Meckelkıkırdağındandestekalarakgelişmektedir.  Meckel kıkırdağı büyük kısmı zarsal olarak kemikleşen mandibula için destek vazifesigörenprimordiyal birkıkırdaktır.  Mandibula meckel kıkırdağının dış yüzünde oluşur. Meckel kıkırdağının hiç bir bölgesi kemikleşerek mandibulanın herhangi bir bölgesini meydan getirmez.  Meckel kıkırdağı yapısına katılmaz. __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ ________________________________________ Slayt 68  Mandibula; kondil haricinde tamamen intramembranöz kemikleşmeilekemikleşir (6. hafta).  Kondil ise endokondral kemikleşir.  Mandibulanın oluşumu sırasında öncelikle bu kemik organ sağ ve sololmaküzereikiparça halindedir(esas çekirdek).  Esas çekirdekten öne doğru gelişerek nervus mentalisin etrafını çevirir, foramen mentalisi meydana getirir ve simfizedoğru ilerler.  Simfiz bölgesinde bu iki parçanın kaynaşması ile mandibula tek bir kemik haline dönüşür.  10. haftadan itibaren sekonder kıkırdaklar yapısına eklenir. __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ ________________________________________ Slayt 69  Öne arkaya ve dikey olarak aşağıya doğru gelişerek Meckel kıkırdağının dış yüzeyinde Dış Lamina adı verilen bir lamina oluşur.  Dış kemiksel laminanın altında bir uzantı oluşur ve Meckel kıkırdağının dış yüzünü takip ederek yukarı doğru gelişir. Buna İç Lamina denir. __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ ________________________________________ Slayt 70  İç ve dış laminalar oluştuktan sonra korpus mandibula frontal kesitte bir olukhalini alır. Aşağıdan yukarıya doğru yer alan oluşumlar(B): 1. Kemiğe ait birvena 2. Mandibuladamarsinirpaketi 3. En üstte diş folikülleri __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ ________________________________________ Slayt 71  İç ve dış laminalar içeriye doğru çeşitli uzantılar vererek kemiksel venanın üzerini kapatırlar ve Serre Kanalını oluştururlar.  Daha sonra damar sinir paketinin üzerini kapatırlar ve Canalis mandibularis’i oluştururlar.  En üstte diş foliküllerini içeren Foliküler Olukbulunur.  Böylece esasçekirdekten korpus mandibulanın büyük bir kısmı ve ramusun alt kenarı oluşur. __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ ________________________________________ Slayt 72  Çene ucunda meydana gelen kemikleşme noktasına Çene ucu (menton) kemikleşmenoktası denir.  Bu noktadan gelişen kemik kütlesi Meckel kıkırdağının simfiz bölgesini içine alarak arkaya doğru gelişip korpus mandibulanın ön kısmı ile kaynaşır. Kaynaşma doğumdan önce tamamlanmış olur. __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ ________________________________________ Slayt 73 Üçüncü, dördüncü aylara doğru Meckel Kıkırdağına komşu üç ayrı kıkırdak meydana gelir. Bunlara sekonder kıkırdaklar denir. 1. Koronoidçıkıntı kıkırdağı 2. Anguluskıkırdağı 3. Kondilkıkırdağı __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ ________________________________________ Slayt 74 Sekonder Kıkırdaklar  Koronoid  Angulus  Kondil  Doğumda kondil kıkırdağı hariç tüm sekonder kıkırdaklar ossifiye olmuştur. __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ ________________________________________ Slayt 75  Koronoidçıkıntı kıkırdağı oldukça kısa süredekemikleşir.  Angulus kıkırdağı 8. aya doğru kemik dokusu tarafından istila edilir.  Kondil kıkırdağının üst tarafında bulunan bağ dokusu hücrelerinden zengin bölge postnatal dönemde de yeni kıkırdak tabakaları meydana getirerek mandibulanın gelişiminekatkıda bulunur. __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ ________________________________________ Slayt 76 1. Maksillanın gelişimi intramembranöz kemikleşmedir. 2. Mandibulanın kemikleşmesi intramembranöz kemikleşmedir. Sadece simfiz bölgesinde ve kondilde çok az birbölümdekıkırdaksal kemikleşmeolur. __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ ________________________________________ Slayt 77  Ortodontinin Biyolojik Temelleri (1981) – Nedret Gürsoy  Klinik Yönleri ile İnsan Embriyolojisi - Keith L. MOORE  Facial Growth - Donald ENLOW  Dusdata - Ortodonti Kitabı __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ ________________________________________ Slayt 78 __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ ________________________________________ Slayt 79 __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ ________________________________________

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