The document discusses the embryology of several structures in the head and neck region. It describes the development of the mandible from mesenchymal condensations and ossification centers. It also discusses the development of the temporomandibular joint from condylar and temporal blastemas, and the development of the palate from the maxillary processes and shelves. Finally, it provides an overview of the development of the tongue from lingual swellings in the branchial arches.
pharyngeal arches and pouches responsible for the development of head and neck including it's muscular development, neural development, vascular and skeletal development
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Anomalies of the first and second branchial archesDr Medical
https://userupload.net/8n9v7tg9jkl1
Anomalies of the branchial arches are the second most common congenital lesions of the head and neck in children [1]. They may present as cysts, sinus tracts, fistulae or cartilaginous remnants and present with typical clinical and radiological patterns dependent on which arch is involved. The course of a particular branchial anomaly is caudal to the structures derived from the corresponding arch and dorsal to the structures that develop from the following arch. Branchial anomalies are further typed into cysts, sinuses, and fistulas.
pharyngeal arches and pouches responsible for the development of head and neck including it's muscular development, neural development, vascular and skeletal development
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The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and offering a wide range of dental certified courses in different formats.
Anomalies of the first and second branchial archesDr Medical
https://userupload.net/8n9v7tg9jkl1
Anomalies of the branchial arches are the second most common congenital lesions of the head and neck in children [1]. They may present as cysts, sinus tracts, fistulae or cartilaginous remnants and present with typical clinical and radiological patterns dependent on which arch is involved. The course of a particular branchial anomaly is caudal to the structures derived from the corresponding arch and dorsal to the structures that develop from the following arch. Branchial anomalies are further typed into cysts, sinuses, and fistulas.
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Innervation of the face
The nervvous system
Nerve transmission
Definition of Pain
Pain Receptors
Pain nerve fibers
Reaction to pain
Pain Pathway
Control of Pain
Mode of action of local anesthesia
Embryology is necessary to understand the growth of various anatomical structures pertinent to orthodontics and will help understand the anomalies associated with its maldevelopment.
Craniofacial growth is a complex and a beautiful phenomenon.
It all begins when a sperm cell fuses with an egg cell, a process called fertilization.
Human fertilization is the union of a human egg and sperm, usually occurring in the ampulla of the fallopian tube. The result of this union is the production of a ’Zygote’ cell, or fertilized egg, initiating prenatal development
Prenatal growth can be divided into 3 main stages:
Germinal stage: From ovulation to implantation(0-2 weeks).
Embryonic stage : 3rd week to 8th week.
Fetal stage: 9th week till birth.
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These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
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Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
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Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
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Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
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Anti-ulcer drugs are medications used to prevent and treat ulcers in the stomach and upper part of the small intestine (duodenal ulcers). These ulcers are often caused by an imbalance between stomach acid and the mucosal lining, which protects the stomach lining.
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MANAGEMENT OF ATRIOVENTRICULAR CONDUCTION BLOCK.pdfJim Jacob Roy
Cardiac conduction defects can occur due to various causes.
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This document describes the acute management of AV block.
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2. CONTENTS:
• Development of Mandible
• Development of Temporomandibular joint
• Development of Palate
• Development of Tongue
• Development of Tonsils
• Development of Salivary Glands
• Development of muscle
• Conclusion
• References
3. DEVELOPMENT OF MANDIBLE:
• The cartilages and bones of the mandibular skeleton
form from embryonic neural crest cells that
originated in the mid and hindbrain of the neural
folds.
• The first structure to develop in the region of the
lower jaw is the mandibular division of the
trigeminal nerve that precedes the ectomesenchymal
condensation forming the first branchial arch.
• The mandible is derived from ossification of an
osteogenic membrane formed from
ectomesenchymal condensation at 36-38 days of
development.
4. • A single ossification centre for each half of the
mandible arises in the sixth week intra uterine
life in the region of bifurcation of alveolar
nerve and artery in to mental and incisive
branches.
• Ossification membrane is lateral to Meckel’s
cartilage and its accompanying neurovascular
bundle.
• Ossification spreads from the primary centre
below and around the inferior alveolar nerve
and its incisive branches , and upwards to
form a trough for the developing teeth.
5. • Spread of intramembranous ossification
dorsally and ventrally forms the body and
ramus of mandible.
• Ossifications stops dorsally at the site that will
become mandibular lingula, from where
Meckel’s cartilage continue in to the middle
ear.
• Meckel’s cartilage diverges dorsally to end in
the tympanic cavity of each middle ear, which
is derived from the first pharyngeal pouch,
and is surrounded by the forming petrous part
of temporal bone.
6. • The dorsal end of the Meckel’s cartilage ossifies to
form basis of two of the auditory ossicles
Malleus and Incus
• The third ossicle which is derived primarily from
the cartilage of second branchial arch(Reichert’s
cartilage)
Stapes
7.
8. • Parts of Meckel’s cartilage transform in to
Sphenomandibular
ligament
Malleolar
ligament
9. • Meckel’s cartilage
dorsal to the mental
foramen undergoes
resorption on its
lateral surface at the
same time as
intramembranous
bony trabeculae are
forming immediately
lateral to the resorbing
cartilage.
11. • Secondary accessory cartilages appear between the
10th and 14th week i.u to form
Head of condyle
Part of coronoid process
Mental protuberance
• The appearance of this secondary cartilages is
dissociated from the primary branchial and
chondrocranial cartilages.
• The secondary cartilage of coronoid process develops
within the temporalis muscle as its predecessor.
12. • The coronoid accessory cartilage becomes
incorporated in to the expanding
intramembranous bone of the ramus and
disappears before birth.
• In the mental region ,on either side of the
symphysis, one or two small cartilages
appear and ossify in the 7th month i.u to
form variable number of mental ossicles
in fibrous tissue of symphysis.
13. • The condylar secondary cartilage appears during the 10th week i.u as a
cone shaped structure in the ramal region.
• Cartilage of condylar head increase by
Interstitial growth Appositional growth
14. • Condylar cartilage serves as a important centre of growth
for ramus and body of the mandible.
• By14th week, first evidence of endochondral bone appear in
condylar region.
• Change in mandibular position and form are related to
direction and amount of condylar growth.
• The continuing presence of the cartilage provides a
potential for continued growth ,which is realized in
conditions of abnormal growth such as Acromegaly.
18. Development of Temporomandibular joint:
• The Temporomandibular joint is a
secondary development ,both in its
evolution and embryological history.
• The joint between malleus and incus
that develops at the dorsal end of the
Meckel’s cartilage is phylogenetically
the primary jaw joint.
• When the temporomandibular joint
forms at 10 week i.u., both the malleo-
incudal and definitive jaw joints move
in synchrony for about 8 weeks in fetal
life .
19. • TMJ develops from 2 blastemas :
Condylar blastema Temporal blastema
• Between 10-12 weeks of I.U life
Condylar blastema
develops from the
secondary condylar
cartilage
Temporal blastema
arises from the otic
capsule
20. • During the 10th week intrauterine two clefts
develop in the interposed vascular fibrous
connective tissue, forming the two joint cavities
and thereby defining the intervening articular disk.
• Inferior compartment- 10th week
Separating the future disk from the developing
condyle
• Upper compartment – 11 ½ week.
After which cavitation occurs, due to muscle
movement, by rupture of small spaces to coalesce into
functional cavities.
1. Fibrous layer
2. Cartilage
3. Bone
4. Bone marrow
21. • Condensation of mesenchyme
forms the basis of joint
capsule, which progressively
isolates the joint from the
surrounding tissues.
• The joint capsule composed of
fibrous tissue, recognizable by
the 11th week i.u., forms lateral
ligaments
22. • The Temporomandibular joint of the new born
child is comparatively lax structure, with
stability solely dependant upon the capsule.
• At birth – Mandibular fossa is almost flat and
bears no articular tubercle.
• At 7 years –After the eruption of permanent
teeth, Articular tubercle begin to become
prominent.
• After 12 years- the disk becomes S-shaped,
more compact, more collagenous and less
cellular.
• Mature disk- Avascular and Aneural in its
central portion,but is filled with vessels,
nerves and elastic fibres posteriorly.
24. Early palate formation:
• The primitive stomodeum that forms a wide
central shallow depression in the face is limited in
its depth by the oropharyngeal membrane .
• The characteristically deep oral cavity is formed
by ventral growth of prominences surrounding
the stomodeum .
• The stomodeum establishes as an
oronasalpharyngeal chamber and entrance to the
gut on the 28th day, when the dividing
oropharyngeal membrane disintegrates, providing
continuity of passage between the mouth and
pharynx.
25. • The stomodeal chamber divides into separate
oral and nasal cavities when the frontonasal
and maxillary prominences develop
horizontal extensions into the chamber.
• Frontonasal prominence
Single median primary
palate
• Maxillary prominences
Two lateral palatal shelves
26. • The shelves elevate unevenly with the anterior
third “flipping up” followed by an oozing
“flow” of the posterior two-thirds.
• Elevation of shelves enables their mutual
contact in the midline, the primary palate
anteriorly and the nasal septum superiorly.
• The shelves also fuse with the nasal septum ,
except posteriorly, where the soft palate and
uvula remain unattached.
• Ossification provides the basis for the anterior
bony hard palate. The posterior third of palate
remains unossified.
27. SECONDARY PALATE FORMATION:
• The three elements that make up the
secondary palate formation
Two lateral maxillary
palatal shelves
Primary palate
• Palatine shelves ascend to attain a
position above the tongue and fuse;
forming Secondary palate.
• Incisive foramen is the midline
landmark between primary & secondary
palate.
32. DEVELOPMENT OF TONGUE:
• The tongue arises in the
ventral wall of the
primitive oropharynx
from the inner lining of
the four branchial
arches.
33. • During the 4th week i.u., paired lateral
thickenings of mesenchyme appear
on the internal aspect of the first
branchial arch to form the lingual
swellings.
• Between the swellings a median
eminence appears ,the tuberculum
impar (unpaired tubercle) whose
caudal border is marked by a blind
pit.
• This pit, the Foramen caecum, marks
the site of origin of the thyroid
diverticulum, an endodermal duct that
appears during the somite period.
34. • The diverticulum migrates caudally
ventral to the pharynx ,as the
thyroglossal duct, which bifurcates
and subdivides to form the thyroid
gland.
• The lingual swellings grow and fuse
with each other, emcompassing the
tuberculum impar,to provide
ectodermal derived body of the
mucosa of the tongue.
35. • The ventral bases of the
second, third and fourth
branchial arches elevate in to a
united, single midventral
prominence known as the
Copula.
• A posterior subdivision of this
prominence is identified as the
hypobranchial eminence.
• A V-shaped sulcus terminalis
,whose apex is the foramen
caecum, demarcates the mobile
body of the tongue from its
fixed root.
36. • The line of the sulcus
terminalis is marked by 8-12
large circumvallate papillae
that develop at 2-5 months
i.u.
• Fungiform papillae develop
on the dorsal surface of the
tongue-11 weeks i.u.
• Development of Filiform
papillae is not complete till
postnatally.
• Gustatory cells – 7 th week
i.u.
40. Development of tonsils:
• The endoderm lining the second pharyngeal
pouch between the tongue and soft palate
invades the surrounding mesenchyme as a
solid group of buds.
• Central parts of these buds degenerate to
form TONSILLAR CRYPTS .
Invading lymphoid cells surround the crypts
To group as lymphoid follicles
41. • Lymphoid tissue invades into
Palatine region
Posterior region
Pharyngeal region
Lingual region
Auditory region
• These lymphoid masses encircle the
oropharynx to form Waldayers ring .
• It is a ring of immunodefensive
tissues that grows postnatally in the
oropharynx .
42. • Palatine tonsils arise at site of
second pharyngeal arch.
• Pharyngeal and Lingual tonsils
develop in mucosa of posterior
wall of the pharynx and roof of the
tongue.
• Tubal tonsils are formed by the
lateral extensions of the lymphoid
tissue posterior to the openings of
the auditory tubes.
43. Development of salivary glands:
• During fetal life, each salivary
gland is formed at a specific
location in the oral cavity
through the growth of the bud of
the oral epithelium into the
underlying mesenchyme.
• The three major sets of salivary
glands-
Parotid gland
Submandibular gland
Sublingual gland
44. Developmental stages:
• Stage 1: Induction of oral epithelium by
underlying mesenchyme.
• Stage 2: Formation and growth of
epithelial cord.
• Stage 3: Initiation of branching in
terminal parts of epithelial cord and
continuation of glandular differentiation.
• Stage 4: Repetitive branching of
epithelial cord and lobule formation.
• Stage5: Canalization of presumptive
ducts.
• Stage 6: Cytodifferentiation.
45. Cells of salivary glands:
• The lining epithelium of the ducts,
tubules and acini differentiate both
morphologically and functionally.
• Inner epithelial layer - secretory cells
(serous and mucous)
• Outer epithelial layer- myoepithelial
cells (derived from neural crest)
46.
47. Major Salivary Glands:
• Parotid Gland:
Purely serous.
First to appear, 6th week i.u.
Appears on the inner cheek near the
angle of the mouth and then grows
back to the ear.
Stenson’s duct opens in buccal
mucosa opposite maxillary 2nd
molar.
48. • Submandibular Gland:
Mixed serous and mucus.
Appear late in the 6th week prenatally.
Appears bilaterally in the floor of the
mouth.
Wharton’s duct opens in the floor of the
mouth on either side of the lingual frenum.
• Sublingual Gland:
Predominantly mucus.
Appears around 8th week i.u.
Appears lateral to the submandibular gland.
Bartholin’s duct opens into the Wharton’s
duct and drains through the sublingual
caruncle.
49. Development of Muscle:
• Craniofacial voluntary muscles develop from paraxial mesoderm that
condenses rostrally as incompletely segmented somitomeres and
segmented somitomeres of occipital and rostral cervical regions.
• Myomeres of somitomeres +Myotomes of the somites
Myoblasts
divide and fuse
Myotubes
Cease further mitosis
Myocytes
50.
51. • The mesenchymal component of the pharyngeal arches gives rise to special
visceral (striated) musculature, which is voluntary in nature.
MESENCHYME MUSCLES
1st arch Muscles of Mastication
2nd arch Muscles of Facial
Expression
3rd arch Stylopharyngeus
4th arch Pharyngeal muscles,
Palatopharyngeus, Levator
veli palatini, Uvular
muscles
6th arch Laryngeal muscles
Occipital Somites Muscles of the tongue
52. Schematic description
of the embryonic
origins of (clockwise
from upper right) the
ocular,masticatory,
facial, pharyngeal,
neck, and tongue
muscles.
53. Timeline for muscle development
Orofacial musculature:
1. First to develop in the body.
2. Genioglossus and Geniohyoid- at 32 to 36 days i.u.
3. Mylohyoid & Anterior Belly of Digastric-first to develop from the 1st
arch.
Palatal musculature:
1. Tensor Veli Palatini- 40 days post conception.
2. Levator Veli Palatini, Palatopharyngeus- around 45 days.
3. Uvular muscles-when palatal shelves fuse.
4. Palatoglossus is the last to develop.
54. Masticatory musculature:
1. Develop as individual entities from the 1st
arch mesenchyme.
2. The muscles need constant reattachment
due to remodelling of the mandible during
growth phase.
57. Conclusion:
• Embryology helps us to understand the normal
growth pattern of a variety of structures and the
time at which they complete their growth.
• So embryology is important for providing correct
treatment modalities at an appropriate time.
58. References:
• CRANIOFACIAL EMBRYOLOGY : GEOFFERY SPERBER
• TEN CATE’S ORAL HISTOLOGY
• LANGMAN’S MEDICAL EMBRYOLOGY
• TEXTBOOK OF HUMAN EMBRYOLOGY INDERBIR SINGH