GIT

cleft lip

• incomplete fusion of the embryonic structures surrounding the primitive oral cavity

cleft palate

occurs when primary and secondary palatine plates fail to fuse during embryonic development

Notch in vermillion border

• cleft lip only: This refers to a congenital condition where there is a separation or gap in the upper lip, typically extending to the nose, without involvement of the palate (roof of the mouth). It's often referred to as a cleft lip.

unilateral cleft lip and palate

• This is a congenital condition characterized by a separation or gap in the upper lip on one side, often extending into the roof of the mouth (palate). It involves both the lip and the palate on one side of the mouth.

bilateral cleft lip and palate

• This is a congenital condition where there are separations or gaps in both sides of the upper lip, often extending into the roof of the mouth (palate). It involves both the lip and the palate on both sides of the mouth.

midline

• this refers to a rare congenital condition where there is a separation or gap in the midline of the upper lip, possibly extending into the nose and palate. It's uncommon compared to unilateral or bilateral clefts

forme fruste unilateral cleft lip

A subtle cleft on one side of the upper lip, which may appear as a small indentation.

incomplete unilateral cleft lip

A cleft on one side of the upper lip, which does not extend into the nose.

complete unilateral cleft lip

• A cleft on one side of the upper lip, which extends into the nose. 

incomplete bilateral cleft lip

• Clefts on both sides of the upper lip, not extending to the nose. 

complete bilateral cleft lip

• Clefts on both sides of the upper lip, extending into the nose.

incomplete cleft palate

A cleft in the back of the mouth in the soft palate.

complete cleft palate

A cleft affecting the hard and soft parts of the palate. The mouth and nose cavities are exposed to each other.
 

submucous cleft palate

A cleft involving the hard and/or soft palate, covered by the mucous membrane lining the roof of the mouth. May be difficult to visualize

4-7 wks : maxillary and medial nasal prominence fail to fuse

week of development, cause of failure of cleft lip

6-9 wks: palatal shelves fail to fuse

week of development, cause of failure of cleft palate

folic acid

deficiency of this essential vitamin can lead to cleft lip n palate

hypernasal voice resonance

This refers to a condition where there is excessive nasal airflow during speech, resulting in a nasal quality to the voice. It often occurs in individuals with cleft lip and palate due to the opening between the nose and mouth, which affects the normal resonance of speech sounds.

prone to aspiration during feeding

Individuals with cleft lip and palate may be prone to this because of difficulties in forming a proper seal between the mouth and the oral cavity. This can lead to liquids or foods entering the airway instead of the esophagus, increasing the risk of respiratory complications.

Prone to ear infection

 Cleft lip and palate can affect the structure and function of the Eustachian tube, which helps regulate pressure in the middle ear. Dysfunction of the Eustachian tube can lead to fluid accumulation and recurrent infections in the middle ear, making individuals with cleft lip and palate more prone to ear infections.

eustachian tube

dysfunction of this can lead to fluid accumulation n infection in middle ear

dental malformation

•  Cleft lip and palate can also affect the development of teeth and the alignment of the dental arches. such as missing, extra, or misaligned teeth are common in individuals with cleft lip and palate. Proper dental care and orthodontic treatment are often necessary to address these malformations and ensure proper dental health and function.

cheiloplasty

a surgical procedure repairing cleft lip. done to 3-6 months old

tennison-randall triangular flaps (z-plasty)

involves creating triangular flaps of tissue to reposition and realign the tissues around the cleft, improving the appearance and function of the lip. It's often used in more complex cleft lip repairs.

millard rotational advancement technique

It involves rotating and advancing tissue from the sides of the cleft to reconstruct the lip, creating a more natural appearance.

palatoplasty

repair on cleft palate done in 12-18 months old

velopharyngeal flap operation

• done to revise previous repairs. Usually done @ 8-10 years of age

latham appliance

• is surgically inserted by use of pins during the child's 4th or 5th month. After it is in place, the doctor, or parents, turn a screw daily to bring the cleft together to assist with future lip and/or palate repair.

10 wks old

10 lbs

10 grams hemoglobin

rule of 10

upright position

nursing management : what position should be in feeding to prevent aspiration

mead-johnson bottle, Haberman feeder

special feeding devices

obturator

use in order to close the gap of palate

gastroesophageal reflux

• Chronic symptoms or mucosal damage produced by the abnormal reflux in the esophagus

• Arise due to failed fusion of the tracheoesophageal ridges during the 3rd week of embryological development

lower esophageal sphincter (LES)

also known as the cardiac sphincter, is a ring of muscle at the bottom of the esophagus. Its primary function is to prevent stomach acid and contents from flowing back into the esophagus. If this sphincter becomes weakened or relaxed, it allows stomach acid to reflux into the esophagus, leading to symptoms of GER.

relaxed cardiac sphincter

this allows stomach acid to reflux into the esophagus leading symptoms of GER

gravity

• plays a role in keeping stomach acid in the stomach when we are upright, but when lying down, this mechanism is compromised.

Passive regurgitation

• effortless flow of stomach contents, including stomach acid, into the esophagus and sometimes into the mouth. It can occur without warning and may lead to discomfort or a sour taste in the mouth.

vomiting

•  forceful expulsion of stomach contents through the mouth and is often a result of severe GER. It can be triggered by irritation of the esophagus or stomach due to refluxed stomach acid.

hematemesis

vomiting of blood, which may appear bright red or resemble coffee grounds.

melena

•  black, tarry stools, indicating the presence of digested blood in the stool.

heartburn for older children

• Older children and adolescents with GER may experience this also known as acid indigestion or pyrosis. This burning sensation typically occurs in the chest or upper abdomen and may worsen after meals or when lying down.

antacids

• work by neutralizing stomach acid, providing quick relief from symptoms of GER. They contain various compounds like magnesium, aluminum, calcium, or sodium bicarbonate. By neutralizing stomach acid, antacids can help alleviate heartburn, regurgitation, and other discomfort caused by GER.

magnesium- diarrhea, aluminum-constipation, calcium-constipation

magnesium,aluminum, and calcium is for what?

prokinetic agents

• these are metoclopramide, Urecholine, and Propulsid may be administered for GER to improve gastrointestinal motility, strengthen the lower esophageal sphincter, and reduce the frequency and severity of reflux episodes. They are typically prescribed in conjunction with lifestyle modifications and other medications for comprehensive management of GER

proton pump inhibitors

• class of medications commonly prescribed for the treatment of Gastroesophageal Reflux Disease (GERD) and other conditions related to excessive stomach acid production

histamine receptor

block/ reduce amount of acid in stomach

fundoplication

surgical procedure used to treat Gastroesophageal Reflux Disease (GERD) and hiatal hernias.

gastrostomy

Surgical procedure use to create an opening (stoma) into stomach through abdom. Wall

Gastrostomy tubes

may be placed through the stoma to provide enteral nutrition for individuals who are unable to eat or swallow safely due to medical conditions such as dysphagia, neurological disorders, or gastrointestinal obstruction

gastroschisis

protrusion of the abdominal organs in to the defect in the abdominal wall at the right side of the umbilicus

Omphalocele

Protrusion of abdom. Organs in the defective umbilical ring.

Residual reflux

persistent reflux of stomach contents into the esophagus following surgical repair of gastroschisis or omphalocele.

Omphalocele

 abdominal organs herniate into a sac covered by a membrane at the base of the umbilical cord, which may vary in size and severity. The exposed organs may include the intestines, liver, and occasionally other abdominal structures.

Gastroschisis

 abdominal organs herniate into a sac covered by a membrane at the base of the umbilical cord, which may vary in size and severity. The exposed organs may include the intestines, liver, and occasionally other abdominal structures.