Scalp and Facial Hair Patterning

Hair directional slope is secondary to the plane of stretch exerted on the skin by the growth of underlying tissues during the period of down-growth of the hair follicles at around 10-12 weeks gestation. The posterior parietal hair whorl is interpreted as the focal point from which the growth stretch is exerted by the dome-like out-growth of the brain during the time of hair follicle development. Malformations that antedate hair follicle development, such as encephalocele, produce aberrations...

Measurement of Breast Volume

A variety of methods may be used to define the breast volume 1. weighing the breast on a scale, which can be done with pendulous breasts 2. using a water-filled container placed over the breast and into which the breast is placed. Since the volume of water in the container is known, the breast size can be calculated from the amount of water displaced 3. making a cast of the breast, and the volume of the breast is measured from the cast 4. measuring the breast size with a special...

Orbital Protrusion

Definition Degree of protrusion of the eye (exophthalmos). Landmarks The calibrated end of a Luedde exophthalmometer is held firmly against the lateral margin of the orbit. The long axis of the instrument is held parallel to the long axis of the eyeball. The examiner sights the anterior margin of the cornea through the calibrated scale and reads the distance in millimeters (Fig. 7.50). Instruments A Luedde exophthalmometer for details, see Gerber et al. (1972). A transparent calibrated ruler...

Glossary

Accessory nipple Additional nipple, unilateral or bilateral, on the trunk, lying on the milk linewhich runs caudally from the normal position of the nipples and cranially toward the axilla. acrocephaly Tall or high skull the top of the head is pointed, peaked, or conical in shape usually involving premature closure of the lambdoid and coronal sutures, with a vertical index above 77 also referred to as oxycephaly, turricephaly, and tower skull. acromelic Referring to the distal portion of the...

Ear Position

Definition Location of the superior attachment of the pinna. Note the size and rotation of the external ear are not relevant. Landmarks Four methods to determine the position of attachment of the ear are outlined. 1. Draw an imaginary line between the outer canthus of the eye and the most prominent part of the occiput. The superior attachment of the pinna should be on or above this line (Fig. 7.62a). 2. Draw an imaginary line through the inner and outer canthi and extend that line posteriorly....

Nose

The nose is remarkable in its variability, in profile, frontal plane, and from the undersurface. Details and definitions of the soft tissue and bony landmarks are available in references at the end of this chapter and are illustrated in Fig. 7.65a. A qualitative assessment of the nose should include 1. the nasofrontal angle is it normal, flat, or deep 2. the nasal root protrusion is it average, high, or low 3. the nasal bridge is it high, low, broad, beaky, or bulbous 4. the nasal tip is it...

Interalar Distance Nasal Width

Definition Distance between the most lateral aspects of the alae nasi. Landmarks Measure from the lateral-most aspect of one ala nasi to the lateral-most aspect of the ala nasi (Fig. 7.72). Instruments Spreading calipers are the most accurate instruments, although a transparent calibrated ruler or tape-measure can be substituted. Position The patient should be reclining, with the vertical. Remarks Values for nasal width from birth to age 16 years are shown in Fig. 7.73. There is tremendous...

Eyes

The eyes develop from three sources the neural ectoderm of the forebrain, the surface ectoderm of the head, and the mesoderm between the two aforementioned layers. Eye formation is first evident at about 22 days gestation, when a pair of grooves called optic sulci appear in the neural folds at the cranial end of the embryo. Soon these sulci form a pair of optic vesicles on each side of the forebrain. The optic vesicles contact the surface ectoderm and induce development of the lens placodes,...

Info

Figure 7.96 Effective mandibular length, both sexes, 6 to 16 years. From McNamara (1984), by permission. Maxillomandibular Differential Cephalometric Definition This measurement is determined by subtracting the effective midfacial length from the effective mandibular length (Fig. 7.97). Landmarks See sections on effective midfacial length and effective mandibular length for details. Definition The bigonial width. The distance between the two most lateral aspects of the mandible. Landmarks...

Length of the Philtrum

Definition Distance between the base of the nose and the border of the upper lip, in the midline. Landmarks Measure from the base of the nose (subnasion) to the superior aspect of the vermilion border of the lip, in the midline (Fig. 7.74). Instruments Ideally the philtral length is measured with spreading calipers however, a calibrated transparent ruler could be used. Position The head should be held (in the resting position) erect with the eyes facing forward. The observer should be lateral...

Directions For Administration

Try to get child to smile by smiling, talking or waving. Do not touch him her. 2. Child must stare at hand several seconds. 3. Parent may help guide toothbrush and put toothpaste on brush. 4. Child does not have to be able to tie shoes or button zip in the back. 5. Move yarn slowly in an arc from one side to the other, about 8 above child's face. 6. Pass if child grasps rattle when it is touched to the backs or tips of fingers. 7. Pass if child tries to see where yarn went. Yarn should be...

Stages of Puberty Tanner Stages

To assess how far an individual has progressed through puberty, a rating scale that describes the successive stages of growth of the genitalia and pubic hair in boys and breast development and pubic hair development in girls was introduced by Tanner (Fig. 10.2). The stage of development in the individual is compared with visual standards which are referred to as G-1 to G-5 for male genitalia development, B-1 to B-5 for breast development, and PH-1 to PH-5 for pubic hair development. The...