The Anatomy of the Cleft, What Is Actually Interrupted
Take the reading one piece at a time. For each piece: read it once, underline the sentence that says what happens, then look up any word in the list. Tap a word to see its definition.
Piece 1 of 2
The team examines Baby Mateo (a composite teaching case, not a real patient). On the left side, his upper lip is split all the way up into the nostril. The split continues back through his gum ridge (the alveolus) and through the whole roof of his mouth, hard palate and soft palate, on the left side. The right side is intact. There is an open connection between his mouth and nose along the gap. The rest of his newborn exam is normal, with no other birth defects noted.
Piece 2 of 2
Now look at the muscles. In the lip, the orbicularis oris ring is interrupted at the cleft. The fibers do not just end; instead of crossing the midline they turn and insert in the wrong place, running up along the edges of the cleft toward the base of the nostril and the base of the columella. Because the muscle pulls along the gap instead of across it, the lip is pulled apart and the nose is distorted. In the palate, the levator veli palatini does not form its normal side-to-side sling; the fibers run the wrong way (front to back) and insert abnormally onto the back edge of the bony hard palate. Imaging studies confirm the levator is abnormal in thickness and insertion in cleft palate, with the most disturbed anatomy in children who still cannot seal the velopharynx.
Reading the Research
- Skim the title and abstract first to get the gist.
- Circle the one sentence that states the main claim.
- Box the evidence the authors give for that claim.
- Mark one sentence that confuses you, and move on.
Now put it together: In one or two sentences, say what this whole reading is telling you about Mateo. Then go back to the lesson and fill in the guided notes.