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176 Cards in this Set
- Front
- Back
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4 important genes in embryogenesis
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sonic hedgehog
wnt-7 FGF homeobox |
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sonic hedgehog
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@ base of limbs in
zone of polarizing activity anterior-posterior |
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wnt-7
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apical ectodermal ridge
dorsal-ventral |
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fgf
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apical ectodermal ridge
+ mitosis of underlying mesoderm --> lengthening of limbs |
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homeobox
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segmental
craniocaudal |
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week 1
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implantation of blastocyst,
then hCG secretion |
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week 2
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bilaminar disk (epiblast, hypoblast)
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week 3
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gastrulation
primitive streak notochord neural plate |
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week 3-8
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neuroectoderm --> neutral tube
closes by week 4 organogenesis teratogen susceptibility |
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week 4
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heart beat
limb buds |
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week 8
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movement
looks like a baby fetal period begins @ end of week 8 |
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week 10
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genitalia show male/female
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_ plate and _ plate of the fetus...
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alar (dorsal) -- sensory
basal plate (ventral) -- motor |
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formation of neural tube from neural plate takes place...
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day 18 - 21
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_ _ _ ... neural plate
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notochord induces
overlying ectoderm --> neuroectoderm --> neural plate |
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neural plate -->
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neural tube
neural crest |
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rule of 2's for 2nd week
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2 germ layers, 2 cavities, 2 components of placenta
(bilaminar disk) epiblast, hypoblast amniotic cavity, yolk sac cytotrophoblast, syncytiotrophoblast |
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rule of 3's for 3rd week
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3 germ layers (gastrula)
ectoderm, mesoderm, endoderm |
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rule of 4's for 4th week
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4 heart chambers
4 limb buds |
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_ _ --> primitive streak --> _ _
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epiblast (precursor to ectoderm)
invaginates --> primitive streak whose cells form --intraembryonic mesoderm --part of the endoderm |
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surface ectoderm --> (9)
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lens
sensory organs of ear olfactory epithelium epidermis oral epithelium adenohypophysis glands: --salivary --sweat --mammary |
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neuroectoderm --> (8)
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CNS neurons
oligodendrocytes astrocytes ependymal cells neurohypophysis pineal gland retina spinal cord |
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__ --> lens
__ --> retina |
surface ectoderm
neuroectoderm |
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neural crest --> (11)
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ANS
dorsal root ganglia cranial nerves Schwann cells melanocytes chromaffin cells parafollicular (C) cells pia & arachnoid bones of the skull odontoblasts aorticopulmonary septum |
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endoderm -->
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gut
lungs liver pancreas etc. thymus parathyroid thyroid follicular cells |
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__ --> parafollicular (C) cells
vs. __ --> thyroid follicular cells |
neural crest
endoderm |
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mesoderm --> (17)
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muscle
bone connective tissue cardiovascular structures blood lymphatics kidney bladder urethra testes ovaries vagina adrenal cortex dermis eustacian tube serous linings (e.g. peritoneum) spleen |
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--> spleen
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foregut mesentery (mesoderm)
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__ --> chromaffin cells
__ --> adrenal cortex |
neural crest
mesoderm |
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mesodermal defects -->
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VACTERL
Vertebral Anal atresia Cardiac Tracheo-Esophageal Renal Limb |
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malformation vs.
deformation |
intrinsic disruption
during embryonic period (weeks 3-8) extrinsic after embryonic period |
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agenesis
hypoplasia aplasia |
absent organ
2^ absent primordial tissue incomplete organ devo absent organ; primordial tissue is present |
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teratogen timeline of susceptibility
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< week 3: all-or-none effects
weeks 3-8: most susceptible > week 8: growth and function |
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teratogen:
ACE inhibitors --> |
renal damage
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teratogen:
alkylating agents --> |
absence of digits
multiple anomalies |
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teratogen:
aminoglycosides --> |
CN VIII toxicity
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teratogen:
cocaine |
abnormal fetal development
fetal addiction placental abruption |
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teratogen:
lithium |
Ebstein's anomaly
= atrialized R ventricle |
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teratogen:
maternal diabetes |
caudal regression syndrome
(anal atresia to sirenomelia) |
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mermaid syndrome is aka
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sirenomelia
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teratogen
smoking (nicotine, and ____) |
CO
preterm labor placental problems IUGR ADHD |
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teratogen
thalidomide |
flipper limbs
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teratogen
valproate |
- intestinal folate absorption
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teratogen
vitamin A (excess) |
spontaneous abortions
cleft palate cardiac abnormalities |
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teratogen
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bone deformities
fetal hemorrhage abortion |
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teratogens include (20
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"4 All the Cute & Dead" is a FILM about
Some Terrible, Terrible Very Very Wicked (stuff = 4 things) ACE inhibitors alcohol alkylating agents aminoglycosides cocaine diethylstilbestrol folate antagonists iodide lithium maternal diabetes smoking tetracyclines thalidomide valproate vitamin A warfarin x-rays, anticonvulsants fetal infections, some Abx |
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fetal alcohol syndrome -->
(6) |
developmental retardation
microcephaly holoprosencephaly facial abnormalities limb dislocation heart & lung fistulas |
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fetal alcohol syndrome mechanism may include...
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inhibition of cell migration
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formation on what day?
chorion amnion |
3
8 |
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_ secretes hCG, which is similar to _ and -->
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syncytiotrophoblast
LH --> corpus luteum to secrete progesterone during first trimester |
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umbilical arteries come from _
umbilical veins go to _ |
internal iliac
IVC |
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single umbilical artery is associated with _
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congenital
& chromosomal anomalies |
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umbilical _ (vessel) is oxygenated
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vein
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umbilical arteries and veins are derived from _
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allantois
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the umbilical cord contains (4)
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2 arteries
1 vein urachus wharton's jelly |
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natural history of the urachus
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3rd week -- yolk sac forms allantois, which extends into UG sinus
allantois becomes urachus, which is a duct between bladder and yolk sac |
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if the urachus is not patent, but is not obliterated, you have __
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vesicourachal diverticulum
(outpouching from bladder) |
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vitelline duct natural history
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vitelline duct (connects yolk sac to midgut) is obliterated in 7th week
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vitelline duct is aka
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omphalomesenteric duct
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vitelline duct abnormalities
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vitelline fistula
--> meconium from umbilicus Meckel's diverticulum --> partial closure |
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2 sxs of Meckel's
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melena
periumbilical pain |
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__ -->
ascending aorta pulmonary trunk |
truncus arteriosus
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heart embryological structures (8)
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truncus arteriosus
bulbus cordis primitive ventricle primitive atria left horn of sinus venosus right horn of SV right common cardinal vein right anterior cardinal vein |
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bulbus cordis -->
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R ventricle
smooth parts (outflow tract) of L & R ventricles |
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primitive ventricle -->
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portion of the LV
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primitive atria
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trabeculated L&R atria
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left horn of sinus venosus -->
right horn of sinus venosus --> |
coronary sinus
smooth part of RA |
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right common cardinal vein -->
right anterior cardinal vein --> |
both:
SVC |
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SVC comes from
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right common and right anterior cardinal veins
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coronary sinus comes from
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left horn of sinus venosus
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smooth parts (outflow tract) of left & right ventricles come from
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bulbus cordis
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__ --> smooth part of RA
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right horn of sinus venosus
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__ --> coronary sinus
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left horn of sinus venosus
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truncus arteriosus devo sequence
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neural crest migration -->
truncar & bulbar ridges they spiral and fuse --> aorticopulmonary septum --> ascending aorta & pulmonary trunk |
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pathologies of truncus arteriosus
(3) |
failure to spiral -->
transposition of great vessels skewed AP septum --> tetralogy of Fallot partial AP septum devo--> persistent truncus arteriosus |
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IV septum devo
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1. muscular ventricular septum forms
2. AP septum fuses with it--> membranous IV septum is formed, which closes IV foramen 3.endocardial cushions grow--> --separate atria from ventricles also contribute to... --atrial separation --membranous IV septum |
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pathology of IV septum devo
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membranous septal defect -->
initially L-->R shunting shunt reverses (Eisenmenger) |
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interatrial septum devo (8)
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1. septum primum grows toward endocardial cushions
2. it gets perforated at the top, forming foramen secundum 3. foramen secundum maintains R--> L shunt 4. septum secundum grows but contains a permanent opening: foramen ovale 5. foramen secundum enlarges/upper part of septum primum degenerates 6. remaining septum primum is the valve of foramen ovale 7. secundum & primum fuse to form the atrial septum 8. ovale usually closes soon after birth because of ^^ LA pressure |
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septum primum vs. septum secundum
which is R, which is L? which is eventually more inferior, which is eventually more superior? |
primum: L
secundum: R primum: inferior secundum: superior |
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fetal erythropoiesis occurs in
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Young Liver Synthesizes Blood (weeks)
Yolk Sac 3-8 Liver 6-30 Spleen 9-28 Bone marrow 28--> |
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fetal hemoglobin vs. adult hemoglobin
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alpha2 gamma2 vs.
alpha2 beta2 |
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blood in umbilical vein is __ % saturated with oxygen
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80%
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3 importan fetal shunts
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1. umbilical vein --> ductus venosus --> IVC.
bypasses hepatic circulation. 2. oxygenated blood from IVC --> foramen ovale --> aorta to head & body 3. deoxygenated blood from SVC --> pulmonary artery --> ductus arteriosus --> lower body |
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closure of foramen ovale happens b/c
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infant breathes-->
v resistance in pulmonary vasculature--> ^ LA pressure vs. RA pressure |
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closure of ductus arteriosus b/c
(name two meds also) |
^ O2 -->
v prostaglandins indomethacin: closes PDA prostaglandins: keep it open |
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prosencephalon -->
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telencephalon
diencephalon |
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rhombencephalon-->
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metencephalon
myelencephalon |
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regions of developing brain
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telencephalon
diencephalon mesencephalon metencephalon myelencephalon |
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___ -->
metencephalon myelencephalon |
rhombencephalon
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if neuropores fail to fuse
then --> persistent connection between _ and _ |
amniotic cavity
spinal canal |
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neuropores fail to fuse --> labs
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^ alpha-fetoprotein AFP
--amniotic fluid --maternal serum ^ AFP & acetylcholinesterase --CSF |
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holoprosencephaly is associated with (3)
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Patau's syndrome
severe fetal alcohol syndrome cleft lip/palate |
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trisomy 13 is aka
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patau's syndrome
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2 posterior fossa malformations
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Chiari II
Dandy-Walker |
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Chiari II (4)
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cerebellar tonsillar herniation through foramen magnum
aqueductal stenosis --> hydrocephaly often presents with --syringomyelia --thoracolumbar myelomeningocele |
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Dandy-Walker (5)
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large posterior fossa
absent cerebellar vermis cystic enlargement of 4th ventricle can --> --hydrocephalus --spina bifida |
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syringomyelia (5)
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enlargement of central canal of spinal cord
crossing fibers of spinothalamic tract are damaged first "cape-like" bilateral loss of pain & temperature in upper extremities; preservation of touch associated with Chiari II most common @ C8-T1 |
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1st aortic arch -->
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part of maxillary artery
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2nd artic arch -->
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stapedial artery & hyoid artery
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3rd aortic arch -->
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--common Carotid
--proximal internal carotid |
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4th aortic arch -->
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L: aortic arch
R: proximal R subclavian |
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6th aortic arch -->
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proximal pulmonary arteries
ductus arteriosus |
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branchial apparatus includes (3)
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CAP (outside to inside)
Clefts = ectoderm Arches = mesoderm, neural crest Pouches = endoderm |
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branchial clefts are aka
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branchial grooves
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branchial arches are derived from
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mesoderm (muscles, arteries)
neural crest (bones, cartilage) |
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1st branchial cleft -->
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external auditory meatus
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external auditory meatus comes from branchial ___
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1st branchial cleft
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branchial clefts 2-4 form...
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temporary cervical sinuses;
obliterated by proliferation of 2nd arch mesenchyme |
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persistent cervical sinus is 2^
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branchial cleft cyst within lateral neck
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1st branchial arch: cartilage
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Meckel's cartilage:
--mandible --malleus, incus --sphenoMandibular ligament |
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1st branchial arch: muscles
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MAT
4 muscles of mastication mylohyoid anterior belly digastric anterior 2/3 tongue tensor tympani tensor veli palatini |
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1st branchial arch: nerves
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V2, V3
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1st branchial arch: abnormalities
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Treacher Collins syndrome:
1st arch neural crest fails to migrate --> --mandibular hypoplasia --facial abnormalities |
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2nd branchial arch: cartilage
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Reichert's cartilage:
--stapes --styloid process --lesser horn of hyoid --stylohyoid ligament |
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hyoid comes from what branchial arches?
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lesser horn: 2nd
greater horn: 3rd |
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2nd branchial arch: nerve
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VII
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2nd branchial arch: muscles
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--muscles of facial expression
--stapedius --stylohyoid --posterior digastric |
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digastric comes from what branchial arches?
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anterior belly: 1st
posterior belly: 2nd |
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3rd branchial arch: muscles
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stylopharyngeus
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3rd branchial arch: nerve
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IX
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stylopharyngeus is innervated by
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glossopharyngeal nerve
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abnormalities of 3rd branchial arch
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congenital pharyngocutaneous fistula:
persistence of cleft & pouch--> fistula between tonsillar area cleft in lateral neck |
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branchial arches 4-6: cartilages
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thyroid
cricoid arytenoids corniculate cuneiform |
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4th branchial arch: muscles
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--most pharyngeal constrictors
--cricothyroid --levator veli palatini |
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6th branchial arch: muscles
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all intrinsic muscles of larynx
except cricothyroid |
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4th branchial arch: nerves
6th branchial arch: nerves |
X: superior laryngeal branch (swallowing)
X: recurrent laryngeal (speaking) |
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posterior 1/3 of tongue comes from branchial arches...
anterior 1/3 comes from... |
3 & 4
1 |
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1st branchial pouch -->
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middle ear cavity
eustacian tube mastoid air cells |
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2nd branchial pouch -->
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epithelial lining
of palatine tonsil |
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3rd branchial pouch -->
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dorsal wings --> inferior parathyroids
ventral wings --> thymus |
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4th branchial pouch -->
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superior parathyroids
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MEN 2A is associated with a mutation of _ in _ cells
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RET
neural crest cells |
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anterior 2/3 of tongue, sensation vs. taste innervation
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sensation: V3
taste: VII |
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taste goes to _ in the brain
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solitary nucleus
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muscles of the tongue are derived from _
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occipital myotomes
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most common ectopic thyroid tissue site:
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tongue
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two possible cysts in the neck. one moves with swallowing, one doesn't.
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moves:
--thyroglossal duct cyst --in midline neck doesn't move: --persistent cervical sinus--> branchial cleft cyst --in lateral neck |
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cleft lip is 2^ failure of fusion of...
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maxillary and medial nasal processes
(formation of 1^ palate) |
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cleft palate is 2^ failure of fusion of
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--lateral palatine processes
--nasal septum --median palatine process (formation of 2^ palate) |
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hindgut is from _ to _
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distal transverse colon to rectum
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etiology of anterior abdominal wall defects
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failure
-->result rostral fold closure --> sternal defects lateral fold closure --> omphalocele, gastroschisis caudal fold closure --> bladder extrophy |
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duodenal atresia is 2^
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failure of recanalization
(trisomy 21) |
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jejunal, ileal, colonic atresia is due to... ___ and --> ___
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vascular accident
(apple peel atresia) |
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midgut development timeline
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6th week: midgut herniates through umbilical ring
10th week: returns to abdominal cavity + rotates around SMA |
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tracheoesophageal fistula --> (6)
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--cyanosis
--air bubble in stomach on CXR --pneumonitis --choking/vomiting with feeding --failure to pass NG tube into stomach --polyhydramnios |
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congenital pyloric stenosis (5)
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--hypertrophy of pylorus
--> obstruction --palpable epigastric "olive" --nonbilious projective vomiting @ 2 weeks --1/600 live births --often 1st-born males |
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dorsal & ventral pancreatic buds -->
dorsal only --> |
head
uncinate process main pancreatic duct body tail isthmus accessory pancreatic duct |
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annular pancreas
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ventral bud
encircles 2nd part of duodenum may --> duodenal narrowing |
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pancreas divisum
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dorsal & ventral parts fail to fuse at 8 weeks
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if dorsal & ventral pancreatic buds don't fuse at _ weeks,
it's called _ |
8 weeeks
pancreas divisum |
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spleen arises from _ and hence is _
is supplied by artery of _ |
dorsal mesentery
mesodermal foregut (celiac) |
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kidney embryology:
pronephros |
week 4; then degenerates
"The pronephros arises as segmental collections of mesoderm in the cervical region at 3 weeks of development and then regresses at 4 weeks" |
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mesonephros (2)
(kidney embryology) |
interim kidney for 1st trimester
contributes to male genitals |
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metanephros (2)
(kidney embryology) |
permanent
(week 5) - (week 32-36) |
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nephrogenesis involves (2)
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ureteric bud
metanephric mesenchyme |
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ureteric bud
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from caudal end of mesonephros -->
ureter pelvises calyces collecting ducts fully canalized by 10th week |
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metanephric mesenchyme
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interaction with ureteric bud
--> differentiation & formation of glomerulus-DCT |
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____ is last to canalize, and therefore...
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ureteropelvic junction
most common site of obstruction (hydronephrosis) in fetus |
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potter's syndrome sxs (3)
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limb
facial pulmonary hypoplasia |
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potter's syndrome MOA
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malformation of ureteric bud
--> bilateral renal agenesis --> oligohydramnios |
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horseshoe kidney: describe location and functional changes
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trapped under IMA
functions normally |
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females:
_ duct degenerates, & _ duct develops males are opposite |
females: paramesonephric
males: mesonephric |
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mechanism in males of
--suppression of paramesonephric --stimulation of development of mesonephric |
SRY gene
-->testis-determining factor (testis development) ---------------------------------- Mullerian inhibitory factor from Sertoli --> suppresses development of paramesonephric ducts ----------------------------- ^ androgens from Leydig cells --> development of mesonephric |
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female & male embryological ducts
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mesonephric aka wolffian
paramesonephric aka mullerian |
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mesonephric duct -->
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SEED
seminal vesicles epididymis ejaculatory duct ductus deferens |
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paramesonephric duct -->
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fallopian tube
uterus upper 1/3 vagina |
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lower 2/3 of vagina is from
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urogenital sinus
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bicornuate uterus:
caused by __ associated with __ |
incomplete fusion of paramesonephric ducts
urinary tract abnormalities infertility |
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<-- genital tubercle -->
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glans penis
corpus cavernosum corpus spongiosum glans clitoris vestibular bulbs |
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<-- urogenital sinus -->
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--bulbourethral glands
(of Cowper) --prostate gland --greater vestibular glands (of Bartholin) --urethral and paraurethral glands (of Skene) |
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<-- urogenital folds -->
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ventral shaft of penis
(penile urethra) labia minora |
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hypospadias is 2^
epispadias is 2^ |
failure of urethral folds to close
faulty positioning of genital tubercle |
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_ is associated with epispadias
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extrophy of the bladder
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_spadias is more common than _spadias
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hypospadias is > common than epispadias
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fix hypospadias to prevent _
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UTIs
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female remnant of gubernaculum
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ovarian ligament
round ligament of uterus |
