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High Yield Embryology

High Yield Embryology

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Published by Jamie Rhodes

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Published by: Jamie Rhodes on Jul 05, 2012
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HIGH-YIELD EMBRYOLOGY 
EARLY EMBRYOLOGY Capacitation –
pruning of the sperm glycocalyx; permits the sperm-oocyte interaction
Ectopic pregnancy –
implantation occurs outside of the uterine cavity; can occur in the uterine tubes or in thepelvic cavity 
Placenta previa –
implantation occurs near the cervix; provides a high risk of bleeding
Placental abruption –
placenta becomes detached
Placenta accreta –
abnormal adherence of the chorionic villi to the myometrium
Placenta percreta –
 villi penetrate the full thickness of the myometrium
Hydatidiform moles –
cn give rise to choriocarcinomas or persistent trophoblastic disease
Complete –
a cystic swelling of the uterus that forms when an embryo dies and the chorionic villi fail to vascularize; fertilization of empty oocyte (contains only paternal chromosomes); produces high levels of hCG
Partial –
derives from a poorly developed embryo; always haploid and produce hCG
Dizygotic (fraternal) twins –
arises from multiple ovulations (high levels of FSH)
Monozygotic (identical) twins –
arise from splitting of a single zygote
Human chorionic gonadotrophin (hCG) –
secreted by syncytiotrophoblast
Progesterone –
secreted by corpus luteum for five months, then by placenta; contraceptive “pill” and RU-486 areanti-progesterones
Gastrulation –
process where the epiblast gives rise to mesoderm, endoderm and ectoderm
Notochord –
derives from both endoderm and mesoderm; forms the nucleus pulposus
Sirenomelia –
caudal dysgenesis from inadequate mesoderm; lower limb defects
Sacrococcygeal teratoma –
persistence of primitive streak, forms multi-tissue tumor
 Alpha-fetoprotein –
liver glycoprotein; leaks into amniotic fluid with neural tube or ventral wall defects
Spina bifida occulta –
incomplete neural arch, patch of hair over defect
CARDIOVASCULAR Splanchnic mesoderm –
forms the primitive hear tube; beats on day 22
Pleuropericardial membranes –
form the pericardium and pleura (somatic parts)
Tetralogy of Fallot –
a combination of four heart defects:1. pulmonary stenosis2. right ventricular hypertrophy 3. ventricular septal defect4. over-riding aorta
Undivided truncus arteriosus –
neural crest defect where the bulbar regions fail to form
Patent ductus arteriosus –
common defect associated with rubella and pregnancies occurring in high altitudes;more common in females
 Atrial septal defect –
patent foramen ovale, common, can involve defect in septum primum or septum secundum
 Ventricular septal defect –
common; involves the membranous part of the interventricular septum
Transposition of the great vessels –
most common cause of cyanosis in newborn
 Veins
 Vitelline – left disappears, right forms portal systemUmbilical – right disappears, left drains placenta (becomes ligamentum teres hepatis)CardinalSubcardinal – drains kidneysSacrocardinal – common iliacSupracardinal – drains body wall (azygos veins)
Ductus venosus –
 between left umbilical and right vitelline veins; forms ligamentum venosum
RESPIRATORY Early development
– begins in the 4
th
week; derived from the gut tube; lungs become viable during the 24
th
gestational week due to secretion of surfactant; formation of most alveoli occurs between birth and the 8
th
 year
Tracheoesophageal Fistulas
– abnormal connections between esophagus and airway, usually involves a proximalesophagus that ends in a blind pouch and a distal esophagus that connects to the trachea
 VACTERL Association
– combination of defects that arise from exposure to high levels of estrogens/progesteronesduring the embryonic period (weeks 3 – 9)
NERVOUS SYSTEMEarly development –
notochord induces formation of neural plate which gives rise to neural crest and neural tube
Notochord –
persists as the nucleus pulposus of the intervertebral disc
1
 
Neural tube
– alar plate is dorsal (sensory); basal plate is ventral (motor)
Neural crest –
gives rise to all ganglia, Schwann cells, meninges, melanocytes, cartilage, bone and blood vessels of the head
Spina bifida cystica–
incomplete closure of the neural tube caudally (caudal neuropore on day 27); can be detected by alpha-fetoprotein and includes a sac containing CSF
meningocele –
sac includes meninges and CSF
meningomyelocele –
includes nervous tissue
 Anencephaly –
result when the anterior neuropore fails to close (day 25); forebrain is poorly developed
 Arnold-Chiari malformation –
cerebellum herniates through the foramen magnum; seen in conjunction withspina bifida cystica accompanied by hydrocephalus
Hydrocephalus –
most often due to stenosis of the cerebral aqueduct secondary to a fetal viral infection
Mental retardation –
most commonly caused by maternal alcohol abuse
GASTROINTESTINALOmphalocele –
occurs when the intestines do not return to the abdominal cavity following normal herniation; theguts are covered by the amniotic sac
Umbilical hernia –
guts protrude outside of the abdominal cavity but covered with skin and connective tissue
Congenital pyloric stenosis –
characterized by projectile vomiting in a newborn
 Atresia
interruption of the gastrointestinal tract; at esophagus vomit contains uncurdled milk; at gastric region the vomit contains curdled milk; at the duodenum the vomit contains bile
Meckel’s diverticulum –
a remnant of the vitelline stalk and yolk sac, exists as an outward projection of the distalilium about one meter form the ileocecal junction that can contains gastric or pancreatic tissue; found in about 2%of the population
Hirschsprung’s disease – o
ccurs when the hindgut fails to be invaded by migrating neural crest cells, results inhypomobility, constipation and congenital megacolon
Imperforate anus – t
he anal membrane does not regress
 Vitelline Fistula –
connection between the midgut and umbilicus
UROGENITALDerivatives of the genital ducts:male –
high level of testosterone stimulates development of the mesonephric duct; Mullerian inhibiting factorprevents development of paramesonephric ducts
female
– low level of testosterone prevents development of mesonephric ducts and no Mullerian inhibiting factorpermits development of the paramesonephric ducts
Mesonephric ducts:male:
epididymis, ductus deferens, seminal vesicle and ejaculatory duct
female:
epoophoron, paroophoron, Gartner’s duct
Paramesonephric duct:male:
appendix of testes and prostatic utricle
female:
uterine tube, uterus and superior part of vagina
Horseshoe Kidney –
occurs when the inferior poles of the kidneys contact each other before ascent; the kidneysfuse and ascent to the lumbar region is prevented by the inferior mesenteric artery 
Bifid ureter –
involves the ureteric bud
Epispadias –
rare; seen with exstrophy of the bladder
Hypospadias –
common; opening on the ventral aspect of the penis; results from a failure of urethral folds tocompletely meet
Turner’s syndrome –
45 XO; infantile female genitalia, ovarian streaks and webbed neck 
Klinefelter’s syndrome –
47 XXY; common (1/500); gynecomastia, infertile males
External Genitalia:
after week 9 the genitalia can be distinguished as male or female!
MALEFEMALEUG folds
floor of urethralabia minora
Genital swellings
scrotumlabia majora
Genital tubercle
penisclitoris
UG sinus
urethra/prostateurethra/vagina
Gonads –
develop from epiblast and migrate along the yolk sac and mesentery to the lumbar region
Hydrocele –
fluid in the cavity of the tunica vaginalis from a patent processus vaginalis
Urachal Fistula –
connection from bladder to umbilicus
HEAD AND NECK Pharyngeal Apparatus2
 
Clefts (Grooves) –
four pairs; ectoderm that forms only epitheliumThe
first cleft
gives rise to the external auditory meatus.The
second through fourth clefts
typically regress; may form a cervical sinus.
Pouches –
four pairs; endoderm that forms only epitheliumThe
first pouch
gives rise to the auditory tube, mastoid antrum and tympanic cavity.The
second pouch
forms the palatine tonsil
.
The
third pouch
gives rise to the thymus and inferior parathyroid gland.The
fourth pouch
gives rise to the superior parathyroid
Pharyngeal Arches –
There are five pharyngeal arches; mesoderm forms skeletal muscle; neural crest growsinto each arch and forms all connective tissue (cartilage, bone and blood vessels)
Derivatives of the Pharyngeal ArchesFirstSecondThirdFourthSixthNerve
CN V3CN VIICN IXCN XCN X
Muscles
muscles of mastication, anterior belly of digastric,mylohyoid, tensortympani and tensor veli palatinifacialmuscles,stapedius,posterior belly of digastricandstylohyoidstylopharyngeusmuscles of palate,pharynx andcricothyroidmuscles of larynx,inferiorconstrictor,cricopharyngeusand superiorportion of esophagus
 Artery 
maxillary hyoid andstapedialcommon andinternal carotidleft: portion of arch; right: partone of subclavianPulmonary trunk (left - ductusarteriosus)
Cartilage
malleus and incusstapes,styloidprocess,lesser hornand superiorportion of  body of hyoidgreater horn andinferior portion of  body of hyoidlaryngeal cartilagelaryngeal cartilage
Torticollis –
This is a condition characterized by a shortening of the sternocleidomastoid muscle and results in anelevation of the chin to the opposite side; can be caused by damage to the muscle, spinal accessory nerve or can becongenital.
Cysts of the Neck 
Lateral cervical cysts (branchial fistula) – arises from the second through fourth pharyngeal cleftsMidline cysts – most often arise from a remnant of the thyroglossal duct (
thyroglossal duct cysts
)
Cleft Lip –
Results from failure of the maxillary prominence to join the medial nasal prominences to form the
intermaxillary segment
(primary palate derives from intermaxillary segment)
Cleft Palate
 Anterior cleft – anterior to incisive foramen; lateral palatine process fails to fuse with primary palatePosterior cleft – occurs through the 2
°
palate where lateral palatine process don’t fuse or meet nasal septumComplete cleft – involves both the primary and secondary palate 
MISCELLANEOUSSitus inversus –
reversal of organs; can involve all organs or just single organs (heart – dextrocardia)
Diaphragm –
develops from the septum transversum, pleuroperitoneal membranes, paraxial mesoderm and dorsalmesentery of the esophagus
Congenital diaphragmatic hernia –
results from a failure of the pleuroperitoneal fold to close thepericardioperitoneal canal; most common on the left side
Stem villi -
form from trophoblast and somatic layer of extraembryonic mesoderm
3

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