JIGJIGA UNIVERSITY

Embryology for PCI Medicine

The Fourth to Eight Week (Embryonic Period)

ORGANOGENESIS
(Formation of basic organs and
systems)
 THE FOURTH TO EIGHT WEEK (EMBRYONIC PERIOD)

 By the end of eighth week all the main organ systems

have begin to develop, but function of most organs is
minimal except CVS.
 Because basic organs and systems develop during this
period, exposure to teratogens during this period may
cause major congenital malformations.
– Teratogens are agents such as drugs and viruses that
produce or increase the incidence of congenital anomalies.
• It is the most critical period of development.
 Folding of the embryo
• Folding changes the flat trilaminar embryonic
disc into a cylindrical C-shaped embryo.
• The endodermal, mesodermal and ectodermal
layers fuse to change the embryonic disc into
three-dimensional body form.
– It is due to rapid differential growth of various
portion of the embryo.
• Folding occurs in both the median and
horizontal planes.
 Folding in median plane
• Occurs in head and tail region.
• Folding results a constriction between embryo
and yolk sac and the dorsal part of the yolk sac
is incorporated into the embryo and give rise to
primitive gut.
• Folding in medial plane is due to rapidly
lengthening of neural tube.
 Folding in median plane cont…
Head fold
– Cranial to neural plate
there is oropharyngeal
membrane
– cranial to this membrane a
2nd structure has begun to
appear: the horseshoe-
shaped cardiogenic
area(form future heart)
– Cranial to cardiogenic
area a 3rd structure appear:
the septum transversum
 Head fold cont…
– As the head region folds ventrally, part of the yolk
sac is incorporated into the developing head as the
foregut.
– The foregut lies between the brain & heart
– The developing brain becomes the most cranial
part of the embryo.
– Septum transversum lies caudal to heart after the
folding and develops into central tendon of
diaphragm.
 The derivatives of the foregut
• The primordial pharynx and its derivatives
• The lower respiratory system
• The esophagus and stomach
• Proximal 1/2nd of the duodenum
• The liver, biliary apparatus (hepatic ducts, gall
bladder, and bile duct), and pancreas
 Tail fold
– As tail folds ventrally, part of the yolk sac is
incorporated into the caudal end of embryo as
hind gut.
– Terminal part of the hindgut expands to form
cloaca.
– Folding of tail also results in the cloacal
membrane, connecting stalk and allantois
being carried to the ventral surface of the
embryo.
 The derivatives of the hindgut

• The left 1/3rd of the transverse colon

• The descending colon and sigmoid colon,
• The rectum, and the superior part of the anal
canal
• The epithelium of the urinary bladder and
most of the urethra
 Folding in the horizontal plane
– This incorporates yolk sac into embryo as
mid gut.
– The yolk sac remains attached to the mid gut
by a narrow yolk stalk.
The derivatives of the midgut
– The small intestine, including the distal 1/2 nd
of duodenum
– The cecum, appendix, ascending colon, and
the right one half to two thirds of the
transverse colon
 Derivatives of the germ layers
Derivatives of ectoderm
Central nervous system
Peripheral nervous system
Sensory epithelia of the eye, ear, and nose
Epidermis and its appendages (hair and nails)
Mammary glands
Pituitary gland
Enamel of teeth.
 Derivatives of ectoderm cont…
Neural crest cells, derived from neuroectoderm.
Give rise to:
The cells of the spinal, cranial (cranial nerves V,
VII, IX, and X), and autonomic ganglia.
Ensheathing cells of the PNS (Schwann cells)
Pigment cells of the dermis (melanocyte).
Muscle, connective tissues, and bone of
pharyngeal arch origin
Suprarenal medulla and
Meninges of the brain and spinal cord
 Derivatives of mesoderm
Mesoderm gives rise to:
Connective tissue
Cartilage
Bone
Striated and smooth muscles
Heart, blood, and lymphatic vessels
Kidneys, ovaries, testes & genital ducts.
Serous membranes (pericardial, pleural &
peritoneal)
Spleen and cortex of suprarenal glands.
 Derivatives of endoderm
Endoderm gives rise to:
• The epithelial lining of the gastrointestinal and
respiratory tracts.
 Oropharyngeal membrane rupture at the 4th week to
form the mouth and
 Cloacal membrane rupture at 7th wk to form anal orifice.
•Parenchyma of the tonsils, thyroid and parathyroid
glands, thymus, liver, and pancreas
•Epithelial lining of the urinary bladder and most of the
urethra, and
•Epithelial lining of the tympanic cavity, tympanic
antrum, and pharyngotympanic (auditory) tube.
 Clinical importance
Anterior body wall defect:
•Result from failure of the anterior body wall formation
during folding and subsequent development.
•Commonest type are omphalocele and gastroschisis.
– In both case GIT system herniate beyond the
anterior body wall.
– However, in omphalocele, the bowel is
membrane covered, in contrast to gastroschisis,
in which bowel protrude through the anterior body
wall.
Clinical cont…

Omphalocele
Gastroschisis
 NINTH WEEK TO BIRTH
(The fetal period)

Maturation of organ system and growth

 The Fetal Period
• Development during the fetal period is primarily
concerned with rapid growth of the body and
differentiation of tissue and organs.
• There is a relative slowdown in the growth of the head
compared with that of the rest of the body
• At the beginning of the third month, the head
constitutes approximately half of the crown-rump
length (CRL).
• By the beginning of the fifth month, the size of the
head is about one third of the crown-heel length
(CHL), and
• At birth it is approximately one fourth of the CHL
 Highlights of Fetal Period
9-12 weeks
•At the beginning of 9th week head constitute
half of the crown-rump length of the fetus
•The liver is the major site of erythropoiesis.
•Primary ossification centers appear in the
skeleton in the (skull and long bones).
•External genitalia of males and females appear
similar until the end of 9th week and
distinguished from 12 to 14 week
 9-12 weeks cont…
• The upper limb reached their final relative
length.
• Urine starts to form and is excreted into the
amniotic fluid.
• 11th week, intestine have returned to the
abdomen
Figure: Diagram illustrating the changing proportions of the body during the fetal period. At 9
weeks, the head is approximately half the crown-heel length of the fetus. By 36 weeks, the
circumferences of the head and the abdomen are approximately equal. After this (38 weeks),
the circumference of the abdomen may be greater.
 13-16 weeks
• Growth is very rapid during this period & the
lower limbs have lengthened
• By 16 weeks, the head is relatively small
compared with that of the 12-week fetus
• Ossification of skeleton active and the bones
are clearly visible on radiographs
• In 13th week, slow eye mov’t occur.
• By 16 week, the ovaries are differentiated
and have many primordial follicles containing
oogonia.
 17-20 weeks
• Growth slows down.
• Fetal movements ‘quickening’ are commonly
felt by the mother.
• The skin is covered with a greasy cheese-like
material called vernix caseosa.
– It consists of a mixture of dead epidermal cells
and a fatty substance (secretion) from the fetal
sebaceous glands.
– It protects the delicate skin from abrasions and
hardening.
 17-20 weeks cont…
• The body of 20-week fetus is usually completely
covered with fine downy hair called lanugo,
– Which help holding the vernix caseosa on the skin
• Eyebrows and head hairs are also visible.
• Brown fat forms during this period.
• By 18 weeks uterus of female fetus is completely
formed and canalization of vagina has begun .
• By 20 weeks the testes of male fetus begun their
descent, but they are still located on posterior
abdominal wall.
 21-25 weeks
• There is a substantial weight gain.
• The skin is usually wrinkled and more
translucent
• At 21 week rapid eye mov’t begin
• By 24 week, the secretory epithelial cells or
types II pneumocytes in the interalveolar
walls of the lung have begun to secrete
surfactant (maintain the patency of the
developing alveoli of the lungs)
• Finger nails are also present by 24 week.
 26-29 weeks
• A fetus may survive if born prematurely and
given intensive care because lungs are capable
of breathing air.
• The lungs and pulmonary vasculature have
developed sufficiently to provide adequate gas
exchange.
• Eyelids open at the beginning of this period.
• Toe nails become visible
 26-29 weeks cont…
• Considerable subcutaneous fat has formed.
• The quantity of white fat increases to
approximately 3.5% of body weight
• The fetal spleen is now an important site of
hematopoiesis .
• Erythropoiesis in the spleen ends by 28
weeks:
– By which the time bone marrow has become the
major site of formation of erythrocytes.
 30-34 weeks
• Pupillary light reflex can be elicited by 30
weeks.
• Skin -Pink and smooth & UL &LL have
chubby appearance.
• Fat in the body is about 8% of the body
weight.
• 32 weeks and above usually survive.
 35-38 weeks
• Fetuses born at 35 weeks have a firm grasp and
exhibit a spontaneous orientation to light.
• Slowing of growth

• By 36 weeks, the circumferences of the head and

abdomen are approximately equal.
• Full term (266 days/38 weeks after fertilization
or 280 days/40 weeks after LNMP)
 35-38 weeks cont…
By full term:
•Most fetuses usually reach a CRL of 360 mm
and weigh approximately 3400 g.
•The amount of white fat is approximately 16%
of body weight.
•A fetus adds approximately 14 g of fat per day
during these last weeks of gestation.
•The thorax (chest) is prominent, and the breasts
often protrude slightly in both sexes.
•The testes are usually in the scrotum in full-
term male infants.
 Expected date of delivery

 The expected date of delivery of a fetus is 266 days

or 38 weeks after fertilization, i.e., 280 days or 40
weeks after LNMP.
The common method for estimating the EDD is:
 Nagele's rule
LNMP – 3 month + 1 year + 7 days
For e.g., if the LNMP of miss “X” is 8/5/2020.
The EDD will be in 15/2/2021.