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1.) Initiation
limb bud formation
4.) Growth
occurs into early adulthood
Limb Development
Limb development begins with the activation of a
group of mesenchymal cells from the somatic
layer of lateral mesoderm.
Mesenchymal cells aggregate the posterior margin of the limb to form the zone of
polarizing activity ( ZPA ). Fibroblast growth factors from the AER activate the
ZPA
The distal ends of the flipper- like
limb buds flatten into paddle- like
hand and foot plates.
As the tissue breakdown progresses, separate digits are formed by the end of 8th
week.
Chondrification centers
appear later in the 5th week.
By the end of the 6th week,
the entire limb skeleton is
cartilaginous.
From the dermomyotome regions of
the somites, myogenic precursor cells
migrate into the limb bud and later
differentiate into myoblasts
( precursors of muscle cells ).
Sensory axons enter the limb buds after the motor and use them for guidance.
Neural crest cells ( precursors of Schwann cells ) surround the motor and sensory nerve
fibers in the limbs and form the neurolemmal and myelin sheaths.
A dermatome is the area of skin supplied by a single spinal nerve and its ganglion.
A cutaneous nerve area is the area of skin supplied by a peripheral nerve.
During the 5th week, the peripheral nerves grow from the developing limb plexuses ( brachial
and lumbosacral ) into the mesenchyme of the limb buds .
The spinal nerves are distributed in segmental bands supplying both dorsal and ventral
surfaces of the limb buds.
Although the original dermatomal pattern changes during growth of the limbs, the
distribution can still be recognized in the adult.
In the upper limb, observe that the area supplied by C5 and C6 adjoin the areas supplied by
T2, T1 and C8 but the overlap between them is minimal at the ventral axial line.
Originally the flexor aspect of the limbs is ventral and the extensor aspect dorsal
and the preaxial and postaxial borders are cranial and caudal respectively.
Early in the 7th week the limbs extend ventrally. The developing upper and lower
limbs rotate in opposite directions and to different degrees.
The upper limbs rotate laterally 90 degrees on their longitudinal axes. So, the
future elbows point dorsally and the extensor muscle lie on the lateral and
posterior aspects of the limb.
The lower limbs rotate medially through 90 degrees. So, the future knees face
ventrally and the extensor muscles lie on the anterior aspect of the lower limb.
Embryo about 52 days.
The fingers are
separated and the toes
are beginning to
separate. Note that the
feet are fan- shaped.
Several
congenital
anomalies of
arterial pattern
may be found in
Cogenital Anomalies of Limb
1.) Reduction defects
Meromelia
Amelia
3.) Dysplasia
Syndactyly
Gigantism
Webbed Hand (Syndactyly)
Formation of Supernumerary Limbs
Meromelia
Congenital Clubfoot
Any deformity of the foot involving the
talus ( heel ) is called clubfoot or
talipes.
It is uncommon, occurring about once
in 1000 births.
As the children develop, they tends to
walk on the ankle ( talus ) rather than
on the sole of the foot.
Talipes equinovarus, the most common type of clubfoot. It occurs twice in males.
The sole is turned medially ( inverted foot ) with hyperextension and incurving of
the feet.