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Friedman's Ophthalmology > Embryo > Flashcards

Embryo Flashcards

1
Q

Arrange the following structures in order of formation of the eye:

  • optic pits
  • optic cups
  • embryonic plate
  • optic vesicles
  • neural plate
A

embryonic plate–> neural plate–> optic pits–> optic vesicles –> optic cups

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2
Q

What are the 3 layers that make up the Embryonic Plate?

A
  1. Ectoderm
  2. Mesoderm
  3. Endoderm
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3
Q

Which layer of the embryonic plate forms the eye and brain?

A

Ectoderm

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4
Q

What are the 3 layers that make up ectoderm?

A
  • Neural ectoderm
  • Surface ectoderm
  • Neural crest
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5
Q

What is the blue layer on the figure?

A

Ectoderm

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6
Q

What is the yellow layer on the figure?

A

Mesoderm

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7
Q

What is the red layer on the figure?

A

Ectoderm

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8
Q

What is the central green structure prior to folding of the embryonic plate?

A

Notochord

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9
Q

What is the analogous structure to the notochord after folding?

A

Neural Tube

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10
Q

What is the name of the layer of ectoderm indicated?

A

Neural Plate

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11
Q

Which ectodermal cells migraine into the pockets shown?

A

Neural crest cells

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12
Q

What does the endoderm fold to form?

A

Gastrointestinal Tube

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13
Q

The optic pit forms at which day of gestation?

A

Day 23

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14
Q

What is the optic vesicle?

A

anterolateral outpouching of primitive brain stem

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15
Q

When does the optic vesicle form the globe?

A

evaginates on day 25 and becomes the globe

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16
Q

On which day does the optic vesicle induce the lens placode?

A

Day 25

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17
Q

Name some of the possible disorders that can arise from abnormalities in envagination of the optic vescile.

A
  • anophthalmia
  • cyclopia (synophthalmia)
  • congenital cystic eye
  • congenital nonattachment of the retina
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18
Q

Name 4 disorders that are associated with synopthalmia

A

Apical forebrain lesions such as synophthalmia are associated with arrhinencephaly, proboscis, ethmocephaly, trisomy 13

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19
Q

How does the optic cup develop?

A

develops embryologically as an anterolateral evagination of the forebrain

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20
Q

What does the inner layer of the optic cup become?

A

Inner layer becomes the retina

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21
Q

What does the outer layer of the optic cup become? Outer layer becomes the retinal pigment epithelium

A

Outer layer becomes the retinal pigment epithelium

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22
Q

What does the potential space between the inner and outer layer of the optic cup become?

A

Potential space between the two becomes the SUBRETINAL SPACE (which was the cavity of the neural tube)

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23
Q

What do cells at the anterior margin of the optic cup form?

A

the posterior pigment epithelium of the iris

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24
Q

As the optic cup forms, what do cells between the future iris and the future retina form?

A

the ciliary body

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25
Q

Name the following structures:

A
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26
Q

What does the lens pit form before it bcomes the Lens vesicle?

A

Lens pore

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27
Q

Name the following components of the formation of the optic cup.

A
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28
Q

where is the embryonic fissure located on the optic cup?

A

undersurface

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29
Q

When does the embyonic fissure close?

A

closes on day 33 allowing pressurization of globe

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30
Q

Where does the closure of the embryonic fissure begin?

A

Closure occurs first in midzone/equator, then extends posteriorly and anteriorly

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31
Q

what embronic tissue uses the embyonic fissure as a portal to enter the eye?

A

Embronic fissure serves as portal for mesoderm to enter eye (i.e. hyaloid artery)

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32
Q

What is it called when the embyonic fissure fails to close?

A

Coloboma

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33
Q

What is the inheritance pattern of colobomas?

A

sporadic or autosomal dominant (AD)

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34
Q

What is the typical quadrant location of a coloboma?

A

typical (located in inferonasal quadrant)

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35
Q

If a coloboma involves the retina and choroid what other conditions or syndromes can it be associated with?

A

associated with basal encephalocele, cleft palate, and CHARGE syndrome)

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36
Q

Is eyelid coloboma associated with closure of the embryonic fissure?

A

No

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37
Q

What do you call a small, abnormal eye with cystic expansion extending postioerly into the orbit?

A

Microphthalmos with cyst

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38
Q

Where does the cyst in microphthalmos with cyst typically arise?

A

Arises in area of and external to a choroidal coloboma

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39
Q

What kind of tissues are contained in the cyst with microphthalmos with cyst?

A

cyst usually contains dysplastic neuroectodermal tissue and may not directly connect with the eye

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40
Q

T/F: an optic pit is a coloboma?

A

True, an optic pit is considered an atypical coloboma

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41
Q

What abnormality is associated with optic pit?

A

basal encepholocele

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42
Q

Through wich structure does the hyaloid artery enter the eye?

A

embryonic fissure

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43
Q

What stucture does the hyaloid artery form?

A

vasa hyaloidea propria

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44
Q

what does the vasa hyaloidea propria supply blood to?

A

primary vitreous

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45
Q

At what gestational age does the intravitreal portion of the hyaloid artery regress?

A

8.5 months

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46
Q

What does the intraneural portion of the hyaloid artery form?

A

central retinal artery

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47
Q

What supplies blood flow to the posterior lens in embryologic development?

A

Posterior tunica vasculosa

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48
Q

At what gestational age does retinal vscular devlopement begin?

A

16th week

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49
Q

what cell type located next to the hyaloid artery form capillary network, then form arteries and veins

A

mesenchymal cells

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50
Q

in what pattern do retinal vessels grow?

A

vessels grow centrifugally from optic disc

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51
Q

When do retinal blood vessels reach the ora serrata?

A

Nasal: 8 months

Temporal: 1-2 months later

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52
Q

what percentage of normal neonates have a patent hyaloid artery?

A

3%

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53
Q

Name the 4 remnants of hyaloid vasculature system

A
  1. Bergmeister Papillae
  2. Peripapillary Loop
  3. Mittendorf’s Dot
  4. Peristent Pupillary membrane
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54
Q

Where is a Bergmeister papillae located?

A

At the optic nerve head

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55
Q

Describe how the bergmeister papillae interacts with the hyaloid artery-glial sheath of Bergmeister envelops posterior third of hyaloid artery and begins to atrophy during 7th month

A

glial sheath of Bergmeister envelops posterior third of hyaloid artery and begins to atrophy during 7th month

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56
Q

What is seen if the glial sheath of the bergmeister papillae does not fully regress?

A

epipapillary veil

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57
Q

From what structure does the peipapillar loop extend?

A

optic nerve head

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58
Q

What ocular conditions is one at increased risk for if a Peripapillary loop is present?

A

risk of artery obstruction or vitreous hemorrhage

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59
Q

Where is a mittendorf’s dot located?

A

at the posterior lens capsule

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60
Q

what does the mittendorf’s dot represent?

A

location where the hyaloid artery is attached to posterior tunica vasculosa lentis

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61
Q

what does a persistent pupillary membrane represent?

A

remnants of anterior tunica vasculosa lentis

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62
Q

Which cells eventually form the optic disc?

A

Primative epithelial papillae- cells from inner layer of optic cup at superior end of embryonic fissure

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63
Q

Axons of which cell type grow through the primartive epithelial papillae?

A

ganglion cells

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64
Q

Does myelination of the optic nerve start centrally or peripherally?

A

centrally

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65
Q

At what gestational age does myelination of the optic nerve reach the chiasm?

A

7.5 months

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66
Q

At what gestational age does myelination of the optic nerve reach the lamina cribrosa?

A

birth

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67
Q

At what gestational age is myelination of the optic nerve complete?

A

approximately 1 month after birth

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68
Q

What is the embronic structure that is contiguous with the retinal ILM that covers the optic nerve?

A

Inner limiting membrane of Elschnig

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69
Q

Why can newborns optic nerves appear exaggeratedly cupped initially?

A

ON may show deceptively exaggerated cupping because nerve fibers posterior to lamina cribrosa are incompletely myelinated at birth

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70
Q

What systemic condition is associated with optic nerve hypoplasia?

A

DeMorsier’s Syndrome

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71
Q

What percentage of patient’s with DeMorsier’s Syndrome have pituitary abnormalities?

A

13%

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72
Q

Which 3 ocular strutures produce the vitreous?

A
  1. lens
  2. retina
  3. walls of the hyaloid artery
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73
Q

What type of embyonic cells are contained in the vitreous?

A

mysechymal cells

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74
Q

What forms the primary vitreous?

A

hyaloid vascular system

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75
Q

what blood vessels system make up the hylaloid vascular system (aka vasa hyaloidea propria)?

A

hyaloid canal

hyaloid vessels

posterior portions of tunica vasculosa lentis

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76
Q

What eventually replaces the primary vitreous?

A

secondary vitreous

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77
Q

What is the disease state caused by failure of the primary vitreous to regress?

A

persistent hyperplastic primary vitreous (PHPV)

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78
Q

By which ocular structure is the secondarty vitreous formed?

A

the retina

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79
Q

What is the name of the area that extends from the disc into the vitreous?

A

Area of Martegiani

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80
Q

What does the Area of Martegiani become?

A

Cloquet’s canal

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81
Q

What is does Cloquet’s canal represent?

A

junction of primary and secondary vitreous

82
Q

What ocular strutures important to cataract surgery make up the tertiary vitreous?

A

zonule fibers

83
Q

Which ocular structures from the tertiary vitreous?

A

ciliary processes and lens capsule

84
Q

Name the embryologic space directly behind the lens

A

Berger’s space

85
Q

Of which embryologic tissue is teh retina derived?

A

neuroectoderm

86
Q

When does retinal vascularization begin?

A

4 months

87
Q

Which area of the retina is the last to become vascularized?

A

termporal periphery

88
Q

At what age is development of the fovea complete?

A

4 weeks after birth

89
Q

What is the condition called in which there is an abnormal proliferation of developing retina produces tubular structures with a rosette-like appearance?

A

Retinal dysplasia

90
Q

How does retinal dysplasia occur?

A

It is a nonspecific response to disorganizing influence during development

91
Q

There are 8 conditions associated with retinal dysplasia, name at least 4 of them

A
  1. materal LSD use
  2. Patau syndrome (trisomy 13)
  3. microphthalmos
  4. congenital gluacoma
  5. Peter’s anomaly
  6. uveal and optic nerve colobomas
  7. cycloplia
  8. synophthalmia
92
Q

What ocular structure/cell type does the choroid require for development?

A
93
Q

From which embryologic tissue is the stromal choroid derived?

A

neural crest cells

94
Q

From which embrologic tissue is the vascular endothelium derived?

A

mesoderm

95
Q

From which embryologic tissue are choroidal blood vessel walls derived?

A

neural crest cells

96
Q

From which embryologic tissues is the scelra derived?

A

nerual crest cells

mesoderm (temporal aspect)

97
Q

Why do babies have a blueish hue to their sclera at birth?

A

due to thinness (seeing the underlying uveal pigment)

98
Q

From which embryologic tissue is the cornea derived?

A

neural crest cells (2 waves)

99
Q

Between which 2 ocular tissues does the first wave of neural crest cell migration occur to form a duble layer of corneal endothelium?

A

epithelium and the lens

100
Q

Between which two ocular tissues does the 2nd wave of neural crest migration occur?

A

epithelium and endothelium

101
Q

The second wave of neural crest cell migration in conreal formation is rich in which biochemicals?

A

hyaluonic acid and collagen fibrils

102
Q

At which gestational age does Descemet’s membrane develop?

A

4 months

103
Q

At which gestational age does Bowman’s membrane develop?

A

5 months

104
Q

From which embryologic tissue is the angle derived?

A

neural crest cells from peripheral cornea differentiate into chamber angle

105
Q

At which gestational age does the angle develop?

A

7th week

106
Q

At which gestational age does Schlemm’s canal develop?

A

4th month

107
Q

At which gestational age does the angle move posteriorly?

A

7th month

108
Q

At which gestational is the formation of the angle complete?

A

8th month

109
Q

At which gestational agedoes the trabecular meshwork appear?

A

just before birth

110
Q

At which gestational age does the lens begin to form?

A

27 days

111
Q

What tissues begin to form the lens?

A

surface ectoderm adjacent to optic vesicle enlarges to form lens placode

112
Q

Describe the steps involved in the development of the lens outlined in the drawing:

A
  1. Circular indentation occurs on lens plate, forming lens pit, which invaginates the wall of the optic vesicle until it closes to form a sphere
  2. Basement membrane of the surface ectoderm forms the surface of the sphere (the lens vesicle) and subsequently becomes the lens capsule
  3. Lens epithelial cells on posterior aspect of this sphere elongate and migrate first (primary lens fibers)
  4. At 7 weeks, anterior cells migrate toward equator and proliferate to form secondary lens fibers that encase the embryonal nucleus and form the Y sutures
113
Q

At what gestational age do the posterior lens epithelial cells fill the core of the lens to form the embryonal nucleus?

A

40 days

114
Q

What do the Y sutures represent?

A

the meeting of embryonal and fetal nuclei

115
Q

Describe the orientation of the “Y” of the Y suture in the anterior lens and posterior lens

A

upright anteriorly, inverted posteriorly

116
Q

At which gestational age does the lens placode form?

A

3 weeks

117
Q

From which embryologic tissue does the lens placode form?

A

surface ectoderm

118
Q

At which gestational age does the lens vesicle form?

A

6 weeks

119
Q

Further development of the lens vesicle requires which ocular tissue to be normal to proceed?

A

Normal neuroretina

120
Q

At which gestational age does the tunica vasculosa lentis form?

A

12 weeks

121
Q

At which gestational age does the tunica vasculosa lentis degenerate?

A

28-38 weeks

122
Q

Why would the anterior chamber of a newborn appear more shallow than an adult?

A

Lens of a newborn is more spherical than that of an adult

123
Q

How does the iris form?

A

rim of optic cup grows around lens and forms iris

124
Q

From which embryologic strucutre does the Iris pigment epithelium develop?

A

from inner and outer layers of the optic cup

125
Q

Describe the pigmentation status of the anterior and posterior iris pigment epitheliumanterior pigmented and posterior nonpigmented

A

anterior pigmented and posterior nonpigmented

126
Q

From which embryologic tissue do the IPE layers develop?

A

neuroectoderm

127
Q

Iris pigment epithelium forms which important ocular divide?

A

blood-aqueous barrier

128
Q

At which gestational age does the iris stroma form from neural crest cells?

A

7th week

129
Q

At which gestational age does the sphincter and dilator muscles form?

A

7th week

130
Q

From which embryologic tissues are the sphincter and dilator muscles derived?

A

neuroectoderm

131
Q

At which gestational age blood vessels enter the iris?

A

7th month

132
Q

At which gestational age does the tunica vaculosa lentis disappear?

A

9th month

133
Q

What color is the typical pigmentation of the newborn iris?

A

grey-blue

134
Q

How does the final color of the iris develop?

A

stromal chromatophores (dendritic melanocytes from neural crest) complete their migration into uvea shortly after birth

135
Q

Why do newborns have relative miosis in infancy?

A

Iris dilator muscle is immature

136
Q

which two tissues form the outer layer of the optic cup?

A

RPE and posterior iris pigment epithelium

137
Q

why does the outer layer of the optic cup have matuer pigmentation?

A

pigment granules develop very early in gestation

138
Q

when does the formation of the ciliary body begin?

A

3rd month

139
Q

what becomes the epithelial layers of the ciliary processes?

A

folds in the optic cup

140
Q

At which gestational age do ciliary body filaments from surface cells form zonules; the major arterial circle of the iris (located in CB), the longitudinal ciliary muscle, and the ciliary processes develop?

A

4th month

141
Q

At which gestational age does the pars plana, ciliary body stroma and ciliary muscle develop?

A

5th month

142
Q

From whcih embryologic tissues does the paras plana, ciliary muscle and ciliary body stroma develop?

A

neural crest cells adjacent to cornea

143
Q
A
144
Q

At which gestational age do the circular fibers of the ciliary muscle differentiate?

A

7th month

145
Q

How can you tell how old a person is by looking at their ciliary body?

A

Patient’s age can be determined by analysis of CB cellularity

146
Q

At which gestational age does the nasolacrimal system begin to develop?

A

6 weeks

147
Q

What is the first sign of the formation of the nasolacrimal system?surface ectoderm is buried in mesoderm, between maxillary and lateral nasal processes

A

surface ectoderm gets buried in mesoderm, between maxillary and lateral nasal processes

148
Q

At what gestational age does the nasaolacrimal system canalize?

A

3rd month

149
Q

What defects can result from problems in canalization of the nasolacrimal system?

A

may result in imperforate valve of Hasner; rarely, absent puncta or canaliculi

150
Q

At what gestational age does the eyelids begin to form?

A

8 weeks

151
Q

The fusion of which tissues form the upper eyelids?

A

medial and lateral frontonasal processes

152
Q

The fusion of which tissues form the lower eyelids?

A

maxillary processes and medial nasal processes

153
Q

At what gestational age do eyelid folds fuse?

A

12 weeks

154
Q

At what gestational age do eyelids begin to seperate?

A

24 weeks

155
Q

do eyelids begin to seperate from the nasal or lateral side?

A

nasal

156
Q

From which embryologic tissue does the sensory retina develop?

A

Neural ectoderm

157
Q

From which embryologic tissue does the RPE develop?

A

Neural ectoderm

158
Q

From which embryologic tissue does nonpigmented ciliary body epithelium develop?

A

Neural ectoderm

159
Q

From which embryologic tissue does the the pigmented CB epithelium develop?

A

Neural ectoderm

160
Q

The pigmeneted CB epithelium is an extension of which tissue?

A

RPE

161
Q

From which embryologic tissue does the IPE develop?

A

Neural ectoderm

162
Q

From which embryologic tissue does the iris sphincter and dilator muscle develop?

A

neural ectoderm

163
Q

From which embryologic tissue does the optic nerve (glial and neural elements) develop?

A

Neural ectoderm

164
Q

From which embryologic tissue does the sympathetic ganglion and lateral geniculare body develop?

A

neural ectoderm

165
Q

From which embryologic tissue does ocular pigment granules develop? (RPE, CB, IPE)

A

neural ectoderm

166
Q

From which embryologic tissue do the peripheral nerves related to eye function develop?

A

neural ectoderm

167
Q

From which embryologic tissue do the erector pili muscle associated with hair follicles of the skin develop?

A

neural ectoderm

168
Q

From which embryologic tissue does the crystalline lens develop?

A

Surface ectoderm

169
Q

From which embryologic tissue does the corneal and conjunctival epithelium develop?

A

surface ectoderm

170
Q

From which embryologic tissue does the eyelid epithelium develop?

A

surface ectoderm

171
Q

From which embryologic tissue does the lacrimal gland develop?

A

surface ectoderm

172
Q

From which embryologic tissue does the nasolacrimal system develop?

A

surface ectoderm

173
Q

From which embryologic tissue does the vitreous develop?

A

surface and neural ectoderm

174
Q

From which embryologic tissue do the zonules develop?

A

surface and neural ectoderm

175
Q

From which embryologic tissue does the corneral stroma and endothelium develop?

A

neural crest cells

176
Q

From which embryologic tissue does the iris stroma develop?

A

neural crest cells

177
Q
A
178
Q

From which embryologic tissue does the trabecular meshwork develop?

A

neural crest cells

179
Q

From which embryologic tissue does Schlemm’s canal develop?

A

neural crest cells

180
Q

From which embryologic tissue does the sclera (except temporal portion) develop?

A

neural crest cells

181
Q

From which embryologic tissue does the sheaths and tendons of extraocular muscles develop?

A

neural crest cells

182
Q

From which embryologic tissue does the ciliary muscle (nonpigmented layer of the ciliary body) develop?

A

neural crest cells

183
Q

From which embryologic tissue does the choroidal stroma develop?

A

neural crest cells

184
Q

From which embryologic tissue do melanocytes develop?

A

neural crest cells

185
Q

From which embryologic tissue domeningeal sheaths develop?

A

neural crest cells

186
Q

From which embryologic tissue dothe orbital bones develop?

A

neural crest cells

187
Q

From which embryologic tissue does the connective tissue of the orbit develop?

A

neural crest cells

188
Q

From which embryologic tissue do the musclar and connective tissue layers of the blood vessels develop?

A

neural crest cells

189
Q

What stain is specific for neural crest derived structures?

A

S-100 stain

190
Q

What what gestational age do the 3 waves of Neural crest cell migration occur?

A

7th week

191
Q

Name 3 ocular structures that are forme dby the waves of neural crest cell migration

A
  1. corneal and TM endothelium
  2. keratocytes (corneal stroma)
  3. iris stroma
192
Q

Name the 5 conditions that can be caused by abnormal neural crest migration.

A
  1. congenital glaucoma
  2. posterior embryotoxin
  3. Axenfield-Reiger syndrome
  4. Peter’s anomaly
  5. sclerocornea
193
Q

Which ocular syndromes result from an abnormal proliferation of neural crest cells?

A

iridocorneal endothelial (ICE) syndromes

194
Q

Which ocular conditions result from an abnormal terminal induction of neural crest cells?

A

corneal endothelial dystrophies

195
Q

From which embryologic tissue does the blood vessel endothelium develop?

A

mesoderm

196
Q

From which embryologic tissue does the anterior chamber angle outflow apparatus develop?

A

mesoderm

197
Q

From which embryologic tissue does the small temporal area of the sclera develop?

A

mesoderm

198
Q

From which embryologic tissue do the extraocular muscles develop?

A
199
Q

From which embryologic tissue does the primative connective tissue develop?

A

mesenchyme

200
Q

From which embryologic tissues does mesenchyme originate?

A

neural crest cells and mesoderm

201
Q

Reference of timeline for Ocular Development:

A

Friedman's Ophthalmology (12 decks)

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