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Embryology Flashcards

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1
Q

Stages of first trimester

A

Embryogenic(14-16 days)

Embryonic(16-50 days)

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2
Q

Embryogenic stage function

A

Determine pluripotent embryonic cells and extraembryonic cells

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3
Q

Embryonic stage function

A

Determine germ layers and differentiate tissue layers

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4
Q

What is foetal stage

A

50-270 days

Migration of organs to final position
Extensive growth and foetal viability

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5
Q

What does the ovulated oocyte become

A

Zygote
Embryo
Morula
Blastocyst

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6
Q

Maternal to zygotic genome transition

A

Before 4 cell stage: embryo is dependent on maternal mRNA and proteins

4-8 cell stage: zygotic genome activation

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7
Q

What is pluripotent embryonic cells and extraembryonic cells made of

A

Pluripotent embryonic cells->inner cell mass

Extraembryonic cells->trophoectoderm

Blastocoel is fluid filled cavity from trophoblasts pumping Na into cavity

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8
Q

How and when does implantation occur

A

Day 7-9
Trophoblasts fuse->syncitiotrophoblast
Invades and destroys maternal cells in endometrium

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9
Q

What does inner cell mass separate into

A

Epiblast->foetal tissue

Hypoblast->yolk sac

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10
Q

When and how does bilaminar embryonic disc formation occur

A

Day 12+
Epiblasts separate->form amniotic cavity
Amnion cells contribute to extraembryonic membrane
2 layered disc of epiblast and hypoblast between cavities

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11
Q

What is gastrulation

A

Occurs after bilaminar disc formation
Formation of primitive streak: head/tail and left/right axes
Invagination of cells into primitive streak: endoderm, mesoderm, ectoderm

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12
Q

What is notochord and when does it form

A

Day 13+
Rod-like structure along embryo midline
Organising centre for neurulation and mesoderm development

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13
Q

Process of neurulation

A

Notochord signals->neural plate invagination->neural groove
2 neural folds form along craniocaudal axis
Neural crest cells reside in neural folds
Neural folds move over neural groove, fusing and forming a hollow tube
Neural tube overlaid with epidermis
Crest cells migrate from neural folds

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14
Q

When does neural tube close

A

Head: day 23
Tail: day 27

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15
Q

Failure to close neural tube

A 
Anencephaly(head fail)
Spina bifida(tail fail)
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16
Q

What is somitogenesis

A

Formation of somites(paired blocks of paraxial mesoderm)

Blocks of somites condense and bud off

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17
Q

What are some somite derived tissue

A

Sclerotome->vertebrae and rib cartilage

Dermomyotome->muscles and skin

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18
Q

When and how does gut tube form

A

Day 16+
Lateral and ventral folding
Pinches off part of yolk sac

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19
Q

When and how does heart form

A

Day 19
From mesoderm
Starts pumping at day 22
Foetal heartbeat at week 6

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20
Q

When and how do lungs form

A

From endoderm in week 4

Lung splits and progressively branches

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21
Q

How do gonads form

A

From mesoderm
XX: gonadal cells become granulosa cells
XY: gonadal cells become sertoli cells

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22
Q

Causes of early pregnancy loss

A

Embryo-foetal development errors
Implantation failure
Inability to sustain development

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23
Q

Miscarriage classification

A

Early: <12 weeks
Late: >23 weeks

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24
Q

Aneploidy mechanism and causes

A

Maternal age

Cohesin that holds homologous chromosomes together is not replaced ->chromatids separate and drift

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25
Cause of recurrent pregnancy loss/miscarriage
Lif deficiency->implantation failure
26
Types of gestational trophoblastic disease(GTD)
Benign: hydatidiform moles-> complete(empty egg) or partial(normal egg) Malignant: gestational trophoblastic neoplasia
27
Gene mutation causing recurrent hydatidiform moles
NLRP7
28
Main location for ectopic pregnancy
Fallopian tube
29
Ectopic pregnancy treatment
Expectant management Chemotherapy Surgery->remove trophoblast and/or tube
30
How does smoking affect ectopic pregnancy
Cotinine:increase PROKR1 expression-> fallopian tube smooth muscle contractility dysregulated Cotinine: induce proapoptosis protein Tobacco smoke inhibits ciliary function
31
How does cannabis affect ectopic pregnancy
CB1 receptor expression reduced Endocannabinoid levels higher THC hinders embryo transit
32
Difference between first and second trimester nutrition
1st: histiotrophic->uterine gland secretions and breakdown of endometrium 2nd: haemotrophic->maternal blood contacts foetal membranes
33
Origins of placenta
Ammion Chorion(outer membrane) Connecting stalk(embryo to chorion) Trophoblastic lacunae
34
What is trophoblastic lacunae
Large spaces filled with maternal blood from breakdown of maternal capillaries Becomes intervillous spaces
35
What is amnion
Inner foetal membrane Forms a closed avascular sac Secretes amniotic fluid->protect foetus
36
What is chorion
Outer foetal membrane Highly vascular Gives rise to chorionic villi
37
What is allantois
Outgrowth of yolk sac Grows along connecting stalk Coated in mesoderm and vessels to become umbilical cord
38
Formation of chorionic villi
Outgrowths of cytotrophoblast into syncitiotrophoblast layer Undergo branching Convolution and dilation->slows blood flow to enable exchange
39
Spiral artery remodelling
Undergo conversion Extravillus trophoblast(EVT) invade maternal spiral arteries Endothelium and smooth muscle broken down EVT coats inside of vessels
40
Important points of nutrient exchange
Calcium: actively transported Amino acids: reduced maternal urea excretion, active transport to foetus
41
Stages of labour
1: contractions start, cervix dilates 2: delivery of foetus, maximal myometrial contractions 3: placenta delivery, post partum repair
42
How does cervix retain foetus in uterus
High connective tissue content provides rigidty and is stretch resistant
43
What happens during ripening of cervix
Monocyte infiltration IL-6, IL-8 Hyaluronan deposition
44
What happens during cervix dilation
Raised hyaluronidase | Raised MMPs
45
Initiation of labour
Foetal CRH rises High ACTH->high cortisol->placental CRH production->positive feedback Switch from activating to repressing progesterone receptor Uterus blind to progesterone, sensitise to oestrogen Stretch receptors->Ferguson reflex-> oxytocin
46
Oxytocin function in labour
Raise connectivity of myocyte in myometrium Destabilise membrane potential->lower threshold for contraction Liberates Ca stores
47
Prostaglandin functions in labour
Leukocyte recruited, IL release->cervix remodelling Myocyte connectivity->myometrial contractions Lower uterine relaxation
48
How does placental expulsion occur
Foetal membranes fold and peel off endometrium Haematoma forms between decidua and placenta Uterus remains contracted->uterine vessel thrombosis
49
Pre-eclampsia diagnosis
New onset hypertension >20 weeks gestation Reduced foetal movement/amniotic fluid volume by 30%
50
Pre-eclampsia subtypes
Early onset(10%): <34 weeks, foetal and maternal symptoms, placental changes Late onset(90%): >34 weeks, maternal symptoms, little placental changes
51
Pre-eclampsia risk factors
``` Previous pregnancy with PE BMI>30 Age>40 Hypertension Comirbidities: diabetes, PCOS, renal, autoimmune ```
52
Pre-eclampsia prognosis
Mother: Systemic damage(liver/kidneys/brain) Eclampsia(seizures, unconsciousness) Placental abruption Foetus: Reduced growth Premature birth Pregnancy loss
53
Pre-eclampsia pathophysiology
EVT invasion limited to decidual layer Spiral arteries not extensively remodelled Placental perfusion limited
54
Pre-eclampsia investigations
PLGF: proangiogenic so low->risk if premature delivery Flt-1/PLGF ratio: Flt-1 is antiangiogenic so >38 -> risk of PE
55
Pre-eclampsia management
<34 weeks: maintain pregnancy >37 weeks: deliver Antihypertensive Corticosteroids for <34 for foetal lung development
56
Pre-eclampsia prevention
Weight loss Exercise throughout pregnancy Aspirin for high risk individuaks
57
Primitive reflexes(infant)
Moro reflex: neck extension->arm moves Standing reflex Grasp reflex Parachute reflex
58
4 Domains of infant development
Gross motor skills Fine motor skills Speech/language skills Social skills
59
Gross motor skills red flags
Head control 4m Unsupported sit 9m Independent stand 12m Independent walk 18m
60
Fine motor and vision red flags
Follows object 3m Reaches for objects 6m Transfers 9m Pincer grip 12m
61
Speech and language red flags
Polysyllabic babble 7m Consonant babble 10m 6 words with meaning 18m 3 word sentences 2.5 years
62
Social red flags
``` Smiles 8w Fear of strangers 10m Feeds self 18m Symbolic play 2.5y Interactive play 3.5y ```
63
Healthy child programme
Screening: newborn bloodspot, hearing and physical, vision(4-5y) General examination/immunisation: 6-8w, 1y, 2y reviews Health education/promotion
64
Causes of global developmental delay
``` Down syndrome Fragile X Hypothyroid Infection, drug, toxin, folate deficiency Environmental social Chronic illness ```
65
Causes of motor development delay
``` Cerebral palsy Duchenne’s muscular dystrophy Spina bifida Hydrocephalus Congenital hip dislocation ```
66
Causes of language development delay
``` Hearing loss Developmental dysphasia Stammer, dysarthria Learning disability Autism ```
67
Developing brain dorsal view
Prosencephalon(fore) Mesencephalon(mid) Rhombencephalon(hind)
68
Developing brain flexures
Cephalic Pontine Cervical
69
Which germ layer are neural crest cells derived from
Ectoderm
70
Neural crest cells and final structure
Cranial: face and cranial neurons Cardiac: aortic arch, large arteries Trunk: sympathetic ganglia, melanocytes, adrenal medulla Vagal & sacral: parasympathetic and enteric ganglia

Y2 (10 decks)

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