Embryology Flashcards

(387 cards)

1
Q

What are the prerequisites for development ie to increase in size and complexity

A

Capacity to increase cell number

Capacity for differentiation

Capacity to organise in long range structures

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2
Q

What is menstrual age

A

From the first day of last menstrual period

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3
Q

What is conceptual/ fertilisation age (used most in lectures l)

A

Timing from first day of fertilisation

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4
Q

When are the foetal and embryonic stages?

A

Embryonic: first 2 months
Foetal: last 7 months

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5
Q

What are the Carnegie stages

A

A standardised system of 23 stages of development based upon anatomical features in the embryonic phase

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6
Q

What happens on day 0

A

Fertilisation

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7
Q

When is implantation

A

Day 7

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8
Q

When does gastrulation occur

A

Day 14

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9
Q

When is the beginning of neurogenesis

A

Day 16

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10
Q

When is the first functioning organ formed

A

Day 22 when the heart begins to beat

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11
Q

When does neural tube close occur

A

Day 27

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12
Q

When is quickening? What does this mean?

A

Day 112/ Week 16

Mother begins to feel movements of the foetus

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13
Q

When does the foetus become viable

A

Day 161/ week 23

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14
Q

Over which weeks does gastrulation and neurogenesis occur

A

3-8

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15
Q

Where does fertilisation occur and what does it result in

A

In the Fallopian tube forming a zygote

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16
Q

What happens day 3 (how many cells)

A

8 cell stage: embryo activates the genome (embryonic genome activation (EGA))

On day 4 compaction occurs and intercellular signalling begins

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17
Q

What does the first lineage decision establish

A

The trophoblast and inner cell mass

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18
Q

What does the second lineage decision make

A

Pluripotent epiblast and extraembryonic hypoblast

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19
Q

What does the hypoblast give rise to

A

The yolk sac

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20
Q

What happens days 6-7

A

Embryo hatches from zona pellucida and is now ready for implantation

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21
Q

Give the 3 populations in the late blastocyst

A

Epiblast
Hypoblast
Trophoblast

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22
Q

What is implantation

What kind of implantation do humans undergo

A

Attachment of late blastocyst to the uterus

Interstitial implantation with the blastocyst penetrating the endometrial lining

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23
Q

What does the epiblast specify and form

A

Amnion, forming the amniotic cavity and gives rise to the embryonic disc

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24
Q

What happens to hypoblasts

A

Expand and form the primary and secondary yolk sac

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25
What does trophoblast diversify into
Cytotrophoblast and syncytiotrophoblast
26
What are lacunae
Cavities in the syncytiotrophoblast, which play an important role in embryo nutrition prior to development of the placenta
27
3 germ layers?
Ectoderm - outermost layer Mesoderm- middle layer Endoderm- innermost layer
28
What is induction
One cell type (the inducer) induces the fate of another cell type (responder)
29
What coordinates gastrulation
Hypoblast
30
What does the ectoderm form
Skin and nervous system
31
What does the mesoderm form
Muscles, connective tissue, bones and circulatory system
32
What does the endoderm form
Digestive and respiratory system + other internal organs
33
What is the gut formed from
The inner of the 3 concentric tubes generated when the 3D embryo is formed (ie the endoderm)
34
What does the gut tube initially consist of
Blind ending tubes at the cranial and caudal ends and a central portion, the midgut that still connects to the yolk sac
35
Where does the foregut terminate
The buccopharyngeal membrane (which goes on to form the mouth and nose)
36
Where does the hind gut end
The cloacal membrane
37
What does the cloacal membrane go on to form
urogential and rectum
38
What forms the thoracic part of the foregut
The stomach
39
Which side of the stomach grows faster
The dorsal wall grows faster than the ventral wall resulting in the ventral lesser curvature and dorsal greater curvature
40
What happens after the curvature of the stomach is formed
It undergoes a 90 degree rotation about the cranio-caudal axis so that the greater curvature lies on the left and the two branches of the vagus nerve that were left and right now lie anterior and posterior respectively There is an additional tilting caudally which orientates the great curve so that is inferior
41
What is formed as a result of stomach rotation
The lesser sac
42
Discuss pyloric stenosis
3/1000 affected Male babies 2-8 weeks most at risk Symptoms: forced projectile vomiting leading to severe dehydration Requires surgery
43
Where does the hepatic diverticulum sprout from What happens next
The duodenum into the ventral mesentery Interacts with the surrounding septum transversum mesenchyme
44
What does the liver bud require
An indicative signal from the heart mesoderm
45
How do we know that heart mesoderm is essential for inducing liver development
If early pre liver endoderm is explanted with Pre liver mesoderm alone, no liver differentiates but with both pre-heart and - liver mesoderm, well formed hepatic cords develop
46
What are the signals from the heart mesoderm to the developing liver
Growth factors eg FGF1 and FGF2 Also promote liver specific gene transcription by blocking inhibitory factors present in the endoderm
47
What happens after hepatic specification
Endothelial cells intercede between hepatic endoderm cells and the septum transversum mesenchyme. They promote the morphogenesis phase of organogenesis
48
What happens in the morphogenesis phase of hepatic development
Hepatogenic cells multiply and migrate into the septum transversum mesenchyme to develop the liver bud and ducts
49
What happens to the lateral plate mesoderm surrounding the newly formed liver bud
Becomes the supporting stroma
50
What is the cystic diverticulum
It sprouts from the base of the hepatic bud and forms the gall bladder and cystic duct
51
Give an overview of the development of the pancreas
Forms from 2 buds: dorsal (forms first) and ventral (grows more slowly) Buds are induced by endoderm, adjacent mesoderm and ectoderm (eg notochord) allowing them to emerge and develop Then first pancreatic-specific genes (eg Pdx1) are expressed Exocrine and endocrine tissue is formed 2 buds eventually fuse when the smaller ventral bud migrates round and meets the dorsal bud
52
What does exocrine pancreatic tissue produce
Amylase and α- fetoprotein
53
What does endocrine pancreatic tissue produce
Insulin Glucagon Somatostatin
54
What regulates the ratio of exo to endocrine cells
Follistatin which is secrete by the pancreatic mesenchyme
55
What forms the uncinate process
The pancreatic ventral bud
56
What is an annular pancreas Give a complication and it’s incidence
If the ventral bud is duplicated migrating lobes can encircle the duodenum Affects 1/7000 people May result in narrowing or constriction of duodenum
57
Why does herniation occur in gut development
The extensive growth of the midgut, especially the ileum, leads to it growing faster than the abdomen and the primary intestinal loop formed is forced out into the umbilical cord, carrying with it the superior mesenteric artery
58
What happens to the developing herniated loop
Rotates 90 degrees anti-clockwise (programmed by left right organisation) The continued lengthening of the duodenum and the jejunum gives rise to a series of folds and the midgut is retracted, rotating a further 90 Finally the caecum moves inferiorly, completing the 270 degree rotation
59
What is omphalocele
When the umbilical ring doesn’t close and the loop of midgut remains outside the abdominal wall in a peritoneal sac
60
What is Mickel’s Diverticulum
Finger like pouch on antemesenteric border of ileum It is a failure of the Vitelline duct to regress completely It may rotate and obstruct
61
What can abnormal gut rotation lead to What is needed to diagnose
Freely suspended coils of intestine prone to torsion or volvulus Barium meal/ enema
62
Where does the kidney develop from What are its 3 phases of development
The intermediate mesoderm Pronephros -> mesonephros -> metanephros
63
When does the urogential ridge begin to form and in what direction
In week 4 in a rostral caudal direction
64
Discuss pronephros development
Begins to develop at day 24 between somites 3-5 with the duct forming between somites 5-7 It is a rudimentary structure in higher vertebrates but is essential for embryonic survival of fish and amphibians It degenerates v rapidly and is never functional in humans
65
Discuss the development of the mesonephros
Differentiates from ~28 days and begins to regress at the cranial end at 5 weeks Never has more than 30 nephrotomes It produces dilute urine
66
Briefly describe metanephros development
Ureteric bud grows out of the mesonephric duct at ~5 weeks and induces formation of the metanephric kidney
67
How do the tubules in the mesonephros form
In cranio-caudal succession Earlier tubules degenerate as later ones form so usually ~30 tubules at any time
68
Is the mesonephros functional
Yes it is functional in the embryo, producing a dilute urine important in maintaining the composition of amniotic fluid
69
How can you show experimentally what induces Kidney development
By artificially placing a barrier between the ureteric bud and surrounding cells to stop movement of secreted proteins stops kidney development
70
Define induction
Alteration of the fate of a cell or tissue by interaction with a second
71
What are the phases of initiation Give a description of each in the context of kidney development
Initiation: signals from metanephrogenic mesenchyme induce growth of ureteric bud Commitment to development: response to inducing signals - proliferation and differentiation of bud and mesenchyme Morphogenesis: in response to signals from mesenchyme bud commences branching morphogenesis, mesenchyme responds by becoming epithelial in nature and forming nephrons
72
Give the 2 key consequences of induction in kidney development
Ureteric branching morphogenesis Epithelial morphogenesis
73
Describe the epithelial morphogenesis in kidney development
The mesenchyme to epithelial transition occurs in response to Wnt expression Formation of S shaped bodies Thins on one side to form glomerulus Fuses with UB tip Extends to form proximal and distal tubules
74
What causes outgrowth of ureteric bud towards metanephrogenic mesenchyme
Production of glial derived neurotrophic factor (GDNF) by MM which binds to the Ret receptor expressed on ureteric buds
75
What does the ureteric bud induce the mesenchyme to do
Condense around the tips of the branching ureteric epithelium and time undergo MET to form renal vesicles
76
What is MET
Mesenchyme to epithelial transition
77
What triggers MET What does this do
Wnt signalling via secretion of Wnt9b from the ureteric tip Upregulates (Fgf8) and Wnt4 production by the MM
78
What does Fgf4 do
Stimulates proliferation of mesenchyme
79
What does Wnt4 do
Regulates formation and differentiation of the comma and S shaped bodies to form renal vesicles
80
What follows induction at the ampulla in kidney development
The bud branches and a nephron forms
81
What is dichotomous branching What does it give rise to from the ureteric bud
Branching that results in the regular form of the kidney It gives rise to the collecting ducts while the surrounding cells wil form the nephron and convoluted tubules
82
When does the mean glomerular number level off Is this the end of kidney development
36 weeks No, nephrogenesis and functional maturation continues after birth
83
What is the differential lineage if nephron cells
There are different lineages; Collecting duct is from the ureteric bud Convoluted tubules and glomerulus from the metanephric blastema
84
Where do renal blood vessels come from
Smaller vessels are derived by vasculogenesis within the kidney Larger vessels were developed by angiogenesis and invaded the kidney from the renal arteries
85
How common is developmental abnormality in the urinary tract Do all cause clinical problems
10% of all new norms No but if the ureteric bud does not reach/ signal properly to mesoderm the kidneys don’t form (agenesis)
86
What are polycystic / dysplastic kidneys
Kidneys whose tubules failed to form correctly and may continue to proliferate Bifurcated ureters may also occur due to defects in induction
87
What is the mean globular number at 15 and 40 weeks and then in the adult How does this relate to disease
15:15000 40: 740000 Adult: 617000 (declines with age) Related to risk of hypertension Genetically induced reduction in nephron number in mice is associated with high blood pressure Number of nephrons is strongly related to birth weight
88
How are nephron number and birth weight related
Babies with birthweight below 10th percentile have 30% fewer nephrons This is the developmental programming hypothesis
89
What happens after the mesonephric duct and ureteric bud enter the urogential sinus
In the Male the mesonephric duct migrates inferiorly to enter urethra Asia has deferens But regresses in females Ureteric bud grows and elongates to become ureter and the portion closest to the urogential sinus splays out to generate posterior bladder wall
90
What is the trigone
The posterior wall of the bladder
91
Discuss the urachus in the foetus
It constitutes the connection between the developing bladder and the allantois, so runs from the bladder to the umbilicus and umbilical cord
92
What happens to the urachus
Normally fibroses after delivery forming the median vesical ligament If this fails a urachal fistula May develop, resulting in urine leaking from the umbilicus
93
Where do the gonads develop
On the medial side of the mesonephric ridge (the urogential ridge)
94
When does te genital ridge firm When do gonads differentiate
5-6 weeks On medial side of mesonephros After 7-8 weeks of gestation Associated with dual ductal system
95
Why is urogential development associated with a dual Ductal system
``` Wolffian (mesonephric) ducts firm first Then Mullerian (paramesonephric) ducts Form laterally ``` Ducts form by invagination of the coelomic epithelium
96
Do primordial germ cells begin at genital ridges
No they migrate by amoeboid movement from the hindgut along the dorsal mesentery around weeks 4-6 They are guided by chemitaxis
97
What does sex determination depend upon
Presence or absence of Y chromosome
98
What allows Y and X to pair at meiosis
Y retains homology with X at telomeres as they arose from a common ancestor
99
What are the gonadal and somatic sex structures in males
Gonadal: testis Somatic: penis, scrotum, prostate, vasa
100
What are the gonadal and somatic sex structures in females
Gonad: ovary Somatic: clitoris, vagina, uterus, oviducts
101
Where is SRY located What does this position allow
Near the end of the short arm of Y Allows SRY to be exchanged in crossover events between X-Y or completely lost Exchange can lead to sex reversal
102
What are the 3 phases of limb development
Limb bud outgrowth and patterning Morphogenesis Growth
103
What do limb buds consist of
A core of loose Mesenchyme and and an ectodermal layer
104
What is the AER
The apical ectodermal ridge A thickening of ectoderm the tip of the developing limb Plays a critical role in outgrowth
105
What does removal of the AER do
Leads to a truncated limb The earlier the AER is removed the less developed the limb is This suggests AER produces a signal promoting proximal distal development of the limb
106
What happens if a chick’s AER is grafted onto the lower limb bud in place of leg AER Give another example to prove the same effect
Bud will still produce a leg Mouse AER can substitute for chick AER
107
Which is the important protein secreted by the AER How do we know this
FGF8 If AER is replaced by bead of FGF8 an almost normal limb still develops
108
What is FGF4
Works similarly to FGF8 and is expressed in posterior AER
109
Why does older mesenchyme give more distal structures?
The structures formed depend on the length of time exposed to FGF Cells close to the FGF source remain undifferentiated and don’t differentiate until out of reach of FGF Cells exiting first form proximal structures, cells exposed for longest form distal structures
110
What is SHFM
Split Hand Foot Malformation Rare limb condition linked to AER failure
111
Discuss thalidomide’s effect on development
Prevents proliferation of cells in progress zone so cells are exposed to FGF for longer and develop as more distal structures (phocomelia - a loss of proximal limb structures)
112
Where is the AER located
Boundary between dorsal and palmar on limb bud
113
How is dorsal palmar patterning coordinated
Ectoderm produces signals to confer dorsal/ palmar information Wnt7a is produced by dorsal part only. This diffuses into the mesoderm where it induces expression of genes that coordinate dorsal fates
114
Describe 2 experiments showing the importance of Wnt7a and the ectoderm in dorsal palmar development
If ectoderm is removed and replaced back to front, hand develops back to front If Wnt7a is removed in mouse embryos, double ventral limbs develop
115
What happens if you graft the posterior zone of one limb into the anterior of another limb
It leads to a limb with mirror image duplication of digits This is affected by position of graft, which suggests the cells produce a diffusible signal and the type of digit formed depends on the concentration of signal that the cell is exposed to
116
What is the morphogen concept
the cells produce a diffusible signal and the type of digit formed depends on the concentration of signal that the cell is exposed to
117
Which signal is important in digit formation and patterning (ZPA) Prove it
Sonic Hedgehog SHH transplantation shows that number and identity of digits formed depends on concentration of SHH
118
What causes polydactyly
Mutated SHH
119
What regulates Hox genes
SHH regulates their expression
120
Discuss Hox genes Which are important for limb development
Found in 4 clusters in mammals (a-d) Hox d
121
What results in syndactyly What is it and how is it treated
Mutated Hox d13 Results in fusion of digits Zig zag incisions to give skin flaps to cover cut region
122
What do the initial phases of skeletogenesis involve in the limbs
Formation of cartilage condensations regulated by GDF5 Bone Initiates in the mesenchyme, GDF5 increases condensation
123
What happens if you abnormally increase GDF5
Abnormal bone growth / thickening
124
What is CGT and CHTT
Chondrodysplasias Grebe type And Hunter Thompson type Caused by mutations in GDF5 Pronounced shortening of skeletal elements
125
How is cartilage converted to bone
Ossification Growth hormone, thyroid hormones and IGF1 all influence bone growth by acting on germinal zone stem cells FGF3 inhibits growth and promotes differentiation
126
Where is the FGF3 receptor present
Chondrocytes
127
What causes dwarfism
Achondroplasia is associated with an activating mutation in FGF3R
128
What happens if FGF is exposed to the flank
A new limb grows with AER and ZPA
129
What ensures limbs grow in the right place
Tbx5 expression Defects in Tbx5 are associated with Holt Oran syndrome
130
Which limbs position upper and lower limbs
``` Tbx5 = upper Tbx4 = lower ```
131
When does the zygote undergo cleavage What is this
Days 1-5 Cell division in the absence of cellular growth. There is no increase in total cell mass
132
Which part of the fertilised egg is cleavage dependent on
The large cytosolic compartment
133
What happens at day 3
This is the 8 cell stage | Here the human embryo activates the genome
134
What is EGA
Embryonic genome activity
135
When does compaction occur How many cells are there here
Day 4 8
136
When does cavitation occur What also happens here
Day 4-5 The morula becomes the early blastocyst The first lineage decision occurs here
137
What does the first lineage decision establish
Trophoblast and Inner Cell Mass (ICM)
138
What is the trophoblast and what does it give rise to What does the ICM form
An extra embryonic lineage Gives rise to the placenta ICM forms the embryo
139
What happens days 6-7
ICM undergoes 2nd lineage decision The embryo hatched from the zona pellucida
140
at the second lineage decision, what does the ICM differentiate into
The pluripotent epiblast and the extraembryonic hypoblast
141
What does the hypoblast give rise to What about the epiblast
The yolk sac The epiblast is the founding population of the entire foetus
142
When is the embryo ready for implantation
Days 6-7 when the embryo hatched from the zona pellucida
143
The human late blastocyst has established which 3 founding populations
Epiblast Hypoblast Trophoblast
144
What is embryo implantation
Attachment of the late blastocyst to the uterus
145
What kind of implantation do human embryos undergo
Interstitial implantation where the blastocyst penetrates the endometrial lining
146
Where does the amnion come from What related structures are also formed from this
The epiblast specifies the amnion, forms the amniotic cavity and gives rise to a flat embryonic disc
147
What is Heuser’s Membrane
The secondary yolk sac, derived originally from the hypoblast
148
What does the trophoblast mediate
Invasion intro maternal tissue
149
What does the trophoblast diversify into
Cytotrophoblast (proliferative compartment) Syncytiotrophoblast (multinucleate cells)
150
What forms lacunae What is the role of these embryonic lacunae
Cavity formation in the syncytiotrophoblast Embryo nutrition prior to development of the placenta
151
What did Wolpert say of Gastrulation
“It is not birth, marriage, or death, but gastrulation which is truly the most important time in your life”
152
What are the 3 germ layers and when are they established
Ectoderm Mesoderm Endoderm Established during gastrulation
153
Gastrulation is simply the formation of the 3 germ layers. True or false
False Gastrulation also ensures correct positioning of the germ layers as a result of cell differentiation and relocation
154
When does Gastrulation occur
~day 14
155
What coordinates Gastrulation
Hypoblast
156
What happens to the epiblast cells of the embryonic disc in Gastrulation
They delaminate and migrate through the primitive streak in between epiblast and hypoblast
157
What does ectoderm give rise to
Epidermis and nervous system
158
What does the mesoderm give rise to
Muscle Connective tissue Bones Circulatory system
159
What does the endoderm produce
Digestive system Respiratory system Internal organs
160
How many cells are in a morula
~128
161
What are the 2 sections of the blsatocyst
The inner cell mass and trophoectoderm
162
What are the fetal membranes
The amnion Yolk sac Allantois Chorion
163
What is the amnion
A fluid filled sac surrounding the embryo, providing a protective aqueous environment for the developing foetus
164
What is the yolk sac
A highly vascular extra embryonic membrane It provides the nutrient supply prior to the formation of the placenta
165
Where do the first blood cells originate
The yolk sac
166
What is the allantois
An extension the yolk sac into the connecting stalk to act as a source of embryonic blood cells
167
What is the chorion
The fetal component of the placenta | It is highly vascular for gas exchange, waste management, and nutrient transport during fetal growth
168
Are humans diploblastic or triploblastic
Triploblastic - human embryos have 3 germ layers
169
What is a diploblastic animal
Animals whose embryos have only 2 germ layers | Eg Hydra
170
What 2 germ layers do diploblastic animal embryos have
Ectoderm and endoderm
171
How is Gastrulation induced
Induced in the epiblast by the hypoblast through transmission of diffusible peptides
172
How does the embryo specialise
Inside out
173
When is the head tail axis of the embryo defined
Cell migration at the primitive streak
174
What have all embryos acquired by the end of Gastrulation
A body axis with a head and tail end An inside out specialisation with 3 basic layers A left right axis
175
What organises the main body axis
The node or primitive knot
176
What happens if you graft Hesen’s node from a quail embryo to a chick embryo
The chick embryo will have 2 axes: the host axis and the induced axis from the transplanted node
177
Discuss conjoined twins
Identical twins who develop with a single placenta from a single fertilised ovum More common in females (3:1) Mechanism responsible is probably a failure for twins to separate after Gastrulation (day 13)
178
How common are conjoined twins
1 in 40,000 but only 1 in 200,000
179
How is the embryonic endoderm formed When does this occur
Hypoblast induces epiblast cells to undergo a an epithelial-mesenchymal transition. These cells leave the primitive streak and invade the hypoblast, forming the definitive endoderm Day 16
180
How is the mesoderm formed
After the formation of the endoderm, epiblast cells migrate into the space between the endoderm and the epiblast. The mesoderm forms 5 separate layers.
181
How many layers does the mesoderm form? What are they?
5 ``` Cardiogenic mesoderm Axial mesoderm (AKA notochord) Paraxial mesoderm Intermediate mesoderm Lateral plate mesoderm ```
182
What happens once the endoderm and mesoderm are formed
Migration ceases and the epiblast becomes ectoderm
183
How does the notochord form
Days 19-21: there is invagination from the primitive node and axial cell migration The notochord grows anteriorly
184
What does the formation of the notochord do
Determines longitudinal axis for the future differentiation of the vertebral body Induces epiblast differentiation to become neural plate
185
Which part of the mesoderm is primarily involved in neurulation When does this occur Which to germ layers are involved
Notochord Day 19 onward Communication between mesoderm and ectoderm
186
Give evidence that the mesoderm induces neural tube formation in the ectoderm
Transplantation of a second notochord leads to a duplicate neural tube Any ectoderm transplanted next to the notochord will be induced to form neural tissue
187
When do the anterior neural folds close
The later part of the 4th week
188
When does the posterior neuropore close What becomes evident here
2 days after the anterior An upper limb bud is evident
189
Give 2 defects caused by a failure of the neural tube to close What are each caused by
Anencephaly - failure of anterior neuropore closure Spina bifida - failure of posterior neuropore closure
190
What may cause defects in neural tube closure How frequent are they
Folate deficiency Valproate (drugs) Cholesterol metabolism 1/300 - 1/5000
191
What does the neural crest develop
Schwann cells Neuroglial cells SNS PNS
192
What does the neural tube form
``` Brain Neural pituitary Spinal cord Motor neurons Retina ```
193
What does the outer ectoderm form
``` Epidermis Hair Nails Teeth enamel Anterior pituitary ```
194
When do epiblast cells undergo transition to epithelial mesenchyme What signals this
16 days Underlying hypoblast
195
What layers does the lateral plate mesoderm divide into
Somatic | Visceral
196
4 facts about somites
Derived from paraxial mesoderm Transient structures Formed in pairs that flank to midline Formed sequentially from cranial to caudal
197
When do somites begin to form
21 days
198
What is the clock and wavefront model
Describes somitogenesis in vertebrates Mainly controlled by retinoic acid and FGF (these are antagonistic) Every 90mins a new pair of Somites form Negative feedback loop
199
What are the 3 types of somite
Myotome Sclerotome Dermatome
200
What do the myotome somites form
Epaxial (dorsal) and hypaxial (ventral) muscles of trunk and limbs
201
What does the sclerotome form
Axial skeleton, vertebrae and ribs
202
How are the vertebrae formed from somites
1 vertebra formed from 2 half sclerotomes on each side of the notochord
203
What disease spreads and shows a single dermatome
Zoster | Blistering in a single dermatome
204
What dictates a somite’s fate?
It’s cranial caudal position Eg ribs will form from thoracic somites
205
Give experimental evidence that the fate of a somite depends on its position
If you transplant a somite from one region to another region it will grow structures appropriate to the original site
206
Which class of gene family controls correct axial specification of somites What do these genes do
Hox Give each segment an address/ specification
207
What happens if Hox expression is perturbed Give an example/ evidence
Structures will form in the wrong place Eg ribs can grow in lumbar and sacral vertebrae in Hox gene knockout mice
208
What is aristapedia
Hox gene mutation leading to flies having legs in the place of their antennae
209
What is the motif found in Hox genes What does it do
The homeodomain Activates or inhibits downstream genes concerning axis patterning, migration, cell death etc
210
Give an example of how Hox genes determine number and types of vertebrae in different animals
Hoxc -6 In chicks this determines that 7 vertebrae will develop into ribs In snakes Hoxc-6 is expanded dramatically towards the head and towards the rear so there are many more vertebrae which develop ribs and lose limbs
211
How common are cervical ribs? What might cause it
<1% live births Spontaneous homoeotic mutation
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How many Hox genes are implicated in human heritable diseases
>27
213
Spinal nerve segmentation comes before somite organisation | True or false?
False The segmental Organization of the spinal nerves is secondary to that of the somites
214
What does coelom mean
Cavity in Greek
215
What forms the thoracic cavity
Cranial folding
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Where is the cardiogenic region originally When How does it move
Near the forebrain In the flat embryonic disc Cephalic growth displaces the cardiogenic region and is folded underneath, coming to lie on the ventral surface of the chest
217
How is the septum transversum first seen Where does it move to during folding
As a thick bar of mesoderm between the cardiogenic region and the cranial margin of the embryonic disc Lies between cardiac region and neck of yolk sac, separating thoracic and abdominal cavities
218
What does the septum transversum form
Part of the diaphragm
219
What innervates the diaphragm Why is this not surprising
Cervical nerves (phrenic nerve: C3,4,5) Septum transversum was originally adjacent to forebrain
220
What does the ventral folding of the embryo produce
Intraembryonic coelom lined with mesoderm
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Intraembryonic coelom is lined with mesoderm. What does the mesoderm form?
The serous membranes (Parietal and visceral)
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Where are the somatic and splanchnic mesoderm What are their other names What is the space between them called
Somatic (parietal) mesoderm: outer layer, beneath the ectoderm Splanchnic (visceral) mesoderm: overlying the endoderm Coelom
223
How does the dorsal mesentery form
Primitive gut tube hangs from the posterior body wall by a broad bar of mesentery Below the septum transversum, the mesenteric bar thins out to form the more membranous dorsal mesentery That suspends the abdominal viscera in the coelomic cavity
224
Name 2 visceral organs that develop in the body wall What group are these a part of Why is this
Kidney Bladder Retroperitoneal organs These organs are separated from the coelom by a covering of serous membrane
225
What separates the thoracic cavity
Pleuropericardial folds arise from the lateral body walls and grow medially towards each other separating developing lungs from the heart. They meet and fuse forming the pericardial cavity and the pleural cavities (right and left)
226
How common are congenital pericardial defects What does this involve
1/14000 3x more common in men Persistent pleuropericardial foramen due to arrested development of pleuropericardial folds
227
What is the diaphragm formed from
``` 4 structures Septum transversum Pleuroperitoneal membranes Muscular components of lateral body walls Dorsal mesentery of oesophagus ```
228
How common is congenital diaphragmatic hernia What is it How is it diagnosed
1/2000 to 1/5000 Failure of diaphragm to fuse allowing developing developing abdominal viscera to bulge into pleural cavity. If large enough this may stunt the lungs. Using ultrasound
229
What is the usual cause of failure of diaphragm fusion
One of pleuroperitoneal membranes fails to meet septum transversum
230
How does a congenital diaphragmatic hernia present
Severe pulmonary hypoplasia and pulmonary hypertension Scaphoid abdomen Severely affected babies will be symptomatic after birth. Most will develop symptoms within 24 hours
231
What is a scaphoid abdomen
Boat shaped | Anterior abdominal wall is sunken and presents a concave contour
232
What induces lung development? Prove it
Mesoderm If cultured alone, a lung bud shows no further differentiation If a lung bud is cultured with stomach mesoderm, gastric glands are formed If the lung bud is cultured with intestinal mesenchyme, villi form If developed with bronchial mesoderm, bud branches If developed with tracheal mesoderm collagen forms but there is no branching
233
What is the respiratory diverticulum
When two tracheo oesophageal ridges start to separate the oesophagus from the lung bud
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What happens to the lung bud after the respiratory diverticulum is formed What happens to the tracheo-oesophageal ridges
Lung bud bifurcates into the precursors to the 2 bronchi and lungs They fuse to divide the oesophagus from the trachea and the laryngo-tracheal endoderm becomes the lining of the trachea and the rest of the airway
235
What is TEF and how common is it
Tracheoesophageal fistula OR oesophageal atresia Failure to separate trachea and oesophagus Causes severe choking in neonatal baby 1/5000
236
Describe the signals that coordinate lung branching
FGF10 is secreted by mesoderm and guides bronchial branching FGF10 induces new gene expression in the cells at the ends of the bronchial branches SHH acts as negative feedback, inhibiting FGF10 expression locally. This stops outgrowth, promoting next round of branching.
237
How many live births are affected by congenital cardiovascular abnormalities
1%
238
What is the earliest functioning organ? When does it begin to function?
The heart Starts to beat at 22 days
239
When can the heart first start to propel fluid
24 days
240
What are the 4 structural shapes the heart goes through in development
Cardiac crescent Linear heart tube Looping heart Remodelling heart
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How are cardiac progenitors first recognisable
As a crescent shaped epithelium
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How does the linear heart tube form
Heart progenitors move ventrally to form the linear heart tube, compromising an endothelial lining (endocardium) enveloped by a myocardial epithelium
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How does blood flow through the linear heart tube
In flow caudal, outflow cranial
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How does the linear heart tube form the looping heart
The tubular heart adopts a spiral shape. The inflow portion, including the common atrium, is forced dorsally and cranially so ends up above the developing ventricles
245
How is the heart remodelled after the looping heart stage
Heart divided into chambers by septation | This leaves distinct left and right ventricles and atria
246
How many sides of the heart tube has a thick layer of mesoderm What does this become
3 sides Myocardium
247
What is cardiac jelly
A gelatinous acellular matrix, secreted by the myocardium, separating the myocardium and endocardium
248
What are the primitive chambers of the heart
``` A series of bulges which form: Sinus venosus Primitive atrium Ventricle Bulbus cordis Truncus arteriosus ```
249
How does the linear heart pump What prevents back flow Where is blood expelled
Contractions begin at the sinus venosus (which acts as the pacemaker) and a wave of muscle contraction is propagated up the tubular heart Cardiac jelly and constrictions From the truncus arteriosus
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When is the patterning of the heart initiated How do we know this
During Gastrulation In the linear heart the primitive atrium and ventricle have different cardiac myosin
251
What happens on day 23
The heart begins to elongate and fold and loop
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What does looping of the heart do
Displaces bulbus Cordis inferiorly, ventrally and the right Displaces primitive ventricle to the left Displaces the primitive atrium posteriorly and superiorly
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When is heart looping complete
By day 28
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What forms the outflow regions of the ventricles What about the actual ventricles
Superior end of Bulbus cordis Inferior end of bulbus cordis forms most of right ventricle Primitive ventricle forms most of left ventricle
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Where does the base to apex heart axis point What is it called when this is reversed What is the name when all organs are swapped on the left-right axis
Left Dextrocardia Situs inversus
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When does left right patterning begin Elaborate
Gastrulation The nodal gene is only transcribes in cells on the left side of the primitive streak
257
Where does our understanding of left right asymmetry come from
Studies of 2 mouse mutants
258
What is the inv mutation What is nodal
In version of turning Results in 100% reversal of looping When nodal gene is transcribed on right side of primitive streak
259
What is inversus viscerum (iv)
Randomised left right orientation of the heart Nodal is transcribed randomly on left or right
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True or false: | The primitive atrium is v important for atrium formation
False They mainly form the auricles
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How do the definitive atria arise What does this result in for the right?
Incorporation if the sinus horn (right atrium) and pulmonary veins (left atrium) to give the smooth walls of the atria The SVC, IVC, and coronary sinus lie within the definitive right atrium
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In the embryo, all venous flow enters which part of the heart How do they get in
The right sinus horn (future right atrium) Via the SVC and IVC
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What does the left sinus horn give rise to
The coronary sinus
264
How does oxygenated blood enter the IVC
Via the ductus venosus in the liver
265
What is the first step in separating systematic and pulmonary circulations
Partial separation of the definitive atria and division of the common atrioventricular canal into right and left AV canals
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How is the total separation of systemic and pulmonary circulations achieved in the embryo
IT DOESNT HAPPEN V little blood flows through the foetal lungs and blood is shunted from right to left
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How is foetal blood oxygenated
From the placenta, oxygenated blood enters the right atrium from the IVC and passes into the left atrium via the foramen ovale
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What does the AV canal do initially How is it remodelled
Connects the primitive atrium with the left ventricle RV increases in size, pulling canal to the right Tissue surrounding the canal thickens forming the endocardial cushions Endocardial cushions grow towards each other, fusing to form the septum intermedium, separating the AV canal into the left and right canals
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What do the left and right AV canals eventually form
The tricuspid and mitral openings
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What induces endocardial cushion formation
Signals from the. Myocardium
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When does the septum primum first form What does it look like What does it separate
Day 28 A thin membranous septum originating from the superior heart surface Left and right atria
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What happens to the heart in the 5th week
As the Septum primum approaches septum intermedium, the ostium primum is diminished
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When is the ostium primum obliterated ? This means blood can no longer travel from the foetal right atrium to the left atrium. True or false?
At the end of the 6th week False: apoptosis occurs at the cranial end of the septum primum, forming the ostium secundum Blood can always pass between the atria in the foetus
274
Describe the septum secundum
A second “fence”, this time thick and muscular that descends from the roof of the right atrium, to the right of the first fence
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When does the septum secundum reach the septum intermedium?
It never quite reaches the septum intermedium and the remaining gap forms the foramen ovale
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Is the blood in the foetal right atrium Oxy or deoxy
It receives both Oxy and and deoxy from the IVC and SVC
277
Describe the movement of blood through the foetal heart after the formation of the foramen ovale
The higher blood pressure in the right atrium pushes blood through the foramen ovale, easily pushing the flimsy septum primum open, into the left atrium to be pumped around the body
278
How does the foramen ovale close
Closes with the newborn baby’s first breath as the abrupt dilation of pulmonary vasculature and cessation of umbilical flow increase the blood pressure in the left atrium. This increased pressure forces the septum primum against secundum, closing the foramen ovale
279
What causes atrial septal defect
AKA hole in the heart If septum secundum is too short and the foramen ovale persists
280
How common is ASD What happens in the heart What are the symptoms
5-10% of babies congenital heart defects Causes left to right shunting in newborn Generally asymptomatic but persistent increased flow to RA leads to enlarged RV and pulmonary trunk, and eventually cardiac failure in later life
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How is hole in the heart fixed? When is surgery performed
Small holes can close spontaneously Larger defects may require surgery to prevent complications Between the ages of 3 and 5 years
282
How is the muscular ventricular septum formed
It grows from the inferior edge of the foetal ventricle after the 4th week towards the septum intermedium. This growth halts in the middle of the 7th week, leaving an opening between the ventricles that connects to the common outflow tract (truncus arteriosus)
283
When does the muscular ventricular septum begin to form? Why does growth of the muscular ventricular septum halt in the 7th week
After the 4th week Otherwise the LV would be shut off from the outflow tract
284
How is septation of the heart completed
2 spirals form on opposite sides of the inner surface of the truncus arteriosus The ridges spiral and fuse at inferior edge of truncus arteriosus. This fusion spreads cranially and caudally, separating the outflow tract when the spiral septum fuses inferiorly with the septum intermedium and the muscular ventricular septum
285
What gives rise to the membranous ventricular septum What does this form
When the spiral septum fuses with the muscular ventricular septum The 2 separate ventricles
286
What is the most common congenital heart defect? What causes this? What can this defect lead to?
Ventricular septal defect (33%) Failure of complete fusion of the spiral septum with the muscular ventricular septum and with the septum intermedium Tetralogy of Fallot
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How common is VSD Which septum is it most common in
3/1000 live births Membranous ventricular septum
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How severe is VSD How can it be treated
Severity depends on size and position of defect Small defects close spontaneously in 50% of cases with no long term harm A large VSD may damage heart or lungs as it causes heart to pump inefficiently by pumping oxygenated blood through the lungs repeatedly. This leads to pulmonary hypertension Without surgical intervention, a large VSD can lead to congestive heart failure
289
What is the most common cyanotic congenital heart malformation What causes it
Tetralogy of Fallot 1/1000 live births Defect in spiral septum, which divides outflow tract into pulmonary trunk and aorta
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What is the Tetralogy of Fallot
1. Pulmonary stenosis 2. Overriding aorta 3. Large VSD 4. Right ventricle hypertrophy
291
What is pulmonary stenosis
Pulmonary artery is too wide
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What is an overriding aorta
Aorta too wide and shifted right so receives blood from right ventricle too
293
Why does hypertrophy occur in the Tetralogy of Fallot
The right ventricle has to work extra hard to pump blood up narrow pulmonary trunk
294
When is the tetralogy of Fallot surgically repaired
<1 year
295
Which 2 shunts allow blood to bypass the lungs
Foramen ovale | Ductus arteriosus
296
What does the ductus arteriosus allow
Shunts blood from pulmonary artery to aorta to by pass the lungs
297
How do the pulmonary vessels open at birth What does this lead to
Pulmonary resistance drops Closing of foramen ovale and ductus arteriosus
298
When do the first and second fences fuse
3 months after birth
299
What causes the ductus arteriosus to close
Reduced flow through it due to change in pulmonary circulation resistance Reduced prostaglandin levels as maternal input is removed
300
What is a PDA How common is it When is it more common
Patent ductus arteriosus 10% of congenital heart diseases In pregnancies with persistent perinatal hypoxaemia or maternal rubella or In babies born at high altitudes or born prematurely
301
What can we do to close a patent ductus arteriosus
Prostaglandin inhibitors Surgery Coil to seal it
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Why can’t we use prostaglandin inhibitors for every case of PDA
Only effective in the first few weeks of life It is most important for premature babies
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How many patients with PDA die if it is not repaired How do they die
1/3 by age of 40; 2/3 by the age of 60 Heart failure, pulmonary hypertension, endarteritis
304
What is endarteritis
Inflammation of inner arterial lining
305
How can you keep the ductus arteriosus patent Why would we want to do this
Administration of prostaglandins In babies with other cardiac abnormalities to keep them alive until corrective surgery
306
What does the arterial system look like originally
With paired aorta and symmetrical pharyngeal/aortic arch arteries
307
How does the venous system look originally
Paired cardinal veins, umbilical veins, and Vitelline veins
308
How do pharyngeal/ aortic arches develop How many arches are there
Sequentially - the earliest ones regressing as later ones form 5 (I-VI) but V is not present in mammals
309
What does arch III form
Common carotid arteries
310
What forms the arch of the aorta
Arch IV
311
What forms the pulmonary trunk and the ductus arteriosus
Arch VI
312
How is the final aortic arch
Initial part: truncus arteriosus Ascendant part: aortic sac Transverse arch: from left IV pharyngeal/ aortic arch Descending aorta: left dorsal arch
313
Which side contributes to the aorta? What happens to the other side?
Left side Right side structures regress or can be incorporated into other parts of the vascular system
314
How common is coarctation of the aorta What is it associated with
3/10,000 births ~5% of congenital heart defects Valve defects
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What is coarctation of the aorta What also is found if it is pre/ductal What is found if it is post-ductal
Aortic lumen becomes significantly narrowed (from the Latin “coartare” - to press together) Persistent ductus arteriosus Circulation to distal body parts usually occurs through enlarged intercostals and internal thoracic arteries
316
What does coarctation of the aorta cause
High blood pressure in arms and upper body but low blood pressure in lower body and legs
317
How can you identify coarctation of the aorta
Different pulses in neck and groin and a distinctive heart murmur that can be heard through a stethoscope placed over the patient’s back
318
How is aortic coarctation repaired?
A small one can be removed and the two ends anastomosed Large ones require bypass surgery
319
How common is aortic interruption When is surgery required
1/10,000 births 1.3% of children with heart disease 1st year of life
320
What is Type B aortic interruption
Caused by obliteration of left VIth arch
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For aortic interruption: Where is Type A Where is Type B Where is Type C
A: distal to left subclavian artery B: distal to left common carotid C: distal to brachiocephalic artery
322
Why may there be an abnormal origin of the R subclavian artery Where is the abnormal origin What are the symptoms?
Abnormal obliteration of right VIth arch, leaving distal part of right dorsal aorta Instead of ariseung with the right common carotid as the brachiocephalic artery, it rises as its own 4th branch from the aorta, after the left subclavian artery. It hooks back to reach the right side Asymptomatic
323
Which organ greatly affects the vitelline and umbilical veins
Liver
324
What happens to the developing vitelline veins
A plexus forms between the left and right veins which is then surrounded by liver cords This gives rise to the liver sinusoids
325
What happens to the left and right vitelline veins after a plexus forms between them
Left loses its connection to the heart and the anastomotic network develops into a single vessel: the portal vein Right forms the hepatocardiac portion of the IVC
326
When does the ductus venosus form What does it do
Forms with the hepatic sinusoids Shunts blood from the placenta (via left umbilical vein) to the IVC
327
What happens to the umbilical veins
Left persists and anastomoses with the ductus venosus Right is obliterated
328
When do the umbilical vein and ductus venosus close
After birth The obliterated ductus venosus forms the ligamentum venosum The obliterated umbilical vein is found in the lost margin of the falciform ligament
329
Congenital cardiovascular malformations accounts for how many of all congenital defects in live births and occur in how many of all live births?
20% 0.5-1% of all live births
330
Which gene is one of the earliest genes expressed in the cardiac lineage
Nkx2.5
331
What do you see in Nkx2.5 mutant mice
Absence of myosin light chain
332
What does Nkx2.5 encode
A homeodomain transcription factor that coordinates with zinc finger transcription factors of the GATA family to activate cardiac specific genes
333
When was Nkx2.5 first discovered to be required for normal heart development How many mutations have been recorded to cause heart defects
In fruit flies >10
334
Both copies of the Nkx2.5 gene need to be mutated to cause disease
False | It is a dominant pattern of disease inheritance - only one mutation necessary
335
What do point mutations in Nkx2.5 cause Can mutations in this gene affect adults
Atrial septal defects and AV conduction delays Yes eg can cause progressive loss of AVN activity
336
What gene helps valve formation from the endocardial cushions
Notch1
337
Where do endocardial cushions form What is this formation called
Where localised swellings of cardiac jelly become cellularised when endocardial cells delaminate in response to signals from the myocardium Epithelial mesenchymal transition (EMT)
338
What are the reciprocal interactions involved in the EMT
Between the myocardium and endocardium
339
How do the endocardial cushions develop into valves Which gene is required Give evidence
They elongate to gradually form thin valve leaflets Notch1 If Notch1 is blocked, cushions don’t form
340
What causes bicuspid atrial valve
Notch1 mutations (only 1 copy needs to be mutated)
341
Why might Notch1 mutations not become obvious until later in life
It is also important in preventing calcification of the valve
342
What causes Alagille syndrome What are symptoms
Jagged 1 mutations Pulmonary artery stenosis and Tetralogy of Fallot (jagged 1 mutations can lead to these individually, without Alagille syndrome)
343
What is Jagged 1 What does a mutation here cause
The ligand first the Notch receptor Alagille syndrome: Pulmonary artery stenosis and Tetralogy of Fallot
344
True or false: the heart can regenerate before birth.
True but it loses this ability at birth
345
How can knowledge of heart development help treatment
Can be applied to derive cardiomyoctes from pluripotent stem cells May also be possible to wake up dormant cardiomyocytes that are thought to exist within the heart
346
Which germ layer does the kidney develop from
Intermediate Mesoderm
347
What are the 3 stages of kidney development
Pronephros Mesonephros Metanephros
348
When does the urogential ridge begin to form In which direction?
Week 4 Rostral caudal direction
349
When and where does the pronephos begin to develop Is this structure essential for higher vertebrates
Day 24 Between somites 3-5 with the duct finding between somites 5-7 No it is a rudimentary structure but it is essential for embryonic survival of fish and amphibians
350
What happens to the pronephros once it is formed?
Degenerates v rapidly and is never. Functional in humans
351
What does mesonephros form
From day 28 and begins to regress at the cranial end at 5 weeks
352
How many nephrotomes does the mesonephros have? What does it produce?
Never more than 30 Dilute urine
353
When does the ureteric bud form
Grows out of the mesonephric duct at 5 weeks
354
What induces formation of the metanephric kidney
The ureteric bud
355
How do the tubules in the mesonephros form How many tubules are there
In cranio- caudal succession (cranial ones form first, then thoracic then abdominal) Earlier ones degenerate as new ones form 30 tubules at any one time
356
What is an important function of the mesonephros
Production of weak urine which maintains the composition of the amniotic fluid
357
How do the metanephroi develop
Begins with 2 buds (the ureteric buds) which originate from the caudal end of the mesonephric duct. These buds grow out unit the surrounding mesoderm and surrounding cells as the bud secretes signalling proteins
358
How do we know the ureteric buds signal induction in surrounding cells
If an artificial barrier is used to prevent proteins moving between cells, development stops
359
Define induction
Alteration of the fate of one cell type or tissue by interaction with a second
360
What are the 3 phases of induction
Initiation Commitment to differentiation Morphogenesis
361
Discuss the phases of induction in the example of metanephros development
Initiation: signals from the metanephrogenic mesenchyme induce growth of ureteric bud Commitment: proliferation and differentiation of bud and mesenchyme (the response to the inducing signals) Morphogenesis: in response to signals from the mesenchyme, the bud commenced branching morphogenesis and the mesenchyme responds by becoming epithelial in nature and forming nephrons
362
In short, what are the consequences of induction in mesonephros development
Ureteric branching morphogenesis | Epithelial morphogenesis
363
Describe the epithelial morphogenesis associated with metanephros development
Mesenchyme-epithelial transition is in response to Wnt expression S shaped bodies form thins on one side to form glomerulus Fuses with ureteric bud tip Extends to form proximal and distal tubules
364
What induces outgrowth of the ureteric bud What does it grow towards
GDNF secreted From the metanephric mesenchyme (MM) Grows towards the MM
365
What is GDNF What does it bind to
Glial derived neurotrophic factor Binds to Ret receptor on ureteric bud cells
366
How are the renal vesicles formed
The metanephric mesenchyme is induced by the ureteric bud to condense around the tips of the branching ureteric epithelium and undergo a mesenchyme to epithelial transition, forming renal vesicles
367
What triggers the mesenchyme-to-epithelial transition (MET)
Wnt9b from the ureteric tip upregulates FGF8 and Wnt4 production from the metanephric mesenchyme This triggers (MET)
368
What do the following signalling proteins do in kidney development: a) Wnt9b b) FGF8 c) Wnt4 Where is each secreted from
a) up regulates FGF8 and Wnt4 (from ureteric bud) b) stimulates proliferation of metanephrogenic mesenchyme (from MM) c) regulates formation and differentiation of the comma and S shaped bodies to form renal vesicles (from MM)
369
What is the ampulla in the developing kidney
The growing tip of the branching bud
370
What follows induction at the ampulla during kidney ampulla What is this called What does it result in
Another branch grows out and one nephron forms Dichotomous branching The regular patterning of the kidney
371
What forms the collecting duct, the nephron and the convoluted tubules?
Collecting duct: from ureteric bud branches | The metanephrogenic mesenchyme form the nephron and convoluted tubules
372
When does the mean glomerular number level off in the embryo Is this the final number?
36 weeks No some nephrogenesis and functional maturation continues after birth
373
What processes form kidney blood vessels in the embryo
Smaller vessels are derived from vasculogenesis differentiated within the kidney Large vessels are formed via angiogenesis- the invasion of the kidney by the renal arteries
374
How common is a development abnormality in the urinary tract
10% of all babies However most don’t cause problems
375
When does kidney agenesis occur
If the ureteric bud does not reach / signal properly to the surrounding mesenchyme
376
What causes poly cystic or dysplastic kidneys
Tubules fail to form correctly Cells may continue to proliferate
377
What probably causes double or bifurcated ureters
Defects in early stages of induction
378
Give the mean glomerular number at 3 points in life
15 weeks: 15,000 40 weeks: 740,000 Adult: 617,000
379
True or false: | Mean glomerular number decreases with age
True
380
Which other disease is a decline in glomerular number related to According to whom Give evidence
Risk of hypertension Developmental Origins of Health and Disease Genetically induced reduction in nephron number in mice is associated with increased blood pressure
381
What is nephron number in babies strongly associated with Give a statistic
Birth weight Babies with birthweight below 10th centile have 30% fewer nephrons
382
What is the Developmental programming hypothesis
That there is a relationship between low birthweight, nephron number and hypertension
383
How does the bladder form
The mesonephric duct and the ureteric bud both enter the posterior inferior aspect of the urogenital sinus. In the males the mesonephric duct migrates inferiorly go enter the urethra as the vas deferens and in the female it regresses The ureteric bud grows out and elongates you’re become the ureteric and the portion closest to the urogenital sinus splays out to generate the trigone
384
What is the trigone
Part of the posterior wall of the bladder
385
What is the urachus What is its path
The connection between the developing bladder and the allantois From the bladder to the umbilicus and the umbilical cord
386
What happens to the urachus after delivery
It fibroses to form the median umbilical ligament
387
What happens if the urachus fails to obliterate fully
A urachal fistula, cyst, or sinus may develop A urachal fistula will result in urine leaking from the umbilicus