Embryology and anatomy Flashcards
(162 cards)
1
Q
Sonic hedgehog gene mutations
A
Holoprosencephaly (A-P axis)
2
Q
Wnt-7 gene mutation
A
Limb development (dorsal-ventral axis)
3
Q
FGF gene mutation
A
Lengthening of limbs
4
Q
Homeobox (Hox) genes
A
Appendages in the wrong locations
5
Q
Implantation of the blastocyst occurs?
A
Stick at 6 (days)
6
Q
Formation of the bilaminar disc timing?
A
2 weeks (=2 layers)
7
Q
Formation of the trilaminar disc timing?
A
3 weeks (=3 layers) Primitive streak, notochord, mesoderm and its organization, and neural plate begin to form
8
Q
Neural tube formed by what cell layer?
A
Neuroectoderm (neural tube closes at 4 weeks)
9
Q
When is the fetus most susceptible to teratogens?
A
3-8 weeks
10
Q
What occurs at week 4 or embryogenesis?
A
Limb development (4 limbs)
11
Q
What occurs at week 6 of embryogenesis?
A
Fetal cardiac activity visible by transvaginal US
12
Q
What occurs at week 10 of embryogenesis?
A
Genitalia have female/male characteristics
13
Q
What is the process called that forms the trilaminar disc?
A
Gastrulation (Ectoderm, mesoderm, and endoderm germ layers form)
14
Q
What comes from surface ectoderm?
A
Epidermis, adenohypophysis (Rathke pouch), lens of the eye, epithelial linings of oral cavity, sensory organs of ear, and olfactory epithelium, anal canal below the pectinate line, parotid, sweat, and mammary glands
15
Q
What comes from neuroectoderm?
A
Brain (Neurohypophysis, CNS neurons, oligodendrocytes, astrocytes, ependymal cells, pineal gland), retina and optic nerve, spinal cord
*Think CNS
16
Q
What comes from neural crest?
A
CA MOTEL PASS *Think PNS and nearby) Craniofacial bones Arachnoid/pia mater Melanocytes Odontoblasts (teeth) Trachael cartilage Enterochomaffin-like cells Layrngeal cartilage Parafollicular cells (thyroid) All ganglia (including adrenal medulla) Schwann cells Spiral septum (heart development)
17
Q
Mesoderm
A
M=middle=meat layer
Muscle, bone, CT, serious linings of body cavities, spleen, CV structures, lymphatics, blood, wall of gut tube, vagina, kidneys, adrenal cortex, dermis, testes, ovaries
18
Q
Mesoderm defects?
A
VACTREL Vertebral defects Anal atresia Cardiac defects Tracheo-esophageal fistula Renal defects Limb defects (bone and muscle)
19
Q
Endoderm
A
Gut tube epithelium
Urethra
Luminal epithelial derivatives (lungs, liver, gallbladder, pancreas, eustachian tube, thymus, parathyroid, thyroid follicular cells)
20
Q
DEformation
A
Extrinsic disruption, occurs after embryonic period
21
Q
Malformation
A
Intrinsic disruption, occurs during embryonic period
22
Q
Aplasia
A
Absent organ development despite present primordial tissue
23
Q
Disruption
A
Secondary break down of previously normal tissue (amniotic band syndrome)
24
Q
Teratogen: ACE inhibitors
A
Renal damage
25
Teratogen: alkylating agents
Absence of digits
26
Teratogen: aminoglycosides
CN VIII ("a min gly hit the baby in the ear")
27
Teratogen: Carbamazepine
Facial dysmorphism, dev. delay, neural tube defects phalanx/fingernail hypoplasia
28
Teratogen: Diesthylstilbestrol (DES)
Vaginal clear cell adenocarcinoma, congenital Mullerian anomalies
(Old oral contraceptive)
29
Teratogen: folate antagonist
Neural tube defects
30
Teratogen: Isotretinoin
Severe/multiple birth defects
31
Teratogen: lithium
Ebstein anamoly (atrialized right ventricle-->tricuspid vavle in the ventricle)
32
Teratogen: methimazole
Aplasia cutis congenita
33
Teratogen: Phenytoin
Fetal hydantoin syndrome: cleft palate, cardiac defects, phalanx/finger hypoplasia
34
Teratogen: Tetracyclines
Discolored teeth
35
Teratogen: Thalidomide
Limb defects
36
Teratogen: valproate
Inhibition of maternal folate absorption-->neural tube defects
folATE~valproATE
37
Teratogen: Warfarin
Bone deformities, fetal hemorrhage, abortion, opthalmologic abnormalities
38
Teratogen: Alcohol
FAS- birth defects and ID
39
Teratogen: cocaine
Abnormal fetal growth and fetal addiction, placental abruption
40
Teratogen: Smoking
Low birth weight, preterm labor, placental problems, IUGR, ADHD
nicotine=vasoconstriction
CO-->impaired O2 delivery
41
Teratogen: Iodine (lack or excess)
Congential goiter or hypothyroidism (cretinism-severely stunted physical and mental growth)
42
Teratogen: Maternal diabetes
Caudal regression syndrome (anal atresia to sirenomelia), congenital heart defects, neural tube defects
43
Teratogen: Vit A excess
Extremely high risk for spontaneous abortions and birth defects (cleft palate/cardiac)
44
Teratogen: X rays
Microcephaly, ID (minimize with lead shielding)
45
Most common type of monozygotic twins? When does separation occur?
Monochorionic, diamniotic (75% of monozygotic twins)
| 4-8 days after formation of morula
46
Separation of monozygotic twins at 0-4 days?
Dichorianic, diamniotic between 2 cell stages and morula
47
Cytotrophoblast is part of what?
Fetal component of placenta
48
What is the cytotrophoblast made out of?
Inner layer of chorionic villi
49
Syncytiotrophoblast is part of what?
Fetal component of placenta
50
Syncytiotrophoblast is made out of?
Outer layer of chorionic villi, secrets hCG (structually similar to LH, stimulates corpus luteum to secrete progesterone during first trimester)
51
Decidua basalis if part of what?
Maternal component of the placenta
52
Decidua basalis is made out of what?
Derived from endometrium. Maternal blood in the lacunae.
53
How many umbilical arteries are there?
2
54
How many umbilical veins are there?
1
55
What vessel deliveries deoxygenated blood from the fetal internal iliac arteries to the placenta?
Umbilical arteries
56
What vessel delivers oxygenated blood from the placenta to the IVC via the ductus venosus
Umbilical vein
57
Where are the umbilical arteries and vein derived from?
Allantois
58
What does the allantois become?
Urachus, a duct between fetal bladder and yolk sac
59
Patent urachus
Total failure of urachus to obliterate-->urine discharge from umbilicus
60
What forms from the yolk sac in week 3 of embryogenesis?
Allantois, which extends into urogenital sinus
61
Urachal cyst
Partial failure of urachus to obliterate; fluid-filled cavity lined with uroepithelium, between umbilicus and bladder
62
Presence of urachal cyst leads to risk of?
Infection and adenocarcinoma
63
Vesicourachal diverticulum
Slight failure of urachus to obliterate-->outpouching of the bladder
64
Vitelline duct
Connection between the yolk sac and the midgut lumen
65
What week does the vitelline duct close?
week 7
66
Vitelline fistula
Vitelline duct fails to close-->meconium and discharge from umbilius
67
Meckel diverticulum
Partial closure of vitelline duct, with patent portion attach to ileum, may have heterotopic gastric/pancreatic tissue--> melena, hematochezia, abdominal pain
68
Treacher Collins syndrome
1st arch neural crest fails to migrate-->mandibular hypoplasia, facial abnormalities
69
Congenital pharyngocutaneous fistula
Persistence of cleft and pouch-->fistula between tonsillar area and lateral neck
70
Branchial pouch- 1st
Middle ear cavity, eustachian tube, mastoid air cells
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Branchial pouch- 2nd
Epithelial lining of palatine tonsil
72
Branchial pouch- 3rd
Doral wings-develop into inferior parathyroids
| Ventral wings-develop into thymus
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Branchial pouch- 4th
Dorsal wings-develop into superior parathyroids
74
DiGeorge syndrome branchial pouch defect
Abberant 3rd and 4th pouch development-->Thymic aplasia and failure of parathyroid development (hypocalcemia)
75
MEN2A
Mutation of germline RET (neural crest cells):
Adrenal medulla (pheochromocytoma)
Parathyroid (tumor): 3/4 branchial pouches
Parafollicular cells (medullary thyroid cancer)
76
Cleft lip pathology
Failure of fusion of the maxillary and medial nasal processes (Formation of the primary palate)
77
Cleft palate pathology
Failure of fusion of the two lateral palatine processes or failure of fusion of lateral palatine processes with the nasal septum/median palatine process (formation of secondary palate)
78
Female genital embryology-first step
Default dev: Mesonephric duct degerenates and paramesonephric duct develops
79
Male genital embryology first step
SRY gene on Y chromosome produce testis determining factor--> testis development
80
What do the sertoli cells secrete in male genital dev?
Mullerian inhibitory factor that suppresses dev. of the paramesonephric ducts
81
What do leydig cells secrete in male genital dev?
Androgens that stimulate development of the mesonephric ducts
82
Paramesonephric ducts aka?
Mullerian ducts
83
Paramesonephric ducts develop into?
Female internal structures
84
What are the female internal genital structures and what are they derived from?
Fallopian tubes, uterus, upper portion of the vagina
| Derived from the paramesonephric ducts
85
Mullerian agenesis presents as?
```
Primary amenorrhea (lack of uterine development)
Fully developed secondary sex characteristics (functional ovaries)
```
86
Mesonephric duct aka?
Wolffian duct (me-so-horny=male)
87
Mesonephric duct
Develops into male internal structures EXCEPT prostate
88
What are the male internal genital structures and what are they derived from?
SEED
| Seminal vesicles, ejaculatory duct, Epididymis, ductus deferens)
89
In females, the remnant of the mesonephric duct becomes?
Gartner duct
90
Septate uterus
Y shaped uterus on contrast
Incomplete resorption of septum
Decreased fertility
Treat with septoplasty
91
Bicornuate uterus
Incomplete fusion of Mullerian ducts--> Increased risk of complicated pregnancy
92
Uterus didelphys
Complete failure of fusion-->double uterus, vagina, and cervix.
Pregnancy possible
93
Male/female genital tubercle becomes
Male: Glans penis and Corpus cavernosum/spongiosum
Female: Glans clitoris and Vestibular bulbs
94
Male/female urogenital sinus becomes
Male: Bulbourerthral glands (Cowper) and Prostate gland
Female: Greater vestibular glands (Bartholin) and
Urethral and paraurethral glands (Skene)
95
Male/female urogenital folds becomes
Male: Ventral shaft of penis
Female: Labia majora
96
Male/female labioscrotal swelling becomes
Male: Scrotum
Female: Labia majora
97
Hypospadias
Abnormal opening of the urethra onto the ventral side-failure of urethral folds to fuse
More common than epispadias
98
Epispadias
Abnormal opening of penile urethra on dorsal surface of penis due to faulty positioning of genital tubercle (makes glans penis/corpus cavernosum&spongiosum)
99
Hypospadias is associated with?
Inguinal hernia and cryptochidism
100
Extrophy of the bladder associated with?
Epispadias
101
Gubernaculum (band of fibrous tissue) in males becomes
Anchors testes within scrotum
102
Gubernaculum (band of fibrous tissue) in female becomes
Ovarian ligament + round ligament of uterus
103
Processus vaginalis (evagination of peritoneum) in males becomes
Tunica vaginalis
104
Processus vaginalis in females becomes
Obliterated
105
Gubernaculum function
Aids in the descent of the testes and ovaries
106
Where does the proximal vagina/uterus lymphatics drain?
Obturator, external iliac, hypogastric nodes
107
Infundibulopelvic ligament (suspensory ligament of the ovary) connects?
Ovaries to the pelvic wall
108
Infundibulopelvic ligament (suspensory ligament of the ovary) structures that are contained?
```
Ovarian vessels (ligate these vessels during oophorectomy to avoid bleeding)
Ureter courses retroperitoneally, close to gonadal vessels-->at risk of injury during ligation of ovarian vessels
```
109
Cardinal ligament connects?
Cervix to side wall of pelvis
110
Cardinal ligament contains?
Uterine vessels
| Ureter at risk of injury during ligation of uterine vessels in hysterectomy (water under the bridge)
111
Round ligament of the uterus connects?
Uterine fundus to labia majora
| Derived from gubernaclum
112
Broad ligament connects?
Uterus, fallopian tubes and ovaries to pelvic side wall
113
Ovarian ligament connects?
Medial pole of ovary to lateral uterus
| Derived from gubernaculum
114
Broad ligament contains?
Ovaries, fallopian tube, road ligaments of uterus
115
What comprises the broad ligament?
Mesosalpinx, mesometrium, and mesovarium
116
Histology of the ovaries
Simple cubodial epithelium
117
Pathway of sperm during ejaculation
```
SEVEN UP
Seminiferous tubules
Epididymis
Vas deferens
Ejaculatory ducts
nothing
Urethra
Penis
```
118
Pelvic fracture puts what male genital area at risk?
Posterior membranous urethra
119
Blunt trauma puts what male genital area at risk?
Posterior bulbar urethra
| Injury to the posterior urethra-->urine leakage into the retropubic space
120
Perineal straddle injury puts what male genital area at risk?
Anterior urethra, urine can lead into the deep fascia of Buck. If fascia is torn, urine escapes into superficial perineal space
121
Ejaculation uses what nerves
Visceral and somatic nerves (pudendal)
122
Emission uses what nerves
Sympathetic nervous system (hypograstric nerve)
123
PDE-5-inhibitors mechanism
Erectile dysfunction
| Decreases the breakdown of cGMP
124
Spermatagonia functions and location
Germ cells-maintain germ pool and produce primary spermatocytes
Line the seminiferous tubules
125
Sertoli cells function and location
Secrete inhibin --> inhibit FSH
| Line seminiferous tubules
126
Sertoli cells are a homolog of what female cell?
Granulosa cells
127
What secretes androgen-binding- protein and what is it's function?
Sertoli cells secrete ABP and it stimulates local testosterone levels
128
What secrets inhibin and what is its function?
Sertoli cells secret inhibin, and it negatively inhibits FSH
| FiSH
129
What was testosterone negatively feedback on after being produced by the leydig cells
Hypothalamus (-GnRH) and -LH
130
What forms the blood-testis barrier?
Tight junctions of the sertoli cells (isolates gametes from autoimmune attack)
131
What is MIF produced by?
Sertoli cells
132
If temperature is decreased how is sperm production affected?
Decreased sperm production (and inhibin)
133
If temperature is decreased how is testosterone production affected?
Unaffected.
134
Leydig cells are homologs of what female cells?
Theca interna cells
135
What is the most potent form of estrogen?
Estradiol (>estrone>estriol)
136
Where is estrogen produced?
Ovary (17B-estradiol), placenta (estriol), adipose tissue (estrone via aromatization)
137
What is the function of estrogen?
Develops genitals and breast tissue, and fat distribution
Growth of follicle, endometrial proliferation, ^ myometrial excitability
Up-regulates estrogen, LH, and progesterone receptors
Inhibition of FSH and LH, then LH surge
Stimulation of prolactin secretion
138
What is progesterone produced?
Corpus luteum, placenta, adrenal cortex, testes
139
What is the function of progesterone?
Stimulation of endometrial glandular secretions and spiral artery development
Maintenance of pregnancy
Decrease myometrial excitability
Production of thick cervical mucus, which inhibits sperm entry into uterus
Increases body temperature
Inhibitions LH and FSH
Uterine smooth muscle relaxation (prevents contractions
Decreases estrogen receptor expression
Prevents endometrial hyperplasia
140
How many days in the luteal phase?
14 days always (ovulation+14 days=menstruation)
141
How many days is the follicular phase?
varies-Ovulation+ 14 days= menstruation
142
Conducting zone of the respiratory tree
Nose-->terminal bronchioles
| Warms air but does not participate in gas exchange
143
What is the part of the respiratory tree that doesn't exchange oxygen called?
Anatomic dead space
144
What is the cell type from the beginning to terminal bronchioles?
Pseudostratified ciliated columnar cells
145
What kind of cells line after the terminal bronchioles after the respiratory tree?
Cuboidal cells
146
Where do the goblet cells and cartilage end?
Bronchi
147
What is considered the respiratory zone of the tree?
Lung parenchyma: respiratory bronchioles, alveolar ducts, alveoli
Participates in gas exchange
148
What type of cells line the respiratory bronchioles?
Cubodial cells
149
What type of cells line the alveoli?
Simple squamous
150
Where does the cilia terminate?
At the end of the respiratory bronchioles
151
Where does airway smooth muscle end?
Terminal bronchioles
152
Type 1 pneumocytes
97% of alveolar surfaces, gas exchange
153
Type 2 pneumocytes
```
Secrete pulmonary surfactant
Stem cells (proliferate during lung damage)
```
154
Club cell pneumocytes
Nonciliated; low-columnar/cubodial with secretory granules
| Secrete component of surfactant, degrade toxins, act as reserve cells
155
Lecithin to spingomyelin should be what to signify fetal lung maturity?
>2 in amniotic fluid
156
What gestational week is surfactant synthesis fully functional?
35 weeks (begins to produce ~26)
157
What is the "scientific" name for surfactant?
Lecithins (dipalmitoylphosphatidylcholine is the most important)
158
Collapsing pressure=
2 (surface tension)/radius
159
Relation of pulmonary artery to each lung hilum?
RALS
Right lung=anterior
Left lung=superior
160
What structures perforate the diaphragm? name what level
IVC-T8 Esophagus-T10 Aorta-12
| "I 8, 10 eggs, at 12"
161
Where should you do a thoracentesis?
Midclavicularly: above 7th rib (I broke my clavicle when I was 7)
Midaxillary: 9th rib (It took nine AXes to chop down the tree)
Post scapular line: 11th rib
162
How far is the lung away from the pleura?
2 ribs above
