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Human Development Flashcards

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1
Q

Male vs female pelvis

A 
Female = larger and wide 
Female = more flared iliac crests 
Male = sharper pubic arch 
Females = wider more oval pelvic inlet 
Males = coccyx angled more forwards 
Males = ischial bones closer giving narrower pelvic outlet
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2
Q

Sacrotuberous ligament

A

Sacrum –> ischial tuberosity

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3
Q

Sacrospinous ligament

A

Sacrum –> ischial spine

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4
Q

Sacroiliac ligament

A

sacrum –> ilium

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5
Q

Greater sciatic foramen

A

Formed by sacrotuberous and sacrospinous ligaments

Piriformis, sciatic nerves, superior and inferior gluteal vessels and nerves, internal pudendal nerve and vessels

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6
Q

Lesser sciatic foramen

A

Former by sacrospinous ligaement superiorly and sacrotuberous inferiorly
Obturator internus, internal pudendal nerve (re-entering the pelvis)

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7
Q

Parts of levator ani from anterior to posterior

A

Levator prostate/sphincter vaginalis
Puborectalis - pubic bone around rectum
Pubococcygeus - pubis –> anococcygeal body
Iliococcygeus - ilium –> sanococcygeal body and coccyx

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8
Q

Coccygeus

A

Ischial spines –> lateral sacrum and coccyx

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9
Q

Function of pelvic floor

A

Support and maintain pelvic viscera is position
Maintain continence
Resisting abdominal and intra-pelvic pressure

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10
Q

Folic acid in preventing birth defects

A

400mg per day

Could prevent around 75% of neural tube defects

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11
Q

Embryonic vs foetal period

A 
Embryonic = 3-8 weeks 
Foetal = 8 weeks --> term
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12
Q

Major vs minor congenital defects

A

Major = require medical or surgical intervention or causes significant handicap

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13
Q

Anencephaly

A

Malformed head and brain

Failure of anterior neuropore to close

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14
Q

Spina bfida

A

Herniation of spine and contents in the lower back

Failure of posterior neuropore to close

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15
Q

Hypospadias

A

Male urethra opens out in unusual place

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16
Q

Cleft lip

A

Failure of maxillary and medial nasal prominences to fuse

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17
Q

Cleft palate

A

Failure of palatine shelves to fuse

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18
Q

Holoprosencephaly

A

Loss of midline structures

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19
Q

Omphalocele

A

Abdominal contents do not correctly return from umbilical cord

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20
Q

Gastrochisis

A

Abdominal contents herniate through defect in anterior abdominal wall

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21
Q

Phocemelia

A

Limb abnormalities

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22
Q

Syndactylyl

A

Digits fused together

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23
Q

Polydactyly

A

Extra digits

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24
Q

Ankyloglossia

A

Tongue tie

Unusually thick and short frenulum

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25
Hydatiform male
Diploid cells but genetic material purely from father
26
Sirenomelia
Lower body parts fused | Epiblast cells stop invaginating too early
27
Situs invterus
Reversal of left and right axis of the body
28
Atrial septal defect
Blood can flow between two atria
29
Ventricular septal defect
Blood can flow between two ventricles
30
AV canal
Lack of AV septum
31
Coarctation of aorta
Aortic narrowing where ductus arteriosus inserts
32
Transposition of the great vessels
Vessels connect to incorrect heart chamber
33
Truncus arteriosus
Aorta and pulmonary trunk fail to fully separate
34
Tetralogy of Fallot
Overriding aorta that can take blood from left heart
35
Pelvic kidney
Kidney that failed to migrate up to posterior abdominal wall
36
Horseshoe kidney
Kidneys fused inferiorly
37
Vitelline duct abnormality
Meckel's diverticulum | Small pocket of vitelline duct remains in the ileum
38
Tracheo-oesophageal fistula
Failure of trachea and oesophagus to fully divide
39
Hirschprung's disease
Loss of enteric nervous system ganglion cells in the gut
40
Female vs male primitive genital tubes
Female = Mullerian ducts Male = Wolffian ducts Mullerian ducts more lateral
41
When do gonadal ridges begin to form?
5th week of gestation
42
Where does the gubernaculum attach?
To the gonadal ridge and the labioscrotal swellings (future scrotum or labia majora)
43
Contents of spermatic cord
Gubernaculum, vas deferens, testicular vessels, nerves and lymphatics
44
What is the tunica vaginalis?
Portion of peritoneum that was pulled down into the scrotum with the descent of the testicles
45
When does testicular descent occur?
Around the 26th week
46
Inguinal canal structure
4cm long 2mm above inguinal ligament Starts at deep inguinal ring Ends at superficial inguinal ring
47
What passes through the inguinal canal
Ilioinguinal nerve Round ligament in females Spermatic cord in males
48
Testicular blood supply
Bia testicular arteries from L2 of AA | Venous drainage via testicular veins to the IVC on the right and left renal vein on the left
49
Vas deferens length
45cm
50
Vas deferens course
From the epididymis in the scrotum Up into the pelvis through the spermatic cord Crosses external iliac vessels Passes around the lateral walls of the pelvis Crosses ureter posterior to the bladder Joined by seminal vesicle to empty into the ejaculator duct in the prostate
51
Indirect inguinal hernia
Herniation of abdominal contents through the deep inguinal ring Processes vaginalis fails to close
52
Hydrocele
Accumulation of peritoneal fluid in the scrotum | Processes vaginalis still slightly open
53
Ovarian ligament
Cranial gubernaculum remains | Ovary --> uterus
54
Round ligament
Caudal gubernaulum remains | Uterus --> labia majora
55
Broad ligament
Double fold of peritoneum overlying uterus
56
Suspensory ligament
Peritoneum overlying ovarian vessels
57
Ovarian blood supply
From AA | Venous drainage to AA on the right and left renal vein on the left
58
Peritoneal pouches
Vesicouterine = between bladder and uterus Rectouterine (pouch of Douglas) = between uterus and rectum Fluid can accumulate here
59
Support of the uterus
Levator ani Transverse cervical ligaments Pubocervical ligaments Sacrocervical ligaments
60
Vagina fornices
Anterior Posterior 2 lateral
61
Ureter course in females
Pass over pelvic prim at common iliac bifurcation Pass under ovarian arteries Run of lateral pelvic walls and pass anterior to reach the bladder passing either side of the cervix
62
Ectoderm
Skin, hair, nails, nervous system
63
Mesoderm
Muscles, skeleton, heart, connective tissue
64
Endoderm
GI system, lungs, liver, pancreas, GU system
65
Foregut
Pharynx --> superior duodenum
66
Midgut
Superior duodenum --> 2/3 of transverse colon
67
Hindgut
1/3 of transverse colon --> rectum
68
Urogenital triangle borders
Pubic symphysis anteriorly Inferior pubic rami laterally Line between ischial tuberosities posteriorly
69
Anal triangle borders
Line between ischial tuberosities anteriorly Sacrotuberous ligaments laterally Coccyx posteriorly
70
Pudendal canal
Contains pudendal vessels and nerve | Lies within the fascia of the obturator internus in the lateral walls of the ischioanal fossa
71
Branches of internal pudendal artery
Dorsal artery of the clitoris/penis Perineal artery Inferior rectal artery
72
Pudendal nerve
S2-4 Leaves pelvis through greater sciatic foramen Re-enters pelvis to reach the perineum through lesser sciatic foramen Branches to give the dorsal nerve of penis/clitoris, perineal and inferior rectal
73
Deep perineal pouch contents
``` External urethral sphincter Deep transverse perineal Vagina Proximal female urethra Membranous male urethra Male bulbourethral gland ```
74
Superficial perineal pouch contents
``` Crura of penis/clitoris Bulb of penis/clitoris Bulbospongiosus Ischiocavernosus Superficial transverse perineal Bartholin's gland in females ```
75
Superficial perineal fascia layers
Membranous (Colles') - thin, strong layer binding muscles of the root of the penis Fatty (Camper's) - continuous with fascia of the thigh
76
Erection
Parasympathetic outflow via inferior hypogastric plexus Nitric oxide release Vasodilation and engorgement
77
Ejaculation
Sympathetic fibres cause contraction of the epididymis, vas deferens, seminal vesicles and prostate Bladder sphincter contracts to prevent retrograde ejaculate flow
78
Bulb of vestibule
Divided by vagina | Superficially covered by bulbospongiosus
79
Crura of clitoris
Attaches to pubic arch and rami and pubis and ischium | Superficially covered by ischiocavernosus
80
Bartholin's gland
Found posterior to the bulbs of vestibule Secrete lubricating mucous into the vaginal orifice Blockage of ducts can lead to Bartholin's cyst
81
Muscles attaching to perineal body
Levator ani External anal sphincter Bulbospongiosus Superficial transverse perineal
82
Genitofemoral nerve
L1-2 Skin of scrotum/labia majora Cremaster muscle
83
Lumbosacral trunk
L4-5 Emerges medial from psoas major Joins sacral plexus
84
Anatomical orientation of the uterus
Anteverted with respect to the vagina | Anteflexed with respect to the cervix
85
Process of gastrulation
Formation of primitive streak in epiblast Epiblast cells invaginate to displace the hypoblast to become endoderm Cells that do not invaginate become the ectoderm Cells between the layers become mesoderm
86
What do neural crest cells form?
Cranial --> bones of the skull, pia and arachnoid mater, cranial nerves components Trunk --> melanocytes, Schwann cells, dorsal root ganlia, parasympathetic nerves
87
Oligohydramnios
Lack of amniotic fluid | Due to kidney defects
88
Poluhydramnios
Excessive amniotic fluid | Due to GI atresia
89
AFP
= foetal albumin High levels = neural tube defects, GI atresia Low levels = Down's syndrome
90
Haemopoiesis sources in gestation
``` Initially = yolk sac Secondly = liver, thymus and spleen Finally = bone marrow ```
91
Sinus venosus becomes...
Coronary sinus and smooth part of right atrium
92
Primitive atrium becomes...
Trabeculated atrial parts
93
Primitive ventricle becomes...
Trabeculated ventricular parts
94
Bulbus cordis becomes...
Smooth ventricular parts
95
Truncus arteriosus becomes...
Aorta and pulmonary trunk
96
1st pharyngeal arch
CN V Muscles of mastication, mylohyoid, anterior belly of digastric Maxilla, mandible, incus, malleus, zygomatic, temporal, palatine, vomer
97
2nd pharyngeal arch
CN VII Muscles of facial expression, posterior belly of digastric, stylohyoid, stapedius Stapes, styloid process, lesser horn of hyoid
98
3rd pharyngeal arch
CN IX Stylopharyngeus Greater horn of hyoid
99
4th pharyngeal arch
``` CN X (superior laryngeal) Muscles of soft palate and pharynx, cricothyroid ```
100
5th pharyngeal arch
``` CN X (recurrent laryngeal) Muscles of the larynx, upper oesophageal muscle ```
101
1st pharyngeal pouch
Epithelial lining of auditory tube and middle ear
102
2nd pharyngeal pouch
Palatine tonsil
103
3rd pharyngeal pouch
Inferior parathyroid gland and thymus
104
4th pharyngeal pouch
Superior parathyroid gland
105
1st pharyngeal groove
External auditory meatus
106
1st pharyngeal membrane
Tympanic membrane
107
Origins of the tongue
Anterior 2/3 from 1st pharyngeal arch | Posterior 1/3 from arches 2-4
108
Skull fontanelles
Anterior Sphenoid Mastoid Posterior
109
Testosterone secretion
From Leydig cells by LH
110
Sertoli cell function
Support and nourishment of spermatogenic cells Secretion of androgen binding protein Secretion of inhibin for negative feedback
111
Epididymis function
Accumulation, storage and maturation of spermatozoa
112
Epididymis epithelium
Pseudostratified columnar with sterocilia
113
Vas deferens epithelium
Pseudostratified columnar with sterocilia
114
Seminal vesicles secretions
Secretion rich in fructose, vitamin C and prostaglandins
115
Prostate divisions
Anterior fibromuscular zone with CT and muscle fibres Central zone around ejaculatory ducts Transitional zone around urethra Peripheral zones where the majority of glands are found
116
Where does BPH occurs?
Transitional zone
117
Where does carcinoma of the prostate occur?
Peripheral zones
118
Prostate gland secretions
Rich in citric acid and hydrolytic enzymes such as fibrinolysin
119
Endo vs ectocervix
Endocervix closer to uterus Ectocervix closer to vagina Endocervix = simple columnar epithelium Ectocervix - stratified squamous epithelium
120
Layers of villi at the start
Capillary endothelium Loose CT of the villus core Cytotrophoblast Syncytiotrophoblast
121
Layers of villi after maturation
Capillary endothelium | Syncytiotrophoblast
122
When do erthyrocytes lose their nuclei?
9th week of gestation
123
Telomere sequence
TTA GGG
124
Diseases where shortened telomeres are found
Atherosclerosis Heart disease Hepatitis Cirrhosis
125
Pearl index formula
= number of unintended pregnancies per 100 women years of use
126
COCP mechanisms of action
Oestrogens inhibits FSH secretion resulting in anovulation | Progesterone inhibits LH secretion resulting in anovulation, thickens cervical mucous and causes endometrial atrophy
127
COCP contraindications
Heart disease, stroke, hyperlipidaemia, liver disease, pregnancy, oestrogen dependant tumours
128
COCP advantages
Protection from ovarian and endometrial cancer | Reduced incidence of benign breast lumps, ovarian cysts and endometriosis
129
COCP disadvantages
Increased chance of clots Impaired liver function Weight gain
130
POP mechanism of action
Progesterone inhibits LH secretion resulting in anovulation, thickens cervical mucous and causes endometrial atrophy
131
POP advantages
No increase in thromboembolic events | Can be used by those with contraindications of COCP use
132
POP disadvantages
Irregular bleeding Headache Acne
133
Fertilisation steps
Sperm finds and recognises egg via ZP3 glycoprotein Acrosome reaction to penetrate extracellular layer Fusion of cell membranes Calcium wave to block polyspermy Fertilisation cone formation Movement and fusion of pronuclei
134
Acrosomal enzymes
Hyaluronidase | Acrosin
135
When does hatching occur?
Day 5
136
When does the blastocyst attach to the uterine wall?
Day 7-9
137
When does first differentiation take place?
Day 6
138
Diseases associated with proportionate short stature
``` Turner syndrome Renal insufficiency GI disease Nutritional deficiency Hypothyroidism Hypercortisolism ```
139
Diseases associated with disproportionate short stature
Achondroplasia Hypochondroplasia Rickets
140
Onset of puberty is defined as...
Tanner stage B2 for girls - breast budding | Tanner stage G3 for boys - testes volume >3ml
141
Mean age of puberty onset
11 for girls | 12 for boys
142
When do the primordial germ cells leave the ectoderm and move to the yolk sac wall?
3rd week
143
When do the PGCs move to the gonadal ridges?
6th week
144
When do oogonia undergo intensive mitosis?
2nd-5th months of pregnancy
145
Stages of meiosis
Meiosis I = reduction division - diploid --> haploid | Meiosis II = equatorial division - independant reassortment of maternal and paternal chromosomes
146
When does crossing over occur?
Prophase I
147
What stimulates completion of meiosis I in primary oocytes
LH
148
Where does meiosis II arrest?
Metaphase
149
What triggers completion of meiosis II?
Fertilisation
150
Follicular antrum contents
Enzymes for digestion of follicular wall | Proteoglycans to attract water
151
Define primary spermacyte
Type B spermatogonia as they enter meiosis I
152
Define secondary spermacyte
Spermacyte that has completed meiosis I
153
How long does sperm meiosis I take?
24 days
154
Define spermatid
Sperm that has completed meiosis II
155
Why is the foetus not rejected by the mother's immune system?
IgM antibodies to fathers MHC molecules Placenta sequesters foetus from maternal T cells Protective features of the trophoblast including HLA-G expression, IDO production (depletes tryptophan to inhibit T cell activation) and lack of classic MHC molecules
156
Which antibody can pass through the placenta?
IgG
157
Which antibody can pass through breast milk?
IgA
158
How is IgG transported across the placenta?
Neonatal FcR
159
Structure of IgA
Dimer Two antibodies connected by J chain Secretory component to prevent degradation
160
Contraindication for immunisation
Anaphylaxis to previous dose Immunosuppression Acute illness
161
Inactivated vs attenuated vaccines
Virus can replicate in attenuated and not in inactivated | Inactivated vaccines general humoral immunity whereas attenuated develop humoral and cell-mediated
162
Labour associated prostaglandins
E2 and F2a
163
Signs of labour
The show Rupturing of membranes regular painful contractions accompanied by cervical dilatation
164
What is cut in an episiotomy?
Vaginal epithelium and perineal skin Bulbocavernosus Superficial and deep perineal muscles Someones external anal sphincter
165
Define menopause
The last menstrual period
166
Average age of menopause
52
167
When are women said to have gone through the menopause?
After 1 year of no periods
168
Perimenopausal symptoms
Changes in menstrual cycle length | Hot flushes and night sweats
169
Short term menopause symptoms
``` Hot flushes Night sweats Palpitations Depression Mood swings Increased urinary frequency Urge incontinence Vaginal dryness Pain during urination and intercourse Dry inelastic skin Hair loss Joint pain ```
170
Long term menopause symptoms
``` Ischaemic heart disease Osteoporosis Inelastic thin skin Prolapse Incontinence Depressed libido Atrophic changes to GU organs Pain during intercourse ```
171
Combinations of HRT
Oestrogen and progesterone if uterus present | Oestrogen only if no uterus present
172
Side effects of HRT
``` Heavy cyclical bleeding Bloating and fluid retention Weight gain Mastalgia Headaches Depression ```
173
Complications of HRT
Increased breast cancer risk | Increased risk of thrombo-embolic events
174
Contraindications for HRT
``` Breast cancer Endometrial cancer Endometriosis Fibroids Ischaemic heart disease ```
175
Non-hormonal treatments for menopause
Biphosphonates and calcitonin - reduce osteoclast activity Selective oestrogen receptor modulators Venlafaxine - reduce vasomotor symptoms
176
Follicular phase
Days 1-10 5-12 follicles stimulated to grow One will become a Graafian follicle GnRH stimulates FSH and LH which stimulates the growth of the follicle and oestrogen secretion
177
Ovulatory phase
Days 11-14 Graafian follicle bulges from ovary wall Ovulation occurs Surge of LH and FSH
178
Luteal phase
Days 15-28 Formation of corpus luteum Progesterone secretion maintains endometrium
179
Menstrual phase
Days 1-5 Collapse of endometrium Withdrawal of oestrogen and progesterone
180
Proliferative phase
Days 6-14 Thickening of endometrium and formation of glands and spiral arteries Synthesis of progesterone receptors on endometrial cells All stimulated by oestrogen from the mature follicle
181
Secretory phase
Days 15-28 Enlargement of glands and secretion of mucous and glycogen Stimulated by progesterone from the corpus luteum
182
Structure of surfactant
Monolayer of phospholipids Mainly consists of DPPC and PG Stabilised by surfactant protein B
183
Foetal metabolic stores
34g of glycogen | 560g of fat
184
Newborn metabolic fuels
Free fatty acids | Glucose and ketone bodies for the brain
185
Immune protection from breastmilk
IgA Lactoferrin Lysozyme Complement
186
Blood changes in pregnancy
Increase in plasma volume by up to 45% Increase in RBC volume RBC increase less so physiological anaemia of pregnancy possible
187
Why does plasma volume increase during pregnancy?
``` Vasodilation Decreased TPR Decreased renal perfusion Activation of RAAS Sodium and water retention ```
188
Cardiac output in pregnancy
Increases by 35-40% in first trimester and 50% by term Increase in stroke volume by 25% Increase in heart rate by 25%
189
When is blood pressure at a low point
17-24 weeks
190
Mediators involved in TPR decrease
Progesterone, oestrogen, NO, relaxin
191
Haemostasis in pregnancy
Hyper coagulable state Increase in fibrinogen and all clotting factors (except XI and TF) Decrease in coagulation inhibitors Increased platelet production
192
Respiratory changes in pregnancy
Increased oxygen consumption Increased alveolar and minute ventilation Increased tidal volume
193
Mechanisms of increase in ventilation
Progesterone-mediated hypersensitivity to CO2
194
Acid base changes in pregnancy
Increased ventilation means more CO2 expelled Respiratory alkalosis Some renal compensation
195
Foetal vs maternal placenta surfaces
``` Foetal = smooth with umbilical cord centrally with vessels radiating outwards Maternal = dull and grey with 15-20 segments ```
196
Umbilical artery vs vein
2 umbilical arteries carrying waste and carbon dioxide from the foetus to the placenta 1 umbilical vein carrying oxygen and nutrients from the placenta to the foetus
197
Human placental lactogen function
Increases FFA by lipolysis Promotes mammary duct proliferation Inhibits gluconeogenesis
198
Human placental growth hormone function
Regulation of maternal blood glucose levels
199
Types of locia
Lochia rubra - red - 0-3 days Lochia serosa - pink - 4-10 days Lochia alba - yellowish white - up to 6 weeks
200
Hormones responsible for mamogenesis
Oestrogen, progesterone, prolactin, human placental lactogen
201
Action of prolactin
Secreted from anterior pituitary gland | Causes lactogenesis
202
Action of oxytocin
Secreted from posterior pituitary Release stimulated by suckling Causes contraction of myoepithelial cells in ducts and alveoli to empty milk from the breast
203
Steroid structure
27 carbon skeleton with 4 fused rings | Core formed by cholesterol
204
Testosterone --> DHT
By 5a reductase enzymes in Sertoli cells
205
Androgen potencies
``` DHT = 100% Testosterone = 50% Androstenedione = 8% DHEA = 4% ```
206
Oestrogen potencies
17b oestradiol = 100% Oestriol = 10% Oestrone = 1%
207
LH vs hCG
Same alpha subunits (and for FSH) | Same beta subunits but hCG contains additional 24 amino acids
208
Sites of inhibin secretion
``` Males = Sertoli cells Females = granulosa cells ```
209
Prostaglandin synthesis
Essential fatty acids --> arachidonic acid | Arachidonic acids are then oxidised by COX enzymes to produce prostaglandins
210
Characteristics of stem cells
Undifferentiated | Can divide indefinitely
211
Order of stem cell potencies
``` Totipotent Pluripotent Multipotent Oligopotent Unipotent ```
212
Visual acuity at birth
6/60
213
Piaget's sensorimotor stage
0-2 Integration of perception and motor actions Cause and effect understanding Object permanence
214
Piaget's pre-operational stage
2-7 Egocentric Animism Only considers one feature of a problem at a time
215
Piaget's concrete operational stage
7-12 Can apply logic Can classify objects according to several features
216
Piaget's formal operational stage
12-19 Abstract reasoning Becomes concerned with hypothetical and future scenarios
217
Freud's psychosexual stages
``` Oral = 0-2 Anal = 2-4 Phallic = 4-5 Latency = 6-puberty Genital = puberty onwards ```

1 - FINALS (6 decks)

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