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Flashcards in Human Development Deck (217):
1

Male vs female pelvis

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

2

Sacrotuberous ligament

Sacrum --> ischial tuberosity

3

Sacrospinous ligament

Sacrum --> ischial spine

4

Sacroiliac ligament

sacrum --> ilium

5

Greater sciatic foramen

Formed by sacrotuberous and sacrospinous ligaments
Piriformis, sciatic nerves, superior and inferior gluteal vessels and nerves, internal pudendal nerve and vessels

6

Lesser sciatic foramen

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

7

Parts of levator ani from anterior to posterior

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

8

Coccygeus

Ischial spines --> lateral sacrum and coccyx

9

Function of pelvic floor

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

10

Folic acid in preventing birth defects

400mg per day
Could prevent around 75% of neural tube defects

11

Embryonic vs foetal period

Embryonic = 3-8 weeks
Foetal = 8 weeks --> term

12

Major vs minor congenital defects

Major = require medical or surgical intervention or causes significant handicap

13

Anencephaly

Malformed head and brain
Failure of anterior neuropore to close

14

Spina bfida

Herniation of spine and contents in the lower back
Failure of posterior neuropore to close

15

Hypospadias

Male urethra opens out in unusual place

16

Cleft lip

Failure of maxillary and medial nasal prominences to fuse

17

Cleft palate

Failure of palatine shelves to fuse

18

Holoprosencephaly

Loss of midline structures

19

Omphalocele

Abdominal contents do not correctly return from umbilical cord

20

Gastrochisis

Abdominal contents herniate through defect in anterior abdominal wall

21

Phocemelia

Limb abnormalities

22

Syndactylyl

Digits fused together

23

Polydactyly

Extra digits

24

Ankyloglossia

Tongue tie
Unusually thick and short frenulum

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