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Jahnavi Patel MD 1
Table of Contents
Chapter 1: Introduction.........1 9
Chapter 3: Spermatogenesis...15 20
Chapter 4: Oogenesis...21 25
What is Embryology?
- Study of the formation and development of the embryo (fetus) from the moment of inception up to
the time when it is born as an infant
- Every individual spends first 9 months (266 days or 38 weeks) within the womb (uterus) of its mother
o During first two months its called an embryo
One cell billions of cells
Recognizable as a human
o From third month until birth its called a fetus
Overview of Gametogenesis
Chromosomes
- A very long DNA molecule and associated proteins, that carry portions of hereditary information of an
organism
3p 3m 1
Chapter 1 Introduction
Chromosomes Continued
Chromosome Structure
- Chromosomes are not visible when in rest due to their chromatin material being highly
dispersed
- However, during cell division the chromatin network in the nucleus becomes condensed into a
number of chromosomes
2
Chapter 1 Introduction
Chromosomes Continued
Significance of Chromosomes
Cell Division
- Mitosis
o Process of cell division which results in the production of two daughter cells from a single
parent cell (equal number of chromosomes)
o Daughter cells are identical to one another and to the original parent cell
- Meiosis
o Process that allows one diploid cell to divide in a special way to generate haploid cells in
eukaryotes
o Word meiosis comes from the Greek meioun, meaning to make smaller, since it results in a
reduction in chromosome number
- Interphase
o The period between two successive divisions
3
Chapter 1 Introduction
Interphase
4
Chapter 1 Introduction
Mitosis
Prophase
Metaphase
Anaphase
Telophase
5
Chapter 1 Introduction
Meiosis I
Prophase I
- The cells genetic material, which is normally in a loosely arranged pile known as chromatin, condenses
into a visible threadlike structures
- Along the thread, centromeres are visible as small beads of tightly coiled chromatin
- 4 Stages of Chromosome in Prophase I
o Leptotene Stage
Individual chromosomes begin to condense into long strands within the nucleus
o Zygotene Stage
Chromosomes approximately line up with each other into homologous chromosomes
The combined homologous chromosomes are said to be bivalent
They are also referred to as a tetrad, a reference to the four sister chromatids
o Pachytene Stage
Heralds crossing over
Non-sister chromosomes of homologous chromosomes randomly exchange segments
of genetic information
o Diplotene Stage
The synaptonemal complex degrades
Homologous chromosomes fall apart and begin to repel each other
The chromosomes themselves uncoil a bit, allowing some transcription of DNA
They are held together by virtue of recombination nodules, betraying the sites of
previous crossing over, the chiasmata
- Diakinesis Stage
o Chromosomes re-condense
o Sites of crossing over entangle together, effectively overlapping, making chiasmata clearly
visible
o In general, every chromosome will have crossed over at least once
o The nucleoli disappears and the nuclear membrane disintegrates into vesicles
- During these stages, centrioles are migrating to the two poles of the cell
o These centrioles, which were duplicated during interphase, fucntion as microtubule
coordinating centers
- Centrioles sprout microtubules, essentially cellular ropes and poles, during crossing over
- They invade the nuclear membrane after it disintegrates, attaching to the chromosomes at the
kinetochore
- The kinetochore functions as functions as a motor, pulling the chromosome along the attached
microtubule toward the originating centriole, like a train on a track
- There are two kinetochores on each tetrad, one for each centrosome
- Prophase I is the longest phase in meiosis
- Microtubules that attach to the kinetochores are known as kinetochore microtubules
- Other microtubules will interact with microtubules from the opposite centriole these are called
nonkinetochore microtubules
6
Chapter 1 Introduction
Meiosis I Continued
Metaphase I
- As kinetochore microtubules from both centrioles attach to their respective kinetochores, the
homologous chromosomes align equidistant above and below an imaginary equatorial plane due to the
continuous counterbalancing forces exerted by the two kinetochores of the bivalent
- Because of independent assortment, the orientation of the bivalent along the plane is random
- Maternal or paternal homologues may point to either pole
Anaphase I
- Kinetochore microtubules shorten, severing the recombination nodules and pulling homologous
chromosomes apart
- Since each chromosomes are pulled toward opposing poles, forming two haploid sets
- Each chromosome still contains a pair of sister chromatids
- Nonkinetochore microtubules lengthen, pushing the centrioles further apart
- The cell elongates in preparation for division down the middle
Telophase I
- The first meiotic division effectively ends when the centromeres arrive at the poles
- Each daughter cell now has half the number of chromosomes but each chromosome consists of a pair
of chromatids
- The microtubules that make up the spindle network disappear and a new nuclear membrane surrounds
each haploid set
- The chromosomes uncoil back into chromatin
- Cytokinesis, the pinching of the cell membrane in animal cells or the formation of the cell wall in plant
cells occurs
- This completes the creation of two daughter cells
Interphase II
7
Chapter 1 Introduction
Meiosis II
Prophase II
Metaphase II
- Centromeres contain two kinetochores, organizing fibers from the centrosomes on each side
Anaphase II
- Centromeres are cleaved, allowing kinetochores to pull the sister chromatids apart
- The sister chromatids by convention are now called sister chromosomes and are pulled toward
opposing poles
Telophase II
- Marked by uncoiling, lengthening and disappearance of the chromosomes occur as the disappearance
of the microtubules
- Nuclear envelopes reform
- Cleavage or cell wall formation eventually produces a total of four daughter cells
o Each with a haploid set of chromosomes
8
9
Chapter 2 Chromosomal Anomalies
Introduction
- Occurs when there is damage to chromatid but the number of chromosomes is normal
- Types of structural changes
o Deletions (deficiencies)
o Duplications
o Inversions
o Translocations
- How can chromosomes break?
o Ionization radiation
Production of free radicals, which act like little atomic cannon balls blasting through
strands of DNA or chromosomes
o Chemical insult
- How do they rejoin?
o Break points of chromosomes are highly reactive (sticky), whereas normal ends of
chromosomes are capped by telomeres, which do not readily bond to other molecules
10
Chapter 2 Chromosomal Anomalies
Structural Chromosomal Anomalies Continued
- Cri-du-chat Syndrome
o Deletion of the short arm of chromosome number 5 (Deletion of 5p)
o Clinical Features
Mental retardation
Slow motor skill development
LBW (low birth weight) and slow growth
Microcephaly (small head)
Partial webbing of fingers or toes
Hypertelorism (wide-set eyes)
High-ptiched cry
- Occurs when there are abnormal numbers of chromosomes but structurally its normal
- Types of numerical changes
o Euploidy
true ploidy, meaning two members of each homologous pair
o Aneuploidy
not true ploidy, meaning more or fewer members than two of each homologous pair
Monosomy
One homolog; partner is missing
Trisomy
Three homologs
Nullisomy
One entire homologous pair is missing
- How do chromosomes have abnormal numbers?
o The normal separation of chromosomes in MI or sister chromatids in MII is termed disjunction
o When the separation is not normal nondisjunction
This results in the production of gametes which have either more or less of the usual
amount of genetic material
It can occur in MI, MII, or mitosis
11
Chapter 2 Chromosomal Anomalies
Numerical Chromosomal Anomalies Continued
o Clinical Features
Severe mental retardation
Heart and organ defects
Polydactyly Extra finger
Death by the age of one year
- Edward Syndrome (Trisomy 18)
o Three homologs of chromosome 18
- Down Syndrome (Trisomy 21)
o Three homologs of chromosome 21, an error in meiosis
It has a recurrence risk of about 1/100
o 1/700 births
o >60% spontaneously aborted
o 20% stillborn
12
Chapter 2 Chromosomal Anomalies
Numerical Chromosomal Anomalies Continued
14
Chapter 3 Spermatogenesis
Testes
- XY - Testes
- Testes develops in the posterior lumbar region
- Coelomic epithelium surrounds the testes in the posterior lumbar region
o At this point they are undifferentiating gonads (XY Y has TDF (testes determining factor)
- Coelomic epithelium burrows inside, sets septa into the gonads
o Septa are called sex cords or medullary cords
- These cords become canalized to become seminiferous tubules
o Not all are canalized, some remain as cord-like structures
They are broken down to interstitium
Function: keep seminiferous tubules apart and support them
- Within interstitium there are specialized cells
o Leydig cells
Secrete testosterone
- Within walls of tubules there are specialized cells
o Sertoli cells
They secrete MIF (Mullerian inhibiting factor)
Maintain blood testes barrier
Germ Cells
15
Chapter 3 Spermatogenesis
Prostate gland
- phosphoric acid
- citric acid
16
Chapter 3 Spermatogenesis
Spermatogenesis
17
Chapter 3 Spermatogenesis
18
Chapter 3 Spermatogenesis
Spermiogenesis
1. Elongation of nucleus
2. Golgi apparatus packaging the membrane
bound granules called the acrosomal
vesicles
3. Acrosomal vesciles takes a superior
nucleus position. When this happens, the
centrioles begin to elongate in the
opposite direction (to form the tail)
4. Mitochondria moves down on either sides
of the elongated centrioles
5. Macrophages (sertoli cells) take away the
residual cytoplasm
6. Mature sperm cell spermatozoa
- Main part of the tail is attached to the proximal centriole called axoneme
- Acrosomal Cap
o Contains enzyme acrosin and hyaluronidase
Important in the penetration of the ovum
- Extra Note: Cowpers gland helps in lubrication
19
Chapter 3 Semen Analysis
Infertility
- If a couple fails to produce a child, the first analysis is done by the male called semen analysis
- Commonly used normal semen parameters
o Volume of semen
o Sperm count
o Morphology
o Motility
o pH
Definition of Terms
- Aspermia
o Absence of semen
- Azoopermia
o Absence of sperm
- Oligospermia
o Less sperm
- Asthenozoospermia
o Weak sperm (in motility)
Asthenic = weak
20
Chapter 4 Oogenesis
Endometrium
- Inner wall of uterus
- Highly vascular
- Endometrial glands
- Responds to hormone levels in
the blood
Intra mural portion of FT
- The tube that still surrounded by
uterine wall
21
Chapter 4 Oogenesis
Ovaries
- XX - Ovary
- The undifferentiated gonads in the posterior lumbar region covered by coelomic epithelium sends
septa known as sex cords or medullary cords
- NONE are canalized, ALL are broken down
o They mostly form granulosa cells(they are descendants of coelomic epithelium)
o Some form interstitial cells
Germ Cell
Oogenesis
22
Chapter 4 Oogenesis
Prenatal Development
23
Chapter 4 Oogenesis
Postnatal Development
Postnatal Development
- Graafian follicle
o Fully developed secondary follicle
o Secondary oocyte and polar body formed by completion of first meiotic
23 chromosomes, double structured (haploid)
DNA material 2N or 2C
o Secondary oocyte enters into 2nd meiotic division and arrests at metaphase II (3 hours before
ovulation)
o 14 days before menstrual cycle, graafian follicle is ready for ovulation
o During ovulation
One secondary oocyte is released
Cumulus oophoricus is also released and renamed corona radiata
Ovulation
Fate of Ovum
- After release of secondary oocyte, it moves into the infundibulum by fimbriae, then goes to ampulla
(site of fertilization)
- Ovum will wait in the fallopian tube for 24 48 hours
- If sperm does not come
o Ovum will degenerate, become apoptotic and die in the fallopian tube
- If sperm comes
o Fertilization zygote
25
Chapter 5 Female Reproductive Cycle
Regulation of Hormones
27
Chapter 5 Female Reproductive Cycle
Phases of Uterine/Ovarian Cycle
- Secretory Phase/ Luteal Phase/ Progestational Phase (14th day to 28th day)
o Endometrium glands enlarge (cork-screw shaped) and accelerate their rates of secretion
o Corpus luteum stimulated by LH secretes progesterone, estradiol
It stimulates development of gland and arteries of endometrium causing it to become
thick and spongy
Glands become watery mucous (assist spermatozoa through uterus and FT)
Estradiol exert negative feedback on hypothalamus
o LH, FSH levels are negligible atresia
o If fertilization takes place and implants in endometrium, placental HCG from the site of
implantation rescues CL, and secretes progesterone for another 2 months
Progesterone is responsible for the maintenance of pregnancy
o No progesterone no HCG Continues menstrual phase
o Threatened abortion
Continue giving progesterone (extra loading)
Can see spotting on the 2nd month
If female does not take proper care, complete abortion can take place
Summary
28
Chapter 6 Formation of Germ Layers
Contraception
Fertilization
29
Chapter 6 Formation of Germ Layers
Fertilization
- Abnormal Implantation
o Normal implantation occurs in the upper uterine segment
o Ectopic pregnancy: implantation occurs outside the uterine cavity
Abdominal pregnancy
A form of an ectopic pregnancy where the pregnancy is implanted within the
peritoneal cavity outside the fallopian tube or ovary and not located in the
broad ligament
Tubal pregnancy
Implantation in the fallopian tube
- Changes in Zygote
o Meiosis II is completed
o Sex Determined
Ova contains 22 + X
Spermatozoa are of 2 types:
Half are 22 + X
Half are 22 + Y
Sex of the child determined at the time of fertilization
o Cleavage initiated
Cleavage
31
Chapter 6 Formation of Germ Layers
Summary of the First Week of Development
32
Chapter 6 Formation of Germ Layers
Second Week of Development Continued
- The inner cell mass arrange themselves into a 2 layered disk Bilaminar disk
o Ectoderm (Epiblast) columnar cells
o Endoderm (Hypoblast) cuboidal cells
- There is a small cavity within the mass of ectoderm called amniotic cavity
- Endoderm forms a membrane called Heusers membrane just beneath cytotrophoblast
- Formation of primary yolk sac
- AC later expands and completely surrounds the yolk sac
o Fetus in the AC
o As enlarges, all structured behind are compressed
o The primary yolk sad becomes smaller in side due to the pressure
Now called secondary yolk sac
o Because of the pressure, the EE coelomic cavity is obliterated
o As a result amniochorionic membrane is formed
Amnionic inside
Chorionic outside
During labour: amniochorionic fluid will rupture first, allowing the head to pass the
cervical canal
If doesnt rupture by itself
o ARM: Artificial rupture membrane
o Anoxia can be a result due to inability of the head to come out
33
Chapter 6 Formation of Germ Layers
Gastrulation - Formation of All Three Germ Layers (3rd Week of Development)
- Some cells (only at one corner) from endoderm and ectoderm proliferate and change shape
o Prochordal plate
Mass of proliferated endodermal cells
Appearance of this determines the head end of the development of embryo
o Primitive Streak
Mass of proliferated ectodermal cells
Tail end
rd
- During the 3 week:
o The primitive streak passes between ectoderm and endoderm to form intraembryonic
mesoderm
o The 3 layered disk (ectoderm, mesoderm and endoderm) is called trilaminar disk
34
Chapter 6 Formation of Germ Layers
What the Germ Layers Form
- Primitive streak cells still accumulate and become knob like structures called primitive node or
primitive knob
- The cells from this will move along the ectoderm from primitive node till the Prochordal plate
- The cells moving are called notochordal plate
o Notochordal process acts as a stimulant, instigator for ectoderm above it to change,
differentiate into special structure known as neural plate
Notochordal plate thickens neural plate
Remaining free space is filled with intraembryonic mesoderm
Which 3 places dont see intraembryonic mesoderm?
o Cloaca, Prochordal plate, notochordal process
35
Chapter 6 Formation of Germ Layers
Third Week of Development
5r
36
Chapter 6 Formation of Germ Layers
Third Week of Development
37
Neurulation & Development of Somites
38
Embryonic Folding
39
Chapter 7 Connecting Stock & Placenta
Connecting Stock
Placenta
- Decidua basalis from the maternal aspect and villi from the embryonic side help to form placenta
(Refer for primary tertiary villi notes)
- Placenta is circular, disk in shape
- Diameter is 5 -7 inches
- Function of placenta
o Enables transport of oxygen, water, electrolytes and nutrition
o Provides excretion of carbon dioxide, urea and other waste products
o Maternal antibodies give fetus immunity against some infections
o Acts as barrier and prevents many bacteria and other harmful substances from reaching the
fetus
But, some pass through the placenta (rubella, measles, poliomyelitis)
Rubella can cause cataracts, deafness, congenital CVS anomalies
o Keeps blood separate, preventing antigenic reaction between them
o Syntheses many hormones produced in the syncytiotrophoblast
Estrogen development of mammary glands
Progesterone CL will secrete progesterone 2 3 months, after secreted by placenta
HCG main base for urine pregnancy test
Somatomammotropin hormone has anti-insulin effect
40
Chapter 7 Connecting Stock & Placenta
Placenta
Formation of Placenta
41
Chapter 7 Connecting Stock & Placenta
Placenta Continued
Anomalies of Placenta
- Anomalies in shape of placenta
o Bidiscoidal
o Fenestrated placenta hole in placenta
o Placenta succenturate extension of placenta
o Circumvallate placenta entire placenta is covered in
o Lobed placenta divided into lobes
o Diffuse placenta chorionic villi persists all around blastocyst
- Anomalies in attachment of placenta
o Placenta percreta sometimes the attachment of villi enters myometrium and perimetrium
o Placenta accrete attachment of villi to myometrium
o Placenta previae placenta attached anywhere other than upper uterine segment
Grade 1 (1st degree)
Attached in LUS away from IOS
Uterus grows, so the placenta can move to UUS
Grade 2
Attached in LUS, touching IOS
Grade 3
Attached in LUS, but edge covers the IOS
Can open if cervix dilates
Grade 4
Attach in LUS, completely covers IOS
Without use of ultra sound for early diagnosis, many death can occur by heavy
bleeding
o Abruptio Placenta
Premature detachment of placenta (before delivery)
Normal: 15 20 minutes placenta still hands and slowly constricts and removes it, this
prevents blood clots, hemorrhage
o Furcate placenta
Before attachment to placenta, arteries are divided
o Battledoor placenta
Umbilical cord is attached to the margin of placenta not the center
42
Chapter 7 Twins
Types of Twins
- Dyzygotic Twins
o 2 ova and 2 sperms
o Non-identical
o 2/3 of twins
- Manozygotic Twins
o 1 ova fertilizes by 1 sperm
o Identical
o 1/3 of twins
Monozygotic Twins
Siamese Twins
43
Chapter 7 Extra Notes
Anomalies & Prenatal Diagnostics Tests
Amniocentesis
- Amniotic fluid also helps in diagnosis of chromosomal anomalies can do karyotyping (FISH)
- Can aspirate after the 14hth week
- Comes with risk: infection can occur
o Chorioamniotic membrane is first exposed, if any organisms enter can result in
chorioamnionitis
o Amniotic bands
Necrotic material in amniotic fluid can result in amniotic bands due to infection
These bands can surround structures in body and can result in abnormal structures or
death
- Amniocentesis analyzes alpha-fetoprotein level which is produced by hepatocytes
o Normal level: 40 microgram/L
o High alpha-fetoprotein level in: tumours and neural tube defect
Neural Tube Defect
Genetic defect Neural tube does not completely emerge
When pregnant, obstetricians give folic acid for nutrition if runs in fam
Ultrasound
44
Chapter 7 Extra Notes
Tests
Elderly primi
45
Timeline
Overview of the Events
Oragnogenesis Week 4 8
46
Skeletal System
Introduction
Endochondral Ossification
47
Skeletal System
Endochondral Ossification
48
Skeletal System
Endochondral Ossification
- Mesenchymal condensation is seen in the limb bud in the region where the bone is to be formed
- Long bone ossifies by 2 ossification centers
o Primary ossification (before birth)
Always for the diaphysis of the bone (shaft of bone)
Calcification starts at the center called primary ossification center in the diaphysis
Calcification is spread to the periphery
Appears during intra uterine life
o Secondary ossification
For the epiphysis
Appears after birth
Calcification starts in the center called secondary ossification center in the epiphysis
- Junction between epiphysis and diaphysis epiphyseal plate
o Stop ossification by 18 20 years of age
49
Skeletal System
50
Skeletal System
Anomalies of Bone
Formation of Limbs
51
Skeletal System
Formation of Limbs
Anomalies of Limbs
- Club foot Congenital Talipes Equinovarus
o Kids feet are inverted
- Amelia or Phocomelia
o Amelia: complete absence
o Phocomelia: Not formed properly
o Thalidomide prevent morning sickness during pregnancy, leads to these conditions
- Polydactyly
o Extra digits
- Sandytyly
o Digits are fused
- Synphalangia
o Interphalangeal joints are fused
52
Skeletal System
53
Skeletal System
54
Skeletal System
- Hemivertebra
o Commonly seen when vertebrae ossifies by 2 ossification centers which fuse
o One of these parts may fail to develop, resulting in only half of the body
o Usually associated with absence of the corresponding rib
- Spinabifida Anterior
o 2 halves of the vertebral body form normally but fail to fuse = gap
Sometimes gap is large enough for meninges and nerves to bulge forward between
them
- Spinabifida
o Gap between neural arches
- Diastetomatomylia
o Small bony projection (spicule) coming out of neural canal
(there is a spinal cord running in bony canal), it can dissect
into the spinal cord
o Depending on the severity of the spicule, may have
neurological abnormalities
- Klipper Feil Syndrome
o Cervical vertebrae are fused Spinabifida
- Sacralization
o 5th lumbar vertebra partially or completely fused to the sacrum
- Lumarization
o 1st sacral vertebra attached with 5h lumbar vertebra
- Occipitilization
o 1st cervical vertebra attached with occipital bone
- Spondylolisthesis
o Articular facets are abnormal in orientation or are deficient
o When deficiency both inferior articular processes of the 5th lumbar vertebra and the body of
the vertebra may slip forwards over the sacrum
55
Skeletal System
Formation of Ribs
- Ribs are derived from ventral extension of the sclerotomic mesenchyme that forms the vertebral
arches
- Small projection from the transverse process is known as costal element
o It is present in transverse process of all vertebrae BUT formation of ribs takes place only in the
thoracic vertebra
o In thoracic vertebrae
The entire extension (primitive costal arch) undergoes chondrification followed by
ossification to form the ribs
o Other regions will not project forward and remain in the vertebrae
Formation of Sternum
- Sternum is formed by fusion of two sternal bars that develop on either side of the midline
o Fusion first occurs at their cranial end manubrium
o Fusion proceeds caudally
- Mesenchymal condensaions forming at these sites become cartilaginous in the 7th week of IUL
- Laterally, sternal bars are continuous with ribs
- Manubrium and body of sternum are ossified separately
- Xyphoid process ossifies only late in life
56
Skeletal System
- Cervical Ribs
o 7th cervical vertebrae has rib formation
May compress brachial plexus, resulting in a tingling sensation
o Treatment: surgically remove
- Funnel Chest
o Thoracic outlet forms a funnel shape
o Lower part of the sternum and the attached ribs are drawn inward into the thorax
o Primary defect is that the central tendon of the diaphragm is abnormally short
- Pigeon Chest
o When manubrium projects forward with a break shape appearance
o Thoracic inlet projecting forward
57
Skeletal System
58
Skeletal System
59
Skeletal System
60
The Skin & Its Appendages
Skin
- Epidermis ectoderm
o Ectodermal cells proliferate to give rise to typical stratified squamous epithelium
o 5 layers of epidermis
Stratum basalis/ stratum germinatum
Stratum spinosum
Stratum granulosum
Stratum lucidem
Stratum corneum
- Dermis mesoderm
o Formed by condensation and differentiation of mesenchyme underlying the surface of
ectoderm
- Dermal papillae
o Line of junction between dermis and epidermis is at first straight
o Subsequently, the epidermis shows regularly spaced thickening hat project into dermis
o The portions of dermis intervening between these projections dermal papillae
- Colour of skin
o Melanin melanocytes neural crest cells neural folds
NCC enter into dermis and become melanoblasts, migrate to upper layer of dermis and
become melanocytes
61
The Skin & Its Appendages
Hair
- Ectoderm
- Stratum basalis dips into dermis and becomes a cup-shape (root of hair)
o This elongates by deposition of keratin
- Hair itself is formed by proliferation of germinal cells overlying the papilla
- Arrector pili
o Thin band of smooth muscle formed by mesodermal cells
o Gets attached to the root and a typical hair follicle is formed
- Primitive Hair Lanugo Hair
o Hair developed in IUL, even there at birth
o 1st year of life, this hair comes off and see formation of regular porous hair
Nail
62
The Skin & Its Appendages
Glands
- Formation of gland
o Ectoderm derivatives Sweat gland, mammary, sebaceous
o Mesoderm derivatives
o Endoderm derivatives Liver, pancreas
o Mixture Prostate gland (endoderm + mesoderm)
- Exocrine glands
o They have a duct, secretions are in a duct system
o How derived?
From epithelium there is a down growth divides terminal duct enlarges to form
the secretory portion canalized
- Endocrine glands
o Ductless glands pituitary, thyroid
o How derived?
Same, but down growth is disconnected
Sebaceous Gland
Mammary Gland
- During development there is milk line/ mammary line which is extending from axilla to inguinal region
- Gland is formed in the pectoral region
- From epidermis there is a down growth which dips in dermis, giving 7 8 lactiferous ducts and forming
secretory elements
- Anomalies of Mammary Gland
o Polythelia Extra nipples along milk line
o Athelia No nipple
o Amastia Absence of mammary gland
o Gynecomastia Enlargement of male breast (excess estrogen)
Anomalies of Skin
- Albinism Lack of pigment melanin
- Atrikia Absence of hair (Can have ulcers too incomplete epithelium)
- Hypertricosis More hair
63
The Skin & Its Appendages
64
The Pharyngeal Arches
Introduction
- Pharyngeal arches are mesodermal thickening in the wall of the cranial most part of foregut
- Another name: Branchial arches
- There are 6 of them, 5th arch degenerates
65
The Pharyngeal Arches
Meckels Cartilage
Hyoid Cartilage
- Bones formed
o Stapes
o Styloid process
o Stylogyoid ligament
o Superior part of the hyoid bone
o Lesser cornu
3rd Cartilage
- Bones formed
o Inferior part of hyoid bone
o Greater cornu
66
The Pharyngeal Arches
67
The Pharyngeal Arches
68
The Pharyngeal Arches
Ectodermal Cleft
Endodermal Pouch
69
The Pharyngeal Arches
Formation of Tongue
- Tongue develops in relation to the pharyngeal arches in the floor of the developing mouth
- At the floor of the first pouch:
o Midline swelling tuberculum impar
o 2 lateral swellings lingual swellings
- Swelling in relation to the 2nd, 3rd and 4th pouch
o Midline swelling Hyperbronchial eminence
Lower portion of HE is left behind which contributes to the epiglottis
- Parts of the tongue
o Posterior most
Derived from hyperbronchial eminence in relation to 4th pouch
Nerve: mandibular nerve
o Posterior 1/3
Derived from hyperbronchial eminence in relation to 2nd and 3rd pouch
HE of 3rd portion overgrows over the HE of 2nd pouch, making 3rd pouch the most
dominant during the formation of posterior 1/3 of tongue
Nerve: Glossopharyngeal nerve
o Anterior 2/3
Derived from the fusion of tuberculumimpar and lingual swellings
Nerve: Superior laryngeal nerve
- Frenulum attaches to the tongue to the oral cavity
o Function: support
- Anomaly
o Ankyloglossia Tongue tie: tip of tongue attached to the floor of oral cavity
o Ankyloglossia superior Tip of the tongue is attached to the palate (roof of oral cavity)
70
Fetal Circulation
Thyroid Gland
Parathyroid Gland
Thymus Gland
71
Fetal Circulation
Intra-Uterine Life
- Oxygenated and nutrient-enriched blood returns to the fetus from the placenta via the left umbilical
vein (note: oxygenated blood is carried by the LUV, not by an artery as in the adult)
- Some blood percolates through the hepatic sinusoids; most of the blood bypasses the sinusoids passing
through the ductus venosus and enters the future IVC
o Note: Liver is formed in septum transversum, so that is present in that area as well
- From future IVC, blood enters the right atrium, where most of the blood bypasses the right ventricle
through the foramen ovale to the left atrium
- From the LA, blood enters the LV and is delivered to fetal tissues via aorta
o The aorta between LV and ductus arteriosus is OXYGENATED ONLY
This gives oxygenated blood to the cranial end
o After ductus arteriosus, it is a mixture of OXYGEN AND CARBON DIOXIDE
o Aorta branches into 2 arteries:
Poorly oxygenated and nutrient-poor fetal blood is sent back to the placenta via right
and left umbilical arteries
- Some blood in the RA enters the RV; blood in the RV enters the pulmonary trunk but most of the blood
bypasses the lungs through ductus arteriosus which is connected to the aorta because
o Fetal lungs are not capable of performing their adult respiratory function because they are
functionally immature and the fetus is underwater (amniotic fluid). The placenta provides
respiratory function
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Fetal Circulation
Intra-Uterine Life
After Birth
Coarctation of Aorta
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Cardiovascular System
Introduction
- Earliest sign of the heart is the appearance of paired endothelial strands angioblastic cords
o Formation of blood vessels is called angiogenesis
Blood vessels have 3 layers
o Near the yolk sac, the mesenchymal cells get transferred into angioblastic cells
Angioblastic cells arrange in a tubular fashion, first layer is the endothelium, muscular
layer derived from mesoderm
- These cords are formed in the splanchnopleuric mesoderm
o Some portion is within the septum transversum
o They canalize to form two thin heart tubes
The two heart tubes fuse by the pressure initiated by lateral folding single heart
tube
Craniocaudal folding puts it in its right position
- Splanchnopleuric mesoderm forms myocardium before and surrounds the heart tubes called
myoepicardial mantle or epimyocardial mantle
- Heart tube invaginates inside the pericardial cavity and gets completely surrounded by it
- Heart tube is dorsal to the developing GUT and ventral to pericardial cavity
o When the craniocaudal folding takes place, there is a switch in position and the heart tube
becomes dorsal to the pericardial cavity and ventral to the gut
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Cardiovascular System
Sinus venosus Primitive atrium Primitive ventricle Conus TA Future aortic sac
- Both horns of the sinus venosus receive blood from 3 important regions of the body
o Oxygenated blood from placenta
Formation of 2 veins
Right umbilical vein
Left umbilical vein
Carry well-oxygenated blood from the chorion
o Yolk sac supplies nutrition rich blood
Formation of 2 veins
Right vetallineum
Left vetallineum
Return poorly oxygenated blood from the umbilical vesicle
o Blood from the body wall
Formation of 2 veins
Right common cardinal vein
Left common cardinal vein
Anterior and posterior cardinal vein fuse to form the common cardinal vein
Return poorly oxygenated blood from the body of the embryo
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Cardiovascular System
- Partitioning of the atrioventricular canal, primitive atrium and ventricle begins around the middle of
the 4th week and is essentially completed by the end of the 8th week
- Although described separately, these processes occur concurrently
- Sinus venosus slowly gets released from septum transversum and moves superiorly and posteriorly
- Primitive atrium divides into 2 atrium
- Primitive ventricle divides into 2 ventricles
o Right ventricle is formed by major portion of conus
Left ventricle is formed by a bit of conus and some by primitive ventricle
- Truncus arteriosus is divided into aorta and pulmonary artery
Partitioning of Atrium
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Cardiovascular System
Partitioning of the Primordial Heart
ATRIOVENTRICULAR CANAL
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Cardiovascular System
Partitioning of the Primordial Heart
- The atrial chamber undergoes division into right and left halves by formation of two septa
- Septum primum
o It arises from the roof of CAC, to the left of septum spurium
o It grows downward towards the septum intermedium but does not fuse initially
o Note: throughout fetal life oxygenated blood reaches the RA from the placenta, this blood has
to reach LA. So communication between RA and LA is essential
o During the formation of the septum, first there is an opening called foramen primum/ ostium
primum
Blood flows from RA to LA through this foramen
o After the first opening, septum primum fuses with septum intermedium BUT before it fuses
there is a small opening at the top (by the breakdown of the upper part of SP)
Foramen secundum/ ostium secundum
Second opening so blood enters from right to left
When this is formed, the foramen secundum is called foramen ovale
o Upper edge of septum primum is thin Fossa Ovalis
- Septum Secundum
o It arises from the roof of CAC and stops right after the second opening
o Lower edge of the septum secundum is thick Anulus Ovalis
When the blood comes, the thick later allows blood to flow from right to left but not
left to right
- After birth, pulmonary vasculature is established
o Pulmonary vein brings blood into LA and these is an increase pressure in LA
o This rise in pressure approximates septum primum and secundum so foramen ovale is closed
o Patent foramen ovale when foramen ovale is slightly open
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Cardiovascular System
Partitioning of the Primordial Heart
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Cardiovascular System
Partitioning of the Primordial Heart
Partition of Ventricles
- A spiral septum appears within the truncus arteriosus and subdivides it into the ascending aorta and
the pulmonary trunk
- It is formed by union of right superior and left inferior truncus swellings or cushions
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Cardiovascular System
Partitioning of the Primordial Heart
Anomalies of Position
- Dextrocardia
o Chambers and blood vessels of the heart are reversed from side to side
- Ectopia Cordis
o Heart lies exposed (front of the chest) due to defective development of the chest wall
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Cardiovascular System
Congenital Anomalies of the Heart
Combined Defects
- Fallots Tetralogy
o Pulmonary stenosis
Myocardium extends toward the mitral valve leaflets, so outlet becomes narrowed
o RV hypertrophy
o Ventricular septal defect
o Overriding aorta
Other Defects
- Taussig-Bing Syndrome
o Ventricular septal defect
Aorta arises from RV
- Ebstein Anomaly
o Valve leaflets are pushed below
o RV volume is decreased
o Atrialization occurs: some of RV is fused with atrium
- Coarctation of Aorta
- Patent Ductus Arteriosus
o Blood enters the pulmonary artery and to the lungs if the DA is open
o Heart cardiac murmur
o If opening is big ligation
o If opening is small anti prostaglandins
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