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Y2 > Embryology > Flashcards

Embryology Flashcards

1
Q

Stages of first trimester

A

Embryogenic(14-16 days)

Embryonic(16-50 days)

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2
Q

Embryogenic stage function

A

Determine pluripotent embryonic cells and extraembryonic cells

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3
Q

Embryonic stage function

A

Determine germ layers and differentiate tissue layers

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4
Q

What is foetal stage

A

50-270 days

Migration of organs to final position
Extensive growth and foetal viability

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5
Q

What does the ovulated oocyte become

A

Zygote
Embryo
Morula
Blastocyst

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6
Q

Maternal to zygotic genome transition

A

Before 4 cell stage: embryo is dependent on maternal mRNA and proteins

4-8 cell stage: zygotic genome activation

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7
Q

What is pluripotent embryonic cells and extraembryonic cells made of

A

Pluripotent embryonic cells->inner cell mass

Extraembryonic cells->trophoectoderm

Blastocoel is fluid filled cavity from trophoblasts pumping Na into cavity

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8
Q

How and when does implantation occur

A

Day 7-9
Trophoblasts fuse->syncitiotrophoblast
Invades and destroys maternal cells in endometrium

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9
Q

What does inner cell mass separate into

A

Epiblast->foetal tissue

Hypoblast->yolk sac

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10
Q

When and how does bilaminar embryonic disc formation occur

A

Day 12+
Epiblasts separate->form amniotic cavity
Amnion cells contribute to extraembryonic membrane
2 layered disc of epiblast and hypoblast between cavities

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11
Q

What is gastrulation

A

Occurs after bilaminar disc formation
Formation of primitive streak: head/tail and left/right axes
Invagination of cells into primitive streak: endoderm, mesoderm, ectoderm

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12
Q

What is notochord and when does it form

A

Day 13+
Rod-like structure along embryo midline
Organising centre for neurulation and mesoderm development

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13
Q

Process of neurulation

A

Notochord signals->neural plate invagination->neural groove
2 neural folds form along craniocaudal axis
Neural crest cells reside in neural folds
Neural folds move over neural groove, fusing and forming a hollow tube
Neural tube overlaid with epidermis
Crest cells migrate from neural folds

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14
Q

When does neural tube close

A

Head: day 23
Tail: day 27

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15
Q

Failure to close neural tube

A 
Anencephaly(head fail)
Spina bifida(tail fail)
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16
Q

What is somitogenesis

A

Formation of somites(paired blocks of paraxial mesoderm)

Blocks of somites condense and bud off

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17
Q

What are some somite derived tissue

A

Sclerotome->vertebrae and rib cartilage

Dermomyotome->muscles and skin

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18
Q

When and how does gut tube form

A

Day 16+
Lateral and ventral folding
Pinches off part of yolk sac

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19
Q

When and how does heart form

A

Day 19
From mesoderm
Starts pumping at day 22
Foetal heartbeat at week 6

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20
Q

When and how do lungs form

A

From endoderm in week 4

Lung splits and progressively branches

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21
Q

How do gonads form

A

From mesoderm
XX: gonadal cells become granulosa cells
XY: gonadal cells become sertoli cells

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22
Q

Causes of early pregnancy loss

A

Embryo-foetal development errors
Implantation failure
Inability to sustain development

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23
Q

Miscarriage classification

A

Early: <12 weeks
Late: >23 weeks

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24
Q

Aneploidy mechanism and causes

A

Maternal age

Cohesin that holds homologous chromosomes together is not replaced ->chromatids separate and drift

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25
Q

Cause of recurrent pregnancy loss/miscarriage

A

Lif deficiency->implantation failure

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26
Q

Types of gestational trophoblastic disease(GTD)

A

Benign: hydatidiform moles-> complete(empty egg) or partial(normal egg)

Malignant: gestational trophoblastic neoplasia

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27
Q

Gene mutation causing recurrent hydatidiform moles

A

NLRP7

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28
Q

Main location for ectopic pregnancy

A

Fallopian tube

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29
Q

Ectopic pregnancy treatment

A

Expectant management
Chemotherapy
Surgery->remove trophoblast and/or tube

30
Q

How does smoking affect ectopic pregnancy

A

Cotinine:increase PROKR1 expression-> fallopian tube smooth muscle contractility dysregulated

Cotinine: induce proapoptosis protein

Tobacco smoke inhibits ciliary function

31
Q

How does cannabis affect ectopic pregnancy

A

CB1 receptor expression reduced
Endocannabinoid levels higher
THC hinders embryo transit

32
Q

Difference between first and second trimester nutrition

A

1st: histiotrophic->uterine gland secretions and breakdown of endometrium
2nd: haemotrophic->maternal blood contacts foetal membranes

33
Q

Origins of placenta

A

Ammion
Chorion(outer membrane)
Connecting stalk(embryo to chorion)
Trophoblastic lacunae

34
Q

What is trophoblastic lacunae

A

Large spaces filled with maternal blood from breakdown of maternal capillaries

Becomes intervillous spaces

35
Q

What is amnion

A

Inner foetal membrane
Forms a closed avascular sac
Secretes amniotic fluid->protect foetus

36
Q

What is chorion

A

Outer foetal membrane
Highly vascular
Gives rise to chorionic villi

37
Q

What is allantois

A

Outgrowth of yolk sac
Grows along connecting stalk
Coated in mesoderm and vessels to become umbilical cord

38
Q

Formation of chorionic villi

A

Outgrowths of cytotrophoblast into syncitiotrophoblast layer
Undergo branching
Convolution and dilation->slows blood flow to enable exchange

39
Q

Spiral artery remodelling

A

Undergo conversion
Extravillus trophoblast(EVT) invade maternal spiral arteries
Endothelium and smooth muscle broken down
EVT coats inside of vessels

40
Q

Important points of nutrient exchange

A

Calcium: actively transported

Amino acids: reduced maternal urea excretion, active transport to foetus

41
Q

Stages of labour

A

1: contractions start, cervix dilates
2: delivery of foetus, maximal myometrial contractions
3: placenta delivery, post partum repair

42
Q

How does cervix retain foetus in uterus

A

High connective tissue content provides rigidty and is stretch resistant

43
Q

What happens during ripening of cervix

A

Monocyte infiltration
IL-6, IL-8
Hyaluronan deposition

44
Q

What happens during cervix dilation

A

Raised hyaluronidase

Raised MMPs

45
Q

Initiation of labour

A

Foetal CRH rises

High ACTH->high cortisol->placental CRH production->positive feedback

Switch from activating to repressing progesterone receptor

Uterus blind to progesterone, sensitise to oestrogen

Stretch receptors->Ferguson reflex-> oxytocin

46
Q

Oxytocin function in labour

A

Raise connectivity of myocyte in myometrium

Destabilise membrane potential->lower threshold for contraction

Liberates Ca stores

47
Q

Prostaglandin functions in labour

A

Leukocyte recruited, IL release->cervix remodelling

Myocyte connectivity->myometrial contractions

Lower uterine relaxation

48
Q

How does placental expulsion occur

A

Foetal membranes fold and peel off endometrium
Haematoma forms between decidua and placenta
Uterus remains contracted->uterine vessel thrombosis

49
Q

Pre-eclampsia diagnosis

A

New onset hypertension
>20 weeks gestation
Reduced foetal movement/amniotic fluid volume by 30%

50
Q

Pre-eclampsia subtypes

A

Early onset(10%): <34 weeks, foetal and maternal symptoms, placental changes

Late onset(90%): >34 weeks, maternal symptoms, little placental changes

51
Q

Pre-eclampsia risk factors

A 
Previous pregnancy with PE
BMI>30
Age>40
Hypertension
Comirbidities: diabetes, PCOS, renal, autoimmune
52
Q

Pre-eclampsia prognosis

A

Mother:
Systemic damage(liver/kidneys/brain)
Eclampsia(seizures, unconsciousness)
Placental abruption

Foetus:
Reduced growth
Premature birth
Pregnancy loss

53
Q

Pre-eclampsia pathophysiology

A

EVT invasion limited to decidual layer
Spiral arteries not extensively remodelled
Placental perfusion limited

54
Q

Pre-eclampsia investigations

A

PLGF: proangiogenic so low->risk if premature delivery

Flt-1/PLGF ratio: Flt-1 is antiangiogenic so >38 -> risk of PE

55
Q

Pre-eclampsia management

A

<34 weeks: maintain pregnancy
>37 weeks: deliver
Antihypertensive
Corticosteroids for <34 for foetal lung development

56
Q

Pre-eclampsia prevention

A

Weight loss
Exercise throughout pregnancy
Aspirin for high risk individuaks

57
Q

Primitive reflexes(infant)

A

Moro reflex: neck extension->arm moves

Standing reflex

Grasp reflex

Parachute reflex

58
Q

4 Domains of infant development

A

Gross motor skills
Fine motor skills
Speech/language skills
Social skills

59
Q

Gross motor skills red flags

A

Head control 4m
Unsupported sit 9m
Independent stand 12m
Independent walk 18m

60
Q

Fine motor and vision red flags

A

Follows object 3m
Reaches for objects 6m
Transfers 9m
Pincer grip 12m

61
Q

Speech and language red flags

A

Polysyllabic babble 7m
Consonant babble 10m
6 words with meaning 18m
3 word sentences 2.5 years

62
Q

Social red flags

A 
Smiles 8w
Fear of strangers 10m
Feeds self 18m
Symbolic play 2.5y
Interactive play 3.5y
63
Q

Healthy child programme

A

Screening: newborn bloodspot, hearing and physical, vision(4-5y)

General examination/immunisation: 6-8w, 1y, 2y reviews

Health education/promotion

64
Q

Causes of global developmental delay

A 
Down syndrome
Fragile X
Hypothyroid
Infection, drug, toxin, folate deficiency
Environmental social
Chronic illness
65
Q

Causes of motor development delay

A 
Cerebral palsy
Duchenne’s muscular dystrophy
Spina bifida
Hydrocephalus
Congenital hip dislocation
66
Q

Causes of language development delay

A 
Hearing loss
Developmental dysphasia
Stammer, dysarthria
Learning disability
Autism
67
Q

Developing brain dorsal view

A

Prosencephalon(fore)
Mesencephalon(mid)
Rhombencephalon(hind)

68
Q

Developing brain flexures

A

Cephalic
Pontine
Cervical

69
Q

Which germ layer are neural crest cells derived from

A

Ectoderm

70
Q

Neural crest cells and final structure

A

Cranial: face and cranial neurons
Cardiac: aortic arch, large arteries
Trunk: sympathetic ganglia, melanocytes, adrenal medulla
Vagal & sacral: parasympathetic and enteric ganglia

Y2 (10 decks)

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