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STEP 1 Review > Embryology and Reproductive Anatomy Review > Flashcards

Embryology and Reproductive Anatomy Review Flashcards

1
Q

Sonic Hedgehog Gene

A

Produced at the bottom of extending limb buds. Causes AP axis patterning. Involved in CNS development. Mutation can cause holoprosencephaly.

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2
Q

WNT-7

A

Produced at the edge of the extending limb buds. Causes dorsoventral patterning.

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3
Q

FGF

A

Produced at the apical ectodermal ridge. Stimulates mitosis of underlying endoderm which causes lengthening of limbs. FGF3 is mutated in achondroplasia.

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4
Q

HOX genes

A

Cause segmental patterning in a craniocaudal direction. Code for DNA binding proteins. Hox mutations cause appendages in the wrong locations, syndactyly.

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5
Q

Why is vitamin A teratogenic?

A

Because it interferes with Hox signaling

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6
Q

When does HCG secretion begin?

A

Around week 1, when the morula becomes a blastocyst.

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7
Q

What happens week 2 of development

A

Bilaminar disk with epiblast and hypoblast, 2 cavities, 2 types of placental tissue (cytotrophoblast and syncitiotrophoblast).

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8
Q

What happens week 3?

A

Trilaminar disk (primitive streak, notochord, mesoderm, and neuralplate begin to form). Neurulation and gastrulation occur.

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9
Q

What is the embryonic period?

A

Weeks 3-8, most vital to development. Terratogens here cause serious problems. Neural tube closes by week 4. Organogenesis happens in this time.

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10
Q

What happens in week 4?

A

Heart begins to beat, limbs begin to form. Heart beat is visible in week 6.

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11
Q

What happens by week 10?

A

Genitalia are distinguishable as male/female. Can identify gender at week 10.

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12
Q

Gastrulation

A

Process that forms the trilaminar disc, this establishes the ectoderm, mesoderm, endoderm. Epiblast invaginates to form the primitive streak.

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13
Q

What structure of the egg prevents implantation?

A

Zona pellucida. When it is dissolved by acrosomal enzymes the egg can implant.

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14
Q

Components of surface ectoderm

A

Adenohypophysis from rathke’s pouch, lens, oral cavity, sensory organs of ear, olfactory epithelium, anal canal below the pectinate line.

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15
Q

Components of neuroectoderm

A

Brain, oligodendrocytes, astrocytes, ependymal cells, pineal gland, retina and optic nerve, spinal cord.

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16
Q

Components of neural crest

A

PNS – schwann cells, dorsal root ganglia, celiac ganglion, melanocytes, chromaffin cells of adrenal medulla, C cells of thyroid, pia and arachnoid, bones of skull

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17
Q

Mesodermal components

A

Bone, muscle, connective tissue, peritoneum, SPLEEN, lymphatics, blood, vagina, kidneys, adrenal cortex, dermis, testes, ovaries.

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18
Q

Endodermal components

A

Gut tube epithelium (including anus above pectinate line), most of urethra, lungs, liver, gallbladder, pancreas, eustacian tube, thymus, parathyroid, thyroid follicular cells.

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19
Q

Agenesis

A

Absent organ development due to lack of primordial tissue

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20
Q

Aplasia

A

Absent organ development despite presence of primordial tissue

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21
Q

Hypoplasia

A

Incomplete organ development

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22
Q

Deformation

A

Extrinsic force stops development (twins)

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23
Q

Disruption

A

Breakdown of a previously normal tissue (amniotic band syndrome)

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24
Q

Malformation

A

Intrinsic disruption during the embryonic period

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25
Q

Sequence

A

Abnormalities due to a single etiology. Potter sequence is renal agenesis, oligohydramnios, pulmonary hypoplasia.

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26
Q

ACE inhibitor terratogen effect

A

Renal damage

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27
Q

Alkylating agents

A

Absence of digits and more

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28
Q

Aminoglycosides

A

Cause ototoxicity (CN VIII)

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29
Q

Carbamazepine

A

Neural tube defects, craniofacial defects,

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30
Q

DES

A

Vaginal clear cell adenocarcinoma, mullerian anomalies

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31
Q

Lithium

A

Ebstein Abnormaility

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32
Q

Methimazole

A

Aplasia cutis congenita (no skin)

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33
Q

Phenytoin

A

Fetal hydantoin syndrome: microcephaly, dysmorphic craniofacial features, hypoplastic nails, cardiac defects.

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34
Q

Tetracyclines

A

Discolored teeth

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35
Q

Thalidomide

A

Dolphin limbs

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36
Q

Valproate

A

Neural tube defects due to decreased folate absorption

37
Q

Warfarin

A

Causes fetal hemorrhage. Use heparin instead which does not cross the placenta.

38
Q

Alcohol

A

Fetal alcohol syndrome with classic appearance. One of the leading causes of congenital abnormailities.

39
Q

Cocaine

A

Can cause placenta abruptio

40
Q

Smoking

A

Can cause low birth weight

41
Q

Lack or excess iodine

A

Can cause goiter or hypothyroidism (cretinism).

42
Q

Maternal Diabetes

A

big babies, TGA, Caudal regression syndrome– syrenomyelia or anal atresia.

43
Q

Vitamin A excess

A

Extremely high risk for spontaneous abortions and lots of birth defects

44
Q

X-rays

A

Microcephaly and intellectual disability.

45
Q

Dizygotic twins chorion and amnion #

A

2 chorions 2 amnions (due to 2 eggs 2 sperm)

46
Q

Monozygotic twins chorion and amnion #

A

If split between 0-3 days, 2 chorions 2 amnions (25%)
If split between 3-6 days, 1 chorion (1 placenta) 2 amnions (75%)
If split after 6 days, 1 chorion, 1 amnion or conjoined.

47
Q

Cytotrophoblasts and syncitiotrophoblasts

A

Cytotrophoblasts are the inner layer of chorionic villi that make syncitiotrophoblasts.

Syncitiotrophoblasts secrete HCG to stimulate corpus luteum to make progesterone during the first trimester.

48
Q

Decidua basalis

A

The maternal part of the placenta. Maternal blood in lacunae that bathe chorionic villi.

49
Q

Components of umbilical cord

A

2 umbilical arteries (become medial ligaments)
1 umbilical vein (drains into IVC, becomes falciform ligament)
Wharton’s Jelly

Derived from allantois

50
Q

Urachus

A

In the third week, yolk sac -> allantois ->urachus. Duct between fetal bladder and yolk sac. Failure to close results in patent urachus with urine discharge from umbilicus, urachal cyst which is a fluid filled cavity. Can lead to infection and adenocarcinoma.
Vesiculourachal diverticulum - outpouching of bladder.

BECOMES MEDIAN LIGAMENT.

51
Q

Vitelline Duct

A

Connects yolk sac to midgut lumen failure to close can cause vitelline fistula where meconium comes out of umbilicus and meckel diverticulum.

52
Q

1st aortic arch derivatives

A

Maxillary artery from external carotid. This is important because MMA is from maxillary artery.

53
Q

2nd aortic arch derivatives

A

Stapedial artery and hyoid artery

54
Q

3rd aortic arch derivatives

A

Common carotid artery and proximal part of internal carotid

55
Q

4th aortic arch derivatives

A

Right is right subclavian (right recurrent laryngeal loops here), left is part of left aortic arch.

5th arch regresses.

56
Q

6th aortic arch derivatives.

A

Proximal pulmonary arteries and on left is ductus arteriosus Left recurrent laryngeal loops here.

57
Q

Branchial apparatus

A

Clefts (ectoderm)
Arches (mesoderm and neural crest)
Grooves (endoderm)

58
Q

1st branchial arch (cartilage, muscle, nerve)

A

Meckel’s cartilage: Mandible, malleus, spheno-mandibular ligament, incus

Muscles of mastication: Temporalis, masseter, medial pterygoids. Mylohyoid, anterior belly of digastric, tensor tympani, tensor veli palatini

Nerves: CN V2 and V3.

59
Q

2nd branchial arch (cartilage, muscle, nerve)

A

Cartilage - stapes, styloid process, lesser horn of hyoid, stylohyoid.

Muscles of facial expression and stapedius, stylohyoid, platysma.

Nerve - CN VII

60
Q

3rd branchial arch (cartilage, muscle, nerve)

A

Greater horn of hyoid

Muscle: stylopharyngeus

CN IX

61
Q

4-6th branchial arch (cartilage, muscle, nerve)

A

Thyroid, cricoid, arytenoids, corniculate, cuneiform

4th: Pharyngeal constrictors, cricothyroid, levator veli palatini
6th: All intrinsic muscles of the larynx except cricothyroid.

Both CN X.

62
Q

1st branchial pouch

A

Middle ear, eustacian tube

63
Q

2nd branchial pouch

A

Tonsils

64
Q

3rd branchial pouch

A

Dorsal wings– inferior parathyroids, ventral wings – thymus

65
Q

4th branchial pouch

A

Dorsal wings - superior parathyroids

66
Q

DiGeorge syndrome

A

22q11 causes aberrant development of 3 and 4th pharyngeal pouches. Causes cleft lip/palate, a?, thymic aplasia, conotruncal abnormalities, hypoparathyroidism.

67
Q

Cleft lip

A

Failure of fusion maxillary and medial nasal processes

68
Q

Cleft palate

A

Failure of the secondary palate to form. Can cause split uvula. Have different etiologies but often occur together. MULTIFACTORIAL INHERITANCE.

69
Q

Genital tubercle becomes what in males and females

A

Glans penis/clitoris, Spongiosum and cavernosum

70
Q

Urogenital sinus becomes what in males and females

A

Becomes upper 1/3 of vagina, vestibular glands of bartholin, skenes glands, and prostate.

71
Q

Urogenital folds become what in males and females

A

Ventral shaft of penis in males, labia minora in females

72
Q

Labioscrotal swelling becomes what?

A

Scrotum and labia majora.

73
Q

Hypospadias

Epispadias

A

Hypospadias is due to poor fusion of the urogenital folds where urethra opens on bottom of penis.

Epispadias is due to problem in gential tubercle where opening on top. Bladder extrophy can happen

74
Q

Gubernaculum in males and females

A

In males it anchors testes, in females becomes the ovarian and round ligaments

75
Q

Processus vaginalis in males and females

A

Forms tunica vaginalis (indirect hernias), obliterated in females.

76
Q

Gonadal venous drainage?

A

Left testicle/ovary drains to left gonadal vein, left renal vein, IVC.

Right testicle/ovary drains to right gonadal vein, then IVC directly.

Varicocele is more common on left due to entering at 90 degrees. Flow is less laminar.

77
Q

Gonadal lymphatic drainage?

A

Ovaries/testes - paraaortic LNs
Distal vagina, vulva strotum - superficial inguinal nodes
Proximal vagina/uterus - obturator, external iliac, hypogastric nodes.

78
Q

Infundibulopelvic ligament (aka suspensory ligament of the ovaries)

A

Connects ovaries to lateral pelvic wall. Contails ovarian vessels. Must ligate vessels during ooferectomy to control bleeding.

79
Q

Cardinal ligament

A

Anchors cervix to the side wall of the pelvis. Contains uterine vessels. Ureter at risk of injury during ligation of uterine vessels in histerectomy.

80
Q

Where does the ureter run?

A

Posterior to uterine vessels in women and vas deferens in men.

81
Q

Round ligament of the uterus

A

Connects uterine fundus to labia majora. Derivative of gubernaculum. Travels through round inguinal canal.

82
Q

Broad ligament

A

Connects uterus, fallopian tubes, and ovaries to pelvic wall. Consists of mesosalpinx, mesometrium, and mesovarium. Contains ovaries, falliopian tubes, and round ligament.

83
Q

Ovarian ligament

A

Connects medial pole of ovary to lateral uterus. A derivative of the gubernaculum.

84
Q

Where do the ovarian arteries arise from?

A

The abdominal aorta.

85
Q

What happens during the excitation phase of the female sexual response cycle?

A

The uterus rises.

86
Q

Where does maturation of sperm happen?

Path of sperm?

A

Mostly in epididymis, but fully in vagina.

SEVEN UP
Seminiferous tubules, epididymis, vas, ejaculatory ducts, nothing, urethra, penis.

87
Q

What nerve controls ejaculation?

A

Pudendal nerve.

88
Q

Treacher collins syndrome

A

First arch of the neural crest fails to migrate. Mandibular hypoplasia, other facial abnormalities.

STEP 1 Review (21 decks)

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