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KCUMB Anatomy II > Embryology EXAM I > Flashcards

Embryology EXAM I Flashcards

1
Q

What occurs during the early and late phase of lung development?

A

Early - positioning of lung primordium and primary lung bud formation

Late - mechanism of bronchial branching and cytodifferentiation

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2
Q

What week does development form and what forms during this in lung development?

A

Week 4

Laryngeotracheal/respiratory diverticulum via Tbx4 gene (endoderm of foregut)

Outgrowth of foregut (future esophagus) into surrounding splanchnic mesoderm

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3
Q

What direction does the laryngeotracheal diverticulum grow and what does it separate from, and what structure separates them?

A

Distally from the esophagus by the tracheoesophageal septum

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4
Q

Tracheoesophageal Fistula, Esophageal Atresia; what fetal anomally is this related to?

A

Abnormal connection b/w trachea and esophagus

Improper formation of tracheoesophageal septum

Feeding tube cannot move beyond upper esophageal pouch

Related to: polyhydramnios (too much amniotic fluid)

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5
Q

Polyhydramnios

A

High volume of amniotic fluid

Baby is not swallowing enough amniotic fluid

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6
Q

Symptoms of esophageal atresia (occlusion) and tracheoesophageal fistula

Treatment?

A

Infant is drooling, with choking, coughing, sneezing

When fed infant swallows but begins to cough and struggle as fluid is regurgitated

Infant may become cyanotic (blue), stop breathing as overflow of fluid from blind pouch is aspirated in trachea and lungs

Treatment: Surgical fix

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7
Q
A
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8
Q

At what week do the bronchial buds form? What will be their final fate?

A

Week 5; left and right buds form

Will become main primary bronchi

After, a series of branchings will occur to become respiratory bronchioles (secondary)

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9
Q

What does the splanchnic mesoderm differentiate into?

A

Smooth muscle

Nerves

Blood vessels of lungs

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10
Q

What are the 5 stages of lung development? At which stage is the infant born viable?

A

EGCTP

Embryonic (4-7)

Pseudoglandular (8-16)

Canalicular (17-26) = viable

Terminal sac (27-birth)

Postnatal (Alveolar)

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11
Q

What occurs during the embryonic stage of lung development?

A

(4-7)

Initial formation of respiratory diverticulum —> formation of major bronchopulmonary segments

Lungs grow into pleural cavities

Pleural differentiation

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12
Q

What occurs during the pseudoglandular stage of lung development?

A

(8-16)

Formation and growth of duct systems within bronchopulmonary segments

No respiratory components or gas exchange

Resembles a gland

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13
Q

What occurs during the canalicular stage of lung development?

A

(17-26)

Formation of respiratory bronchioles & terminal sacs (primitive alveoli)

Increase in vascularization, capillaries = gas exchange = viable

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14
Q

What occurs during the terminal sac stage of lung development?

A

(27-birth)

Alveoli/terminal sacs develop from the respiratory bronchioles

Alveoli differentiates in Type I and Type II

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15
Q

Type I pneumocyte

Type II pneumocyte

A

Type I = blood-air barrier

Type II = produce surfactant (facilitates alveolar expansion)

For viability = capillaries, alveoli, surfactant

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16
Q

What occurs in postnatal/alveolar stage of lung development?

A

Alveoli differentiation

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17
Q

Infant respiratory distress syndrome

A

Deficiency/absence of surfactant

Immature/damaged Type II pneumocytes

60% born less than 28 weeks

5% born less than 37 weeks

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18
Q

Pulmonary agenesis

A

Complete absence of lungs, bronchi, and vasculature

Bilateral or Unilateral

Bronchial buds don’t develop

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19
Q

Pulmonary hypoplasia

A

Poorly developed bronchial tree

Partial or total (entire lung)

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20
Q

Congenital diaphragmatic hernia; which membranes is involved? Signs?

A

Abdominal contents herniated into pleural cavity; can cause pulmonary hypoplasia

Stomach, bowel can be in the thoracic cavity

Failure of pleuroperitoneal membranes to fuse with other components (i.e. septum transversum)

Signs: flat abdomen, breathlessness, cyanosis

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21
Q

What are the major trends of cardiovascular development? (4)

A

Converted into a 2 —> 4 chambered structure

Embryonic vascular system separates into systemic and pulmonary portions

Systemic arterial outflow —> Left

System venous retun —> Right

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22
Q

Describe the vascular circuit of the embryo

A

Series of aortic arches connect to dorsal aortae

= Cardinal, Vitelline, Umbilical

Dorsal aortae subdivide into smaller vessels to supply the embryo

Blood is drained by anterior and posterior cardinal veins

Common cardinal vein is formed by the left, right, anterior and posterior cardinal veins = embryonic circuit

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23
Q

What are the nutritional circuits for the embryo? What does the vitelline system do?

A

Umbilical and Vitelline

Nutritional circuits = Vitelline veins and arteries; supply and drain the yolk sac “nursery for blood cells”

Umbilical/placental arteries and veins

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24
Q

Name the adult structure from each of the embryonic structures

A

Truncus Arteriosus = Aorta, pulmonary trunk

Bulbus cordis = smooth part of right (conus cordis) and left ventricle (aortic vestibule)

Primitive ventricle = trabeculated part of right and left ventricles

Primitive atrium = trabeculated part of right and left atria (auricles)

Sinus venousus = smooth part of right atrium, coronary sinus, oblique vein of left atrium

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25
Q
A

Heart bends towards left

26
Q

Heart loops ventrally around fulcrum

A
27
Q

Dextrocardia

A

Positional abnormality

Heart bends to the left instead of the right

Usually not an issue

28
Q

Function of endocardial cushions? When do they form? What does it initially sit in between?

A

Separates Atrium from Ventricles

Forms after ventral folding and dorsal and ventral blocks of tissue fold towards midline = endocardial tissue

Divides the single AV canal into separate right and left AV canals (which regulate blood blow from atria to ventricles)

29
Q

Atrioventricular communis

A

Failure of the endocardial tissues to fuse you end up with a large communication between the left and right AV canals causing abnormal mixture of oxy- and deoxy- blood

30
Q

What is the critical first step in the development of the 4-chambered heart?

A

Formation and fusion of endocardial cushions

31
Q

What does growth of the bulbar region and muscular portion of the heart form?

A

Downward growth of bulbar region and upward growth of muscular portion towards the endocardial cushions forms the IV septum

32
Q

Ventricular septal defects (VSDs)

A

Opening between the left and right ventricles

Associated with shunting of blood

Require surgical correction

33
Q

Describe the formation of the atrial septum

A

The initial foramen between the atrium is the foramen primum; between the septum primum and dorsal endocardial cushions.

Septum primum grows downward and via apotosis forms the foramen secundum, developing septum primum from the endocardial cushion fuses with septum primum closing the foramen primum.

Septum secundum upper limb is developing from the top into the foramen ovale and eventually connects with the valve of foramen ovale (derived from septum primum)

At birth, high pressure on left atrium causes the septum primum to close valve = fossa ovalis

34
Q

Atrial Septal Defects

A

Ostium/foramen primum - similar to endocardial cushion defects

Secundum type - involves foramen ovale and septum primum

Sinus venosus - usually near opening of SVC

Common atrium

35
Q

Where do sinus venouses initially open into?

A

Dorsal wall of primitive atrium

Changes occur when right horn enlarges as blood is shunted from L –> R

Moves all systemic inflow to the right side

Shunts are created: vascular/nutritional circuit (vitelline & umbilical), embryonic circuits (cardinal)

36
Q

What does the Vitelline Veins shunt turn into? Initially from the sinus venousus

A

Veins become incorporated into liver as hepatic sinusoids, hepatic veins, part of IVC and some GI veins

Loss at birth

37
Q

What is the umbilical shunt that is derived from the sinus venosus?

A

Umbilical shunt bypasses liver and diverts oxygenated blood to heart

Loses direct connection with heart (ligamentum teres hepatis)

Joins the large venous shunt = ductus venosus = bypasses liver and diverts oxygenated blood to heart

Connects umbilical vein w/ IVC

38
Q

What does the right anterior cardinal and common cardinal veins turn into after birth?

A

Anterior left and right cardinal veins connect and become the left brachiocephalic vein

Right anterior cardinal and common cardinal become the SVC

39
Q
A
40
Q

What do cardiac neural crest cells form?

A

Bulbus cordis

Truncus arteriosus

41
Q

What problems are associated with tetralogy of fallot?

A

Pulmonary stenosis

VSD

Overriding aorta

Right Ventricular hypertophy

(large aorta, small pulmonary trunk)

42
Q
A
43
Q

Patent ductus arteriosus

A

No closure of the ligamentum arteriosum

Abnormal connection b/w aorta and pulmonary artery

44
Q
A
45
Q

What initiates specification of the gut tube formation?

A

RA gradient that causes TFs to be expressed in diff regions

SOX2 - esophagus

PDX1 - duodenum & pancreas

CDXC - small intestine

CDXA - large intestine

SHH initiates endoderm & mesenchyme/splanchnic mesoderm interaction

46
Q

Where do post-ganglionics follow in hindgut innervation?

A

Arteries

in addition to IMA

47
Q

Esophageal replacement options

A

Colon interposition

Gastric tube esophagoplasty

Gastric transposition

48
Q

Describe how the esophagus and stomach develop, what do they begin as?

A

Straight tubes suspended by dorsal and ventral mesentery

Dorsal grows rapidly (towards left) with a simultaneous 90 degree rotation

Left side of stomach = anterior

Right side = posterior

Left vagus = anterior vagal trunk

Right vagus = posterior vagal trunk

49
Q

Hypertrophic pyloric stenosis

A

Food never enters duodenum

Projectile vomiting/no bile

50
Q

Duodenal atresia

A

Occluded lumen (2-3 part)

Double bubble sign = Gas distended stomach, no gas in proximal duodenum

Duodenal atresia, duodenal duplication cysts

51
Q

Extrahepatic biliary atresia; symptoms, treatment

A

Incomplete canalization of the bile duct

Jaundice, Dark urine, pale stool surgical correction or transplant

52
Q

What are the signals involved in pancreatic development?

A

PDX1 - pancreas & duodenum

PAX4 - insulin, somatostatin, pancreatic polypeptide

PAX6 - glucagon

3rd month = islets of langerhan

5th month = insulin

53
Q
A
54
Q

Annular pancreas

A

Ventral and dorsal pancreatic buds form a ring around the duodenum

Duodenal obstruction

55
Q

Accessory ectopic pancreatic tissue

A

Most common in stomach or ileum (Meckle’s diverticulum)

Found in the distal esophagus thru the primary intestinal loop

56
Q

Describe the rotation and fixation of the midgut

A

Rapid growth about 6 weeks

Normal physiologic herniation

Gut loops into umbilical cord and rotates 90 degrees counterclockwise around the SMA

10th week - returns to abdominal cavity and rotates an additional 180 degrees (270)

57
Q

Malrotation of the midgut

What is it, symptoms

Volvulus

A

Partial rotation; abnormally positioned viscera

Increased risk of entrapment of portions of the intestine

Usually present within first week as duodenal obstruction with bilious vomiting

Recurrent abdominal pain, intestinal obstruction, malabsorption/diarrhea

Volvulus = abnormal twisting of intestine causing obstruction

Bilious Emesis

58
Q

Omphalocele

A

Herniation of abdominal contents thru enlarged umbilical ring

Midgut loop fails to return to abdominal cavity

Normal if temporary

Covered by a membranous sac

59
Q

Gastroschisis

A

Failure of anterior abdominal wall musculature to close during folding

Guts NOT surrounded by membrane

60
Q

Meckel’s diverticulum

A

Remnant of vitelline duct

Asymptomatic

Gastric or pancreatic tissue

Ileal diverticulum

Fecal discharge through umbilicus

61
Q

Hirschsprung’s Disease; HD

A

Congenital aganglionic megacolon

Failure of migration of neural crest cells

Functional intestinal obstruction, no parasympathetic innervation (colon cannot relax or do peristalsis)

Vagal neural crest cells invade anterior foregult and migrate to foregut, midgut, hindgut = enteric system

Surgical treatment

KCUMB Anatomy II (5 decks)

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