Lecture 7- MSK Development Flashcards

1
Q

When does limb development occur

A
  • week 3-8
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2
Q

Stages of development

A
  • Blastocyst: first 2 weeks
  • Embryonic: week 3-8
  • foetal: week 9+
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3
Q

Gestional age vs embryonic age

A
  • Gestional age: time since last menstuation

- Embryonic age: time since fertilisation

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4
Q

When do limb buds appear

A

Week 4

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5
Q

When do hand plates and digital rays appear

A

Weeks 5,6

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6
Q

When do webbed digits appear

A

Weeks 7,8

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7
Q

Appearance of

  • upper limb buds
  • lower limb buds
  • joints of hand
A
  • mid 4th week
  • 2 days later
  • day 47
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8
Q

2 specialized structures in the limb buds

A
  • Apical ectodermal ridge: ridge of cells around the dorsoventral axis
  • Zone of polarizing activity: group of cells on posterior margin of limb bud
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9
Q

Limb positioning controls

A
  • hox genes in embryonic trunk -> FGF10 on lateral plate mesoderm -> Wnt3 in overlying ectoderm -> dorms AER and induces expression of FGF8

FGF8: proliferation of mesenchyme cells
- positive feedback loop

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10
Q

Determining the identity of limbs

A
  • Tbx5: forelimb
  • TBx4 and Pitx1 hindlimb
  • Tbx2/3: both limbs
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11
Q

Proximal distal axis of limb

  • Signaling center
  • molecular signal
A
  • AER

- FGf8

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12
Q

Antero-posterior axis of limb bud

  • signaling center
  • molecular signal
A
  • ZPA

- shh gradient posterior to anterior

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13
Q

Dorso-ventral axis of limb bud

  • signaling center
  • molecular signal
A
  • Dorsal and ventral ectoderm

- Molecular signal: Wnt7a (dorsal), En-1 (ventral)

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14
Q

Programmed cell death

A
  • shaping of limb structures

- BMP are involved in this process

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15
Q

Bone formation

A
  • mesenchyme initially condences into cartilage

- ossification starts in shafts of long bones and secondary sites at the end of bones

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16
Q

Vasculature

A

First blood vessels formed by vasculogenesis

  • vessels form de novo in embryonic mesenchyme
  • Endothelial precursor cells form an aggregate and produce a small single-layered endothelial tube with a lumeb
  • VEGF involved
17
Q

Nerved

A
  • develop as dermatomes

- first parallel then mixed up

18
Q

Musculature

A
  • muscle precursors migrate frm the somites of the animal into the limb to form muscles
  • Lbx1 gene required for migration
19
Q

Syndactyly

A

Fusion of digits

- BMP or Shh disruption

20
Q

Polydactyly

A
  • extra digits

- Shh disruption

21
Q

Triphalangeal thumb

A
  • shh disruption
22
Q

Amelia

A

Absence of an entire limb

- early loss of Fgf signalining

23
Q

Meromelia

A

Absence of part of a limb

24
Q

Adactyly

A

Absence of digits: late loss of Fgf

25
Q

Thalidomide effects

A
  • loss of immature blood vessel
  • mesenchymal cells cant proliferate
  • longer exposure to FGF8 in AER
  • more distal structures, less proximal structures
26
Q

Developmental displasia of hip

A

1/1000

  • female predominance
  • first born
  • increased risk with breech position and big baby

TREATMENT: Pavlik harness

27
Q

Perthes disease

A
  • hip of growing children
  • more common in boys aged 4-10
  • disruption of blood supply to part of femoral head
  • softening and collapse of bone
  • unknown cause
  • inflammation, limping
  • broomstick plasters
  • good prognosis
28
Q

Club foot (Talipes)

A
  • most common muscoloskeletal defect in children
  • constriction of feet in breech position -> inturned feet)
  • males

TREATMENT

  • gradual plastering technique
  • 95% success rate
29
Q

Toewalking

A
  • walking on toes or ball of fooot
  • can be habitual/idiopathic

TREATMENT
- stretching and strengthening

30
Q

Calcaneal apophysitis: Sever’s disease

A
  • inflammation of growth plate
  • heel pain
  • one or both heal
  • stress/overuse/obesity/ tight achilles tendon
  • pain, limping, toewalking

TREATMENT
- reduce activity, calf stretcking, orthotis, ibuprofen