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Clinical Morphology > Week 6: Urogenital Embryology > Flashcards

Week 6: Urogenital Embryology Flashcards

1
Q

mesophrenic ducts

A

form cranially to caudally and then fuse with the developing bladder

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2
Q

What germ layer do the reproductive and urinary systems develop from?

A

mesoderm (lateral to the somites)

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3
Q

pronephros

A

(first kidney)

develops in cervical region and then regresses (never functions)

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4
Q

mesonephros

A

(middle kidney)
develops in the thoracic to lumbar region (functions)
Interim kidney first trimester

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5
Q

metanephros

A

the third and definitive kidney; buds off the mesonephric duct

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6
Q

2 parts of the metanephros

A

excretory system and collecting system

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7
Q

collecting system of the metanephros develops from

A

the ureteric bud that sprouts from the mesonephric duct

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8
Q

excretory system of the metanephros develops from

A

the intermediate mesoderm cells that surround the ureteric bud, forming the metanephric blastema (metanephric mesenchyme)

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9
Q

collecting system of the metanephros consists of

A

ureter, renal pelvis, calycers, and 1-3 million collecting ducts

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10
Q

excretory system of the metanephros consists of

A

nephrons

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11
Q

nephrons

A

“the functional unit of the kidneys”

they are vesicles or tubules that produce urine in the process of removing waste and excess substances from the blood

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12
Q

how are glomaruli (capillary tufts) formed?

A

capillaries grow into the distal end of each nephron to form glomeruli

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13
Q

Due to growth of the body, kidneys shift where?

A

they shift from the pelvis, cranially

called ascension

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14
Q

horseshoe kidney

A

sometimes inferior ends of the kidneys fuse. They ascend until caught under the IMA

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15
Q

Bifed ureter

A

(aka double ureter)

the ureteric bud bifurcates before the metanephric blastema forms

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16
Q

ectopic kidney

A

kidney crosses to the other side during ascension

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17
Q

pelvic kidney

A

a kidney that doesn’t ascend completely

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18
Q

thoracic kidney

A

it ascends too far

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19
Q

congenital anomalies of the urinary system can lead to

A

urine blockage, infection, or kidney stones

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20
Q

multiple renal arteries

A

kidney is supplied by several arteries off the aorta during ascension; usually they degenerate. If these accessory arteries are damaged or ligated, part of the kidney can become ischemic

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21
Q

when do the kidneys become functional?

A

by 12 weeks

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22
Q

bilateral renal agenesis

A

results in oligohydramnios, causing compression of the fetus by the uterus. It leads to Potter sequence

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23
Q

potter sequence

A

a result of oligohydramnios
limb deformities, wrinkly, dry skin, facial anomalies (wide set eyes with infra-orbital skin creases, beak nose, recessed chin, and low set ears), and pulmonary hypoplasia

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24
Q

cloaca

A

the caudal end of the hindgut from which the urinary bladder forms

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25
Q

urorectal septum

A

(mesoderm)

divides the cloaca into the urogenital sinus and the anorectal canal

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26
Q

urogenital sinus becomes

A

the bladder and urethra

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27
Q

allantois

A

connects the apex of the bladder to the umbilicus

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28
Q

urachus

A

the fibrous cord that remains from the allantois

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29
Q

urachus gets covered by peritoneum and becomes the

A

median umbilical ligament on the posterior aspect of the anterior abdominal wall

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30
Q

if the urorectal septum doesn’t form correctly

A

hindgut abnormalities can occur

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31
Q

imperforate anus

A

a potential consequence of improper formation of urorectal septum

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32
Q

urorectal fistula

A

a potential consequence of improper formation of urorectal septum
it’s either between rectum and bladder or rectum and urethra

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33
Q

anal or anorectal agenesis

A

a potential consequence of improper formation of urorectal septum

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34
Q

persistence of a lumen in the urachus can cause

A

a urachal fistula (urine can come out of the umbilicus), a urachal cyst, or a urachal sinus

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35
Q

primordial germ cells (PGCs)

A
  • originate from epiblast

* migrate from yolk sac into intermediate mesoderm medial to the mesonephros causing formation of the gonadal ridge

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36
Q

primitive or primary sex cords

A

formed when the epithelium covering gonadal ride (mesodermal) invades the underlying mesoderm

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37
Q

paramesonephric ducts

A

a second pair of ducts that forms lateral to the mesonephric ducts

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38
Q

“indifferent stage”

A

week 6 of embryo before differential of gonads into testes or ovaries

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39
Q

Mesonephric (Wolffian) ducts

A

become epididymis, vas deferens, and seminal vescicles

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40
Q

paramesonephric (Mullerian) ducts

A

become the uterus, uterine tubes, and upper vagina

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41
Q

somatic support cells in the XX gonad produce

A

“anti-testes” factrors (Wnt4)

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42
Q

Wnt4 causes

A

maintenance of oocyte number and oocytes

fig alpha causes somatic support cells to differentiate into follicle cells

43
Q

why do paramesonphric ducts persist in female differentiation?

A

there is no MIS (mullerian inhibiting substance)

44
Q

why do mesonephric ducts and tubules regress in female differentiation?

A

no testosterone

45
Q

Somatic support cells in XY gonad have SRY gene that produce

A

TDF (testis determining factor)

SRY is the sex determining region on the Y chromosome

46
Q

AMH (anti-mullerian hormone) or MIS (Mullerian inhibiting substance) cause

A

paramesonephric (Mullerian) ducts to degenerate in males

47
Q

mesenchymal cells in gonadal ridge differentiate into what during male development?

A

leydig cells

48
Q

testosterone causes

A

differentiation of epididymis, vas deferens, and seminal vescicles from mesonephric duct; and male brain differentiation

49
Q

5-alpha reductase causes

A

conversion of testosterone to dihydrotestosterone, which causes male development (penis, scrotum, prostate)

50
Q

testosterone surge at puberty causes

A

maturation of seminiferous tubules, spermatogenesis, and other pubertal changes

51
Q

in male, primitive sex cord becomes

A

testis cords

52
Q

in male, at the hilum, cords form

A

rete testis

53
Q

in male mesonephric tubules become

A

efferent ducts

54
Q

in male mesonephric duct becomes

A

epididymis, ductus deferens, and siminal vesicle

55
Q

in female, primitive sex cords become

A

somatic support cells then follicle cells

56
Q

in female, follicle cells surround

A

the PCGs (primordial germ cells) (oogonia)

57
Q

In female, paramesonephric ducts become

A

uterine tube, uterus, and upper vagina

58
Q

prostatic utricle is

A

remnant of mullerian duct in males

59
Q

gartner’s cyst is

A

remnant of mesonephric duct in females

60
Q

in males prostate and bulbourethral glands bud off

A

the urethra

61
Q

in males the seminal vesicles bud off the

A

mesonephric duct

62
Q

trigone

A

formed in males when the lower end of the mesonephric ducts are incorporated into the bladder. It also results in the vas deferens wrapping over the ureter after testis descend

63
Q

in female, uterus and upper vagina form when

A

caudal ends of the paramesonephric ducts fuse

64
Q

uterine tubes are

A

the remaining unfused paramesonephric ducts

65
Q

the lower vagina forms from

A

sinovaginal bulbs (proliferation of endodermal tissue on the posterior wall of urogenital sinus)

66
Q

uterine and vaginal anomalies result from

A

problems with development of the paramesonephric ducts

67
Q

diethylstilbestrol (DES)

A

a synthetic estrogen used to prevent miscarriage from 1947-71
resulted in higher risk of uterine anomalies and clear cell carcinoma of the vagina in offspring

68
Q

uterine didelphys

A
  • caused by no fusion of the paramesonephric ducts

* double uterus

69
Q

bicornuate uterus

A
  • caused by partial fusion of the paramesonephric ducts

* fundus is indented

70
Q

septated uterus

A
  • medial walls of paramesonephric ducts fail to resorb

* 2 endometrial cavities

71
Q

unicornuate uterus

A
  • incomplete development of one paramesonephric duct

* uterus connects to one ovary

72
Q

cervical atresia

A

paramesonephric ducts resorb too much

73
Q

at indifferentiated stage, embryo has

A

genital tubercle, urogentical folds, labioscrotal swellings, and anal folds

74
Q

in female, genital tubercle becomes

A

clitoris

75
Q

in female, urogenital folds form

A

labia minora

76
Q

in female, labioscrotal swelling form

A

labia majora

77
Q

in male, urogenital folds

A

fuse

78
Q

in male, genital tubercle elongates to become

A

shaft and glans of penis

79
Q

in male, urogenital (urethral) fold

A

fusion also forms penile urethra

80
Q

in male distal urethral forms from

A

canalization of urethral endoderm extending into the glans

81
Q

in male, labioscrotal swellings

A

fuse to form the scrotum

82
Q

What might cause gonads not to develop at all?

A

if the germ cells from the epiblast do not migrate to the gonadal ridges

83
Q

testis determining factor (TDF) causes formation of

A

Sertoli cells and Leydig cells

84
Q

Sertoli Cells produce

A

Mullerian inhibiting substance (MIS)

85
Q

(penile) Hypospadias

A
  • urethral folds don’t fuse completely or form abnormal canalization of the urethral plate within the glans penis, causing a VENTRAL (on the underside of penis) opening of urethra
  • 10% of the time it’s accompanied by chriptorchidism
86
Q

(penile) epispadia

A
  • occurs when the urethral orifice opens on the DORSAL side of the penis. Usually associated with exstrophy of the bladder
  • much less common than hypospadia
87
Q

exstrophy of bladder

A

bladder is outside the ventral/anterior body wall due to a defect in the ventral body wall (ie it doesn’t form completely during body folding, this is very rare)

88
Q

descent of gonads

A
  • gonads form on posterior body wall and must descend to their anatomical position
  • as they descend, gubrnaculum shortens, and the processus vaginalis is pushed along in front
89
Q

what ligaments attach to gonads

A
  • attached cranially to diaphragm by a suspensory ligament

* attached caudally to labioscrotal swellings by a fibrous cord called gubernaculum

90
Q

processus vaginalis

A

(vaginal process) an outpouching of parietal peritoneum that forms the inguinal canal

91
Q

spermatic cord

A

in males, layers of abdominal wall are pushed into the scrotum and form the 3 layers of the spermatic fascia in the spermatic cord

92
Q

processus vaginalis closes to become

A

tunica vaginalis

93
Q

when do testes reach the deep inguinal ring?

A
  • around 4 months of embryonic development

* they descend through the inguinal canal shortly before (or right after) birth

94
Q

cryptorchidism

A
  • when the testis fails to descend

* occurs in 1-4% of live male births and increases the risk of infertility and testicular cancer

95
Q

orchipexy

A

surgical correction of cryptorchidism

96
Q

testicular torsion

A
  • twisting of spermatic cord that crimps the testicular artery
  • an anomaly associated with the processus vaginalis
97
Q

testicular hydrocele

A
  • fluid between parietal and visceral layers of the tunica vaginalis
  • an anomaly associated with the processus vaginalis
98
Q

indirect (congenital) inguinal hernia

A
  • 75% of inguinal hernias
  • occurs lateral to inferior epigastric vessels
  • passes through deep inguinal ring and inguinal canal as a protrusion along the spermatic cord, and lies within the internal spermatic fascia
99
Q

ovaries descend

A
  • into the pelvis, but don’t enter labia majora

* gubernaculum becomes the ligament of the ovary and the round ligament of the uterus

100
Q

round ligament of the uterus

A

transverses the inguinal canal into the labia majora

101
Q

broad ligament in females forms

A

when the peritoneal folds covering the paramesonephric ducts fuse

102
Q

suspensory ligament (of the ovary)

A

contains the ovarian vessels

103
Q

MDs don’t LIe

A
  • for remembering direct versus indirect hernias
  • Direct are Medial to inferior epigastric vessels
  • Indirect are Lateral

Clinical Morphology (25 decks)

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