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Embryology
Ronald W. Dudek, PhD
Professor
Department of Anatomy and Cell Biology
Brody School of Medicine
East Carolina University
Greenville, North Carolina
Questions Contributor:
H. Wayne Lambert, PhD
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Acquisitions Editor: Crystal Taylor
Product Manager: Sirkka E. Howes
Marketing Manager: Brian Moody
Manufacturing Manager: Margie Orzech
Designer: Holly Reid McLaughlin
Vendor Manager: Bridgett Dougherty
Compositor: Aptara, Inc.
Fifth Edition
Copyright © 2011, 2008, 2005, 1998, 1994 Lippincott Williams & Wilkins, a Wolters Kluwer business.
Back cover images from Tasman W, Jaeger EA. Wills Eye Hospital Atlas of Clinical Ophthalmology. Philadelphia:
Lippincott-Raven, 1996, and McMillan JA, DeAngelis CD, Feigin RD, et al., eds. Oski’s Pediatrics. 3rd Ed. Philadelphia:
Lippincott Williams & Wilkins, 1999:2149, Fig. 433-8A.
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987654321
Library of Congress Cataloging-in-Publication Data
Dudek, Ronald W., 1950-
Embryology / Ronald W. Dudek ; questions contributor, H. Wayne Lambert. — 5th ed.
p. ; cm. — (Board review series)
Includes index.
ISBN 978-1-60547-901-9
1. Embryology, Human—Examinations, questions, etc. I. Title. II. Series: Board review series.
[DNLM: 1. Embryology—Examination Questions. 2. Embryology—Outlines. QS 618.2 D845b 2011]
QM601.F68 2011
612.6'4—dc22
2009048434
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Preface
The fifth edition of BRS Embryology has afforded me the opportunity to further fine-
tune a work that was already a highly rated course review book as well as an excellent
review for the USMLE Step 1. This fine-tuning is a result of the many students who
have contacted me by e-mail to point out errors and give suggestions for improve-
ment. I appreciate this student feedback very much.
In the fifth edition, I have placed clinical images closer to the corresponding text
to make reviewing more efficient. As in the previous edition, the Comprehensive
Examination at the end of the book reflects the USMLE Step 1 format.
I hope that students will continue to find BRS Embryology a clear and thorough
review of embryology. After taking the USMLE Step 1, I invite you to e-mail me at
dudekr@ecu.edu to convey any comments or to indicate any area that was particu-
larly represented on the USMLE Step 1, so that future editions of this book may
improve.
Ronald W. Dudek, PhD
iii
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Preface iii
1. PREFERTILIZATION EVENTS 1
I. Sexual Reproduction 1
II. Chromosomes 1
III. Meiosis 2
IV. Oogenesis: Female Gametogenesis 2
V. Spermatogenesis: Male Gametogenesis 4
VI. Clinical Considerations 4
Study Questions for Chapter 1 8
Answers and Explanations 10
2. WEEK 1 OF HUMAN DEVELOPMENT (DAYS 1–7) 12
I. Fertilization 12
II. Cleavage and Blastocyst Formation 12
III. Implantation 13
IV. Clinical Considerations 14
Study Questions for Chapter 2 15
Answers and Explanations 17
3. WEEK 2 OF HUMAN DEVELOPMENT (DAYS 8–14) 18
I. Further Development of the Embryoblast 18
II. Further Development of the Trophoblast 18
III. Development of Extraembryonic Mesoderm 18
IV. Clinical Considerations 20
Study Questions for Chapter 3 22
Answers and Explanations 24
4. EMBRYONIC PERIOD (WEEKS 3–8) 26
I. General Considerations 26
II. Further Development of the Embryoblast 26
III. Vasculogenesis (De Novo Blood Vessel Formation) 29
Contents
iv
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Contents v
IV. Hematopoiesis (Blood Cell Formation) 31
V. Clinical Considerations 31
Study Questions for Chapter 4 33
Answers and Explanations 35
5. CARDIOVASCULAR SYSTEM 37
I. Formation of Heart Tube 37
II. Primitive Heart Tube Dilations 37
III. The Aorticopulmonary (AP) Septum 39
IV. The Atrial Septum 41
V. The Atrioventricular (AV) Septum 43
VI. The Interventricular (IV) Septum 45
VII. The Conduction System of the Heart 46
VIII. Coronary Arteries 47
IX. Development of the Arterial System 47
X. Development of the Venous System 49
Study Questions for Chapter 5 50
Answers and Explanations 53
6. PLACENTA AND AMNIOTIC FLUID 55
I. Formation of the Placenta 55
II. Placental Components: Decidua Basalis and Villous Chorion 55
III. Placental Membrane 58
IV. The Placenta as an Endocrine Organ 59
V. The Umbilical Cord 60
VI. Circulatory System of the Fetus 60
VII. Amniotic Fluid 62
VIII. Twinning 62
IX. Clinical Considerations 64
Study Questions for Chapter 6 67
Answers and Explanations 69
7. NERVOUS SYSTEM 70
I. Overview 70
II. Development of the Neural Tube 70
III. Neural Crest Cells 72
IV. Placodes 74
V. Vesicle Development of the Neural Tube 74
VI. Histogenesis of the Neural Tube 75
VII. Layers of the Early Neural Tube 77
VIII. Development of the Spinal Cord 77
IX. Development of the Myelencephalon 78
X. Development of the Metencephalon 79
XI. Development of the Mesencephalon 80
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vi Contents
XII. Development of the Diencephalon, Optic Structures,
and Hypophysis 81
XIII. Development of the Telencephalon 82
XIV. Development of the Sympathetic Nervous System 84
XV. Development of the Parasympathetic
Nervous System 84
XVI. Development of the Cranial Nerves 84
XVII. Development of the Choroid Plexus 85
XVIII. Congenital Malformations of the Central Nervous System 86
Study Questions for Chapter 7 93
Answers and Explanations 96
8. EAR 98
I. Overview 98
II. The Internal Ear 98
III. The Membranous and Bony Labyrinths 98
IV. Middle Ear 100
V. External Ear 100
VI. Congenital Malformations of the Ear 101
Study Questions for Chapter 8 104
Answers and Explanations 105
9. EYE 106
I. Development of the Optic Vesicle 106
II. Development of Other Eye Structures 109
III. Congenital Malformations of the Eye 110
Study Questions for Chapter 9 113
Answers and Explanations 114
10. DIGESTIVE SYSTEM 115
I. Overview 115
II. Derivatives of the Foregut 115
III. Derivatives of the Midgut 123
IV. Derivatives of the Hindgut 127
V. Anal Canal 130
VI. Mesenteries 130
Study Questions for Chapter 10 131
Answers and Explanations 133
11. RESPIRATORY SYSTEM 134
I. Upper Respiratory System 134
II. Lower Respiratory System 134
Study Questions for Chapter 11 142
Answers and Explanations 144
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Contents vii
12. HEAD AND NECK 145
I. Pharyngeal Apparatus 145
II. Development of the Thyroid Gland 145
III. Development of the Tongue 147
IV. Development of the Face 148
V. Development of the Palate 149
VI. Development of the Mouth 150
VII. Development of the Nasal Cavities 150
VIII. Clinical Considerations 151
Study Questions for Chapter 12 154
Answers and Explanations 155
13. URINARY SYSTEM 156
I. Overview 156
II. Development of the Metanephros 156
III. Relative Ascent of the Kidneys 157
IV. Blood Supply of the Kidneys 158
V. Development of the Urinary Bladder 159
VI. Development of the Female Urethra 159
VII. Development of the Male Urethra 160
VIII. Clinical Considerations 161
IX. Development of the Suprarenal Gland 165
Study Questions for Chapter 13 169
Answers and Explanations 170
14. FEMALE REPRODUCTIVE SYSTEM 171
I. The Indifferent Embryo 171
II. Development of the Gonads 171
III. Development of the Genital Ducts 173
IV. Development of the Primordia of External Genitalia 175
V. Tanner Stages of Female Sexual Development 176
VI. Clinical Considerations 176
Study Questions for Chapter 14 180
Answers and Explanations 181
15. MALE REPRODUCTIVE SYSTEM 182
I. The Indifferent Embryo 182
II. Development of the Gonads 182
III. Development of the Genital Ducts 184
IV. Development of the Primordia of External Genitalia 186
V. Tanner Stages of Male Sexual Development 186
VI. Clinical Considerations 186
VII. Summary 191
Study Questions for Chapter 15 192
Answers and Explanations 193
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viii Contents
16. INTEGUMENTARY SYSTEM 194
I. Skin 194
II. Hair and Nails 198
III. Mammary, Sweat, and Sebaceous Glands 201
IV. Teeth 203
Study Questions for Chapter 16 205
Answers and Explanations 206
17. SKELETAL SYSTEM 207
I. Skull 207
II. Vertebral Column 211
III. Ribs 216
IV. Sternum 216
V. Bones of the Limbs and Limb Girdles 216
VI. Osteogenesis 217
VII. General Skeletal Abnormalities 217
Study Questions for Chapter 17 220
Answers and Explanations 221
18. MUSCULAR SYSTEM 222
I. Skeletal Muscle 222
II. Smooth Muscle 223
III. Cardiac Muscle 224
IV. Clinical Considerations 224
Study Questions for Chapter 18 226
Answers and Explanations 227
19. UPPER LIMB 228
I. Overview of Development 228
II. Vasculature 228
III. Musculature 230
IV. Nerves: The Brachial Plexus 230
V. Rotation of the Upper Limb 231
VI. Skeletal 232
Study Questions for Chapter 19 234
Answers and Explanations 235
20. LOWER LIMB 236
I. Overview of Development 236
II. Vasculature 236
III. Musculature 238
IV. Nerves: The Lumbosacral Plexus 238
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[...]... include abnormalities of the epididymis, abnormalities of the vas deferens, and defective ejaculation 4 Hypothalamic-pituitary disease (1%–2% of cases) This includes congenital idiopathic hypogonadotropic hypogonadism caused by a defect in gonadotropin-releasing factor (GRF) secretion from the hypothalamus, acquired hypogonadotropic hypogonadism caused by a pituitary macroadenoma, surgical therapy for... nondisjunction Clinical findings include moderate mental retardation, microcephaly, microphthalmia, colobomata, cataracts and glaucoma, flat nasal bridge, epicanthal folds, protruding tongue, Brushfield spots, simian crease in the hand, increased nuchal skin folds, congenital heart defects, and an association with a decrease in ␣-fetoprotein LWBK507-c01_p01-11.qxd 11/01/2010 08:45 AM Page 5 Aptara Chapter... period (LNMP age) In this book, age is presented as the fertilization age 12 LWBK507-c02_p12-17.qxd 11/01/2010 01:08 PM Page 13 Aptara Chapter 2 Week 1 of Human Development (Days 1–7) 13 considered totipotent (capable of forming a complete embryo) up to the 4- to 8-cell stage (important when considering monozygotic twinning) 2 Blastomeres form a morula by undergoing compaction, that is, tight junctions... structures from each of the three primary germ layers: for example, colon glandular tissue (endoderm), cartilage (mesoderm), and squamous epithelium (ectoderm) 3 TTC also contains undifferentiated pluripotent stem cells called embryonic carcinoma (EC) cells 4 TTC is associated with elevated ␣-fetoprotein levels 5 TTC can be experimentally produced by implanting a blastocyst in an extrauterine site The... mitochondria present within the secondary oocyte (maternal) remain in the fertilized zygote 8 C This scenario would result in four genetically identical children Blastomeres at the 4to 8-cell stage are totipotent, that is, capable of forming an entire embryo Since blastomeres arise by mitosis of the same cell (zygote), they are genetically identical This phenomenon is important in explaining monozygotic . Designer: Holly Reid McLaughlin Vendor Manager: Bridgett Dougherty Compositor: Aptara, Inc. Fifth Edition Copyright © 2011, 2008, 2005, 1998, 1994 Lippincott Williams & Wilkins, a Wolters. student feedback very much. In the fifth edition, I have placed clinical images closer to the corresponding text to make reviewing more efficient. As in the previous edition, the Comprehensive Examination. 8:30 am to 6:00 pm, EST. LWBK507-FM-i-x.qxd 11/01/2010 07:38 PM Page ii Aptara Preface The fifth edition of BRS Embryology has afforded me the opportunity to further fine- tune a work that was already
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