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3 Embryology and Development
BIOL 6505 − INTRODUCTION TO FETAL MEDICINE 3. EMBRYOLOGY AND DEVELOPMENT Arlet G. Kurkchubasche, M.D. INTRODUCTION Embryology – the field of study that pertains to the developing organism/human Basic embryology –usually taught in the chronologic sequence of events. These events are the basis for understanding the congenital anomalies that we encounter in the fetus, and help explain the relationships to other organ system concerns. Below is a synopsis of some of the critical steps in embryogenesis from the anatomic rather than molecular basis. These concepts will be more intuitive and evident in conjunction with diagrams and animated sequences. This text is a synopsis of material provided in Langman’s Medical Embryology, 9th ed. First week – ovulation to fertilization to implantation Fertilization restores 1) the diploid number of chromosomes, 2) determines the chromosomal sex and 3) initiates cleavage. Cleavage of the fertilized ovum results in mitotic divisions generating blastomeres that form a 16-cell morula. The dense morula develops a central cavity and now forms the blastocyst, which restructures into 2 components. The inner cell mass forms the embryoblast and outer cell mass the trophoblast. Consequences for fetal management: Variances in cleavage, i.e. splitting of the zygote at various stages/locations - leads to monozygotic twinning with various relationships of the fetal membranes. Cleavage at later weeks will lead to conjoined twinning. Second week: the week of twos – marked by bilaminar germ disc formation. Commences with blastocyst partially embedded in endometrial stroma Trophoblast forms – 1) cytotrophoblast – mitotic cells that coalesce to form 2) syncytiotrophoblast – erodes into maternal tissues, forms lacunae which are critical to development of the uteroplacental circulation. -
MDCT of Interatrial Septum
Diagnostic and Interventional Imaging (2015) 96, 891—899 PICTORIAL REVIEW /Cardiovascular imaging MDCT of interatrial septum ∗ D. Yasunaga , M. Hamon Service de radiologie, pôle d’imagerie, CHU de Caen, avenue de la Côte-de-Nacre, 14033 Caen Cedex 9, France KEYWORDS Abstract ECG-gated cardiac multidetector row computed tomography (MDCT) allows precise Cardiac CT; analysis of the interatrial septum (IAS). This pictorial review provides a detailed description of Interatrial septum; the normal anatomy, variants and abnormalities of the IAS such as patent foramen ovale, con- Patent foramen genital abnormalities such as atrial septal defects as well as tumors and tumoral-like processes ovale; that develop on the IAS. Secundum ASD © 2015 Published by Elsevier Masson SAS on behalf of the Éditions françaises de radiologie. Introduction Major technical advances in computed tomography (CT) in recent years have made it pos- sible to use multidetector row CT (MDCT) in the field of cardiac imaging. Besides coronary arteries, ECG-gated cardiac MDCT provides high-resolution images of all cardiac structures. It is therefore important for radiologists to understand and be able to analyze the normal anatomical structures, variants and diseases of these different structures. This article provides an analysis of the interatrial septum (IAS) based on a pictorial review. After a short embryological and anatomical description, we will illustrate the nor- mal anatomy and variants of the IAS, anomalies such as patent foramen ovale (PFO), congenital diseases such as atrial septal defects (ASD) as well as tumors and tumoral-like processes that develop on the IAS. Abbreviations: ASA, atrial septal aneurysm; ASD, atrial septal defect; ECG, electrocardiogram; IAS, interatrial septum; IVC, inferior vena cava; IVS, interventricular septum; LV, left ventricle; M, myxoma; PFO, patent foramen ovale; RSPV, right superior pulmonary vein; RV, right ventricle; SVC, superior vena cava; MIP, maximal intensity projection; TEE, transesophageal echocardiography; TV, tricuspid valve. -
Development of HEART 4-VEINS
Development of brachiocephalic veins 1. Right brachiocephalic vein is formed by cranial part of right anterior cardinal vein and 2. Left brachiocephalic is formed by cranial part of left anterior cardinal vein and the interant.cardinal anastomosis. Development of superior vena cava 1. The part up to the opening of vena azygos develops from caudal part of right ant.cardinal vein and 2. The part below the opening (intrapericardial part) is formed by the right common cardinal vein. Development of azygos and hemiazygos veins A. 1. Vena azygos develops from right azygos line vein and 2. The arch of vena azygos is formed by the cranial end of right postcardinal vein. B. Hemiazygos veins are formed by the left azygos line vein. Development of Inferior vena cava Inferior vena cava is formed, from below upwards by: 1. Begins by the union of the two common iliac veins (postcardinal veins), 2. Right supracardinal, 3. Right supra-subcardinal anastomosis, 4. Right subcardinal, 5. New formation (hepatic segment) and 6. Hepatocardiac channel (terminal part of right vitelline vein). Congenital anomalies • Double inferior vena cava • Absence • Left SVC • Double SVC DEVELOPMENT OF PORTAL VEIN 1. The portal vein is formed behind the neck of pancreas by the union of superior mesentric and splenic vein to the left vitelline vein. 2. The part of the portal vein which is behind the Ist part of duodenum is formed by middle dorsal transverse anastomosis. 3. Part of portal vein which is in the free margin of lesser omentum is formed by cranial or distal part of right vitelline vein. -
Fetal Circulation
The Fetal Circulation Dr. S. Mathieu, Specialist Registrar in Anaesthesia Dr. D. J. Dalgleish, Consultant Anaesthetist Royal Bournemouth and Christchurch Hospitals Trust, UK Questions 1. In the fetal circulation: a) There are two umbilical arteries and one umbilical vein? b) Over 90% of blood passes the liver via the ductus venosus c) The foramen ovale divides the left and right ventricle d) The umbilical artery carries oxygenated blood from the placenta to the fetus e) The foramen ovale allows oxygenated blood to bypass the pulmonary circulation 2. In the fetal circulation: a) The oxygen dissociation curve of fetal haemoglobin is shifted to the left compared with adult haemoglobin ensuring oxygen delivery to the fetus despite low oxygen partial pressures b) It is the presence of the ductus arteriosus and large pulmonary vascular resistance which ensures most of the right ventricular output passes into the aorta c) The patency of the ductus arteriosus is maintained by high oxygen tensions d) The patency of the ductus arteriosus is maintained by the vasodilating effects of prostaglandin G2 e) 2,3-DPG levels are higher in fetal haemoglobin compared with adult haemaglobin 3. Changes at birth include: a) a fall in pulmonary vascular resistance b) a rise in systemic vascular resistance with clamping of the cord c) an increase in hypoxic pulmonary vasoconstriction d) a rise in left atrial pressure e) closure of the ductus arteriosus within 24 hours 4. The following congenital heart lesions are cyanotic: a) Ventricular septal defect b) Atrial septal defect c) Patent ductus arteriosus d) Tetralogy of Fallot e) Transposition of the great arteries MCQ answers at end Key points • The fetal circulation supplies the fetal tissues with oxygen and nutrients from the placenta. -
Mammalogy Lecture 12
Mammalogy Lecture 11 - Reproduction I: General Patterns I. Obviously, reproduction is a very important aspect of biology and whole courses are dedicated to it. It’s easy to understand why reproductive traits would be subject to strong selection because of their direct effects on fitness. II. As we might expect, there are three basic types of mammalian reproduction. These correspond to the three major groups of mammals. Differences among these types reflect the degree of intimacy of fetal-maternal contact. A. Monotreme Type - Retain the primitive amniote pattern, but add a period of lactation. - Egg is very large at ovulation, about 3 mm. It moves down the oviduct where it is fertilized, then it’s coated with albumin, then a shell is laid down by a shell gland, and the shell is mineralized (with CaCO3). - Embryo spends 2-3 weeks in the uterus, then it’s laid. It’s large, 15 mm, when it’s laid. - Embryo growth is supported entirely by the yolk that’s enclosed in the egg. B. Metatherian type: - In some superficial ways it’s similar to monotremes, in that metatherians retain a shell membrane around the fertilized egg; a shell gland is present in Müllerian ducts. - However the shell is never mineralized and young are born live after only ca. 12 days, as we’ve seen, they are very altricial (poorly developed). - Initial intrauterine growth is supported by maternally by a placenta. - Metatherian placenta is the choriovitelline type - yolk-sac placenta (Eutherian placenta is called chorioallantoic placenta) C. Placenta Formation - Let’s look at formation of the placenta in Meta- & Eutherians. -
Echocardiographic Follow-Up of Patent Foramen Ovale and the Factors Affecting Spontaneous Closure
Acta Cardiol Sin 2016;32:731-737 Brief Report doi: 10.6515/ACS20160205A Echocardiographic Follow-Up of Patent Foramen Ovale and the Factors Affecting Spontaneous Closure Ali Yildirim,1 Alperen Aydin,2 Tevfik Demir,1 Fatma Aydin,2 Birsen Ucar1 and Zubeyir Kilic1 Background: The aim of the present study was to evaluate the echocardiographic follow-up of patent foramen ovale, which is considered a potential etiological factor in various diseases, and to determine the factors affecting spontaneous closure. Methods: Between January 2000 and June 2012, records of 918 patients with patent foramen ovale were retrospectively reviewed. Patency of less than 3 mm around the fossa ovalis is called patent foramen ovale. Patients with cyanotic congenital heart diseases, severe heart valve disorders and severe hemodynamic left to right shunts were excluded from the study. The patients were divided into three groups based on age; 1 day-1 monthingroup1,1month-12monthsingroup2,andmorethan12monthsingroup3. Results: Of the 918 patients, 564 (61.4%) had spontaneous closure, 328 (35.8%) had patent foramen ovale continued, 15 (1.6%) patients had patent foramen ovale enlarged to 3-5 mm, 6 patients were enlarged to 5-8 mm, and in one patient patent foramen ovale reached to more than 8 mm size. Defect was spontaneously closed in 65.9% of the patients in group 1, 66.7% of the patients in group 2, and 52.3% of the patients in group 3. There was a negative correlation between the age of diagnosis and spontaneous closure (p < 0.05). Gender, prematurity and coexisting malformations such as patent ductus arteriosus and atrial septal aneurysm did not have any effect on spontaneous closure of patent foramen ovale (p > 0.05). -
Has a Role in Cardiovascular and Placental Development and Is a Binding Partner of the Α4 Integrin
Abl-interactor-1 (Abi1) has a role in cardiovascular and placental development and is a binding partner of the α4 integrin Colleen Ringa,1, Mark H. Ginsbergb, Jacob Halingb, and Ann Marie Pendergasta,1 aDepartment of Pharmacology and Cancer Biology, Duke University Medical Center, Durham, NC 27710; and bDepartment of Medicine, University of California at San Diego, La Jolla, CA 92093 Edited* by Stephen P. Goff, Columbia University College of Physicians and Surgeons, New York, NY, and approved November 30, 2010 (received for review August 19, 2010) Dynamic signals linking the actin cytoskeleton and cell adhesion properties among integrin subunits in that α4 predominantly receptors are essential for morphogenesis during development accumulates at the leading edge of migrating cells, rather than at and normal tissue homeostasis. Abi1 is a central regulator of actin focal adhesions. Moreover, α4 expression is associated with polymerization through interactions with multiple protein com- protrusive activity and enhanced cell migration; however, the plexes. However, the in vivo role of Abi1 remains to be defined. pathways that link α4 integrin to the actin-regulatory machinery The α4 integrin adhesion receptor is associated with enhanced at the leading edge have remained elusive. Here we identify Abi1 protrusive activity and regulation of directional cell migration. as a target of α4 integrin that positively regulates membrane Among integrin subunits, α4 exhibits unique properties in that it protrusion by promoting actin polymerization at sites of integrin predominantly accumulates at the leading edge of migrating cells; engagement. however, the pathways that link the actin-regulatory machinery to The Abi family proteins, Abi1 and Abi2, were originally id- α4 at the leading edge have remained elusive. -
Cardiovascular System Note: the Cardiovascular System Develops Early (Week 3), Enabling the Embryo to Grow Beyond the Short
Lymphatics: Lymph vessel formation is similar to blood angiogenesis. Lymphatics begin as lymph sacs in three regions: jugular (near brachiocephalic veins); cranial abdominal (future cysterna chyla); and iliac region. Lym- phatic vessels (ducts) form as outgrowths of the sacs. mesenchyme Lymph nodes are produced by localized mesoder- sinusoid lymph duct lumen mal invaginations that partition the vessel lumen into sinu- soids. The mesoderm develops a reticular framework within which mesodermal lymphocytes accumulate. The spleen and hemal nodes (in ruminants) invagination develop similar to the way lymph nodes develop. Lymph Node Formation Prior to birth, fetal circulation is designed for an in utero aqueous environment where the pla- centa oxygenates fetal blood. Suddenly, at birth... Three In-Utero Adjustments ductus Stretching and constriction of arteriosus umbilical arteries shifts fetal blood flow aortic arch from the placenta to the fetus. Reduced pulmonary trunk L atrium venous return through the (left) umbili- foramen ovale R cal vein and ductus venosus allows the atrium latter to gradually close (over a period caudal vena cava of days). Bradykinin released by expand- ductus venosus ing lungs and increased oxygen concen- tration in blood triggers constriction of aorta the ductus arteriosus which, over two liver months, is gradually converted to a fibrous structure, the ligamentum arte- umbilical v. riosum. portal v. The increased blood flow to the lungs and then to the left atrium equalizes pres- sure in the two atria, resulting in closure umbilical aa. of the foramen ovale that eventually grows permanent. 29 The cardiogenic area, the place where the embryonic heart originates, is located . -
Endothelial Dysfunction May Link Interatrial Septal Abnormalities and MTHFR-Inherited Defects to Cryptogenic Stroke Predisposition
biomolecules Article Endothelial Dysfunction May Link Interatrial Septal Abnormalities and MTHFR-Inherited Defects to Cryptogenic Stroke Predisposition 1, 2, 1 1 Luca Sgarra y, Alessandro Santo Bortone y, Maria Assunta Potenza , Carmela Nacci , Maria Antonietta De Salvia 1, Tommaso Acquaviva 2, Emanuela De Cillis 2, Marco Matteo Ciccone 2, Massimo Grimaldi 3 and Monica Montagnani 1,* 1 Department of Biomedical Sciences and Human Oncology—Section of Pharmacology, Medical School, University of Bari “Aldo Moro”, 70124 Bari, Italy; [email protected] (L.S.); [email protected] (M.A.P.); [email protected] (C.N.); [email protected] (M.A.D.S.) 2 Department of Emergency and Organ Transplantation—Section of Cardiovascular Diseases, Medical School, University of Bari “Aldo Moro”, 70124 Bari, Italy; [email protected] (A.S.B.); [email protected] (T.A.); [email protected] (E.D.C.); [email protected] (M.M.C.) 3 General Hospital “F. Miulli” Acquaviva delle Fonti, 70021 Bari, Italy; fi[email protected] * Correspondence: [email protected] These authors contributed equally to this work. y Received: 28 March 2020; Accepted: 2 June 2020; Published: 4 June 2020 Abstract: We explored the significance of the L-Arginine/asymmetric dimethylarginine (L-Arg/ADMA) ratio as a biomarker of endothelial dysfunction in stroke patients. To this aim, we evaluated the correlation, in terms of severity, between the degree of endothelial dysfunction (by L-Arg/ADMA ratio), the methylene tetrahydrofolate reductase (MTHFR) genotype, and the interatrial septum (IAS) phenotype in subject with a history of stroke. Methods and Results: L-Arg, ADMA, and MTHFR genotypes were evaluated; the IAS phenotype was assessed by transesophageal echocardiography. -
Equine Placenta – Marvelous Organ and a Lethal Weapon
Equine placenta – marvelous organ and a lethal weapon Malgorzata Pozor, DVM, PhD, Diplomate ACT Introduction Placenta has been defined as: „an apposition between parent (usually maternal) and fetal tissue in order to establish physiological exchange” (1). Another definition of this important organ was proposed by Steven and Morris: „a device consisting of one or more transport epithelia located between fetal and maternal blood supply” (2). The main function of placenta is to provide an interface between the dam and the the fetus and to allow the metabolic exchange of the the nutrients, oxygen and waste material. The maternal circulation is brought into a close apposition to the fetal circulation, while a separation of these two circulatory systems remain separated (3). A degree and complexity of this „intimate relationship” varies greately between species mostly due to the structural diversity of the extraembryonic membranes of the vertebrates. The early feto-maternal exchange in the equine pregnancy is established as early as on day 22 after fertilization. The fetal and choriovitellin circulations are already present, the capsule ruptures and the allantois is already visible (4). The allantois starts expanding by day 32 and vascularizes approximately 90% of the chorion and fuses with it to form chorioallantois by day 38 of gestation (5). The equine placenta continues increasing its complexity till approximately day 150 of gestation. Equids have epitheliochorial placenta, there are six leyers separating maternal and fetal circulation, and there are no erosion of the luminal, maternal epithelium, like in ruminants (6). Thousands of small chorionic microvilli develop and penetrate into endometrial invaginations. -
COMMENTARY the First Evidence of the Tumor-Induced Angiogenesis in Vivo by Using the Chorioallantoic Membrane Assay Dated 1913
Leukemia (2004) 18, 1350–1351 & 2004 Nature Publishing Group All rights reserved 0887-6924/04 $30.00 www.nature.com/leu COMMENTARY The first evidence of the tumor-induced angiogenesis in vivo by using the chorioallantoic membrane assay dated 1913 Domenico Ribatti1 1Department of Human Anatomy and Histology, University of Bari Medical School, Bari, Italy Leukemia (2004) 18, 1350–1351. doi:10.1038/sj.leu.2403411 tional characterization of the immune system in the chick Published online 17 June 2004 embryo. Early lymphoid cells deriving from the yolk sac and spleen are usually recognizable in the thymus on day 8 and in Virchow, the founder of pathological anatomy, drew attention to the bursa of Fabricius on day 11.6 Thymus cells are present by the huge number of blood vessels in a tumor mass as long ago as day 11 and cell-mediated immunity has been demonstrated by 1865. Tumor vascularization was first studied systematically by day 13–14.7 The chick embryo and the nude mouse are 1 Goldman, who described the vasoproliferative response of the immunological incompetent hosts and do not reject tissues organ in which a tumor develops as follows: ‘The normal blood from a foreign source. Indeed, the chick embryo cannot mount vessels of the organs in which the tumor is developing are an ‘immune’ response to foreign tumor cells until well after day disturbed by chaotic growth, there is a dilatation and spiralling 12, but it can respond to tumor cells by infiltration of monocytes of the affected vessels, marked capillary budding and new vessel and inflammatory-like cells such as avian heterophils. -
From Trophoblast to Human Placenta
From Trophoblast to Human Placenta (from The Encyclopedia of Reproduction) Harvey J. Kliman, M.D., Ph.D. Yale University School of Medicine I. Introduction II. Formation of the placenta III. Structure and function of the placenta IV. Complications of pregnancy related to trophoblasts and the placenta Glossary amnion the inner layer of the external membranes in direct contact with the amnionic fluid. chorion the outer layer of the external membranes composed of trophoblasts and extracellular matrix in direct contact with the uterus. chorionic plate the connective tissue that separates the amnionic fluid from the maternal blood on the fetal surface of the placenta. chorionic villous the final ramification of the fetal circulation within the placenta. cytotrophoblast a mononuclear cell which is the precursor cell of all other trophoblasts. decidua the transformed endometrium of pregnancy intervillous space the space in between the chorionic villi where the maternal blood circulates within the placenta invasive trophoblast the population of trophoblasts that leave the placenta, infiltrates the endo– and myometrium and penetrates the maternal spiral arteries, transforming them into low capacitance blood channels. Sunday, October 29, 2006 Page 1 of 19 From Trophoblasts to Human Placenta Harvey Kliman junctional trophoblast the specialized trophoblast that keep the placenta and external membranes attached to the uterus. spiral arteries the maternal arteries that travel through the myo– and endometrium which deliver blood to the placenta. syncytiotrophoblast the multinucleated trophoblast that forms the outer layer of the chorionic villi responsible for nutrient exchange and hormone production. I. Introduction The precursor cells of the human placenta—the trophoblasts—first appear four days after fertilization as the outer layer of cells of the blastocyst.