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USMLE Embryo

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Answer 50 questions in 15 minutes.
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1. From What embryonic layer does a craniopharygioma arise?
Apical ectodermal ridge; limb lengthening; stimulates mitosis of underlying mesoderm
Surface ectoderm
Prosencephalon - mesencephalon - rhombencephalon
Hypertrophy of muscularis externis of pylorus; surgical incision

2. Which branchial apparatus makes the external auditory meatus?
1st cleft/groove (Ectoderm)
3 -4 -6
Polyhydramnios - Down syndrome - Esophageal/duodenal atresia - Imperforate anus - Meckel diverticulum
Valproate acid

3. What is the allantois become? What is this duct connected to ( on both ends)?
Persistent connection between amniotic cavity and spinal canal; low folic acid
Urachus/median umbilical ligament; bladder and yolk sac
During; instrinsic
Ventral shaft of penis (penile urethra); labia minora

4. What is germinal matrix hemorrhage associated with?
Folate antagonists
Respiratory distress syndrome
Post. sup wall; luteal phase
VACTERL- vertebral defect - anal atresia - cardiac defects - tracheo - esophageal fistula - renal defects - limb defects

5. From what region of the brain does the aqueduct form?
Rhombencephalon
Branchial arch 2
Neural crest cells
Mesoderm

6. What effect does warfarin have on the fetus?
Hemorrhage - bone deformities
VSD
Stapedius and hyoid artery
Maternally derived; meconium

7. What two things cause VACTERL syndrome?
ACE inhibitors - HCTZ
Yolk sac; liver (weeks 6-30) and spleen (9-28 weeks)
OCPS and maternal diabetes
Annular pancrease

8. Which branchial derivative accounts for taste in the ant 2/3?
3rd pouch
Turners; inferior
Blastocyst; epiblast and hypoblast; synctiotrophoblast and cytotrophoblast
Branchial arch 2

9. failure to close of what fold results in sternal defects? omphalocele? gastrochisis? bladder extrosphy?
When the AP septum meets and fuses with the muscular ventricular septum to form membranous intraventricular septum - closing interventricular foramen
Ectoderm - mesoderm - endoderm; epiblast - primitive streak - hypoblast; week 3
Rostral fold closure ; lateral fold closure; lateral fold closure; caudal fold closure
Week 2; bilaminar disk; epiblast and hypoblast

10. During what months is the fetus most susceptible to teratogens? What trimester?
Physiologic incomplete muscular ventricular septum
Neural crest cells
Embryonic period; 1st trimester
Transposition of great vessels (failure to spiral)- right to left shunt; tetralogy of Fallout (right to left shunt caused by skewed development of septum); persistent TA (partial septum development - also right to left shunt)

11. What is the effect of teratogens after week 8?
Deformation
Cytotrophoblast
Increase in oxygen concentration which decreases prostaglandin concentration
Neural crest cells

12. What causes the increase in left atrial pressure to close the fossa ovale?
DHT; estrogen
Neuroectoderm
Decreased pulmonary resistance in the pulmonary vasculature
Mesoderm

13. what other facial defect other than cyclopia is associated with holoprosencephaly?
Uretopelvis; most common site for obstruction (hydronephrosis) in fetus
Cleft lip/palate
Mesoderm
A vitelline fistula - failure of vitelline duct to close

14. WithIn what week does gastrulation occur? What is gastrulation?
Week 3; primitive streak formation from the epiblast makes the three layers
Endoderm - floor of primitive pharynx
External auditory meatus
T neuroectoderm

15. What causes the obstruction in pyloric stenosis? treatment?
Aortic arch (from left side); right subclavian (on the right)
Tunica vaginalis not fully fused
Hypertrophy of muscularis externis of pylorus; surgical incision
Meckels cartilage: mandible - malleus - INCUS - sphenoMandibular ligament; CN V2 and V3

16. From What embryonic layer do CNS neurons arise?
2nd pouch
Neuroectoderm
When left to right shunting switching to right to left shunting
Mesencephalon

17. From What embryonic lare are the odontoblasts from?
Neural crest cells
mesoderm
Metencephalon; cerebellum
IX; X

18. From What embryonic layer is the spleen from?
Nicotine; preterm labor
Increase in oxygen concentration which decreases prostaglandin concentration
Mesoderm
Ring of pancreatic tissue can cause duodenal narrowing; ventral pancreatic bud abnormally encircles 2nd part of duodenum

19. From What embryonic layer does the adenohypophysis arise?
Yolk sac; liver (weeks 6-30) and spleen (9-28 weeks)
4th/5th branchial pouches
Mid gut to yolk sac; omphalomesenteric duct; 7th week
Surface ectoderm

20. What secretes hCG?
Neuroectoderm
Synctiotrophoblast
Aortic arch (from left side); right subclavian (on the right)
Initial left to right shunting - then switches

21. What is the most common autopsy finding in brains of premature infants?
Germinal matrix hemorrhage
Annular pancrease
Common carotid and internal carotid
Week 4

22. what junction is the last to canalize? what implications does this have down the line?
Common carotid and internal carotid
Left horn of the sinus venosus
Ampulla
Uretopelvis; most common site for obstruction (hydronephrosis) in fetus

23. Where does fertilization occur?
Temporary cervical sinus
Week 10-12; end of 1st trimester
Ectoderm - mesoderm - endoderm; epiblast - primitive streak - hypoblast; week 3
Ampulla

24. What is the fate of the cervical sinuses that develop from the 2nd -4th branchial grooves?
Lacunae in between the chorionic villi
8
Persistent connection between amniotic cavity and spinal canal; low folic acid
Obliterated

25. From What embryonic layer does the olfactory epithelium arise?
Post. sup wall; luteal phase
Arnold Chiari and Dandy Walker; Arnold Chiari; Dandy Walker; Arnold Chiari
Surface ectoderm
Left horn of the sinus venosus

26. What are markers for neural tube defects in the amniotic cavity? CSF?
Turners; inferior
Maxillary and medial nasal processes
Increased AFP and acetycholinesterase (not ACh!) in CSF
Decidual basalis

27. What is the memranous interventricular formaen made from?
Ventral bud
Midgut; 10th week
When the AP septum meets and fuses with the muscular ventricular septum to form membranous intraventricular septum - closing interventricular foramen
Ventral and dorsal parts fail to fuse at 8th week; 2 pancreatic ducts!- more prone to pancreatitis

28. what muscles are derived from branchial arch 2?
Amniotic epithelium
Dorsal and ventral buds
Muscles of facial expression - stapedius - stylohyoid - posterior belly of the digastric
Mesoderm

29. What is contained in the umbilical cord?
Skewed development of AP septum
Decreased pulmonary resistance in the pulmonary vasculature
Umbilical artery - vein; and whartons jelly (mucus connective tissue) - urachus
pyloric stenosis

30. From What embryonic layer does the gut tube derivatives arise (lungs liver - pancreas - parathryroid - thyroid follicular cells - thymus)?
is no longer intact
Nicotine; preterm labor
Surface ectoderm
Endoderm

31. What is meckel's diverticulum? What is it associated with? What does that cause?
Myelencephalon
Partial closure of vitelline duct so that the patent portion is attached to ileum; ectopic gastric mucosa; melena and periumbilical pain
Found in lateral neck; from no obliteration of 2-4th clefts
Thyroglossal duct; persists as pyramidal lobe of thyroid; foramen cecum on tongue is normal remnant of thyroglossal duct

32. What type of blood do umbilical veins carry? From where to where?
Prosencephalon
Oxygenated; placenta to fetus (IVC)
Wolffian; mullerian
Cerebral hemisphere - thalami

33. What embryological structure gives rise to the trabeculated parts of the left and right ventricle?
Fluid filled syrinx causes expansion and degeneration of cord tracts
mesodermal
Primitive ventricle
Tunica vaginalis not fully fused

34. What is the Eisenmeger complex?
When left to right shunting switching to right to left shunting
Oligohydramnios
Rhombencephalon
After; extrinsic

35. What are the two walls of the prosencephalon and What do they become?
Cerebral hemisphere - thalami
Diencephalon
Obliterated; forms tunica vaginalis
Caused by compression on trocheal nerve - causes vertical gaze paralysis (associated with arnold chiari)

36. what muscles are derived from branchial arch 6? CN?
All intrinsic muscles of larynx except cricothyroid; CN X (recurrent laryngeal nerve - speaking)
Myelencephalon
IMA
Hypertrophy of muscularis externis of pylorus; surgical incision

37. How do you differentiate a thyroglossal duct cyst from a persistent cervical sinus?
Ampulla
Right common cardinal vein and right anterior cardinal vein
Tetracyclines
Thyroglossal duct cysts will move with swallowing while persistent cervical sinuses in lateral neck wont

38. Where is Wnt 7 gene produced?
Surface ectoderm
Muscles of facial expression - stapedius - stylohyoid - posterior belly of the digastric
Base of limbs in the zone of polarizing activity; ant - post
Apical ectodermal ridge

39. Where is the apical ectodermal ridge?
Neuroectoderm
Endoderm
Thickened ectoderm at end of each developing limb
Dorsal and ventral buds

40. With the first breath the infant take - pulmonary vasculature resistance _______ which causes an increase in left atrial pressure
Mesonephros; male genital system
Decreases
Hepatic circulation; ligamentum venosum
Week 4

41. The notochord is...
mesoderm
Endoderm
Decreases
Nutrient and gas for exchange; endometrium

42. What do the arches of the branchial apparatus correlate to?
Apical ectodermal ridge; limb lengthening; stimulates mitosis of underlying mesoderm
Duodenum to transverse colon; distal transverse colon to rectum
Mesdoerm
Obliterated

43. From What embryonic layer does connective tissue and muscle arise?
1st cleft/groove (Ectoderm)
All or none
Mesoderm
Initial left to right shunting - then switches

44. From which germlayer does the thyroid develop?? From what structure exactly?
Palpable olive mass in epigastric region; nonbilious projectile vomitting @around 2 weeks
Obliterated; forms tunica vaginalis
Endoderm - floor of primitive pharynx
28 week onward

45. From where is the pancreas derived? the spleen?
Bones - cartilage - and nerves
Foregut; dorsal mesentery (mesodermal)
Membrane - all 3 from 1st appartus
Ampulla

46. Cleft lip is a failure of fusion of ________ and ______.
XII
Day 6; maintains corpus luteum; 1st trimester
Maxillary and medial nasal processes
Mesoderm

47. What causes a large posterior fossa in a dandy walker malformation? What is found in this fossa?
3rd pouch
Absent cerebellar vermis; cystic enlargement of 4th ventricle
Polyhydramnios
Endoderm lined structures of ear: middle ear cavity - eustacian tube - mastoid air cells

48. What hormone is hcG structurally similar too?
Ectoderm
LH
Neural crest migration - they then cause spiral
Aortic arch (from left side); right subclavian (on the right)

49. What components do the mesoderm of the branchial arches give rise to?
Fetal alcohol syndrome; mental retardation
can make cells
Muscles and arteries
3rd pouch

50. What teratogen can cause inhibition of intestinal folate absorption and thus neural tube defects?
Neural crest cells
Valproate acid
Outgrowth of mesonephric as ureteric bud; most caudal
Oxygenated; placenta to fetus (IVC)

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USMLE Embryo

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