Langman's medical embryology: General embryology : SAQs for practice

Langman’s medical embryology books

General embryology

 Chapter 1: Matching

Embryology	it is the study of normal developmental process
Teratology	it is the study of abnormal developmental process
Embryogenesis	the first 8 weeks of  development
Fetal period	the period of development from 9 wks to birth
Induction	Process whereby one population of cells or a tissue causes another set of cells or tissues to change their fate.
Exon	region of a gene that can be transcribed into a protein
Intron	region of a gene that can not be transcribed into a protein
Chromatin	a complex of DNA and protein

1. discuss shortly mandle’s law of inhabitant
2. Define growth. Classify growth with example.
3.  what is differentiation
4. What is totipotent cells and pluripotent cells?

Chapter 2: gametogenesis :

1. Define zygote.
2. gametes are derived from primordial germ cells that are formed in the epiblast/ hypoblast
3. Primordial germ cells begins to migrate from .............................. toward developing gonads during 3/4/5 weeks of development
4. Mention three features of teratomas
5. Human chromosomes contain .............................genes
6. what is cross over ?
7. Discuss the result of meiotic divisions.
8. What is polar body?
9. Classify chromosomal abnormality with example.
10. What do you mean by non-disjunction and anaphase lag ?
11. Mention five features of Turner’s syndrome, klinfelter’s syndrome and down syndrome?
12. Define oogenesis. Name of immature and mature female germ cells. 
13. What do you mean by primordial follicle, growing follicle , primary follicle, secondary (antral ) follicle, secondary ( graafian ) follicle
14. Draw and label graafian follicle.
15. When number of oogonia is reach in maximum number?
16. In oogenesis,  When 1^st meiotic and 2^nd meiotic division is complete?
17. Differentiation of primordial germ cells in female ( primordial germ cells ...oogonium(immature cells) ....primary oocyte.......secondary oocyte .......ovum( mature cells ) 
18. How many days are required to complete spermatogenesis ?
19. What are the changes occurred in spermiogenesis?
20. Draw and label cells of testes with their functions.
21. Write the chromosome number of oogonia, primary oocyte, 2^nd oocyte, ovum, spermatogonia, primary spermatocyte, 2^nd spermatocyte, spermatozoa
22. Differentiation of primordial germ cells in male ( primordial germ cells ...spermatogonia (immature cells) ....type A spermatogonia and type B spermatogonia ........ type B spermatogia ....primary spermatocyte .......secondary spermatocyte .....early spermatid ....late spermatid ....spermatozoa( mature cells ) 
23. Write  difference between oogenesis and spermatogenesis :

        When it starts,

              Are oogonia able to divide after birth?

              Number of mature germ cells after each meiotic divisions,

             Chromosome number (sex chromosome X or Y) 

             Polar body

             When oogenesis and spermatogenesis are stop

             Which hormones are act in oogenesis and spermatogenesis etc.

Chapter 3 : 1^st week of development : ovulation to implantation

1. sexual cycles are controlled by hypothalamus/ pituitary glands / ovary or testes
2. gonadotropin releasing hormones (GnRH) produced by hypothalamus/ pituitary glands / ovary or testes
3. Follicle stimulating hormones (FSH) and luteinizing hormones (LH) produces by hypothalamus/ pituitary glands / ovary or testes
4. what is the function of follicle stimulating hormones
5. Which cells produce estrogen and progesterone?
6. what is the function of estrogen and progesterone hormones
7. When LH (lutinizing hormone) surge is occurred?
8. write importance of LH surge
9. What is ovulation? what are the sign of ovulation
10. What do you mean by corpus luteum, corpus albicans ,  corpus luteum of pregnency
11. Define fertilization.
12. what is capacitation and acrosome reaction
13. mention the phases of fertilization
14. mention the egg response
15. Mention the results fertilization.
16. What is cleavage? 
17. Draw and label Blastocyst.
18. how many layers are present in uterus
19. endometrium of uterus passes how many stages in each menstrual cycle, in which stage implantation is occurred ?
20. How many layers are there within uterine endometrium?

Chapter 4: 2^nd week of development : bilaminar germ disc

1. what are the changes take place in 8 days of development
2. what do you mean by lacunar stage
3. When secondary yolk sac cavity and chorionic cavity is formed?
4. What are the changes take place in 2^nd week of development ?
5. What do you mean by decidua reaction?
6. what is primary villi?
7. what is ectopic pregnancy?
8. what is hydatidiform mole ?

  Chapter 5: Third week of development : trilaminar germ disc

1.      what is Gastrulation?

2.      Draw and label dorsal surface of germ disc ( 16 days) showing primitive streak, primitive node and pit, oropharyngeal membrane ( buccopharyngeal membrane ) , cloacal membrane

3.      how notochord is formed ? mention its importance and fate.

4.      what is saccrococcygeal teratoma?

5.      what is Kartagener syndrome?

6.      What do you mean by primary, 2^nd and tertiary villi ( Draw and label)

7.      how umbilical cord is developed? 

Chapter 6 : Third to eight weeks : The embryonic period

1.      define neurulation. how neural tube is formed ? (Draw and label )

2.      How neural crest is formed? mention the derivatives of neural crest cells .

3.      Mention derivatives of neural crest ?

4.      Draw and label transverse section of development of ectoderm, mesoderm and endoderm

5.      Define vasculogenesis and angiogenesis ? what is hemangiomas?

6.      Derivatives of ectoderm, mesoderm and endoderm

Chapter 7 : 3 month to birth : the fetus and placenta

1.      define fetal period .

2.      when primary ossification center of bone is developed?

3.      when intestinal loops is herniated in the umbilical cord?

4.      When mother feel movement of fetus ?

5.      what is vernix caseosa?

6.      Mention the name of fetal membranes

7.      Draw and label a 2^nd month fetus showing decidua capsularis, decidua parietalis and decidua basalis, chorionic leave and chorionic frondosum

8.      Mention the structure of placenta with its functions

9.      define amnion with its functions. What is polyhydramnios and oligohydramnios

10.  Draw and label an umbilical cord. what is true and false knots.

11.  define dizygotic and monozygotic twin

Chapter 8: birth defects and prenatal diagnosis

1.      define teratology, teratogens

2.      mention different types of abnormality

3.      what is malformation, disruption, deformation, syndrome

4.      Draw a graph showing the times of gestation versus the risks of birth defects

5.      shortly discuss the principle of teratology

6.      give some examples of teratogens

7.      Mention the name of common congenital abnormality

Thorax card (new curriculum) : MBBS item viva questions (bangladesh)

THORAX

(Viva- item examination)

Item no-1: Thoracic Wall, thoracic cavity, Pleura & Mediastinum

1. Give the skeletal boundary of thoracic cage. Tell about content of thoracic cavity
2. Give the  boundary of thoracic inlet
3. Give the  boundary of thoracic outlet
4. What do you mean by typical intercostal space?
5. Mention the name of intercostal muscles with origin, insertion & NS
6. Define mediastinum with different subdivision. Give the boundary of superior / inferior (anterior/ middle/ posterior)  mediastinum and list their contents.
7. Joint: sternocondal jt & costochondal jt:  formation & type.
8. What do you mean by i) True ribs ii) False rib iii) Floating ribs
9. Identify sternal angle and write importance of sternal angle.
10. Bones: Typical rib, 1^st rib, 12^th rib
11. Figure- 1^st & 12^th rib

Item-2: Different joint of thorax

1.      Name different joint of thorax, mention their formation & type.

2.      Write about peculiarities of clavicle.

3.      Define joint. Classify joint

4.      Classify (fibrous/cartilaginous/ synovial joint)

5.      Write features of synovial joint.

6.      Difference between primary & secondary cartilaginous joint.

7.      Bone: Clavicle, Sternum  

8.      Figure: clavicle /Sternum/Typical synovial joint./Fibrous joint/Cartilaginous joint.

Item-3:

1.      Define pericardium. Write different layers with blood & nerve supply

2.      How many chambers present within heart.

·         Write a flow chart to describe systemic circulation.

·         Write a flow chart to describe pulmonary circulation

·         Write a flow chart to describe portal circulation

3.      List the name of structure enter into the right atrium of heart.

4.      How sternocostal surface of heart is formed?

5.      Draw & label arterial supply,venous supply of heart and nerve supply of heart

6.      Discuss the  role of sympathetic& para sympathetic nervous system on heart

7.       Mention difference layers of heart.

8.      Identify/formation 

Four chamber of heart 

 Surfaces- sternocostal, diaphragmatic,  left surfce , base

Borders-Right border Left border, interior border

Grooves – Coronary sulcus, ant. & pos. interventricular grooves

Vessels: Rt & Lf coronary artery, coronary sinus

Root of great vessels- SVC, IVC, ascending thoracic aorta, arch of  aorta, descending thoracic aorta, four pulmonary vein, pulmonary trunk

         Interior of heart- Interventricular septum/Papillary muscle/Corda tendenae/Cups/

                                        musculae pectinae/fossa Ovalis /Limbus fossa ovalis.

             Figure:    1. Arterial supply of heart

                               2. Venous system of heart

                               3. Conducting system of heart

Item-4:

1.      Define pleura mention its different layers. Mention blood & nerve supply of pleura.

2.      Extension of trachea. Difference between Rt & left principal bronchus. Blood supply of trachea

3.      Extension of conducting & respiratory part.

4.      Lining epithelium of conducting & respiratory part. 

5.      Identify-

    Surfaces- medial i) Vertebral   ii) Mediastinal, 

    Costal, Base, Apex, Hilum

      

              Bordar- Anterior border & inferior  border.

              Ligament- Pulmonary ligament.

              Groove- Groove for azygous vein, Groove for SVC, IVC, Descending thoracic aorta.

        6.  Function of conducting & respiratory part.

        7.  Define Branchopulmonary segment. Draw & label B.S of both Lung.

 Figure- pleura   

                       - Supra-plueral membrane - formation, attachment function.

  Item-5:The Diaphragm & Oesphagus:

Esophagus: Extension, Lining epithelium, Blood supply,  peritoneal relation, Porto-systemic anastomosis

The Diaphragm- Anatomical points

                          -Formation

                         - Parts

                         - Openings – vertebral label & structure passing through it.

                         - Functions.

                         - Nerve supply- sensory and motor.

                         - Type of muscle present in the diaphragm.

Bones: Typical thoracic vertebrae, Atypical thoracic vertebrae

Item-6:

Phrenic nerve- root value.

                      - Important relation.

                       - what type of nerve it is?

                       -arises from which plexus 

                      - supplied area.

Spinal nerve: Formation & location.  

                      Branches.

                      what type of nerve it is?

                      Draw & label

                      Number.

Intercostal nerve: Formation

                             Location

                             Difference between spinal nerve & intercostal nerve.

Lymphatic drainage:

What are right lymphatic duct, thoracic duct & cisternal chyli?

Branches of ascending aorta & desconding aorta tributaries of SVC, azygous & hemiazygous vein  

Spinal cord at a glance

Spinal Cord & Nerves

This is the viscera of spinal cord and spinal meninges

1.         Anatomical points:

             I.         anteriror median fissure lies anteriorly

          II.      cauda equine lies inferiorly

2.         length : 45cm                    wide 2.5 cm

3.          Extension of spinal cord:

   Adult: at the level of foramen magnum to lower border of 1^st lumbar vertebra

   Children: at the level of the foramen magnum to the 3^rd lumber vertebra

4.         Terminal part of sub-arachnoid space of the spinal cord : lower border of 2^nd sacral vertebra

5.         termination of filum terminalis: at the 1^st coccyx

External feature of spinal cord :

i)                    anteriorly : anterior median fissure

ii)                  posteriorly : posterior median septum

iii)                inferiorly : filum terminalis and cauda equine

iv)                two enlargement in cervical and lumbar region

v)                  external surface is covered by spinal meninges : outer meningeal dura mater, middle arachnoid mater and  inner pia mater

vi)                ventral roots, dorsal roots and dorsal root ganglia and spinal nerve

6.         How many enlargement present within the spinal cord and why?

i)                    Cervical enlargement: extend from the foramen magnum to 1^st thoracic vertebra. Supply upper limb

ii)                  Lumbar enlargement: extend from thoracic 10^th to 12^th vertebra. Supply lower limb.

7.         What is spinal segment?

 Ans: Part of the spinal cord to which one pairs of spinal nerve is attached.

8.         How many spinal segments present in the spinal cord? – 31 spinal segments

9.         What is conus medullaris? – cone shaped terminal part of spinal cord

 1.         What is filum terminalis ? – it is the prolongation of pia mater which extend from the cunus medullaris to 1^st coccyx

2.         What is cauda equine: the lumbar and sacral roots below the termination of spinal cord continue as a leash of nerve roots known as cauda equine.

3.         What is legamentum denticulate: it is the thickening of pia mater situated on either side of spinal cord between nerve roots. (Figure ellis 364)

Spinal nerve

How many Spinal nerves present in our body? Number: 31 pairs. 8 cervical spinal nerve, 12 thoracic spinal nerve, 5 lumbar spinal nerve, 5 sacral spinal nerve and 1 coccygeal spinal nerve

How a spinal nerve is formed? :  Spinal nerve form by union of ventral and dorsal nerve roots

Location of spinal nerve: within the intervertebral foramen

Exit : C1-C7 spinal nerves exit ABOVE C1-C7 vertebrae

                         C8 spinal nerve projects below C7 vertebra

                         T1-S5 spinal nerves project BELOW T1-S5 vertebrae

 Branches of a Spinal Nerve:

                        1. dorsal ramus – supply deep muscles and skin of back

                        2. ventral ramus – supply upper and lower extremities, ventrolateral trunk

                        3. meningeal branch - back into the spinal column

                        4. rami communicantes - for autonomic nerve fibers

Type of spinal nerves: they are mixed nerve (both sensory and motor ).

Component: GSA (general somatic afferent –carry impulse from periphery to CNS) and GSE( general somatic efferent- impulse goes from CNS to skeletal muscle)

Plexus of spinal nerve: plexus of spinal nerve is formed by ventral rami of different spinal nerves. There are four spinal nerve plexus  present within the body.

Name of plexus	Formation	Supplied area	Important nerve of the plexus
1. cervical plexus	ventral rami of C1-C4 with some C5	a. muscles/skin of head, neck, some shoulder b. phrenic nerve - diaphragm muscle (breathing)	phrenic nerve -
2. brachial plexus	ventral rami of C5-C8 and T1	Upper limb and shoulder	Axillary N, musculocutanous  N, Radial N, median N, Ulnar N
3. lumbar plexus	- ventral rami of L1-L4	a. abdominal wall, genitals, part of lower limb	Femoral N, Obturator N
4. sacral plexus	ventral rami of L4-L5 and S1-S4	a. buttocks, perineum, part of lower limb b. sciatic nerve	Sacral n- largest nerve of body,  pudendal n, Sup and inf Gluteal n

                       

 Dermatomes: area of skin is supplied by single spinal nerve

           

Internal feature of spinal cord:

Inner grey matter contains a central canal. Parts of grey matter, ant horn and pos horn and lateral horn only in thoracic and lumbar region

Grey matter contain motor and internuncial neuron

Parts of outer white matter: 1. anterior (ventral) column

                        2. posterior (dorsal) column

                        3. lateral (intermediate) column

white matter contain ascending and descending tracts:

fasciculi/tracts –they are collection  axon bundles within the CNS. They are two types:                                a. ascending tracts – carry sensory impulse to the brain. Spinothalamic tract

            b. descending tracts – carry motor impulse from brain to the effector organ (skeletal muscle). corticospinal tract

Important tract within the spinal cord :

ASCENDING TRACTS (SENSORY)
anterior (ventral) spinothalamic	touch and pressure to thalamus
lateral spinothalamic tract	pain & temperature to thalamus
fasciculus gracilis	touch, 2-pt. discrimination,
fasciculus cuneatus	conscious proprioception,      vibration
posterior spinocerebellar                                  anterior spinocerebellar	subconscious proprioception

DESCENDING TRACTS (MOTOR)
lateral corticospinal                                          anterior corticospinal tract	Carry motor output from cortex to motor neuron of ant. Grey horn which stimulate the skeletal muscles

Blood supply: one ant and two posterior spinal arteries. Other branches: ascending cervical a, pos intercostals a, and the lumbar a

Vein: ant and pos spinal vein.

Development : caudal part of neural tube (neuroectodarm)