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2. The LL. Bud is supplied by ventral rami of L1 to S4 [lumbar & sacral plexuses].
- Each spinal nerve supplies a skin area called dermatome. As the buds grow, the spinal
nerves are elongated. As a result, the cranial dermatomes (e.g. C.4,5,6 in the case of the UL)
occupy the preaxial border whereas the caudal dermatomes (C.8 & T.1,2) occupy the
postaxial border. The central dermatome (C.7) becomes buried in the proximal part of the limb but
reappears distally in the hand.
ANOMALIES:
1. Amelia: Absence of one or more limbs.
2. Meromelia: The limb is represented only by the hand or foot.
3. Syndactyly: Fused one or more digits.
4. Polydactyly: Supernumerary digits.
5. Bradydactyly: Short digits.
6. Club foot: The feet are plantar-flexed & inverted constantly.
7. Cleft hand or foot [Lobster Claw Deformity]: One or more
middle digit(s) is absent. Thus, the hand (or foot) is divided into two parts.
In each part, the digits are fused.
It is the first system to function. The heart starts to beat in the middle of the 3rd. week.
The C.V.S. is totally mesodermal in origin.
- As a result of folding, the heart tube and the pericardial sac rotate with the head fold. Finally, the
heart tube becomes dorsal to the pericardial sac.
- The endocardial heart tube invades the pericardial sac from its dorsal aspect
dividing it into a visceral layer and a parietal layer.
- Five chambers appear as dilatations (separated by constrictions) in the heart tube.
In a caudo-cranial order, they are: sinus venosus, atrium, ventricle, bulbus cordis,
truncus arteriosus.
- The 2 ends of the heart tube are connected to the intra-embryonic vessels:
1. At the venous end, each horn of sinus venosus receives 3 veins:
a- Vitelline vein from the yolk sac.
b- Umbilical vein from the placenta.
c- Common cardinal vein from the body wall.
2. At the arterial end, the truncus arteriosus divides into 2 horns, each is
connected to arteries.
- The heart tube elongates forming an S-shaped cardiac loop. The bulbus cordis
shifts to the right side of the ventricle. The atrium expands transversely, bulging on
either side of the bulbus cordis forming auricles.
SEPTATION OF ATRIA
In the A-V canal between the atrium and ventricle, two endocardial cushions, ventral and dorsal
project from the walls and fuse together forming the septum intermedium which divides the A-V
canal into right and left halves. The upper part of each half (towards the atria) is added to the
corresponding atrium while the lower parts form the mitral and tricuspid
orifices. Local endothelial proliferations form the cusps of the A-V valves (3
cusps in the tricuspid valve & 2 cusps in the mitral valve).
The primitive atrium is divided into right and left chambers by the
development of an inter-atrial septum. In spite of that, throughout the
intrauterine life, this septum always keeps a gap connecting both atria. Steps of
septum formation:
1. The Septum Primum:
- A thin crescentic membrane grows from the roof of the atrium and
descends towards the septum intermedium, but is separated from it by the
foramen primum (ostium primum) which allows free communication
between the right and left sides.
- The foramen primum becomes progressively smaller and is finally closed.
Just before complete closure of the foramen primum, the upper part of the
septum primum ruptures forming another opening, the foramen secundum
which widens cranially.
2. The Septum Secundum:
- Another crescentic membrane grows from the roof of the atrium,
immediately to the right side of the septum primum. The opening below the
septum secundum is called the foramen ovale.
- Blood in the right atrium passes to the left atrium via a tortuous S-shaped
course through the foramen ovale and foramen secundum. Passage of blood
in an opposite direction is prevented by the flap-like valvular action of the
remaining lower part of the septum primum, closing the foramen ovale.
After birth, the pressure in both atria becomes equal and the 2 septa fuse. The
septum primum in the site of the foramen ovale forms the fossa ovalis. The
margins of the septum secundum around the fossa form the limbus fossa ovalis
(annulus ovalis).
The left atrium receives a common pulmonary vein which is formed by union
of four pulmonary veins from the lungs. The proximal part of this pulmonary
venous system is absorbed into the wall of the developing left atrium. As a
result, the four pulmonary veins open directly into the left atrium.
DEVELOPMENT OF ARTERIES
At first, there are 6 aortic arches on each side of the neck (each runs in the
corresponding pharyngeal arch). They connect one horn of the ventral aortic sac
(which arises from the truncus arteriosus) to the corresponding dorsal aorta
Fate: arches 1, 2 & 5 disappear, the rest give the following
arch Right Left
3rd The common carotid a. & internal carotid a. (the external carotid arises
as an outgrowth).
4th Part of the right subclavian a. Part of the arch of aorta
6 th
Proximal part right pulmonary a. Proximal part left pulmonary a.
Distal part disappears. Distal part ductus arteriosus.
N.B: The recurrent laryngeal nerve is the nerve of the 6th pharyngeal arch. It is pulled
down by the 6th aortic arch forming a loop before it returns to the neck.
On the left side, it hooks around the ductus arteriosus in the thorax.
On the right side, the distal part of the right 6th aortic arch + the right 5th aortic
arch disappear; the nerve hooks around the right subclavian artery in the neck (i.e.,
the derivative of the right 4th arch).
B- Fate of the Branches of the Dorsal Aortae:
I. The intersegmental (somatic) branches: pass laterally between somites:
- Cervical: 1st – 6th: are connected by longitudinal anastomotic channels which form
the vertebral artery and other arteries. The 7th subclavian a.
- Thoracic: 1st - 11th intercostal arteries & 12th subcostal a.
- Lumbar: 1st - 4th lumbar arteries & 5th common iliac a.
- Sacral: the lateral sacral arteries.
II. Lateral splanchnic arteries:
Supply the structures derived from the intermediate cell mass mesoderm.
Derivatives:
1. Phrenic arteries.
2. Middle suprarenal arteries.
3. Renal arteries.
4. Gonadal arteries.
Prof. Hany Shawky Nadim 8 Systemic Embryology
Anomalies of Arteries:
Coarctation of aorta: is narrowing of a segment of
the aorta. Its cause is unknown (may be fetal
hypoxia hypertrophy of the wall)
Patent Ductus Arteriosus (PDA): alone or 2ry. to
preductal coarctation of aorta
DEVELOPMENT OF VEINS
The embryo has 3 pairs of major veins:
I. Vitelline Veins: are 2 veins which drain the yolk sac and pass through the septum transversum
(ST) to open in the sinus venosus (SV). Fate:
(1) Caudal to the ST: they form the portal v., its right and left
branches & its 2 tributaries (sup. mesenteric & splenic).
(2) Inside the ST: they form the hepatic sinusoids.
(3) Between the ST & SV: they form 2 hepatic veins which
unite into a common hepatic v. that opens into the right
atrium & gives the upper segment of IVC
II. Umbilical Veins: are 2 veins which carry oxygenated blood
from the placenta to the SV after passing through the ST.
Fate: The right vein disappears & the left vein also
disappears except the part caudal to the ST which remains
(from the umbilicus to the left branch of portal v.). The part inside the ST is replaced by the
ductus venosus that ends in the common hepatic v.
III. Cardinal Veins: 2 veins, which drain the body wall & formed by
union of anterior and posterior cardinal veins. Fate:
A. Common cardinal veins:
(1) Right lower part of SVC (below the azygos v.).
(2) Left oblique vein of left atrium.
B. Anterior cardinal veins: become connected by an oblique
anastomosis which forms the left innominate v. while the right vein
forms the right innominate v. + the upper part of SVC.
C. Posterior cardinal veins: become connected by an iliac anastomosis
which left common iliac v. The right vein root of azygos v. +
right common iliac a.
Anomalies of Veins: SVC: double SVC or left SVC - IVC: double IVC or absent IVC
Prof. Hany Shawky Nadim 9 Systemic Embryology
FETAL CIRCULATION
The lungs do not function during intrauterine life. Three types of blood are found:
I. Highly Oxygenated Blood:
1. Passes from the placenta along the left umbilical vein to the left branch of portal vein.
2. Then reaches the IVC by one of 2 ways:
a. Mostly via the ductus venosus (i.e., by-passing the liver).
b. To a little extent via the liver sinusoids to the hepatic veins.
A physiological sphincter in the ductus venosus diverts blood
to the liver sinusoids when blood flow in the umbilical v. is
high (e.g., during uterine contraction) to prevent overloading
of the heart.
3. In the IVC, oxygenated blood mixes with little deoxygenated
blood returning from lower extremities & abdomen; this
highly oxygenated blood reaches the right atrium, where:
a. Most of it passes to the left atrium via the foramen ovale as
pressure in the left atrium is lower than the right.
b. Little amount passes to the right ventricle, then to the non-
functioning lungs & returns to the left atrium via the
pulmonary veins.
4. Blood in the left atrium mixes with little blood returning from
the lungs and passes to the left ventricle. This highly
oxygenated blood is distributed to the heart (via the coronary
arteries) + head, neck and upper limbs (via the 3 big branches
of the arch of aorta).
II. Deoxygenated Blood:
Returns to the right atrium via the SVC (from the head, neck and upper limb) and via the coronary sinus
(from the heart).
This blood passes to the right ventricle; to the pulmonary trunk, mainly to its left branch to
the ductus arteriosus to the arch of aorta after the origin of its 3 big branches.
III. Mixed Blood:
The mixed blood (oxygenated from the ascending aorta + unoxygenated from the ductus
arteriosus) passes in the descending aorta where it:
a. Supplies the abdomen and lower limbs.
b. Passes in the common iliac arteries to the internal iliac arteries to the umbilical
arteriesto the placenta where gaseous exchange occurs and the cycle is repeated.
Changes just after birth:
1. Pressure is equalized in both atria because:
a. Respiration begins due to exposure to cold temperature so,
blood returns from the functioning lungs to the left atrium.
b. The umbilical cord is ligated, so, no blood returns via the
occluded umbilical vein to the right atrium.
2. As a result, the septum primum and secundum fuse together
closure of the foramen ovale.
3. The occluded umbilical v. the ligamentum teres of the liver.
4. The occluded distal parts of the umbilical arteries the medial
umbilical ligaments.
5. The occluded ductus venosus the ligamentum venosum.
6. The occluded ductus arteriosus the ligamentum arteriosum.
Prof. Hany Shawky Nadim 10 Systemic Embryology
involved in gaseous exchange are not formed yet; therefore a fetus born at this stage cannot
survive.
2. Canalicular period (4-6 months): Respiratory bronchioles & alveolar
ducts develop. Vascularization of the lung occurs. Survival is
theoretically possible but in reality, a fetus born at this stage dies even
with intensive care.
3. Terminal sac period (6th month - birth): alveolar sacs are formed. They
are lined by cuboidal epithelium (Type I pneumocytes). Capillaries bulge
into them. Type II pneumocytes appear & secrete surfactant which is a
phospholipid that lines the alveoli & help in their expansion after birth.
Surfactant production reaches adequate levels by the 7th month. A fetus
born by that time can survive with intensive care.
4. Alveolar period (from late prenatal period - 8 years postnatal): The
number of alveoli increases (95% of the alveoli develop after birth). Mature
(thin walled) alveoli don’t develop except after birth. Now, the alveolo-
capillary membrane is thin enough to permit sufficient gaseous exchange.
Breath Movements:
Before birth, they can be detected by ultrasonography. As the lung is not a
respiratory organ before birth, these prenatal breath movements cause:
1. Suction of amniotic fluid into the airway.
2. Training of the respiratory muscles.
At birth, the fluid in the airways (amniotic fluid + bronchial secretions) becomes replaced by air
via 2 mechanisms:
1. Some become expelled by pressure on the thorax during labour.
2. The majority is absorbed by pulmonary capillaries & more importantly by pulmonary
lymphatics.
Medicolegally, the lungs of a baby who was born alive & died after birth contain air, thus can
float on water. On the other hand, the lungs of a still born baby sink.
Anomalies:
(1) Esophageal atresia & tracheo-esophageal fistula.
Esophageal atresia = obliteration of the esophagus & fistula = abnormal
communication between it and the trachea. This causes impossible feeding &
aspiration of milk into the lungs. Before birth, it causes polyhydramnios.
(2) Surfactant deficiency = hyaline membrane disease (HMD) which is the major
cause of respiratory distress syndrome (RDS).
During folding, the endoderm is enclosed inside the embryo forming the lining of the
gut tube which is formed of 3 parts:
1. Fore-gut in the head fold. Closed cranially by the bucco-pharyngeal membrane.
2. Hind-gut in the tail fold. Closed caudally by the cloacal membrane.
3. Mid-gut in between. Connected to the yolk sac by the vitello-intestinal duct.
The cranial end of the fore-gut is called the primitive pharynx. The respiratory
system is derived from it.
The gut is suspended from the posterior abdominal wall by a double-layered dorsal
mesentery. Its parts are named according to the organ connected to it (i.e. dorsal
Prof. Hany Shawky Nadim 12 Systemic Embryology
THE FOREGUT
STOMACH
Appears as a fusiform dilatation in the fore-gut but lies at a relatively high level & has:
Two ends (cardiac & pyloric) which lie in the midline.
Two borders (ventral & dorsal) which are equal in length.
Two surfaces (right & left) which are related to the right & left vagi respectively.
Two peritoneal folds, a ventral mesogastrium connecting the ventral border to the
anterior abdominal wall & a dorsal mesogastrium connecting the dorsal border to
the posterior abdominal wall.
LATER:
The dorsal border grows faster than the ventral border forming the greater curvature.
The stomach rotates 90° to the right around its longitudinal axis. Thus;
- The right surface becomes posterior & the left becomes anterior.
- The right vagus becomes the posterior gastric nerve & the left vagus becomes the
anterior gastric nerve.
- The lesser curvature faces right & the greater curvature faces left.
- The dorsal mesogastrium becomes stretched & elongated towards the left, thus a
peritoneal recess, the lesser sac, is formed behind the stomach.
The stomach descends to a lower level due to elongation of the esophagus.
The liver develops within the ventral mesogastrium. The part of the mesogastrium
Prof. Hany Shawky Nadim 13 Systemic Embryology
between the stomach and liver forms the lesser omentum. The enlarging liver pushes the cardiac
end to the left of the midline.
The spleen develops in the dorsal mesogastrium which becomes differentiated into 4 parts:
gastro-phrenic lig., gastro-splenic lig., lieno-renal lig. & greater omentum. The greater
omentum becomes redundant, enclosing the inferior recess of lesser sac between its anterior 2
layers and its posterior 2 layers. Later, adhesions occur, obliterating most of the inferior recess.
N.B.: Being derived from the fore-gut, the stomach is supplied by the coeliac trunk.
ANOMALIES:
1. Congenital hvpertrophic pyloric stenosis:
- Occurs more in boys especially the 1st born.
- Hypertrophy of the muscle of the pylorus obstruction & vomiting.
2. Thoracic stomach & hiatus hernia: the whole stomach or part of it lies in the
thorax, due to short esophagus.
3. Reversed rotation as a part of situs inversus totalis.
4. Hour-glass stomach: constricted middle part.
SPLEEN
Develops from the mesodermal cells of the left layer of the dorsal mesogastrium.
The cells proliferate forming separate nodules which fuse later forming a lobulated spleen.
Lobulation is evidenced by the presence of notches on the upper border of the mature spleen.
The spleen is a hemopoietic organ in the fetus.
ANOMALIES: persistent fetal lobulation - accessory splenic nodules.
DUODENUM
A U-shaped duodenal loop, which is convex forwards, develops from the
caudal part of fore-gut & the cranial part of the mid-gut. Just above the
junction of both parts, a liver bud arises from the convexity of the duodenal
loop. The whole loop is connected to the posterior abdominal wall by a
mesoduodenum. Also, the 1st inch is connected to the ventral mesogastrium.
The duodenal loop rotates, with the stomach, 90º to the right until it rests on
the peritoneum of the posterior abdominal wall and fuses with it. The fused
peritoneal surfaces become absorbed, thus the duodenum becomes retro-
peritoneal except the 1st inch.
The opening of the liver bud (the future opening of the common bile
duct) is shifted to the posteromedial aspect of the duodenal loop due
to unequal growth of its walls.
The lumen becomes obliterated, by proliferation of its epithelial
lining, in the 6th week. Recanalization occurs in the 3rd month.
PANCREAS
Develops from 2 endodermal sources:
1. Ventral pancreatic bud from the liver bud.
2. Dorsal pancreatic bud from the concavity of duodenal loop.
The ventral pancreas rotates to the concavity of the duodenal loop and fuses with the
dorsal pancreas within the mesoduodenum;
1. The ventral pancreas most of the head +the uncinate process.
2. The dorsal pancreas the rest of the pancreas.
With rotation and absorption of the mesoduodenum, the pancreas becomes retro-
peritoneal.
Early, the pancreas is drained by two ducts: dorsal & ventral.
Later, both ducts fuse & exchange parts so that
a. The distal part of the dorsal duct joins the proximal part of the ventral duct
forming together the main pancreatic duct which together with the common bile
duct ampulla of Vater.
b. The remaining proximal part of the dorsal duct the accessory duct.
Acini arise as buds that remain connected to the ducts while islets of Langerhans arise, in the 3rd
month, also as buds that disconnect from the ducts & secrete insulin in 5th month.
ANOMALIES:
1. Annular pancreas: a ring of pancreatic tissue encircling the duodenum.
2. Absence of ventral pancreatic duct: the sole dorsal pancreatic duct opens above the C.B.D.
3. Accessory pancreatic tissue in the stomach or intestine.
Prof. Hany Shawky Nadim 15 Systemic Embryology
THE MIDGUT
Forms a loop convex forwards having:
2 limbs (cranial & caudal)
Dorsal mesentery, containing the superior mesenteric artery
An apex connected to the yolk sac by the vitellointestinal duct
Later, a cecal bud appears in the beginning of the caudal limb.
ANOMALIES:
1. Congenital umbilical hernia: may be tied during ligation of the cord.
2. Abnormal rotation:
Incomplete rotation (90° only) rt. small intestine & lt. colon.
Reversed rotation: transverse colon & sup. mesenteric a. behind the duodenum.
3. Congenital subhepatic cecum or apical appendix.
4. Persistent mesentery of ascending colon.
5. Atresia or stenosis of any part of the intestine.
6. Persistent remnants of the vitellointestinal duct:
Meckel’s diverticulum: a blind pouch, 2 inches long, located 2 feet from the ileocecal
junction in 2% of people.
Fecal fistula: connecting the ileum with the umbilicus.
Vitelline cyst = persistent middle part of the duct.
Prof. Hany Shawky Nadim 16 Systemic Embryology
THE HINDGUT
The Cloaca:
- Is the dilated distal end of the hindgut.
- It is closed by the cloacal membrane and is connected to the umbilicus by the
allantois.
- In the angle between the allantois and the proximal part of the hindgut, the
mesoderm proliferates pushing the endoderm in the form of a growing coronal
partition called urorectal septum which divides the cloaca into a ventral
urogenital sinus and a dorsal rectoanal canal. The septum fuses with the
cloacal membrane dividing it into urogenital and anal membranes.
The proctodeum:
- Is an ectodermal depression that develops below the anal membrane & forms
the lower part of the anal canal.
- The anal membrane ruptures establishing continuity between the endodermal
and ectodermal parts of the anal canal. The remnants of the anal membrane
form the anal valves. The 2 parts of the anal canal differ markedly from each
other regarding their nerve supply, blood supply, lymphatic drainage &
sensitivity to pain.
Migrating neural crest cells invade the wall of hindgut forming autonomic
plexuses responsible for peristalsis.
ANOMALIES:
1. Rectal fistula: with the vagina in ♀or the urinary bladder in ♂.
FATE OF METANEPHROS:
I. The ureteric bud gives the collecting system:
It arises as an outgrowth from the mesonephric duct, close to the
cloaca.
Its cranial end penetrates the intermediate cell mass of mesoderm and induces it to form a
metanephric cap around it. This end dilates, forming the renal pelvis; which divides
continuously forming major calyces, minor calyces, papillary ducts of Billini & collecting
tubules. Approximately 1:3 million collecting tubules develop per kidney.
mesonephric ducts and the allantois (a process which extends to the umbilicus and umbilical
cord). It differentiates into 3 parts:
TESTIS:
- If the embryo is a male the primordial germ cells carry XY sex chromosomes. A gene on the
Y chromosome, called the testis-determining factor (TDF), stimulates the undifferentiated
gonad to develop into a testis.
- The TDF induces the primitive sex cords to proliferate and penetrate deep into the medulla.
Near the hilum of the gonad, the cords break and anastomose into a network called rete
testis.
- Later, a dense layer of fibrous connective tissue, the tunica albuginea develops from the
surrounding mesoderm, isolating the testis cords from the surface epithelium.
- The cords become horseshoe-shaped and develop into the seminiferous cords that contain
two kinds of cells:
1. Primordial germ cells (endodermal) Spermatogonia.
2. Supporting cells (mesodermal) Sertoli cells.
- The interstitial cells of Leyding develop from the mesoderm located between the cords.
During the eighth week, these cells begin to produce testosterone, which induces
masculine differentiation of the mesonephric ducts and the external genitalia.
- In addition to testosterone, the fetal testes produce mullerian-inhibiting factor (MIF) by
Sertoli cells. MIF suppresses development of the paramesonephric ducts.
- The cords become canilized at puberty to form the seminiferous tubules. which establish
open communication with the mesonephric tubules that form the vasa efferentia.
Testicular Anomalies:
1. Undescended Testis (cryptorchidism):
- Occurs in 3% of all full-term infants and 30% of premature infants. If a
testis fails to reach the scrotum within 3 months after birth, it remains
permanently high.
- If a testis is left within the abdomen, the high temperature destroys the
seminiferous tubules at puberty. If bilateral sterility. However,
production of testosterone is normal, therefore, the accessory sex organs and
the secondary male sex characteristics develop normally.
- Undescended testis should be treated surgically because it has increased risk to develop
malignant tumors.
- Sites of undescended testis are: (1) Intra-abdominal,
(2) Inguinal canal,
(3) Superficial inguinal ring.
- In some cases, the testis can be pulled down by hand but when released, the cremaster
muscle immediately draws it up. This is called retractile testis & requires no treatment.
2. Maldescended Testis:
- the testis may be found at:
(1) root of the penis, (2) perineum,
(3) femoral triangle or (4) opposite side.
- The testis is pulled by abnormal tails of the gubernaculum.
- Maldescended testis should be treated surgically & placed in the
scrotum because it is liable to injury in this unprotected position.
3. Absent testis (Agenesis) or Double testis: unilateral or bilateral.
4. Hydrocele: collection of peritoneal fluid in the processus vaginalis that remains
connected to the peritoneal cavity by a narrow channel.
5. Congenital lnguinl Hernia: herniation of abdominal contents into a patent
processus vaginalis when its neck is wide enough.
6. Polycystic Testis:
- The rete testis fails to communicate with the vasa efferentia.
- If bilateral sterility & azospermia, however sperms are found in
testicular biopsy.
OVARY:
- The primitive sex cords break into medullary cords which form a rudimentary
rete ovarii.
- The surface epithelium continues proliferation a second generation of cords,
Prof. Hany Shawky Nadim 22 Systemic Embryology
GENITAL DUCTS
The Indifferent Stage:
Both male and female embryos develop two pairs of genital ducts.
Mesonephric (Wolffian) ducts:
Fate in male:
mesonephric tubules: give
1. vasa efferentia & head of epididymis.
2. Some embryonic remnants = superior aberrant ductule + inferior aberrant ductule
+ paradidymis.
mesonephric duct: give
1. body and tail of epididymis, vas deferens, seminal vesicle & ejaculatory duct
2. ureteric bud & trigone of urinary bladder.
3. appendix of epididymis.
Fate in female:
mesonephric tubules embryonic remnants in broad lig. = epoophoron &
paroophoron
mesonephric duct Gartner's duct + the ureteric bud and trigone
abdominal ostium.
- When the paramesonephric ducts reach the future pelvic region of the embryo, they turn
medially, crossing ventral to the mesonephric ducts, until they meet each other in the
median plane and fuse to form a Y-shaped uterovaginal canal which grows caudally to
reach the dorsal wall of the urogenital sinus.
Fate in male
1. Testosterone, secreted by the interstitial cells, stimulates growth of mesonephric ducts.
2. Mullerian-inhibiting factor (MIF), secreted by the Sertoli cells, suppresses development of
the paramesonephric ducts which degenerate except:
a. Its cranial end the appendix testis (small vesicle on the upper pole of testis).
b. Its caudal end the prostatic utricle (small diverticulum on the back of the prostatic
urethra, equivalent to the uterus and vagina in females).
Fate in female:
In female embryos, the mesonephric ducts regress due to the lack of testosterone, while the
paramesonephric ducts develop due to the absence of the mullerian inhibiting factor MIF
most of the female genital tract:
The cranial, unfused, parts form the Fallopian tubes. The cranial
ends of the original groove form the abdominal ostia & fimbria
develop around it.
The caudal fused parts form the uterovaginal canal which gives
rise to the uterus and upper 1/3 of the vagina (the fornices). The
myometrium is derived from the surrounding splanchnic
mesoderm.
Vagina:
- At the site of the mullerian tubercle, two solid evaginations called
sinovaginal bulbs grow out from the urogenital sinus.
- They fuse forming a solid vaginal plate which grows cranially.
- It becomes canalized except a thin plate, known as the hymen, separating
the lumen of vagina from the urogenital sinus. It ruptures in its middle
during perinatal life.
Anomalies of paramesonephric ducts:
(1) Failure of fusion: takes variable forms
1. Double uterus and double vagina (uterus didelphys).
2. Double uterus and single vagina (uterus bicornis); one horn
may be rudimentary (uterus bicornis unicollis).
3. A septum in a single uterus (uterus septatus)
4. An indented fundus of uterus in the middle (uterus arcuatus)
5. Failure of fusion of the sinovaginal bulbs double vagina
(2) Aplasia of one paramesonephric duct (uterus unicornis).
(3) Hypoplasia: A hypoplastic or infantile uterus has the ratio of its body: cervix reversed
(normally it is 2:1, in hypoplasia it is 1:2).
(4) Failure of canalization:
1. Atresia of the cervix or the vagina.
Prof. Hany Shawky Nadim 24 Systemic Embryology
2. Imperforate hymen: passes unnoticed till puberty, when retention of menstrual blood in the
vagina a painful
swelling (hematocolpos)
Prof. Hany Shawky Nadim 25 Systemic Embryology
EXTERNAL GENITALIA
II. Fate in the Female: in the absence of testosterone, female pattern occurs.
- The genital tubercle becomes small the clitoris.
- The urethral folds remain separate the labia minora.
- The genital (labial) swellings enlarge the labia majora.
- The urogenital sinus opens to the surface the vaginal vestibule.
ACCESSORY GLANDS:
Two sets of buds arise from the urogenital sinus in both sexes:
Derivative in males Derivative in females
Cranial buds (from prostatic glands urethral glands
pelvic part) (of Littre)
Caudal buds (from bulbo-urethral glands great vestibular glands
phallic part) (of Cowper) (of Bartholin)
The Prostate:
- 15-20 endodermal outgrowths from the prostatic urethra invade the surrounding mesoderm
prostatic acini, arranged in 5 lobes.
- Surrounding mesoderm stroma of prostate.
- Before birth, the prostate is large due to maternal hormones.
SUMMARY