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Updated: Jul 22 2022

Embryology

Images
https://upload.orthobullets.com/topic/9078/images/limb bud.jpg
https://upload.orthobullets.com/topic/9078/images/ulnar_and_radial.jpg
https://upload.orthobullets.com/topic/9078/images/ulnar_dimelia.jpg
https://upload.orthobullets.com/topic/9078/images/ulnar_dimelia_xr.jpg
https://upload.orthobullets.com/topic/9078/images/sclerotome.jpg
  • Limb Development
    • Overview
      • the appendicular system forms between the 4-8 weeks of gestation
      • limb bud development
        • appears to be under the control of fibroblast growth factors (FGF)
        • enlargement of the limb bud is due to the interaction between the apical ectodermal ridge (AER) and the mesodermal cells in the progress zone.
        • first identifiable by transvaginal ultrasound at 8 weeks
    • Steps of limb development
      • notochord expresses Shh
      • Shh regulates limb bud formation
        • limb bud is combination of lateral plate mesoderm and somatic mesoderm
        • growing outwards into ectoderm (called apical ectodermal ridge)
        • limb bud formed at embryonic stage 12 (26 days after fertilization)
      • mesenchyme condenses into preskeletal blastemal at core of limb bud
      • chondrification occurs where mesenchyme differentiates into chondrocytes
        • All upper limb bones are endochondral except distal parts of distal phalanges (membranous)
        • From proximal (humerus, 36 days after fertilization) to distal (distal phalanges, 50 days)
      • Formation of joints requires repression of chondrogenesis at sites of future joints
        • proteins involved – WNT4, WNT14, growth and differentiation factor 5 (also known as cartilage-derived morphogenetic protein 1)
        • shoulder interzone appears at 36 days, hand interzones appear at 47 days
      • Finger separation
        • digital rays are evident within hand paddle at stage 17 (41 days)
        • interdigital mesenchyme cells undergo programmed cell death (stage 19 to 22)( days 47-54)
        • transcription factor Msx2 is expressed in interdigital mesenchyme, regulates BMP4-mediated programmed cell death pathway
        • transcription factor Hox-7 also expressed in interdigital zones
    • Mutations
      • removal of AER
        • truncated limb
      • duplication of ZPA
        • mirror-image duplication of the limb
        • Key Genes/Regions
        • Gene/Region
        • Expresses
        • Regulates
        • Apical ectodermal ridge (AER)
        • FGF8 is dominant (also FGF 4, 9, 17, which are redundant)
        • Proximal to distal growth and interdigital necrosis
        • Zone of polarizing activity (ZPA)
        • SHH
        • Anterior-posterior (radio-ulnar) growth
        • Non-AER limb ectoderm (dorsal)
        • Dorsal ectoderm expresses WNT7a, that activates Lmx1b (regulates dorsal patterning)
        • Dorso-ventral growth
        • Non-AER limb ectoderm (ventral)
        • Ventral ectoderm expresses en-1, antagonistic to WNT7a (regulates ventral patterning)
        • Dorso-ventral growth
  • Spine and Spinal Cord Development
    • Metameric shift phenomenon
      • the phenomenon of how the spinal nerves, which originally ran in the center of the sclerotome, exit between the two vertebral bodies at each level.
    • Progression
      • neural crest
        • forms PNS, pia mater, spinal ganglia, sympathetic trunk
      • neural tube
        • forms spinal cord
      • notochord
        • forms anterior vertebral bodies and nucleus pulposus
    • Ossification centers
      • vertebrae have 3 primary ossification centers
        • centrum (anterior vertebral body)
        • neural arch (posterior elements, pedicles, small portion of anterior vertebra)
        • costal element (anterior part of lateral mass, transverse process, or rib)
    • Intervertebral disc
      • nucleus pulposus forms from notochord
      • annulus fibrosus forms from sclerotome
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Basic Science | Embryology
  • Basic Science
  • - Embryology
19:1 min
10/16/2019
885 plays
5.0
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Question Session⎪Embryology, Osteochondroma & Multiple Hereditary Exostosis, and Sagittal Band Rupture
  • Basic Science
  • - Embryology
20:6 min
11/7/2019
61 plays
0.0
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