1
Q
What embryological layer does the urinary system develop from?
A
Intermediate mesoderm
2
Q
Name the 3 stages of structures that lead to formation of kidneys
A
Pronephros
Mesonephros
Metenephros
3
Q
What week of development do the pronephros develop?
A
Week 4
4
Q
What weeks of development do the mesonephros function for?
A
Week 6-10
5
Q
From what week of development do the metenephros function from?
A
Week 12
6
Q
What structure forms the permanent kidney and what gestation does it develop from?
A
Metenephros
Week 5
7
Q
What week does urine production begin?
A
Week 12
8
Q
There is part of the mesenephros that does not regress and goes on to form what structure in males?
A
Mesonephric ducts/Wolffian ducts go on to from genital system in males but disappear in females
9
Q
Renal agenesis is more common on which side of body and in which sex?
A
Left side, males
10
Q
How common is unilateral renal agenesis per 1,000 births? And what is it associated with
A
1/1,000
Associated with single umbilical artery
11
Q
How common is biilateral renal agenesis?
And what is it associated with?
A
1/3,000 births
Associated with oligohydramnios and characteristic facial appearance.
12
Q
Between what weeks does the cloaca divide into what structures anteriorly and posteriorly?
A
Week 4-7
Anteriorly: urogenital sinus
Posteriorly: anal canal
13
Q
What 3 parts does the urogenital sinus develop into?
A
cranial part: urinary bladder
middle pelvic part: forms prostatic and membranous urethra in males and entire urethra in female.
Caudal part: forms genital organs
14
Q
What forms the urachus?
A
Obliterated allantois
15
Q
Name the remnant of the fetal urachus
A
Median umbilical ligament
16
Q
What embryological origin is the trigone of the bladder?
A
Mesoderm
17
Q
How common is horseshoe kidney?
A
1/600
18
Q
Which sex is horseshoe kidney more common in?
A
Males
19
Q
In horseshoe kidney, what vessel is just above the central portion?
A
Inferior mesenteric artery - blocks ascent
20
Q
What 4 structures develop from ureteric bud?
A
- Collecting duct
- Calyx
- Renal pelvis
- Ureter
21
Q
What structures develop from metanephric mesoderm?
A
- Renal glomerulus
- Renal capsule
- Proximal convoluted tubule
- Loop of Henle
- Distal convoluted tubule
- Connecting tubule
22
Q
Wilm’s tumour caused by mutation in what? What does this gene do?
A
WT1 - regulates mesoderm to respond to induction by ureteric bud
23
Q
What embryological origin does the epithelium of urethra develops from?
A
Endoderm
24
Q
What week does gonadal development begin from?
A
Week 4
25
What gene determines differentiation of gonads into male or female?
SRY gene - present in males
26
In the presence of SRY gene, what sex forms?
Male
27
What is the name of the genital ducts that form male reproductive system?
Wolffian/mesonephric ducts
28
What is the name of the genital ducts that form female reproductive system?
Mullerian/paramesonephric ducts
29
What 3 structures do the Wolffian/mesonephric ducts give rise to?
Vas deferens
Epididymis
Seminal vesicle
'VES'
30
What structures do the Mullerian/paramesonephric ducts give rise to?
Uterus
Fallopian tubes
Cervix
Upper 2/3rds vagina
31
SRY gene acts on Leydig cells to produce what hormones that promote male sex development?
Testosterone
which then goes on to produce: Dihydrotestosterone (DHT)
32
SRY gene acts on sertoli cells to produce what that prevents development of female reproductive ducts?
MIF - Mullerian inhibitory factor
33
What is the role of the gubernaculum in males?
In males, it guides the testes into the scrotum and becomes the scrotal ligament.
34
What structures does the gubernaculum form in females?
In females, it develops into the round ligament of the uterus and the suspensory ligament of the ovary.
35
What structures does the urogenital sinus give rise to in males?
Urinary bladder
Urethra
Prostate gland
Bulbourethral gland
36
What structures does the urogenital sinus give rise to in females?
Urinary bladder
Urethra
Lower 1/3rd of vagina
Urethral/paraurethral gland
Greater vestibular glands
37
The genital tubercle forms what structure in males and what structure in females?
Males - glans penis, corpora cavernosum, corpus spongiosum
Females - glans clitoris, corpora cavernosum clitoridis, bulb of vesibule
38
Labioscrotal swelling forms what structures in males and what structure in females?
Males: scrotum
Females: labia majora
39
Urethral/urogenital folds form what structures in males and what structure in females?
Males: ventral aspect of penis, penile urethra, perianal tissue (EAS)
Females: labia minora. perianal tissue (EAS)
40
What is genotype and phenotype of someone with androgen insensitivity syndrome?
Genotype: male
Phenotypically: female. External genitalia female but blind pouch.
41
What is hypospadias and what tends to cause it?
Failure of fusion of urethral folds near glans. Get urethral opening on ventral aspect of penis.
Occurs due to inadequate production of androgens from testes.
42
How common is hypospadias?
Affects 1/300 males
43
Epoopheron, paroophoron and Gartner's duct are remnants of what?
Remnants of mesonephric/Wolffian ducts/tubules in females
44
What is a Gartner's duct cyst sometimes mistaken for on examination?
Cystocoele.
45
Epoophoron is homologous to what structure in males?
Epididymis
46
Paroophoron is homologous to what structure in males?
Paradidiymis
47
Ectoderm, mesoderm and endoderm all originate from what cells?
Epiblast cells
48
What structures develop from ectoderm?
CNS
Epidermis
49
What structures develop from endoderm?
lining of GI, respiratory and urogenital tracts
50
Paraxial mesoderm is also known as what?
Somitic mesoderm
51
Paraxial/somatic mesoderm forms what structures?
axial skeleton
trunk and limb muscles
Dermis of skin
52
What structures are derived from intermediate mesoderm?
Gonads
Kidneys
53
What structures are derived from visceral/splanchnic mesoderm?
Connective tissue
Smooth muscle around GI tract, vessels etc
54
Visceral mesoderm is also known as what?
Splanchnic mesoderm
55
Somatic mesoderm is also known as what?
Parietal mesoderm
56
What structures are derived from somatic/parietal mesoderm?
Anterior body wall
Connective tissue of body walls and limbs
Plays cruicial role in limb development
57
What week of development do pharyngeal arches appear?
Week 4-5
58
What bones are derived from 1st pharyngeal arch?
Dorsal portion maxillary process
Ventral portion mandibular process
Some bones of middle ear
59
Muscles derived from 1st pharyngeal arch?
Muscles of mastication
60
Nerve that supplies 1st pharyngeal arch
Trigeminal nerve (CN V)
61
What artery is associated with 1st pharyngeal arch? Which artery does it branch from?
Maxillary artery
Branch of external carotid a.
62
Cleft lip and palate occur from failure of correct development of which pharyngeal arch?
1st pharyngeal arch
63
What bones are derived from 2nd pharyngeal arch?
styloid process of temporal bone
stylohyoid ligament
upper part of hyoid bone
64
What muscles are derived from 2nd pharyngeal arch?
mucles of facial expression
Stapedis
Stylohyoid
65
What nerve is associated with 2nd pharyngeal arch
Facial nerve (CN VII)
66
What arteries are assocaited with 2nd pharyngeal arch?
Stapedial artery (regresses before birth)
Hyoid artery - gives rise to corticotympanic artery in adults
67
Bones from 3rd pharyngeal arch?
lower part of body and greater horn of hyoid bone
68
Muscles from 3rd pharyngeal arch
stylopharyngeus muscle
69
nerve from 3rd pharyngeal arch?
Glossopharyngeal nerve (IX)
70
What artery arises from 3rd pharyngeal arch?
Carotid artery and proximal portion of internal carotid artery
71
Bones/cartillage from 4th and 6th pharyngeal arch?
Thyroid
Cricoid
Cartilages of larynx
72
Muscles assocaited with 4th and 6th pharyngeal arch
Cricothyroid
Levator palantine
Intrinsic muscles of larynx
73
Nerve derived from 4th and 6th pharyngeal arch
Recurrent laryngeal branch of vagus (X)
74
What is the right vascular derivative of 6th pharyngeal arch?
proximal portion of pulmonary arteries
75
Waht is the left vascular derivative of 6th pharyngeal arch?
ductus arteriosus
76
What gestation does fetal urine become the major contributor to amniotic fluid volume?
18 weeks
77
What gestation does fetal skin become keratinised?
19-20 wks
78
What gestation are definitive alveoli formed?
36wks - may take up to 2yrs to completely form
79
What syndrome occurs from Mullerian agenesis?
Mayer-Rokitansky-Kuster-Hauser Syndrome (MRKH)
80
What structures does the utelline duct join?
midgut to yolk sac
81
What is Meckel's diverticulum?
Adult remnant of vitelline duct (duct that joined midgut to yolk sac)
82
Medial umbilical ligaments are remnants of what?
obliterated fetal umbilical arteries
83
Median umbilical ligament is remnant of what?
Urachus
84
Lateral umbilical folds overlie what vessels?
inferior epigastric artery and vein
85
What week does the primitive gut form?
Week 4
86
The herpetic diverticulum that goes on to form liver and biliary system forms in what week?
Week 4
87
What week does haematopoiesis begin?
Week 6
88
What week does bile formation begin from?
Week 12
89
What gestation does insulin secretion begin?
5 months
90
What week does physiological umbilical herniation occur and what is it? What week does it tend to resolve by?
Week 6 - Primary loop of midgut grows quickly and becomes too big to fit in abdominal cavity so herniates into the extraembryonic cavity in umbilical cord.
Resolves by week 10.
91
What is the vitalline duct also known as and What is the purpose of the vitalline duct?
Also known as omphalomesenteric duct/yolk stalk.
Temporary structure that connects yolk sac to midgut to allow for transfer of nutrients.
92
What separates the upper 2/3rds of anal canal and lower 1/3rd?
Pecinate line
93
What type of epithelial cells line upper 2/3rds of anal canal?
columnar
94
What type of epithelial cells line lower 1/3rd of anal canal?
stratified squamous
95
Arterial supply to upper 2/3rds of anal canal?
superior rectal artery - continuation of inferior mesenteric artery
96
Arterial supply to lower 1/3rd of anal canal? What artery is it a branch of?
Inferior rectal artery - branch of internal pudendal artery
97
What is an omphalocoele?
Where abdominal organs (usually intestines) protrude into umbilical cord - surrounded by peritoneal layer
98
What is gastrochisis
Anterior abdominal wall fails to close (usually to right of umbilicus) so abdominal contents (usually intestines) protrude through. Not covered by peritoneal layer so directly exposed to amniotic fluid which can cause intestines to get irritated/inflamed (can cause malabsorption issues).
99
What week does primordial heart form?
Middle of week 3
100
Which sex are atrial septal defects more common in?
Females
101
What is the most common form of Atrial septal defects?
Patent foramen ovale
102
What is the most common congenital heart defect?
ventricular septal defect
103
What sex are VSDs more common in?
Males
104
What heart septal defect is most commonly seen in Down's syndrome?
Atrialventricular septal defect
105
What 4 heart abnormalities are seen in Tetralogy of Fallot?
1. Pulmonary stenosis
2. Right ventricle hypertrophy
3. Ventricular septal defect
4. Aorta over-rides VSD - deoxygenated blood enters aorta as pressure from right ventricular hypertrophy forces blood from RV to LV.
106
What are the signs of tetralogy of fallot in a newborn?
- Cyanosis
- Poor feeding
- FTT
107
What is the most common cause of cyanotic heart disease in newborns?
Transposition of great arteries
108
In fetal circulation, what structure causes blood to bypass liver?
Ductus venosus
109
What is the role of ductus arteriorsus?
Connects pulmonary artery to aorta to allow blood to bypass lungs.
110
What is the remnant of the umbilical vein?
Ligamentum teres herpatis (round ligament of liver)
111
What is the remnant of the ductus venosus?
ligamentum venosum
112
What is the remnant of the umbilical arteries?
proximal portion: stay open as superior vesical arteries.
Distal portion: medial umbilical ligaments
113
What is the level of origin of the artery to the foregut?
T12 (Coeliac artery)
114
What level does the superior mesenteric artery branch from aorta?
Inferior border of L1 vertebra
115
What level does the inferior mesenteric artery branch from aorta?
L3
116
Ureteric bud originates from where?
Mesonephric duct
117
What is the appendix testis a remnanat of?
Mullerian duct
118
Which 3 fetal structures produce AFP?
What pathologies may cause levels be elevated?
Gut
Liver
Yolk sac
It is may be elevated in a defect of the anterior abdominal wall and the neural tube (e.g. spina bifida). As these defects are not covered by skin, AFP freely enters the amniotic fluid from the fetal circulation, leading to elevation of levels.
119
What part of anatomy will a cyst in the canal of Nuck be found?
Inguinal canal
120
Canal of Nuck in females is equivalent to what in males?
patent processus vaginalis
121
What gestational age to fetal breathing movements commence?
Week 12
122
Meconium is found in fetal gut from what gestation?
Week 14 - but passage of meconium rare before week 34
123
What percentage of primordial follicles undergo atresia to create a primary follicle?
99%
124
What week of development does the neural tube close?
Week 4-5
125
MRCOG Part 1
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