Embryology and Anatomy: Endocrine System + Q(Mihlbachler)

myocytes

endothelins in the heart stimulate ________ near coronary vessels to differentiate into Purkinje fibers.

Optic chiasm (Rationale: a. Incorrect. Optic tract involvement leads to homonymous hemianopsia. b. Incorrect. Optic tract involvement leads to homonymous hemianopsia. c. Incorrect. Optic nerve involvement leads to monocular field loss. d. Correct. Optic chiasm involvement leads to bitemporal hemianopsia e. Incorrect. Cranial nerve VI involvement leads to lateral rectus palsy.)

A 70-year-old male presents to the clinic complaining of "running into things". He states that he has been unintentionally bumping into furniture around the house. Upon physical exam you find a loss in the temporal visual field bilaterally. Compression of which of the following structure would explain this patient's findings? A. Left optic tract B. Right optic tract C. Left optic nerve D. Optic chiasm E. Cranial nerve VI

2nd part of the duodenum

A mother brings her 5-day-old daughter to the emergency department due to bilious vomiting after feeding. Mother had polyhydramnios when she was pregnant with this child. Radiologic studies confirm the presence of an annular pancreas. This abnormality is due to incomplete rotation of the ventral pancreatic bud around which structure? A. 2nd part of the duodenum B. Cystic duct C. Duodenojejunal flexure D. Pylorus E. Splenic artery

gonads

According to the HPG axis, the hypothalamus can influence these endocrine organs:

Superior Mesenteric Artery

After a surgical procedure that involved ligating the gastroduodenal artery, the uncinate process of the pancreas continues to receive blood supply from branches of which artery? A. Inferior Mesenteric Artery B. Left Gastric Artery C. Left Gastroepiploic Artery D. Proper Hepatic Artery E. Superior Mesenteric Artery

Pituitary adenoma compressing the optic chiasm

An 80-year-old man presents to the clinic complaining of "running into things." His daughter states that he has been ignoring things at his sides. He only sees what is directly in front of him. After performing a physical exam, you find that he cannot see anything in both of his temporal visual fields. Everything else was within normal limits. You order an MRI because you suspect: A. Aneurysm in anterior communicating cerebral artery compressing his optic tracts B. Brain metastasis to the optic nerves C. Expanding clot in his cavernous sinus compressing the optic nerves D. Pituitary adenoma compressing the optic chiasm E. Pituitary adenoma compressing the optic tracts

pinealocytes

As the pineal body develops it becomes a solid organ, filled with these cells:

changes

Development of the endocrine system is not only during embryology; it _______ throughout life.

melatonin

Pinealocytes secrete this hormone based on circadian rhythm:

brown fat

Secretion of fetal thyroid hormone stimulates production of _____ ___.

3, 4

The *inferior* parathyroid gland develops from the _ pharyngeal pouch, and the *superior* parathyroid gland develops from the _ pharyngeal pouch.

corpus luteum

The ______ ______ develops in the ovary fromthe ovulating follicle and plays a role in maintaining pregnancy.

dorsal

The ______ bud of the pancreas appears first and is larger.

thyroid

The _______ develops in close association with the tongue; the tongue differentially develops around this organ:

placenta

The ________ has a role in development with chorionic gonadotropin hormone.

pituitary

The _________ gland has a major role in development, producing *human growth hormone*.

bone

The adrenal glands produce cortisol, which, among other things, can decrease ____ formation.

ventral

The head of the pancreas is derived from the _______ bud.

caudal

The pineal body begins as a hollow diverticulum on the ______ aspect of the brain.

Rathke

The pituitary gland arises as ______ pouch merges with the infundibulum (also called neurohypophysis).

prolactin

The pituitary plays a role in the expression of this hormone, which stimulates lactation, sexual gratification and oligodendrocyte precursors:

mesonephros

What are the adrenal glands derived from?

Its contents drain directly into the cystic duct

What statement about the structure labeled as G is most accurate? (see attachment) A. Its contents drain directly into the cystic duct B. It carries venous blood to the liver C. It is supplied by the splenic artery D. It drains the superior mesenteric and splenic veins E. It joins the pancreas to the common bile duct

paramesonephric duct

Which duct becomes the uterine tubes in females? 10 weeks

mesonephric duct

Which duct becomes the vas deferens in males? 10 weeks

Splenic artery

Which of the following structures supplying oxygenated blood to the pancreas is a direct branch of the celiac trunk? A. Hepatic artery proper B. Left gastric artery C. Splenic artery D. Inferior pancreaticoduodenal artery E. Superior mesenteric artery

(Rationale: a. Incorrect. Hepatic artery proper is not a direct branch of the superior mesenteric artery. b. Incorrect. Superior pancreaticoduodenal artery is a direct branch of the gastroduodenal artery. c. Incorrect. Splenic artery is a direct branch of the celiac trunk. d. Correct. Inferior pancreaticoduodenal artery is a direct branch of the superior mesenteric artery. e. Incorrect. Gastroduodenal artery is not a direct branch of the superior mesenteric artery.)

Which of the following structures supplying oxygenated blood to the uncinate process of the pancreas is a direct branch of the superior mesenteric artery? A. Hepatic artery proper B. Superior pancreaticoduodenal artery C. Splenic artery D. Inferior pancreaticoduodenal artery E. Gastroduodenal artery

Oral ectoderm

You are following a ten-year-old male with a four month history of recurrent headaches, visual changes, and declining performance in school. A thorough workup including a CT of the brain finds a 3 cm cystic mass in the suprasellar region. The radiologist believes the mass to be a craniopharyngioma. From what embryological tissue is this tumor most likely derived? A. Neuroectoderm B. Neural crest C. Mesoderm D. Oral ectoderm E. Endoderm

Thyroglossal duct cyst (a. Correct. Thyroglossal duct cysts are derived from the remnant of the thyroglossal duct. If a portion of the duct remains, it can develop into a cyst and enlarge, presenting as a midline neck mass. A key finding is elevation of the mass during protrusion of the tongue. b. Incorrect. Branchial cleft cysts are congenital epithelial cysts, which arise on the lateral part of the neck from a failure of obliteration of the second branchial cleft in embryonic development. c. Incorrect. Lingual thyroid is failure of the thyroid gland to descend from the foramen caecum to its normal site. A mass will be seen at base of the tongue. It may present with dysphagia and dysphonia due to local compression. d. Incorrect. Pyramidal lobe is a midline lobe off the isthmus. It is most commonly asymptomatic. e. Incorrect. Thyroid nodule would most likely be in the location of the thyroid gland located below the thyroid cartilage and just above the sternal notch.)

A 3-year-old girl is brought to the office for evaluation of anterior neck mass. Her mother reports that she developed the mass about a week ago and it has not resolved since her recent respiratory infection. Physical exam reveals a soft, painless mass located midline just above the thyroid cartilage. The mass also elevates when she sticks out her tongue. Which of the following is the most likely diagnosis? A. Thyroglossal duct cyst B. Branchial cleft cyst C. Lingual thyroid D. Pyramidal lobe E. Thyroid nodule

Parathyroid glands (Rationale: a. Correct. Accidental removal of the parathyroid glands may occur with thyroid surgeries. Patients will present with increased neuromuscular excitability, circumoral numbness, paresthesias of distal extremities, chvostek sign and trousseau sign. b. Incorrect. Damage to the recurrent laryngeal nerve will lead to hoarseness of the voice. c. Incorrect. Damage/ injury to the thyroid ima artery will lead to hemorrhage. d. Incorrect. Damage to the superior thyroid artery will not lead to the patient's presentation. e. Incorrect. Damage to the recurrent laryngeal nerve will lead to hoarseness of the voice.)

A 30-year-old male undergoes a near total thyroidectomy for treatment. Several days following the surgery, the patient complains of numbness around his mouth and tingling in his fingers. Which structure, inadvertently affected during this surgery, would most likely explain the patient's symptoms? A. Parathyroid glands B. Right recurrent laryngeal nerve C. Thyroid ima artery D. Superior thyroid artery E. Left recurrent laryngeal nerve

3rd pharyngeal pouch (Rationale: a. Correct. 3rd pharyngeal pouch contributes to the development of the inferior parathyroid glands and the thymus. The parathyroid gland was accidently removed in this clinical presentation of hypocalcemia that leads to circumoral numbness, paresthesia, and Chvostek's sign. The parathyroid gland is formed from the 3rd and 4th pharyngeal pouches. b. Incorrect. 2nd pharyngeal pouch gives rise to the middle ear. c. Incorrect. Adrenal medulla is derived from the neural crest cells. d. Incorrect. Neuroectoderm is the tissue derivative of the posterior pituitary and the hypothalamus. e. Incorrect. Adrenal cortex is derived from mesoderm)

A 33-year-old female presents to office for a follow-up visit after a thyroidectomy. Although the patient's previous symptoms of hyperthyroidism have been alleviated, she now complains of numbness around the mouth and a tingling sensation in her arms and feet. During physical exam, you notice contractions in her facial muscles when you tap near the zygomatic-mandibular area. Which of the following structures contributes embryologically to the missing structure that is causing the clinical presentation? A. 3rd pharyngeal pouch B. 2nd pharyngeal pouch C. Neural crest cells D. Neuroectoderm E. Mesoderm

Neural crest cells (Rationale: a. Correct. Neural crest cells leads to formation of adrenal medulla, this patient is presenting with headache, palpitation, high blood pressure, high urine VMA that leads to pheochromocytoma, which is a tumor of adrenal medulla. b. Incorrect. Mesoderm leads to formation of adrenal cortex. Abnormalities in adrenal cortex will include deficiency in aldosterone (Na, K, H, imbalances), cortisol (Cushing's syndrome or Addison syndrome) or sex steroid abnormalities. c. Incorrect. The endoderm develops into the interior linings of the digestive and respiratory tracts. Also develops the lining of the follicles of thyroid and thymus. d. Incorrect. Neuroectoderm is the tissue derivative of the posterior pituitary and the hypothalamus. e. Incorrect. 3rd pharyngeal pouch contributes to the development of the inferior parathyroid glands and the thymus.)

A 35-year-old male presents to your clinic with complaint of a severe headache. Upon review of symptoms, the patient states that he sweats a lot and occasionally feels palpitations. On physical exam, you note his blood pressure is 185 / 105 mm Hg. Laboratory studies show elevated urine vanillylmandelic acid (VMA) levels. What is the embryonic origin of the specific tissue causing the patient's current symptoms? A. Neural crest cells B. Mesoderm C. Endoderm D. Neuroectoderm E. 3rd pharyngeal pouch

Uncinate process of the pancreas (Rationale: a. Correct. This patient presents with annular pancreas, which is a malrotation of the ventral bud around the descending duodenum resulting in obstruction. The classic radiographic sign is the double bubble, which is distension of stomach and proximal duodenum. The main pancreatic duct, head and uncinate process of the pancreas are derived from the ventral bud of the foregut. b. Incorrect. The pancreatic head, neck, body and accessory pancreatic duct, are derived from the dorsal bud of the foregut. c. Incorrect. The pancreatic head, neck, body and accessory pancreatic duct, are derived from the dorsal bud of the foregut. d. Incorrect. The pancreatic head, neck, body and accessory pancreatic duct, are derived from the dorsal bud of the foregut. e. Incorrect. The pancreatic head, neck, body and accessory pancreatic duct, are derived from the dorsal bud of the foregut.)

A mother comes to your clinic with a 3-day-old boy complaining that he is vomiting green fluid after his first feeding. During the pregnancy, the mother was reported to have excess amniotic fluid. Further radiologic examination of the baby shows distension of the stomach and proximal duodenum. The baby's condition is related to a malrotation of embryologic tissue that contributes to which of following structures? A. Uncinate process of the pancreas B. Accessory pancreatic duct C. Neck of the pancreas D. Body of the pancreas E. Common bile duct

Main pancreatic duct

A newborn male is underweight and develops feeding intolerance immediately following birth. Upper and Lower GI series are consistent with a small bowel obstruction. CT scan demonstrates tissue encircling and obstructing the second part of the duodenum. During normal development, the obstructing tissue contributes which of the following structures to the pancreas? A. Neck of the pancreas B. Accessory pancreatic duct C. Bile duct D. Body of the pancreas E. Main pancreatic duct

Uncinate process (Rationale: a. Incorrect. Accessory pancreatic duct, head, neck and body are derived from the dorsal bud of the foregut. b. Incorrect. Accessory pancreatic duct, head, neck and body are derived from the dorsal bud of the foregut. c. Incorrect. Accessory pancreatic duct, head, neck and body are derived from the dorsal bud of the foregut. d. Correct. Main pancreatic duct, head and uncinate process are derived from the ventral bud of the foregut. e. Incorrect. Accessory pancreatic duct, head, neck and body are derived from the dorsal bud of the foregut.)

A two-day-old neonate is noted to have feeding intolerance, abdominal distension, and bilious vomit. Annular pancreas is suspected. During normal development, the ventrally obstructing tissue, contributes to which of the following structures to the pancreas? A. Accessory pancreatic duct B. Neck of the pancreas C. Body of the pancreas D. Uncinate process E. Common bile duct

mesenchyme

Many endocrine organ differentiate through interactions between epithelium and __________.

fetus

Maternal melatonin can influence daily cycles in a _____.