BLOCK 2.

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CONCEPTION, FETAL GROWTH & CONGENITAL ANOMALY

PRACTICAL SESSION OF ANATOMY:

EMBRYOLOGY

Name : ............................................ NIM : ............................................

Group : ............................................ Date : ............................................

Department of Anatomy, Embryology & Anthropology Faculty of Medicine Gadjah Mada University Yogyakarta 2011
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PREFACE
This Anatomy practical sessions support the learning process and content of Block 2.1 (Conception, fetal growth and congenital anomaly) in order to make easier understanding the human growth and development. The topics of this practical sessions are embryology and fetal growth (external morphology of fetus). We hope that after completion the Anatomy practical sessions, students can increase their capabilities of basic reasoning in learning of the problem of the block 2.1 scenarios and competencies in skills especially; obstetric physical examination (leoplold examination) and anatomy imaging (fetal ultrasonogram), fetal gestational age in forensic medicine. For improving this manual of Anatomy practical session, we accept any correction and suggestion.

Contributor: Dr. dr. Djoko Prakosa, PA(K) dr. Dwi Cahyani Ratna Sari, M.Kes.,PA(K) dr. Efrayim Suryadi, SU.,PA(K).,MHPE dr. Santosa Budiharjo, M.Kes.,PA(K) dr. Ch. Tri Nuryana, M.Kes dr. Mawaddah Ar Rochmah

ANATOMY PRACTICAL SESSION REGULATION

1. Students must attend all practical sessions (100% attendance). 2. If students are unable to attend one or more practical session because of an acceptable reason, Students must reschedule practical session before the laboratory exam. The replacement will be arranged regarding to each block's schedule. 3. If students are unable to accomplish full(100%) attendance, they are not allowed to attend the laboratory exam. 4. In each practical session, a test will be carried out which will influence mark n professional behavior. This test will be used as a proof of attendance and may be conducted at the beginning or at the end of a practical session, if the pretest score is not satisfying (below half of the highest score), students have to do an assignment, and should be collected before the next practical session. 5. The minimum score to pass the practical session examination is 50%. If the students score less than 50% (<50%), students should take a remedial practical examination. There is only once remedial practical examination could be taken. If some students have score more than 50% (>50%) and want to take remedial examination, they can take remedial practical examination with permission. The Anatomy practical sessions end score is the best score taken from the main and remedial practical examination. 6. Practical examination score will be sent to block assessment team in a satisfactory letter (for student whose practical examination score is more than/at least 50). If practical examination score is less than 50%, neither the satisfaction letter nor block score will be issued (or block assessment team will decide whether block score can be announced or not). 7. Further items regarding to practical session regulation will be informed later.

Laboratory Practical Session I EMBRYOLOGY

Learning Objective: 1. Identify and describe growth and development of embryo and gastrulation stages 2. Identify and describe growth and development of the brain and cranial nerves in embryonic period a. b. Five stage of early brain and cranial nerves development Embryology of the brain

3. Identify and describe growth and development of face in embryonic period: a. week 4th (length 3,5mm) b. week 5th (length 6,5 mm) c. week 5,5th (length 9 mm) d. week 6th (length 12mm) e. week 7th (length 19mm) f. week 8th ( length 28 mm) A. Identify and describe morphology of embryo (2nd 4th weeks age): 1. Give explanation on the figure 1 using the structures in right column and model GE-1 Figure 1 Embryo Structures a. Endometrium b. Chorion Syncytiotrophoblast Cytotrophoblast Mesodermal extraembryonicum c. Coelom extraembryonicum d. Connecting stalk e. Yolk sac (saccus vitellinus) f. Cavitas amniotica g. Discus embryonicum trilaminaris 4

2. Give explanation on the figure 2 using the structures in right column and model GE-2 (early gastrulation) Structures a. Endometrium b. Chorion villi choriales c. Connecting stalk d. Cavitas amniotica e. Saccus vitellinus f. Coelom extraembryonicum g. Allantois h.Notochorda i. Ectoderma & neural plate j. Mesoderma Mesoderma cardiogenicum Mesoderma Intraembryogenicum Mesoderma extraembryogenicum k. Endoderma Give explanation on the figure 3 using the structures in right Figure 2

3.

column and model GE-3 (late gastrulation) Figure 3 Structures a. Chorion frondosum (placenta area) b. Coelom extraembryonicum c. Connecting stalk d. Canalis allantois e. Flexura cephalica f. Flexura caudalis g. Somite (mesoderma) h. Tubus cardialis i. Tuba neuralis j. Cavitas amniotica k. Stomodeum l. Membrana buccopharyngeal m. Pre enteron n. Mesenteron o. Metenteron p. Membrana cloaca 5

B. Identify and describe growth and development of brain and cranial nerves in embryonal period 1. Give explanation on the figure using the structures in the right column and Brain model 1a& 1b Figure 4 brain development in embryo 7 mm (week 5) Structures a. Prosencephalon Telencephalon Diencephalon b. Mesencephalon c. Rhombencephalon Isthmus rhombencephali Ventriculus quartus (cranial) Pedunculus cerebellaris superior Velum medullare anterior Metencephalon Pons Ventriculus quartus (media) Cerebellum d. Myelencephalon medulla oblongata ventriculus quartus (caudal) e. Flexura cephalica f. Flexura pontis g. Copula optica

Lateral

view

Sagital

section

Give explanation on the figure using the structures in the right column and brain model 2 Figure 5 human embryo 27 mm (week 8) (the roof of 4th ventricle is removed) Embryo structures

a. b. c. d. e. f. g. h. i. j.

Hemispherium cerebri Insulae Bulbus olfactorius Nervus opticus Hypophysis Mesencephalon Nervus trigeminus Nervus facialis Nervus acusticus Cerebellum extraventricular k. Cerebellum intraventricular 2. Identify and describe the five stages of early development of

brain and cranial nerves using the structures below & model BC 1s/d5 as in figure 7 till 11

Figure 7 brain at 20 somites (3,5 weeks)

Figure 8 brain at embryo 4 mm (4 weeks)

Figure 9 brain at embryo 8 mm (5,3 weeks)

Figure 10 brain at embryo 17 mm (7 weeks)

Figure 11 brain at embryo 50-60 mm (11 weeks) Structures

a. Proencephalon b. Telencephalon c. Diencephalon d. Mesencephalon e. Rhombencephalon f. Metencephalon Pons Cerebellum g. Myelencephalon (medulla oblongata)

h. Nervus I i. Nervus II j. Nervus III k. Nervus IV l. Nervus V m. Nervus VI n. Nervus VII o. Nervus VIII p. Nervus IX q. Nervus X r. Nervus XI s. Nervus XII

t. Vesiculla optica u. Foveolae auditiva v. Mandibula w.Hyoid x. Cor y. Pharynx

C. Give explanation on the face development using the structures and model FE-1 - 6 as in figure 12 till 17 7

Figure 12 Face : week 4th (length 3,5mm)

Structures a. Processus frontonasalis b. Placode nasalis c. Oropharyngeal membran d. Processus maxillaris e. Arcus pharyngealis 1 (mandibular part) f. Arcus pharyngealis 2 g. Stomodeum

Figure 13 face at week 5th (length 6,5 mm)

Structures a. Processus frontonasalis b. Cupula optica c. Sulcus nasolacrimalis d. Fovea nasalis e. Prominentia nasalis medialis f. Prominentia nasalis lateralis g. Stomodeum h. Processus maxillaris i. Arcus pharyngealis 1 (mandibular part) j. Arcus pharyngealis 2 k. Arcus pharyngealis 3 & 4

Figure 14 face at week 5,5th (length 9 mm)

Name of the structures a. Fovea nasalis b. Processus nasalis medialis c. Processus nasalis lateralis d. Fissura nasooptica e. Processus maxillaris f. Arcus mandibullis g. Arcus hyoideus h. Fissura hyomandibularis

Figure 15 face at week 6th (length 12mm)

Name of the structure a. Saccus nasalis (nasus) b. Primary palate & nasal septum c. Cupula optica d. rima oris e. sulcus nasolacrimalis f. Processus maxillaris (maxilla) g. Arcus mandibullaris (1st pharyngeal arc) h. Arcus hyoideus i. Meatus acusticus 8

externus (1st pharyngeal cleft) j. auricula

Figure 16 face at week 7th (length 19 mm)

Figure 17 face at week 8th ( length 28 mm)

Structures a. Oculus b. Nasus c. Philtrum (fusion of processus nasalis medialis) d. Site of canalis nasolacrimalis ( fusion of processus nasalis lateralis and maxillaris) e. Site of fusion of processus nasalis medialis and maxillaris f. Auricula

Laboratory Practical Session II FETAL GROWTH

Learning Objective: 1. Identification of the external morphology on 3rd, 4, 5, 6, 7, 8, and 9th months fetal age and full term fetus. 2. Identification of the fetal weight and crown-rump length on 3rd, 4, 5, 6, 7, 8, and 9th months fetal age. 3. Identification of the face development during on 3rd, 4, 5, 6, 7, 8, and 9th months fetal age. 4. Identification of the development of external fetal characteristics such as skin, lanugo, vernix caseosa and nail on 3rd, 4, 5, 6, 7, 8, and 9th months fetal age 9

5. Identification age.

of

the

genitourinary

development

and

differentiation during on 3rd, 4, 5, 6, 7, 8, and 9th months fetal

Practical session guideline: Identify the external morphology of fetus using fetus model no. 1-8 in the embryology boxes, and also see the fetal cadaver in the museum fill the description in the table. 1. Identify the external morphology of fetus: growth proportion of head, trunk and extremity on 3, 4, 5, 6, 7, 8, 9 months fetal age. External Morphology Proportion body segmented to the whole body: (Proporsion head&neck to total body) Proportional (chest width>head width) Upper limb (arm & hand) Lower limb (leg & foot)
Lowe r limbs welldevel oped

Months 2 1: 1 3 4 5 6 7 8 9 Full term 1:4

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2. Identify the fetal weight and crown-rump length on 3rd, 4, 5, 6, 7, 8, and 9th months fetal age. External Morphology 2 Weight (gr) Crown-Rump Length (CRL)
2.7 gra m 5 mm

Months 3 4 5 6 7 8 9 Full term

3.2 kg 34.6 cm

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3. Identify the face development: auricula, eyelids, supercilia, and hair, during on 3rd, 4, 5, 6, 7, 8, and 9th months fetal age. External Morphology 2 Fetus face
Face is disti nctly hum an in appe aran ce Eyeli ds clos e

Months 3 4 5 6 7 8 9 Full term

Palpebral cleft: (Closed) (Open) Cilia and supercilia Auricula

Eyelids widely open

Basi c ear stru ctur e Hea d and bod y hair (lan ugo ) visi ble

Capilli (head hair)

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4. Identify the development of external characteristics such as skin, lanugo, vernix caseosa and nail on 3rd, 4, 5, 6, 7, 8, and 9th months fetal age External Morphology 2 Lanugo 3 4 5
Lanugo visible Skin wrinkled, transluce nt, pink to red in color Ver nix cas eos a cov ers skin Form ation of nail beds

Months 6 7 8 9
Lanug o almost absent

Full term

Body skin Wrinkle Thick

Vernix caseosa Little Thick

Nail Available Tip of finger Radix umbilical cord (central)

5. Identify the genitourinary development and differentiation during on 3rd, 4, 5, 6, 7, 8, and 9th months fetal age. Fill the Genitourinary development and differentiation key events during each month: 3
rd

month

Growth and Development 4th month 6th month

7th, 8th, 9th

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Genitourinary development and differentiation

Formation of kidneys (metanephros ) Formation of gonads, ducts genitalia; oogonia in female Sex distinguishabl e externally

Degeneration of embryonic kidneys (mesonephro s)

Descent of testis

References Cochard Larry R. 2002. Netter's Atlas of Human Embryology. Saunders Elsevier Philadeplhia. Moore KL, Persaud TVN, Shiota Kohei. 2000. Color Atlas of Clinical Embryology, 2nd edition. Saunders Elsevier Philadeplhia.

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