EMBRYOLOGY

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GIT
The gastrointestinal (GI) tract is composed of four layers: mucosa, submucosa, muscularis externa,
and serosa. The microanatomy of each segment varies slightly, reflecting its specific functions in
digestion and absorption. Here's a description of the microanatomical features of the esophagus,
fundus of the stomach, pylorus of the stomach, duodenum, jejunum, ileum, and large intestine:

Oesophagus:

 Mucosa: Non-keratinized stratified squamous epithelium with a thick layer of mucus.

 Submucosa: Dense connective tissue with numerous mucous glands.

 Muscularis externa: Mostly smooth muscle, arranged in two layers (inner circular, outer
longitudinal) to propel food down the esophagus.

 Serosa: Adventitia in the upper part, becoming serosa in the lower part.

Fundus of Stomach:

 Mucosa:

Surface epithelium lined with gastric pits that lead to gastric glands. These glands produce gastric
acid, pepsinogen, and mucus.

 Submucosa:

Well-vascularized connective tissue containing blood and lymphatic vessels, nerves, and gastric
glands.

 Muscularis externa:

Three layers of smooth muscle (inner oblique, middle circular, outer longitudinal) responsible for
churning and mixing food.

 Serosa:

Continuous with the greater omentum.

Pylorus of Stomach:

 Mucosa: Similar to fundus, but with more mucus-producing cells.

 Submucosa: Thick and well-developed to support the pyloric sphincter.

 Muscularis externa: Thick and well-developed, forming the pyloric sphincter.

 Serosa: Continuous with the lesser omentum.

Duodenum:

 Mucosa: Numerous villi and microvilli to increase surface area for absorption. Presence of
Brunner's glands which secrete alkaline mucus to neutralize stomach acid.

 Submucosa: Contains Brunner's glands and many blood vessels and lymphatics.

 Muscularis externa: Well-developed with layers similar to the stomach.

  Serosa: Partially covered by serosa.

Jejunum:

 Mucosa: Similar to duodenum, with numerous villi and microvilli.

 Submucosa: Contains Peyer's patches (lymphoid tissue).

 Muscularis externa: More developed than in the duodenum.

 Serosa: Fully covered by serosa.

Ileum:

 Mucosa: Similar to jejunum, with even more developed villi and microvilli.

 Submucosa: Similar to jejunum, with numerous Peyer's patches.

 Muscularis externa: Similar to jejunum.

 Serosa: Fully covered by serosa.

Large Intestine:

 Mucosa: Simple columnar epithelium with numerous goblet cells producing mucus.

 Submucosa: Contains lymphoid tissue and a well-developed vascular network.

 Muscularis externa: Teniae coli, three distinct bands of muscle that contract to form haustra
(sacculations).

 Serosa: Present in most of the large intestine.

The appendix, liver, gallbladder, pancreas, and suprarenal gland each have unique microanatomical
features related to their specific functions within the digestive and endocrine systems. The appendix
is characterized by its lymphoid tissue, the liver by its hexagonal lobules and hepatocytes, the
gallbladder by its mucosal folds, the pancreas by both exocrine and endocrine tissues, and the
suprarenal gland by its distinct cortex and medulla.

Appendix:

 Microscopic structure:

The appendix is lined with a mucosa, which is a mucous membrane composed of three layers:
epithelium, lamina propria, and muscularis mucosae.

 Key features:

The appendix contains lymphoid tissue (lymph follicles) within the lamina propria.

 Function:

The appendix was previously thought to be vestigial, but current research suggests it may play a role
in immune function and as a reservoir for gut bacteria.

Liver:

 Microscopic structure:
The liver is organized into hexagonal lobules, each centered around a central vein.

 Key features:

Each lobule contains portal tracts with branches of the hepatic artery, HPV, and bile ducts. The liver is
composed of hepatocytes, which are the main cells responsible for liver function.

 Function:

The liver produces bile, detoxifies harmful substances, and stores vitamins and minerals.

Gallbladder:

 Microscopic structure:

The gallbladder's inner lining is a simple columnar epithelium with a highly folded mucosa.

 Key features:

The folds in the mucosa increase the surface area for bile storage and absorption of water.

 Function:

The gallbladder stores and concentrates bile, releasing it when needed for digestion.

Pancreas:

 Microscopic structure:

The pancreas is a mixed gland, containing both exocrine and endocrine tissues.

 Key features:

The exocrine pancreas consists of acinar cells that produce digestive enzymes and bicarbonate
ions. The endocrine pancreas contains islets of Langerhans, which produce hormones like insulin and
glucagon.

 Function:

The pancreas produces digestive enzymes and bicarbonate ions for digestion and also produces
hormones that regulate blood sugar levels.

Suprarenal Gland (Adrenal Gland):

 Microscopic structure:

The suprarenal gland is composed of two layers: the cortex and the medulla.

 Key features:

The cortex is responsible for producing steroid hormones, while the medulla produces
catecholamines.

 Function:

The suprarenal gland plays a crucial role in stress response, metabolism, and other endocrine
functions.
The microanatomical features of the urinary system (kidney, ureter, bladder) and male reproductive
system (testis, epididymis, vas deferens, prostate) involve specialized structures and tissues that
facilitate their respective functions.

Urinary System:

 Kidney:

The functional unit of the kidney is the nephron, which filters blood and produces urine. It consists of
the glomerulus, a capillary network, and the renal tubule, where filtrate is processed. The cortex
contains the glomeruli and proximal and distal convoluted tubules, while the medulla contains the
loops of Henle and collecting ducts.

 Ureter:

The ureter's wall is composed of a mucosa (transitional epithelium), a muscularis (smooth muscle),
and an adventitia (connective tissue). The smooth muscle contracts to propel urine towards the
bladder.

 Bladder:

The bladder's lining is transitional epithelium, which stretches to accommodate urine storage. The
muscularis is composed of smooth muscle layers that contract during urination.

Male Reproductive System:

 Testis:

Testicular lobules contain tightly coiled seminiferous tubules, where sperm are
produced. Spermatogonia (germ cells) and Sertoli cells line the tubules, supporting
spermatogenesis. Interstitial cells produce testosterone.

 Epididymis:

The epididymis consists of a head, body, and tail, where sperm mature and are stored. The
epididymis is lined with pseudostratified columnar epithelium with stereocilia.

 Vas Deferens:

The vas deferens is lined with a pseudostratified columnar epithelium with stereocilia, which aids in
sperm transport. Smooth muscle in the walls of the vas deferens propels sperm during ejaculation.

 Prostate:

The prostate gland's epithelium is composed of glandular and non-glandular cells that produce
seminal fluid. The prostate is also surrounded by smooth muscle tissue.
The microanatomical features of the female reproductive system organs, including the ovary, uterus,
uterine tube, cervix, placenta, and umbilical cord, involve specialized tissues and structures that
support reproductive functions. Ovaries contain follicles where eggs mature, the uterus has a
muscular wall with a lining (endometrium) that thickens during the menstrual cycle, uterine tubes
transport eggs and sperm, the cervix connects the uterus to the vagina, the placenta is a temporary
organ formed during pregnancy, and the umbilical cord connects the fetus to the placenta.

1. Ovary:

 Microscopic Features:

 Ovarian cortex: The outer layer where follicles develop, containing the oocyte (egg
cell) and surrounding cells.

 Follicles: Structures that contain the oocyte and support its development.

 Ovarian stroma: A connective tissue framework that provides support.

 Ovarian medulla: The inner layer containing blood vessels and nerves.

 Key Function:

Produces and releases eggs (ovulation), and secretes hormones like estrogen and progesterone.

2. Uterus:

 Microscopic Features:

o Endometrium: The inner lining, which thickens during the menstrual cycle to
prepare for implantation. It is composed of functional and basal layers, with the
functional layer shedding during menstruation if implantation does not occur.

o Myometrium: The muscular wall of the uterus, which contracts during childbirth.

 Key Function: Provides a site for implantation and fetal development during pregnancy.

3. Uterine Tube (Fallopian Tube):

 Microscopic Features:

 Ciliated epithelium: Lining the tube, the cilia help move the egg towards the uterus.

 Smooth muscle: Facilitates peristaltic contractions, moving the egg along the tube.

 Key Function:

Transports the egg from the ovary to the uterus, and it is the site of fertilization.

4. Cervix:

 Microscopic Features:

 Squamous epithelium: The outer layer of the cervix, which transitions into columnar
epithelium at the endocervical canal.

 Connective tissue: Provides support and structure.

 Glands: Produce mucus that can help or hinder sperm transport.

  Key Function:

Connects the uterus to the vagina and acts as a barrier during pregnancy, preventing infection.

5. Placenta:

 Microscopic Features:

 Chorion: The outermost layer of the fetal membrane that forms the maternal-fetal
interface.

 Villi: Finger-like projections that increase the surface area for gas and nutrient
exchange.

 Key Function:

Provides oxygen and nutrients to the fetus and removes waste products from the fetal circulation
during pregnancy.

6. Umbilical Cord:

 Microscopic Features:

 Two umbilical arteries: Carry deoxygenated blood and waste products from the
fetus to the placenta.

 One umbilical vein: Carries oxygenated blood and nutrients from the placenta to the
fetus.

 Wharton's jelly: A protective, gelatinous tissue that surrounds the umbilical vessels.
Gastro eosophageal junct

1. Mucosa

 Esophagus:

o Stratified squamous epithelium (non-keratinized).

o Lamina propria with occasional mucous glands.

 Stomach (Cardia):

o Simple columnar epithelium (mucus-secreting).

o Gastric pits leading to cardiac glands (mucous-rich).

2. Submucosa

 Connective tissue with nerve plexus (Meissner’s).

3. Muscularis Externa

 Skeletal → smooth muscle transition in esophagus.

 Stomach has three smooth muscle layers.

4. Adventitia/Serosa

 Esophagus: Adventitia (connective tissue).

 Stomach: Serosa (mesothelium-covered).

Identifying Features:

 Sharp epithelial transition (squamous → columnar).

 Cardiac glands (stomach side).

 Z-line (visible demarcation).

Clinical Note:

 Barrett’s esophagus: Squamous → columnar metaplasia (pre-cancerous).

 GERD: Acid reflux damages squamous epithelium.

The diaphragm, a crucial muscle for respiration, develops through a coordinated process involving
several embryonic structures. Congenital diaphragmatic hernia (CDH) occurs when this development
is disrupted, leading to a defect in the diaphragm, allowing abdominal organs to herniate into the
chest cavity. This can result in various complications, including pulmonary hypoplasia and respiratory
distress.

Diaphragm Development:

The diaphragm forms during fetal development, beginning around the 4th week of gestation and
completing by the 12th week. It originates from four main structures:

1. Septum transversum: A central structure that separates the peritoneal and thoracic cavities.

2. Esophageal mesentery: Forms the diaphragm's central portion and crura.

3. Pleuroperitoneal folds: Develops laterally and fuses with other structures, completing the
diaphragm's formation.

4. Chest wall muscular structures: The surrounding muscles contribute to the final diaphragm
formation.

Congenital Diaphragmatic Hernia (CDH):

CDH occurs when the diaphragm fails to close completely, creating an opening or defect. This defect
allows abdominal organs, such as the stomach, intestines, and liver, to move into the chest cavity,
potentially crowding the heart and lungs. CDH can range in severity, with some cases causing
significant respiratory problems at birth and others being less severe or even asymptomatic.

Consequences of CDH:

 Pulmonary hypoplasia: Underdevelopment of the lungs due to crowding by herniated

organs.

 Respiratory distress: Difficulty breathing due to impaired lung function.

 Pulmonary hypertension: High blood pressure in the lungs, further stressing the heart.

 Other complications: Gastrointestinal issues, feeding difficulties, and potential long-term

respiratory problems.

Types of CDH:

 Bochdalek hernia: The most common type, located on the left side of the diaphragm.

 Morgagni hernia: A less common type, located anteriorly.

 Diaphragmatic eventration: Incomplete muscularization of the diaphragm, leading to

herniation.

 Central tendon defects: Herniation through the central tendon of the diaphragm.
The digestive system develops from the primitive gut, which forms during the 4th week of embryonic
development. It's divided into the foregut, midgut, and hindgut, each giving rise to specific
organs. Congenital anomalies arise from disruptions in these developmental processes.

Foregut Development and Anomalies:

 Development:

The foregut develops into the esophagus, stomach, liver, gallbladder, pancreas, and proximal
duodenum.

 Anomalies:

 Esophageal Atresia: A blockage or incomplete development of the esophagus, often

associated with a fistula (abnormal connection) to the trachea.

 Tracheo-Esophageal Fistula: An abnormal connection between the esophagus and

trachea, leading to swallowing difficulties and pneumonia.

 Congenital Pyloric Stenosis: Thickening of the pyloric muscle, leading to vomiting

and obstruction of the stomach outlet, often requiring surgery.

 Annular Pancreas: A ring of pancreatic tissue around the duodenum, causing

obstruction and potentially requiring surgery.

 Congenital Bronchopulmonary Foregut Malformation: A rare anomaly involving the

digestive and respiratory systems, potentially with fistulas or abnormal connections
between the esophagus and respiratory structures.

Midgut Development and Anomalies:

 Development:

The midgut develops into the distal duodenum, jejunum, ileum, cecum, appendix, ascending colon,
and proximal 2/3 of the transverse colon. It undergoes herniation, rotation, and return to the
abdomen.

 Anomalies:

 Intestinal Malrotation: Failure of the midgut to rotate properly, potentially causing

volvulus (twisting of the intestine) and obstruction.

 Meckel's Diverticulum: A remnant of the omphalomesenteric duct, a connection

between the midgut and the yolk sac, which can cause intestinal obstruction or
bleeding.

 Intestinal Atresia/Stenosis: Blockage or narrowing of the intestinal lumen, causing

obstruction.

 Gastroschisis and Omphalocele: Abdominal wall defects where intestines protrude

outside the body, often requiring surgical correction.

Hindgut Development and Anomalies:

 Development:
The hindgut develops into the distal 1/3 of the transverse colon, descending colon, sigmoid colon,
and the upper anal canal. The urorectal septum separates the urogenital sinus from the anorectal
canal.

 Anomalies:

 Hirschsprung's Disease: Absence of nerve cells in the colon, leading to lack of

peristalsis and bowel obstruction.

 Anorectal Malformations: Abnormalities in the anal canal, including imperforate

anus (no opening), and other variations.

 Duplication of Hindgut: A rare anomaly with multiple perineal openings, often

associated with neural tube defects.
The development of the urinary system, also known as the renal system, begins early in fetal
development, starting around the fourth week of gestation. It progresses through three stages:
pronephros, mesonephros, and metanephros. The metanephros eventually forms the permanent
kidneys.

 Pronephros:

This is the earliest, most primitive form of kidney and appears in the cervical region of the embryo. It
is non-functional and regresses.

 Mesonephros:

This is the second kidney stage and develops in the thoracic and lumbar regions. It is a temporary,
functional excretory system that eventually regresses as the metanephros takes over.

 Metanephros:

This is the final, permanent kidney system. It appears around the fifth week of gestation and
develops into the functional kidneys. Nephrogenesis (the formation of nephrons) is complete around
week 36.

Other Important Structures:

 Nephrogenic Cord:

This is the precursor to the three kidney stages and develops in the intermediate mesoderm.

 Ureteric Bud:

This structure, derived from the mesonephric duct, initiates the development of the collecting
system in the kidney and ureters.

 Metanephric Blastema:

This is the mesoderm that will differentiate into the renal tubules and glomeruli.

 Cloaca:

The cloaca is a common cavity that the urinary and reproductive systems initially share. It is divided
by the urorectal septum to form the urogenital sinus (where the bladder and urethra develop) and
the anorectal canal.

 Urogenital Sinus:

This structure develops into the urinary bladder, urethra, and the genital tract

 The urinary and reproductive systems share a common origin in the intermediate
mesoderm.

 The development of the urinary system is closely related to the development of the
reproductive system, particularly in the earlier stages.

 Both systems develop from the same intermediate mesoderm and initially share a common
cavity, the cloaca

 Renal agenesis (absence of a kidney), Renal dysplasia (abnormal kidney development),

Multicystic dysplastic kidney disease (MDD), and Polycystic kidney disease (PKD)
The reproductive systems of both males and females begin developing early in embryonic
development, with initial structures being undifferentiated and capable of becoming either male or
female. The key factor in determining the sex of the reproductive system is the presence or absence
of the SRY gene on the Y chromosome. In males, the SRY gene triggers the development of the testes
and the subsequent development of male reproductive structures, while in females, the absence of
SRY leads to the development of ovaries and female reproductive structures.

Development of the Male Reproductive System:

1. 1. Gonadal Differentiation:

In males, the undifferentiated gonad differentiates into testes under the influence of the SRY gene.

2. 2. Development of Male Reproductive Structures:

The Wolffian ducts develop into the male reproductive tract (vas deferens, epididymis, ejaculatory
ducts), and the external genitalia (penis and scrotum) develop under the influence of testosterone.

3. 3. Descent of Testes:

The testes initially develop in the abdomen and descend into the scrotum at about 10 weeks of
development.

Development of the Female Reproductive System:

1. 1. Gonadal Differentiation:

In females, the undifferentiated gonad differentiates into ovaries, a process that takes longer than in
males.

2. 2. Development of Female Reproductive Structures:

The Müllerian ducts develop into the female reproductive tract (uterus, fallopian tubes, upper
vagina), and the external genitalia (labia, clitoris) develop in the absence of testosterone.

3. 3. Descent of Ovaries:

The ovaries initially develop in the abdomen and descend into the pelvic cavity, remaining there
throughout life.

Key Players in Development:

 SRY Gene:

The SRY gene on the Y chromosome is crucial for male development, triggering the development of
the testes and repressing the development of female structures.

 Testosterone:

Testosterone, produced by the testes, is essential for the development of male reproductive
structures.

 Anti-Müllerian Hormone (AMH):

AMH, also produced by the testes, represses the development of the Müllerian ducts, preventing the
development of female reproductive structures in males.
  Ovaries:

In the absence of SRY and testosterone, the undifferentiated gonads differentiate into ovaries, and
the Müllerian ducts develop into the female reproductive tract.