USMLE Step 1 Web Prep — Gonad Development, Week 1: Beginning

of Development, Week 2: Formation of Bilaminar Embryo, Embryonic

Period (Weeks 3-8)
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Section II
Early Embryology
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Gonad Embryology
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Gonad Development: Meiosis
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Spermatogenesis
 Primordial germ cells arrive in the indifferent gonad at week 4 and remain
dormant until puberty.
 When a boy reaches puberty, primordial germ cells differentiate into type A
spermatogonia, which serve as stem cells throughout adult life.
 Some type a spermatogonia differentiate into type B spermatogonia.
 Type B spermatogonia enter meiosis I to form primary spermatocytes.
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Spermatogenesis
 Primary spermatocytes from two secondary spermatocytes.
 Secondary spermatocytes form two spermatids.
 Spermatids undergo spermiogenesis, which is series of morphological changes
resulting in the mature sperm.
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Oogenesis
 Primordial germ cells arrive in the indifferent gonad at wk 4 and differentiate into
oogonia.
 Oogonia enter meiosis I to form primary oocytes. All primary oocytes are formed
by month 5 of fetal life and remain arrested in prophase (diplotene) of meiosis I
until puberty.
 No oogonia are present at birth.
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Oogenesis
 When a girl reaches puberty, a primary oocyte completes meiosis I to form a
secondary oocyte and polar body.
 The secondary oocyte becomes arrested in metaphase of meiosis II and is
ovulated.
 At fertilization within the uterine tube, the secondary oocyte completes meiosis II
to form a mature oocyte and polar body.
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WEEK 1:
Beginning of Development
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Clinical Correlate
Ectopic Tubal Pregnancy
This is the most common form of ectopic pregnancy. It most usually occurs when
the blastocyst implants within the ampulla of the uterine tube because of delayed
transport. Risk factors include endometriosis, pelvic inflammatory disease (PID),
tubular pelvic surgery, or exposure to diethylstilbestrol (DES). Clinical signs include
abnormal or brisk uterine bleeding, sudden onset of abdominal pain that may be
confused with appendicitis, last menses 60 days ago, positive human chorionic
gonadotropin (hCG) test, and culdocentesis showing intraperitoneal blood.
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WEEK 2:
Formation of the Bilaminar Embryo
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Clinical Correlate
Human Chorionic Gonadotropin
hCG is a glycoprotein, produced by the syncytiotrophoblast, which stimulates the
production of progesterone by the corpus luteum (i.e., maintains corpus luteum
function).

hCG can be assayed in maternal blood at day 8 or maternal blood at day 8 or

maternal urine at day 10 and is the basis for early pregnancy testing. hCG is
detectable throughout pregnancy. Low hCG levels may predict a spontaneous
abortion or ectopic pregnancy. High hCG levels may predict a multiple pregnancy,
hydatidiform mol, or gestational trophoblastic neoplasia.
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WEEK 3-8:
Embryonic Period
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Clinical Correlate
A sacrococcygeal teratoma is a tumor that arises from remnants of the primitive
streak. It often contains various types of tissue (bone, nerve, hair, etc).

A chordoma is a tumor that arises from remnants of the notochord found either
intracranially or in the sacral region.
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Clinical Correlate
Caudal Dysplasia (Sirenomelia)
Caudal dysplasia refers to a constellation of syndromes ranging from minor lesions of
the lower vertebrae to complete fusion of lower limbs as a result of abnormal
gastrulation in which migration of mesoderm is disturbed. It is associated with
VATER (vertebral defects, anal atresia, tracheoesophageal fistula, and renal defects)
or VACTERL (vertebral defects, anal atresia, cardiovascular defects, tracheo
esophageal fistula, renal defects, and upper limb defects).
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Development of the Fetal Structures From the Three Germ Layers - Table II-4-1.
Ectoderm Mesoderm Endoderm
Epidermis, hair, nails Muscle (smooth, cardiac, Epithelial lining of:
Cochlear duct, semicircular skeletal) Gastrointestinal tract
ducts Extraocular muscles (preotic Trachea, bronchi,
Enamel of teeth somites) lungs
Adenohypophysis Muscles of the tongue (occipital Biliary apparatus
Lens of the eye somites) Urinary bladder,
Parotid gland Connective tissue, dermis of the urethra
Mammary glands skin Vagina
Epithelial lining of lower anal Bone, Cartilage Auditory tube
canal Blood and lymph vessels Middle ear cavity
Heart Parenchyma of:
Adrenal cortex Liver
Spleen Pancreas
Kidney Submandibular gland
 Dura mater Subligual gland
Testes, ovaries Thyroid
Parathyroid

Table II-4-1 Further detail of the development into adult structures is presented in the Gross anatomy section. (Page 107)
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Development of the Fetal Structures From the Three Germ Layers - cont.
Neuroectoderm Mesoderm Endoderm
All neurons within brain and spinal cord
Retina
Neurohypophysis
Astrocytes, oligodendrocytes

Table II-4-1 Further detail of the development into adult structures is presented in the Gross anatomy section. (Page 107)
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Development of the Fetal Structures From the Three Germ Layers - cont.
Neural Crest Mesoderm Endoderm
Ganglia: dorsal root, cranial, autonomic
Schwann cells
Pia and arachnoid
Adrenal medulla
Parafollicular cells (calcitonin)
Aorticopulmonary septum
Dilator and sphincter
pupillae mm.
Ciliary muscle

Table II-4-1 Further detail of the development into adult structures is presented in the Gross anatomy section. (Page 107)
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Development of the Fetal Structures From the Three Germ Layers - cont.
Mesoderm Endoderm
Muscle (smooth, cardiac, skeletal) Extraocular muscles Epithelial lining of:
(preotic somites) Gastrointestinal tract
Muscles of the tongue (occipital somites) Trachea, bronchi,
Connective tissue, dermis of the skin lungs
Bone, Cartilage Biliary apparatus
Blood and lymph vessels Urinary bladder,
Heart urethra
Adrenal cortex Vagina
Spleen Auditory tube
Kidney Middle ear cavity
Dura mater
Testes, ovaries Parenchyma of:
Liver
Pancreas
Submandibular gland
Subligual gland
 Thyroid
Parathyroid

Table II-4-1 Further detail of the development into adult structures is presented in the Gross anatomy section. (Page 107)