OBJECTIVES
By the end of this lecture , the student will be able to:
Depict the origin of the limb bud. Recognize results of rotation ( innervation and dermatome ) Describe the common anomalies of limbs and digits.
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5th week
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Mesoderm
Apical ectodermal
ridge
Ectoderm
5th week
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The mesoderm is derived from lateral plate mesoderm and some migrating myotomes.
Myotomes
Mesoderm AER Lateral plate mesoderm
6th week
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Later, a second constriction divides the proximal part of the limb into 2 segments
(B)
2nd circular constriction
7th week
Ossification At 8th 12th week, 1ry centers of ossification appear to form diaphysis (shaft) of long bones. 2ry centers of ossification for ends of long bones form epiphysis usually appear after birth. Epiphyseal plates (hyaline cartilage) separate epiphysis from diaphysis to allow growth of bones in length. Epiphyseal cartilage disappear after adult age.
Endochondral Ossification
2o ossification center
cartilage
calcified cartilage
bone
Just before birth
epiphyseal plate
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epiphyseal line
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Childhood
Adult
In long bones an epiphyseal plate is found on each extremity. In smaller bones, such as the phalanges, it is found only at one extremity. In irregular bones, such as the vertebrae, one or more primary centers of ossification and usually several secondary centers are present.
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Digital rays divide the hand & foot plates to form fingers & toes
H
(B) Mesodermal condensation in the hand and foot plates results in appearance of digital rays.Zaki Dr: Azza
6th week
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7th week
A. Digital rays
B. Webs
C. Notches
The thin membranes ( webs ) in between the digital rays break down and the digits become separated by notches.
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Illustrations of embryonic development of the limbs (32-56 days). Note that development of the upper limbs precedes that of the lower limbs.
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Rotation Of Limbs
At a later stage 7thweek, the limb buds undergo rotation.The limbs rotate in
opposite directions. The upper limb: rotates 90 laterally, so that the extensor muscles lie on the lateral and posterior surface and the thumbs lie laterally. The lower limb: rotates approximately 90 medially, placing the extensor muscles on the anterior surface and the big toe medially.
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right angle to the trunk. 2 borders: Preaxial (cephalic, big digit) Post-axial ( caudal, little digit). 2 surfaces: Ventral (flexor). Dorsal (extensor(
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8th week
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Rotation Of Limbs
U.L
Rotation Muscles Lateral (90) Flexorsant. Extensors post. Radius---lat. Ulna---med. Thumb---lat.
L.L
Medial (90) Flexors--post. Extensors ant. Tibia---med. Fibula---lat. Big toe--med.
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Bones Digits
The muscles are derived from myotomes of somites, which migrate to limb bud carrying their nerve supply Around the developing bones, the mesoderm forms a muscle mass, which separates into flexor and extensor compartments. At end of 4th month, the muscles become strong and the baby starts to kick against the uterine wall.
The mother starts to feel the movement of quickening.
7th week
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The upper limb bud arises opposite the lower cervical & upper thoracic segments (C5 T1) & supplied by brachial plexus. The dermomyotomes (give muscles & dermis of the limbs) come from somites & migrate carrying their nerve supply from spinal cord The neural tube gives the motor fibers (axons of anterior horn cells) Neural crest cells migrate gives sensory axons, dorsal root ganglion, Schwann cells
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3rd month
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4th month
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A group of ventral rami of spinal nerves supplies the skin and muscles of each limb bud. U.L: C4-T2( brachial plexus )
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Phacomelia
Hands & feet are attached to the trunk by irregular bones.
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Amelia, absence of a limb. Meromelia (Greek, meros, part, and melos, limb), absence of part of a limb. A, Quadruple amelia: absence of upper and lower limbs. B, Meromelia of the upper limbs: the limbs are represented by rudimentary stumps. C, Phacomelia a form of Meromelia with the rudimentary upper limbs attached directly to the trunk.
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Syndactyly
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Polydactyly
In polydactyly, one or more extra digits develop. It tends to run in families. The additional digits are removed surgically.
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Bradydactyly
Shortness of the digits (fingers or toes) is the result of reduction in the length of the phalanges.
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Lobster claw
One or more middle digit(s) is absent, the hand or foot is divided into 2 parts. In each part, the digits are fused.
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Polydactyly
Syndactyly
Cleft foot A) Polydactyly: extra digits B) Syndactyly : fused digits Dr: Azza Zaki C) Cleft foot cleft between metatarsal bones
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Floating thumb due to absence of first metacarpal bone, Dr: Azza Zaki But the phalanges are present
Macrodactyly
affecting thumb & index fingers 44
Achondroplasia: common cause of dwarfism, it is autosomal dominant disease early closure of epiphyseal cartilages affect long bones short limbs. A) A child with large skull & short limbs B) & C) A girl 15 years old with dwarfism of short limb type.
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Achondroplasia : An autosomal dominant disease: (short limbs with normal trunk & head.
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Syndactyly
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Polydactyly
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Syndactyly
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