Basic Sciences for Obstetrics and Gynaecology by Tim Chard MD, FRCOG, Richard Lilford MRCOG, MRCP (auth.)

By Tim Chard MD, FRCOG, Richard Lilford MRCOG, MRCP (auth.)

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The tertiary stems are arranged in circles around a hollow core. ::~~.. ': Cardiogenic Notochord plate Buccopharyngeal membrane Mesoderm Allantois in body stalk Fig. 18. Schematic longitudinal section of a presomite embryo. Neural plate Foregut Hindgut '. I... '". Cardiac tube . , .... -;. "," . ~ "",:" , .. ~. " ;;"': i . ( - i '-~: . : . . . ... Notochord {lateral to this mesoderm is found) Yolk sac cavity Fig. 19. Longitudinal section of a 7-somite embryo; 24 days of embryonic life, Note that the pericardial cavity now lies below the cardiac tube, lobules and the cotyledons viewed as part of the gross morphology of the placenta.

The mucosa has a transitional epithelium near the bladder neck, grading to a non-keratinised stratified squamous epithelium near the external orifice. On the posterior wall is an epithelial fold, the urethral crest. There are numerous mucosal glands; near the lower end the ducts of these join to form the two para-urethral (Skene's) ducts, which end in an aperture lateral to the external orifice. The arterial and venous blood supply to the upper third of the urethra is associated with that of the bladder, and the lower two-thirds with that of the anterior vaginal wall and clitoris.

All products are found in the amniotic fluid at lower levels than in the fetus or the mother. The main factors controlling the secretion of placental products (and hence maternal levels) are the functional mass of the trophoblast and uteroplacental blood-flow. Maternal levels, therefore, usually correlate with the weight of the placenta and the fetus. Oestrogens Oestriol is synthesised in the placenta from fetal precursors: dehydroepiandrosterone (DHA) is produced by the fetal adrenal and hydroxylated in the fetal liver (160H-DHA)j aromatisation of the A-ring of 160H-DHA in the placenta yields oestriol.

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