mebooksfree.com Textbook of Clinical Embryology mebooksfree.com This page intentionally left blank mebooksfree.com Textbook of Clinical Embryology Second Edition Vishram Singh, mbbs, ms, phd(hc), micps, fasi, fimsa Professor and Head, Department of Anatomy Santosh Medical College Member Academic Council and Core Committee, PhD Course Santosh University, Ghaziabad, NCR, Delhi Editor-in-chief, Journal of the Anatomical Society of India Examiner in National and International Universities; Member, Editorial Board Indian Journal of Otology; Journal of Anatomy and Cell Biology Ex-Vice President, Anatomical Society of India Medicolegal Advisor, ICPS, India Consulting Editor, ABI, North Carolina, USA Associate Editor, Acta Medica International Member, COPE (England & Wales) Formerly at: GSVM Medical College, Kanpur King George’s Medical College, Lucknow Al-Arab Medical University, Benghazi (Libya) All India Institute of Medical Sciences, New Delhi mebooksfree.com RELX India Pvt. Ltd. Registered Office: 818, 8th Floor, Indraprakash Building, 21, Barakhamba Road, New Delhi 110 001 Corporate Office: 14th Floor, Building No. 10B, DLF Cyber City, Phase II, Gurgaon-122 002, Haryana, India Textbook of Clinical Embryology, 2nd Edition, Vishram Singh Copyright © 2017 by RELX India Pvt. Ltd. Prior Edition Copyright © 2012 by Reed Elsevier India Private Limited All rights reserved. ISBN: 978-81-312-4882-9 eISBN: 978-81-312-4937-6 No part of this publication may be reproduced or transmitted in any form or by any means, electronic or mechanical, including photocopying, recording, or any information storage and retrieval system, without permission in writing from the publisher. Details on how to seek permission, further information about the Publisher’s permissions policies and our arrangements with organizations such as the Copyright Clearance Center and the Copyright Licensing Agency, can be found at our website: www.elsevier.com/permissions. This book and the individual contributions contained in it are protected under copyright by the Publisher (other than as may be noted herein). Notice Knowledge and best practice in this field are constantly changing. As new research and experience broaden our understanding, changes in research methods, professional practices, or medical treatment may become necessary. Practitioners and researchers must always rely on their own experience and knowledge in evaluating and using any information, methods, compounds, or experiments described herein. In using such information or methods they should be mindful of their own safety and the safety of others, including parties for whom they have a profes- sional responsibility. 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Manager–Content Strategy: Renu Rawat Content Strategist: Arvind Koul Product Manager–E Clinical and Medical Education: Smruti Snigdha Sr Project Manager–Education Solutions: Shabina Nasim Sr Content Development Specialist: Goldy Bhatnagar Project Manager: Nayagi Athmanathan Sr Operations Manager: Sunil Kumar Sr Production Executive: Ravinder Sharma Sr Graphic Designer: Milind Majgaonkar Typeset by GW India Printed in India by mebooksfree.com Dedicated to My Parents Late Smt Ganga Devi Singh and Late Shri HR Singh an ever guiding force in my life My Wife Late Smt Manorama Rani Singh for her unending support and cooperation of my pursuits mebooksfree.com This page intentionally left blank mebooksfree.com Preface to the Second Edition It gives me great pleasure to present second edition of Textbook of Clinical Embryology, which is widely used not only by the undergraduate students but also by the postgraduate students of anatomy, pediatrics, and obstetrics and gynecology. The popularity of this book reflects the appeal of its concept building approach and easy to understand language. This approach has also been retained in this edition with unique problem-solving approach and its utility in highlighting the embryo- logical basis of clinical problems. Based on a large number of suggestions, criticisms and comments received from the VS-Chapstert-06u.inddd 7e1nts and fellow academicians, the text has been extensively 6r/21e/20v12i 3s:5e0:0d9 PM for further improvement of the book. In this edition new features such as learning objectives, facts to remember, new line diagrams, tables, and flowcharts have been included to further enhance the utility of this book. In addition, at the end of each chapter the summary of timing of events is given for easy recall. Most of the diagrams are completely revised and redrawn for easy understanding and repro- ducibility in the exam by the students. The topics on fertilization, gametogenesis, extraembryonic membranes, heart and blood vessels, urogenital system and sensory organs have been thoroughly revised in detail due to high incidence of con- genital problems associated with these systems. In addition, complimentary access to online animations, chapter-wise image bank along with complete e-book is also pro- vided. I sincerely hope that the readers will find this edition more interesting and useful than the previous one. I would love to get fair comments, good or bad, both from students and teachers. “Providing good teaching material or its source and inspiring the students for learning is the real contribution of a teacher.” Vishram Singh mebooksfree.com This page intentionally left blank mebooksfree.com Preface to the First Edition Textbook of Clinical Embryology has been carefully planned for the first year medical and dental students. It follows the revised anatomy curriculum of the Medical Council of India. Following the current trends of clinically oriented study of Anatomy, I have adopted a parallel approach of imparting basic embryological knowledge to students and simultaneously providing them its applied aspects. To help students score high in examinations the text is written in simple language. It is arranged in easily understandable VS-Chapter-06.indd 71 6/21/2012 3:50:09 PM small sections. While embryological details of little clinical relevance, phylogenetic discussions, and comparative analogies have been either omitted or described in brief, all clinically important topics are described in detail. Because of increasingly significant role of molecular biology and genetics in embryology and study of birth defects, the basic molecular and genetic principles are discussed throughout the text. In addition, a separate chapter on medical genetics has been added. The tables and flowcharts given in the book summarize important and complex information into digestible knowledge capsules. Multiple choice questions have been given chapter-by-chapter at the end of the book to test the level of understanding and memory recall of the students. The numerous simple four-color illustrations and clinical photographs further assist in fast comprehension and retention of complicated information. All the illustrations are drawn by the author himself to ensure accuracy. Throughout the preparation of this book one thing I have kept in mind is that thorough knowledge of embryology is required by Clinicians, especially Gynecologists, Pediatricians, and Pediatric Surgeons for physical examination, prenatal diagnostic tests, and surgical procedures. Therefore, embryological events relevant to prenatal diagnostic and surgical procedures are clinically correlated throughout the text. Further, patient-oriented problems and their embryological and genetic basis are presented at the end of each chapter for problem-based learning so that the students could use their embryological knowledge in clinical situations. Moreover, keeping in mind the relevance of embryological knowledge in day-to-day clinical practice, a separate chapter on developmental events during the entire period of gestation and their application in clinical practice is given at the end of the book. I pay my heartfelt tribute to all the authors of various embryology books, especially Developing Human: Clinically Oriented Embryology, 8th edition by Keith L Moore and TVN Persaud, which I have consulted during the preparation of this book. From Developing Human and few other books, some photographs have been used in this book after obtaining due permission from concerned authorities (please refer to page 331 for Figure Credits). As a teacher, I have tried my best to make the book easy to understand and interesting to read. For further improvement of this book, I would greatly welcome comments and suggestions from the readers. All these comments and suggestions can be e-mailed at [email protected] and [email protected]. ‘Mind perceives new ideas best only when put to test.’ Vishram Singh mebooksfree.com