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b. B
c. C
d. D
e. E
 ANS: D
The cytotrophoblast is the inner layer of the trophoblast. It gives rise to (1) the outer
layer of trophoblast (syncytiotrophoblast), (2) amnioblasts (cells that form the
amnion), and (3) part of the extraembryonic mesoderm. The cytotrophoblast, as the
prefix cyto- implies, is a cellular layer.

3.
Lacunar network
a. A
b. B
c. C
d. D
e. E
ANS: A
The lacunar networks form by coalescence of lacunae in the syncytiotrophoblast. As
the maternal sinusoids are eroded, blood seeps into these networks. Nutrients in the
embryotroph diffuse through the two layers of trophoblast and pass to the embryo by
way of the extraembryonic coelom.

4.
Epiblast forms its floor
a. A
b. B
c. C
d. D
e. E
ANS: B
The floor of the amniotic cavity is formed by the epiblast. The amnion enclosing the
amniotic cavity is attached to the epiblast of the embryonic disc. Initially, some
amniotic fluid may be secreted by the amniotic cells, but most of it is derived from the
maternal blood.

5. Develops as a localized thickening of hypoblast

a. Corpus luteum
 b. Zona pellucida
c. Prechordal plate
d. Ectopic implantation
e. Chorionic sac
ANS: C
The prechordal plate indicates the future cranial end of the embryo and the future site
of the mouth. It is a circular area of endoderm that is firmly adherent to the overlying
embryonic epiblast. It is an important landmark in the early embryo and serves as an
organizer of the cranial region of the embryo.

6. Develops from a ruptured ovarian follicle

a. Corpus luteum
b. Zona pellucida
c. Prechordal plate
d. Ectopic implantation
e. Chorionic sac
ANS: A
The corpus luteum develops from the ovarian follicle after ovulation. Under the
influence of luteinizing hormone (LH) produced by the adenohypophysis (anterior
lobe of pituitary gland), the ruptured follicle develops into a glandular structure. At
ovulation, the walls of the follicle collapse and, with cells of the theca folliculi, form
the corpus luteum. The corpus luteum is an important source of progesterone for about
4 months. After this, the placenta is the major producer of this hormone.

7. Surrounds embryo, amnion, and umbilical vesicle (yolk sac)

a. Corpus luteum
b. Zona pellucida
c. Prechordal plate
d. Ectopic implantation
e. Chorionic sac
ANS: E
The chorion forms the chorionic sac from the wall of which the embryo, its amnion
and umbilical vesicle are suspended by the connecting stalk. The chorionic sac gives
rise to the embryonic part of the placenta.

8.
Derived from cytotrophoblast
a. A
b. B
c. C
 d. D
e. E
ANS: D
The syncytiotrophoblast, a multinucleated protoplasmic mass, is derived from the
cytotrophoblast. Cells of the cytotrophoblast divide mitotically, and some of these
cells move outward, where they fuse with and become part of the increasing mass of
syncytiotrophoblast. The syncytiotrophoblast produces human chorionic gonadotropin,
which acts like luteinizing hormone in maintaining the corpus luteum. Later, it also
produces other hormones. The syncytiotrophoblast is actively involved in
implantation.

9.
Ventral layer of embryonic disc
a. A
b. B
c. C
d. D
e. E
ANS: E
The hypoblast (primordial endoderm) forms the ventral layer of the embryonic disc. It
is first recognizable on the ventral surface of the embryoblast about 7 days after
fertilization.

10.
Site of the decidual reaction
a. A
b. B
c. C
d. D
e. E
ANS: C
The connective tissue in the compact layer of the endometrium in the region of the
implanting blastocyst is the site of cellular and other changes known as the decidual
reaction. The enlarged decidual cells contain large amounts of glycogen and lipids that
provide nourishment for the embryo.
11.
Lies between the cytotrophoblast and the epiblast
a. A
b. B
c. C
d. D
e. E
ANS: B
The amniotic cavity lies between the cytotrophoblast and the epiblast of the embryonic
disc. Cells from the epiblast (amnioblasts) soon form a thin roof over this cavity called
the amnion. It is continuous with the epiblast of the embryonic disc.

12.
Most common site of an ectopic pregnancy
a. A
b. B
c. C
d. D
e. E
ANS: C
The most common site of an ectopic pregnancy is the uterine tube, usually in the
ampulla or isthmus. The incidence of tubal pregnancy ranges from 1 in 80 to 1 in 250
pregnancies, depending on the geographic location, socioeconomic level, and age of
the pregnant woman. Pelvic inflammatory disease is a common cause of tubal ectopic
pregnancy. As the embryo increases in size, the uterine tube ruptures, leading to
hemorrhage and a serious threat to the mother’s life.

13.
 Abdominal pregnancy
a. A
b. B
c. C
d. D
e. E
ANS: B
In an abdominal pregnancy, the conceptus develops on the peritoneal surfaces of the
abdominal cavity. Abdominal pregnancies are relatively uncommon (about 0.03% of
all ectopic pregnancies), and they are usually associated with intra-abdominal
hemorrhage and severe abdominal pain. Rarely, the embryo continues to develop until
term and a live fetus may be delivered surgically. In some cases, the abdominal fetus
dies and becomes calcified, forming a so-called stone fetus or lithopedion.

14.
Usual site of implantation
a. A
b. B
c. C
d. D
e. E
ANS: A
The blastocyst usually implants on the superior part of the posterior wall of the uterine
cavity. Implantation occurs slightly more often on the posterior than on the anterior
wall.

15.
Implantation at internal os
a. A
b. B
c. C
d. D
e. E
 ANS: A
Implantation of the blastocyst in the uterine cervix in the region of the internal os may
cover the entrance to the cervix, resulting in a condition known as placenta previa, in
which the placenta may completely or partially cover the internal opening of the
cervical canal. Serious hemorrhage may occur as a result of premature separation of
the placenta during pregnancy or at delivery.

16.
Ovarian pregnancy
a. A
b. B
c. C
d. D
e. E
ANS: D
Ovarian pregnancy is relatively uncommon, with an incidence of approximately 0.5%
of all ectopic pregnancies. In an ovarian pregnancy, fertilization of the oocyte
probably occurs in the ampulla of the uterine tube with subsequent implantation in the
ovary after becoming dislodged from the tube. Because of intra-abdominal
hemorrhage and other medical complications, surgical management is necessary.
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