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Embryology of Head and Neck

Sep 6, 2025

Overview

This lecture covers high-yield embryology of the head and neck, focusing on germ layers, pharyngeal arches, and related developmental processes relevant for dental and medical board exams.

Early Embryonic Development

  • Germinal stage: fertilization to week 2; highest risk for miscarriage.
  • Fertilization occurs in the fallopian tube; forms the zygote.
  • Zygote undergoes cleavage to morula, then blastula (blastocyst in mammals).
  • Implantation: blastula embeds in the uterine wall.
  • Blastocyst consists of the inner cell mass (embryoblast) and trophoblast (forms placenta).

Formation of Germ Layers

  • Week 2: embryoblast forms the bilaminar disk—epiblast (upper) and hypoblast (lower).
  • Amniotic cavity (above) and yolk sac cavity (below) arise.
  • Week 3: gastrulation forms three germ layers—ectoderm, mesoderm, endoderm.
  • Embryonic period (weeks 3-8): organ systems develop; sensitive to teratogens.
  • Ectoderm: forms skin, nervous system, teeth enamel; mesoderm: muscles, skeleton, connective tissue; endoderm: linings of hollow organs.

Neurulation and Body Segmentation

  • Week 4: neurulation—neural plate forms neural tube (future CNS).
  • Neural crest cells migrate and contribute to facial skeleton, nerves.
  • Somites (body segments) and pharyngeal arches (head/neck segments) arise.

Pharyngeal Arch Derivatives

  • Five key arches: 1 (mandibular), 2 (hyoid), 3, 4, 6; each has artery, nerve, muscle, cartilage.
  • Arch 1: mandibular structures, muscles of mastication, innervated by CN V.
  • Arch 2: facial expression muscles, stapes, facial nerve (CN VII).
  • Arch 3: part of hyoid, stylopharyngeus, glossopharyngeal nerve (CN IX).
  • Arches 4 & 6: laryngeal structures, vagus nerve (CN X).
  • Arch 5 is transient and regresses.

Clefts, Pouches, and Placodes

  • Ectodermal clefts and endodermal pouches separate arches; placodes develop sensory ganglia.
  • Cleft 1: external acoustic meatus; clefts 2-4 form cervical sinus (can form branchial cysts if persistent).
  • Pouch 1: middle ear, auditory tube; pouch 2: palatine tonsil; pouch 3: thymus, inferior parathyroids; pouch 4: superior parathyroids, thyroid C cells.

Development of Pituitary, Tongue, Thyroid, and Ear

  • Pituitary gland: anterior from oral ectoderm, posterior from neural ectoderm.
  • Tongue: sensation/taste/motor divided by CN V, VII, IX, X, and XII (from occipital somites).
  • Thyroid: develops from the foramen cecum at tongue base; migrates down via thyroglossal duct.
  • External ear: forms from six auricular hillocks (arches 1 and 2).

Cleft Lip and Palate Formation

  • Cleft lip: failure of fusion between maxillary and medial nasal prominences (weeks 4-6).
  • Cleft palate: failure of palatal shelf fusion (weeks 6-8); primary palate from medial nasal, secondary palate from palatal shelves.

Clinical Correlates

  • DiGeorge syndrome: defects in pouches 3/4 lead to thymic aplasia, hypocalcemia, congenital heart defects (CATCH-22 mnemonic).
  • Teratogens like retinoic acid can disrupt first/second arch development (e.g., microtia, micrognathia).

Key Terms & Definitions

  • Gastrulation — formation of three germ layers from the epiblast.
  • Neurulation — process by which the neural tube forms from the neural plate.
  • Pharyngeal arches — embryonic structures that form head and neck components.
  • Cleft (branchial, palatal, lip) — failure of normal tissue fusion during development.
  • DiGeorge syndrome — disorder due to abnormal development of 3rd/4th pharyngeal pouches.

Action Items / Next Steps

  • Memorize key pharyngeal arch derivatives (nerves, muscles, bones).
  • Review diagrams of germ layers, neural tube, and pharyngeal arches.
  • Study cranial nerve associations with arches.
  • Practice drawing developmental pathways for head and neck structures.