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Kaplan Medical USMLE Step 1 Lecture Notes (2021)

Kaplan Medical USMLE Step 1 Lecture Notes (2021) includes a mix of multiple-choice and scenario-based questions to help you prepare comprehensively.

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    USMLE ® Step 1 Lecture Notes 2021 USMLE ® is a joint program of the Federation of State Medical Boards (FSMB) and the National Board of Medical Examiners (NBME), which neither sponsor nor endorse this product. Anatomy Behavioral Science and Social Sciences Biochemistry and Medical Genetics Immunology and Microbiology Pathology Pharmacology Physiology

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    USMLE® is a joint program of The Federation of State Medical Boards of the United States, Inc. and the National Board of Medical Examiners. USMLE ® Step 1 Lecture Notes 2021

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    Copyright © 2021 Kaplan, Inc. ISBN: 978-1-5062-5958-1 All rights reserved. The text of this publication, or any part thereof, may not be reproduced in any manner whatsoever without written permission from the publisher. This book may not be duplicated or resold, pursuant to the terms of your Kaplan Enrollment Agreement. USMLE® is a joint program of the Federation of State Medical Boards (FSMB) and the National Board of Medical Examiners (NBME), which neither sponsor nor endorse this product.

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    USMLE TM* STEP 1 ANATOMY USMLE TM* STEP 1 BEHAVIORAL SCIENCE USMLE TM* STEP 1 BIOCHEMISTRY AND MEDICAL GENETICS USMLE TM* STEP 1 IMMUNOLOGY AND MICROBIOLOGY USMLE TM* STEP 1 PATHOLOGY USMLE TM* STEP 1 PHARMACOLOGY USMLE TM* STEP 1 PHYSIOLOGY

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    USMLE ® is a joint program of the Federation of State Medical Boards (FSMB) and the National Board of Medical Examiners (NBME), which neither sponsor nor endorse this product. USMLE ® Step 1 Lecture Notes 2021 Anatomy

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    USMLE ® Step 1 Lecture Notes 2021 Anatomy KP00372_USMLE_Anatomy.indb 1 8/22/20 1:36 PM

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    USMLE® is a joint program of the Federation of State Medical Boards (FSMB) and the National Board of Medical Examiners (NBME), which neither sponsor nor endorse this product. This publication is designed to provide accurate information in regard to the subject matter covered as of its publication date, with the understanding that knowledge and best practice constantly evolve. The publisher is not engaged in rendering medical, legal, accounting, or other professional service. If medical or legal advice or other expert assistance is required, the services of a competent professional should be sought. This publication is not intended for use in clinical practice or the delivery of medi- cal care. To the fullest extent of the law, neither the Publisher nor the Editors assume any liability for any injury and/or damage to persons or property arising out of or related to any use of the material contained in this book. © 2021 by Kaplan, Inc. Published by Kaplan Medical, a division of Kaplan, Inc. 750 Third Avenue New York, NY 10017 10 9 8 7 6 5 4 3 2 1 All rights reserved. The text of this publication, or any part thereof, may not be reproduced in any manner whatsoever without written permission from the publisher. Course ISBN: 978-1-5062-5950-5 Course Kit ISBN: 978-1-5062-5957-4 Retail ISBN: 978-1-5062-5935-2 Retail Kit ISBN: 978-1-5062-5934-5 Kit items come as a set and should not be broken out and sold separately. Kaplan Publishing print books are available at special quantity discounts to use for sales promotions, employee premiums, or educational purposes. For more information or to purchase books, please call the Simon & Schuster special sales department at 866-506-1949. KP00372_USMLE_Anatomy.indb 2 8/22/20 1:36 PM

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    Editors James White, PhD Assistant Professor of Cell Biology School of Osteopathic Medicine Rowan University Stratford, NJ Adjunct Assistant Professor of Cell and Developmental Biology University of Pennsylvania School of Medicine Philadelphia, PA David Seiden, PhD Professor of Neuroscience and Cell Biology Rutgers–Robert Wood Johnson Medical School Piscataway, NJ KP00372_USMLE_Anatomy.indb 3 8/22/20 1:36 PM

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    We want to hear what you think. What do you like or not like about the Notes? Please email us at medfeedback@kaplan.com . KP00372_USMLE_Anatomy.indb 4 8/22/20 1:36 PM

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    v Table of Contents Part I: Early Embryology and Histology: Epithelia Chapter 1: Gonad Development 3 Chapter 2: First 8 Weeks of Development 7 Chapter 3: Histology: Epithelia 13 Part II: Gross Anatomy Chapter 1: Back and Autonomic Nervous System 21 Chapter 2: Thorax 35 Chapter 3: Abdomen, Pelvis, and Perineum 85 Chapter 4: Upper Limb 179 Chapter 5: Lower Limb 195 Chapter 6: Head and Neck 207 Part III: Neuroscience Chapter 1: Nervous System Organization and Development 225 Chapter 2: Histology of the Nervous System 235 Chapter 3: Ventricular System 245 Chapter 4: The Spinal Cord 251 Chapter 5: The Brain Stem 275 Chapter 6: The Cerebellum 309 Chapter 7: Basal Ganglia 317 KP00372_USMLE_Anatomy.indb 5 8/22/20 1:36 PM

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    vi Chapter 8: Visual Pathways 325 Chapter 9: Diencephalon 335 Chapter 10: Cerebral Cortex 341 Chapter 11: Limbic System 359 Index 365 Additional resources available at kaptest.com/usmlebookresources KP00372_USMLE_Anatomy.indb 6 8/22/20 1:36 PM

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    PART I Early Embryology and Histology: Epithelia KP00372_USMLE_Anatomy.indb 1 8/22/20 1:36 PM

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    KP00372_USMLE_Anatomy.indb 2 8/22/20 1:36 PM

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    3 Learning Objectives ❏ Explain information related to indifferent gonad ❏ Interpret scenarios on testis and ovary ❏ Answer questions about meiosis ❏ Interpret scenarios on spermatogenesis ❏ Solve problems concerning oogenesis GONAD DEVELOPMENT Although sex is determined at fertilization, the gonads initially go through an indifferent stage weeks 4–7 when there are no specific ovarian or tes- ticular characteristics. The indifferent gonads develop in a longitudinal elevation or ridge of intermediate mesoderm called the urogenital ridge . The components of the indifferent gonads are as follows: • Primordial germ cells provide a critical inductive influence on gonad development, migrating in at week 4. They arise from the lining cells in the wall of the yolk sac. • Primary sex cords are finger-like extensions of the surface epithe- lium which grow into the gonad that are populated by the migrat- ing primordial germ cells. • Mesonephric (Wolffian) and the paramesonephric (Mullerian) ducts of the indifferent gonad contribute to the male and female genital tracts, respectively. The indifferent gonads develop into either the testis or ovary . Development of the testis and male reproductive system is directed by the following: • Sry gene on the short arm of the Y chromosome , which encodes for testis-determining factor (TDF) • Testosterone, which is secreted by the Leydig cells • Müllerian-inhibiting factor (MIF), which is secreted by the Sertoli cells • Dihydrotestosterone (DHT): external genitalia Development of the ovary and female reproductive system requires estro- gen. Ovarian development occurs in the absence of the Sry gene and in the presence of the WNT4 gene. Gonad Development 1 KP00372_USMLE_Anatomy.indb 3 8/22/20 1:36 PM

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    4 Part I l Early Embryology and Histology: Epithelia Anatomy Pharmacology Physiology Pathology Microbiology Immunology Biochemistry Medical Genetics Behavioral Science/Social Sciences Urogenital ridge Yolk sac Primordial germ cells Mesonephric duct (Wolffian) Paramesonephric duct (Müllerian) Indifferent gonad TDF Testosterone MIF No factors Testis and male genital system Ovary and female genital system Figure I-1-1. Development of Testis and Ovary MIF: Müllerian-inhibiting factor TDF: testis-determining factor Figure I-1-1. Development of Testis and Ovary GAMETOGENESIS Meiosis Meiosis, occurring within the testis and ovary, is a specialized process of cell division that produces the male gamete (spermatogenesis) and female gamete (oogenesis) . There are notable differences between spermatogenesis and oogenesis. Two cell divisions take place in meiosis. In meiosis I , the following events occur: • Synapsis: pairing of 46 homologous chromosomes • Crossing over: exchange of segments of DNA • Disjunction: separation of 46 homologous chromosome pairs (no centromere-splitting) into 2 daughter cells, each containing 23 chromosome pairs In meiosis II, synapsis does not occur, nor does crossing over. Disjunction does occur with centromere-splitting. MIF: Müllerian-inhibiting factor TDF: testis-determining factor KP00372_USMLE_Anatomy.indb 4 8/22/20 1:36 PM

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