Genetics of scapula and pelvis development: An evolutionary perspective

In tetrapods, the scapular and pelvic girdles perform the important function of anchoring the limbs to the trunk of the body and facilitating the movement of each appendage. This shared function, however, is one of relatively few similarities between the scapula and pelvis, which have significantly different morphologies, evolutionary histories, embryonic origins, and underlying genetic pathways. The scapula evolved in jawless fish prior to the pelvis, and its embryonic development is unique among bones in that it is derived from multiple progenitor cell populations, including the dermomyotome, somatopleure, and neural crest. Conversely, the pelvis evolved several million years later in jawed fish, and it develops from an embryonic somatopleuric cell population. The genetic networks controlling the formation of the pelvis and scapula also share similarities and differences, with a number of genes shaping only one or the other, while other gene products such as PBX transcription factors act as hierarchical developmental regulators of both girdle structures. Here, we provide a detailed review of the cellular processes and genetic networks underlying pelvis and scapula formation in tetrapods, while also highlighting unanswered questions about girdle evolution and development.

Regulation of scapula development

The scapula is a component of the shoulder girdle. Its structure has changed greatly during evolution. For example, in humans it is a large quite flat triangular bone whereas in chicks it is a long blade like structure. In this review we describe the mechanisms that control the formation of the scapula. To assimilate our understanding regarding the development of the scapula blade we start by addressing the issue concerning the origin of the scapula. Experiments using somite extirpation, chick-quail cell marking system and genetic cell labelling techniques in a variety of species have suggested that the scapula had its origin in the somites. For example we have shown in the chick that the scapula blade originates from the somite, while the cranial part, which articulates with the upper limb, is derived from the somatopleure of the forelimb field. In the second and third part of the review we discuss the compartmental origin of this bone and the signalling molecules that control the scapula development. It is very interesting that the scapula blade originates from the dorsal compartment, dermomyotome, which has been previously been associated as a source of muscle and dermis, but not of cartilage. Thus, the development of the scapula blade can be considered a case of dermomyotomal chondrogenesis. Our results show that the dermomyotomal chondrogenesis differ from the sclerotomal chondrogenesis. Firstly, the scapula precursors are located in the hypaxial domain of the dermomyotome, from which the hypaxial muscles are derived. The fate of the scapula precursors, like the hypaxial muscle, is controlled by ectoderm-derived signals and BMPs from the lateral plate mesoderm. Ectoderm ablation and inhibition of BMP activity interfers the scapula-specific Pax1 expression and scapula blade formation. However, only somite cells in the cervicothoracic transition region appear to be committed to form scapula. This indicates that the intrinsic segment specific information determines the scapula forming competence of the somite cells. Taken together, we conclude that the scapula forming cells located within the hypaxial somitic domain require BMP signals derived from the somatopleure and as yet unidentified signals from ectoderm for activation of their coded intrinsic segment specific chondrogenic programme. In the last part we discuss the new data that provides evidence that neural crest contributes for the development of the scapula.

Multiple roles of mesenchymal beta-catenin during murine limb patterning

Recently canonical Wnt signaling in the ectoderm has been shown to be required for maintenance of the apical ectodermal ridge (AER) and for dorsoventral signaling. Using conditional gain- and loss-of-function beta-catenin alleles, we have studied the role of mesenchymal beta-catenin activity during limb development. Here, we show that loss of beta-catenin results in limb truncations due to a defect in AER maintenance. Stabilization of beta-catenin also results in truncated limbs, caused by a premature regression of the AER. Concomitantly, in these limbs, the expression of Bmp2, Bmp4 and Bmp7, and of the Bmp target genes Msx1, Msx2 and gremlin, is expanded in the mesenchyme. Furthermore, we found that the expression of Lmx1b, a gene exclusively expressed in the dorsal limb mesenchyme and involved in dorsoventral patterning, is reduced upon loss of beta-catenin activity and is expanded ventrally in gain-of-function limbs. However, the known ectodermal regulators Wnt7a and engrailed 1 are expressed normally. This suggests that Lmx1b is also regulated, in part, by a beta-catenin-mediated Wnt signal, independent of the non-canoncial Wnt7a signaling pathway. In addition, loss of beta-catenin results in a severe agenesis of the scapula. Concurrently, the expression of two genes, Pax1 and Emx2, which have been implicated in scapula development, is lost in beta-catenin loss-of-function limbs; however, only Emx2 is upregulated in gain-of-function limbs. Mesenchymal beta-catenin activity is therefore required for AER maintenance, and for normal expression of Lmx1b and Emx2.

The formation of the avian scapula blade takes place in the hypaxial domain of the somites and requires somatopleure-derived BMP signals

The avian scapula is a long bone located dorsally on the thorax. The cranial part that articulates with the upper limb is derived from the somatopleure of the forelimb field, while the caudal part, the scapula blade, originates from the dermomyotomes of brachial and thoracic somites. In previous studies, we have shown that scapula blade formation is intrinsically controlled by segment-specific information as well as extrinsically by ectoderm-derived signals. Here, we addressed the role of signals derived from the lateral plate mesoderm on scapula development. Chick-quail chimera experiments revealed that scapula precursor cells are located within the hypaxial domain of the dermomyotome adjacent to somatopleural cells. Barrier implantation between these two cell populations inhibited scapula blade formation. Furthermore, we identified BMPs as scapula-inducing signals from the somatopleure using injection of Noggin-producing cells into the hypaxial domain of scapula-forming dermomyotomes. We found that inhibition of BMP activity interfered with scapula-specific Pax1 expression and scapula blade formation. Taken together, we demonstrate that the scapula-forming cells located within the hypaxial somitic domain require BMP signals derived from the somatopleure for their specification and differentiation.

Arthroscopic study of the shoulder joint in fetuses

PURPOSE

The purpose of this study was to macroscopically examine the fetal shoulder joint using arthroscopy. We attempted to identify and describe the specific characteristics of the fetal shoulder joint, how it evolves during the last few weeks of intrauterine development, and any possible variations with regard to the adult shoulder.

TYPE OF STUDY

Observational anatomic case series.

METHODS

We used 20 frozen fetuses with a gestational age of 24 to 40 +/- 2 weeks, obtained from spontaneous abortions. Examination was performed with standard arthroscopic surgical equipment, using a 2.7-mm optical lens. Whenever possible, we tried to use the standard arthroscopic portals. Images were obtained for comparison with the adult shoulder.

RESULTS

The arthroscopic images of the fetal glenohumeral joint are similar to those of an adult shoulder, with the only differences being those related to the stage of development. In this study we observed no so-called bare spot in the glenoid cavity such as has been described in treatises on the adult shoulder joint. The arthroscopic images of the anterosuperior region of the fetal joint show more highly defined structures than in the adult shoulder, especially the coracohumeral and glenohumeral ligaments.

CONCLUSIONS

To our knowledge, this is the first arthroscopic study to target the fetal shoulder joint. The results indicate minimal differences when compared with the adult shoulder joint; for some structures, particularly in the anterosuperior region, the anatomy observed was easier to discern than what is observed in adult shoulder arthroscopy.

CLINICAL RELEVANCE

Our study obtained clear images of virgin shoulder joints that had never been subjected to deterioration from wear or other distorting forces. The clarity of these images is useful for locating and identifying structures in the adult shoulder.

The role of Emx2 during scapula formation

The scapula is subdivided into head, collum, and blade. Due to the expression pattern of Emx2 and the absence of the scapula blade in Emx2 knockout mice, it has been suggested that Emx2 is involved in the formation of the scapula. Micromanipulation experiments revealed that ectoderm ablation over the somites does not affect Emx2 expression but inhibits the formation of the scapula blade indicating that Emx2 is not sufficient to induce scapula blade formation. Furthermore, we show that the formation of the scapula head is dependent, scapula blade formation independent of FGFR-1-mediated signaling. Overexpression of Emx2 does not influence scapula blade formation but leads to the development of an additional posterior digit in the anterior border of the limb. Taken together, the data presented implicate that Emx2 expression is necessary but not sufficient for the development of the scapula blade. It is not a marker for scapula development but rather provides positional information along the proximodistal and anterior-posterior limb axes, whereas the specificity of the developing skeletal elements is determined by the concerted interaction of Emx2 with other factors.

Intrinsic cartilage-forming potential of dermomyotomal cells requires ectodermal signals for the development of the scapula blade

The avian scapula has a dual origin. The cranial part derives from the somatopleure of the forelimb field, while the caudal part, the scapula blade, originates from the dermomyotomes of the cervicothoracic transition zone. Thus, these dermomyotomes have, in addition to the well-known myogenic, angiogenic, and dermogenic potential, the ability to form cartilage. The scapula blade is therefore a derivative of dermomyotomal chondrogenesis. Although the mechanisms that direct the sclerotomal chondrogenesis are beginning to be understood, little is known about dermomyotomal chondrogenesis. Here, we address the mechanisms that control dermomyotomal cells to become chondrocytes. After heterotopic transplantation of dorsal epithelial somite halves from the scapula-forming level to the cervical level, the grafted tissue retains the capability to form cartilage, indicating that the dermomyotomal chondrogenic potential must be specified during anterior-to-posterior regionalization of the paraxial mesoderm. Furthermore, we show that signals from the ectoderm are required, allowing dermomyotome cells to express markers associated with the chondrogenic lineage.

Carboxypeptidase Z (CPZ) modulates Wnt signaling and regulates the development of skeletal elements in the chicken

Carboxypeptidase Z (CPZ) is a secreted Zn-dependent enzyme whose biological function is largely unknown. CPZ has a bipartite structure consisting of an N-terminal cysteine-rich domain (CRD) and a C-terminal catalytic domain. In the early chicken embryo CPZ is initially expressed throughout the somites and subsequently becomes restricted to the sclerotome. To initiate a functional analysis of CPZ, a CPZ producing retroviral vector was applied to the presomitic mesoderm at the level of the future wing. This resulted in a loss of the scapular blade and of rostral ribs. Such dysmorphogenesis is preceded by ectopic Pax3 expression in the hypaxial part of the dermomyotome, a region from which the blade of the scapula normally derives. A mutant CPZ, lacking a critical active site glutamate, fails to induce Pax3 expression and does not cause skeletal defects. The induction of Pax3, a Wnt-responsive gene in somites, and the presence of a CRD prompted us to examine whether CPZ affects Wnt signaling. In an in vitro assay we found that CPZ, but not its inactive mutant form, enhances the Wnt-dependent induction of the homeobox gene Cdx1. In addition, immunoprecipitation experiments suggest that the CRD of CPZ acts as a binding domain for Wnt. Taken together these data provide the first evidence for CPZ playing a role in Wnt signaling.

Ontogenesis of the scapula in marsupial mammals, with special emphasis on perinatal stages of didelphids and remarks on the origin of the therian scapula

The development of the scapula was studied in embryonic and postnatal specimens of Monodelphis domestica and perinatal specimens of Philander opossum, Caluromys philander, and Sminthopsis virginiae using histological sections and 3D reconstructions. Additionally, macerated skeletons of postnatal M. domestica were examined. This study focused on the detachment of the scapulocoracoid from the sternum and on the acquisition of a supraspinous fossa, a supraspinatus muscle, and a scapular spine, all these events associated with the origin of the therian shoulder girdle. In none of the specimens is there a continuity of the cartilaginous scapulocoracoid with the sternum, even though the structures are in close proximity, especially in S. virginiae. At birth, the first rib laterally presents a pronounced boss that probably contacts the humerus during certain movements. Only the acromial portion of the scapular spine, which originates from the anterior margin of the scapular blade, is preformed in cartilage. The other portion is formed by appositional bone ("Zuwachsknochen"), which expands from the perichondral ossification of the scapula into an intermuscular aponeurosis between the supra- and infraspinous muscles. This intermuscular aponeurosis inserts more or less in the middle of the lateral surface of the developing scapula. Thus, the floor of the supraspinous fossa is present from the beginning of scapular development, simultaneously with the infraspinous fossa. The homology of the therian spine with the anterior border of the sauropsid and monotreme scapula is questioned. We consider the dorsal portion (as opposed to the ventral or acromial portion) of the scapular spine a neomorphic structure of therian mammals.

On the development of the shoulder girdle in Crocidura russula (Soricidae) and other placental mammals: evolutionary and functional aspects

The development of the shoulder girdle was studied in embryonic stages and a neonate of Crocidura russula using histological sections and 3-D reconstructions. Neonatal stages of Suncus etruscus and Mesocricetus auratus, both altricial placentals, were also studied. The earliest stage of C russula, in which the scapula is still partially blastematous, has already a supraspinous fossa. The dorsal portion of the scapular spine does not develop from the anterior margin of the scapula. Its mode of development varies among the placentals studied to date. In some it is completely appositional bone, in others it consists of bone formed mostly by endochondral ossification of a dorsal cartilaginous process stemming from the acromium. During development the supraspinatus muscle increases in size in proportion to the infraspinatus muscle and the humeral head increases in size in relation to the glenoid fossa. Placentals have secondary cartilage in the sternal and acromial ends of the clavicle, a derived feature absent in Marsupialia. Even the most altricial placentals have a more developed shoulder girdle at birth than any newborn marsupial studied to date.

Developmental morphological and histological studies on structures of the human fetal shoulder joint

In the present work, morphological changes in the interior structures of the developing human shoulder joint were studied at different prenatal ages (9, 12, 16, 23 and 40 weeks) and were compared with the same structures in the adult joint. It was found that the shoulder joint had gone through important developmental changes during the 12th week of the prenatal life and it is assumed that genetic factors operative during this stage of development were more important than mechanical factors. A subsequent development of the intracapsular glenohumeral ligaments was present at the 16th week. The glenoid labrum, the biceps tendon and the three glenohumeral ligaments formed a complete ring around the glenoid fossa which constituted a functional unit, which seemed to have a role in stabilizing the joint. In the present work, histological prenatal studies were done on sagittal and radial sections from the glenoid fossa and its associated structures and the results were compared with the same structures in adults. At a crown-rump length of 30 mm (9 weeks), intermingling of the collagen fibres of the superior labrum and the biceps tendon was observed and the superior labrum could be considered as an extension of the biceps tendon. While the superior and inferior parts of the labrum appeared fibrous, the posterior labrum appeared as a primitive cellular condensation. At the 12th week, it became a fibrocellular structure and changed to a fibrocartilaginous structure at the 16th week. But until full term, no definitive fibrocartilage was found due to its hypercellularity compared to the adult. It was found that at all ages, the capsule was formed of cellular and fibrous elements, its collagenous content was progressively increased with age and at full term, it became generally fibrous but was still different compared to adults. In all stages of development, the synovial tissue of different regions of the same joint exhibited marked variations in thickness, vascularity, cellular density and collagenous content. It lined the capsule, surrounded the biceps tendon and reflected on the labrum. Its cell density as well as their vascular and collagenous contents were progressively increased with age. At full term, the synovial tissue was thickest at its inferior reflection and forming large folds. The synovial tissue lining the capsule was thinner than the synovial tissue at its reflection from the labrum, many villi and processes arising from it and projecting into the joint cavity.

Dual origin and segmental organisation of the avian scapula

Bones of the postcranial skeleton of higher vertebrates originate from either somitic mesoderm or somatopleural layer of the lateral plate mesoderm. Controversy surrounds the origin of the scapula, a major component of the shoulder girdle, with both somitic and lateral plate origins being proposed. Abnormal scapular development has been described in the naturally occurring undulated series of mouse mutants, which has implicated Pax1 in the formation of this bone. Here we addressed the development of the scapula, firstly, by analysing the relationship between Pax1 expression and chondrogenesis and, secondly, by determining the developmental origin of the scapula using chick quail chimeric analysis. We show the following. (1) The scapula develops in a rostral-to-caudal direction and overt chondrification is preceded by an accumulation of Pax1-expressing cells. (2) The scapular head and neck are of lateral plate mesodermal origin. (3) In contrast, the scapular blade is composed of somitic cells. (4) Unlike the Pax1-positive cells of the vertebral column, which are of sclerotomal origin, the Pax1-positive cells of the scapular blade originate from the dermomyotome. (5) Finally, we show that cells of the scapular blade are organised into spatially restricted domains along its rostrocaudal axis in the same order as the somites from which they originated. Our results imply that the scapular blade is an ossifying muscular insertion rather than an original skeletal element, and that the scapular head and neck are homologous to the ‘true coracoid’ of higher vertebrates.

Distribution of cartilage molecules in the developing mouse joint

This study describes the precise spatial and temporal patterns of protein distribution for aggrecan, fibromodulin, cartilage oligomeric matrix protein (COMP) and cartilage matrix protein (CMP) in the developing mouse limb with particular attention to those cells destined to form articular chondrocytes in comparison to those cells destined to form a mineralized tissue and become replaced by bone. Mouse glenohumeral joints from fetal mice (12-18 days post coitus (dpc) to the young adult (37 days after birth) were immunostained with antibodies specific for these molecules. Aggrecan staining defined the general chondrocytic phenotype, whether articular or transient. Fibromodulin was associated with prechondrocytic mesenchymal cells in the interzone prior to joint cavitation and with the mesenchymal cells of the perichondrium or the periosteum encapsulating the joint elements of the maturing and young adult limb. Staining was most intense around developing articular chondrocytes and much less abundant or absent in those differentiating cells along the anlage. CMP showed an almost reciprocal staining pattern to fibromodulin and was not detected in the matrix surrounding articular chondrocytes. COMP was not detected in the cells at the articular surface prior to cavitation but by 18 dpc, as coordinated movement of the mouse forelimb intensifies, staining for COMP was most intense around the maturing articular chondrocytes. These results show that the cells that differentiate into articular chondrocytes elaborate an extracellular matrix distinct from those cells that are destined to form bone. Fibromodulin may function in the early genesis of articular cartilage and COMP may be associated with elaboration of a weight-bearing chondrocyte matrix.

[The etiology and pathogenesis of Sprengel's disease]

Basing on the analysis of clinico-radiological and functional signs, electromyographic and histological changes in the shoulder girdle (SG) upper extremities muscles, macro- and microscopic investigations of omovertebral formations in the patients with Sprengel disease, and the literature data there was formulated the scheme of etiology and pathogenesis of the inborn high position of shoulder blade. The leading role in the Sprengel disease etiology plays teratogenic exo- or endogenous harmful agent, affecting mesenchymal tissue in the moment of the vertebral column and SG inlay on the 4-5th week of embryogenesis. Underdevelopment and degeneration of the SG muscles, creation of fibrous, fibrous-cartilaginous and osteal tissues due to the embryogenesis disorder occurrence, are playing essential role in pathogenesis of anatomic-functional disorders, causing occurrence of the inborn high position of shoulder blade.

A comparative study of the expression patterns for vegf, vegf-b/vrf and vegf-c in the developing and adult mouse

With the goal of better understanding the function and regulation of the different members of the VEGF family this study reports mapping of vegf, vegf-b and vegf-c mRNA expression in developing and adult mice. On embryonic day 14 (E14) there is a high expression of vegf and vegf-b, vegf-b being exceptionally high in heart and CNS. The vegf-c expression is lower with distinct signals in CNS and heart. Prior to birth (E17), vegf and vegf-b expression is moderately downregulated. Overlapping expression is present in intrascapular fat and heart. vegf dominates in thyroid and lung, while vegf-b appears to be the only VEGF member expressed at detectable levels in the CNS. In young adult mouse vegf and vegf-b show partly overlapping expression patterns particularly in kidney, heart and in the thymus, vegf displays higher levels in lung and liver, vegf-b appears to be dominating in brain, heart, testis and kidney. In brain the highest levels of vegf-b is present in the hippocampus. No vegf-c mRNA expression could be detected in the adult. Taken together, these results illustrate, in detail, the different regulations of the members of the VEGF gene family. There are at present at least three specific effectors of vascular proliferation with clear differences in their expression.

[Studies on the development of fetus scapula]

Extract and measure the scapular every part from the fetus that was carried into Saga medical college, the data was processed statistically. Also, the morphological characteristic of scapula of the fetus was clarified by image processing that a computer is used. The result was as follows. A scapular morphological length and also height become big in proportion to the height of fetus. Index of height-length of a fetus was big compared with adult, this trend is remarkable especially in a early stage of development of a fetus. Spinal axis angle of a fetus was also bigger than that of adult and it remarkable differ from an anthropoid very small ane. In general, the scapular shape of a fetus was short length with wide-spreading side and this form resembles to scapula of Jomon period people. The width of cartilage part tend to decrease as ossification progress fast width-wise with growth. However, area of cartilage part tend to become big, because the growth of a cartilage part is going fast lengthwise.

Scapula length measurement for assessment of fetal growth and development

To determine the value of prenatal ultrasonographic scapula measurements for fetal growth and development as an adjunct to assessing in utero development, a prospective study of ultrasonography was conducted in 343 pregnant women with uneventful pregnancies with gestational ages from 16 to 41 weeks, and several biometric measurements were obtained. The relationships of scapula length with gestational age and with biparietal diameter, femur length, abdominal circumference and scapula length were examined. With the ultrasonographic examinations of 343 healthy pregnant women, a nomogram of scapula length measurements estimating gestational age and predicting the biparietal diameter, abdominal circumference, and femur length was generated. Linear relationships were found between the scapula length and the gestational age (R2 = 0.94, p < 0.0001), the biparietal diameter (R2 = 0.94, p < 0.0001), abdominal circumference (R2 = 0.94, p < 0.0001), and the femur length (R2 = 0.95, p < 0.0001). The rate of increase of scapula length was significantly higher before 28 weeks of gestation than in later pregnancy (p < 0.0001). The correlation coefficients between gestational age and scapula length were 0.95 before 28 weeks of gestation and 0.86 in later weeks. These results suggest that scapula length measurement is a valuable parameter for the assessment of fetal growth and development.

Expression and function of Pax 1 during development of the pectoral girdle

Pax 1 is a member of the paired-box containing gene family. Expression has previously been observed in the developing sclerotomes and later in the anlagen of the intervertebral discs. Analysis of Pax 1-deficient undulated mice revealed an important role for this gene in the development of the axial skeleton, in which Pax 1 apparently functions as a mediator of notochordal signals during sclerotome differentiation. Here we demonstrate that Pax 1 is also transiently expressed in the developing limb buds. A comparative phenotypic analysis of different undulated alleles shows that this expression is of functional significance. In mice that are mutant for the Pax 1 gene severe developmental abnormalities are found in the pectoral girdle. These include fusions of skeletal elements which would normally remain separate, and failures in the differentiation of blastemas into cartilaginous structures. Although Pax 1 is also expressed in the developing hindlimb buds and Wolffian ridge, no malformations could be detected in the corresponding regions of Pax 1 mutant mice. These findings show that, in addition to its role in the developing vertebral column, Pax 1 has an important function in the development of parts of the appendicular skeleton.

Fetal scapular length in the ultrasonographic assessment of gestational age

A prospective cross-sectional study of 515 singleton fetuses of ages between 15 and 42 weeks' gestation was performed. At gestational ages greater than 26 weeks, only fetuses with a sonographic estimated fetal weight between the 10th and 90th percentiles for growth were included. Scapular length (cm) as a function of gestational age (weeks) was expressed by the regression equation: SL = 0.3289 + 0.9553 (GA) with a Pearson correlation coefficient of R2 = 0.942. This study defines the normal limits of scapular length, demonstrates a high correlation between scapular length, gestational age, and other standard measurements of fetal growth, and indicates that scapular length can predict gestational age in fetuses with normal growth.

The effects of paralysis on skeletal development in the chick embryo. I. General effects

In order to investigate further the effects of paralysis on skeletal development in the chick embryo, paralysis was induced at 6 days of incubation by dropping 0.2% solution of decamethonium bromide onto the chorioallantoic membrane and maintaining paralysis through to 20 days of incubation. General effects of paralysis included lower body weight, marked subcutaneous oedema, twisting of the neck to the right with marked rigidity, and protrusion of the lower beak beyond the upper. Skeletal abnormalities included cartilaginous and later bony fusion between cervical vertebrae and distortion of scapula and pubis. Long bones were normal in their general form but showed marked reductions in full length and in length of the calcified diaphysis. The patella occasionally underwent chondrification, unlike the tibial cartilage at the tarsus. Reduction in length of the bones of both jaws occurred but was substantially greater in the upper, resulting in the protrusion of the lower. Ossification times of most skeletal elements were little affected by paralysis but some centres appearing nearer the end of incubation showed slight delay in their times of appearance.

The human vertebral column at the end of the embryonic period proper. 3. The thoracicolumbar region

The present study of the thoracicolumbar region continues an investigation of the vertebral column at 8 postovulartory weeks (the end of the embryonic period proper) by means of graphic reconstructions. The cartilaginous vertebrae have short neural processes associated with the normal spina bifida occulta present at this time. The separate cartilaginous centres that several authors believe to exist in the cervical and lumbar costal elements, but which have not been observed by the present authors, have been thought to be the forerunners of extrathoracic ribs. A distinction needs to be made, however, between such centres and ribs. Similarly, in the fetal period, ossific loci in the costal elements of CV 7 are very frequent, whereas cervical ribs in the adult are relatively rare. The neurocentral joints, and hence the boundaries between neural arches and centra, are unclear before ossification has begun and has progressed during the fetal period. The sternal bands are almost completely united and the scapula is high in position. Neural relationships aid in the determination of homologous parts within the vertebral column, but clarification of corresponding parts has not previously been possible within the embryonic period. Areas ventral to the dorsal rami are ribs in the thoracic region and costal elements in other regions. Areas underlying the dorsal rami are transverse processes in the thoracic region and minute 'true' transverse elements in the cervical and lumbar regions. Thus, the descriptive lumbar transverse processes correspond to the true transverse processes and the ribs in the thoracic region. The dorsal rami of the thoracic nerves pass between the transverse processes and the tubercles of the ribs and then divide. The ventral rami of lumbar Nerves 1 and 2 resemble the thoracic in their course, whereas those of Nerves 3-5 are similar to the sacral. The thoracic dorsal roots are sloping and, associated with the greater height of the lumbar centra, the lumbar roots even more so. The directions of the various dorsal roots reflect differences in growth gradients between vertebral column and spinal cord. The thoracic and lumbar portions of the column change little in proportion during the embryonic period proper.

Subclavian artery supply disruption sequence: hypothesis of a vascular etiology for Poland, Klippel-Feil, and Möbius anomalies

A hypothesis is presented to explain the pathogenesis of the Poland, Klippel-Feil, and Möbius anomalies, isolated absence of the pectoralis major with breast hypoplasia, isolated terminal transverse limb defects, and the Sprengel anomaly. We propose that these conditions are the result of an interruption of the early embryonic blood supply in the subclavian arteries, the vertebral arteries and/or their branches, and hypothesize that the occlusions occur at specific locations in these vessels during or around the sixth week of embryologic development and produce predictable patterns of defects. The term subclavian artery supply disruption sequence (SASDS) is suggested for the group of birth defects represented by the above conditions. Possible causes for interruption of embryonic blood supply are discussed.

Anterior capsular redundancy of the shoulder: congenital or traumatic? An embryological study

A study of the attachment of the joint capsule to the scapula, and of the shape of the humeral head, has been carried out in 52 fetal and embryonic shoulders. In 77% of cases the anterior capsule was attached to the labrum or close to it; in the remaining 23% it was inserted into the neck of the scapula, so creating a pouch. In all 52 specimens the humeral head was spherical. It was concluded that the pouched and redundant anterior capsule sometimes seen during surgery for recurrent dislocation of the shoulder, may not be traumatic in origin, but could be a developmental variant.

Anomalies of the scapula

This is a report of a case of double acromion and double coracoid and a commentary on the comparative anatomy and embryology of the shoulder. Congenital elevation of the scapula, ossification of the transverse scapular ligament, clasp-like superior border of the scapula, coracoclavicular joint, coracoclavicular bridge, coracosternale bone, os acromiale, elongated acromion, convex glenoid, hypoplasia of the inferior border of the glenoid, dentated glenoid, infrascapular bone, and notched inferior angle of the scapula are other anomalies of the scapula reported in the literature.