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I. Embryology
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10. The Yolk-sac
The yolk-sac (Figs. 22 and 23) is situated on the ventral aspect of the embryo; it is lined by entoderm, outside of which is a layer of mesoderm. It is filled with fluid, the vitelline fluid, which possibly may be utilized for the nourishment of the embryo during the earlier stages of its existence. Blood is conveyed to the wall of the sac by the primitive aortæ, and after circulating through a wide-meshed capillary plexus, is returned by the vitelline veins to the tubular heart of the embryo. This constitutes the vitelline circulation, and by means of it nutritive material is absorbed from the yolk-sac and conveyed to the embryo. At the end of the fourth week the yolk-sac presents the appearance of a small pear-shaped vesicle (umbilical vesicle) opening into the digestive tube by a long narrow tube, the vitelline duct. The vesicle can be seen in the after-birth as a small, somewhat oval-shaped body whose diameter varies from 1 mm. to 5 mm.; it is situated between the amnion and the chorion and may lie on or at a varying distance from the placenta. As a rule the duct undergoes complete obliteration during the seventh week, but in about three per cent. of cases its proximal part persists as a diverticulum from the small intestine, Meckel’s diverticulum, which is situated about three or four feet above the ileocolic junction, and may be attached by a fibrous cord to the abdominal wall at the umbilicus. Sometimes a narrowing of the lumen of the ileum is seen opposite the site of attachment of the duct.   1


FIG. 22– Human embryo of 2.6 mm. (His.) (See enlarged image)
 


FIG. 23– Human embryo from thirty-one to thirty-four days. (His.) (See enlarged image)
 


 

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The United States Medical Licensing Examination (USMLE) is a three-step examination for medical licensure in the United States. The Federation of State Medical Boards (FSMB) and the National Board of Medical Examiners (NBME) sponsors USMLE.
The Three Steps of the USMLE
Step 1 tests the important concepts of basic sciences basic to the practice of medicine. It also places special emphasis on principles and mechanisms underlying health, disease, and modes of therapy. Step 1 ensures mastery of the sciences that provide a foundation for the safe and competent practice of medicine. It also tests the scientific principles required for maintenance of competence through lifelong learning.
Step 2 CK tests the medical knowledge, skills, and understanding of clinical science essential for the provision of patient care under supervision. It also includes emphasis on health promotion and disease prevention. Step 2 CK ensures that due attention is devoted to principles of clinical sciences and basic patient-centered skills.
Step 2 CS tests your capacity to practice and provide good medical service in real-life situations. It also tests your communication skills.
Step 3 tests your medical knowledge and understanding of biomedical and clinical science essential for the unsupervised practice of medicine. Step 3 provides a final assessment of physicians assuming independent responsibility for delivering general medical care.