Past exam of the medicine course of the University of Oxford / 1865 / First examination / Anatomy and physiology / 8 / Solution

The amnion, allantois and yolk sac are distinct extraembryonic structures whose relations change as the embryo folds and the umbilical cord forms. The historical umbilical vesicle is the yolk sac; its duct must not be identified with the allantoic channel.

Early in development the embryonic disc lies between the amniotic cavity dorsally and the yolk sac ventrally. The amnion has an epithelial lining facing its fluid and an outer supporting mesodermal component. The yolk sac has an endodermal lining and an external splanchnic mesodermal covering. Outside them is the chorionic cavity, interrupted by the connecting stalk linking the embryonic region to the chorion. The chorion consists of trophoblastic tissues and extraembryonic somatic mesoderm; it is not simply another name for the amnion or an outgrowth of yolk-sac endoderm.

The human allantois appears as a small endodermal diverticulum from the caudal yolk-sac region and extends into the connecting stalk. With incorporation of the caudal region into the embryo it becomes related to the cloaca and developing urinary bladder. Its intraembryonic remnant is associated with the urachus, later represented by the median umbilical ligament. Unlike the large allantoic sac of a bird, the human allantois is not an expanding external urine reservoir or an independent aerial respiratory organ.^[ref]

Embryonic folding converts part of the original endodermal roof of the yolk sac into the gut tube. The remaining sac lies outside the embryo and communicates with the midgut through the narrowing vitelline duct. Vitelline vessels accompany its early vascular apparatus. The sac supports early nutritional and blood-forming functions even though it contains no large yolk store in humans. Its connection normally regresses; persistence of a vitelline duct is a different anomaly from persistence of the urachus. The presence of a duct alone does not make the two structures interchangeable.^[ref]

As the amnion expands, it surrounds the embryo more completely and encloses the roots of the connecting stalk and yolk-sac connection at the umbilical region. Those structures are brought together within an amniotic covering to form the early umbilical cord. The cord initially includes the stalk with allantoic remnants and developing umbilical vessels, together with the vitelline connection and associated structures. The mature cord chiefly contains two umbilical arteries and one umbilical vein embedded in Wharton's jelly, beneath an amniotic surface. The vessels arise within vascular mesodermal tissues; it would be inaccurate to say that the endodermal allantoic tube simply turns into all three blood vessels.

The amnion subsequently comes into apposition and fuses with the chorion, greatly reducing the intervening chorionic cavity. Its surface continues along the cord towards the fetal placental surface. The yolk sac remains outside the amniotic cavity rather than becoming a normal free object floating in amniotic fluid. The mature amnion is avascular, whereas the placental chorion and the cord have crucial fetal vascular connections.^[ref]

These relations can be understood by comparing developmental stages in section: first a disc between two cavities, then a folded embryo with narrowed ventral connections, and finally an expanded amniotic covering around the cord. A section through a later cord cannot by itself reveal every early channel that has regressed. The same membrane names are used across vertebrates, but their relative sizes and functions are not identical in a human fetus and a yolk-rich bird egg.