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USMLE® Step 1 questions

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USMLE® Step 1 style questions USMLE

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A 60-year-old man is admitted to the hospital for an elective cholecystectomy secondary to symptomatic cholethiasis. The diseased organ/structure in this patient originated from which of the following embryological layers?  

External References

First Aid









branchial pouch derivation p. 643

derivatives of p. 637

Endodermal tubules p. 684

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The endoderm is the innermost germ layer, which makes it easy to remember the body parts it gives rise to: stuff inside our bodies, specifically, spaces and cavitations like the gut tube and body cavities that house our internal organs.

Endoderm also forms things like the lining of the ear canals, the trachea and respiratory tract, and parts of the bladder and urethra.

During week 4 of development, the embryo folds in two directions.

In the longitudinal plane, the embryo folds slightly at the cranial and caudal ends, so it looks less like a pancake and more like a little shrimp.

This is the very beginning of its curling into the fetal position.

This folding shapes part of the yolk sac into a gut tube, with the remainder of the yolk sac remaining connected not at the cranial or caudal end, but just in the middle.

Now let’s switch to the transverse plane, looking at a spot near the middle of our embryo where you can see the yolk sac.

In the transverse plane, the lateral plate mesoderm splits into a dorsal layer called the parietal (or somatic) mesoderm layer, and a ventral layer called the visceral (or splanchnic) mesoderm layer.

The parietal layer of mesoderm follows the ectoderm and forms the chest wall and abdominal body wall of the embryo.

The visceral layer of mesoderm follows the endoderm and forms the gut tube.

More specifically, the endoderm becomes the epithelial cell lining of the gastrointestinal tract while the visceral layer of mesoderm becomes the muscular wall.


Endoderm refers to the innermost layer of cells in a developing embryo. It gives rise to the lining of the gastrointestinal tract, the liver, pancreas, and gallbladder. It also gives rise to the respiratory tract, the thyroid and parathyroid glands, and the lining of the bladder and urethra.


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