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GASTRO > 3: Development of Gut / Salivation and Swallowing > Flashcards

3: Development of Gut / Salivation and Swallowing Flashcards

1
Q

What does the folding in week 4 and 5 create? (3 things)

A
  1. Primitive Gut
  2. Abdominal Wall
  3. Coleomic Cavity
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2
Q

What does the lateral folding do?

A

Makes primitive gut become tubular

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3
Q

What are the 3 regions of the primitive gut?

A
  1. Foregut
  2. Midgut
  3. Hindut
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4
Q

What surrounds the gut?

A

Mesoderm

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5
Q

What does the mesoderm split into?

A
  1. Somatic MEsoderm
  2. Splanchninc Mesoderm
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6
Q

What does the somatic mesoderm develop into?

A

Muscle and fasciae of abdominal wall

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7
Q

What does the splanchnic mesoderm develop into?

A

SM of gut wall

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8
Q

What is the space created by the mesoderm split caled?

A

Coleomic cavity (intraembryonic cavity)

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9
Q

What is the coleomic cavity the forerunner of?

A

Pleural and peritoneal cavities

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10
Q

What does the coleomic cavity surround?

A

Gut cavity

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11
Q

What does the rotation of the mid-gut loop establish?

A

Disposition of abdominal viscera (internal organs)

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12
Q

What does the first rotation of the midgut loop do?

A

Lengthens small and large intestines

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13
Q

What does the second rotation of the midgut loop do? (2 things)

A
  1. Puts small and large intestines in position
  2. Gives mesentry of small intestine its twisted appearance
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14
Q

When and where does the hindgut end?

A

At cloaca

Week 6

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15
Q

What happens after the hindgut ends at the cloaca?

A

Cloaca undergoes anteroposterior division

Wedge of mesoderm fold (urorectal fold) grows down and splits cloaca:

  1. Anteriorly: Urogenital Sinus + Urethra
  2. Posteriorly: Anorectal Canal
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16
Q

Where is the superior part of the anal canal derived from?

A

Hindgut

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17
Q

Where is the inferior part of the anal canal derived from?

A

Endoderm

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18
Q

Where do the superior and inferior parts of the anal canal meet?

A

Pectinate line

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19
Q

What is the Vitelline Duct?

A

Tube that connects yolk sac to midgut lumen

Supposed to obliterate but can persist → causes problems

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20
Q

What are the problems that occur if the Vitelline Duct persists? (3 things)

A
  1. Meckel’s Divericulum
  2. Vitelline Cyst
  3. Vitelline Fistula
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21
Q

What is Meckel’s Diverticulum? (3 points)

A
  1. Vitelline duct bulges out from small intestine
  2. Contains ectopic gastric / pancreatic tissue
  3. Ectopic tissue secrets enzymes and acids into tissue → ulceration
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22
Q

What is Vitelline Cyst?

A

Duct forms fibrous strand (of ligaments) on either end

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23
Q

What is Vitelline Fistula?

A

Direct communication between umbilicus and intestinal tract → faecal matter comes out of umbilicus (belly button)

FFFFFistula iffffeeeee khara leaking out

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24
Q

What happens to the primitive gut if cell growth of some structures is so rapid?

A

Lumen of primitive gut is obliterated

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25
Q

What restores the obliteration of the primitive gut lumen?

A

Recanalisation

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26
Q

What is recanalisation?

A

Restoration of the lumen of the primitive gut

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27
Q

What occurs if recanalisation of the primitive gut lumen is unsuccesful? (2 things)

A
  1. Aterisa: complete loss of lumen
  2. Stenosis: narrowing of lumen
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28
Q

What is pyloric stenosis?

A

Narrowing of the exit of the stomach

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29
Q

What is pyloric stenosis caused by?

A

Hypertrophy of circular muscle in pyloric sphincter region

30
Q

What are some abdominal wall defects? (2 things)

A
  1. Gastroschisis
  2. Omphalacoele
31
Q

What is Gastroschisis?

A

Failure to close abdominal wall at embryo folding

→ Gut tube and its derivatives outside body

32
Q

What is Omphalacoele?

A

Part of the gut remains outside of abdominal cavity through the belly button

But still covered by thin amnion layer

33
Q

What are some hindgut abnormalities? (3 things)

A
  1. Imperforate Anus (D)
  2. Anal / Anorectal Agenesis (B)
  3. Hindgut Fistulae (A)
34
Q

Wha is Imperforate Anus?

A

Failure of anal membrane to rupture

D in picture

35
Q

What is Anal / Anorectal Agenesis?

A

No development of anus / rectum

B in picture

36
Q

What is Hindgut Fistulae?

A

Abnormal connection within the hindgut

A in picture

37
Q

What are the functions of saliva? (3 things)

A
  1. Lubricates + wets food
  2. Starts digestion of carbs (amylase)
  3. Protects oral environment
38
Q

What type of gland are salivary glands?

A

Ducted exocrine glands

39
Q

What are the salivary exocrine glands made up of?

A
  1. Acini (lined with acinar cells)

connected via:

  1. Duct cells
40
Q

What are the 3 pairs of salivary glands?

A
  1. Parotid glands (25%)
  2. Sublingual glands (5%)
  3. Submaxilary glands (70%
41
Q

What is the saliva of the Parotid glands like?

A

Serous saliva

Water secretion:

  • Lots of enzymes
  • Little mucus

Subway is a green logo so beh mucus, but parrot’s don’t have bogies

42
Q

What is the saliva of the Sublingual glands like?

A

Mucus saliva

Viscous secretion:

  • No enzymes
  • Lots of mucus

Subway is a green logo so beh mucus, but parrot’s don’t have bogies

43
Q

What is the saliva of the Submaxillary glands like?

A

Mixed serous and mucus saliva

Serous + mucus acini

Best of both worlds living life to da MAX

44
Q

What is the chemical property of saliva?

A

Hypotonic

45
Q

What is the general serous saliva secretion mechanism?

A
  1. Acinar cells secrete isotonic fluid with enzymes
  2. Duct cells then remove Na+ and Cl-, and add HCO3-
46
Q

What is the in-depth serous salivary secretion mechanism?

A
  1. Acinar cells actively secrete Cl- into duct lumen
    * Water + Na+ follow
  2. Na/K-ATPase Antiporter lowers Na+ concentration inside Duct Cell
  3. This causes Na+ to diffuse from Duct Lumen → Duct Cell
  4. Na/K-ATPase Antiporter increases K+ concentration inside Duct Cell
  5. This causes Cl- to be expelled via K/Cl-Symporter
    * This lowers Cl- concentration in Duct Cell
  6. This causes Cl- to diffuse from Duct Lumen → Duct Cell via Cl/HCO3-Antiporter
  7. HCO3- goes other way via Cl/HCO3-Antiporter
47
Q

What nervous system controls salivary secretion?

A

Autonomic (PS NS & SNS)

48
Q

What does the Parasympathetic NS do in salivary secretion? (2 things)

A
  1. Increases Primary secretion (acinar cells)
  2. Increases HCO3- secretion (duct cells)
49
Q

Which nerves supply parasympathetic innervation to the Parotid gland (for salivation)? (2 things)

A
  1. Glossopharyngeal N. (CN 9)
  2. Otic ganglion
50
Q

What does the Sympathetic NS do to salivary secretion?

A

Reduces blood flow to glands → reduces salivary flow → dry mouth

51
Q

What nerves supply sympathetic innervation to the Parotid gland? (1 thing)

A

Superior Cervical Ganglion

52
Q

Where does the oesophagus extend from and to?

A

Pharynx → Stomach

53
Q

What are the 3 layers of the oesophagus?

A
  1. Mucosa
  2. Submucosa
  3. Muscularis Externae
54
Q

What is the layers of the oesophagus mucosa? (3 things)

A
  1. Non-Keratinised Stratified Squamous
  2. Lamina Propria
  3. Muscularis Mucosa (MM)
55
Q

What can be foud in the Submucosa of the oesophagus?

A

Mucus secreting glands

56
Q

What is the difference between the upper and lower oesphogeal Muscularis Externae?

A

In upper 1/3 of oesophagus, the ME is:

  • Striated (skeletal) muscle →for conscious swallowing
  • Somatic (voluntary) control

In lower 2/3 of oesophagus, the ME is:

  • Smooth muscle under autonomic control (peristalsis)
  • PNS control
57
Q

What are the 3 phases of swallowing?

A
  1. Voluntary Phase
  2. Pharyngeal Phase
  3. Oesophageal Phase
58
Q

What happens in the Voluntary Phase of swallowing?

A

Tongue moves bolus back onto the pharynx

59
Q

What happens in the Pharyngeal Phase of swallowing?

A

Afferent information from pressure receptors in Palate & Anterior Pharynx → Swallowing Centre in Brainstem → triggers set of movements

60
Q

What set of movements are triggered by the Swallowing Centre in Brainstem? (4 things)

A
  1. Breathing inhibition
  2. Raising of larynx
  3. Glottis closure
  4. Upper oesophageal “sphincter” opens
61
Q

What happens in the Oesophageal Phase of swallowing? (2 things)

A
  1. Peristalsis propels bolus into stomach
    * Coordinated by extrinsic nerves from Swallowing Centre in Brainstem
  2. Lower Oesophageal “sphincter” opens
62
Q

What are some swallowing disorders? (2 things)

A
  1. Dysphagia (difficulty swallowing)
  2. Odynophagia (pain when swallowing)
63
Q

What are the causes of Dysphagia? (2 things)

A
  1. Primary oesophageal disorder
    * e.g motility problems of smooth muscle → NO peristalsis (achalasia)
  2. Secondary oesophageal disorder
    * e.g obstruction / compression of oesophagus because tumour
64
Q

What are the 2 types of Dysphagia?

A
  1. Oesophageal Dysphagia (for solids)
  2. Oropharyngeal Dysphagia (for liquids)
65
Q

How do you investigate Oesophageal dysphagia?

A

With barium swallow / endoscopy

66
Q

How do you investigate Oropharyngeal dysphagia?

A

With flexible endoscopy evaluation of swallowing

67
Q

How is gastro-oesophageal reflux prevented by the body? (3 things)

A
  1. Lower oesophageal “sphincter” (one way valve)
    * Stops stomach contents refluxing into oesophagus
  2. Angle of His (at same point of “sphincter”)
  3. Crus of diaphragm (helps with sphincter activation)
68
Q

What are the consequences of gastro-oesophageal reflux?

A

Barret’s oesophagus

  • Abnormal changes of epithelial cells of oesophagus
  • Non K Stratified Squam – Metaphasia →Columnar / Goblet Cells
69
Q

What is Barrets oesophagus associated with?

A

Adenocarcinoma

70
Q

What are the symptoms of Gastro-oesophageal reflux disease? (3 things)

A
  1. Cough
  2. Hoarseness
  3. Asthma

GASTRO (10 decks)

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