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GIGU > Dev. of GI > Flashcards

Dev. of GI Flashcards

1
Q

What does endoderm make up?

A
  • Mucosal epithelium and GI glands
  • Except the lower 1/3 of the anus
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2
Q

What does the splanchnic mesoderm make up?

A
  • Connective tissue
  • Vasculature
  • Smooth muscle wall
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3
Q

What does ectoderm make up?

A
  • Enteric ganglia nerves and glia via neural crest
  • Epithelium of lower 1/3 of anus
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4
Q

What are the deravitives of the foregut (6) and what supplies it?

A
  • Esophagus
  • Stomach
  • Liver
  • Gallbaldder
  • Pancreas
  • Upper duodenum

Celiac trunk

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5
Q

Midgut derivatives (7) and arterial supply?

A
  • Lower duodenum
  • Jejunum
  • Ileum
  • Cecum
  • Appendix
  • ascending colon
  • Proximal 2/3 transverse colon

SMA

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6
Q

Hindgut derivatives (5) and arterial supply?

A
  • Distal 1/3 transverse colon
  • descending colon
  • sigmoid colon
  • rectum
  • upper anal canal

IMA

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7
Q

What are the dorsal mesentery derivatives?

A
  • Greater omentum
    • gastrosplenic, gastrocolic, splenorenal ligaments
  • Small intestine mesentary
  • mesoappendix
  • Transverse mesocolon
  • Sigmoid mesocolon
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8
Q

Ventral mesentery derivatives?

A
  • Lesser omentum
    • Hepatoduodenal and hepatogastric ligaments
  • Falciform ligament of liver
  • Coronary ligament of liver
  • Triangular ligaments of liver

Lesser = Liver

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9
Q

What organs are retroperitoneal?

A

Suprarenal glands

Aorta

Duodenum (2nd and 3rd parts)

Pancreas

Ureters

Colon ascending and descending

Kindeys

Esophagus

Rectum

Sad Pucker

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10
Q

Describe how the stomach rotates in development?

A

The left side rotates ventrally and the right side dorsally

It will drag the dorsal mesentery to become greater omentum and ventral mesentery to lesser omentum

Vagus nerve: LARP - left anterior, right posterior

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11
Q

What is hypertrophic pyloric stenosis?

A

Faulty migration of neural crest cells, the ganglion cells of enteric nervous system are not properly populated.

  • The sphincter cannot properly relax and the pyloric lumen is narrow so food cannot pass
  • Presents with a palpable olive mass at right costal margin
  • Projectile non bilious vomit after feeding
  • Fewer and smaller stools
  • failure to gain weight
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12
Q

What interesting job does the liver do in utero at week ten?

A

Takes over hematopoesis

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13
Q

What do the liver and its derivatives form from?

A
  • Begins as hepatic diverticulum from gut endoderm
  • Connection of diverticulum to foregut via common bile duct
  • Endoderm makes hepatocytes, bile ducts and hepatic ducts
  • Splanchnic mesoderm makes stromal cells Kupffer and stellate cells
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14
Q

What does the gallbladder form from?

A
  • Begins as cystic diverticulum, an outgrowth from cystic endoderm
  • Secondary outpouching off of common bile duct
  • Cystic duct connects to the bile duct
  • Bile formed by hepatic cells in week twelve
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15
Q

Biliary Atresia?

A

Congenital and adult forms exist. It is the obliteration of the bile duct and inflammation will replace the duct with fibrotic tissue

Presents with immediate onset of progressive jaundice in infants, white clay stool, dark urine (bilirubin)

Poor prognosis 12-19 month life span

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16
Q

Describe pancreas formation

A
  • Development starts as two endodermal buds from the foregut below the cystic diverticulum
    • Ventral bud forms uncinate process and grows into ventral mesentary
    • Dorsal bud derivatives are pancreas head body and tail and grows into dorsal mesentary
  • The buds develop both endo and exocrine functions

In week five the ventral pancreas migrates around posteriorly to fuse with dorsal pancreas

17
Q

Describe ventral and dorsal pancreatic ducts

A

Ventral is main pancreatic duct which connects to duodenum

Dorsal is accessory pancreatic duct

18
Q

Pancreatic anomalies?

A
  • Acessory pancreatic duct (common)
  • Pancreas divisum
    • Ventral and dorsal parts dont fuse at week 5 mostly asymptomatic, prone to pancreatitis
  • Annular pancreas
    • poor migration of pancreas, ring around the second part of duodenum
    • Presents with duodenal obstrution, Bilious vomitting, and low birth weight
19
Q

Spleen formation?

A

Week four - starts as a mesenchymal condensation that forms in the dorsal mesogastrium

week five - it is fully formed

Mesodermal derivative

20
Q

Describe midgut rotation in weeks 6 10 and 11.

A

Week 6 - midgut loop protrudes out and makes a 90 degree turn resulting in the proximal portion on the right (convoluted), and the distal portion on the left developing the cecum.

Week 10 - the proximal portion of loop moves back into the abdomen passing uder the distal portion making another 90 degree counterclockwise turn bringing the cecum to URQ and ascending colon anterior to duodenum

Week 11 - the distal portion of the loop returns making another 90 degree CC turn resulting in the cecum descending into the LRQ carrying ascending colon to end on the right side of abdomen

21
Q

What is an Omphalocele?

A
  • Herniated bowel doesn’t fully retract back to abdomen
  • Herniation through umbilicus and covered by parietal peritoneum
22
Q

What is Gastroschiscis?

A
  • Abnormal lateral body folding and fusion creates weakness in the wall that allows bowel to herniate OR Connect tissue of skin and hypaxial mm of body wall doesnt form normal resulting in wall weakness
  • Not covered bt parietal peritoneum
23
Q

Meckle’s Diverticulum?

A
  • Failure of yolk stalk connection to midgut to regress remaining connected to umbilicus
  • Presents asymptomatic - can lead to abdominal swelling intestinal obstruction, bowel sepsis, and GI bleeding

Rule of 2’s:

  • 2% of pop
  • 2x more likely in males
  • 2% have symptoms
  • 2 in long
  • presents in first 2 years of life
24
Q

Malrotation/Non-rotation of Midgut loop?

A

Completes first CCW rotation but not remaining two

Presents:

  • left sided colon right sided small intestines
  • Formation of fibrous ladd bands volvulus and duodenal obstruction
25
Q

Reverse gut rotation?

A

Midgut completes initial 90 CCW rotation but then does a 180 degree CW rotation

Duodenum ends up anterior to transverse colon (bacwards)

26
Q

Volvulus?

A
  • Twisting of bowel around its mesentary
  • Increased risk with gut totation anomalies
  • Presents with acute ab pain vomiting and GI bleeding
  • Complications:
    • Bowel obstruction
    • Bowel infarction

“coffee bean sign”

27
Q

Describe the separation of the cloaca?

A
  • Portion of the hingut in the early embryo that separates into rectum and urogenital sinus
  • Urorectal septum develops forlk-like extensions of the cloacal walls that grow inward to partition cloaca into ventral urogenital sinus (bladder and urethra) and dorsal anorectal canal
  • Cloacal membrane ruptures to open both to the exterior
28
Q

Germ layer and vasculature of the rectum?

A
  • Endoderm
  • Superior rectal (IMA) and middle rectal (internal iliac a.)
29
Q

Germ layer and vasculature of the anus?

A
  • Ectoderm
  • inferior rectal arteries (pudendal a.)
30
Q

What is the pectineal line?

A
  • Divides the origin of the hindgut and anal pit within the anal canal
    • superior 2/3 endodermal epithelium supplied by the superior rectal and middle rectal
    • Lower 1/3 ectodermal epithelium supplied by inferoir rectal arteries
31
Q

Imperforate Anus?

A

Opening to anus is missing or blocked due to persistent anal membrane

Low, intermediate, or high distinction - relative to levator ani muscles and pelvic bony landmarks

32
Q

Hirschsprung’s diesase (Megacolon)

A

Failure of neural crest cells to migrate leading to absence of ganglionic plexus - resulting in loss of peristalis. The colon fails to relax so the colon proximal to it will hypertrophy (bc stool can’t pass through).

Presents with:

  • Intestinal wall hypertrophy proximal to aganglionic segment
  • Lack of peristalsis
  • Abnormal colonic dilation or distension
  • Failure to pass mesoconium

GIGU (17 decks)

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