Development & Congenital Abnormalities of the Upper GI tract Flashcards
How is the GI tract subdivided?
- Esophagus
- Stomach
-
Small intestine
- duodenum
- jejunum
- ileum
-
Large intestine
- cecum
- appendix
- colon
- rectum
- anal canal
What do the 3 GI germ layers give rise to?
- Ectoderm:
- Mesoderm (Splanchnic mesoderm):
- Endoderm:
- Ectoderm** ⇒ enteric nervous system**
- Splanchnic mesenchyme ⇒ muscle, connective tissue, and other layers of the wall of the gut
- Endoderm ⇒ epithelial components of the gut
Following gastrulation, small indentations develop first in the anterior and then in the posterior of the embryo producing the ….
foregut diverticulum (anterior intestinal portal) and the hindgut diverticulum (caudal intestinal
portal)
What is the result of folding of the embryo for the GI tract?
- Folding in the transverse plane creates:
- primitive gut tube from the endoderm
- Folding in the sagittal plane creates:
-
3 subdivisions of the primitive gut tube:
- foregut
- midgut
- hindgut
-
3 subdivisions of the primitive gut tube:
What is the associated ventral branch of the dorsal aorta for each subdivision of the primitive gut tube?
- Foregut: celiac trunk
- Midgut: superior mesenteric artery
- Hindgut: inferior mesenteric artery
What does the foregut give rise to?
- esophagus
- thyroid
- lung
- stomach
- liver
- pancreas
- proximal duodenum (1st and 2nd parts)
What does the midgut give rise to?
- distal duodenum (3rd and 4th parts)
- jejunum
- ileum
- cecum
- appendix
- ascending colon
- 1/3-1/2 of the transverse colon
What does the hindgut give rise to?
- remaining transverse colon
- descending and sigmoid colon
- rectum
- superior part of the anal canal
The stomach is a ______ ___ between the esophagus and intestine where food undergoes both _________
and _______ digestion to form _____
The stomach is a dilated sac between the esophagus and intestine where food undergoes both mechanical
and chemical digestion to form chyme
- When does the simple gut tube begin to dilate?
- How is it attached to the body wall?
- What flanks the stomach to the left and right?
- The simple gut tube in the foregut region destined to form the stomach begins to dilate around week 4
- Attached to the body wall by the dorsal and ventral mesenteries
- Left and right vagus nerves flank the the left and right sides of the stomach, respectively
What happens between weeks 5-7 for the formation of the stomach?
Week 5:
- The primordial stomach enlarges and broadens along the dorsal-ventral axis
- The dorsal wall of the stomach expands more quickly than the ventral wall ⇒ creating the greater curvature of the stomach and the lesser curvature of the stomach
**Week 7: **
- stomach rotates 90° clockwise around its longitudinal axis
- greater curvature, which arose from the embryonic dorsal side, now faces the left side of the body
- lesser curvature, which arose from the embryonic ventral side, faces the the right side of the body
Results from rotation of the developing stomach:
- Left vagus nerve ⇒
- Right vagus nerve ⇒
- What is produced behind the stomach?
- How does it affect the postitioning of stomach and the duodenum?
- Dorsal mesentery extends from the greater curvature forming the _______ _______
- Ventral mesentery also attached to the developing liver is known as the ______ _______
- left vagus nerve ⇒ supplies the anterior wall of the mature stomach (anterior vagal trunk nerve)
- right vagus nerve ⇒ supplies the posterior wall (posterior vagal trunk nerve)
- Produces a space behind the the stomach referred to as the lesser sac or omental bursa
- Pulls the stomach and duodenum upward placing these organs in their final body position
- Dorsal mesentery extends from the greater curvature forming the greater omentum
- Ventral mesentery also attached to the developing liver is known as the lesser omentum
- The space posterior to the stomach is referred to as the _____ ___ or ______ _____
- The space anterior and inferior to the stomach is known as the ______ ___
- The space posterior to the stomach is referred to as the lesser sac or omental bursa
- The space anterior and inferior to the stomach is known as the greater sac
What type of epithelium is in the mature stomach?
simple columnar
The liver, gallbladder, and the biliary duct system develop as an outgrowth of the ______ ______ _______
The liver, gallbladder, and the biliary duct system develop as an outgrowth of the ventral foregut
endoderm
What are the three distinct phases of liver bud (hepatic diverticulum) formation?
- Foregut endoderm composed of polarized columnar epithelial cells protrudes into the surrounding septum transversum mesenchyme
- derives from the splanchnic mesoderm between the heart and the midgut
- gut lumen and the basal surfaces contact laminin-rich basement membrane
- Simple columnar epithelium transforms to a pseudostratified epithelium encased in basement membrane
- Basement membrane is degraded, and bipotential hepatoblasts delaminate and migrate into the septum transversum mesenchyme forming cords of hepatic cells within the mesenchyme
- hepatoblasts have the potential to differentiate into ⇒
- hepatocytes
- cholangiocytes
- hepatoblasts have the potential to differentiate into ⇒
- Why are FGFs and BMPs important to the developing liver?
- What are endothelial cells required for?
- FGFs and BMPs secreted from the heart and the septum transversum mesenchyme are essential for proper specification and outgrowth the the primordial liver bud
-
Endothelial cells surround the pseudostratified bud
- required for delamination and expansion of the liver
- Why is the fetal liver important?
- What are sinusoids?
- The fetal liver is also an important site of hematopoiesis
- key site of hematopoiesis prior to the onset of marrow hematopoiesis.
- gives the liver its bright red appearance
-
Sinusoids: blood vessels residing at the basal surface of polarized hepatocytes
- derive from vessels resident in the septum transversum mesenchyme via angiogenesis
- What forms the gall bladder?
- What forms the cystic duct?
- How is the bile duct formed?
- A small caudal region of the liver bud gives rise the the gall bladder
- The stalk of the bud forms the cystic duct
- The stalk connecting the hepatic and cystic ducts to the duodenum becomes the bile duct
- This duct initially attaches to the ventral aspect of the duodenal loop
- As the duodenum grows and undergoes rotation ⇒ bile duct is carried to the dorsal aspect of the duodenum
- Where do the two buds of the developing pancreas arise from?
- How does rotation affect the pancreatic buds?
- What eventually happens to the buds?
- The pancreas develops as two buds emanating from the dorsal and ventral foregut endoderm
- The endoderm gives rise to the exocrine and endocrine epithelial cells of the pancreatic parenchyma
- As the developing duodenal region of the small intestine rotates rightward and takes on a “C” shape, the ventral bud is carried dorsally to lie posterior to the dorsal pancreatic bud
- The buds eventually fuse
Formation of the small and large intestines:
- endoderm:
- splanchnic mesenchyme:
- neural crest:
- **endoderm: **
- simple columnar epithelium that covers the villi and crypts of Lieberkuhn
- duodenum
-
splanchnic mesenchyme:
- smooth muscle and connective tissue
- duodenum
-
neural crest:
- neurons that innervate the gut
- i.e. enteric nervous system
- duodenum
- neurons that innervate the gut
- As the duodenum expands, it transforms from a ______ tube to a __ ______ tube
- As the developing stomach rotates, the duodenum also rotates to the ____
- How is development of the duodenum similar to esophageal development?
- ___________ results in restoration of the lumen.
- As the duodenum expands, it transforms from a straight tube to a “C” shaped tube
- As the developing stomach rotates, the duodenum also rotates to the right
- Similar to esophageal development, the epithelial cells derived from the endoderm proliferate to occlude the lumen of the gut tube
- Re-canalization results in restoration of the lumen.
As the midgut elongates during week 5 of development, it forms a ventral U-shaped tube termed the ….
As the midgut elongates during week 5 of development, it forms a ventral U-shaped tube termed the midgut loop or primary intestinal loop
- The midgut loop has a _____ limb and _____ limb
- What arises from each limb of the midgut loop?
- What normally happens by week 6 of midgut loop development?
- The midgut loop has a cranial limb and caudal limb
-
cranial limb ⇒
- bulk of the small intestine (distal duodenum, jejunum, and most of the ileum)
-
caudal limb ⇒
- distal ileum
- cecum
- appendix
- parts of the colon (ascending colon and part of the proximal transverse colon)
-
by week 6 of development the midgut loop:
-
physiological umbilical herniation
- organs expand more quickly than the body cavity itself expands ⇒
- herniates through the umbilicus into the umbilical cord
-
physiological umbilical herniation