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GIGU > Development of GI > Flashcards

Development of GI Flashcards

1
Q

What does the foregut make?

A

Oral cavity, pharynx, lower respiratory tract, esophagus, stomach, liver, gallbladder, pancreas, upper duodenum

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2
Q

What does the midgut make?

A

Lower duodenum, jejunum, ileum, cecum, appendix, ascending colon, proximal 2/3 of transverse colon

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3
Q

What does the hindgut make?

A

distal 1/3 transverse colon, descending colon, sigmoid colon, rectum, upper anal canal

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4
Q

What supplies blood to the foregut distal to the diaphragm?

A

celiac trunk

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5
Q

What supplies blood to the midgut?

A

superior mesenteric artery

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6
Q

What supplies blood to the hindgut?

A

inferior mesenteric artery

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7
Q

What are the beginning and end of the primitive gut tube?

A

Oropharyngeal membrane

Cloacal membrane

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8
Q

What connects the gut tube to the yolk sac?

A

vitelline duct

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9
Q

What makes the epithelial lining and glands of the GI tract, excluding the lower 1/3 anus?

A

endoderm

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10
Q

What makes the CT, vasculature and SM walls of the GI tract?

A

splanchnic mesoderm

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11
Q

What makes the epithelium of the lower 1/3 anus and NCC that make enteric ganglia, nerves and glia of GI tract?

A

ectoderm

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12
Q

When does maturaiton of the GI tract begin?

A

8 weeks

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13
Q

When does peristalsis occur?

A

10 weeks

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14
Q

What are the secondary retroperitoneal organs?

A

ascending colon
descending colon
duodenum
bulk of pancreas

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15
Q

When do the ventral and dorsal mesenteries form?

A

4th week

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16
Q

What does the ventral mesentery form?

A

lesser omentum

  • –> hepatoduodenal L
  • –> hypogastric L

falciform L

coronary L
triangular L
—>both of liver

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17
Q

Where does the ventral mesentery form?

A

between the body wall and foregut and between the diaphragm and umbilicus

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18
Q

Where does the dorsal mesentery form?

A

suspends diaphragm between lower esophagus to caudal hindgut

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19
Q

What does the dorsal mesentery make?

A

Greater omentum

  • ——> gastrosplenic L
  • ——-> gastrocolic L
  • ——-> splenorenal L

SI mesentery

Transverse mesocolon

Sigmoid mesocolon

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20
Q

What makes the SI mesentery?

A

dorsal mesentery

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21
Q

What makes the transverse mesocolon?

A

dorsal mesentery

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22
Q

What makes the sigmoid mesocolon?

A

dorsal mesentery

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23
Q

What makes the greater omentum?

A

dorsal mesentery

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24
Q

What makes the lesser omentum?

A

ventral mesentery

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25
Q

What makes the falciform L?

A

ventral mesentery

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26
Q

What makes the coronary L of the liver?

A

ventral mesentery

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27
Q

What makes the triangular L of the liver?

A

vental mesentery

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28
Q

What makes R and L vagal nerves turn into Posterior and Anterior vagal trunks?

A

stomach rotation in development

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29
Q

What mesenteries is the stomach suspended by prior to rotation?

A

ventral and dorsal mesenteries

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30
Q

Describe rotation of stomach during development

A

Elongates, rotates 90 degrees so ventral mesentery is RIGHT and dorsal mesentery is LEFT

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31
Q

What is the portion of mesentery between the stomach and body wall after stomach rotation?

A

dorsal mesogastrium

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32
Q

What becomes the double-layered apron drape that eventually turns into the greater omentum?

A

dorsal mesogastrium

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33
Q

What does the stomach rotation make in terms of sacs?

A

lesser sac behind stomach

greater sac is continuous with abd cavity

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34
Q

Describe hypertrophic pyloric stenosis

A

pyloric lumen narrows and obstructs food passage

–>muscularis external hypertrophies and makes olive at the R costal margin

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35
Q

What is the etiology behind pyloric stenosis?

A

sphincter can’t relax d/t faulty NCC migration

—>ENS isn’t populated correctly

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36
Q

What are sx of pyloric stenosis?

A

non-bilious vomiting
few and small stools
can’t gain weight

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37
Q

What makes liver stromal, Kupffer and stellate cells?

A

splanchnic mesoderm

38
Q

What is the embryonic hematopoietic organ?

A

liver

39
Q

What organ has rare congenital abnormalities?

A

liver

40
Q

When does bile begin to form?

A

week 12

41
Q

Describe liver formation

A

diverticulum from gut ENDODERM buds–> grows into septum transversum–> differentiates into hepatocytes, bile duct and hepatic ducts

42
Q

What percent of the population has an accessory pancreatic duct?

A

33%

43
Q

What is pancreatic divisum?

A

two totally separate ducts, prone to pancreatitis

44
Q

What are you prone to having if you have pancreatic divisum?

A

Pancreatitis

45
Q

Where do the first endodermal buds of the pancreas form?

A

dorsal bud in dorsal mesentery

ventral bud in ventral mesentery

46
Q

Do dorsal and ventral buds of the pancreas have exo/endo fxns?

A

Yes

47
Q

When does the ventral pancreatic bud move to fuse with the dorsal bud?

A

5th week

48
Q

What does the dorsal pancreatic bud form?

A

head, body and tail

49
Q

What does the ventral pancreatic bud form?

A

unicate process

50
Q

What occurs in an annular pancreas?

A

ventral bud wraps around the duodenum instead of completely migrating to the dorsal bud

51
Q

What does annular pancreas cause?

A

duodenal obstruction/stenosis

BILIOUS vomiting if inferior to bile duct

52
Q

What is the origin of the gallbladder and bile duct?

A

cystic endoderm

53
Q

Describe how the bile duct forms

A

initially closed, opens via recanilization

54
Q

Define biliary atresia

A

obliteration of the extra-/intra-hepatic ducts–>replaced with fibrous tissue d/t inflammation

55
Q

What are the hallmarks of biliary atresia?

A

progressive jaundice soon after birth
white clay stools
dark urine

56
Q

What is the treatment for biliary atresia?

A

liver transplant within 12-19 months of life

57
Q

When does the spleen begin to develop?

A

4th week

58
Q

Where does the spleen begin to form?

A

as a mesenchymal condensation in the dorsal mesogastrium

59
Q

What is the spleen populated by during development?

A

mesoderm populated by myeloid lymphoid cells

60
Q

What are the stages of herniation and re-entry of the midgut during development?

A

herniates out umbilicus at 6 weeks

comes back in at 10 weeks

61
Q

Describe midgut rotation

A

1: 90 degree counterclockwise rotation
——> cecum and asc colon on L side of abd cavity
2: 180 degree counterclockwise rotation as it reenters abdomen
——-> cecum in RUQ, asc colon anterior to duodenum
3: rest of midgut enters abdomen
——–> cecum RUQ, pulls asc colon down to R side
——–> transverse colon in front of duodenum and
pancreas

62
Q

Describe an omphalocele

A

herniation of gut continues out of the umbilicus

**covered with peritoneum

63
Q

What causes an omphalocele?

A
  • bowel doesn’t fully retract
  • abnormal lateral body folding and fusion creates weakness in wall–>herniates
  • CT of skin and hypaxial M of body wall dont form–>weakness–>herniation
64
Q

Describe gastroschisis

A

herniation of abdomen contents through abd wall

–>not covered by peritoneum so exposed to external environment

65
Q

Describe Meckel’s Diverticulum

A

vitelline duct doesn’t degenerate–>midgut still connected to umbilicus

66
Q

List the rule of 2’s related to Meckel’s Diverticulum

A 
2% incidence
2x more common in males
2% have medical sx
2 feet proximal to terminal ileum
2 inches long
2 years of age
67
Q

What are the sx of Meckel’s Diverticulum?

A

abdominal swelling
SI obstruction
bowel sepsis
GI bleeding

68
Q

Describe volvus

A

rolled up and twisted intestines

69
Q

What do midgut rotation anomalies increase the risk of?

A

volvus

70
Q

What are sx of gut volvus?

A

acute abdominal pain
omiting
GI bleeding

71
Q

What are Trisomy 13 and 18 associated with?

A

omphalocele

72
Q

What occurs in non-rotation of midgut loop?

A

only completes the first 90 degree counterclockwise rotation (not the 180)

73
Q

What are the effects of non-rotation of midgut loop?

A

L sided colon, R sided SI

74
Q

What occurs in a reverse gut rotation?

A

completes the first 90 degree counterclockwise rotation but then does a 180 degree rotatoin CLOCKWISE

—>so only net 90 degree clockwise rotation

75
Q

What are the effects of reverse gut rotation?

A

transverse colon is posterior to duodenum

76
Q

What are the sx of reverse gut rotation?

A

ischemia

stenosis of colon

77
Q

Describe intestinal stenosis and atresia

A

partial occlusion/ ineffective recanalization of intestines OR complete occlusion

78
Q

Why are the intestines closed during the 5-6th months?

A

endoderm proliferation causes the lumen to close–>recanalizes later

79
Q

What is trisomy 21 associated with?

A

intestinal stenosis/atresia

80
Q

What does the urorectal septum divide the cloaca into?

A

dorsal anorectal canal

ventral urogenital sinus

81
Q

The cloaca ruptures after septum proliferates to give _______________

A

urogenital membrane and anal membrane

  • ->sinuses open to exterior
  • -> septum become perineum b/t urogenital and anus
82
Q

What is the function of the anal plug?

A

temporarily closes anal rectal lumen

–>anal pit with ectodermal walls d/t mesenchymal proliferation

83
Q

What is the anal canal made of?

A

2/3 endodermal epithelium (BV, N of hindgut)

1/3 ectodermal epithelium (BV, N of anal pit)

84
Q

What BV supply upper anal canal?

A

superior and middle rectal As

85
Q

What BV supply lower anal canal?

A

inferior rectal A

86
Q

What divides the hindgut and anal pit?

A

pectineal line

87
Q

What is the difference between anal canal and anal pit?

A

anal canal is the hindgut and anal pit

anal pit is lower anal canal that butts up to anus

88
Q

What is an imperforated anus?

A

persistent anal membrane

89
Q

What disease is due to a lack of ganglionic plexus (failure of NCC migration)?

A

Hirschsprung’s disease

90
Q

List possible consequences of abnormal urorectal septum development

A 
Persistent anal membrane
Anal atresia
Anoperineal fistula
Rectovaginal fistula
Rectourethral fistula
Rectovesical fistula

GIGU (37 decks)

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