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Emma IV > Development of GI system > Flashcards

Development of GI system Flashcards

1
Q

outer tube of flat trilaminar disk

A

ectoderm, covers outer surface of embryo (except umbilical region)

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2
Q

central tube of flat trilaminar disk

A

endodermal primary gut tube

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3
Q

middle tube of flat trilaminar disk

A

mesoderm

contains coelom or body cavity

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4
Q

How does the midgut remain in communication with the yolk sac?

A

vitelline duct

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5
Q

what forms the epithelial lining of GI tract and parenchyma of derivative glands

A

endoderm

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6
Q

what forms the smooth muscular components of the GI tract

A

splanchnic (visceral) mesoderm

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7
Q

cranially, foregut terminates in

A

buccopharyngeal membrane

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8
Q

caudally, hindgut terminates in

A

cloacal membrane

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9
Q

at the buccopharyngeal and cloacal membranes –> what fuses?

A

endoderm fuses w/ ectoderm excluding the mesoderm

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10
Q

double-layered connection between splanchnic mesoderm and somatic mesoderm

A

dorsal mesentery

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11
Q

organ completely covered by peritoneum (having a mesentery) is called

A

intraperitoneal

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12
Q

organ covered by peritoneum, only on anterior surface

A

retroperitoneal

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13
Q

ventral mesentery

A

liver develops between this

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14
Q

pharyngeal gut (or pharynx)

A

from buccopharyngeal membrane –> respiratory diverticulum

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15
Q

respiratory diverticulum

A

out pouching of upper part of foregut, first rudiment of lung

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16
Q

tracheoesophogeal septum

A

separates upper part of foregut into ventral trachea and dorsal esophagus

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17
Q

upper 2/3 of trachea n. supply

A

vagus n.

striated muscle

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18
Q

lower third of esophagus n. supply

A

autonomic n.

smooth muscle

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19
Q

lung bud appears from ventral surface of foregut when?

A

4th week of devel

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20
Q

bronchial buds –>

A

R main bronchi –> forms 3 secondary bronchi

L main bronchi –> forms 2 secondary bronchi

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21
Q

pulmonary agenesis

A

lung bud fails to split into R and L bronchi and continue growing (bronchial morphogenesis)

result: abnormal number of lobes/bronchial segments, complete absence of lung, abnormal number of alveoli

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22
Q

possible CXR findings for pulmonary angenesis

A

complete opacity of R hemithorax
displacement of heart and mediastinum
tracheal displacement to R

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23
Q

esophageal atresia

A

congenital malformation
failure of esophagus to develop continuous passage into stomach

infants exhibit choking, coughing, aspiration pneumonia

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24
Q

trachea-esophageal fistula

A

trachea and esophagus fail to separate into distinct structures, passage created between them

infants exhibit choking, coughing, aspiration pneumonia, cant pass catheter thru esophagus to stomach

often assoc w. other anomalies like ventricular septal defect/patent ductus arteriosus/tetralogy of fallout

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25
stomach at 4th/5th weeks
stomach is a dilatation of foregut, rotates 90 degrees clockwise, vagus n. follows rotation
26
stomach at 7th and 8th weeks
rotate santeroposteriorly caudal (pyloric end) moves up and to R cranial (cardiac end) moves down and to L overal, axis of stomach runs from above L to below R
27
what forms lesser sac/omental bursa
dorsal mesogastrium being pulled to L, forming space behind stomach
28
two ligaments next to spleen in dorsal mesogastrium
``` lienorenal ligament (splenicorenal ligament) gastrolienal ligament (gastrosplenic ligament) ```
29
iliorenal ligament contains
splenic vessels | tail of pancreas
30
gastrolienal ligament contains
short gastric vessels | L gastroepiploic vessels
31
congenital hypertrophic pyloric stenosis
thickening of pylorus narrowing of pyloric canal and obstruction to passage of food stomach --> markedly distended, infants expel food w/ nonbilious projectile vomiting progressive loss of fluid, H, Cl --> metabolic alkalosis and dehydration
32
bilious vomiting
obstruction distal to entrance of bile duct via ampulla of water (2nd pt of duodenum)
33
nonbilious vomiting
obstruction proximal to entrance of bile duct
34
duodenum develops from
caudal part of foregut and cranial end of midgut
35
Error in which part of duodenum development can lead to duodenal stenosis or atresia
5th/6th week, lumen of duodenum becomes smaller and temporary obliterated bc of proliferation of epithelial cells If no recanalization --> stenosis/atresia
36
most duodenal atresia involve which parts of the duodenum? which comorbidity these pts have 25% of time?
2nd/3rd part duodenum distal to opening of bile duct results in bilious projectile vomiting 25% of cases have Down Syndrome
37
duodenal atresia
complete occlusion of duodenal lumen in infants, vomiting begins a few hours after birth, almost always CONTAINS BILE prenatal ultrasound shows double-bubble sign can lead to polyhydramnios
38
double-bubble sign
prenatal ultrasound of pt w/ duodenal atresia results from overfilled stomach and superior part of duodenum
39
polyhydramnios
xs amniotic fluid bc fluid cant pass to stomach and intestines for absorption and transfer thru placenta to mother's blood for disposal can be due to duodenal atresia or esophageal atresia sx: dyspnea, edema, abd distension, preterm labor
40
oligohydramnios
deficiency of amniotic fluid
41
liver bud
aka hepatic diverticulum appears day 22 from caudal end of foregut (midway thru 2nd pt of duodenum) penetrates septum transverse and divides ventral mesentery connection w/ duodenum narrows to form hepatic bile duct outgrowth of ventral wall of bile duct --> cystic duct and gallbladder
42
hepatocytes are formed from which germ layer
endoderm
43
connective tissue of liver gallbladder is derived from which germ layer
splanchnic mesoderm
44
visceral peritoneum hemopoietic cells Kupffer cells (macrophages) derived from?
mesoderm of septum transversum
45
serial membrane of septum transverse becomes _____, which covers most of the surface of the liver except _____
serial membrane of septum transverse becomes VISCERAL PERITONEUM, which covers most of the surface of the liver except BARE AREA OF LIVER
46
zone of reflection of visceral peritoneum becomes
coronary ligament
47
remnant of ventral mesentery connecting liver to anterior wall becomes
falciform ligament
48
liver divides ventral mesentery into 3 parts...
thin peritoneal lining falciform ligament lesser omentum
49
extra hepatic biliary atresia
blockage of bile from liver to gall bladder rare due to failure of ducts to recanalize or liver infection during fetal development jaundice occurs soon after birth
50
ventral mesentery gives rise to
lesser omentum falciform ligament visceral peritoneum of liver hepatogastric ligament
51
uncinate process
of pancreas hook-like superior mesenteric a. and v. pass over this
52
pancreas develops from 2 buds
dorsal bud of duodenum ventral bud from origin of liver bud
53
pancreas becomes _________ _________ as its mesentery fuses w/ the posterior abd wall
secondarily retroperitoneal
54
annular pancreas
occurs when two lobes of ventral pancreas migrate around the duodenum in opposite directions to fuse w/ dorsal bud infant sx: feeding intolerance, bilious vomiting, abd distension adult sx: abd pain, nausea, vomiting, upper GI bleed (stomach ulceration), acute or chronic pancreatitis
55
cephalic limb of primary intestinal loop forms
rest of duodenum jejunum part of ileum
56
caudal limb of primary intestinal loop forms
``` rest of ileum cecum appendix ascending colon proximal 2/3 of transverse colon ```
57
Physiological umbilical herniation
physiological herniation of the primary intestinal loop into the umbilicus due to continued midgut elongation and pressure from abdominal organ growth week 6
58
midgut rotation
week 6 herniated primary intestinal loop rotates 270 counterclockwise about its long axis while the jejunum and ileum form, creating jejunal-ileal loops
59
midgut retraction
week 10 intestinal loops retract into the abd with the jejunum entering first, and the cecum (with its new vermiform appendix) entering last
60
absent or incomplete secondary rotation of midgut can lead to
small intestine located on R side of abd cavity
61
reversed secondary rotation of midgut
net rotation is 90 clockwise viscera in normal location, but duodenum ANTERIOR to transverse colon --> can compress/obstruct colon
62
subhepatic cecum/appendix
cecum initially lies below the liver then descends to the right iliac fossa failure to descend --> sub hepatic cecum/appendix
63
how do ascending and descending colons become secondarily retroperitoneal
they are pushed against posterior body wall causing fusion of their mesentery with the parietal peritoneum
64
structures that were intraperitoneal that become secondarily retroperitoneal during development
duodenum pancreas ascending colon descending colon
65
midgut volvulus
malrotation of gut causes narrowed mesenteric line of attachment of midgut ligament of treitz in abnormal position (lower, to R of midline) small intestine loops can twist (corkscrew sign) dilatation of proximal duodenum
66
gut atresia and stenoses commonly occur where? as a result of what?
can occur anywhere along intestine mostly duodenum fewest in colon caused by "vascular accidents" due to malrotation and volvulus blood supply torsion is comprised, segment dies
67
Meckel's diverticulum
persistent vitelline duct (or yolk stalk) small outpouching of ileum connected to umbilicus by fibrous cord fistula, cyst 98% cases: asymptomatic can mimic appendicitis sx: painless rectal bleeding, intestinal obstruction, volvulus, intussusception (collapsing in on itself)
68
omphalocele
failure of umbilicus to close completely hernial sac from epithelium of umbilical cord (peritoneum)
69
ectopia cordis
failure of abd wall closure more superiorly, GI protrudes out most cases --> death shortly after birth (infection, hypoxemia, cardiac failure)
70
gastroschisis
abd wall does not involve umbilicus incomplete closure of lateral folds during 4th week GI system does not function properly - protrudes out
71
congenital umbilical hernia
protrusion of intestines through IMPERFECTLY CLOSED umbilicus hernia covered by subcutaneous tissue/skin defect through linea alba, protrudes during crying/straining/coughing ~15-20% infants affected
72
which part of pancreas is derived from ventral pancreatic bud?
part of head of pancreas and uncinate process
73
smooth m. of GI tract is derived from
lateral plate somatic mesoderm
74
rotation of primitive intestinal loop occurs in a _______ direction and amounts to approx _____ degrees
counterclockwise direction 270 degrees

Emma IV (22 decks)

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