Development of the Abdomen Flashcards

1
Q

What are the 3 layers of the trilaminar embryo?

A

Ectoderm
Lateral plate mesoderm
Endoderm

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2
Q

What does the lateral plate mesoderm split into?

A

Somatic and visceral layer of lateral plate mesoderm

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3
Q

What layers form the gut tube?

A

Endoderm + visceral layer of lateral plate mesoderm

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4
Q

What layers surround the gut tube?

A

Ectoderm + parietal layer of lateral plate mesoderm

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5
Q

What attaches the gut tube to the posterior body wall?

A

Dorsal mesentery

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6
Q

What surrounds the embryo?

A

Amniotic cavity.

This is done when the ectoderm and parietal layer fuse anteriorly to create the body wall.

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7
Q

What does the gut tube extend from?

A

Oropharyngeal membrane to cloacal membrane.
AKA
Mouth to anus

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8
Q

What are the additional extensions of the mesoderm called?

A

Allantois
Secondary yolk sac

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9
Q

What connects the yolk sac to the gut tube?

A

Vitelline duct.

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10
Q

What supplies blood to the yolk sac?

A

Vitelline artery.

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11
Q

What does the vitelline artery develop into?

A

Celiac
Superior mesenteric
Inferior mesenteric

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12
Q

What organs make up the foregut?

A

Distal esophagus
Stomach
Proximal duodenum
Liver & Gallbladder
Pancreas
Spleen

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13
Q

What 4 steps develop the initial gut tube into the foregut organs?

A
  1. Separation of the esophagus from the trachea.
  2. Stomach dilation and rotation
  3. Development of the gallbladder, liver, spleen, and pancreas.
  4. Rotation of the gut tube and glands to form spaces, ligaments, omenta & mesenteries.
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14
Q

What kind of emesis is a tracheoesophageal fistula?

A

Non-bilious.

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15
Q

What condition is a trachesoesophageal fistula almost always with?

A

Esophageal atresia.

90% of have an associated tracheo-esophageal fistula.

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16
Q

What are some key indications of an esophageal atresia?

A

Non-bilious emesis
Frothing at mouth
Inability to swallow food
Inability to pass an orogastric tube.

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17
Q

What are the two hernias that happen around the stomach/esophagus?

A

Hiatal hernia: cardiac region of stomach goes into thoracic cavity.

Para-esophageal hernia: Fundus of stomach displaces through diaphragm next to the esophagus.

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18
Q

How does the stomach get its shape?

A

Distends and rotates left.
Left side gets big, makes greater curvature.
Right side smaller, makes lesser curvature.
Duodenum gets its C shape.

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19
Q

What does intestinal atresia cause?

A

Bilious emesis
Inability to consume food until surgically repaired.

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20
Q

What does bilious emesis indicate?

A

Obstruction DISTAL to common bile duct insertion.

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21
Q

When does the liver bud extend off the foregut?

A

The hepatic diverticulum extends off at the 3rd week.

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22
Q

What does the hepatic diverticulum become?

A

The hepatic diverticulum embeds itself into the septum transversum, becoming the central part of the diaphragm.
Its connection to the gut tube becomes the common bile duct.

23
Q

How is the gallbladder and cystic duct formed?

A

It is an outpouching of the hepatic diverticulum.
It makes its own duct, which becomes the cystic duct.

24
Q

What two congenital abnormalities can form in regards to the gallbladder?

A

Double gallbladders (minor issue)
Biliary atresia (major issue)

If the atresia is proximal to the duodenum, bile can’t leave the liver. This will eventually cause cirrhosis.

25
Q

How does the pancreas form embryologically?

A

Ventral and dorsal buds swivel around.

The ventral bud is found on the hepatic diverticulum.
The dorsal bud is a separate extension off the gut tube (bigger).

As the stomach swivels, the ventral bud moves to the left with the common bile duct, fusing with the dorsal bud.

26
Q

What are the two pancreatic ducts and what part of the pancreas do I find them in?

A

The accessory pancreatic duct is found in the dorsal (body) of the pancreas.

The main pancreatic duct is off the ventral pancreas (head), connecting to the common bile duct. It does stretch throughout the entire pancreas.

27
Q

What is an annular pancreas? How is it caused?

A

The ventral pancreas surrounds the duodenum by going both anteriorly and posteriorly, causing duodenal stenosis.

28
Q

How is the omental bursa formed?

A

The stomach moves left, making the liver go right.
The posterior space created is the omental bursa.

29
Q

What connects the omental bursa to the rest of the peritoneal cavvity?

A

Omental foramen.

30
Q

What happens to the pancreas as the omental bursa is created?

A

It moves posteriorly to the body wall, losing its mesentery and becoming a retroperitoneal organ.

31
Q

What does the greater omentum combine with?

A

The mesentery of the transverse colon.

32
Q

What supplies the midgut organs with blood? What are the midgut organs?

A

Superior mesenteric artery

Distal duodenum
Jejunum
Ileum
Cecum
Appendix
Ascending colon
Transverse colon

33
Q

What are the two major events that develop the midgut?

A

Rotation
Elongation

34
Q

Describe the rotation phase of the midgut.

A

Midgut rotates around the superior mesenteric artery 270 deg, such that the transverse colon is anterior to the duodenum.

35
Q

What do the two loops of the midgut become?

A

The proximal loop rotates inferiorly, becoming the distal duodenum, jejunum, and part of the ileum.

The distal loop rotates superiorly, becoming the rest of the ileum, cecum, appendix, ascending colon, and proximal half of the transverse colon.

36
Q

What is the vitelline duct an extension off of? What can it become it if doesn’t disappear?

A

It is an extension off the ileum.

It can become an ileal diverticulum, or Meckel’s.

37
Q

What does an ileal diverticulum cause?

A

Entrapment of loops of small intestine, causing volvulus and possible necrosis.

Note: It presents like appendicitis but in the wrong area.

38
Q

What other vitelline duct malformations can occur besides ileal diverticulum?

A

Vitelline cyst
Vitelline fistula

39
Q

How long does it take the midgut to physiologically herniate/elongate?

A

4 weeks. From weeks 6-10.

40
Q

Why is the appendix located in so many different locations?

A

It forms as the cecum returns to its location, which causes the appendix to shift based on the organs it comes into contact with on the way there.

41
Q

What is omphalocele?

A

Congenital herniation of intra-abdominal viscera.

It comes as an INTACT peritoneal sac, which is absent in gastroschsis.

42
Q

How does a left-sided colon occur?

A

When the abdomen only rotates 90 deg before returning to its original position.

43
Q

How does the duodenum end up anterior to the transverse colon?

A

The gut rotates 270 deg to the right.

44
Q

What does malrotation of the guts do?

A

Increases risk of volvulus
Volvulus can create life-threatening bowl obstruction.

45
Q

How is stenosis and atresia of the gut tube often diagnosed?

A

Most infants are symptomatic day 1.

Failure to pass meconium
Abdominal distension
Bilious vomiting
Abd XRAY showing multiple air-fluid levels

46
Q

What supplies blood to the hindgut? What organs make up the hindgut?

A

Inferior mesenteric artery

Descending colon
Sigmoid colon
Rectum

47
Q

What separates the urogenital and GI tract?

A

Mesoderm between the vitelline duct and allantois.

48
Q

What separates the rectum from the urogenital sinus?

A

Urorectal septum.

49
Q

What becomes the bladder and urethra?

A

Urogenital sinus: bladder
Allantois: Urethra

50
Q

What is the cloaca?

A

A development structure that receives content from urinary, digestive, and reproductive systems.

51
Q

What does descent of the urorectal septum create?

A

Anal and urogenital membrane.

52
Q

What do malformations of the urorectal septum cause?

A

Females can have persistent cloaca or rectovaginal fistulas.

Males can have urorectal fistulas.

53
Q

How does the anal pit form?

A

The ectoderm has to vaginate and then perforate to meet the rectum.

54
Q

What is an imperforate anus?

A

Failure of the anal membrane to rupture. This leaves the anal pit unconnected to the rectum.