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GIGU Exam 1 > Development of the GI System > Flashcards

Development of the GI System Flashcards

1
Q

Endoderm forms what part of the GUT

A

Mucosal Epithelium and GI glands (all only NOT lower 1/3 of anus)

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2
Q

Splanchnic Mesoderm forms what part of the GUT

A

CT
Vasculature
SM wall

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3
Q

Ectoderm forms what part of the GUT

A

Enteric Ganglia, N, and Glia (by neural crest cells)

Epithelium of lower 1/3 anus

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4
Q

Foregut

A

Esophagus, stomach, liver, gallbladder, pancreas, upper duodenum

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5
Q

Foregut Blood supply

A

Celiac Trunk

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6
Q

Midgut

A

Lower duodenum, Jejunum, Ileum, Cecum, Appendix, Ascending Colon, proximal 2/3 transverse colon

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7
Q

Midgut Blood supply

A

SUPERIOR MESENTERIC A.

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8
Q

Hindgut

A

Distal 1/3 transverse colon, Descending colon, Sigmoid colon, rectum, upper anal canal

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9
Q

Hindgut Blood supply

A

INFERIOR MESENTERIC A

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10
Q

Visceral Peritoneum

A

directly around each organ

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11
Q

Parietal Peritoneum

A

directly around the Peritoneal Cavity with includes the organs inside

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12
Q

Dorsal Mesentery Derivatives

A 
Greater Omentum (gastrosplenic, Gastrocolic, Splenorenal Ligaments)
SI mesentary
Mesoappendix
Transverse mesocolon
Sigmoid Mesocolon
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13
Q

Ventral Mesentary Derivatives

A

LESSER UMENTUM ( hepatoduodenal, hepatogastric Ligaments)
Flaciform Ligament of Liver
Coronary Ligament of Liver
Triangular Ligament of Liver

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14
Q

Intraperitoneal Organs

A

organs in the mesentery, surrounded by the peritoneal cavity
EX: abd esophagus, liver, stomach, gallbladder, cecum, sigmoid, appendix, jejunum, Ileum

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15
Q

Retroperitoneal organs

A

organs outside the peritoneal cavity

Ex: thoracic esophagus, Rectum

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16
Q

Secondarly Retroperitoneal organs

A

organs that were initially in the mesentery (interperitoneal) and then fused with the body wall
EX: Ascending + Descending colon, Duodenum, most of Pancreas

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17
Q

ALL RETROPERITONEAL (INCLUDING SECONDARY)

A 
SADPUCKER
Suprarenal (Adrenal) Glands
Aorta/ IVC
Duodenum (2nd+3rd part)
Pancreas (not tail)
Ureter
Kidneys
Colon (ascending +descending)
Esophagus - thoracic
Rectum
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18
Q

How does the developing stomach rotate

A

Stomach rotates 90 degrees
LEFT= VENTRAL
RIGHT= DORSAL
Greater curvature- attached to greater omentum
Lesser curvature- attached to lesser omentum

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19
Q

Left Vagus N

A

Anterior Stomach

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20
Q

Right Vagus N

A

Posterior Stomach

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21
Q

Lesser sac

A

behind stomach

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22
Q

Greater Omentum

A

connects stomach to transverse colon

double layer of peritoneum

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23
Q

lesser Omentum

A

connects stomach to the liver and duodenum

double layer of peritoneum

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24
Q

Hypertrophic Pyloric Stenosis

What happens

A

narrowed opening from stomach to duodenum due to thickened muscle

  • NCC dont migrate to ganglion enteric cells = sphincter cant relax
  • muscularis externa hypertrophy = narrowing pyloric lumen
25
Q

Hypertrophic Pyloric Stenosis Sx:

A 
Sx: starts a few months after birth
olive mass over right costal margin 
projectile vomiting 
few + smaller stools
X gain weight, can loose weight
26
Q

Where does the liver form from

A

Hepatic Diverticulum from GUT ENDODERM

27
Q

GUT ENDODERM 3 parts

A
  1. connects to Foregut : common bile duct
  2. Endoderm: Hepatocytes, Bile ducts, Hepatic ducts
  3. Splanchnic mesoderm : stromal cells, Kupffer cells, stellate cells
28
Q

Liver formation happens when

A

week 10, it takes over hematopoiesis

very love anomalies

29
Q

Where does the Gallbladder and Bile duct from from

A

Cystic Diverticulum of the CYSTIC ENDODERM

  1. it outpatches from the common bile duct—> ventral mesentery +cyctic duct (connection to bile duct)
  2. Recanilzation of bile duct
  3. bile forms week 12
  • right above the Ventral Pancreatic Fold
30
Q

Biliary Atresia

A

Fibro-inflammatory obstruction of extra-hepatic bile duct
obliterated bile duct

SX: immediate jaundice in infants
white clay stool
Dark urine
12-19mo lifespan

31
Q

How is the Pancrease form and from what

A
  1. inferior to the cystic diverticulum, 2 endodermal buds from FOREGUT form
    - Ventral Pancreatic Bud: uncinate process and grows —> VENTRAL MESENTERY
    - Dorsal Pancreatic Bud: Pancreatic Head, Body, and Tail and grows —-> DORSAL MESENTERY
  2. both exocrine and endocrine portions form
  3. ducts fuse
32
Q

Week 5 of pancreatic formation

A

The Ventral pancreas (under cystic diverticulum) migrates around posteriorly to the dorsal pancreas bud

  1. Ventral Pancreatic Duct= main Pancreatic duct + connects to Duodenum
  2. Dorsal Pancreatic Duct = Accessory Pancreatic Duct
33
Q

Pancreas Divisum

A

Ventral and dorsal parts dont fuse by week 8
Sx: asymptomatic
prone to abd pain and pancreatitis

34
Q

Having an accessory pancreatic duct

A

33% population

35
Q

Annular Pancreas

A 
Poor migration of pancreas = pancreatic ring around duodenum (2nd part)
Sx: duodenal obstruction +necrosis
Bilious Vomiting  (in annulus is inferior to bile duct)
Low birth weight

= basically the ventral pancreatic bud migrates some posteriorly and some anteriorly to the dorsal pancreatic bud forming a ring when it fuses

36
Q

what does the spleen form from and what happens week 4

A

dervied from mesoderm

1. mesenchymal condensation in the dorsal mesogastrium

37
Q

spleen formation week 5

A

fully formed

38
Q

Midgut formation in general

A

week 6: herniates out from umbilicus

week 10: goes back to ABD

39
Q

How does the midgut rotate week 6

A

week 6: rotated 90 degrees counterclockwise

  • proximal part: right and convoluted
  • distal left and develops cecum
40
Q

How does the midgut rotate week 10

A

week 10: proximal portion of loop returns to abd going under the distal portion = 90 counterclockwise turn

  • cecum : URQ
  • ascending colon : anterior to duodenum
41
Q

How does the midgut rotate week 11

A

week 11: distal portion of loop returns to the abd = 90 counterclockwise turn

  • cecum: LRQ
  • ascending colon : right side of abd.
42
Q

Omphalocele

A

higher risk if trisomy 13 or 18
Hermiated bowel does not fully go back into abd
SX: herniation through the umbilicus, covered by perietal peritoneum

43
Q

Gastroschiscis

A

Abnormal lateral body folding and fusion = wall weakness and bowel herniated
OR
CT of skin and hypaxial muscles of body wall doesnt form normally = wall weakness
Bowel not covered by parietal peritoneum

44
Q

Meckel’s Diverticulum

A 
Yolk sac (vitelline duct) connection to midgut doesnt go back to abd. = midgut is still connected to umbilicus
SX: asymptomatic
abd swelling, intestinal obstruction, GI bleeding

*basically a little string of midgut tissue connected to the body wall of the umbilicus
RULE OF 2 for all Sx:

45
Q

Malrotation/ Non-Rotation of the Midgut loop

A

only completes first week 6 90 degree rotation
(still return to abd.)
Sx: left sided colon
right sided SI
= formation of Ladd Bands –> volvulus +duodenal obstruction

46
Q

Reverse Gut Rotation

A

Initial midgut week 6 90 degree rotation is normal
other 2 are clockwise rotations
Sx: Duodenum : anterior to Transverse Colon

47
Q

Volvulus

A 
Bowel twists around its mesentary 
high risk of gut rotation anomalies 
CT= Coffee bean sign 
SX: acute, abd pain, Vomit, GI bleeding
- can lead to bowel obstruction and Infarction
48
Q

Cloaca separates to

A

part of hindgut and separates to rectum and urogenital sinus

49
Q

how does the Hindgut form

A
  1. Urorectal septum (b/w hindgut and urogenital sinus) grows fork like extensions to separate the cloaca
  2. Cloaca becomes VENTRAL urogenital Sinus
    DORSAL anorectal canal
  3. Cloaca membrane ruptures = opens both parts to outside
50
Q

Ventral Urogenital Sinus becomes the

A

bladder and urethra

51
Q

how does the anus and rectus form

A
  1. anal rectal lumen closed by ENDOTHELIAL ANAL PLUG
  2. MESODERM around opening grows out and forms anal pit
  3. Anal pit is lined by ECTODERM
52
Q

what does the Pectineal Line Divide

A

the hindgut and anal pit inside anal canal
1. Superior 2/3 : ENDODERM, IMA artery and Internal Iliac Artery - superior and middle rectal arteried
(RECTUM)
2. Inferior 1/3 : ECTODERM, Puedendal Artery - inferior rectal arteries
(ANUS)

53
Q

Imperforate Anus

A

X anal opening, anal membrane (endoderm) is still there

there is low, intermediate and high malformation = due to LEVATOR ANI MUSCLES and pelvic bone

54
Q

Abnormal Urorectal Septum : Rectovaginal

A

Females

rectum goes to vagina canal

55
Q

Abnormal Urorectal Septum : Rectovestibular

A

Females

rectum opens at vaginal opening

56
Q

Abnormal Urorectal Septum : Rectoperineal

A

Females and Males

rectum opens however ventral to the anus (so no anus in opening)

57
Q

Abnormal Urorectal Septum : Rectovesical

A

Males

rectum opens into prostate

58
Q

Abnormal Urorectal Septum : Rectourethral

A

Males

rectum opens into sperm canal to exit the penis

59
Q

Hirschsprung’s Disease (congenital Aganglionic Megacolon)

A

NCC dont migrate = X Ganglionic plexus in GI
X peristalsis (COLON does not relax)
SX: hypertrophy of Intestinal wall proximal to aganglionic segment
Megacolon: dilated colon
X pass meconium - first poop of newborn

GIGU Exam 1 (19 decks)

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