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GI exam 1 > Embryology GI (Funk) > Flashcards

Embryology GI (Funk) Flashcards

1
Q

formation of the intraembryonic body cavity forms within what layer

A

lateral plate mesoderm

divides lateral plate into parietal (somatic) and visceral (splanchnic) mesoderm

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2
Q

body wall defects occur when what happens?

A

when the ventral body wall fails to fuse and viscera herniate through the defect

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3
Q

what is cantrell’s pentology

A 
cleft sternum
ectopic cordis
gastroschisis or omphalocele 
diaphragmatic hernia (anterior) 
congenital heart defects
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4
Q

what are the dorsal mesentery derivatives

A 
DORSAL MESENTERY DERIVATIVES:
Mesoesophagus 
Greater omentum (gastrocolic, gastrosplenic, gastrophrenic ligaments)
Splenorenal ligament
Phrenicosplenic ligament
Phrenicocolic ligament 
Mesentery proper
Mesoappendix 
Transverse mesocolon
Sigmoid mesocolon
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5
Q

what are the ventral mesentery derivatives

A

Lesser omentum (hepatogastric, hepatoduodenal ligaments)
Falciform Ligament
Coronary Ligaments
Right and Left Triangular Ligaments

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6
Q

what is a mesentery

A

double layer of peritoneum

provides pathway for vessels, nerves to organs

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7
Q

what is the function of the dorsal mesentery

A

suspends gut tube to posterior body wall

extends from caudal foregut to hindgut

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8
Q

what is the function of the ventral mesentery

A

suspends gut tube to anterior body wall

extends from caudal to foregut to proximal duodenum

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9
Q

what are the three types of peritonealization

A

primary retroperitoneal
secondary retroperitoneal
peritonealized

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10
Q

what are organs that are primary retroperitoneal

A

kidney
ureter
bladder

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11
Q

what are organs that are secondary retroperitoneal

A

parts 2-3 of duodenum
ascending colon
descending colon
pancreas

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12
Q

what are examples of organs that are peritonealized

A 
stomach
spleen
parts 1 and 4 of duodenum 
jejunum
ileum 
transverse and sigmoid colon
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13
Q

what is the septum transversum and what does it form in the adult

A

plate of mesoderm that separates the throacic and peritoneal cavities (forms from somites 3, 4 and 5)

will form bulk of diaphragm (muscle and central tendon)

note it does not

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14
Q

what do the pleuropericardial membranes separate in the embryo

A

pleural and pericardial cavities

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15
Q

what do pleuorperitoneal membranes separate in the embryo

A

pleural and and peritoneal cavities

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16
Q

what are the sources that contribute to the formation of the diaphragm

A

septum transversum

pleuroperitoneal membrane

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17
Q

the mesoderm of the diaphragm forms from what and what is the positional changes of the diaphragm
where does the diaphragm sit at week 8

A

cervical somites 3-5

differential growth of the body leads to a descent of the diaphragm into the thorax

by week 8 sitting at level of 1st lumbar vertebra

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18
Q

what is the motor innervation to the diaphragm

sensory?

A

motor - phrenic

sensory = phrenic n to central tendon
intercostal nn to muscu. diaphragm

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19
Q

what is a bochdalek defect

A

posterolateral defect –> incomplete formation of pleuroperitoneal membranes (often on left side)

small intestine or viscera herniate through

the lugns and heart are compressed
common cause of pulmonary hypoplasia

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20
Q

what is a morgagni defect

A

parasternal hernia

anterior defect in muscular portion of diaphragm
small and sometimes not detected until child is several years old

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21
Q

what are two causes of congenital diaphragmatic hernias

A

failure of pleuroperitoneal membranes to form

small gap between sternal and costal portion of diaphragm

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22
Q

what is eventration of the diaphragm

A

weakness of diaphragm due to failure of myotome migration (lack of muscle differentiation)

allows abdominal viscera to ballon into thoracic cavity

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23
Q

all three germ layers contribute to the formation of the gut tube. what do each of the three layers make

A

endoderm- epithelium and glands

mesoderm - CT and muscle

ectoderm– epithelium at ends of tubes (mouth, lower 1/2 of anal canal)

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24
Q

what comprises the foregut 8

A 
Pharynx
Esophagus
Stomach
½ duodenum (parts 1 and 2) 
Spleen
Pancreas
Liver
gallbladder
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25
Q

when does the oropharygneal membrane rupture

A

4th week

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26
Q

when does the cloacal membrane (anus) rupture

A

7th week

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27
Q

what comprises the mid gut 7

A

½ duodenum (parts 3 and 4)

Jejunum
Ileum
Cecum
/appendix
Ascending colon
2/3 transverse colon
28
Q

what comprises the hindgut 5

A 
distal 1/3 of transverse colon 
decending colon 
sigmoid colon
rectum
proximal anal canal
29
Q

during what week does the esophagus become partly obliterated

A

week 5

recanalizes by week 8

30
Q

what is the cause of esophageal atresias and stenoses and tracheoesophageal fistula

A

malformation of tracheoesophageal septum
–> leads to development of esophageal fistula

incomplete recanalizaiton of distal esophagus
-during week five the canalization occurs in which the endoderm proliferates very rapidyly and produces an epithelial plug

by week 8 it will recanalize
incomplete –> stenosis
absent recanalizaiton–> atresia

31
Q

what is the cause of a congenital hiatal hernia

A

esophagus fails to elongate, pulls stomach through diaphragm into thorax

32
Q

what is the rotation of the stomach

A

rotates 90 degreses clockwise aroudn longitudinal axis (greater curvature is now left, lesser curvature is not right)

rotates around its anterioposterior axis
pyloric part moves upward and to right
fundus part moves down and to left

33
Q

what is going on with the omental bursa as the stomach is developing

A

as the stomach rotates it stretches dorsal mesentery and the omental bursa comes to lie inferior and posterior to the stomach

during later development the layers of the greater omentum fuse

34
Q

what is the cause of pyloric stenosis

A

hypertrophy of smooth muscle around pyloric sphincter

forcible vomiting of stomach contents after eating

35
Q

what does the spleen form from

A

mesenchymal cells within the two layers of dorsal mesogatrium

36
Q

what is the hepatic diverticulum

A

an outgrowth from second portion of duodenum

37
Q

endoderm derived portion of the liver is what?
mesoderm portion is what ?

what does the liver function as during 2nd month

when does bile formation begin

A

endoderm–> perenchyma
mesoderm –> stroma

hematopoietic organ–> 2nd month

bile formation–> 12 week

38
Q

what does the gallbladder from from

because of rotation of the gut, where does the bile duct pass in relation to the duodenum

A

forms from evagination of bile duct

rotation–> bile duct passes posterior to duodenum

39
Q

what is the development of the pancreas like? from what portion of the gut

how does rotation of the gut effect pancreatic development

A

arises from two endodermal outgrowths of duodenum (ventral and dorsal buds)

ventral bud forms lower portion of head and uncinate process

dorsal bud forms most of pancreas

40
Q

what is the main pancreatic duct derived from

A

ventral pancreatic duct and distal dorsal pancreatic duct

41
Q

what is the accessory pancreatic duct derived from

A

proximal part of dorsal pancreatic duct

42
Q

what is the problem with accessory pancreatic tissue

A

can degrade surrounding tissue

43
Q

what is annular pancreas

A

“ring” around the duodenum

bifid ventral pancreatic duct

during rotation the bifid bud encircles the duodenum

after fusion of the pancreas the annular tissue can constrict the duodenum

44
Q

what occurs in gestational diabetes

A

fetal insulin=secreting cells are exposed to high levels of maternal glucose

as a result, insulin-secreting cells hypertrophy and increase rate of insulin secretion

45
Q

what does the duodenum derive from

A

caudal end of foregut (parts 1 and 2)
rostal end of the midgut (parts 3 and 4)

stomach rotates –> pulls duodenum superiorly and to the right
pancreas grows rapidly causing C-shape

46
Q

what is the cause of duodenal stenosis
how does it present
how does a pregnant mother present

A

failure to recanalize

usually affects parts 3 and 4

digested food + bile are forcibly vomited (green-colored)

distended epigastrium due to overfilled stomach

infant is not swalloing amniotic fluid so mother presents with polyhydramnios

47
Q

what happens during week 5 of midgut development

A

midgut loop forms

48
Q

what happens during week 6 of midgut formation

A

midgut loops physiologically herniates through the umbilical ring (gut around the superior mesenteric artery herniates) into the extraembryonic cavity

49
Q

what occurs later after the week 6 and before week 10 in midgut development

what happens in terms of peritonealization to the midgut at this point

A

the primary intestinal loop undergoes a rotation of 270 degrees counterclockwise

mesentery proper becomes twisted and the ascending and descending colon becomes secondarily retroperitoneal

50
Q

what happens in midgut develpement around week 10-12

A

midgut loop retracts into the abdominal cavity
jejunum first and lies on the left side
cecum returns last and lies in the upper quadrant

51
Q

what is the path of the cecum after it retracts back into the abdomen

A

returns last and lies in the upper right quadrant

the cecum then descends to lie in the lower right quadrant

the appendix forms after the midgut returns to the abdomen as the cecum is descending

thus retrocecal position

52
Q

what is omphalocele

A

results from failure of midgut to return to abdominal cavity
tssue protrudes through umbilicus and is covered by the amniotic membrane***

often prognosis of this is poor and is associated with other congential abnormalities

53
Q

what is gatroschisis

A

results when gut herniates through weakness in body wall

typically occurs lateral to umbilicus (to right)

usually results from incomplete fusion of ventral body wall during folding

herniated bowel is not covered by amniotic membrane *** bathed in amniotic fluid

54
Q

what is an umbilical hernia

A

occurs when gut herniates into umbilical cord after returning to abdominal cavity

loops of bowel herniate through an imperfectly closed umbilicus (along midline)

herniated tissue covered by skin subcutaneous tissue

55
Q

what is meckel’s diverticulum

what does it present similar to

A

persistence of vitelline duct

RULE OF 2’s

occurs in 2% of population
2x more likely in males
found within distal 2 feet of ileum
usually about 2 inches long
2 percent become symptomatic before age of 2
2 types of tissue (gastric and pancreatic)

presents very similar to appendicitis

56
Q

what occurs with malrotation of the gut

A

may results in volvulus (twisting of intestine)

or potential loss of blood supply

57
Q

can stenoses and atresia occur in the midgut

A

yes anywehre along intestine

resulting from vascular compromise or failure to re-canalize

58
Q

what is the problem with failure of the ascending colon to become retroperitoneal

A

results in long mesocolon which may allow for abnormal movements and potentially volvulus of the colon

retrocolic hernia (entrapment of small intestine behind colon) may also result

59
Q

what is the cloaca and what is it lined with

what does it contribute to forming

A

distal most portion of the gut tube

endoderm lined cavity which will contribute to formation of the hindgut and urogenital system

60
Q

what does the urorectal septum do

A

divides cloaca into urogenital sinus and anorectal canal

61
Q

when does the cloacal membrane rupture

A

during week 7

62
Q

what is the pectinate line demarcating

A

marks division between ectoderm/endoderm

63
Q

what is Hirschprung’s disease

A

aka congenital mesocolon

failure of neural crest cells to migrate into caudal large intestine or rectum

absence of parasymapthetic ganglia b/c neural crest cells typically form into parasympathetic nerves

soo…. the area proximal to the paralyzed portion will have a build up of fecal matter

64
Q

fistulas and atresias of the cloaca result from what?

A

improper formation of urorectal septum

65
Q

what do rectourethral and rectovaginal fistulas result from ?

A

anterior displacement of the hindgut

66
Q

rectoanal atresias (abnormally closed or absent) result from what?

A

loss of vascular supply or failure of recanalization

67
Q

how does an imperforate anus occur

A

failure of cloacal membrane to degenerate

GI exam 1 (11 decks)

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