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Gastrointestinal System > EXAM #1: EMBRYOLOGY OF THE GI SYSTEM > Flashcards

EXAM #1: EMBRYOLOGY OF THE GI SYSTEM Flashcards

1
Q

What germ layer do the stomodeum and protodeum develop from?

A

Ectoderm

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2
Q

What are the derivatives of the foregut?

A

Pharynx to duodenum distal to the bile duct, plus:

  • Liver
  • Biliary apparatus
  • Pancreas
  • Respiratory system
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3
Q

What artery supplies the foregut?

A

Celiac artery

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4
Q

What are the midgut derivatives?

A

Duodenum distal to the bile duct to the right half of the transverse colon

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5
Q

What artery supplies the midgut?

A

SMA

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6
Q

What are the derivatives of the Hindgut?

A

Distal half of the transverse colon to the superior part of anal canal, plus:

  • Bladder epithelium
  • Most of the urethra
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7
Q

What artery supplies the Hindgut?

A

IMA

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8
Q

What part of the primitive gut does the respiratory system develop from?

A

Foregut

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9
Q

Describe the normal development of the esophagus.

A

1) Single tube
2) Branching of a lung bud and foregut from common tuve
3) Trachea and respiratory passageway are separted by tracheoesophageal folds that form a septum
4) Esophagus elongates

Note that growth of the epithelium in the lumen of the esophagus nearly obstructs the esophagus and then re-canalizes

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10
Q

What is a Short Esophagus?

A

Failure of the esophagus to elongate pulls some of the stomach into the thoracic cavity that can lead to lung hypoplasia

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11
Q

What is esophageal atresia?

A

Failure of the esophagus to form

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12
Q

What is tracheoesophageal fistula?

A
  • Proximal esophageal atresia

- Fistula forms between trachea and distal esophageal segment

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13
Q

What is esophageal stenosis?

A

Narrowing of the esophageal lumen

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14
Q

What are the three mechanisms that cause esophageal stenosis?

A

1) Sequestration of respiratory tissue elements
2) Myenteric plexus damage that causes hypertrophy (muscularis mucosa)
3) Mucosal diaphragm

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15
Q

What vascular anomaly can lead to esophageal stenosis?

A

4th branch on the LEFT side of the aortic arch; an anomalous right subclavian retroesophageal artery

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16
Q

What is the eponym for an anomalous right subclavian retroesophageal artery?

A

Lusorian artery

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17
Q

Describe the normal development of the stomach.

A

1) Expansion of primitive gut tube
2) More dorsal growth than ventral
3) 90 degree CLOCKWISE rotation
4) Slight pivot from growing esophagus

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18
Q

What part of the primitive stomach becomes the greater curvature?

A

Dorsal

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19
Q

What part of the primitive stomach becomes the lesser curvature?

A

Ventral

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20
Q

What is the LARP mnemonic?

A 
Left= Anterior 
Right= Posterior
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21
Q

What is Infantile Hypertrophic Pyloric Stenosis?

A

Hypertrophy of the pyloric sphincter in the neonate

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22
Q

What is the US characteristic that is pathognomonic for an Infantile Hypertrophic Pyloric Stenosis?

A

Sonolucent donut

23
Q

What is the hallmark sign of Infantile Hypertrophic Pyloric Stenosis?

A

Non-bilious projectile vomiting

24
Q

What causes duodenal stenosis?

A

Incomplete recanalization of the duodenum

25
Q

What causes duodenal atresia?

A

Complete failure of recanalization

26
Q

Mutations in what growth factor have been implicated in duodenal obstruction?

A

Sonic Hedge Hog

27
Q

What x-ray findings is pathogmnemonic for duodenal atresia?

A

Double Bubble Sign

28
Q

What is the most common cause of jejunal and ileal atresia?

A

Vascular accident, NOT failure of recanalization

29
Q

What are the three stages of midgut rotation? What happens during these stages?

A

1) Herniation into the umbilical cord
2) Reduction back into the abdominal cavity
3) Fixation to posterior abdominal wall

30
Q

What happens to the cranial and caudal limbs in midgut rotation? What is the axis of rotation?

A

Axis= SMA

Cranial= superior to SMA

  • Undergoes rapid elongation
  • Comes back in to left

Caudal= inferior to SMA
- Comes back in to right and inferior

31
Q

What direction does the midgut rotate?

A

1) 90 degrees COUNTER-CLOCKWISE going OUT
2) 90 degrees counter clockwise
3) Additional 90 degrees COUNTER-CLOCKWISE

32
Q

What is Omphalocele?

A

Failure of midgut reduction–results in external abdominal contents

33
Q

What is a midgut nonrotation?

A

Midgut ROTATES, but only the first 90 degrees

34
Q

What is the manifestation of midgut nonrotation?

A

Reversal of midgut contents–left sided-colon and right-sided small intestine

35
Q

What is reversed rotation of the midgut?

A

270 degree rotation CLOCKWISE instead of counter- clockwise

36
Q

What is the manifestation of reversed midgut rotation?

A
  • Duodenum is anterior to the SMA

- Transverse colon is posterior to SMA

37
Q

What is the mixed rotation of the midgut?

A
  • Cranial limb rotates but caudal limb doesn’t in first rotation
  • 2nd rotation, only caudal limb rotates
38
Q

What is the manifestation of mixed rotation of the midgut?

A

1) Cecum lies inferior to pylorus
2) Peritoneal bands form over duodenum
3) Duodenal obstruction
- Peritoneal bands
- Volvulus

39
Q

How does a midgut volvulus appear on imaging?

A

1) “Corkscrew sign” on CT

2) Whirpool sign on US

40
Q

What is a Meckel’s Diverticulum?

A

Persistence of the vitelline duct that forms an outpocketing of the ileum–a TRUE diverticulum

41
Q

What type of diverticulum is a Meckel’s Diverticulum?

A

True–all walls involved

42
Q

What causes ulceration of a Meckel’s Diverticulum?

A

Heteroptoic parietal cells that screte HCl

43
Q

How is the cloaca normally partitioned?

A

1) Urorectal septum divides the cloaca (terminal hindgut) into dorsal and ventral portions
- Ventral= urogenital sinus
- Dorsal= rectum
2) Urorectal septum contacts cloacal membrane forming:
- Anal membrane
- Urethral membrane
3) Anal membrane lies at bottom of proctodeum

44
Q

What is the division of the dual derivation of the anal canal?

A

Pectinate line

  • Proximal= hindgut
  • Distal= ectoderm
45
Q

What is the white line in the anal canal?

A

Division between internal and external sphincters

46
Q

What arteries and veins supply the anal canal from the hindgut?

A

Superior rectal artery and veins

47
Q

What lymph nodes supply the anal canal above the pectinate line?

A

IM

48
Q

What arteries and veins supply the anal canal below the pectinate line?

A

Inferior rectal

49
Q

What lymph nodes drain the anal canal distal to the pectinate line?

A

Superficial inguinal

50
Q

Describe the innervation of the anal canal.

A

Superior to pectinate line= ANS

Inferior to pectinate line= Inferior rectal nerve

No pain with issue superior to pectinate line*

51
Q

What is a Congenital Megacolon?

A

Absence of Myenteric Plexus in the colon that leads to contraction and dilation similar to achalasia

52
Q

What is an annular pancreas?

A

Bilobed pancreas wraps around the duodenum

53
Q

What can an annular pancreas cause?

A

Duodenal stenosis

54
Q

What sign can be present with an annular pancreas on x-ray?

A

Double bubble

Gastrointestinal System (42 decks)

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