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Bloc E - GI & Metabolism > Feb28 M2-GI Embryology In the Trenches Part 1 > Flashcards

Feb28 M2-GI Embryology In the Trenches Part 1 Flashcards

1
Q

general cause of duodenal atresia

A

defect in development

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2
Q

usual cause of jejunum and ileum atresia

A

blood supply problem (thrombus, vessel spasm)

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3
Q

how and when gut grows

A

week 4. primordial gut: outpouching of endoderm growing in adjacent mesenchyme

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4
Q

structures derived from foregut

A
  • pharynx
  • lower resp tract
  • esophagus
  • stomach
  • duodenum
  • liver and biliary tract
  • pancreas
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5
Q

important concept in duod embryo

A

stuff in midgut can affect it bc duod is transition to

midgut

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6
Q

why stomach has greater and lesser curvature

A

dorsal border grew faster than ventral border = greater curvature

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7
Q

vagus and stomach 90 deg clockwise rotation

A
  1. left side became anterior (left vagus anterior)

2. right vagus posterior

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8
Q

cause of stomach fixation anomaly

A

loose attachments, diaphragmatic defects

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9
Q

consequence of stomach fixation problem

A

possible volvulus (obstructive and or ischemic)

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10
Q

treatment of fixation anomaly of stomach

A

gastropexy: stitch stomach laparo + stitch to diaphragm

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11
Q

organoaxial volvulus def

A

stomach twisted upwards on its axis. lesser curvature points down

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12
Q

organomesenteric volvulus def

A

stomach twisted on its entire mesentery + pylorus pushing against diaphragm

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13
Q

organoaxial volvulus conseq

A

ischemia

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14
Q

organomesenteric volvulus conseq

A

obstruction: pylorus can’t empty. vomiting

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15
Q

(IMPORTANT) most common GI anomaly in infants

A

pyloric stenosis

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16
Q

symptoms of pyloric stenosis

A

projectile vomiting. non bilious

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17
Q

pyloric stenosis charact and causes

A

genetic (more in males). kind of congenital (pylorus thickens in weeks after birth)

18
Q

pyloric stenosis dx test

A

US. shoulder effect (shouldering is seen)*

19
Q

pyloric stenosis treatment

A

cut stenosis (temporary and anws stenosis resolve by itself later)

20
Q

duod development

A
  1. hollow organ first then filled by the prolif of epith cells
  2. apoptosis and shedding due to ischemia and overprolif = recanalization
    hollow to solid to hollow
21
Q

4 causes of duod obstruction

A
  • duod atresia
  • duod stenosis
  • annular pancreas
  • malrotation
22
Q

duod obstruction: often where + 2 main things

A

often distal to ampula of Vater (and sphincter of Oddi)

  • bilious vomiting
  • polyhydramnios
23
Q

(IMPORTANT) dx sign of duod obstruction

A

double bubble sign

24
Q

(IMPORTANT) how to dx complete vs partial obstruction of duodenum

A
  • complete = no distal air (other than double bubble)

- partial obstruction = distal air present (other than double bubble)

25
Q

in GENERAL: which is worse partial or complete obstruction and why

A

complete bc more distension higher P on wall, move venous congestion, poor arterial supply, necrosis

26
Q

(IMPORTANT) exception where partial obst worse than complete and why

A

duodenum obstruction caused by MIDGUT VOLVULUS (there is air distal on XR): URGENT BECAUSE OF ISSUE OF POSSIBLE GUT ISCHEMIA

27
Q

annular pancreas cause

A

bifid ventral bud fuses with dorsal bud

28
Q

what allows reduction of phgy herniation

A

liver reduces in size + abd cavity increases in size

29
Q

duod obstruction cause that is not in duodenum

A

midgut volvulus

30
Q

duod obstructions where get air distal and those with no air distal

A

air distal = stenosis, midgut volvulus
no air distal = atresia
annular pancreas may have air

31
Q

midgut forms what

A

duod starting D3, instestine, cecum and appendix, colon until splenic flexure

32
Q

why atresia (no air distal), stenosis (air distal) and annular pancreas (yes or no air distal) are not emergencies compared to midgut volvulus causing duod obst (air distal)

A

because no issue of ischemia

33
Q

duodenojejunal limb and cecocolic limb location to SMA after total gut rotation

A

duodenojejunal to SMA left

cecocolic to SMA right

34
Q

name of duct persisting if failure of yolk sac stalk obliteration

A

omphalomesenteric duct

35
Q

consequences of omphalomesenteric duct that persists

A

many anomalies possible. most common is Meckel’s diverticulum

36
Q

what kind of duod obstruction in midgut volvulus

A

PARTIAL (which is why get distal air)

37
Q

partial duod obstruction on XR: next dx step

A

upper GI test to check for volvulus

38
Q

2 types of volvulus

A

classical and segmental

39
Q

classical volvulus cause

A

no fixation, mesentery didn’t widen + have ladd’s bands. malrotation causes volvulus to occur

40
Q

segmental volvulus cause

A

mass in bowel (tumor or malformation) causes bowel to volvulize

41
Q

malrotation main concern

A

RISK OF VOLVULUS

Bloc E - GI & Metabolism (58 decks)

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