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GINME > First Aid Embryology > Flashcards

First Aid Embryology Flashcards

1
Q

Foregut consists of

A

esophagus to the upper duodenum

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2
Q

Midgut consists of

A

lower duodenum to proximal 2/3 of transverse colon

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3
Q

Hindgut consists of

A

distal 1/3 of transverse colon to anal canal above pectinate line

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4
Q

Mid gut development

A

6th week - physiologic midgut herniates through umbilical ring

10th week - returns to abdominal cavity + rotates around superior mesenteric artery (SMA) total 270° counterclockwise

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5
Q

Ventral wall defects

A

developmental defects due to failure of rostral fold closure (eg sternal defects [ectopia cordis]), lateral fold closure (eg, omphalocele, gastroschisis), or caudal fold closure (eg, bladder exstrophy)

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6
Q

Gastroschisis etiology

A

Extrusion of abdominal contents through abdominal folds (typically right of the umbilicus)

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7
Q

Gastroschisis coverage

A

not covered by peritoneum or amnion

“The abdominal contents are coming out of the G”

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8
Q

Gastroschisis associations

A

cot associated with chromosome abnormalities

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9
Q

Gastroschisis overview

A

TBD

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10
Q

Omphalocele etiology

A

Failure of lateral walls to migrate at the umbilical ring -> persistent midline herniation of abdominal contents into umbilical cord

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11
Q

Omphalocele coverage

A

Surrounded by peritoneum (light gray shiny sac)

“Abdominal contents are sealed in the O”

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12
Q

Omphalocele associations

A

Associated with congenital anomalies

  • trisomy 13
  • trisomy 18
  • Beckwith-Wiedermann syndrome

And other structural abnormalities

  • cardiac
  • GU
  • neural tube
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13
Q

Omphalocele overview

A

TBD

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14
Q

Description of Congenital umbilical hernia

A

failure of the umbilical ring to close after physiologic herniation of the intestines

Small defects usually close spontaneously

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15
Q

Tracheoesophageal anomalies

A

Esophageal atresia with distal tracheoesophageal fistula (TEF) is the most common (85%) and often presents as polyhydramnios in utero (due to inability of fetus to swallow amniotic fluid).

Neonates drool, choke and vomit with first feeding, TEFs allow air to enter the stomach (visible on CXR)

Cyanosis is 2° to laryngospasm (to avoid reflux-related aspiration

Clinical test: failure to pass nasogastric tube into stomach

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16
Q

Clinical test for Esophageal Atresia w/ distal TEF

A

Clinical test: failure to pass nasogastric tube into stomach

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17
Q

TEF AKA

A

Tracheoesophageal fistula

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18
Q

Describe H-type TEF

A

the fistula resembles the letter H

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19
Q

Describe pure Esophageal Atresia

A

CXR shows gasless abdomen

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20
Q

Identify structures and pathology

A
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21
Q

Describe presentation of intestinal atresia

A

Present with bilious vomiting and abdominal distension within first 1-2 days of life

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22
Q

What is duodenal atresia?

A

Caused by failure of duodenum to recanalize

Duodenal atresia is a condition in which the first part of the small bowel (the duodenum) has not developed properly. It is not open and cannot allow the passage of stomach contents.

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23
Q

Duodenal atresia associations

A
  • Associated with “double bubble” (dilated stomach, proximal duodenumm) on x-ray
  • Associated with down syndrome
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24
Q

Jejunal and ileal atresia description

A

Jejunal or ileal Atresia is a birth defect in which the fold of the stomach membrane needed to connect the small intestine to the back wall of the abdomen is, in part, absent. As a result, a portion of the small intestine (the jejunal) twists about one of the arteries to the colon. This twisting may be so severe that the artery in question is completely blocked (atrasia). It is sometimes compared to an apple peel in appearance.

disruption of mesenteric vessels -> ischemic necrosis -> segmental resorption (bowel discontinuity or “apple peel”)

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25
Q

What is the most common cause of gastric outlet obstruction in infants?

A

Hypertrophic pyloric stenosis

26
Q

Signs of hypertrophic pyloric stenosis

A
  • Palpable olive-shaped mass in the epigastric region
  • visible peristaltic waves
  • nonbilious projectile vomiting around 2-6 weeks old
27
Q

hypertrophic pyloric stenosis is most common in?

A

Firstborn males

28
Q

Hypertrophic pyloric stenosis associations

A

associated with exposure to macrolides

29
Q

Imaging of hypertrophic pyloric stenosis

A

ultrasound shows thickened and lengthened pylorus

30
Q

Treatment of hypertrophic pyloric stenosis

A

surgical incision (pyloromyotomy)

31
Q

Complications of hypertrophic pyloric stenosis

A

Results in hypokalemic hypochloremic metabolic alkalosis (2° to vomiting of gastric acid and subsequent volume contraction

32
Q

Identify structures and pathology

A

Hypertrophic pyloric stenosis

33
Q

Pancreas derived from?

A

Foregut

34
Q

Pancrease development

A

ventral pancreatic buds contribute to uncinate process and main pancreatic duct

The dorsal pancreatic bud alone becomes the body, tail, isthmus and accessory pancreatic duct

Both ventral and dorsal buds contribute to the pancreatic head

35
Q

Describe annular pancreas

A

abnormal rotation of ventral pancreatic bud forms a ring of pancreatic tissue -> encircles the 2nd part of the duodenum

may cause duodenal narrowing and vomiting

36
Q

Pancreas divisum

A

ventral and dorsal parts fail to fuse at 8 weeks

common anomaly

mostly asymptomatic

but may cause chronic abdominal pain and/or pancreatitis

37
Q

Spleen derived from

A

Spleen arises in mesentery of stomach (hence is mesenchymal) but has foregut supply (celiac trunk -> splenic artery)

38
Q

Retroperitoneal structures

A

SAD PUCKER

Suprarenal (adrenal) glands

Aorta and IVC

Duodenum (2nd through 4th parts

Pancreas [except tail]

Ureters

Colon (descending and ascending)

Kidneys

Esophagus [thoracic portion]

Rectum (partially)

39
Q

Identify structures

A
40
Q

Identify structures

A
41
Q

Falciform ligament connects

A

Liver to anterior abdominal wall

42
Q

Falciform ligament structures contained

A

ligamentum teres hepatis (derivative of fetal umbilical vein)

Patent paraumbilical veins

43
Q

Falciform ligament is derived from

A

derivative of ventral mesentery

44
Q

Hepatoduodenal ligament connects

A

liver to duodenum

45
Q

Hepatoduodenal ligament structures contained

A

Portal triad

(Proper hepatic artery, portal vein, common bile duct)

46
Q

Describe the Pringle maneuver

A
  • The Hepatoduodenal ligament may be compressed between thumb and index finger placed in omental foramen to control bleeding
47
Q

Hepatoduodenal ligament location

A

Part of the lesser omentum

Borders the omental foramen which connects the greater and lesser sacs

48
Q

Gastrohepatic ligament connects

A

liver to lesser curvature of stomach

49
Q

Gastrohepatic ligament structures contained

A

Gastric vessels

50
Q

Gastrohepatic ligament location

A

Part of the lesser omentum and connects liver to lesser curvature of the stomach and separates greater and lesser sacs on the right

51
Q

Sugical considerations of gastrohepatic ligament

A

May be cut during surgery to access the lesser sac

52
Q

This May be cut during surgery to access the lesser sac

A

Gastrohepatic ligament

53
Q

Gastrocolic ligament connects

A

Greater curvature of stomach and transverse colon

54
Q

Gastrocolic ligament structures contained

A

gastroepiploic arteries

55
Q

Gastrocolic ligament location

A

part of the greater omentum and connects the greater curvature of the stomach to the transverse colon

56
Q

Gastrosplenic ligament connects

A

greater curvature of the stomach and spleen

57
Q

Gastrosplenic ligament structures contained

A

short gastrics

left gastroepiploic vessels

58
Q

Gastrosplenic ligament location

A
  • Separates greater and lesser sacs on the left and connects the greater curvature of the stomach and the spleen
  • Part of the greater omentum
59
Q

Splenorenal ligament connects

A

Spleen to posterior abdominal wall

60
Q

Splenorenal ligament structures contained

A
  • Splenic artery and vein
  • vein of pancreas
61
Q

Identify structures

A
62
Q
A

GINME (63 decks)

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