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Netters Upper Limb > Gastrointestinal Embryology > Flashcards

Gastrointestinal Embryology Flashcards

1
Q

What is the epithelial lining of the gut tube made from?

A

The endoderm

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2
Q

What are all other walls besides the epithelial made out of ?

A

Mesoderm

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3
Q

What is the serous membrane in the abdomen (periotenum) derived from?

A

Mesoderm

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4
Q

What are mesenteries?

A

They suspend the GI tract from the body wall.

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5
Q

Where are mesenteries?

A

Where the visceral peritoneum covering an organ reflects back onto the abdominal wall to become parietal peritoneum.

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6
Q

What are the boundaries of the foregut, midgut, and hindgut?

A

The superior mesenteric artery (SMA), Inferior mesinteric artery (IMA), and the celiac trunk.
They travel from the posterior wall to the gut tube through the dorsal mesentery suspending the gut tube from the posterior body wall.

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7
Q

What is the mesoderm that the liver buds off into called?

A

Septum transversum (transverse septum). It forms the connective tissue and blood vessels of the liver, and also the diaphragm.

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8
Q

What does the liver bud off into and what does it divide?

A

It buds off of the foregut into the ventral mesentery (suspending the gut tube from the ventral body wall) dividing it into the falciform ligament and the lesser omentum.

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9
Q

Where does the pancreas bud off of?

A

The foregut just above the midgut junction.

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10
Q

What are the two buds of the pancreas?

A

The dorsal pancreas buds into the dorsal mesentery and the ventral pancreas buds into the ventral mesentery.

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11
Q

What does the spleen develop from?

A

The mesoderm in the dorsal mesentery of the stomach.

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12
Q

How does the stomach rotate?

A

It rotates 90 degrees clockwise on the longitudinal axis so the left side faces anteriorly.

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13
Q

What does the dorsal mesentery of the stomach becomes as the stomach grows and rotates?

A

It becomes the greater omentum.

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14
Q

How does stomach rotation move the liver, duodenum, pancreas, and dorsal mesentery?

A

It moves the liver to the right side of the abdomen. it pushes the dudodenum, pancreas and part of the dorsal mesentery against the posterior body wall, resulting in a retroperiotneal duodenum and pancreas.

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15
Q

What are the parts of the dorsal mesentery of the stomach that do not fuse with the parietal peritoneum covering the posterior body wall called?

A

Splenorneal (linenorenal) ligament, the gastrosplenic ligament, and the greater omentum.

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16
Q

How does the greater omentum loop?

A

It loops over itself and passes the anterior transverse colon, resulting in the adult anatomy.

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17
Q

Where does foregut rotation move the ventral pancreatic bud? What does it fuse with?

A

It moves it dorsally where it fuses with the dorsal pancreatic bud.

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18
Q

What is a physiological herniation?

A

The midgu loops into the umbilical cord. It is still connected to the rapidly resorbing yolk sac and yolk stalk.

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19
Q

What does the cranial limb of the midgut loop form?

A

The jejunum and upper ileum.

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20
Q

What does the caudal limb form?

A

The lower ileum through the proximal 2/3 of transverse colon.

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21
Q

How does the midgut rotate? Where do the jejunu, ilium, and cecum go?

A

The midgut loop rotates 270 degrees around the superior mesenteric artery.
The jejunum returns first to the left side, and the ileium to the right side.
The cecum returns last to the right upper quadrant but it moves down to the right lower quadrant.

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22
Q

What does the dorsal mesentery fuse with during rotation of the midgut?

A

It fuses with the posterior abdominal wall.

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23
Q

What do the mesenteries of the ascending and descending colon fuse with during midgut rotation.

A

They fuse with the posterior abdominal wall so they become retroperitoneal.

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24
Q

What does the transverse mesocolon fuse with during rotation of the midgut?

A

It fuses with the greater omentum as the greater omentum passes anterior to it.

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25
Q

What do the mesentery (proper) of the jejunoileal loops attach to during rotation of the midgut?

A

They attach diagonally from the ileocecal junctions to the duodenal-jejunal junction.

26
Q

what is pyloric stenosis?

A

It results from hypertrophy of the muscularis externa of the pylorus so that the pyloric canal is ubstructed leading to forceful (projectile), nonbilous vomiting.

27
Q

When do symtpoms of pyloric stenosis show?

A

3 to 5 weeks of age.

28
Q

What is annular pancreas?

A

When the ventral pancreatic bud has two lobes moving in opposite directions to form a ring around the second part of the duodenum.
This constricts the duodenum. Symptoms may include feeding intolerance, vomitin, and abdominal distension.

29
Q

What is omphalocele?

A

When the midgut loop fails to the return to the abdominal cavity. The viscera herniate through the umbilical ring and are contained in an amnion covered parietal peritoneum at the base of the umbilical cord.

30
Q

What is gastroschisis?

A

It results when the abdominal viscera herniate through the body wall directly into the amniotic cavity.

31
Q

Where does gastroschisis usually occur?

A

To the right of the umbilicus.

32
Q

What causes gastroschisis?

A

A defect in the lateral folding of the embryo that leaves a gap or weakness in the anterioral abdominal wall.

33
Q

Which typically presents with other abnormailiteis: omphalocele or gastroschisis?

A

Omphalocele

34
Q

What is Meckel’s Diverticulum?

A

The persistence of the proximal portion of the yolk stalk (vistelline duct).

35
Q

What does ectopic gastric mucosa in meckel’s diverticulum lead to?

A

Ulceration, perforation, or GI bleeding.

36
Q

Where is meckels diverticulum found?

A

About 2ft from the ileocecal junction.

37
Q

Why does volvolus occur?

A

Malrotation of the midgut. The midgut partially rotates. It may partially rotate, rotate clockwise, or does not rotate at all. This results in abnormal positioning of the abdominal viscera.

38
Q

Where do the small intestine and large intestine end up if no rotation occurs?

A

The small is on the right and the large is on the left.

39
Q

If clockwise rotation of the midgut occurs, where does the large intestine end up?

A

Posterior to the duodenum.

40
Q

If malrotation occurs what happens to the mesentery?

A

It does not fuse correctly so the small intestine can twist around the SMA, resulting in volvulus (twisting).

41
Q

what are the symptoms of volvulus?

A

Vomiting, absence of stool and abdominal distention. If SMA is obstructed this can be life threatening.

42
Q

What is intestinal atresia and stenosis?

A

When the lumen of the midgut fills in from the epithelial proliferation and recanalizes to form vili and crypts. This is a normal process but when problems occur in recanalization, this can result in stenosis (which is abnormal narrowing).
Atresia refers to a closed or abscent septa and cysts.

43
Q

What is duodenal atresia?

A

This occurs from failed recanalization and is a condition where the duodenum does not develop properly.

44
Q

What is duodenal atresia associated with?

A

Polyhydraminos (too much umbilical fluid) in utero, bilious vomit and a distended abdomen.

45
Q

Where does duodenal atresia usually occur in relation to the major papilla?

A

Distal to the major papilla.

46
Q

What is intussusception?

A

A segment of instestine invaginates or telescopes into an adjacent segment.

47
Q

What could be a possible cause of intussusception?

A

Excessive peristalsis could cause it, however the etiology is unknown.

48
Q

What are symptoms of intussusception?

A

Intermittent abdominal pain, vomiting, bloating, and bloody stool.

49
Q

What is aganglionic magacolon (hirschsprung’s disease)?

A

A lack of ganglia in the colon

50
Q

What causes aganglionic magacolon?

A

A defect in the RET gene, a receptor tyrosine kinase involved in neural cell migration. The neural cells fail to migrate to the hindgut?

51
Q

When do neural cells migrate to the gut?

A

Weeks 5-7

52
Q

What areas do agaglionic magacolon typically effect?

A

Rectum to sigmoid colon

53
Q

What are typical symptoms of aganlionic megacolon?

A

A loss of peristalsis and immobility, fecal retention and abdominal distention up to the transverse colon (megacolon).

54
Q

What is polyhydraminos associated with? What is polyhdraminos?

A

It is too much umbilical fluid in uterus and it is associated with duodenal atresia and stenosis (a type of intestinal atresia/stenosis)

55
Q

What part of the gut tube is derived from mesoderm?

A

All the other layers besides the epithelium lining of the gut tube(the lamina propria, submucosa, muscularis, and aventitia or serosa (visceral peritoneum)) and their components; with the exception of nerves and ganglia.

56
Q

What does the dorsal mesentery become?

A

it becomes the splenorenal and gastrosplenic ligaments, the greater omentum, the mesentery proper, the transverse mesocolon, and the sigmoid mesocolon

57
Q

Where and from what is the spleen derived?

A

The spleen develops in the dorsal mesentery of the stomach; it is mesodermal derived

58
Q

Which condition is associated with projectile nonbilous vomiting?

A

Pyloric stenosis

59
Q

Is annular pancreas typically bilous or nonbilous?

A

nonbilous

60
Q

Which conditions can present with bilous vomiting?

A

Duodenal atresia and midgut volvulus may present with bilious vomiting

61
Q

Which embryological GI defect is likely to not present for days/weeks?

A

Volvolus

Netters Upper Limb (21 decks)

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