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human development > GI development > Flashcards

GI development Flashcards

1
Q

at what point is organogenesis complete?

A

12 weeks

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2
Q

which organs are formed at what points of development?

A
  • 4 weeks – gut tube forms
  • 5 weeks – liver and pancreas formation
  • 6 weeks – ventral pancreatic bud fuses with dorsal bud
  • 7 weeks – primary intestinal loop herniates into the umbilicus and rotates
  • 11 weeks – midgut rotates and retracts into abdomen
  • 12 weeks – ascending and descending colon attach to body wall
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3
Q

what supplies the foregut, midgut and hindgut?

A
  • Foregut supplied by the coeliac artery
  • Midgut supplied by the superior mesenteric artery
  • Hindgut supplied by the inferior mesenteric artery
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4
Q

what does the foregut give rise to?

A

pharynx, oesophagus, stomach, cranial half of the duodenum and the ampulla of Vater, liver parenchyma and hepatic duct epithelium, gallbladder, cystic duct and common bile duct

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5
Q

what does the midgut give rise to?

A

caudal half of duodenum, jejenum, ileum, cecum, appendix, ascending colon and proximal 2/3 of transverse colon

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6
Q

what does the hindgut give rise to?

A

distal 1/3 of transverse colon, descending colon, rectum and urogenital sinus

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7
Q

name foregut development abnormalities?

A
  • Oesophageal atresia/stenosis – blockage
  • Tracheo-oesophageal fistulae
  • Congenital hiatus hernia
  • Pyloric stenosis
  • Duodenal atresia
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8
Q

what does failure to separate the oesophagus and respiratory tract lead to?

A
  • Failure of separation
  • Atresia of the oesophagus
  • Atresia of the oesophagus with fistula
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9
Q

what can cause reflux in infants?

A

overfeeding

GORD

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10
Q

what can cause GORD in babies?

A

o Immaturity of motor function in neonates
o Suck reflex not present prior to 32 weeks’ gestation
o Lower oesophageal sphincter pressure is reduced
o Gastric emptying delayed
o Slow mouth to anus transit time

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11
Q

why does GOR in a child improve?

A

LOS develops

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12
Q

what is duodenal atresia?

A

blockage in the duodenum

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13
Q

how does duodenal atresia present?

A

vomiting (maybe an hour or 2 after feeding)

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14
Q

how does an x-ray of duodenal atresia present?

A

classic double bubble

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15
Q

how does a diaphragmatic hernia present?

A

• Presents w severe respiratory distress bc of pulmonary hypoplasia

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16
Q

where does a diaphragmatic hernia occur?

A

posterolateral aspect of the diaphragm

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17
Q

what causes alongation and rotation of the midgut?

A

rapid growth

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18
Q

name midgut developmental abnormalities?

A
  • Jejunal atresia
  • Malrotation
  • Meckel’s diverticulum
  • Omphalocele – gut is outside the baby’s body
  • Gastrochisis
19
Q

how does jejenal atresia present?

A

presents as vomiting with BILE (not seen in other atresias – bile only present in jejenum)

20
Q

how can jejunoileal atresia be classified?

A

• I, II, IIIa, IIIb (apple peel), IV

21
Q

what happens in malrotation, what does it cause and how is it treated?

A
  • Bowel twisted around the superior mesenteric artery  necrotic, gangrenous gut
  • Treated by unwinding the bowel and seeing if the blood supply returns
22
Q

what is the duodenum-jejenum junction anchored by?

A

ligament of Treitz

23
Q

what causes intestinal malrotation?

A

failure of normal rotation and fixation

  • Duodenojejunal junction is to the right of the spine
  • Ligament of Treitz is absent
  • Abnormal placement of mesenteric ligaments may obstruct the second portion of the duodenum
24
Q

what does persistence of the vitelline duct give rise to?

A

Meckel’s diverticulum

25
Q

how does Meckel’s diverticulum occur?

A
  • vitelline duct loses connection to the midgut loop before it goes to the abdominal cavity
  • perisstence of proximal part forms MD
  • MD attached to terminal ileum
  • ectopic gastric mucos or pancreatic tissue may be present in MD
26
Q

what hindgut abnormalities can occur?

A

anorectal abnormalities

27
Q

what gives rise to the rectum and urogenital sinus?

A

cloaca

28
Q

what do neural crest cells give rise to?

A

enteric ganglia

29
Q

what does Hirschprung’s disease result from?

A

failure of development of the enteric ganglia (no ganglion cells)

30
Q

how does Hirschsprung’s disease occur?

A

failure of neural crest cells to migrate to the correct location leads to absence of ganglion cells

31
Q

how does Hirschsprung’s disease present?

A

neonatal colonic obstruction

32
Q

how does human small intestinal villus and crypt formation occur?

A

through a process of epithelial and mesenchymal reorganisation

33
Q

what is the surface area of the small intestine increased by?

A
  • Folding of the mucosa into plicae circulares
  • Formation of villi
  • Development of microvilli
34
Q

when is intestinal elongation rapid?

A

in utero

35
Q

when do most small intestinal microvillus enzymes begin to appear?

A

8 weeks

36
Q

when does • Small intestinal lactase activity reach maximal levels?

A

end of gestation

37
Q

when are fetuses unable to swallow/breathe?

A

before 32-34 weeks of gestation

38
Q

when do teeth appear?

A

6 months of age

39
Q

how is breast’s milk different to cow’s milk?

A

• Lower protein in breast milk
o More Whey protein > Casein – whey more easily digested
• Lower minerals eg Na – lower solute load on the baby
• Essential fatty acids – better absorbed
• Lipase - digestion
• Anti-infective -
• Vitamin A/C/D greater
• Lower calcium and phosphorus (high phosphorus in CM leads to hypocalcemic tetany)

40
Q

when can you stop using infant formula?

A

12 months

41
Q

when should weaning be introduced?

A

6 months

42
Q

when should allergenic food be introduced?

A

6 months

43
Q

what foods can be considered allergenic?

A

eggs

gluten containing food

44
Q

how should eggs be introduced?

A

egg yolk first, then egg whites

human development (20 decks)

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