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GI Exam 1 > GI Embryology > Flashcards

GI Embryology Flashcards

1
Q

Primitive gut forms during what week?

A

4

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2
Q

term for beginning of the primitive gut?

A

stomadeum

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3
Q

Primitive gut tube lined by what type of cells?

A

endoderm

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4
Q

term for the end of the primitive gut tube?

A

cloaca / proctodeum

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5
Q

the cloaca and the stomadeum are lined by what cell type?

A

ectoderm

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6
Q

glands arise from what cell type?

A

endoderm

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7
Q

primitve gut divided into what sections?

A

foregut
midgut
hindgut

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8
Q

foregut makes what?

A
  • GI from pharynx to duodenum dital to bile duct (ampulla vatter?)
  • liver
  • biliary apparatus
  • pancreas
  • respiratory system

-celiac a

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9
Q

midgut makes what?

A
  • duodenum distal to bile duct to right half or two thirds of TC (transverse colon)
  • SMA
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10
Q

hindgut makes what?

A
  • distal TC to superior part of anal canal
  • bladder epithelium and most of urethra

-IMA

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11
Q

what separates the trachea and the esophagus?

A

tracheoesophageal folds - fuse into a septum

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12
Q

smooth muscle comes from where?

A

splanchnic mesenchyme

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13
Q

beginning of the lung part?

A

off foregut = the lung bud

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14
Q

most common atresia/fistulae?

A

83% children have atresia with a fistulae of distal esophagus

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15
Q

3 mechanisms of esophageal stenosis?

A

1) stenotic region contains squestered respiratory tissue elements (hyaline cartilage and respiratory epithelium)
2) Fibromuscular hypertrophy due to myenteric plexus damage
3) mucosal diaphragm is persent

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16
Q

dorsal vs ventral aspect of stomach growth? What does this do?

A

dorsal aspect grows faster than the ventral = great (and lesser) curvatures formed

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17
Q

Vagal nerves in the abdomen?

A

the LEFT is ANTERIOR
the RIGHT goes POSTERIOR

“L.A.R.P.”

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18
Q

rotation of the stomach?

A

clockwise 90 degrees

19
Q

hallmark symptom of infantile hypertrophic pyloric stenosis?

A

projectile vomiting

20
Q

Duodenum rotation?

A

with the stomach 90 degrees to the right - forms the C-curve

21
Q

duodenal atresia most commonly involves which part?

A

part 2 - usually just distal to where ducts empty into duodenum

22
Q

duodenal stenosis most commonly involves which part?

A

parts 3 and 4

23
Q

most common cause of duodenal stenosis?

A

incomplete recanalization

24
Q

Causes of duodenal obstruction?

A

-mutations in sonic hedgehog signaling

  • incomplete recanalization (stenosis)
  • annular pancreas (stenosis)
  • no recanalization (atresia)
25
classic sign of duodenal atresia or stenosis?
-doublt bubble sign on ultra-sound
26
most frequent cause of ileal or jejunal atresia (and stenosis)?
vascular accident - lack of blood supply
27
3 stages of midgut rotation?
- herniation - protrudes into proximal umbilical cord - reduction - returns into abdominal cavity - fixation - final positioning is made
28
formation of the midgut...
- cranial and caudal limbs (midgut loop) herniate into the umbilical cord area (bringing SMA with them AND ROTATE CCW 90 around the SMA (so cranial limb is on top-or moves RIGHT-and caudal limb is on bottom-MOVES LEFT FROM VENTRAL ASPECT) - cranial limb grows quicker (forms convoluted structure) and returns to abdominal cavity first (small intestinal loops) - caudal limb comes back while completing another CCW 180 degrees of additional rotation - the cecum (diverticulum that grew into the caudal limb) returns last - where it moves to is controversial (up near the liver or goes to "usual" spot in body) fixation - intestines enlarge, lengthen and assume final positions
29
what is an omphalocele?
failure of the midgut to return to the abdominal cavity
30
rotation defects of midgut:
1) non-rotation: first CCW 90 degrees of rotation happens but rest of dev is meh. Left sided colon = asymptomatic 2) Reversed rotation: makes *CW* 270 degrees =duodenum is anterior to SMA and TC is posterior to SMA-->SMA compresses TC 3) Mixed rotation and volvulus (twisting of intestines): FIRST CCW 90 degrees happens but then cranial limb aborts rotation and caudal cant rotate or vice versa = cecum lies inferior to pylorus; peritoneal bands and volvulus usually cause a duodenal obstruction = Ladd's band obstructs the duodenum = duodenal dilation
31
two classic radiological signs of midgut volvulus?
- corckscrew sign | - whirl(pool) sign - intestines wrapping around the SMA
32
Mechel's diverticulum - how does it happen? What is it?
-ectopic gastric tissue with parietal cells that produce HCl - if attached to the umbilicus and the anterior wall - could potentially form an external opening at umbilicus
33
what is the partitioning of the cloaca?
formation of urinary system and rectum - urorectal septum going down hindgut and fuses with cloacal membrane (perineum) = urogenital sinus and the rectum
34
dividing line between the hidngut and proctodeum?
pectinate line - divides anal canal into upper and lower part
35
upper anal canal- 1) arterial supply 2) LN drainage 3) innervation?
1) Superior rectal a and v 2) IM Lymph nodes 3) ANS - fairly insensitive to pain
36
Lower anal canal- 1) arterial supply 2) LN drainage 3) innervation?
1) inferior rectal a and v 2) superficial inguinal lymph nodes 3) Inferior rectal nerve - can convey pain
37
congenital megacolon: what is it?
no myenteric nervour plexus = constricted segment of rectum = upstream from that part has accumulation of poop - Hirschprungs disease
38
Development of the liver?
- made out outgrowths of the foregut - from 2 limbs - cranial limb is the larger limb = functional tissue of the liver - caudal limb smaller = gallbladder and cystic duct
39
Alagille syndrome ... - what is it? - how do you get it?
- due to mutations in the Notch pathway=(syndromic paucity of interlobular ducts) - most common cause of familial intrahepatic cholestasis (lack of bile flow) - decreased number of bile ducts in the portal spaces
40
Development of the pancreas:
- from the foregut endoderm - ventral (smaller) and dorsal (larger) buds - ventral rotates clockwise with the stomach and ventral meets up with the dorsal - ventral becomes the head of the pancreas and the dorsal the tail - the two ducts from ventral and dorsal fuse (the bile duct came along with in the 90deg CW twist
41
Minor pancreatic papilla - where do secretions come from (ducts)? main pancreatic papilla- where do secretions come from -
- proximal part of the dorsal pancreatic | - distal dorsal pancreatic duct meets up with the ventral pancreatic duct
42
Annular pancreas- what is it? how to get? problems?
-developmental error - have a bilobed pancreatic ventral bud ad one bud swings CW around duodenum and other bud swings CCW around duodenum and they pinch off the duodenum (ring around the pancreas)
43
View of annular pancreas on some imaging?
double bubble
44
Pancreas divisum - what happens? - problem?
- no fusion of dorsal pancreatic duct and ventral pancreatic duct - the dorsal pancreatic ducts secretes out of the minor papilla and duct which is smaller = potential to obstruction = predisposed to pancreatitis

GI Exam 1 (11 decks)

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