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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
Q

classic sign of duodenal atresia or stenosis?

A

-doublt bubble sign on ultra-sound

26
Q

most frequent cause of ileal or jejunal atresia (and stenosis)?

A

vascular accident - lack of blood supply

27
Q

3 stages of midgut rotation?

A
  • herniation - protrudes into proximal umbilical cord
  • reduction - returns into abdominal cavity
  • fixation - final positioning is made
28
Q

formation of the midgut…

A
  • 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
Q

what is an omphalocele?

A

failure of the midgut to return to the abdominal cavity

30
Q

rotation defects of midgut:

A

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
Q

two classic radiological signs of midgut volvulus?

A
  • corckscrew sign

- whirl(pool) sign - intestines wrapping around the SMA

32
Q

Mechel’s diverticulum - how does it happen? What is it?

A

-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
Q

what is the partitioning of the cloaca?

A

formation of urinary system and rectum - urorectal septum going down hindgut and fuses with cloacal membrane (perineum) = urogenital sinus and the rectum

34
Q

dividing line between the hidngut and proctodeum?

A

pectinate line - divides anal canal into upper and lower part

35
Q

upper anal canal-

1) arterial supply
2) LN drainage
3) innervation?

A

1) Superior rectal a and v
2) IM Lymph nodes
3) ANS - fairly insensitive to pain

36
Q

Lower anal canal-

1) arterial supply
2) LN drainage
3) innervation?

A

1) inferior rectal a and v
2) superficial inguinal lymph nodes
3) Inferior rectal nerve - can convey pain

37
Q

congenital megacolon: what is it?

A

no myenteric nervour plexus = constricted segment of rectum = upstream from that part has accumulation of poop -

Hirschprungs disease

38
Q

Development of the liver?

A
  • 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
Q

Alagille syndrome …

  • what is it?
  • how do you get it?
A
  • 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
Q

Development of the pancreas:

A
  • 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
Q

Minor pancreatic papilla - where do secretions come from (ducts)?

main pancreatic papilla- where do secretions come from -

A
  • proximal part of the dorsal pancreatic

- distal dorsal pancreatic duct meets up with the ventral pancreatic duct

42
Q

Annular pancreas- what is it? how to get? problems?

A

-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
Q

View of annular pancreas on some imaging?

A

double bubble

44
Q

Pancreas divisum

  • what happens?
  • problem?
A
  • 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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