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Med 1: GI > Goal 2: Development Of GI > Flashcards

Goal 2: Development Of GI Flashcards

1
Q

What arch and parts form the anterior 2/3rds of the tongue?

A
  • 2 Lateral lingual swelling and tuberculum impar (a medial swelling)
  • Arch 1
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2
Q

What arches and parts form the 1/3 posterior part of the tongue?

A
  • 2,3, and anterior part of the 4th arch

- medial swelling called copula or hypobranchial eminence

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3
Q

What are the general sensory nerve supplies of parts of the tongue? What is different in the taste nerve supply?

A

GENERAL

  • anterior: V3
  • posterior: 9
  • epiglottis: 10

TASTE
-all same except anterior: 7

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4
Q

What is Ankyloglossia?

A
  • Tongue tied
  • frenulum attached to tip of tongue so it’s stuck to floor of the mouth
  • poor feeding with infant
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5
Q

Developmental path to gastrulation starting at primitive streak? What week does this happen?

A

Primitive steak—->epiblast—-> 3 germ layers

-week 3

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6
Q

Where are the walls of the digestive and respiratory tract derive from?

A

Splanchnic mesoderm

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7
Q

Where do the epithelial lining of the digestive tract derive from?

A

Endoderm

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8
Q

Where are somites derived from?

A

Paraxial mesoderm

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9
Q

What supplies the muscles of the tongue? Where are they derived from?

A
  • CN 12, hypoglossal nerve

- myoblasts originating in occipital somites

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10
Q

Which germ layer undergoes neurulation? What does it form?

A
  • ectoderm

- neural plate—> neural tube to make brain and spinal cord

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11
Q

What is the appearance of “Tube on top of a tube?” What forms these tubes?

A
  • ectoderm: neural tube

- endoderm: gut tube

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12
Q

What type of foldings happen during week 3-4 of IUL? Where are the foldings not complete at?

A
  • craino caudal folding with neural tube
  • lateral folding, then ventral folding
  • area that doesn’t fully close, but is normal, is the umbilical region where the connecting stalk and yolk sac duct remain attached
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13
Q

What is Gastroschisis? What causes it? How can it be detected? What other symptoms do you see with it?

A
  • failure of lateral walls to close
  • intestinal loops herniate directly into amniotic cavity so prone to abrasions from the fluid, usually lie on right side
  • AFP high when abdominal organs are out so will see high AFP in mom’s blood test and amniotic fluid test
  • polyhydraminos and NOT ASSOCIATED WITH CHROMOSOMAL ABNORMALITIES
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14
Q

What are three types of ventral wall defects?

A
  • Ectopia Cordis: heart outside body
  • Gastrochisis: intestines outside body
  • Cloacal Exstrophy: urogenital organs outside body
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15
Q

What are the 3 divisions of the primitive gut? Where do they start and end?

A
  • foregut: respiratory diverticulum to liver outgrowth
  • mid guy: liver outgrowth to right 2/3rd and left 1/3rd of transverse colon
  • hind gut: left 1/3 of transverse colon to cloacal membrane
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16
Q

Derivatives of Foregut? Artery? Parasympathetic and Sympathetic innervation? Where is the pain referred to?

A
  • esophagus, stomach, duodenum(1st and upper 1/2 of second part), liver, pancreas, biliary apparatus, gall bladder
  • celiac trunk
  • para: vagus
  • symp: pre-T5-T9 thoracic splanchnic nerves, post-celiac ganglion
  • epigastrium
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17
Q

Derivatives of Midgut? Artery? Parasympathetic and Sympathetic innervation? Where is the pain referred to?

A
  • duodenum(lower 1/2), jejunum, ileum, cecum, appendix, ascending colon, transverse colon (proximal/right 2/3rd)
  • superior mesenteric artery
  • para: vagus
  • sym: pre- T10-T11 thoracic splanchnic nerves, post-s superior mesenteric ganglion
  • umbilical pain
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18
Q

Derivatives of Hindgut? Artery? Parasympathetic and Sympathetic innervation? Where is the pain referred to?

A
  • transverse colon (distal/ left 1/3rd), descending colon, sigmoid colon, rectum, anal canal (above pectinate line)
  • inferior mesenteric artery
  • para: pelvic splanchnic
  • sym: pre- L1-L2 lumbar splanchnic nerves, post-inferior cell bodies
  • hypogastric pain
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19
Q

What are the parts of the ventral mesentery?

A
  • lesser omentum (hepatoduodenal and hepatogastric ligaments)
  • falciform lig
  • coronary lig
  • triangular lig
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20
Q

What are the parts of the dorsal mesentery?

A
  • greater Omentum (gastrorenal, gastrosplenic, gastrocolic, splenorenal lig)
  • mesentery of small intestine
  • mesoappendix
  • transverse mesocolon
  • sigmoid mesocolon
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21
Q

What are the intraperitoneal organs?

A
  • organs suspended by mesentery
  • stomach, liver and gallbladder, duodenum, small intestine (jejunum and ileum), tail of pancreas, spleen, cecum, appendix, transverse and sigmoid colon
22
Q

What are the primary retroperitoneal organs?

A
  • organs located behind peritoneum

- kidneys and adrenal glands, ureters, aorta, IVC, sympathetic trunks, lower rectum and anal canal

23
Q

What are the secondary retroperitoneal organs?

A
  • layers that used to be intraperitoneal until they lost a layer of mesentery during development
  • pancreas (except tail), duodenum (2,3,4th part), ascending colon, descending colon, upper rectum
24
Q

When does the respiratory/trachea-bronchial diverticulum (lung bud) appear in the foregut? What two structures does it separate?

A
  • week 4 of IUL

- separates esophagus (foregut) from respiratory primordium (lung bud) by the TRACHEOESOPHAGEAL SEPTUM

25
Q

What causes the esophagus to length during development? What can happen if this process doesn’t happen?

A
  • The decent of the heart and lungs

- hiatal hernia

26
Q

Where is the muscular coat of the esophagus derived from?

A

Splanchnic mesenchyme

27
Q

What is Esophageal Atresia/Trachea-Esophageal Fistula? What causes it? Other symptoms seen?

A
  • common: proximal esophagus ends blindly and distal esophagus connects to trachea
  • caused by spontaneous posterior deviation of tracheo esophageal septum
  • polyhydraminos, esophageal stenosis, projectile vomiting, hungry all the time, hard to breath, blue skin during feeding, coughing and choking while feeding
28
Q

When does the stomach appear as a fulsiform dilation? What direction does it rotate? What forms the curvatures?

A
  • 4th week
  • 90 degrees clockwise
  • original posterior wall grows faster than anterior wall to form the two curvatures
29
Q

What is the space behind the stomach? What is a function of it?

A
  • Omental bursa

- allows room for stomach expansion when it’s filled

30
Q

What is pyloric stenosis? What can cause it? What symptoms will you see?

A
  • extreme narrowing of pyloric lumen because of hypertrophy of circular muscle there
  • erythromycin that’s given when babies are born to prevent blindness
  • severe projectile vomiting especially after feeding, dehydration, always hungry, no urine output
31
Q

Where does the spleen develop from? What ligaments are connected to it?

A
  • From mesoderm within the dorsal embryonic mesentery

- gastrosplenic and splenorenal

32
Q

When does the liver, gallbladder, and extrahepatic ducts develop?

A

Week 3

33
Q

What is the difference between extrahepatic biliary atresia and intrahepatic biliary atresia?

A
  • extra: correctable, outside liver

- intra: fetal infection cause it and is lethal, inside liver, need a liver transplant

34
Q

What do the two pancreatic buds form?

A
  • ventral: uncinate process, inferior part of head of pancreas
  • dorsal: rest of pancreas
35
Q

How is the pancreas formed? What forms the main pancreatic duct? Where does the accessory pancreatic duct come from?

A
  • duodenum posteriorly rotates ventral bud around and fuse it with dorsal bud at the 2nd PART OF THE DUODENUM
  • main: dorsal and ventral duct joins with bile duct and opens to major duodenal papilla
  • accessory: from dorsal duct, opens to minor duodenal papilla
36
Q

What is Annular Pancreas? What symptoms do you see? What disorder is it associated with?

A
  • ventral bud roared around both sides of duodenum and forms a collar around it, choking it, see after birth
  • polyhydraminos, BILE STAINED PROJECTILE VOMITING
  • a/w Down’s syndrome
37
Q

What primitive gut divisions does the duodenum develop from? What artery or arteries supply it? Where is the junction of the two parts? When is the duodenum recananlized and obliterated?

A
  • foregut and midgut
  • superior mesenteric and celiac trunk
  • at the major duodenal papilla (opening of hepatopancreatic duct)
  • at 2 months
38
Q

What week does the rest of the small intestine and large intestine develop? What are the two limbs and what develops from them?

A
  • week 5
  • cephalic limb: distal part of duodenum, jejunum, part of ileum
  • caudal limb: lower portion of ileum, cecum, appendix, ascending colon, proximal 2/3 of transverse colon
39
Q

What are the two stages of primitive gut rotation and the week it happens? What’s happening in both stages? What artery are they wrapping around?

A
  • week 6: 90 degree rotation where it HERNIATES through umbilical ring- PHYSIOLOGICAL UMBILICAL HERNIATION
  • week 10: herniated loops rotate 180 degrees and RETRACT back into abdomen
  • total is 270 degrees counterclockwise and they are rotating around the superior mesenteric artery
40
Q

What is Omphalocele? What development process failed to happen? How is it diagnosed?

A
  • herniation of abdominal viscera through enlarged umbilical ring, covered by amnion so NOT DIRECTLY STICK OUT INTO THE AMNIOTIC CAVITY
  • will see from 6-10weeks since this is when the loops were supposed to retract back into the abdomen
  • diagnose by Ultrasonography (USG)
  • have chromosomal abnormalities
41
Q

What is Meckel’s diverticulum?

A
  • persistence of remnants of Vitelline duct
  • usually asymptomatic
  • might cause ulceration, bleeding or perforation
42
Q

What is Vitelline fistula?

A
  • persistence of patent Vitelline duct
  • there’s DIRECT communication between umbilicus and intestinal tract
  • may see fecal matter at umbilicus
43
Q

What is the Vitelline duct (Omphaloenteric duct)?

A
  • Temporary yolk sac (ileum) connection to the midgut (belly button area)
  • supposed to go away naturally
  • if yolk sac FAILS TO REGRESS, can lead problems
44
Q

What is Vitelline Cyst?

A

Remnants of the duct make a cord around a large cyst that’s formed

45
Q

What is Volvulus? What is Mobile Cecum? What is Retro colic hernia?

A
  • volvulus: malrotation of gut, can get decrease bloood supply to gut and get ischemic, causes bowel abd nausea vomiting and abd pain
  • mobile cecum: portion of mesocolon persistence
  • retro: portion of small intestines trapped behind mesocolon
46
Q

What is Hirshsprung Disease? What gene is mutated? What areas are commonly affected? What will you see in a patient with this?

A
  • absence of parasympathetic ganglion in bowel wall (derived from neural crest)
  • RET gene
  • rectum more often, also sigmoid colon
  • no peristalsis, no bowel movement when born, explosive forceful stool when rectal examination done
47
Q

What is the process of recanalization of the gut?

A
  • week 5: endoderm proliferates and occluded
  • week 6: over 2 weeks, tube is open and hollow (recanalization-Hollow, solid, Hollow process)
  • end of week 8: endoderm tube is a closed tube again
48
Q

If the gut fails to recanalate, what can happen?

A
  • stenosis: partial obstruction

- atresia: complete obstruction

49
Q

What type of atresia do you see a double bubble sign on scans?

A

-duodenal atresia

50
Q

What is an Apple Peel Atresia?

A
  • where the jejunum ends blindly and the remaining distal bowel wraps around the blood supply there
  • aka Christmas Tree Atresia
51
Q

What gene problems can cause gut atresia?

A

HOX and FGF

Med 1: GI (15 decks)

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