L35: Abdominal Cavity I Flashcards

1
Q

Contributions of embryologic germ layers to the abdominal cavity/contents

A
  • Ectoderm: lining of anus (proctodeum) and mouth (stomodeum)
  • Splanchnic mesoderm: muscle, bone, CT and other layers of gut and gut-derived abdominal organs
  • Endoderm: lining of gut and gut-derived abdominal organs
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2
Q

What is recanalization of gut tube? Clinical relevance of failure of this to occur

A
  • Gut tube is solid tube early in development. Process of recanalization is hollowing out of this tube.
  • Failure/error in this process leads to atresia (blockage) or stenosis (narrowing) of gut tube
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3
Q

What embryologic germ layer gives rise to mesenteries?

A
  • Splanchnic mesoderm
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4
Q

What are mesenteries? Two types?

A
  • Double layer of peritoneum that connects organs to the body wall
  • Two types of peritoneum: visceral (lines organs) and parietal (lines inside of body wall)
  • Two types of mesenteries: ventral and dorsal
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5
Q

Remnants of ventral mesentery?

A

a. ) Falciform ligament (liver to ventral body wall)
b. ) Coronary ligament (liver to diaphragm)
c. ) Lesser omentum (liver to diaphragm and stomach)

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6
Q

3 relationships of organs to mesenteries

A
  1. ) Intraperitoneal: organs suspended in mesentery
  2. ) Primarily retroperitoneal: organs always external / behind peritoneum
  3. ) Secondarily retroperitoneal: organs developed in mesentery, but d/t fusing during development are now behind mesentery
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7
Q

Which organs are intraperitoneal?

A
  • Stomach, spleen, transverse colon
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8
Q

Which organs are primarily retroperitoneal?

A
  • Esophagus, rectum, anal canal, kidneys
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9
Q

Which organs are secondarily retroperitoneal?

A
  • distal 2/3rds duodenum, ascending and descending colon
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10
Q

Which organs are retroperitoneal?

A
  • SAD PUCKER
  • S: suprarenal glands
  • A: aorta, vena cava
  • D: duodenum
  • P: pancreas
  • U: ureters
  • C: colon – ascending/descending
  • K: kidneys
  • E: esophagus
  • R: rectum
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11
Q

Describe divisions of the embryologic gut: note what structures are located in each division, the outpocketings/diverticula of each and major blood supply to each

A
  1. ) Foregut: pharynx, esophagus, stomach and proximal 1/3rd of duodenum. Outpocketings include pharyngeal pouches, lower resp system, liver, pancreas and GB. Blood supply = celiac trunk
  2. ) Midgut: small intestine (except proximal 1/3rd duodenum), cecum, appendix, ascending colon and proximal 2/3rd of transverse colon (to left colic flexure). Gives rise to yolk stalk. Blood supply = SMA.
  3. ) Hindgut: distal 1/3rd of transverse colon, descending colon, sigmoid colon, rectum and superior portion of anal canal. Outgrowths include urinary bladder and most of urethra. Blood supply = IMA
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12
Q

Describe development of stomach

A
  • Dorsal border growth exceeds ventral border growth = lesser, greater curvatures result
  • 90 degree clockwise rotation along longitudinal axis = lesser curvature to right, greater curvature to left = R vagus on dorsal surface and L vagus on ventral surface
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13
Q

From what germ layer does the spleen develop?

A
  • Mesoderm
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14
Q

Describe development of intestines

A
  • Midgut forms a U-shaped loop with SMA as axis and yolk stalk at apex
  • Counter-clockwise rotation of intestines around SMA
  • Cecum descends to lower right and caudal midgut typically elongates
  • Rotation presses many organs against posterior body wall and peritoneum fuses to dorsal body wall causing secondarily retroperitoneal configuration of some organs
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15
Q

What is the cloaca? What does it form from? What occurs with this structure during development? Describe

A
  • Cloaca = common sewer (urine and fecal matter deposits here)
  • Derived from caudal hindgut
  • During development urorectal septum divides allantois and yolk stalk separating cloaca into urogenital membrane and anal membrane.
  • Anal membrane separates caudal hindgut from proctodeum
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16
Q

What is polyhydramnios?

A
  • Excess accumulation of amniotic fluid in utero. Can result from various embryologic pathologies including a trachea-esophageal fistula/esophageal atresia, duodenal atresia etc. as the fetus consumes the amniotic fluid turning it over and over again, extruded via allantois
17
Q

From what does the liver, GB and pancreas develop?

A
  • Distal foregut. Pancreas forms from two outpocketings: ventral and dorsal buds
18
Q

Describe anomalies from errors in pancreatic development

A
  1. ) Bilobed ventral pancreatic bud: splitting of ventral bud into two lobes and failure of buds to fuse
  2. ) Annular pancreas: fusion of ventral and dorsal buds occurs by wrapping of pancreatic tissue around duodenum causing constriction of gut
19
Q

Describe anomalies from errors in duodenal development

A
  • Duodenal stenosis
  • Duodenal atresia
  • Both result from errors in recanalization
20
Q

Describe anomalies that result from developmental errors in midgut development

A
  • Volvulus: piece of intestine folds around itself or other structures causing obstructions
  • SMA compresses transverse colon
  • Intestines develop inside mesenteries forming an internal hernia sac
21
Q

What is the pectinate line?

A
  • Line separating anal canal into that derived from hindgut (endoderm) and that derived from proctodeum (ectoderm)
  • Pressure and stretch is detected above pectinate line (no pain)
  • Pain detected below pectinate line
22
Q

Describe anomalies resulting from errors in cloacal development

A
  • Persistent anal membrane (non-perforate anus): anal membrane usually degenerates to ensure continuity between upper and lower parts of anal canal
  • Anoperineal fistula: communication of rectum to area on perineum other than anal pit
  • Rectourethral fistula: communication of rectum to urethra – feces comes out of urethra
  • Rectovaginal fistula: communication of rectum to vagina – feces comes out of vagina