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Brett GI Midterm > 10 GI Embryo > Flashcards

10 GI Embryo Flashcards

1
Q

What surrounds the endoderm of the embryo

A

Splanchnic mesoderm

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2
Q

The narrowed opening of the yolk sac is

A

The vitelline duct

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3
Q

What is in the foregut

A 
Esophagus
Stomach
Liver
Gallbladder
Pancreas
Upper duodenum
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4
Q

What is in the midgut

A 
Lower duodenum
Jejunum
Ileum
Cecum
Appendix
Ascending colon
Proximal 2/3 of transverse colon
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5
Q

What is in the hindgut

A 
Distal 1/3 of transverse colon
Descending colon
Sigmoid colon
Rectum
Upper anal canal
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6
Q

What does the endoderm make in the GI

A

Mucosal epithelium (mucosa) and GI glands except for lower 1/3 of anus

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7
Q

What does the splanchnic mesoderm make in the GI

A

Muscular wall (muscularis), vascular elements, CT

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8
Q

What does the ectoderm make in the GI

A

Enteric ganglia, nerves and glia (NCC)

Epithelium of lower 1/3 of anus

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9
Q

What are the adult derivatives of the dorsal mesentery

A
  • greater omentum - gastrosplenic, gastrocolic, and splenorenal ligaments
  • small intestine mesentery
  • mesoappendix
  • transverse mesocolon
  • sigmoid mesocolon
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10
Q

What are the adult derivatives of the ventral mesentery

A
  • lesser omentum - hepatoduodenal and hepatogastric ligaments
  • falciform ligament of liver(umbilical V)
  • coronary ligament of liver
  • triangular ligament of liver
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11
Q

What mesentery does the stomach form in

A

Ventral and it rotates 90 degrees CCW

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12
Q

What mesogastrum forms the greater omentum

A

Dorsal

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13
Q

Why does the lesser sac end up behind the stomach

A

Rotation of stomach

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14
Q

Where is the L vagus on the stomach? R?

A

L - ventral stomach

R - dorsal stomach

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15
Q

The ______ surface of the stomach becomes ventral and the ________ surface becomes dorsal

A

Left; right

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16
Q

What causes hypertrophic pyloric stenosis

A

Inability of the sphincter to relax due to faulty migration of the NCC so ganglion cells of the enteric NS are not properly populated

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17
Q

What symptoms are associated with hypertrophic pyloric stenosis

A
  • projectile, non-bilious vomiting after feeding
  • fewer and smaller stools
  • failure to gain weight
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18
Q

What is associated with hypertrophic pyloric stenosis

A

Increase incidence in infants treated with erythromycin

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19
Q

What begins as a diverticulum from gut endoderm

A

Liver

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20
Q

What does the endoderm differentiate into in the liver

A

Hepatocytes, bile ducts, hepatic ducts

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21
Q

What does the splanchnic mesoderm differentiate into in the liver

A

Stromal, kupffer, and stellate cells

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22
Q

What do stellate cells do

A

Support sinusoidal cells of the liver

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23
Q

What functions as the early hematopoiesis organ

A

Liver

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24
Q

What percentage of BW is the liver at week 10? At birth?

A

10%; 5%

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25
Q

Where does the pancreas form

A

Ventral mesentery

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26
Q

What does the dorsal and ventral pancreas form? When does it fuse

A

D - head, body, tail
V - uncinate process

5th month

27
Q

What causes the accessory pancreatic duct

A

Ventral pancreatic duct that doesn’t disappear

28
Q

What is the prevalence of accessory pancreatic duct

A

1/3

29
Q

What is a pancreas divisum

A

Ventral and dorsal pancreatic duct don’t connect internally

4% incidence

30
Q

When is bile formed by hepatic cells

A

Week 12

31
Q

Bile duct is initially closed but opens via

A

Recanalization

32
Q

What happens if the bile duct doesn’t recanalize

A

Biliary atresia

33
Q

What are the extrahepatic or intrahepatic ducts replaced by in biliary atresia

A

Fibrosis

34
Q

What are the symptoms of biliary atresia

A
  • progressive neonatal jaundice soon after birth
  • white clay colored stool
  • dark colored urine
  • 12-19 month average survival
  • can be treated with liver transplant
35
Q

When does the spleen form

A

Week 5 but in week 4 there is a mesenchymal consideration in dorsal mesogastrium

36
Q

What is special about the spleen

A

It is derived from the mesoderm and not endoderm

37
Q

What does the midgut do during formation

A

Physiologically herniates at week 6 and back in at week 10

38
Q

How des the ascending and tranverse colon end up anterior

A

90 degree CCW roatation at 50 days and 180 degree CCW rotation at 70 days

39
Q

What is an omphalocele

A

Hernitation through umbilicus with peritoneal covering

40
Q

What increases the risk of omphalocele

A

Trisomy 12 or 18

41
Q

What causes omphalocele

A
  • herniated bowel doesn’t fully retract
  • lateral body bolding and fusion fails creating a wall weakness
  • CT of skin and hypaxial mm of body wall does not form normally
42
Q

What is gastroschiscis

A

Herniation through abdominal wall with no parietal peritoneum covering

43
Q

What is meckel’s diverticulum

A

Failure of yolk stalk (vitelline duct) connection to the midgut to regress

44
Q

What are the rules of 2 with meckel’s diverticulum

A 
2% incidence
2x more common in males
2% have medical symptoms
Usually 2 feet proximal to terminal ileum
Usually 2 inches long
Usually 2 years of age
45
Q

What can meckel’s diverticulum cause

A

Abdominal swelling, intestinal obstruction, bowel sepsis, GI bleeding

46
Q

What is non-rotation of the midgut loop

A

Completes first 90 degree rotation but does not do the 180 degree complete rotation

47
Q

What is the consequence of non-rotation of the midgut

A

Ends up with left-sided colon and right-sided small intestine

48
Q

What is reverse gut rotation

A

Completes initial 90 CCW but goes 180 CW so the transverse colon ends up posterior to the duodenum

49
Q

What is volvulus

A

Rolled up or twisted intestines

50
Q

What are the symptoms of volvulus

A

Acute abdominal pain
Vomiting
GI bleeding

51
Q

What increases the risk of volvulus

A

Gut rotation anomalies (non-rotation or reverse rotation)

52
Q

During what month does the lumen of intestines is temporarily obliterated because of endodermal proliferation

A

5-6th

53
Q

What is duodenal stenosis

A

Partial occlusion due to ineffective recanalization (usually involves the horizontal and/or ascending parts)

54
Q

What is duodenal atresia

A

Complete occlusion of lumen

55
Q

What is intestinal stenosis or atresia commonly associated with

A

Trisomy 21 (Down’s syndrome)

56
Q

The separation of the cloaca forms what

A

Urethra and anus

57
Q

What allows the distal 1/3 of the anus to be ectodermally derived

A

Anal plug that is later apoptosed, this is the future pectineal line

58
Q

What is the vascularization of the proximal 2/3 of the anus? Distal 1/3?

A

IMA; internal iliac A

59
Q

What is the innervation of the proximal 2/3 of anus? Distal 1/3?

A

Inferior hypogastric N; pudendal N

60
Q

What is the failure of the anal plug to degenerate

A

Imperforated anus

Can be low, intermediate, high, or atresia

61
Q

What is hirschsprung disease

A

Absence of ganglionic plexus due to absence of migration of NCC

62
Q

What are the symptoms of hirshsprung disease

A

Increase wall thickenss due to hypertrophy in intestine proximal to aganglionic segment

Lack of peristalsis

Abnormal colonic dilation or distension

63
Q

What is the treatment of hirschsprung disease

A

Surgical removal of constricted distal segment

Brett GI Midterm (11 decks)

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