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GI > Embryology > Flashcards

Embryology Flashcards

1
Q

Foregut starts

A

Distal oesophagus

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2
Q

Foregut ends

A

Halfway along the duodenum

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3
Q

Midgut starts

A

Halfway along the duodenum
(Just distal to the entrance of the bile duct)

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4
Q

Midgut ends

A

Junction of the proximal 2/3 of the transverse colon

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5
Q

Hindgut starts

A

Distal 1/3 of transverse colom

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6
Q

Hindgut ends

A

Upper anal canal

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7
Q

Arterial supply of foregut

A

Coeliac trunk

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8
Q

Arterial supply of midgut

A

Superior mesenteric artery

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9
Q

Arterial supply of Hindgut

A

Inferior mesenteric artery

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10
Q

Sympathetic innervation of the foregut

A

Greater splanchnic nerve (T5-9)

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11
Q

Sympathetic innervation of the midgut

A

Lesser splanchnic nerve (T10-11)

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12
Q

Sympathetic innervation of the Hindgut

A

Least splanchnic nerve (T12) and lumbar splanchnic nerves (L1)

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13
Q

Parasympathetic innervation of the foregut

A

Vagus

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14
Q

Parasympathetic innervation of the midgut

A

Vagus

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15
Q

Parasympathetic innervation of the Hindgut

A

Pelvic splanchnics

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16
Q

Visceral pain of the foregut is felt in

A

Epigastric region

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17
Q

Visceral pain of the midgut is felt in

A

Umbilical region

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18
Q

Visceral pain of the Hindgut is felt in

A

Suprapubic region

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19
Q

Gastrulation

A

Epiblast cells migrate to the primitive streak and invaginate through it
Some cells displace the hypoblast and form the endoderm
Some cells create a new layer between the Epiblast and endoderm = mesoderm
Epiblast = ectoderm

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20
Q

What does the visceral mesoderm become

A

Muscle walls
Visceral peritoneum

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21
Q

What does the endoderm become

A

Gut lining

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22
Q

Vitelline duct

A

Closure of the gut tube along its length except for a connection that remains between the midgut region and yolk sac
Narrows and degenerated during gestation

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23
Q

Umbilical cord

A

Closure of the ventral body wall complete except at the connecting stalk

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24
Q

When does Gut tube differentiation occur

A

Gut tube starts to differentiate whilst lateral folding is bringing the ventral body wall together

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25
Q

What causes gut tube differentiation

A

Concentration gradient of retinoic acid

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26
Q

Where are the lowest levels of retinoic acid

A

Cranially

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27
Q

Where are the highest levels of retinoic acid

A

Distally

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28
Q

What specifies how regions of the gut tube develop

A

Differential expression of transcription factors and genes

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29
Q

What does the parietal mesoderm give rise to

A

Parietal peritoneum

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30
Q

Foregut includes

A

Oesophagus
Stomach
First 1/2 of duodenum (1st and 2nd parts)

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31
Q

Formation of primitive gut tube

A

during week 3-4 by incorporating the yolk sac during craniocaudal and lateral folding of the embryo

primitive gut is formed when a portion of the yolk sac becomes incorporated into the embryo, which occurs due to the cephalocaudal and lateral folding of the embryo. The portions that remain outside the embryo are the yolk sac and the allantois. The primitive gut forms a blind-ended tube on both the cephalic and caudal ends of the embryo, forming the foregut and the hindgut, respectively. The middle part forms the midgut, but remains temporarily connected to the yolk sac via the vitelline duct (yolk stalk).

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32
Q

Failure of closure during lateral folding in thoracic region

A

Ectopia cordis

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33
Q

Failure of closure during lateral folding in abdomen

A

Gastroschisis

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34
Q

Failure of closure during lateral folding in pelvic region

A

Bladder exstrophy

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35
Q

Foregut derivatives

A

Liver
Pancreas

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36
Q

Foregut mesenteries

A

Dorsal mesentery
Ventral mesentery

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37
Q

Formation of the oesophagus

A

Lung bud appears at ventral wall of the foregut in the 4th week
Become separated from each other

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38
Q

What suspends the gut tube from the posterior wall within the developing embryo

A

Dorsal mesentery

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39
Q

When does the stomach begin to dilate

A

Week 4

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40
Q

Formation of stomach

A

Section of gut tube starts to dilate
Changes shape due to different rates of growth of different parts
Changes position-rotates 90 degrees clockwise around its long axis; brings the left side to lie anteriorly and the right side to lie posteriorly
Brings duodenum to the right

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41
Q

How does the developing stomach rotate

A

90 degrees clockwise around its long axis

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42
Q

When does the liver bud appear

A

Week 3

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43
Q

Development of the liver

A

Liver bud is an outgrowth from the distal foregut
Cells proliferate into the septum transversum (mesoderm)
Connection between the liver bud and foregut (duodenum) narrows —> bile duct
As the liver grows, endoderm of the septum transversum forms the falciform ligament and lesser omentum

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44
Q

How does the bile duct form

A

Connection between the liver bud and foregut (duodenum) narrows

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45
Q

What connects part of the foregut to the anterior wall

A

Ventral mesentery

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46
Q

Tracheoesophageal septum

A

Forms between the trachea and pharynx/oesophagus to separate them

47
Q

Formation of the gallbladder

A

Small outgrowth from the bile duct

48
Q

Oesophageal atresia

A

Oesophagus doesn’t form

49
Q

Tracheoesophageal fistula

A

Unusual connection between the oesophagus and trachea

50
Q

What does the mesoderm of the liver septum transversum form

A

Falciform ligament
Lesser omentum

51
Q

What does the ventral mesentery split into

A

Lesser omentum
Falciform ligament

52
Q

Lesser omentum

A

Connects the liver to the stomach and duodenum

53
Q

Falciform ligament

A

Connects the liver to the anterior abdominal wall

54
Q

Development of the pancreas

A

Dorsal and ventral buds arise from the duodenum
Dorsal bud develops in dorsal mesentery
Rotation of the stomach swings the ventral bud posteriorly
Dorsal and ventral buds fuse

55
Q

Final position of the stomach

A

Rotation of the stomach brings its left side anteriorly and swings the duodenum right

56
Q

Final position of the dorsal mesentery

A

Along the greater curvature of the stomach bulges down and grows- greater omentum
Becomes fixed to the mesentery of the transverse colon (and posterior wall)

57
Q

Final position of the pancreas and duodenum

A

Brought into contact with the posterior abdominal wall and become retroperitoneal

58
Q

Lesser sac

A

Small space behind the stomach between the stomach and liver

59
Q

Where does the liver develop

A

In the ventral mesentery

60
Q

Greater sac

A

Larger part of peritoneal cavity

61
Q

Greater omentum

A

Dorsal mesentery along the greater curvature bulges down and grows
Becomes fixed to the mesentery of the transverse colon and posterior wall

62
Q

What cause changes to the positions of the mesenteries, omenta, peritoneal ligaments and organs

A

Rotation of the stomach (90 degrees clockwise)

63
Q

5 stages of midgut development

A

Elongation
Physiological herniation
Rotation
Retraction
Fixation

64
Q

Elongation of midgut

A

Formation of primary intestinal loop
Connection to the yolk sac (the vitelline duct) is maintained but narrows

65
Q

2 limbs of primary intestinal loop

A

Cephalic limb
Caudal limb

66
Q

Cephalic limb of primary intestinal loop

A

Distal part of the duodenum
Jejunum part of the ileum

67
Q

Caudal limb of the primary intestinal limb

A

Distal part of the ileum
Caecum
Appendix
Ascending colon
Proximal 2/3 transverse colon

68
Q

Caecal bud

A

Develops on caudal limb of intestinal loop

69
Q

When does physiological herniation occur

A

6th week

70
Q

Physiological herniation

A

Intestinal loops herniate into the umbilical cord as abdominal cavity is too small for the gut loops and the liver which are both rapidly growing
During herniation, gut loop starts to rotate

71
Q

Rotation of midgut

A

90 degrees anticlockwise as viewed from the front around the axis of the superior mesenteric artery
Brings the caudal limb more cranially

72
Q

What will the caudal limb form

A

More distal parts of midgut

73
Q

What axis does the primary intestinal loop loop around

A

Superior mesenteric artery

74
Q

At what angle does the midgut rotate

A

90 degrees anticlockwise

75
Q

Continued elongation of midgut

A

Elongation continues: the part destined to become small intestine develops coils
Segment destined to become large intestine also elongates but doesn’t coil

76
Q

When does retraction of midgut occur

A

Week 10

77
Q

Retraction of midgut

A

Gut loop returns to abdomen
Gut loop rotates a further 180 degrees anticlockwise

78
Q

Total rotation of gut loop

A

270 degrees anticlockwide

79
Q

Which part of midgut returns to abdomen first during retraction

A

Jejunum on left side

80
Q

Which part of midgut returns to abdomen second during retraction

A

Ileum
Settles towards the right

81
Q

Which part of midgut returns to abdomen last during retraction

A

Caecum
Returns to right upper quadrant then descends to right iliac fossa so ascending limb settles on right

82
Q

Which primary intestinal limb coils

A

Cephalic limb

83
Q

Fixation of midgut

A

Some mesenteries come into close contact with the posterior abdominal wall and become fused / fixed to the posterior wall- They are considered ‘retroperitoneal’

Where this happens, a fascial layer – Toldt fascia – develops between the parietal peritoneum on the posterior body wall and the visceral peritoneum on the organ

84
Q

Toldt fascia

A

A fascial layer that develops between the parietal peritoneum on the posterior body wall and the visceral peritoneum on the organ

85
Q

Final position of Jejunum

A

Central Upper left

86
Q

Final position of ileum

A

Central lower right

87
Q

Final position of ileum to caecum

A

On the right

88
Q

Final position of caecum

A

Right iliac fossa

89
Q

Dorsal mesentery of small intestine rotates around…

A

Superior mesenteric artery along with gut loop

90
Q

Caecal bud final position

A

Once gut returns to abdomen, Caecal bud is first in upper right quadrant
It descends to the right iliac fossa as the ascending colon lengthens

91
Q

When does appendix develop

A

During descent of Caecal bud

92
Q

Which primary intestinal loop limb retracts into abdomen first

A

Cephalic limb

93
Q

Meckel’s diverticulum

A

In up to 4% of people vitelline duct persists to form an out-pouching from the ilium – a ‘diverticulum’

Normally asymptomatic

May ulcerate and bleed

Inflammation can mimic appendicitis

94
Q

Omphalocoele

A

Midgut loop doesn’t return to the abdomen in the 10th week; remains in the umbilical cord

Gut is covered with a layer of amnion

High mortality – often associated with other congenital and chromosomal anomalies

95
Q

What does the last part of the Hindgut communicate with

A

Cloaca

96
Q

Urorectal septum

A

Grows towards the cloacal membrane and separates the urogenital sinus from the cloaca
Separates urinary bladder/ureter and anorectal canal

97
Q

Pelvic splanchnic nerves contain which type of fibres

A

Parasympathetic

98
Q

Greater, lesser, least, lumbar splanchnic nerves contain which type of nerve fibres

A

Sympathetic

99
Q

The primary intestinal loop forms during which stage of midgut development?

A

Elongation

100
Q

Intestinal loops herniate into the umbilical cord during which week?

A

6th

101
Q

Intestinal loops return to the abdomen in which week?

A

10th

102
Q

In total, the gut loop rotates:

A

270 degrees anticlockwise

103
Q

Anorectal canal

A

Ectoderm invaginates to form anal pit and lower part of anorectal canal
Cloacal membrane ruptures - upper and lower parts of anal canal become continuous with each other

104
Q

What does the anal canal arise from

A

Endoderm and ectoderm

105
Q

Is the caecum Intraperitoneal or retroperitoneal

A

Intraperitoneal
[no mesentery]

106
Q

Is the sigmoid colon Intraperitoneal or retroperitoneal

A

Intraperitoneal

107
Q

Do Intraperitoneal or retroperitoneal viscera have a mesentery

A

Intraperitoneal

108
Q

Appendix position

A

Can lie in a variety of position
Base of appendix is constant [McBurney’s point]

109
Q

Congenital abnormalities can occur with midgut development

A

Gut rotation - clockwise?
Return of the gut loops to the abdomen
Mesenteries formation - Volvulus

110
Q

Cloaca

A

Blind-ended sac
Receives last part of Hindgut and distal parts of urinary tract

111
Q

Lining of cloaca

A

Endoderm

112
Q

Cloacal membrane

A

Ectoderm
Outer wall of embryo

113
Q

Anal pit

A

Formed by invagination of ectoderm at end of anorectal canal

114
Q

Imperforate anus

A

Failure of breakdown of cloacal membrane
No continuity of anal pit and rectum

GI (12 decks)

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