Development of the GI System Flashcards

1
Q

Endoderm forms what part of the GUT

A

Mucosal Epithelium and GI glands (all only NOT lower 1/3 of anus)

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2
Q

Splanchnic Mesoderm forms what part of the GUT

A

CT
Vasculature
SM wall

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3
Q

Ectoderm forms what part of the GUT

A

Enteric Ganglia, N, and Glia (by neural crest cells)

Epithelium of lower 1/3 anus

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4
Q

Foregut

A

Esophagus, stomach, liver, gallbladder, pancreas, upper duodenum

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5
Q

Foregut Blood supply

A

Celiac Trunk

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6
Q

Midgut

A

Lower duodenum, Jejunum, Ileum, Cecum, Appendix, Ascending Colon, proximal 2/3 transverse colon

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7
Q

Midgut Blood supply

A

SUPERIOR MESENTERIC A.

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8
Q

Hindgut

A

Distal 1/3 transverse colon, Descending colon, Sigmoid colon, rectum, upper anal canal

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9
Q

Hindgut Blood supply

A

INFERIOR MESENTERIC A

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10
Q

Visceral Peritoneum

A

directly around each organ

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11
Q

Parietal Peritoneum

A

directly around the Peritoneal Cavity with includes the organs inside

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12
Q

Dorsal Mesentery Derivatives

A
Greater Omentum (gastrosplenic, Gastrocolic, Splenorenal Ligaments)
SI mesentary
Mesoappendix
Transverse mesocolon
Sigmoid Mesocolon
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13
Q

Ventral Mesentary Derivatives

A

LESSER UMENTUM ( hepatoduodenal, hepatogastric Ligaments)
Flaciform Ligament of Liver
Coronary Ligament of Liver
Triangular Ligament of Liver

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14
Q

Intraperitoneal Organs

A

organs in the mesentery, surrounded by the peritoneal cavity
EX: abd esophagus, liver, stomach, gallbladder, cecum, sigmoid, appendix, jejunum, Ileum

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15
Q

Retroperitoneal organs

A

organs outside the peritoneal cavity

Ex: thoracic esophagus, Rectum

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16
Q

Secondarly Retroperitoneal organs

A

organs that were initially in the mesentery (interperitoneal) and then fused with the body wall
EX: Ascending + Descending colon, Duodenum, most of Pancreas

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17
Q

ALL RETROPERITONEAL (INCLUDING SECONDARY)

A
SADPUCKER
Suprarenal (Adrenal) Glands
Aorta/ IVC
Duodenum (2nd+3rd part)
Pancreas (not tail)
Ureter
Kidneys
Colon (ascending +descending)
Esophagus - thoracic
Rectum
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18
Q

How does the developing stomach rotate

A

Stomach rotates 90 degrees
LEFT= VENTRAL
RIGHT= DORSAL
Greater curvature- attached to greater omentum
Lesser curvature- attached to lesser omentum

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19
Q

Left Vagus N

A

Anterior Stomach

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20
Q

Right Vagus N

A

Posterior Stomach

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21
Q

Lesser sac

A

behind stomach

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22
Q

Greater Omentum

A

connects stomach to transverse colon

double layer of peritoneum

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23
Q

lesser Omentum

A

connects stomach to the liver and duodenum

double layer of peritoneum

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24
Q

Hypertrophic Pyloric Stenosis

What happens

A

narrowed opening from stomach to duodenum due to thickened muscle

  • NCC dont migrate to ganglion enteric cells = sphincter cant relax
  • muscularis externa hypertrophy = narrowing pyloric lumen
25
Hypertrophic Pyloric Stenosis Sx:
``` Sx: starts a few months after birth olive mass over right costal margin projectile vomiting few + smaller stools X gain weight, can loose weight ```
26
Where does the liver form from
Hepatic Diverticulum from GUT ENDODERM
27
GUT ENDODERM 3 parts
1. connects to Foregut : common bile duct 2. Endoderm: Hepatocytes, Bile ducts, Hepatic ducts 3. Splanchnic mesoderm : stromal cells, Kupffer cells, stellate cells
28
Liver formation happens when
week 10, it takes over hematopoiesis | very love anomalies
29
Where does the Gallbladder and Bile duct from from
Cystic Diverticulum of the CYSTIC ENDODERM 1. it outpatches from the common bile duct---> ventral mesentery +cyctic duct (connection to bile duct) 2. Recanilzation of bile duct 3. bile forms week 12 * right above the Ventral Pancreatic Fold
30
Biliary Atresia
Fibro-inflammatory obstruction of extra-hepatic bile duct obliterated bile duct SX: immediate jaundice in infants white clay stool Dark urine 12-19mo lifespan
31
How is the Pancrease form and from what
1. inferior to the cystic diverticulum, 2 endodermal buds from FOREGUT form - Ventral Pancreatic Bud: uncinate process and grows ---> VENTRAL MESENTERY - Dorsal Pancreatic Bud: Pancreatic Head, Body, and Tail and grows ----> DORSAL MESENTERY 2. both exocrine and endocrine portions form 3. ducts fuse
32
Week 5 of pancreatic formation
The Ventral pancreas (under cystic diverticulum) migrates around posteriorly to the dorsal pancreas bud 1. Ventral Pancreatic Duct= main Pancreatic duct + connects to Duodenum 2. Dorsal Pancreatic Duct = Accessory Pancreatic Duct
33
Pancreas Divisum
Ventral and dorsal parts dont fuse by week 8 Sx: asymptomatic prone to abd pain and pancreatitis
34
Having an accessory pancreatic duct
33% population
35
Annular Pancreas
``` Poor migration of pancreas = pancreatic ring around duodenum (2nd part) Sx: duodenal obstruction +necrosis Bilious Vomiting (in annulus is inferior to bile duct) Low birth weight ``` = basically the ventral pancreatic bud migrates some posteriorly and some anteriorly to the dorsal pancreatic bud forming a ring when it fuses
36
what does the spleen form from and what happens week 4
dervied from mesoderm | 1. mesenchymal condensation in the dorsal mesogastrium
37
spleen formation week 5
fully formed
38
Midgut formation in general
week 6: herniates out from umbilicus | week 10: goes back to ABD
39
How does the midgut rotate week 6
week 6: rotated 90 degrees counterclockwise - proximal part: right and convoluted - distal left and develops cecum
40
How does the midgut rotate week 10
week 10: proximal portion of loop returns to abd going under the distal portion = 90 counterclockwise turn - cecum : URQ - ascending colon : anterior to duodenum
41
How does the midgut rotate week 11
week 11: distal portion of loop returns to the abd = 90 counterclockwise turn - cecum: LRQ - ascending colon : right side of abd.
42
Omphalocele
higher risk if trisomy 13 or 18 Hermiated bowel does not fully go back into abd SX: herniation through the umbilicus, covered by perietal peritoneum
43
Gastroschiscis
Abnormal lateral body folding and fusion = wall weakness and bowel herniated OR CT of skin and hypaxial muscles of body wall doesnt form normally = wall weakness Bowel not covered by parietal peritoneum
44
Meckel's Diverticulum
``` Yolk sac (vitelline duct) connection to midgut doesnt go back to abd. = midgut is still connected to umbilicus SX: asymptomatic abd swelling, intestinal obstruction, GI bleeding ``` *basically a little string of midgut tissue connected to the body wall of the umbilicus RULE OF 2 for all Sx:
45
Malrotation/ Non-Rotation of the Midgut loop
only completes first week 6 90 degree rotation (still return to abd.) Sx: left sided colon right sided SI = formation of Ladd Bands --> volvulus +duodenal obstruction
46
Reverse Gut Rotation
Initial midgut week 6 90 degree rotation is normal other 2 are clockwise rotations Sx: Duodenum : anterior to Transverse Colon
47
Volvulus
``` Bowel twists around its mesentary high risk of gut rotation anomalies CT= Coffee bean sign SX: acute, abd pain, Vomit, GI bleeding - can lead to bowel obstruction and Infarction ```
48
Cloaca separates to
part of hindgut and separates to rectum and urogenital sinus
49
how does the Hindgut form
1. Urorectal septum (b/w hindgut and urogenital sinus) grows fork like extensions to separate the cloaca 2. Cloaca becomes VENTRAL urogenital Sinus DORSAL anorectal canal 3. Cloaca membrane ruptures = opens both parts to outside
50
Ventral Urogenital Sinus becomes the
bladder and urethra
51
how does the anus and rectus form
1. anal rectal lumen closed by ENDOTHELIAL ANAL PLUG 2. MESODERM around opening grows out and forms anal pit 3. Anal pit is lined by ECTODERM
52
what does the Pectineal Line Divide
the hindgut and anal pit inside anal canal 1. Superior 2/3 : ENDODERM, IMA artery and Internal Iliac Artery - superior and middle rectal arteried (RECTUM) 2. Inferior 1/3 : ECTODERM, Puedendal Artery - inferior rectal arteries (ANUS)
53
Imperforate Anus
X anal opening, anal membrane (endoderm) is still there | there is low, intermediate and high malformation = due to LEVATOR ANI MUSCLES and pelvic bone
54
Abnormal Urorectal Septum : Rectovaginal
Females | rectum goes to vagina canal
55
Abnormal Urorectal Septum : Rectovestibular
Females | rectum opens at vaginal opening
56
Abnormal Urorectal Septum : Rectoperineal
Females and Males | rectum opens however ventral to the anus (so no anus in opening)
57
Abnormal Urorectal Septum : Rectovesical
Males | rectum opens into prostate
58
Abnormal Urorectal Septum : Rectourethral
Males | rectum opens into sperm canal to exit the penis
59
Hirschsprung's Disease (congenital Aganglionic Megacolon)
NCC dont migrate = X Ganglionic plexus in GI X peristalsis (COLON does not relax) SX: hypertrophy of Intestinal wall proximal to aganglionic segment Megacolon: dilated colon X pass meconium - first poop of newborn