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GIGU Midterm > Development of the GI system > Flashcards

Development of the GI system Flashcards

1
Q

What embryonic germ layer do the foregut, midgut, and hindgut form from?

A

endoderm

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2
Q

what is the narrow opening to the yolk sac referred to as?

A

vitelline duct

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3
Q

what does the endoderm contribute to the GI tract?

A

mucosal epithelium and GI glands (except the lower 1/3 of the anus)

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4
Q

what does the splanchnic mesoderm contribute to the GI tract?

A

connective tissue, vasculature, and smooth muscle wall

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5
Q

what does the ectoderm contribute to the GI tract?

A

enteric ganglia, nerves, and glia (via neural crest) and the epithelium of the lower 1/3 of the anus

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6
Q

what is the arterial supply of the foregut?

A

the celiac trunk

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7
Q

what is the arterial supply of the midgut?

A

superior mesenteric artery

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8
Q

what is the arterial supply of the hindgut?

A

inferior mesenteric artery

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9
Q

what arises from the foregut?

A

esophagus, stomach, liver, gallbladder, pancreas, upper duodenum

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10
Q

what arises from the midgut?

A

lower duodenum, jejunum, ileum, cecum, appendix, ascending colon, proximal 2/3 of the transverse colon

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11
Q

what arises from the hindgut?

A

distal 1/3 of the transverse colon, descending colon, sigmoid colon, rectum, and upper anal canal

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12
Q

what is the abdominopelvic cavity lined with?

A

peritoneum

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13
Q

what does the dorsal mesentery give rise to?

A

the greater omentum, small intestine mesentery, mesoappendix, transverse mesocolon, and the sigmoid mesocolon

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14
Q

what does the ventral mesentery give rise to?

A

lesser omentum, falciform ligament of liver, coronary ligament of liver, triagnular ligaments of liver

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15
Q

what is the general description of intraperitoneal organs?

A

they are suspended by mesentery

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16
Q

what is the general description of retroperitoneal organ?

A

they are excluded from the peritoneal cavity

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17
Q

what are secondary retroperitoneal organs?

A

they were initially suspended within mesentery that later fused with a body wall

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18
Q

what are some examples of secondary retroperitoneal organs?

A

ascending/descending colon, duodenum, and bulk of pancreas

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19
Q

what are the retroperitoneal organs?

A

suprarenal glands, aorta/IVC, duodenum (2nd and 3rd parts), pancreas, ureters, colon (ascending and descending), kidneys, Esophagus, rectum

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20
Q

When the stomach rotates 90 degrees, how will the left side be positioned?

A

it will be ventral

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21
Q

when the stomach rotates 90 degrees, how will the right side be positioned?

A

it will be dorsal

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22
Q

the rotation of the stomach also causes the vagus nerve to rotated. The left vagus nerve will be positioned how after 90 degrees of rotation?

A

anteriorly

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23
Q

the rotation of the stomach also causes the vagus nerve to rotate. The right vagus nerve will be positioned how after 90 degrees of rotation?

A

posteriorly

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24
Q

where does the lesser sac sit?

A

behind the stomach

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25
what ligaments make up the lesser omentum?
the hepatoduodenal ligament and the hepatogastric ligament
26
what causes hypertrophic pyloric stenosis?
faulty migration of neural crest cells--> ganglion cells of enteric nervous system not properly populated
27
what is hypertrophic pyloric stenosis?
inability of the pyloric sphincter to relax- narrowing of the pyloric lumen between the stomach and the duodenum
28
how does hypertrophic pyloric stenosis present?
palpable mass (OLIVE) at the right costal margin, projectile non-bilious vomiting after feeding, within a few months after birth
29
When does the stomach/liver form?
week 4 of development
30
what does the formation of the liver begin as?
hepatic diverticulum from the gut endoderm
31
what is the connection of the diverticulum to the foregut?
the common bile duct
32
what does the endoderm of the liver give rise to?
hepatocytes, bile ducts, and hepatic ducts
33
what does the splanchnic mesoderm in the liver give rise to?
stromal cells, Kupffer, and stellate cells
34
when does hematopoiesis in utero begin? and where does it occur?
by week 10 and in the liver
35
what does the gallbladder begin as?
cystic diverticulum
36
what does the cystic diverticulum come off of?
the common bile duct
37
what is the connection between the cystic diverticulum and the common bile duct called?
the cystic duct
38
when is bile formed by the hepatic cells?
beginning of week 12
39
what is biliary atresia?
obliteration of the bile duct/ inflammation replaces the duct with fibrotic tissue
40
what is the presentation of biliary atresia?
immediate onset of progressive jaundice in infants, white colored stool, dark urine
41
how does pancreas formation begin?
as two endodermal buds sprouting from the foregut inferior to the cystic diverticulum- the ventral and dorsal pancreatic bud
42
what does the ventral pancreatic bud give rise to?
the uncinate process of the pancreas
43
what does the dorsal pancreatic bud give rise to?
the pancreatic head, body, and tail
44
when does the ventral pancreatic bud migrate posteriorly to fuse with the dorsal pancreatic bud?
week 5
45
after rotation and fusion, what does the ventral pancreatic duct become?
the main pancreatic duct
46
what happens to the dorsal pancreatic duct after rotation and fusion?
it will disintegrate or if it remains it is known as an accessory pancreatic duct
47
what is pancreas divisum?
it is when the ventral and dorsal parts fail to fuse by week 8
48
what are patients with pancreas divisum prone to?
it is mostly asymptomatic, but they are prone to abdominal pain and pancreatitis
49
what is annular pancreas?
poor migration of the pancreas--> there is a pancreatic ring around the 2nd part of the duodenum
50
how does annular pancreas present?
duodenal obstruction/stenosis, bilious vomit, low birth weight
51
when does the spleen begin formation?
week 4
52
where does the spleen begin formation and as what?
as a mesenchymal condensation that forms in the dorsal mesentery
53
when is the spleen fully formed?
week 5
54
what is the spleen derived from?
from mesoderm NOT endoderm
55
when does the midgut herniate out from the umbilicus?
week 6
56
when does the midgut return to the abdomen?
by week 10
57
what does the proximal portion of the midgut loop do after it makes a 90 degree counterclockwise rotation outside of the abdomen?
it is now on the right and it becomes convoluted
58
what happens to the distal portion of the midgut loop after it makes a 90 degree counterclockwise rotation outside of the abdomen?
it is on the left and it develops the cecum
59
What ligaments make up the great omentum?
the gastrosplenic, gastrocolic, and splenorenal ligaments
60
what day does the gallbladder begin developing?
day 26
61
where does the gallbladder grow into?
the ventral mesentery
62
What happens with the midgut at week 6 of development?
it herniates out of the umbilicus and makes a 90 degree counterclockwise rotation
63
what happens to the midgut during the 10th week of development?
the proximal portion of the loop returns, passing under the distal portion- makes a second 90 degree counterclockwise turn
64
what is the positioning of the midgut during the 10th week of development?
the cecum is in the upper right quadrant and the ascending colon is anterior to the duodenum
65
what happens to the midgut during the 11th week of development?
the distal portion of the loop returns, making a 3rd 90 degree counterclockwise turn
66
what is the positioning of the midgut after the 11th week of development?
the cecum descends to the right lower quadrant, carrying the ascending colon to end up on the right side of the abdomen
67
what is an omphalocele?
a herniated bowel through the umbilicus that does not fully retract
68
what is an omphalocele covered with?
parietal peritoneum
69
who is at risk for having an omphalocele?
there is an increased risk with trisomy 13 or 18
70
what is gastroschiscis?
when there is an abnormal lateral body folding and fusion- so it creates wall weakness that allows the bowel to herniate
71
what does not form normally in a patient with gastroschiscis?
the connective tissue of skin and hypaxial musculature of body wall
72
what is the main difference between omphalocele and gastroschiscis?
with omphalocele, the herniated bowel is covered with parietal peritoneum; with gastroschiscis, the herniation is not covered by parietal peritoneum
73
what is meckel's diverticulum?
failure of the yolk stalk (vitelline duct) connect to the midgut to regress- the midgut remains connected to the umbilicus
74
what is the presentation of Meckel's diverticulum?
usually asymptomatic; rule of 2s: 2x more likely in males, presents in first 2 years of life
75
what is malrotation/non-rotation of the midgut loop?
the midgut loop completes the first 90 degree CCW turn, but does not do the remaining 180 degree CCW turn
76
what is the presentation of a malrotation/non-rotation midgut loop?
there is a left-sided colon and right sided small intestines; formation of fibrous Ladd bands
77
what can fibrous ladd bands lead to?
volvulus or duodenal obstruction
78
what is reverse gut rotation?
the midgut loop complete the first 90 degree CCW turn, but then does a 180 clockwise turn resulting in a 90 degree clockwise turn of the midgut loop
79
what is the presentation of a reverse gut rotation?
the duodenum ends up anterior to the transverse colon
80
what is a volvulus?
twisting of bowel around its mesentery
81
who is at an increased risk for developing a volvulus?
people with gut rotation anomalies
82
what is the presentation of a volvulus?
acute abdominal pain, vomiting, GI bleeding; coffee bean sign
83
what could a volvulus lead to?
bowel obstruction or infarction
84
what is the cloaca?
its a portion of the hindgut in the early embryo that separates into the rectum and the urogenital sinus
85
how is the cloaca divided?
by the urorectal septum
86
what is the cloaca divided into?
the ventral urogenital sinus and the dorsal anorectal canal
87
what is the anal rectal lumen temporarily closed by?
an endodermal epithelial anal plug- it eventually opens up via apoptosis
88
what germ layer makes up the rectum?
endoderm
89
what is the vasculature of the rectum?
the superior rectal (from the IMA) and the middle rectal (from the internal iliac artery) arteries; veins of hindgut
90
what germ layer makes up the anus?
ectoderm
91
what is the vasculature of the anus?
inferior rectal arteries (from the pudendal artery) and veins
92
what is the pectineal line?
it divides the origin of hindgut and anal pit within the anal canal
93
what is an imperforate anus?
when the opening of the anus is missing/blocked due to persistent anal membrane
94
what is hirschsprung's disease?
failure of neural crest cell migration--> there is an absence of ganglionic plexus; lack of peristalsis (the colon fails to relax)
95
what is the presentation of hirschsprung's disease?
intestinal wall hypertrophy proximal to the aganglionic segment; abnormal colonic dilation or distention (megacolon); failure to pass meconium

GIGU Midterm (19 decks)

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