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Embryology GI (Funk) Flashcards

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1
Q

formation of the intraembryonic body cavity forms within what layer

A

lateral plate mesoderm

divides lateral plate into parietal (somatic) and visceral (splanchnic) mesoderm

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2
Q

body wall defects occur when what happens?

A

when the ventral body wall fails to fuse and viscera herniate through the defect

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3
Q

what is cantrell’s pentology

A 
cleft sternum
ectopic cordis
gastroschisis or omphalocele 
diaphragmatic hernia (anterior) 
congenital heart defects
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4
Q

what are the dorsal mesentery derivatives

A 
DORSAL MESENTERY DERIVATIVES:
Mesoesophagus 
Greater omentum (gastrocolic, gastrosplenic, gastrophrenic ligaments)
Splenorenal ligament
Phrenicosplenic ligament
Phrenicocolic ligament 
Mesentery proper
Mesoappendix 
Transverse mesocolon
Sigmoid mesocolon
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5
Q

what are the ventral mesentery derivatives

A

Lesser omentum (hepatogastric, hepatoduodenal ligaments)
Falciform Ligament
Coronary Ligaments
Right and Left Triangular Ligaments

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6
Q

what is a mesentery

A

double layer of peritoneum

provides pathway for vessels, nerves to organs

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7
Q

what is the function of the dorsal mesentery

A

suspends gut tube to posterior body wall

extends from caudal foregut to hindgut

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8
Q

what is the function of the ventral mesentery

A

suspends gut tube to anterior body wall

extends from caudal to foregut to proximal duodenum

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9
Q

what are the three types of peritonealization

A

primary retroperitoneal
secondary retroperitoneal
peritonealized

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10
Q

what are organs that are primary retroperitoneal

A

kidney
ureter
bladder

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11
Q

what are organs that are secondary retroperitoneal

A

parts 2-3 of duodenum
ascending colon
descending colon
pancreas

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12
Q

what are examples of organs that are peritonealized

A 
stomach
spleen
parts 1 and 4 of duodenum 
jejunum
ileum 
transverse and sigmoid colon
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13
Q

what is the septum transversum and what does it form in the adult

A

plate of mesoderm that separates the throacic and peritoneal cavities (forms from somites 3, 4 and 5)

will form bulk of diaphragm (muscle and central tendon)

note it does not

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14
Q

what do the pleuropericardial membranes separate in the embryo

A

pleural and pericardial cavities

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15
Q

what do pleuorperitoneal membranes separate in the embryo

A

pleural and and peritoneal cavities

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16
Q

what are the sources that contribute to the formation of the diaphragm

A

septum transversum

pleuroperitoneal membrane

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17
Q

the mesoderm of the diaphragm forms from what and what is the positional changes of the diaphragm
where does the diaphragm sit at week 8

A

cervical somites 3-5

differential growth of the body leads to a descent of the diaphragm into the thorax

by week 8 sitting at level of 1st lumbar vertebra

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18
Q

what is the motor innervation to the diaphragm

sensory?

A

motor - phrenic

sensory = phrenic n to central tendon
intercostal nn to muscu. diaphragm

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19
Q

what is a bochdalek defect

A

posterolateral defect –> incomplete formation of pleuroperitoneal membranes (often on left side)

small intestine or viscera herniate through

the lugns and heart are compressed
common cause of pulmonary hypoplasia

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20
Q

what is a morgagni defect

A

parasternal hernia

anterior defect in muscular portion of diaphragm
small and sometimes not detected until child is several years old

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21
Q

what are two causes of congenital diaphragmatic hernias

A

failure of pleuroperitoneal membranes to form

small gap between sternal and costal portion of diaphragm

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22
Q

what is eventration of the diaphragm

A

weakness of diaphragm due to failure of myotome migration (lack of muscle differentiation)

allows abdominal viscera to ballon into thoracic cavity

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23
Q

all three germ layers contribute to the formation of the gut tube. what do each of the three layers make

A

endoderm- epithelium and glands

mesoderm - CT and muscle

ectoderm– epithelium at ends of tubes (mouth, lower 1/2 of anal canal)

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24
Q

what comprises the foregut 8

A 
Pharynx
Esophagus
Stomach
½ duodenum (parts 1 and 2) 
Spleen
Pancreas
Liver
gallbladder
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25
when does the oropharygneal membrane rupture
4th week
26
when does the cloacal membrane (anus) rupture
7th week
27
what comprises the mid gut 7
½ duodenum (parts 3 and 4) ``` Jejunum Ileum Cecum /appendix Ascending colon 2/3 transverse colon ```
28
what comprises the hindgut 5
``` distal 1/3 of transverse colon decending colon sigmoid colon rectum proximal anal canal ```
29
during what week does the esophagus become partly obliterated
week 5 | recanalizes by week 8
30
what is the cause of esophageal atresias and stenoses and tracheoesophageal fistula
malformation of tracheoesophageal septum --> leads to development of esophageal fistula incomplete recanalizaiton of distal esophagus -during week five the canalization occurs in which the endoderm proliferates very rapidyly and produces an epithelial plug by week 8 it will recanalize incomplete --> stenosis absent recanalizaiton--> atresia
31
what is the cause of a congenital hiatal hernia
esophagus fails to elongate, pulls stomach through diaphragm into thorax
32
what is the rotation of the stomach
rotates 90 degreses clockwise aroudn longitudinal axis (greater curvature is now left, lesser curvature is not right) rotates around its anterioposterior axis pyloric part moves upward and to right fundus part moves down and to left
33
what is going on with the omental bursa as the stomach is developing
as the stomach rotates it stretches dorsal mesentery and the omental bursa comes to lie inferior and posterior to the stomach during later development the layers of the greater omentum fuse
34
what is the cause of pyloric stenosis
hypertrophy of smooth muscle around pyloric sphincter forcible vomiting of stomach contents after eating
35
what does the spleen form from
mesenchymal cells within the two layers of dorsal mesogatrium
36
what is the hepatic diverticulum
an outgrowth from second portion of duodenum
37
endoderm derived portion of the liver is what? mesoderm portion is what ? what does the liver function as during 2nd month when does bile formation begin
endoderm--> perenchyma mesoderm --> stroma hematopoietic organ--> 2nd month bile formation--> 12 week
38
what does the gallbladder from from because of rotation of the gut, where does the bile duct pass in relation to the duodenum
forms from evagination of bile duct rotation--> bile duct passes posterior to duodenum
39
what is the development of the pancreas like? from what portion of the gut how does rotation of the gut effect pancreatic development
arises from two endodermal outgrowths of duodenum (ventral and dorsal buds) ventral bud forms lower portion of head and uncinate process dorsal bud forms most of pancreas
40
what is the main pancreatic duct derived from
ventral pancreatic duct and distal dorsal pancreatic duct
41
what is the accessory pancreatic duct derived from
proximal part of dorsal pancreatic duct
42
what is the problem with accessory pancreatic tissue
can degrade surrounding tissue
43
what is annular pancreas
"ring" around the duodenum bifid ventral pancreatic duct during rotation the bifid bud encircles the duodenum after fusion of the pancreas the annular tissue can constrict the duodenum
44
what occurs in gestational diabetes
fetal insulin=secreting cells are exposed to high levels of maternal glucose as a result, insulin-secreting cells hypertrophy and increase rate of insulin secretion
45
what does the duodenum derive from
caudal end of foregut (parts 1 and 2) rostal end of the midgut (parts 3 and 4) stomach rotates --> pulls duodenum superiorly and to the right pancreas grows rapidly causing C-shape
46
what is the cause of duodenal stenosis how does it present how does a pregnant mother present
failure to recanalize usually affects parts 3 and 4 digested food + bile are forcibly vomited (green-colored) distended epigastrium due to overfilled stomach infant is not swalloing amniotic fluid so mother presents with polyhydramnios
47
what happens during week 5 of midgut development
midgut loop forms
48
what happens during week 6 of midgut formation
midgut loops physiologically herniates through the umbilical ring (gut around the superior mesenteric artery herniates) into the extraembryonic cavity
49
what occurs later after the week 6 and before week 10 in midgut development what happens in terms of peritonealization to the midgut at this point
the primary intestinal loop undergoes a rotation of 270 degrees counterclockwise mesentery proper becomes twisted and the ascending and descending colon becomes secondarily retroperitoneal
50
what happens in midgut develpement around week 10-12
midgut loop retracts into the abdominal cavity jejunum first and lies on the left side cecum returns last and lies in the upper quadrant
51
what is the path of the cecum after it retracts back into the abdomen
returns last and lies in the upper right quadrant the cecum then descends to lie in the lower right quadrant the appendix forms after the midgut returns to the abdomen as the cecum is descending thus retrocecal position
52
what is omphalocele
results from failure of midgut to return to abdominal cavity tssue protrudes through umbilicus and is covered by the amniotic membrane*** often prognosis of this is poor and is associated with other congential abnormalities
53
what is gatroschisis
results when gut herniates through weakness in body wall typically occurs lateral to umbilicus (to right) usually results from incomplete fusion of ventral body wall during folding herniated bowel is not covered by amniotic membrane *** bathed in amniotic fluid
54
what is an umbilical hernia
occurs when gut herniates into umbilical cord after returning to abdominal cavity loops of bowel herniate through an imperfectly closed umbilicus (along midline) herniated tissue covered by skin subcutaneous tissue
55
what is meckel's diverticulum what does it present similar to
persistence of vitelline duct RULE OF 2's occurs in 2% of population 2x more likely in males found within distal 2 feet of ileum usually about 2 inches long 2 percent become symptomatic before age of 2 2 types of tissue (gastric and pancreatic) presents very similar to appendicitis
56
what occurs with malrotation of the gut
may results in volvulus (twisting of intestine) | or potential loss of blood supply
57
can stenoses and atresia occur in the midgut
yes anywehre along intestine resulting from vascular compromise or failure to re-canalize
58
what is the problem with failure of the ascending colon to become retroperitoneal
results in long mesocolon which may allow for abnormal movements and potentially volvulus of the colon retrocolic hernia (entrapment of small intestine behind colon) may also result
59
what is the cloaca and what is it lined with | what does it contribute to forming
distal most portion of the gut tube endoderm lined cavity which will contribute to formation of the hindgut and urogenital system
60
what does the urorectal septum do
divides cloaca into urogenital sinus and anorectal canal
61
when does the cloacal membrane rupture
during week 7
62
what is the pectinate line demarcating
marks division between ectoderm/endoderm
63
what is Hirschprung's disease
aka congenital mesocolon failure of neural crest cells to migrate into caudal large intestine or rectum absence of parasymapthetic ganglia b/c neural crest cells typically form into parasympathetic nerves soo.... the area proximal to the paralyzed portion will have a build up of fecal matter
64
fistulas and atresias of the cloaca result from what?
improper formation of urorectal septum
65
what do rectourethral and rectovaginal fistulas result from ?
anterior displacement of the hindgut
66
rectoanal atresias (abnormally closed or absent) result from what?
loss of vascular supply or failure of recanalization
67
how does an imperforate anus occur
failure of cloacal membrane to degenerate

GI exam 1 (11 decks)

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