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GI - MSI Spring > Embryology of GI system > Flashcards

Embryology of GI system Flashcards

1
Q

Specification of the gut tube is initiated by what?

A

RA gradient that causes TFs to be expressed in different regions of the tube

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2
Q

The molecular regulation of gut tube development requires interaction between what two tissues? What allows the communication to occur?

A

endoderm epithelium with mesenchyme (splanchnic mesoderm)

SHH

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3
Q

The gut tube rotates in what direction in the umbilical herniation during development?

A

270 counterclockwise

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4
Q

The epithelial lining and glands forms from what?

A

endoderm

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5
Q

The lamina propria, submucosa, muscularis externa layers and serosa/adventitia forms from what?

A

splanchnic mesoderm

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6
Q

Least splanchnic nerves go to what plexus?

A

aortico-renal plexus

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7
Q

What plexus will lumbar splanchnics from L1-2 go to

A

Inferior mesenteric plexus

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8
Q

What is tracheoesophageal fistula?

A

when the tracheoesophageal septum does not form properly

Esophagus is connected to trachea

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9
Q

What is the most common form of tracheoesophageal fistual?

A

Upper segment of esophagus ending in blind pouch; lower segment originating from trachea just above bifurcation

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10
Q

What is esophageal atresia or stenosis?

A

Narrowed (stenosis) or occluded (atresia) esophagus due to incomplete recanalization, usually found in the lower 1/3

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11
Q

Successful esophageal anastomoses may be performed in those few with ‘long gap’ esophageal atresia > 3 cm using what techniques?

A

Colon interposition: colon taken to replace sophagus
Gastric tube esophagoplasty: longitudinal segment from the stomach
Gastric transposition: whole stomach is freed, mobilized and moved into chest

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12
Q

What is a corkscrew esophagus?

A

spirals down as it goes to the stomach: digestion complications or no symptoms

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13
Q

What is a zenker’s diverticulum?

A

Out of pocket of esophagus
Get food or water trapped
Back of the neck

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14
Q

Which surface of the stomach grows relatively faster?

A

dorsal: greater curvature

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15
Q

Dorsal side of the stomach rotates which way?

A

to the left

Clockwise 90*

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16
Q

Why does the left vagus become the anterior vagal trunk and the right vagus the posterior vagal trunk?

A

The left side of the stomach lies anterior and right side posterior after rotation

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17
Q

When does hypertorphic pyloric stenosis present? What is this disfunction?

A

2-3 weeks after birth
Overgrowth of sphincter
Projectile vomiting/ no bile
Scaphoid abdomen (stomach distended and palpable olive size mass)

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18
Q

What is recanalization?

A

In the GI system during development, parts of the tube (esophagus, duodenum etc) over porliferize the epithelium and create an epithelial plug, recanalization is reopening the lumen

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19
Q

If poor vacuolization occurs in the duodenal what results?

A

Duodenal stenosis
Small lumen
Usually 3rd or 4th part

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20
Q

If there is no vacuolization in the duodenal what results? What else do you see with this malformation

A 
Duodenal atresia
occluded lumen 
Usually 2nd or 3rd part 
no gas passed duodenum 
Biliary vomit 
1/4 have Down's 
Familial duodenal atresia: autosomal recessive
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21
Q

What is duodenal duplication cysts? What is a meconium cyst?

A

A tubular structure with internal lining of GI epithelium
Sm m. in its wall and adherence to some portion of alimentary tract

Meconium trapped and can enter cavity, become septic and form ascites

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22
Q

What mesentery does the liver develop in?

A

Ventral

Gallbladder and bile ducts also develop in ventral mesentery

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23
Q

What organ develops from both ventral and dorsal mesenteries?

A

pancreas

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24
Q

The entire foregut endoderm has the potential to express what specific genes? What signals may possibly block the expression?

A

liver

Signals from mesoderm and ectoderm possibly Wnts - restrict hepatic development in posterior endoderm

25
Q

What signals allows for the formation of the liver?

A

FGF2 secreted by cardiac mesoderm and BMPs secreted by septum transversum
They block inhibiting factors the prevent the liver from forming

26
Q

How do sinusoids form?

A

heptaic cords coalesce around extraembryonic veins

**Gallbladder and cystic duct forms in same manner?

27
Q

The growht of the liver divides the ventral mesentery into what?

A

falciform ligament and lesser omentum

28
Q

What is the ligamentum venosum?

A

remnant of ductus venosus

29
Q

What are the symptoms of extrahepatic biliary atresia?

A

= incomplete canalization of bile duct
jaundice
Dark urine -kidney filters bilirubin
Pale stool - no bile or bilirubin in intestines

30
Q

What is menkes disease?

A

kinky hair syndrome - decrease in the liver cell’s ability to absorb copper

31
Q

What is wilson’s disease?

A

copper is not eliminated properly by the liver and accumulates
kayserfleischer ring

32
Q

Islets of langerhans secrete what?

A

insulin

33
Q

What is annular pancreas?

A

Ventral and dorsal buds form ring around duodenum and presents as duodenal obstruction

34
Q

What ectopic tissue can be found from distal esophagus through the primary intestinal loop and is the most common in stomach or ileum (diverticulum)?

A

Pancreatic tissue

35
Q

Which peritoneal cavity will become smaller and be the lesser sac?

A

right side

36
Q

Where is the most common location of gut atresias and stenoses?

A

Upper duodenum due to failure to recanalize

lower gut probably due to vascular compromise

37
Q

What is apple peel atresia?

A

10% of all atresias are due to proximal jejunum intestine becomes short and portion distal to defect is coiled around mesenteric remnant
Associated with low body weight and other abnormalities

38
Q

Which part of the gut does the rotation and herniation?

A

midgut - loop rotates 90 degrees counterclockwise around SMA

39
Q

What does the cranial end of the midgut in the umbilical herniation become? the caudal end?

A

Cranial: distal duodenum to ileum
Caudal: lower ileum to proximal 2/3 transverse colon

40
Q

When the midgut returns to the abdominal cavity what additional rotation occurs?

A

180 degrees

41
Q

What is malrotation? What complications can come with it?

A

only partial rotation of the gut
abnormally positioned viscera
Increased risk of entrapment of portions of the intestine
Extraconnections = ladd’s bands
Bilious vomiting
Infants - recurrent abdominal pain, obstruction, malabsorption, solid food intolerance, abdominal distention, septic shock

42
Q

What is volvulus?

A

abnormal twisting of intestine causing obstruction
Compromises the intestine or blood flow
Bloat

43
Q

What is bilious emesis?

A

malrotation with volvulus

green color vomit

44
Q

What is intussusception?

A

The enfolding of one segment of intestine within another

Recurring attacks of cramping abdominal pain that becomes more painful. Blood vessels get entrapped

45
Q

What is omphalocele?

A

Herniation of abdominal contents through enlarged umbilical ring
In membranous sac
Untreated: higher mortality rate and often have cardiac defects, neural tube defects, chromosomes defect

46
Q

What is gastroschisis?

A 
Failure of anterior abdominal wall musculature to close during folding 
No membrane 
Cocaine use?
Not associated with other malformations 
High survival rate
47
Q

What is prune belly/eagle-barrett syndrome?

A 
Triad of features:
- abdominal musculature deficient or absent
-urinary tract anomalies
-bilateral cryptorchidism 
Almost only males
48
Q

What are the hypotheses of PBS?

A

urinary tract obstruction: hypoplastic prostate creates urinary tract obstruction leading to over distention of bladder and stretch abdominal wall
Primary mesodermal developmental defect: intermediate and lateral plate mesoderm gives rise to genitourinary and abdominal wall

49
Q

What is the difference between urachal diverticulum and illeal diverticulum?

A

Urine vs feces leaking

50
Q

What is hirschspring’s disease/congenital aganglionic megacolon?

A

Motor disorder of colon due to failure of neural crest cell migration
Colon cant relax or undergo peristalsis
Functional obstruction
Most common in hindgut (descending/sigmoid colon)

51
Q

What does the cloaca develop from?

A

hindgut endoderm

52
Q

What is the cloaca divided by?

A

urorectal spetum into urogenital sinus and rectum

53
Q

Failure of partitioning cloaca results in what?

A

rectourethral fistula: rectum may end in blind pouch or may open to urethra, bladder, or vagina. may be an absence of the anus

54
Q

What does a rectourethral fistula in males become?

A

Rectoprostatic fistula

55
Q

What does the rectourethral fistula in females become?

A

Either a rectocloacal canal or a rectovaginal fistula

56
Q

What is an anal agenesis?

A

Anal canal ends as blind sac below pelvic diaphragm; this is better

57
Q

What is an anorectgal agenesis?

A

Rectum ends as blind pouch above the pelvic diaphragm

58
Q

What is the clinical prognosis of imperforate anus?

A

surgical correction and prgnosis excellent

59
Q

Rectovesical fistula has what type of clinical prognosis?

A

have poorly developed sacral bones and sphincters. prognosis for normal bowel function is poor

GI - MSI Spring (11 decks)

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