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1.2 Lectures > Week 6 (Development of the GI System) > Flashcards

Week 6 (Development of the GI System) Flashcards

1
Q

What are GI malformations among?

A

the most common birth defects

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2
Q

GI malformations are frequently associated with which syndromes?

A
  • VACTERL syndrome
  • CHARGE syndrome
  • Kartagener syndrome
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3
Q

What increases good outcomes in GI malformations?

A

in-utero or early diagnosis

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4
Q

Understanding the embryonic origins helps make sense of what?

A

the adult anatomy

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5
Q

What are the components of the foregut?

A
  • Pharynx
  • Esophagus
  • Stomach
  • Duodenum
  • Liver + biliary apparatus
  • Pancreas
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6
Q

What structures are included in the midgut?

A
  • Duodenum (parts 2-4)
  • Jejunum
  • Ileum
  • Cecum and Appendix
  • Ascending colon
  • Right 2/3 of transverse colon
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7
Q

What does the hindgut consist of?

A
  • Left 1/3 of transverse colon
  • Descending colon
  • Sigmoid colon
  • Rectum
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8
Q

What are key developmental mechanisms in GI tract development?

A
  • Differential growth
  • Budding (diverticula)
  • Canalization
  • Rotations
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9
Q

What can result from disruptions of key developmental mechanisms?

A
  • Stenosis or atresia
  • Misplacement of organs
  • Volvulus
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10
Q

What does differential growth lead to?

A
  • Hypertrophy
  • Hypoplasia
  • Aplasia
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11
Q

What does budding result in?

A
  • Absence of structures
  • Duplication of structures
  • Structures in atypical locations
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12
Q

What are the germ layers involved in the digestive system?

A
  • Endoderm
  • Mesoderm
  • Ectoderm
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13
Q

What does the endoderm contribute to in the GI tract?

A

epithelial lining of the gut & glands

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14
Q

What does the mesoderm contribute to in the GI tract?

A
  • Muscles
  • Connective tissue
  • Vasculature
  • Mesenteries
  • Mesenchymal components of glands
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15
Q

What does the ectoderm contribute to in the GI tract?

A

epithelium of mouth and anus

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16
Q

What does somatic/parietal mesoderm give rise to?

A

parietal peritoneum

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17
Q

What does splanchnic/visceral mesoderm wrap around?

A

gut tube to form mesenteries and wall of gut tube

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18
Q

What does the neural crest contribute to in the digestive system?

A

neurons and nerves of submucosal and myenteric plexi

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19
Q

What are the three arteries that determine the divisions of the foregut, midgut, and hindgut?

A
  • Celiac artery
  • Superior mesenteric artery
  • Inferior mesenteric artery
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20
Q

Fill in the blank: The midgut connection narrows to _______.

A

OM duct

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21
Q

True or False: The foregut and hindgut are blind ending tubes.

A

True

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22
Q

What happens to the communication of the gut and yolk sac during development?

A

gets smaller

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23
Q

What is the developmental origin of the esophagus?

A

Derives from foregut caudal to pharynx

Develops from endoderm, skeletal muscle from occipital somites, and smooth muscle from splanchnic/visceral mesoderm

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24
Q

What is the primary cause of esophageal atresia?

A

Deviation of the tracheoesophageal septum in a posterior direction

Can also result from incomplete separation of the esophagus from the laryngotracheal tube or insufficient vascular perfusion

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25
What condition results when the fetus is unable to swallow amniotic fluid?
Polyhydramnios ## Footnote Associated with esophageal atresia or stenosis
26
True or False: Tracheoesophageal fistula is an abnormal passage between the trachea and esophagus.
True
27
What is the time frame for stomach development?
4-8 weeks ## Footnote Stomach develops alongside the duodenum, liver, gall bladder, pancreas, and spleen (3-6 weeks)
28
What happens during the first rotation of the stomach?
Clockwise rotation on longitudinal axis (~90 degrees) ## Footnote Anterior border (lesser curvature) becomes right; posterior border (greater curvature) becomes left
29
What is the consequence of abnormal stomach rotation?
Malrotation can lead to volvulus ## Footnote This can cause obstruction and ischemia due to twisting of the mesenteries
30
What is pyloric stenosis?
Condition presenting with non-bilious projectile vomiting and a palpable 'olive' mass in the epigastrium ## Footnote Occurs in 2-4/1000 births, typically at 2-8 weeks of age
31
Fill in the blank: The dorsal mesentery is derived from _______.
Visceral mesoderm
32
What is the function of the dorsal mesentery?
Maintains gut tube/derivatives in normal anatomical positions ## Footnote Serves as a pathway for blood vessels, nerves, and lymphatics supplying the GI tract
33
What is the fate of the dorsal mesentery of jejunal and ileal loops?
Forms mesentery proper
34
What does the greater omentum develop from?
Dorsal mesogastrium ## Footnote Is carried with the stomach during its rotations
35
What is a common symptom of pyloric stenosis?
Non-bilious projectile vomiting
36
What anatomical changes occur to the stomach's orientation after rotation?
Long axis of stomach becomes transverse to long axis of body ## Footnote Liver shifts to right, spleen to left
37
List the components derived from the foregut.
* Esophagus * Stomach * Duodenum * Liver * Gall bladder * Pancreas * Spleen
38
From which parts of the primordial gut does the duodenum develop?
Caudal part of the foregut and cranial part of the midgut ## Footnote The caudal part is supplied by the celiac trunk, and the cranial part is supplied by the SMA.
39
What shape does the presumptive duodenum take during development?
C shape ## Footnote The presumptive duodenum is displaced to the right.
40
Which parts of the duodenum are intraperitoneal?
1st part ## Footnote Parts 2-4 adhere to the dorsal body wall.
41
What developmental mechanism is key for the duodenum's formation?
Recanalization of the gut tube ## Footnote This involves mesodermal and endodermal proliferation, occlusion, and apoptosis.
42
What conditions can arise from errors in the recanalization process?
Stenosis and atresia ## Footnote Stenosis refers to partial occlusion, while atresia refers to complete occlusion.
43
What is a common sign associated with duodenal atresia?
'Double bubble' sign ## Footnote This sign indicates a dilated duodenum and stomach.
44
Where does blockage most commonly occur in cases of duodenal atresia?
At the junction of the bile duct and pancreatic duct (hepatopancreatic ampulla) ## Footnote This often results in vomiting of stomach contents containing bile.
45
What induces the formation of the hepatic diverticulum?
Retinoic acid and FGF from cardiac mesoderm and septum transversum ## Footnote The hepatic diverticulum develops from ventral foregut endoderm.
46
What structures are formed from the ventral mesentery?
* Peritoneum of liver (except bare area) * Falciform ligament * Lesser omentum (hepatogastric and hepatoduodenal ligaments) ## Footnote These modifications occur due to the growth of the liver.
47
What does the cystic bud of the hepatic diverticulum develop into?
Gallbladder and cystic duct ## Footnote The cystic bud forms on the ventral side of the duodenum.
48
What is biliary atresia?
A condition where the bile ducts are obliterated ## Footnote It affects both extra- and intrahepatic bile ducts and prevents bile from flowing from the liver to the small intestine.
49
How does the dorsal pancreatic bud relate to the hepatic diverticulum?
It forms opposite to the hepatic diverticulum ## Footnote The head, body, and tail of the dorsal pancreatic bud do not rotate.
50
What happens to the ventral pancreatic buds during development?
They sprout into the ventral mesentery and fuse rapidly ## Footnote This leads to the formation of the ventral pancreas and common bile duct.
51
What is an anomaly associated with the pancreas?
Annular pancreas ## Footnote This occurs due to a bifid ventral bud that migrates in opposite directions, potentially leading to duodenal stenosis.
52
What defines pancreatic divisum?
Two separate ducts drain the pancreas ## Footnote This occurs when the duct systems fail to fuse, leading to the dorsal pancreatic duct draining most of the pancreas via the minor papilla.
53
When does the midgut begin to herniate into the umbilicus?
Beginning ~ week 6-7
54
What rotation occurs during the midgut development?
90° counter-clockwise rotation of gut tube
55
By which week is the midgut retracted into the abdominal cavity?
By 10-11th week
56
What is the total counter-clockwise rotation of the midgut during development?
270° counter-clockwise
57
What are the reasons for physiological herniation of the midgut?
* Rapid intestinal growth * Limited space in abdominal cavity * Constrained by skeletal/muscular structure
58
What molecular controls are associated with midgut development?
* Retinoic acid * Wnt/β-catenin pathway * Hox genes (A-P patterning)
59
What are the two limbs of the primary intestinal loop?
* Cranial limb * Caudal limb
60
In which direction does the primary intestinal loop rotate around the superior mesenteric artery?
90° counter-clockwise
61
Which limb enters the abdominal cavity first during midgut development?
Cranial limb (prox. jejunum)
62
What happens to the proximal jejunum during its return to the abdominal cavity?
It rotates counterclockwise and is positioned to the left
63
What anatomical structures become retroperitoneal during midgut rotation?
* Ascending colon * Descending colon
64
What is the last part to enter the abdominal cavity during midgut development?
Cecal bud
65
What is the subtotal rotation during retraction of the midgut?
180° counter-clockwise
66
What controls the looping of the midgut?
* Primary and secondary looping * Genetic control * Heterotaxia syndromes showing malrotation
67
What is tertiary looping characterized by?
Non-predictable pattern
68
What factors control the return of the midgut to the abdominal cavity?
* Growth and expansion of abdominal cavity * Development of mesenteries * Positioning and anchoring of intestines
69
What results from midgut rotation in terms of anatomical positioning?
* Establishes the anatomical position of the large intestine * Small intestine elongates and coils behind colon
70
What are some midgut defects that can occur?
* Volvulus * Rotational defects * Gastroschisis * Omphalocele
71

1.2 Lectures (9 decks)

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