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134 Cards in this Set

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  • Back
What helps in forming the primitive gut tube?
longitudinal and lateral folding
What are the three parts of the developing GI? What do members of each part share?
foregut, midgut, hindgut
similar vascular supply, innervation, and lymph vessels, similar referred pain
What is the consequence of lateral folding?
endodermal ling of the upper part of the Yolk Sac is incorporated into the embryo and forms the lining of the primitive gut
The cephalic part of the gut is called what? caudal?
foregut
hindgut
What attaches the primitive gut to the body wall? Is it fixed of suspended?
dorsal mesentery
suspended
As folding of the gut occurs what happens to the splanchnic mesoderm? Why is this important?
right and left sides of splanchnic mesoderm fold toward each other
these lateral folds merge in the midline and form dorsal and ventral mesentery
What differs between dorsal and ventral mesentery?
the ventral mesentery only forms to the foregut segment
the dorsal mesentery goes to all parts
Why are mesenteries referred to as being 'two-layered' thick of 'bilayered'?
b/c they have origins from both the right and left splanchnopleure
How are nevers and vessels able to reach the developing GI?
mesenteries
What are the derivatives of the primitive dorsal mesentery? Where does each go to?
dorsal mesogastnum-to stomach
the mesentery-small intestine (jejunum & ileum)
transverse mesocolon-transverse colon
sigmoid mesocoln-sigmoid colon
Anatomically and clinically, what are mesenteries known as?
bilayered visceral peritoneum or visceral peritoneal folds
What is the layer of splanchnopleure enclosing an organ called?
visceral peritoneal covering
What is the mesoderm lining the body wall called? What is the wall called?
parietal peritoneum
peritoneal cavity
What are the EARLY derivatives of the foregut?
stomach, liver and gall bladder
What does the liver form between?
the two 'layers' of the ventral mesentery
What artery supplies the foregut? midgut? hingut?
F-celiac
M-Superior mesenteric A
H-Inferior mesenteric A
The stomach is initally attached to the ventral wall by the ventral mesentery (as well as to the dorsal wall by dorsal mesentery). What is this ventral mesentery later called?
lesser omentum
Which side of the stomach is faster growing? What does this create?
dorsal surface, creates Greater Curvature
Why is a long mesenteric fold hanging freely from the stomach in some adults?
the original dorsal mesogastrium grows much more than its adjacent dorsal mesentery
Why does the Lesser Curvature form? What side is this located on?
the ventral surface does not match the growth pace of the dorsal surface
Which way does the stomach rotate? What does this do to the original dorsal and ventral sides?
rotates 90 to the right
dorsal swept to left, ventral moves toward right
What creates a bulge near the junction of the stomach and esophagus? What is this called?
differential growth in the cranial end of the stomach tube
called the fundus
What is the notch that is between the fundus and the esophagus?
cardiac incisure
What is the name of the region of the stomach located distally?
pyloric region
What does the ventral mesentery become partitioned by?
liver
What is the proximal part of the ventral mesentery between? What is this called?
between stomach and liver
called lesser omentum
Which way does the lesser omentum move when the stomach rotates?
right
What are the two parts of the lesser omentum?
hepatogastric ligament
hepatoduodenal ligament
Which ligament of the lesser omentum is more inferior? Which is smaller?
hepatoduodenal ligament for both
What is the distal part of the ventral mesentery between? What is it called?
between liver and ventral body wall
falciform ligament
What is the narrowing of the pyloric of the stomach called?
hypertrophic pyloric stenosis
What is the cause of hypertrophic pyloric stenosis?
thickening of the circular muscle in the wall of the stomach
What creates the 'blind pouch' posterior to the stomach? What is this called?
rotation of the stomach dragging along its attached mesenteries
omental bursa
What does the omental bursa come off of?
peritoneal cavity
What is another name for the omental bursa?
lesser peritoneal sac
What binds the lesser peritoneal sac?
lesser omentum, stomach, dorsal mesogastrium and posterior body wall
What is the entry point to the lesser peritoneal sac called? Where is this opening located?
omental foramen
caudal to the inferior edge of the lesser omentum
What is the clinical importance of the lesser peritoneal sac?
it's an important entry point for the spread of pathology into the bursa
What is the spleen derived from?
mesoderm (not endoderm)
The spleen begins as mesenchymal condensations within what?
dorsal mesogastrium
What is the result of the 'clumps' that make the spleen?
a notched border on the spleen is seen in adults
What does the spleen deveop between?
R&L layers of the dorsal mesentery
Which side of the body is the spleen on? What causes it to move in this direction?
left
due to repositiong of the mesentery w/ the rotation of the stomach
What does the spleen subdivide? What are the divisions named?
mesentery
splenorenal (lienorenal) ligament and gastrosplenic (gastrolienal) ligament
What forms the left boundary of the lesser peritoneal sac?
splenorenal and gastrosplenic ligaments
What forms the hepatic diverticulum? What part of the gut does this bud from?
hepatic plate of tissue from duodenal/gastric area
foregut
What keeps the hepatic diverticulum connected to the foregut?
hepatic duct (stalk)
What do the liver cords eventrually become?
hepatocytes/parenchyma
What do the spaces in the mesodermal core between the liver cords become?
hepatic sinusoids
What bud does the hepatic duct give rise to? What will this go on to form?
cystic diverticulum
will develop gall bladder
What will the proximal hepatic duct be called?
common bile duct
Where does the common bile duct empty its contents?
duodenum
What is the biliary duct system composed of?
cystic duct attached to hepatic duct, the proximal part of hepatic duct is called the common bile duct
What causes the liver to be in the RUQ?
the liver grows rapidly, neighboring organs grow slower and stomach rotates
How much weight does the liver account for at birth?
10%
What is the ventral mesentery partitioned by?
liver
What is the proximal part of the ventral mesentery called? distal?
lesser omentum
falciform ligament
Which region of the gut is the ventral mesentery found?
foregut
What is the remnant of the umbilical vein called?
ligamentum teres hepatis
Where does the umbilical vein run?
along the inferior free margin of the ventral mesentery
What makes up the portal triad?
hepatic artery & (portal) vein, and bile duct
What ist he reflection of peritoneum from the liver's surface tot he inferior surface of the diaphragm called?
coronary ligament
Does the bare area of the liver have a peritoneal or non-peritoneal surface?
non-peritoneal
What is the duodenum derived from?
distal end of foregut and proximal end of midgut
What is the vascular supply of the duodenum?
celiac trunk and SMA
What are the four parts of the duodenum?
1-duodenal bulb (cap)
2-descending part
3-horizontal
4-ascending
At what part of the duodenum is the entry point for the duct system from the liver
descending segment
What is reduction in the size of the duodenum w/ abnormal narrowing of the gut segment? At what part of the duodenum does this normally occur?
duodenal stenosis
3 or 4
What is canalization? How does this relate to duodenal stenosis?
normally, duodenal lumen fills w/ cells, but lumen is re-opened by the process of canalization, in duodenal stenosis there is incomplete recanalization
What is duodenal atresia?
abnormal degeneration of the duodenum
Which type of duodenal anomality has bile in the vomit? Duodenal atresia or dudenal stenosis?
both do
What is the ventral bud of the pancreas associated with?
hepatic duct
What will the ventral bud of the pancreas become? dorsal bud?
uncinate process (fishhook shaped)
neck, body and tail
What does the duct of the ventral bud become?
main pancreatic duct
The main pancreatic duct and bile duct combine to form what?
hepatopancreatic duct
The hepatopancreatic duct expands to form what?
ampulla of Vater
What part of the duodenum does the ampulla of vater enter?
2nd part
What is the major duodenal pailla?
the raised mucosal tissue present on the duodenum where the hepatopancreatic duct enters
What is the old attachment of the duct from the original dorsal bud of the pancreas called?
minor papilla
What does the tail of the pancreas grow between?
dorsal mesogastrium , toward the spleen
eventually within the splenorenal ligament
Which type of pancreatic cells produce digestive enzymes? What do these cells differentiate from?
exocrine cells, from pancreatic bud endoderm
Which type of pancreatic cells are in the islets of Langerhans? What are 2 things they have been suggested to come from?
endocrine cells, from neural crest cells or gut endoderm
What is Annular Pancreas? What can this cause?
bilobed ventral pancreatic bud
the two ends migrate around the duodenum causing strangulation (duodenal atresia or stenosis)
What part of the small intestine is midgut derived?
distal half of duodenum, all of jejunum and illeum
What part of the large intestine is midgut derived?
cecum, appendix, ascending colon and proximal 2/3 of transverse colon
What are the three phases of midgut development?
elongation & herniation
return of the loop to abdominal cavity
fixation of mesenteries
Which phase of midgut development is responsible for forming the primary intestinal loop?
elongation & herniation (phase I)
What is the apex of the primary intestinal loop attached to?
yolk sac
The proximal limb of the primary intestinal loop will form what?
distal half of the duodenum and the jejunum and ileum
The distal limb of the primary intestinal loop will form what?
cecum, ascending colon and 2/3 of transverse colon
Which limb (proximal/distal) grows faster for the primary intestinal loop?
proximal
During phase 1 which way does the midgut loop rotate? What ist he axis that defines this rotation?
to the right
SMA
Where do you find blood vessels leading to and draining the gut?
within the mesentery
Where is the transverse colon located with respect to the duodenum?
anterior and transverse to
What is a subhepatic cecum? Where is the cecum normally located?
when the cecum fails to descend to the RLQ and remains just under the liver
Normally in RLQ
What is the SMA between?
posterior to transverse colon and anterior to 3rd part of duodenum
Which quadrant is the jejunum located? ileum?
jejunum-LUQ
ileum-RLQ
What forms a diverticulum or bud off the cecum?
appendix
Which limb of the primary intestinal loop forms coils? Which limb retruns first?
proximal for both
What is malrotation of the gut? What is there an increased risk of?
gut didn't rotate normally
chance of necrosis
Which mesentery is fixed during fixation of the mesenteries?
dorsal
What causes the mesenteries to be 2-layered?
during embryonic folding the right and left side layers of splanchnic mesothelium come together
Which layer of the mesentery is swept toward the body wall? Is this layer visceral or peritoneal peritoneum?
right side
visceral
The visceral and peritoneal peritoneums interact to become what?
fusion fascia
What is retroperitoneal?
when an organ is covered on 3 sides or less by visceral peritoneum
What is a secondarily retroperitoneal organ?
when an organ starts as intraperitoneal and becomes retroperitoneal
Name two organs that develop from the start retroperitoneal?
rectum and kidneys
What provides a plane for surgical dissection that would avoid invasion of the peritoneal cavity?
fusion fascia
Is the pancreas retroperitoneal or intraperitoneal? duodenum?
both become retroperitoneal
Which layer of the mesentery (right/left) fuses w/ the peritoneum of the dorsal body wall and fuses the pancreas? Which part of the pancreas is fused?
left layer
tail of the pancreas
What replaces the fused peritoneal lyers of the pancreas posteriorly?
fusion fascia
When the right layer of the dorsal mesentery fuses with the parietal peritoneum on the dorsal wall which part of the pancreas is fused? Which other organ is at this level?
head of pancreas
duodenum
What is the definitive mesentery to the jejunum and ileum called? Where does it attach in the adult?
The Mesentery
diagonally along the posterior abdominal wall from the 4th part of duodenum down to R sacroiliac joint
What is the attachment line of The Mesentery called?
root
The SMA travels in the root of the mesentery and between its 2 layers where it arrives at what?
mesenteric surface (line of attachment) of the jejunum and ileum
What forms the paracolic gutters? What is their significance?
fixation causes the depressions in the peritoneum on each side of the ascending and descending colons
the gutters act as conduits for movement of fluid through the peritoneal cavity
What does the greater omentum fuse to?
itself and part of the mesentery to the transverse colon
The resultant mesentery that attaches to the stomach and to the transverse colon is also called what?
gastrocolic ligament
What creates the transverse mesocolon?
fusion of the transverse colon's mesentery proximally to peritoneum overlying the pancreas and duodenum and tot he posterior aspect of the greater omentum
Is the transverse colon retroperitoneal or intraperitoneal?
intraperitoneal
What attaches the transverse colon to the posterior wall?
hepatic flexure and splenic flexure
What are the derivatives of the hindgut?
distal 1/3 of transverse colon, descending and sigmoid colons, rectum and superior part of anal canal
What is the non-fixed, mobile mesentery of the sigmoid colon called? Is the sigmoid retroperitoneal or intraperitoneal?
sigmoid mesocolon
intraperitoneal
Discuss the peritoneum of the rectum?
upper 1/3 is covered on 3 sides
middle 1/3 only has peritoneum anteriorly
distal 1/3 has no peritoneum
=retroperitoneal
What is the vascularture of the large intestine?
SMA and IMA
What are the 3 folds of the mesoderm? What do they partition?
cloaca
Tourneux fold
Rathke folds
separate distal hindgut, or urogenital sinus from the anorectal canal
What is the dilated junction of the allantois and hindgut?
cloaca
What is the cranial-to-caudal migrating mesoderm? This fold will join inferiorly with which other fold?
Tourneux fold
Rathke folds
What are Rathke folds?
infolding mesoderm from the left and right sides
What are the 3 folds of the mesoderm collectively called?
urorectal septum
The fusion of uorectal septum with the cloacal membrane divides what two things?
urogenital membrane and anal membrane
Proliferation of mesenchyme around the anal membrane and deep to the superficial ectoderm creates what?
ectodermal proctodeum or anal pit
The lower 1/3 of the anal canl is lined by what? upper 2/3?
ectoderm
endoderm
What is the anatomic junctional zone between the 2 different linings of the anal canal?
pectinate line