Development of the Abdominal Viscera
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| Ectopia Cordis | Thoracic Wall defect. The ribcage and sternum dont fuse on the midline but the heart develops more or less normally. Can be corrected but associated with other abnormalities and very low survivability.
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| Gastroscisis. | abdominal wall defect. Incomplete closure of abdominal wall, causing protrusion of the viscera.
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| Bladder/cloacal exstrophy | Pelvic wall defect. Along with exposure of the bladder, the external genitalia may be affected since they also originate from the somatic layer of lateral plate mesoderm.
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| esophageal atresia | Problem with the seperation of the esophagous from the gut tube. causes an inability to swallow food. gut tube doesnt form.
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| Congenital esophageal stenosis | causes dysphagia. Tracheobronchial obstructions due to overgrowth of cartilage, glands, epithelium. Membranous diaphragm in lumen. Fibromuscular stenosis that narrows lumen.
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| Congenital Hiatal Hernia | Occurs when the esophagus does not lengthen enough and causes the cardiac region of the stomach to be pulled into the throacic cavity. Associated with acid reflux. Very common.
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| Paraesophageal hernia | When the fundus of the stomach displaces through diaphragm next to the esophagus
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| Hiatal Hernia | The gastroesophageal junction slides through diaphragm into the thorax.
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| How does the stomach form? | It distends and rotates to the left. The left side forms the greater curvature as it expands. This pushes the distal end to the right, bringing the duodenum into a C-Shape curve.
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| Intestinal Atresia | Blocks the upper gastrointestinal tract. Children cant be fed until surgically repaired. Patient presents with bilious emesis, which is always abnormal and indicates obstruction distal to the common bile duct insertion.
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| Hepatic Diverticulum | 3rd week extends off foregut. Embeds itself into the septum transversum. Becomes the common bile duct. Develops into the gallbladder, Ventral pancreatic bud, and liver. (spleen?)
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| What becomes the common bile duct? | The Hepatic Diverticulum.
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| How does the gallbladder form? | It develops as an outpouching of the hepatic diverticulum with its own duct, the cystic duct, that connects it to the common bile duct.
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| How does the pancreas form? | The ventral pancreatic bud develops from the hepatic diverticulum. The dorsal pancreatic budy develops from the gut tube. These are fused once the stomach rotates and brings them together.
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| Annular Pancreas | When the ventral pancreas migrates anteriorly AND postriorly, surrounding the duodenum and partially occluding its lumen.
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| Omental Bursa | The space created posteriorly when the stomach shifts left and the liver shifts right. This space becomes a blind pouch that communicates with the rest of the peritoneal cavity via the omental foramen.
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| The Midgut Becomes: | Distal duodenum, Jejunum, ileum cecum, appendix, ascending colon, transverse colon.
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| The Proximal (cephalic) loop: | rotates inferiorly to become the distal duodenum, jejunum, and part of the ileum.
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| The Distal (caudal) loop: | Rotates superiorly to become the rest of the ileum, cecum, appendix, ascending colon and most of the transverse colon.
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| Which artery supplies the midgut? | the mesenteric artery.
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| Vitelline duct | Extends off of the ileum but normally disappears during development. Sometimes it remains as a blind pouch connected to the umbilicus and can entrap loops of small intestines causing volvulus and necrosis.
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| How is the midgut positioned? | The jejunum is positioned primarily on the left and other midgut structures are laid down progressively more towards the right.
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| Omphalocele | Congenital herniation of intra-abdominal viscera through a defect in the abdominal wall around the umbilicus. Contains the intact peritoneal sac covering the viscera.
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| Left-sided colon | When the gut only rotates 90 degrees before returning to the abdomen from its physiological herniation.
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| When happens if the gut rotates 270 degrees in the opposite direction? | The gut will appear completely normal except that the duodenum will run anterior to the transverse colon.
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| Volvulus | a life threatening bowel obstruction
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| Hindgut Development: | Descending colon, sigmoid colon, rectum
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| The hindgut receives blood from: | the inferior mesenteric artery.
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| Cloaca | a structure that receives content from the urinary, digestive, and reproductive systems.
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| Urorectal Septum | the urogenital and digestive tracts are partitioned by this. Separates the rectum from the urogenital sinus and eventually reaches the surface to form the perineal body.
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| imperforate Anus | results from failure of the anal membrane to rupture, leaving the anal pit unconnected to the rectum.
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