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Mid/Hind Gut
Medical School Devo
33
Other
Graduate
10/28/2011

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Cards

Term
How many rotations do the intestines do after they herniate out of the umbillicus?
Definition
2 rotations

one rotation of 180 degrees
one rotation of 90 degrees
Term
After the first rotation, where is the appendix located?
Definition
directly below the liver
Term
What is non rotation of the midgut? Where does the appendix end up?
Definition
Non-rotation of the mid-gut means that none of the rotations in development occur. This means the appendix stays in its original location (left lower quadrant)
Term
A patient with a non rotated midgut presents with appendicitis. Where would the original pain be located?
Definition
The diffuse pain of appendicitis will always be referred pain to the umbilicus
Term
What does volvulus mean?
Definition
twisting of an organ
Term
Where is the appendix in a case of malrotation of the midgut?
Definition
Subpyloric or subhepatic region. Malrotation is also associated with mesenteric strangulation of parts of the digestive track
Term
Where does the appendix end up in reverse rotation?
Definition
lower right hand quadrant like in a regularly rotated mid-gut
Term
What are possible clinical complications of a reversed rotated mid-gut?
Definition
Patient is at increased risk of compression of the transverse colon (via superior mesenteric artery) as well as a risk of large intestinal volvulus
Term
What is an Omphalocele?
Definition
Abnormal herniation into the umbilicus. Remember that some herniation is normal (To complete the twisting of the bowels)
Term
What is Gastroschisis?
Definition
Herniation of the bowl out through the anterior abdominal wall (typically along the linea alba)
Term
How does Meckel's diverticulum form?
Definition
Meckel's diverticulum is formed by a failure of the yolk sac to regress
Term
What clinical presentation can someone with Meckels present?
Definition
Since Meckels has gastric mucosa and pancreatic tissue (degrades the area of bowel) it can present like appendicitis (lower left hand quadrant pinpoint pain instead of lower right). Also sometime Meckels can form as a fistula or cyst towards the umbilicus
Term
What is intussusception?
Definition
It is when bowel folds into itself and project into a distal portion of bowel. This can cause ischemia and necrotic bowel. Ileocecal is the most common
Term
What are possible causes of Intestinal Atresia?
Definition
vascular insult and failure of recanalization
Term
What is intestinal duplication?
Definition
essentially a duplication of the lumen in the intestine. Can result in a cyst, impaction due to duplication that closes off at one end, or simply a double lumen with few complications
Term
The upper anal canal and urogenital sinus are derived from which tissues?
Definition
endoderm
Term
The urorectual septum is derived from what tissue?
Definition
Mesoderm
Term
the proctodeum and lower anal canal are derived from what?
Definition
ectoderm
Term
The perineal body is derived from what?
Definition
mesoderm
Term
What is the function of the urorectal septum?
Definition
separate the urogenital sinus and the anal canal
Term
What is the pectinate line?
Definition
divides the anal canal from its perspective contributions (ectoderm from proctodeum and endoderm from hindgut
Term
The hindgut contribution to the anal canal has vascularization/lymphatic drainage from where?
Definition
Inferior mesenteric, lymphatic drainage goes to the inferior mesenteric lymphnodes
Term
The proctodeum contribution to the anal canal gets its vascularization/lymphatic drainage from where?
Definition
The vascularization comes from the Internal pudendal artery (branch of internal illiac). The lymphatic drainage goes to the superficial inguinal nodes
Term
What sort of ennervation does the hindgut contribution to the anal canal have?
Definition
Autonomic
Term
What sort of enervation does the contribution to the anal canal from the proctodeum have?
Definition
somatic enervation
Term
What seperates the anal and urigenital triangles in the cloacal region?
Definition
Perineal body
Term
What is Exstrophy of the cloaca?
Definition
abnormally large cloacal region that cannot be closed off by the body wall. Results in exposing the lumen of the bladder and the rectum.
Term
What are the two general classes of anorectal anomalies?
Definition
Urorectal septum problem or Anorectal agenesis
Term
Persistant cloaca is associated with what type of anorectal anomaly?
Definition
Urorectal septum defect
Term
Anoperineal fistula is associated with what kind of urogenital defect?
Definition
Urorectal septum problem
Term
What is the significance of the puborectalis muscle and anorectal anomalies?
Definition
anomalies below the muscle mean that the patient will still have bowel control. Anomalies below the muscles mean that the patient will suffer from incontinence
Term
What is an imperforate anus?
Definition
persistent anal membrane where the infant cannot pass stools
Term
What is Hirschprung Disease?
Definition
Congenital megacolon results from a failure of neural crest cells to migrate and ennervate sections of bowel. This part of bowel will not be able to undergo peristalsis and will result impacted colon
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