embrio abdomen 2
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7/28/2019 Embrio Abdomen 2
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MEDICAL GROSS ANATOMY & EMBRYOLOGY
dr. Mihai Turcanu
Embryology ofGastrointestinal Tract
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Contents
❖ Origin of GIT
❖
Divisions of GIT
❖ Mesenteries
❖ Foregut
❖ Midgut
❖ Hindg ut
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Contents
❖ Origin of GIT
❖
Divisions of GIT
❖ Mesenteries
❖ Foregut
❖ Midgut
❖ Hindg ut
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Origin of the Gut Tube
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Origin of the Gut Tube
Endoderm
❖ epitelium of GIT, glands
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Origin of the Gut Tube
Endoderm
❖ epitelium of GIT, glands
Mesoderm
❖muscle, connective tissue,peritoneum
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Orig in of the Gut Tube
Endoderm
❖ epitelium of GIT, glands
Mesoderm
❖muscle, connective tissue,peritoneum
Ectoderm
❖ buco-pharyngeal & cloacalmembrane
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Divisions of the Gut Tube
❖ Embryo folding:
primitive gut
❖ endodermicportion of yolksac
❖ yolk sac
❖ allantois
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Divisions of the Gut Tube
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Divisions of the Gut Tube
Cephalic:
❖ Foregut
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Divisions of the Gut Tube
Cephalic:
❖ Foregut
Middle:
❖ Midgut - temporally connected to yolk sac( vitelline duct, or yolk
stalk)
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Divisions of the Gut Tube
Cephalic:
❖ Foregut
Middle:
❖ Midgut - temporally connected to yolk sac( vitelline duct, or yolk
stalk)
Caudal:
❖ Hindgut
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Mesenteries
Dorsal and ventral mesenteries
❖ double layers of peritoneum
❖ enclose an organ
❖ connect it to the body wall
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Dorsal mesentery - 5th week
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Intraembryonar coelom
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Intraembryonar coelom
20th day
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Intraembryonar coelom
20th day
ectoderm
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Intraembryonar coelom
20th day
ectoderm
mesoderm
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Intraembryonar coelom
20th day
ectoderm
mesoderm
endoderm
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Intraembryonar coelom
20th day
23rd day
ectoderm
mesoderm
endoderm
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Intraembryonar coelom
20th day
23rd day
25th day
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Intraembryonar coelom
20th day
23rd day
25th day
intraembryonyc coelom
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Intraembryonar coelom
20th day
23rd day
25th day
intraembryonyc coelom
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Intraembryonar coelom
20th day
23rd day
25th day
intraembryonyc coelom
extraembryonyc coelom
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Intraembryonar coelom
29th day
20th day
23rd day
25th day
intraembryonyc coelom
extraembryonyc coelom
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Intraembryonar coelom
29th day
20th day
23rd day
25th day
intraembryonyc coelom
extraembryonyc coelom
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Intraembryonar coelom
29th day
20th day
23rd day
25th day
intraembryonyc coelom
extraembryonyc coelom
CLINICAL APPLICATION
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Derivates of dorsal mesentery
CLINICAL APPLICATION
CLINICAL APPLICATION
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Derivates of dorsal mesentery
❖ Foregut
❖ Stomach - dorsal mesogastrium or greater omentum
❖ Duodenum - dorsal mesoduodenum
CLINICAL APPLICATION
CLINICAL APPLICATION
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Derivates of dorsal mesentery
❖ Foregut
❖ Stomach - dorsal mesogastrium or greater omentum
❖ Duodenum - dorsal mesoduodenum
❖ Midgut
❖ jejunal and ileal loops - mesentery proper
CLINICAL APPLICATION
CLINICAL APPLICATION
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Derivates of dorsal mesentery
❖ Foregut
❖ Stomach - dorsal mesogastrium or greater omentum
❖ Duodenum - dorsal mesoduodenum
❖ Midgut
❖ jejunal and ileal loops - mesentery proper
❖ Hindgut
❖ Colon - mesocolon
C C C O
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Ventral mesentery - 5th week
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Septum transversum
❖ arises from cranialmesenchyme
Forms:
❖ thoracic diaphragm
❖ ventral mesentery
CLINICAL APPLICATION
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Derivates of ventral mesentery
CLINICAL APPLICATION
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Derivates of ventral mesentery
❖ Foregut
❖ Stomach & Duodenum- lesser omentum
❖ Liver - falciform ligament
CLINICAL APPLICATION
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Derivates of ventral mesentery
❖ Foregut
❖ Stomach & Duodenum- lesser omentum
❖ Liver - falciform ligament
❖ Midgut
❖ NOTHING
CLINICAL APPLICATION
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Derivates of ventral mesentery
❖ Foregut
❖ Stomach & Duodenum- lesser omentum
❖ Liver - falciform ligament
❖ Midgut
❖ NOTHING
❖ Hindgut
❖ NOTHING
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Foregut5 week embryo
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Foregut
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Foregut❖
Esophagus❖ Trachea
❖ Lung buds
❖
Stomach
❖ Proximal duodenum ( entranceof the bile duct )
❖ Liver
❖ Pancreas
❖ Biliary apparatus
❖ Celiac trunk
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4th week
Esophagus
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4th week
Esophagus
❖ respiratory
primordium andesophagus
❖Respiratorydiverticulum ( lung
bud )
❖Tracheoesophagealseptum
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Lung bud
CLINICAL APPLICATION
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Esophageal Abnormalities
❖ Esophageal atresia(polyhydramnios )
❖ Esophageal stenosis
❖ Tracheo-esophageal fistula
CLINICAL APPLICATION
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Esophageal Abnormalities
❖ Esophageal atresia(polyhydramnios )
❖ Esophageal stenosis
❖ Tracheo-esophageal fistula
CLINICAL APPLICATION
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Esophageal Abnormalities
❖ Esophageal atresia(polyhydramnios )
❖ Esophageal stenosis
❖ Tracheo-esophageal fistula
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Stomach
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❖ 4th week: fusiformdilatation
Stomach
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❖ 4th week: fusiformdilatation
❖ 90° rotationclockwise ( vagusnerve )
Stomach
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❖ 4th week: fusiformdilatation
❖ 90° rotationclockwise ( vagusnerve )
Stomach
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Stomach
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Stomach
CLINICAL APPLICATION
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Stomach Abnormalities
CLINICAL APPLICATION
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Stomach Abnormalities
❖ Pyloric stenosis
❖
Hypertrophy of circularmusculature
❖ Most common
CLINICAL APPLICATION
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Stomach Abnormalities
❖ Pyloric stenosis
❖
Hypertrophy of circularmusculature
❖ Most common
❖ Atretic pylorus
CLINICAL APPLICATION
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Stomach Abnormalities
❖ Pyloric stenosis
❖
Hypertrophy of circularmusculature
❖ Most common
❖ Atretic pylorus
❖ Prepyloric septum
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❖Duodenum and head of the pancreas - fixed in a retroperitonealposition ( dorsal mesoduodenum disappears )
Duodenum
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Liver
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Liver
❖ 10th week:
❖ 10 % of the total body weight
❖ hematopoietic function
❖ 12th week:
❖
bile is formed
❖ bile can enter the gastrointestinal tract ( dark green )
CLINICAL APPLICATION
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Liver and Gallbladder Abnormalities
❖Variations in liver lobulation
❖ Accessory hepatic ducts
❖ Intrahepatic biliary duct atresia and hypoplasia
❖Duplication of the gallbladder
❖ Failure of recanalization ( extrahepatic biliary atresia )
❖
CLINICAL APPLICATION
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Liver and Gallbladder Abnormalities
❖Variations in liver lobulation
❖ Accessory hepatic ducts
❖ Intrahepatic biliary duct atresia and hypoplasia
❖Duplication of the gallbladder
❖ Failure of recanalization ( extrahepatic biliary atresia )
❖
CLINICAL APPLICATION
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Liver and Gallbladder Abnormalities
❖Variations in liver lobulation
❖ Accessory hepatic ducts
❖ Intrahepatic biliary duct atresia and hypoplasia
❖Duplication of the gallbladder
❖ Failure of recanalization ( extrahepatic biliary atresia )
❖
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Pancreas
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Pancreas
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Pancreas
a.dorsal and ventralpancreatic buds
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Pancreas
a.dorsal and ventralpancreatic buds
b.ventral bud rotates behindthe duodenum
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Pancreas
a.dorsal and ventralpancreatic buds
b.ventral bud rotates behindthe duodenum
c.rotation involves superiormesenteric artery
d.formation of uncinateprocess
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Pancreas
❖
3rd
month:❖ pancreatic islets ( Langerhans )
❖ 5th month:
❖
Insulin secretion
CLINICAL APPLICATION
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Pancreatic Abnormalities
CLINICAL APPLICATION
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❖ In about 10% of cases the duct system fails to fuse, and the
original double system persists❖Accessory pancreatic tissue
❖Annular pancreas:
❖ The right portion of the ventral bud migrates along its normal route, butthe left migrates in the opposite direction
❖ Complete obstruction of duodenum
Pancreatic Abnormalities
CLINICAL APPLICATION
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Pancreatic Abnormalities
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Foregut
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Foregut
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Midgut
❖ Primary intestinal loop
❖ Distal duodenum
❖
Jejunum
❖ Ileum
❖ Ascending colon
❖ Right two-thirds of thetransverse colon
❖ Superior mesenteric artery
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Midgut❖ rapid elongation of the gut and its mesentery
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Midgut
❖ cephalic limb
❖ caudal limb
CLINICAL APPLICATION
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❖ 6th week:
❖ Rapid elongation of the cephaliclimb
❖ Rapid growth of the liver
❖ Intestinal loops enter theextraembryonic cumbilical cord
Physiological herniation
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❖ Axis: superior mesenteric artery
❖Counterclockwise
❖ Approximately 270°
❖ during herniation ( about 90° )
❖ during return ( remaining 180° )
Rotation of Midgut
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Rotation of Midgut
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Rotation of Midgut
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Rotation of Midgut
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Rotation of Midgut
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Rotation of Midgut - great omentum
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Great omentum
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❖
10th
week:❖ loops begin to return to the abdominal cavity
❖ regression of the mesonephric kidney, reduced growth of theliver, expansion of the abdominal cavity
❖ Jejunum – left
❖ Loops – more to the right
Retraction of herniated loops
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Retraction of herniated loops
CLINICAL APPLICATION
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Body Wall Defects
❖Omphalocele
❖ Herniation through enlargedumbilical ring
❖ 6th to 10th weeks
❖ associated with a high rate of mortality ( 25%) and severe
malformations
❖ associated with chromosomeabnormalities
CLINICAL APPLICATION
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Body Wall Defects
❖Gastroschisis
❖ herniation through the body wall - lateral right
❖ not associated withchromosome abnormalities
❖ Cocaine
❖ Volvulus
CLINICAL APPLICATION
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Vitelline Duct Abnormalities
❖ Portion of the vitelline duct persists
CLINICAL APPLICATION
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Gut Atresia and Stenosis❖ Most occur in the duodenum ( lack of recanalization )
❖ vascular "accidents“
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Midgut
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Hindgut
❖Distal third of thetransverse colon
❖Descending colon
❖ Sigmoid colon
❖Rectum
❖Upper part of the analcanal
❖ Inferior mesenteric artery
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Hindgut
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Hindgut
❖ Primitive anorectal canal
❖
7th
week: cloacal membrane ruptures
❖ Tip of the urorectal septum: perineal body
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Hindgut❖ Primitive anorectal canal
❖ 7th week: cloacal membrane ruptures
❖ Tip of the urorectal septum: perineal body
CLINICAL APPLICATION
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Hindgut Abnormalities
❖ Rectoanal atresias, and
fistulas
❖ Imperforate anus
❖ Congenital megacolon( aganglionic megacolon:
Hirschsprung disease )
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Hindgut
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“Fagaras” Mountain, Carpathians, Romania
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