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GASTROINTESTINAL TRACT
Profile view of a human embryo estimated at twenty or twenty-one days old. (Dorsal aorta labeled at center left.)
Dorsal aorta
Each primitive aorta receives anteriorly a vein the vitelline veinfrom the yolk-sac, and is prolonged backward on the lateral aspect of the notochord under the name of the dorsal aorta. The dorsal aort give branches to the yolk-sac, and are continued backward through the bodystalk as the umbilical arteries to the villi of the chorion. The two dorsal aortae combine to become the descending aorta in later development
TOPICS
Highlights. Introduction. Derivation of individual parts of alimentary tract. /foregut, midgut, hindgut/ Rotation of the gut. Fixation of the gut. Timetable of some events described in this lecture.
HIGHLIGHTS
ENDODERM
At first it is in the form of a flat sheet,
Converted into a tube by formation of head, tail and lateral folds of embryonic disc.
Later it becomes tubular. Part of midgut forms a loop that is divisible into prearterial and postarterial segments.
HIGHLIGHTS (continue)
Cloaca
It is the most caudal part of the hind gut.
It is partitioned to form the primitive rectum (dorsal) and the primitive urogenital sinus.
DUODENUM
The superior part and the upper part of the descending part is derived from the foregut, The rest of the duodenum develops from the midgut loop.
HIGHLIGHTS (continue)
The jejunum and ileum are derived from the prearterial segment of the midgut. The postarterial segment of the midgut loop gives off a caecal bud. The caecum and the appendix are formed by enlargement of the caecal bud.
The ascending colon develops from the postarterial segment of the midgut loop.
After ascending colon formation the gut undergoes rotation.
As a result of rotation; the caecum and ascending colon come to lie on the right side; The jejunum and ileum lie mainly in the left-half of the abdominal cavity.
INTRODUCTION
Epithelial lining of the various parts of the gastrointestinal tract is endodermal origin. In the mouth and anal canal, some of the epithelium is derived from ectoderm (stomatodaeum, proctodaeum). Head and tail folds
Part of the Yolk sac is enclosed within the embryo to form the primitive gut.
Gut is in free communication with the yolk sac. Foregut cranial to communication, Hind gut ------? Midgut --------?? Cranially Buccopharyngeal membrane separates the foregut from the stomatodaeum. Caudally Cloacal membrane separate the hindgut from the proctodaeum. Later both membrane disappear and gut opens to the exterior at 2 ends.
INTRODUCTION
(continue)
While the gut is being formed, the circulatory system of the embryo undergoes considerable development. A midline artery, the dorsal aorta, is established and comes to lie just dorsal to the gut. It gives off a series of branches to the gut. Vitelline arteries connect midgut with the yolk sac. Most of the ventral arteries disappear, only three of them remain;
segments.
INTRODUCTION
(continue)
After a number of weeks, the midgut loop comes to lie outside the abdominal cavity of the embryo. It passes through the umbilical opening into a part of the extraembryonic coelom (that persists in relation to the most proximal part of the umbilical cord). The loop is subsequently withdrawn into the abdominal cavity. Allantoic diverticulum opens into the ventral aspect of the hindgut.
The part of the hindgut caudal to the attachment is called the cloaca.
The cloaca shows subdivision into a broad ventral part and narrow dorsal part.
INTRODUCTION
(continue)
The ventral subdivision is called the primitive urogenital sinus and gives origin to some parts of the urogenital system. The dorsal subdivision is called the primitive rectum. It forms the rectum and part of the anal canal. The urogenital septum grows towards the cloacal membrane and fuses with it.
2. 3. 4. 5. 6.
Jejunum. Ileum. Caecum and appendix. Ascending colon. Right 2/3rd of the transverse colon.
Note
At this stage, The endoderm of the foregut, midgut and hindgut gives rise only to the epithelial lining of the intestinal tract. The smooth muscle, connective tissue and peritoneum are derived from splanchnopleuric mesoderm.
DERIVATION OF INDIVIDUAL PARTS OF THE ALIMENTARY TRACT JEJUNUM AND ILEUM The jejunum and most of the ileum are derived from the prearterial segment of the midgut loop. The terminal portion of the ileum is derived from the postarterial segment proximal to the caecal bud.
CAECUM AND APPENDIX Caecal bud is derived from the postarterial segment of the midgut. The caecum and the appendix are formed by the enlargement of this bud. The proximal part of the caecal bud grows rapidly to form the caecum. The distal part of the caecal bud remains narrow and forms the appendix. The appendix arises from the apex of the caecum. The lateral (right) wall of the caecum grows much more rapidly than the medial (left) wall, The point of attachment of the appendix with caecum comes to lie on the medial side.
Ascending colon develops from the postarterial segment of the midgut loop distal to the caecal bud. Transverse colon;
The right 2/3rd develop from the postarterial segment of the midgut loop. The left 1/3rd arises from the hindgut. The right 2/3rd are supplied by the superior mesenteric artery. The left 1/3rd is supplied by the inferior mesenteric artery.
Descending colon develops from the hindgut. The rectum is derived from the primitive rectum (dorsal subdivision of the cloaca). Anal canal is formed partly from the endoderm of the primitive rectum, And partly from the ectoderm of the anal pit (proctodaeum). Pectinate line = the line of junction of the endodermal and ectodermal parts of the anal canal is represented by the anal valves.
The loop has a prearterial (proximal) segment and postarterial (distal) segment.
prearterial segment lies on the right, and the postarterial segment lies on the left).
2. The prearterial segment undergoes great increase in length to form the coils of the jejunum and ileum. (loops still out side the
abdominal cavity, to the right of the distal limb).
3. The coils of the jejunum and ileum (proximal segment) return to the abdominal cavity. As they do so, the midgut loop undergoes further anticlockwise rotation. Jejunum and ileum pass behind the SMA into the left half of the abdominal cavity. Duodenum comes to lie behind the artery. The jejunum and ileum occupy the posterior and left part
of the abdominal cavity.
ROTATION OF THE GUT STEPS OF ROTATION (viewed from ventral side) 4. Finally, the postarterial segment of the midgut loop returns to the abdominal cavity. It also rotates in an anticlockwise direction. With the result the transverse colon lies anterior to the SMA, and the caecum comes to lie on the right side. 5. At this stage the caecum lies below the liver, and an ascending colon cannot be demarcated. Gradually, the caecum descends to the right iliac fossa, and the ascending, transverse and descending parts of the colon become distinct.
3. DUPLICATION.
4. DIVERTICULA. 5. ERRORS OF ROTATION. 6. ERRORS OF FIXATION.
7. SITUS INVERSUS.
2) Stenosis (abnormal narrowing). 3) Non-development of nerve plexuses in the wall of a part of the intestinal tract. (megacolon or Hirschsprungs disease) 4) Abnormal thickening of muscular wall. (congenital pyloric stenosis) 5) External pressure by abnormal band or abnormal blood vessels.
(bands seen in relation to the duodenum or compressed by annular pancreas)
DUPLICATION
Varying length of the intestinal tract may be duplicated. The duplication may form only a small cyst, Or may be considerable length. It may or may not communicate with the rest of the intestine.
DIVERTICULA
Diverticula may arise from any part of the gut. Diverticula are most common in and near the duodenum. (pylorus, fundus of stomach) Meckels diverticulum (diverticulum ilei);
Persistence of vitello-intestinal duct. It is of surgical importance. May contain pancreatic tissue. May contain gastric mucosa. May give rise to fecal fistula, umbilical sinus, cyst (enterocystoma or vitelline cyst), fibrous band or growths.
ERRORS OF ROTATION
I. Non-rotation of the midgut loop. (small intestine
lies towards the right side of the abdominal cavity, and the large intestine towards the left).
ERRORS OF FIXATION
a) Volvulus; where parts of intestine, that are
normally retroperitoneal, may have mesentery.
SITUS INVERSUS
All the abdominal and thoracic viscera are laterally transposed. All parts normally on the right side are seen on the left side, and vice versa. For example, the appendix and duodenum lie on the left side and the stomach on the right side.