Development of GI system 陳建榮

GI system: -Primitive Gut Morphogenesis -Foregut -Midgut -Hindgut -Foregut embryology -Midgut embryology -Hindgut embryology

Formation of primitive gut Head fold, tail fold and lateral fold -Foregut -Midgut -Hindgut

Primitive gut:

The primitive gut: -Foregut 前腸 -oesophagus -stomach(S) -proximal half of the duodenum (PD), -liver and pancreas. -Midgut 中腸 -distal half of the duodenum(DD) -jejunum(J), -ileum(I), -cecum(C), -appendix, -ascending colon and the right 3/4 of the transverse colon. -Hindgut 後腸 -left 1/4 of the transverse colon -the descending colon -sigmoid colon -the rectum(R) down to the ano-rectal line (the endoderm-ectoderm junction).

The blood supply: -Foregut : celiac artery -Midgut :superior mesenteric artery -Hindgut :inferior mesenteric artery The venous drainage of the gut : -Foregut : portal vein -Midgut : superior mesenteric vein -Hindgut :inferior mesenteric vein.

DIVISIONARTERYVEINLYMPHATICSSYMPATHETIC PARASYMPATH ETIC FOREGUT: Oesophagus Stomach Proximal half of duodenum (up to common bile duct (CBD)) Liver Pancreas CELIAC ARETERY PORTAL VEIN Spleenic vein Gastric vein CELIAC NODESCELIAC GANGLIAVAGUS MIDGUT: Distal half of duodenum (from CBD) Jejunum Ileum Appendix Cecum Ascending colon Right 3/4 of transverse colon SUPERIOR MESENTERIC ARTERY SUPERIOR MESENTERIC VEIN SUPERIOR MESENTERIC NODES SUPERIOR MESENTERIC GANGLIA VAGUS HINDGUT: Left 1/4 of transverse colon Descending colon All of rectum down to ano-rectal line INFERIOR MESENTERIC ARTERY INFERIOR MESENTERIC VEIN INFERIOR MESENTERIC NODES GANGLIA HYPOGASTRIC PLEXUS PELVIC SPLANCHNIC NERVES Functional divisions of primitive GI system

GI system: -Primitive Gut Morphogenesis -Foregut Embryology -Development of stomach -Development of mesentery -Liver morphogenesis -Pancrease morphogenesis -Midgut embryology -Hindgut embryology

Development of stomach Stomach: -Clock wise 90 -Greater curvature of stomach 胃大彎 -Lesser curvature of stomach 胃小彎 -Vagus n.

Development of stomach

GI system: -Primitive Gut Morphogenesis -Mesentery morphogenesis -Dorsal mesentery 背總腸繫膜 -Ventral mesentery 腹總腸繫膜 -Foregut Embryology -Midgut embryology -Hindgut embryology

Formation of Greater omentum 大網膜

網膜囊 網膜孔

THE MESENTERY: -ventral mesentery: -falciform lig. 鐮狀韌帶 -lesser omentum 小網膜 -coronary lig. 冠狀韌帶 -triangular lig. 三角韌帶 -dorsal mesentery: -Mesogastrium : greater omentum 大網膜, omentum bursa 網膜囊 -Mesoduodenum 十二指膜系膜 -mesentery proper (distal duodenum, jejunum and ileum), -mesocolon 結腸系膜 -Mesorectum 直腸系膜

Development of liver: -Hepatic diverticulum 肝憩室 -Hepatic cords 肝索 -Gallbladder 膽囊 -Ventral pancreatic bud 腹側胰芽 4 weeks 5 weeks 6 weeks

Development of pancrease -Dorsal pancreatic bud 背側胰芽 -Body and tail of pancrease, accessory pancreatic duct -Ventral pancreatic bud 腹側胰芽 -Uncinate process of pancrase, main pancreatic duct

Annular pancrease 環狀胰臟

Duodenal stenosis or atresia

Development of spleen Accessory spleen 副脾

GI system: -Primitive Gut Morphogenesis -Foregut Embryology -Midgut embryology -Rotation of midgut loop -Retum of midgut to abdomen -Fixation of intestine -Cecum and appendix -Hindgut embryology

Rotation of midgut loop - Counterclock wise 90 6 weeks Retum of midgut to abdomen 10 weeks 11 weeks

Umbilical hernia

Gastroschisis 裂腹畸形 ( 前腹壁缺損 )

Nonrotation of midgutMixed rotation and volvulusReversed rotation Internal herniaMidgut volvulsu

Fixation of intestine

Cecum and appendix

Meckel diverticulum

Ileal diverticulum 迴腸憩室

Duplication of intestine 腸重覆

GI system: -Primitive Gut Morphogenesis -Foregut Embryology -Midgut embryology -Hindgut embryology -Partitioning of cloaca 泄殖腔 -Urorectal septum 泌尿直腸隔 -Cloaca 泄殖腔 -Urogenital sinus 泌尿生殖竇 -Anal canal 肛管

Partition of claca

Anal canal 原肛 恥狀線

直腸尿道瘻管 直腸陰道瘻管 肛門會陰瘻管

Membraneous atresia of anal