GIT DEELOPMENT- PART 1

Objectives:
To understand the parts of Primitive gut tube. To understand and list the derivatives of the foregut and the events involved in their formation. To understand the structures derived from the mesentery. To understand the developmental errors of foregut structures.

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Preface
Gastrulation
Epiblast cells migrate through the primitive streak. Definitive (embryonic) endoderm cells displace the hypoblast. Mesoderm spreads between endoderm and ectoderm.
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http://www.youtube.com/watch?v=x-p_ZkhqZ0M

http://www.youtube.com/watch?v=iFd8M3dJr88 http://www.youtube.com/watch?v=qMnpxP6EeIY

The developing endoderm (yellow) is initially open to the yolk sac (the cardiac region is initially most anterior) Longitudinal (head and tail) folding at both ends of the embryo and lateral folding at the sides of the embryo bring the endoderm inside along with the part of the yolk sac and form the gut tube. Hence a tube lined by endoderm is formed k/a primitive gut
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Cloacal membrane

Folding creates the anterior and posterior intestinal portals (foregut and hindgut, respectively) The cardiac region is brought to the ventral side of the developing gut tube. Juxtaposition of ectoderm and endoderm at: Oropharyngeal (buccopharyngeal) membrane - future mouth Cloacal membrane - future anus
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Proctodaeum

Gut-associated and other organs begin to form as buds from the endoderm: (e.g., thyroid, lung, liver, pancreas) Midgut opening to the yolk sac progressively narrows Cranially, the foregut is separated from the stomodaeum by the buccopharyngeal membrane. Caudally, the hindgut is separated from the proctodaeum by the cloacal membrane.
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 By the end of the first month: The stomach bulge is visible, Dorsal pancreas has begun to bud Connection of the midgut to the yolk sac is reduced to a yolk stalk. Hence yolk sac becomes small called definitive yolk sac and the narrow channel connecting it to the gut is called vitelline duct or vitello - intestinal duct.
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With lateral folding, mesoderm is recruited to gut wall

Lateral folding of the embryo completes the gut tube Mesodermal layer of the gut tube is called splanchnic (visceral) mesoderm - derived from lateral plate mesoderm Somatic mesoderm lines body cavity
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Divisions of the gut:

Foregut: Part extending from the oropharyngeal or buccopharyngeal membrane up to the liver outgrowth. Part of foregut up to the level of tracheobronchial diverticulum is called pharyngeal gut as it develops into pharynx. Midgut: Part lying caudal to the liver bud and that extends up to the junction of right 2/3 and left 1/3 of adult transverse colon. Hindgut: Part extending from the left 1/3 of transverse colon to the cloacal membrane.

Foregut

Hindgut

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Mesenteries: Double layer of peritoneum that encloses

portions of the gut and its derivatives and suspends it from the dorsal and ventral body wall.

Dorsal mesentery Suspends caudal part of foregut, midgut and major part of
hindgut. Extends from lower end of oesophagus to the cloaca. Part suspending the stomach is known as dorsal mesogastrium which eventually forms greater omentum. Part suspending the duodenum is k/a mesoduodenum. Covering the jejunal and ileal loops it forms mesentry proper. In the region of the colon it is k/a dorsal mesocolon.

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Ventral mesentery
Is derived from the septum transversum and exists only in the region of terminal part of esophagus, stomach and upper part of duodenum. Is divided in to, -Lesser omentum: From lower portion of esophagus to stomach & upper portion of duodenum to liver. -Falciform ligament: From the liver to the ventral body wall.
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Derivatives from foregut in digestive system:

Part of the mouth. Primordial pharynx and its derivatives. Esophagus. Stomach. Duodenum up to the opening of bile duct. Liver and biliary apparatus ( hepatic ducts, gallbladder and bile duct) Pancreas

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Mouth:
Derived partly from the Stomodeum and partly from the foregut. Hence lining epithelium is partly ectodermal and partly endodermal. Buccopharyngeal membrane separating them disappears eventually. Epithelium of lips, cheeks and palate are ectodermal. Epithelium of tongue is endodermal.

Pharynx:
Derived from the cranial most part of the foregut. With the establishment of palate and mouth, the pharynx shows subdivisions into nasopharynx, oropharynx and laryngopharynx. Muscles of pharynx are derived from 3rd , 4th and 6th pharyngeal arches.

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Esophagus:
At about 4th week, the respiratory diverticulum (lung bud)
appears at the ventral wall of foregut. This gradually separates from dorsal part of foregut by tracheoesophageal septum. Thus foregut divides in to ventral portion the respiratory primordium and a dorsal portion, the esophagus. Esophagus develops from the foregut. Initially shorter but elongates rapidly, mainly because of the growth and descent of heart and lungs and also due to the formation of neck as the pharyngeal arches develop. Reaches its final relative length by the 7th week. Epithelium and glands are derived from endoderm. Proliferation of epithelium partly or completely obliterates the lumen, however recanalization occurs by the end of 8th week. Muscular coat is derived from the surrounding splanchnic mesoderm.
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Pharyngeal gut ( part of foregut)

Foregut

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Stomach

http://www.youtube.com/watch?v=s2cNCUL1r3A

Appears as a fusiform dilation of the caudal part of the foregut at the 4th week. Initially cranial (cardiac) and caudal (pyloric) ends are in the median plane. Soon enlarges and broadens ventrodorsally Rotation of stomach: 1st rotation is 90 clockwise around its longitudinal axis. Ventral border moves to the right & dorsal border to the left hence left side faces anteriorly (ventrally) and right side face posteriorly (dorsally). Original dorsal border grows faster than the ventral border which forms the greater and lesser curvatures respectively. 2nd rotation is clockwise around an anteroposterior axis. Cranial (cardiac) end moves to the left and slightly downwards. Caudal (pyloric) end moves to the right and upwards.
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http://www.youtube.com/watch?v=uPBEgBIvRcI

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 Stomach is suspended from dorsal wall of abdominal cavity by dorsal mesogastrium and from ventral wall by ventral mesogastrium. Due to the 1st rotation, the dorsal mesogastrium is pulled to the left creating a space behind the stomach called omental bursa. Spleen develops between the 2 layers of dorsal mesogastrium from a mass of mesenchymal cells & divides the mesentery into 2 parts, *Lienorenal ligament- between posterior body wall and spleen *Gastrolienal ligament- between spleen and stomach. Ventral mesogastrium is pulled to the right . As liver cords grow in to it, it thins to form peritoneum of the liver, falciform ligament and lesser omentum . Due to the 2nd rotation, dorsal mesogastrium bulges down and forms a doubled layered fold called greater omentum.
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Duodenum:
Formed by terminal part of foregut & proximal part of midgut. Junction of two parts is at the origin of liver bud. Rotation of stomach and rapid growth of head of pancreas swings the duodenum from initial midline position to the right. Mesoduodenum disappears and duodenum becomes fixed in a retroperitoneal position. However small portion near the pylorus retains its mesentery and remains intraperitoneal. Due to the dual origin it receives blood supply from artery of foregut (coeliac trunk) and midgut (superior mesenteric artery).

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Liver & Biliary Apparatus:

Liver primordium appears in the middle of 3rd week from the distal end of foregut as an outgrowth of endodermal epithelium called hepatic diverticulum or liver bud. Proliferating cells of liver bud penetrate into septum transversum. Liver bud enlarges and divides in to 2 parts -Larger cranial part- pars hepatica. -Smaller caudal part- pars cystica. Cells of the pars hepatica proliferate giving rise to interlacing cords of hepatocytes (liver cords) and lining of biliary ducts and continue to penetrate into septum transversum. Vitelline & umbilical veins form the liver sinusoids. Hematopoietic cells, Kupffer cells & connective tissue cells are derived from mesoderm of septum transversum. Hemopoiesis begins during the 6th week and bile formation begins during the 12th week.
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 As the liver grows in to septum transversum, the septum transforms into -Peritoneum of liver except on the cranial surface which is in contact with diaphragm. -Falciform ligament, between liver and anterior body wall. -Lesser omentum, between stomach and liver. Free margin of falciform ligament contain umbilical vein that obliterates after birth to form ligamentum teres hepatis. Cranial surface of the liver uncovered by peritoneum forms bare area of liver.
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Gallbladder: Pars cystica of liver bud give rise to gallbladder & cystic duct. Stalk connecting the hepatic and cystic ducts to the foregut becomes the bile duct. Growth and rotation of duodenum carries the opening of bile duct to posteromedial position from its original ventral position.
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Pancreas:
Develops from two endodermal buds that arise from caudal part of foregut. Dorsal pancreatic bud appears on the dorsal aspect of the foregut and grows in to dorsal mesentery. Ventral pancreatic bud arises close to the bile duct.
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 As the duodenum rotates to the right, the ventral pancreatic bud moves dorsally along with it and comes to lie below and behind dorsal pancreatic bud. Parenchyma and duct systems of both the buds fuse to form a single mass. Ventral bud forms the uncinate process and inferior part of the head of pancreas. Remaining part of gland is derived from dorsal bud. Main pancreatic duct( of Wirsung) is formed by distal part of dorsal pancreatic duct and entire ventral pancreatic duct. Accessory pancreatic duct (of Santorini) is formed by proximal part of dorsal pancreatic duct. Insulin secretion begins at 5th month.
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Developmental Anomalies:
Oesophageal atresia and/or tracheoesophageal fistula. Polyhydramnios Oesophageal stenosis. Short oesophagus congenital hiatal hernia

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 Accessory spleens (Polysplenia) may exists in one of the peritoneal folds. Congenital hypertrophic pyloric stenosis. Duodenal stenosis. Spleen Duodenal atresis Uncommon.
Accessory spleen

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Duodenal stenosis

Accessory hepatic ducts. Intra hepatic biliary duct atresia Rare abnormality. Extra hepatic biliary duct atresia. Duplication of gallbladder.

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 Accessory pancreatic tissue- Often located in the wall of stomach or duodenum or meckels diverticulum. Annular pancreas

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