3D Midgut Embryology - Rotation of Midgut in 3D - Physiological Umbilical Hernia and Intestines

In this visual medical lecture Dr. Aizaz from MedicoVisual explains the midgut rotation and development of midgut
00:00 intro to midgut, foregut and hindgut
02:46 Physiological Umbilical Hernia of the midgut
04:15 What is Primary Intestinal Loop
06:36 Formation cecal bud or cecal swelling
08:58 Pre-arterial and Post-arterial limb of intestinal loop of midgut
10:24 Initial 90 degrees anticlockwise rotation
13:49 Remaining 180 degree anticlockwise rotation during retraction phase
17:28 Retraction of midgut intestinal loops
18:57 Downward movement of ascending colon into the lower abdomen
22:00 Complete 3D Animation of Midgut Rotation
22:19 Fixation of Intestines (Ascending colon's peritoneum)
25:00 Formation of Cecum and Appendix from the cecal bud
Initially the midgut is very small in length and almost all of it is connected directly and broadly with the vitelline duct. However, as it grows in length, it forms a loop or coil, which at it’s apex, is connected to the vitelline duct. As this primary midgut loop (also called primary intestinal loop lengthens further, it is impossible to keep this loop resided within the tiny abdomen of the fetus. The abdomen is small and there is a huge liver sitting in there as well. So, this loop has to herniate out of he abdomen and finds a temporary spot within the umbilical cord, which itself lies within the extraembryonic celom. The loop will later come back into the abdomen, and we will see that later. This normal and temporary herniation of primary intestinal loop into the umbilical cord is called Physiological hernia.
The midgut is supplied by the superior mesenteric artery, a branch of dorsal aorta. The foregut is supplied by the celiac trunk and hindgut by the inferior mesenteric artery.
The superior mesenteric artery’s main stem terminates at the apex of the primary intestinal loop. The cranial limb of this loop is more appropriately called pre-arterial limb and caudal limb is called post-arterial. I said, “more appropriately called”, because later we will see that this coil will rotate around the main stem of superior mesenteric artery. As this will happen, the cranial and caudal demarcation will longer hold true. (For example, with the first 90-degree anticlockwise rotation, both of the limbs will lie in the same plane, and it would be hard to demarcate which one is cranial and which one is caudal).
While inside the umbilical cord, few changes occur within both of the limbs of this loop. The Pre-arterial limb (or cranial limb) will form most of the small intestines viz., a part of duodenum, jejunum and a part of ileum. Since the aim of life of small intestine is to absorb nutrients, it wants to absorb as much nutrients as possible. For this purpose, the small intestines must be quite longer to fetch every possible particle of the nutrients from the food. So naturally the prearterial limb lengthens more as compared to the postarterial limb. Therefore, it forms a convoluted appearance.
The postarterial limb forms the remaining part of the ileum, cecum, ascending colon and proximal 2/3rd of the transverse colon. At termination of primordial ileum, a conical swelling appears which will later develop into the cecum. This swelling is called the cecal bud.
 
Rotation of midgut loop:
Within the extraembryonic celom and umbilical cord, the primary intestinal loop takes it first 90 degrees turn anticlockwise around the axis of superior mesenteric artery. Now both of the limbs lie in the same horizontal plane.
After this initial 90-degree rotation, this loop undergoes another 180 degrees anticlockwise rotation.
Now the prearterial limb is on the left and the post-arterial limb is on the right side.
The proximal part of the postarterial limb between the cecal bud and the origin of vitelline duct forms the distal part of ileum. The cecal bud grows into cecum which cranially continues as ascending colon. The part of postarterial limb that is distal to cecal bud and is continuous with the hindgut, forms the ascending colon and proximal 2/3rd part of the transverse colon.
Actually the first 90 degree anticlockwise rotation occur within the umbilical cord while the remaining 180 degrees happens as the loop is retracted back into the abdomen, as it has grown enough. However, for the sake of simplicity and ease of explanation I have shown the complete 270 degrees rotation within the umbilical cord.
So, the loops are retracted back into the abdomen. By this time, the vitelline duct is obliterated, and it loses its connection with the intestine.
Here you can see that the cecal bud is into the upper right quadrant of the abdomen. It should be at the right lower quadrant.

[@MedicoVisual]

This visual lecture is part of the Premium GastroIntestinal Embryology 3D MasterClass. If you enjoyed this video, please consider buying the course. Enroll NOW: www.medicovisual.com/courses/premium-gastrointestinal-embryology-3d-masterclass Enter the coupon code "KZbin" at the checkout for 20% OFF

[@user-zb9dk3ls6j]

20:19 20:19

[@rishika-p4l]

the bestest explaination🙌,the 3d model,the representation is just outstansing.. im left wid crystal clear concept with no doubts

[@MrKaushikful]

Excellent.. it’s clear for me now after years of passing medicine

[@ThommyDaba]

Most precise explanation on youtube

[@Kwizzzer]

Finally I understood the rotation of gut. Embryology was always tougher for me. Thanks for making it easier.

[@idektega4271]

You make embryology so interesting ❤

[@1rrrrrrrrrrr544f]

This channel is definitely underrated! I expected it to have million subscribers! 😢

[@WTSeeMD]

You have explained it really clearly and well. It was very helpful, thank you!

[@039hashimazeez7]

Really amazing. Can’t believe such content exists on youtube. Really helpful for medical students like me! ❤

[@Sebentinarmy]

None of the teachers ,of any subject ,at any platform, taught so well. Kudos to you Sir🙌. Thankyou so much🙌

[@sharadsnagarale9249]

Thank you for the Video sir…….plz keep uploading all the videos of embryology sir………

[@harshagangadharan4594]

Very good presentation.Very easy to understand the concept🎉

[@harryholden795]

Discovered this video whilst doing a DEV3022 assignment at Monash University in 2023. Absolute top notch content and deserving of far more recognition. Keep up the excellent work king 👑

[@luqmanbakr5848]

Keep on the awesome job man! You’re an impressive teacher.Without these beautiful illustrations, it would be almost impossible to grasp these foundational concepts. Your great must be immensely appreciated.Salutes!

[@aplutos1573]

never seen someone talk around a topic this hard

[@MedicoVisual]

Thank you for your feedback on my '3D Midgut Embryology' lecture. I'm always striving to make my content as informative and accessible as possible. Could you please clarify if there were specific aspects of the lecture that felt indirect or if there are particular ways you think I could improve the presentation? Your insight is invaluable to me as I continue to develop educational content. Looking forward to hearing from you!

[@user-iu5qd7id6y]

@@MedicoVisualur absolutely perfect. No changes required 😊

[@dr.sunitjadhav9945]

Best midgut rotation video on the internet! And you are such a passionate teacher! Thank you for your contribution to the anatomical sciences! God bless

[@michellerose9318]

Best one so far

[@ikhan4938]

Exceptional work, efforts and explanations, Can't say thanks enough, Thank you. 🙏

[@vincentpinto1127]

Superb! Stunning! Thank you!

[@azrahodzic-kamber821]

Amazing animation and explanation! Keep up the good work 👍

[@user-ut2bl2jt4x]

This you sir👏🏼👏🏼This is amazing. Studying the books alone was totally strange to me. But combining it with this video has given me a clear picture. I look forward to learning more from you sir.

[@riteshwadhwani8387]

Excellent as we need 💖💖

[@benjaminarchibong9712]

Earnestly speaking this is the best video I've watched so far that i really understand. The models are so vivid and the teacher is so sound. I love this. Thanks for Helping me 😊❤️

[@MedicoVisual]

Happy to help :-)

[@hiraafzal6208]

Outstanding description 👍

[@Aspiring.dermat]

Beautifully explained! Thank you for the video

[@EmediongAkpan-yk4cn]

Beautiful video.

[@FlourishJohnson-io4zy]

You are a life saver 😭❤️❤️✨✨

[@CHIAMAKAENWESI]

Amazing!!!!

[@SanjarOdil]

Thank you so much. It is amazing.

[@DanielFilipeTirano]

Actually helped me understand this topic! thanks

[@AhmedAli-qw9pl]

Amazing description!!!!!!

[@dr.mohamedsalahelzahr5473]

You made it easy .. great effort .. thank you

[@shraddhadisale7657]

The best presentation ever

[@mri6708]

Thank you so much sir .. i am a final yr student and my unferstanding of these topics have increased manyfolds ❤❤

[@arpitapadhy3414]

Excellent video

[@marufhasan1684]

Awesome lecture. Thanks a lot.

[@phatimah4002]

Thank you for the animation 👍🏻👍🏻It helped me a lot ☺️

[@MohamedNasser1]

Awesome work. Thanks man

[@saadabdullah9946]

I watched four videos before this finally i understood it thankyou

[@Doodledo2627]

Exceptional work helped me so much❤

[@princeugochukwu9341]

God bless you sir...I'm really grateful❤

[@gabriels2395]

Thank you so much!

[@user-fo4pi2sw8l]

Amazing Work Sir .Really Good explanation and Models ..

[@chinemeremchristabel7411]

👏👏👏 Your animations are so nice and help with our imaginations a lot 😅. Thank you Sir!

[@drblockbuster7072]

really great effort 😍

[@sarahabib7592]

thank you that is so helpful

[@akankshachaudhary9456]

Amazing 👏

[@advjalilbiltu9962]

Your teaching skill is so good🥹 Thank you very much sir Keep making embryology easy like this 😭please

[@user-rs2cd7hg5t]

Thank u so much sir fully understood this topic ❤

[@rubina14]

Finally understood this topic.

[@muhammedzainab3540]

The best!!❤

[@mohamedalbna6782]

Thank you very much ❤❤❤

[@freewill4912]

It blew my mind 🤯

[@anassule6468]

Thank you so much for all your videos, there are really helpful when studying embryology for the first time as it makes obscure developmental events more understandable and appreciable. I wish I have money to buy all your courses😢 that would really have been amazing

[@MedicoVisual]

Hi Thank you so much for your appreciation. Do not worry if you do not have money to buy the courses. Please contact me for the access. WhatsApp: [phone] Email: [e-mail]

[@sadafshareef6670]

Thankyou sir this is great work jazakallah

[@veenadaspk9625]

Very useful

[@loisthomas9083]

Wow..,Awesome

[@darkknightentertainments2113]

Hoping for urogenital development etc.., soon ....big fan of your work...very helpful sir 🙏....you made embryology very easy

[@user-rk8wb4yj8p]

Sir your why of teaching specially using animations it's really very help for us thank you sir 🙏

[@kirubasubramani1429]

Best one❤

[@tasibaislam6051]

You are actually awesome wholesome ❤

[@oniassakala9800]

Your videos are absolutely amazing, i love them 🥰🥰

[@MedicoVisual]

Thank you so much

[@santhoshmythreya7085]

excellent video...........

[@dgm7765]

perfect 🎉

[@kavithasakthivel395]

Literally amazing!!! Ohh i should have found it somewhat earlier it seems.....

[@asmasleim8590]

U r amazing thnk u

[@sheejaprem9987]

This is 👌

[@frozensoul903]

Sir u r the legend

[@muhammadhisham9881]

😍 excellent

[@shrishri8799]

excellent and easy / efficient (very) way . helped me very well with embryological rotation of gut which is tough and very important to learn cause it kinda gives condition like Volvulus and omphelocele and gastrochias . Thanks for the amazing video andyou sir Dr.Aizaz are amazing .

[@shrishri8799]

🙏

[@user-fp5fd9pf7p]

Thx alooot

[@amanyalnajjar4263]

love it , thank you. neurology senior registrar coming to understand this for step1 !

[@MedicoVisual]

That's an honor for me! 😊 Thanks

[@suvrodevroy258]

Awesome❤️

[@MedicoVisual]

Thank you so much

[@ousama8514]

Thanks

[@MedicoVisual]

Thank you so much for the super thanks Ou Sama. 😊 I feel honored.

[@udiptaborah6438]

very great work.sir....you make embryology very easy sir🙏🙏🙏

[@MedicoVisual]

Thanks a lot for your appreciation

[@kennethadebayo3425]

bless 🙏

[@vnarasimha202]

Awesome 🎉sir

[@MedicoVisual]

Thanks ✌️

[@drjyothishrocks4417]

Gold

[@MedicoVisual]

Thank you so much

[@shanthimanivannan9051]

Extremely well made videos . Thank you so much sir

[@MedicoVisual]

Most welcome and Thanks a lot for your appreciation.

[@umearkakar7766]

Sir plz upload special embryology video

[@Acts-4-12]

Very very helpful thank you sooo much sir 😭💜💜💜💜💜❤️❤️❤️❤️🔥🔥🔥

[@Muhammadsalman11998]

Sir please make a 3d video on peritoneum Because it's so confusing while studying in the book and imagining. Sir i request you to make it happen soon and clear our doubts

[@MedicoVisual]

I have discussed Peritoneum briefly in GIT Embryology course here: www.medicovisual.com/courses/premium-gastrointestinal-embryology-3d-masterclass

[@chiamafrancis9323]

The proximal first rotate 180 and the distal rotate 90

[@Hinatahinata8]

Amazing explanation, you got one for hindgut?

[@MedicoVisual]

The complete GIT Embryology course that includes all the videos of GIT embryology, including hindgut, is available for a small fee at www.medicovisual.com/courses/premium-gastrointestinal-embryology-3d-masterclass Please contact [e-mail] or WhatsApp at [phone] if you need more info or if you cannot pay the full price.

[@mohammadhdaib1009]

is there a video for foregut development?

[@MedicoVisual]

There is a complete section dedicated to Development of Foregut in the GIT Embryology course (www.medicovisual.com/courses/premium-gastrointestinal-embryology-3d-masterclass#preview). For more info, feel free to contact me at [e-mail] or WhatsApp at [phone]

[@nourhan5570]

Can I get the link for foregut development plz?

[@MedicoVisual]

The complete GIT Embryology course that includes all the videos of GIT embryology, including hindgut, midgut and foregut, is available for a small fee at www.medicovisual.com/courses/premium-gastrointestinal-embryology-3d-masterclass Please contact [e-mail] or WhatsApp at [phone] if you need more info or if you cannot pay the full price.

[@ahsanijaz7126]

Can some share his lec of foregut and hindgut

[@MedicoVisual]

Complete 3D Gastrointestinal System Embryology (including foregut and hindgut) is already available for a small fee at www.medicovisual.com/courses/premium-gastrointestinal-embryology-3d-masterclass Do not hesitate to contact me if you have any questions or concerns. WhatsApp: [phone] Email: [e-mail]

[@robh5812]

There is a small mistake in animation which can be corrected. At 15:45 the SMA is on the top of foregut and at 15:46 it crosses the gut lumen and rest below the foregut.crossing the lumen is not possible.This could be a bit difficult to understand the Doppler SMA-SMV axis for diagnosis of malrotation of gut. Else the animation and explanation is awesome . Thanks Subscribing to your channel.

[@MedicoVisual]

Thank you so much for pointing out the mistake. I'm genuinely interested in addressing this concern, but I'm currently having trouble grasping the exact aspect you're referring to. Could you kindly elaborate a bit more on the issue you've identified? I'm eager to learn from this and make necessary improvements, although I must admit that I don't claim to be an absolute expert. Sometimes, despite my best efforts, certain nuances can be missed, and I truly appreciate when viewers like you point them out. It is always a great learning opportunity which I do not want to miss. Also, if you're comfortable with it, I'd love for you to get in touch with me directly. You can reach me on WhatsApp at [phone] or email me at [e-mail]. Your expertise is super important to me, and I'd be really happy to talk more and learn from what you know. Thank you once again for your dedication to improving the learning experience for everyone. Your contribution is deeply appreciated, and I'm looking forward to hearing from you.

[@esaiesai6354]

❤️

[@sandeeipsapkota8200]

I dont know how true is it because lange textbook of embryology writes, 90° rotation occurs outside during herniated phase, 90° counter clockwise rotation occurs during return of the intestinal limb and 90° counterclockwise occurs inside abdomen to reach a final(normal) position, but u showed all the rotation outside during herniated phase

[@MedicoVisual]

Thank you for your astute observation! You are absolutely right about the textbook description of the embryological rotation of the intestines. I did mention in the video that there is a total of 270 degrees of anticlockwise rotation, which occurs in two phases: 90 degrees during herniation and an additional 180 degrees as the intestines retract back into the abdomen. To avoid confusion and make the animation clearer, I chose to simplify the representation and not show the rotation during retraction. The process is quite complex, and I wanted to ensure that the fundamental concepts were understood without overcomplicating the visual. I appreciate your attention to detail and hope this clarification helps. If there are any more questions or if anything else is unclear, please feel free to ask. Your feedback is invaluable for improving our learning resources!

[@sandeeipsapkota8200]

@@MedicoVisual thanks a lot, that quite a nice way to illustrate, gave me a good revision :)

[@MedicoVisual]

@@sandeeipsapkota8200 Thank you for your appreciation. Also, I forgot to mention the timestamp. It's 14:01

[@faithabovefear5737]

👏

[@bhagyashreepatil5878]

😍😍😍😍💯👏

[@AnastasijaYelisejeva]

Dear Dr. Aizuz, thank you so much for your work❣️ I have a question. When we are talking about the human body, the right site is where the right hand for the person about whom we are talking about. Why did you say that the midgut is rotating conter-clockwise when if the person watching his own midgut would say, that it is rotating clockwise?😉

[@MedicoVisual]

Yes you are right. In the field of anatomy, when referring to the left and right side of a patient or anatomical diagrams, it is always from the perspective of the patient or the diagram, not the viewer or the doctor. However, when a clock is placed in front of a person, it will appear to rotate anticlockwise from both perspectives. Watch 12:59

[@AnastasijaYelisejeva]

I would agree, if we move the viewer to the viewer of the embryo, but keep the clock in it's position as in the video. But if the embryo watches his gut and looks for the correlation with the clock on the wall...😅 Thank you for your answer!❤

[@MedicoVisual]

@@AnastasijaYelisejeva Then the Embryo will have to view the clock from a mirror. Of course mirror image is inverted.

[@1rrrrrrrrrrr544f]

❤❤❤❤❤❤❤❤❤❤❤

[@paglet313]

😍

[@drbilalfarhatali]

When you will start pathology? Literally waiting from your side.

[@MedicoVisual]

Not yet. I will first focus on anatomy, physiology and biochemistry. Thanks for the comment BTW

[@Salman-khan-official]

Nice and easyy