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Anatomy > 02 - Cardiac Development > Flashcards

02 - Cardiac Development Flashcards

1
Q

What are the two closed circuits of the adult circulatory system
How are they connected

A

connected in series
- pulmonary circuit –> removal of CO2, oxygenation of blood
- systemic circuit –> delivery of O2 and nutrients to tissues, transportation of wastes to organs of elimination

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2
Q

TF for adults, pressure on the right side of the heart is greater than the pressure on the left side of the heart

A

F
pressure on the left side (oxygenated blood) of the heart is greater than the pressure on the right side (deoxygenated blood) of the heart

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3
Q

What is the fetal circulatory system composed of
How do they communicate

A

open circuits that operate in parallel

two circuits communicate through bypasses/shunts

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4
Q

Which side is pressure greater in a fetus circulatory system

A

right side greater than left side (high pulmonary resistance)
- vessels in the lungs are collapsed because not breathing out air

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5
Q

Where is blood with the highest oxygen content found in a fetus

A

in the umbilical vein (oxygenated)
- because exchanged blood with maternal blood across the pacental membrane

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6
Q

Where happens in a fetus placenta

A

gas exchange, nutrient and waste transfer
- provides oxygen and nutrients to the fetus

does the work of the heart, the kidney and the liver

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7
Q

TF fetal circulation mixes with maternal circulation

A

False
- never mixes
- at most, two cells away from each other

placenta acts as an exchange membrane

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8
Q

Describe how the blood flows through the circulatory system

A
  1. placenta
  2. umbilical vein(highest oxygen concentration)
  3. umbilicus
  4. liver (developing, not functioning) – so a lot of blood bypasses through to the ductus venosus
  5. inferior vena cava (also drains blood from lower abdomen so mixes with deoxygenated blood)
  6. right atrium
  7. left atrium (directly because foramen ovale –> hole in interatrial septum – wall between atriums)
  8. left ventricle
  9. aorta
  10. supplies rest of body
  11. umbilical arteries –> become part of umbilical cord, wrap around umbilical vein and send systemic blood to placenta to offload waste and get oxygen back

Blood can also enter right atrium from sup vena cava (head, neck, upper limbs) –> right ventricle –> pulmonary trunk –> aorta through ductus arteriosus (allows mixed blood from right side to systemic circuit)

interal iliac: branch off of the abdominal aorta – goes to right and left legs, across pelvis, feeds bladder and reproductive structures and placenta

don’t need to send a lot to lungs because not doing gas exchange

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9
Q

Which structures allow mixed blood from right side of heart to left side of heart

A

ductus arteriosus

foramen ovale

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10
Q

What are the purposes of bypasses and shunts

A

divert blood around organs that have limited function in utero

deliver oxygenated blood from he placenta to the systemic circuit (left side of heart) as quickly as possible

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11
Q

Which fetal structures change postnatal

A

foramen ovale
ductus arteriosus
ductus venous
umbilical arteries
umbilical vein

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12
Q

What happens when bypasses/shutns and other fetal vessels close after birth

A

become remnant structures that persist in the adult

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13
Q

What happens to the umbilical vein at birth

A

umbilical vein –> ligamentum teres (white band of tissue in the anterior abdominal wall) – collagen (scar tissue)

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14
Q

What happens to the ductus arteriosis

A

ductus arteriosus closes – because of vasoconstricts after taking first breath -> lungs starts producing bradykinin to tell to close – replaced by collagen, becomes ligamentum arteriosum

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15
Q

What happens to the ductus venosus

A

ductus phenosis – vein collapses to seperate right and left lobes of liver –> ligamentum venosum

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16
Q

What happens to the formane ovale

A

foramen ovale closes - first expansion of lungs decreases pulmonary vascular resistance – (alveoli exapands, BV stretches = open up) pressure on the right decreases compared to left causing the foramen ovale to close (prevents blood from going from left to right) –> develops fossa ovalis (depression)

17
Q

What happens to the umbilical arteries

A

become medial umbilical ligamets (from bladder up the anterior abdominal wall)

18
Q

Describe the development of the heart

A

fusion of heart tubes (20-21 days)
- two tubes fuse together with a venous (entering) end and an arteriol (ejection) end

sacculation (22 days)
elongation
- forms buldges –> truncus arteriosus (great vessels coming off heart) –> bulbus cordis (right ventricle) –> ventricle (left ventricle)–> atrium –> sinus venosus

folding (U- to S-shape) (24 days)
partitioning
- forms all the chambers of the heart (still has all the parts from sacculation and elongation)

primordial heart (28 days)
- primordial structures become the chambers and great vessels of the heart

19
Q

What does the truncus arteriosus develop into

A

great vessels of the heart (aorta & pulmonary trunk) – major outflow tracts of atriums

20
Q

When does the development occur

A

through the division of the truncus arteriosus by an aorticopulmonary (spiral) septum

21
Q

What does the septum form from

A

lateral ridges of the truncus arteriosis

spiral septum will twist 180 degrees when completely formed

22
Q

What happens with persistent truncus

A

failure of the aorticopulmonary septum to form
- right and left ventricles share the same outflow tract and there is mixing of blood
- also a ventricular septal

= right ventricular hypertrophy

23
Q

What happens if the aorticopulmonary septum does not spiral 180 degrees

A

leads to transposition (switch) of the great vessels
- the right ventricle leads to the aorta while the left ventricle leads to the pulmonary trunk (two circuits operating in isolation)

= right ventricular hypertrophy

24
Q

Where do the semilunar valves of the heart develop

A

at the base of the truncus arteriosus

25
Q

What does the formation of the spiral septum help to do

A
  • partition the truncus arteriosus into great vessles
  • partition the semilunar valve cusps
26
Q

What does the truncus arteriosus develop into (how does it partition the semilunar valves)

A

1 vessel + 4 cusps –> 2 vessels + 3 cusps each

27
Q

What happens in unequal partitioning of the truncus arteriosus by the aorticopulmonary septum

A

results in semilunar valve stenosis
- one side expanded
- one side stenosed

28
Q

What happens in pulmonary valve stenosis (narrowing)

A

obstruction
reduced flow into pulmonary trunk
pressure overload - more resistance and pressure on right side of heart
acyanotic or cyanotic depends on the extent of the stenosis (assuming the DA has closed)

29
Q

How to repair a valve stenosis

A
  1. stabalize with prostaglandins to promote relaxation of ductal smooth muscle
  2. undergo balloon valvuloplasty to repair the stenosed pulmonary valve (stretches valve)
    - balloon catheter advanced up the femoral vein –> IVC –> right atrium –> right ventricle –> pulmonary semilunar valve
30
Q

What happens in patent ductus arteriosus

A

leads to volume overload in the pulmonary circuit – too much blood flow

increased blood flow can lead to pulmonary edema (interferes with proper oxygenation of the blood)

shunt (blood flowing from aorta to trunk)
blood flows from aorta to pulmonary trunk
Volume overload – more blood volume in the pulmonary circuit
acyanotic or cyanotic depends on the extent of the volume overload (pulmonary edema)

31
Q

How to treat patent ductus arteriosus

A

ligation (tying off) of the patent ductus arteriosus

stabalize before surgery using indomethacin (a prostaglandin synthesis inhibitor)

32
Q

How is the interatrial septum formed

A

first wall – septum primum
- forms the valve
second wall – septum secundum
- forms the bulk of the interatrial septum and the foramen ovale (between the two atria and an associated valve that closes at the time of birth)

33
Q

What does the valve of the foramen ovale do

A

permits blood to flow from right to left in utero but prevents left to right movement postnatally

34
Q

What controls the opening and closing of the foramen ovale

A

changes in pressure

35
Q

What are the two major vascular changes that occur imediately after birth

A
  • increased systemic resistance with loss of placenta
  • decreased pulmonary vascular resistance with breathing
36
Q

What happens in a patent foramen ovale

A

foramen ovale is open after birth
- volume overlaod of the right side of the heart as blood is shunted from left to right atrium (too much blood in lungs, but wouldnt cause edema)
- mixing blood from right to left shunt (goes back through lungs)

shunt
flow from left to right atrium
volume overload -more blood volume through the pulmonary circuit
asymptomatic for decades (rarely cyanotic)

37
Q

What happens in the formation of the interventircular septum

A

from the apex toward sthe centre of the hear (endocardial cushion)
- consists of a muscular and membranous (thin) portion

gives rise the valves of the heart

Anatomy (21 decks)

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