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SF3 - Test 1 > 1 - Development of Great Vessels > Flashcards

1 - Development of Great Vessels Flashcards

1
Q

How is the heart initially connected to the paired dorsal aorta?

What embryological structure is the aortic sac the rostral part of?

What occurs to this pair of vessels during development?

A

By paired aortic arches from the aortic sac

Truncus Arteriosus

The paired dorsal aortae fuse to form single aorta

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2
Q

What are the branches of the fused single aorta?

A
  1. Paired intersegmental arteries
  2. Unpaired Vitelline arteries
  3. Paired umbilical arteries
  4. Paired Lateral splanchnic arteries
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3
Q

Where do the paired intersegmental arteries grow?

Where do they supply blood?

What do they form in the mature body (from what intercostal spaces)?**

A

Grow between somites

Supply blood to body wall

  1. Posterior Intercostal and Lumbar Arteries (part of right / left subclavian A.’s) - 7th Intersegmental - Upper Extremity
  2. Common Iliac Arteries - 5th Lumbar Intersegmental - Lower Extremity
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4
Q

What structures do the unpaired vitelline arteries supply?

What vessels do they form in the mature body?

A

Yolk Sac (primitive gut) derivatives

  1. Esophageal and Bronchial Arteries
  2. Celiac, Superior/Inferior Mesenteric
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5
Q

What do the Paired Umbilical Arteries branch off?

What do they become in the mature body?

A

Branch off 5th Lumbar Intersegmental Artery (future Common Iliac)

  1. Internal Iliac Arteries
  2. Superior Vesicle Artery (bladder)
  3. (Not artery) Medial Umbilical Ligament
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6
Q

What is the fate of aortic carches 1, 2, and 5?

What do aortic arches 1 and 2 form?

A

They degenerate

Part of Maxillary A. and Stapedial A.

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7
Q

What does Aortic Arch 3 from?

What occurs to the dorsal aortae connecting Arches 3 and 4?

A

Proximal - Forms Common Carotid Artery

Distal + oart of dorsal Aorta form Internal Carotid Artery, External Carotid Artery

They degenerate

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8
Q

What does the Left Aortic Arch 4 form?

What does the Right Aortic Arch 5 form?

A

Left - Arch of the Aorta (with Aortic Sac / Left Dorsal Aorta)

Right - Right Subclavian Artery (with Right Dorsal Aorta / Right 7th Intersegmental Artery)

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9
Q

What three embryonic vessels for the Arch of the Aorta?

What three embryonic vessels for the Right Subclavian?

What forms the Left Subclavian?

A

Arch of Aorta: Left Aortic Arch 4, Aortic Sac, Left Dorsal Aorta

Right Subclavian: Right Aortic Arch 4, Right Dorsal Aorta, Right 7th Intersegmental Artery

Left Subclavian: Left 7th Intersegmental Artery

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10
Q

What does the Proximal part of Aortic Arch 6 form?

What does the Distal part of Aortic Arch 6 form?

A

Proximal - Left and Right Pulmonary Arteries

Distal - Right degenerates, Left persists as ductus arteriosus

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11
Q

What are the two fetal bypasses of pulmonary circulation?

What occurs to these following birth?

A
  1. Foramen Ovale connecting RA and LA
  2. Ductus Arteriosus connecting Left Pulmonary Artery to Arch of Aorta
    - - -
  3. Foramen Ovale closes (normal) due to reversal of Pressure Gradient
  4. Ductus Arteriosus smooth muscle wall constrict, closing off. Becomes Ligamentum Arteriosum
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12
Q

What forms the braciocephalic trunk?

A

Aortic Sac

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13
Q

What is the fate of the causal part of right dorsal aorta bwteen the 7th Intersegmental Artery and the fused right and left dorsal aortae?

A

Shit go bye bye

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14
Q

What nerve supplies the 6th Pharyngeal Arch?

A

Recurrent laryngeal nerve of the vagus nerve

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15
Q

What is the fate of the right recurrent laryngeal nerve?

What structure does it hook around?

A

Due to the 6th/5th Aortic Arch degeneration on the right, it hooks around the 4th which forms the right subclavian artery

This is how the Right Recurrent Laryngeal Nerve hooks around the Right Subclavian Artery

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16
Q

What is the fate of the left recurrent laryngeal nerve?

A

Left 6th Arch persists as ductus arteriosus

Left Recurrent Laryngeal hooks around the mature form of this, the Ligamentrum Arteriosus as well as the Arch of the Aorta

Left Hooks Ligamentum Arteriosus

17
Q

Clinical: Postductal Coarctation of the Aorta

How does blood reach structures?

What is a clinical presentation?

A

Narrowing of the Aorta

Postductal = Narrowing inferior to ductus arteriosus (normally closed)

Most Common

- - -

For blood to reach inferior structures, collateral circulation develops in 2 locations

1. Anterior Intercostal Branchs of Internal Thoracic + Posterior Intercostals of Aorta

2. Superior Epigastric + Inferior Epigastric

- - -

Often asymptomatic, but xrays may show rib-notching

18
Q

Clinical: What anastomes must form to provide inferior circulation to a Postductal Coarctation Aortic narrowing?

A
  1. Anterior Intercostal Branchs of Internal Thoracic + Posterior Intercostals of Aorta
  2. Superior Epigastric + Inferior Epigastric
19
Q

Clinical: Preductal Coarctation

A

Narrowing of aorta superior to ductus arteriosus

Ductus Arteriosis remains patent to supply aorta with blood

20
Q

Clinical: Patent Ductus Arteriosus

At Risk Population?

When surgically correcting, what is a complication you need to avoid?

A

Failure of clusure of the ductus post-natally

Results in shunting of blood from aorta (high pressure) to pulmonary artery (low pressure)

At Risk: Premature Infants, Mothers with Rubella

During surgery you have to watch for Left Recurrent Laryngeal Nerve (permanent hoarse voice)

21
Q

Clinical: Abnormal Right Subclavian Artery

Symptoms?

Cause?

A

Abnormal branch of aortic arch, passes posterior to esophagus

Can result in kinking of the esophagus, difficulty swalling

Cause:

Obliteration of right 4th aortic arch and adjacent part of rt dorsal aorta (between 4th and 7th)

Forms from right 7th intersegmental artery and persistence of distal part of right dorsal aorta (which normally degenerates)

22
Q

Clinical: Double Aortic Arch

A

Abnormal right arch develops in addition to left

Due to persistence of distal part of right dorsal aorta

Forms vascular ring around trachea and esophagus causing difficulty in swallowing or breathing

23
Q

Clinical: Right Aortic Arch

A

Can oass anterior or posterior (retroesophageal) to the esophagus and trachea

Retroesophageal Right Arch can cause difficulties in swallowing or breathing

Due to persistence of entire right dorsal aorta and degeneration of distal part of left dorsal aorta

24
Q

What are the major three pairs of embryonic veins?

What type of flow occurs during embryonic development?

A

Vitelline Veins

Umbilical Veins

Cardinal Veins

Left-to-Right Shunting of blood to right atrium

25
Q

What do the right and left Vitelline Veins drain?

What definitive structures do they form?

What is the ultimate fate of each of the two veins?

A

Primitive Gut

Form: Hepatic Sinusoids (liver channels), Ductus Venosus

Right: Forms part of Inferior Vena Cava and Hepatic Portal System

Left: Degenerates due to L-to-R shunting post-natally

26
Q

What is the purpose of the Ductus Venosus during natal development?

What does it form post natally?

A

Venous by-pass of developing liver and a L-to-R shunt to Right Atrium

Shunts fblood from left umbilical vein to inferior vena cava

Forms Ligamentum Venosum post natally

27
Q

What is the fate of the Left and Right paired Umbilical Veins?

A

Right: Degenerates

Left: Fetal - carries oxygenated placental blood, goes to liver–drains into Hepatic Sinusoids and (via Ductus Venosus) drains into Inferior Vena Cava

Post Natal: Left forms Ligamentum Teres Hepatis

28
Q

Why is the liver mostly bypassed during development?

How does this occur?

A

Blood is already ‘processed’ by mother

Ductus Venosus shunts oxygen rich blood into inferior cava for distribution by heart

29
Q

What is the developmental purpose of the Three Cardinal Veins?

What is the fate of the Right and Left Anterior Cardnial Veins?

What forms the Superior Vena Cava?

What is the fate of the Posterior Cardinal Vein?

A

Anterior / Posterio drain Cephalic and Caudal early embryo into the Common Cardinal V. , which drains into Sinus Venosus

- - -

R/L Anterior Cardinal Veins: Contribute to Internal Jugular V., become connected by Oblique ansatomosis–which become Left Brachiocephalic Vein

Right also conributes to Right Brachiocephalic V.

- - -

R. Anterior Cardinal + R. Common Cardinal form Superior Vena Cava

Mostly degenerate; form segment of Inferior Vena Cava and Common Iliac Veins

30
Q

Clinical: Double Superior Vena Cava

A

Terminal L. Ant. Cardinal vein normally degenerates sticks around to be a dick

31
Q

Clinical: Left Superior Vena Cava

A

Terminal L. Ant. Cardinal V. normally degenerates, but terminal R. Ant. Cardinal V. degenerates instead–

results in a Left Superior Vena Cava

32
Q

Prenatal: Left Umbilical Vein

Postnatal: ?

A

Postnatal: Ligamentum teres Hepatis

33
Q

Prenatal: Ductus Venosus

Postnatal: ?

A

Postnatal: Ligamentum Venosum

34
Q

Prenatal: Foramen Ovale

Postnatal: ?

A

Postnatal: Fossa Ovalis (closes foramen)

35
Q

Prenatal: Ductus arteriosis

Postnatal: ?

A

Postnatal: Ligamentum Arteriosum

36
Q

Prenatal: Umbilical Artery

Postnatal: ?

A

Postnatal: Gives rise to Internal Iliac A., Superior Vesicle A., Medial Umbilical Ligament

37
Q
A

SF3 - Test 1 (28 decks)

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