2.5 Cardiovascular embryology Flashcards

1
Q

What are the 3 stages of heart formation?

A
  1. Formation of primitive heart tube.
  2. Cardiac looping.
  3. Cardiac septation.
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2
Q

Describe what happens in the formation of the primitive heart tube.

A

Two endocardial tubes form (day 19). The tubes fuse together and the heart beats (day 22).

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3
Q

Describe what happens in cardiac looping.

A

Nodes secrete nodal, this circulates to the left due to ciliary movement. Nodal causes a cascade of transcription factors that transduce looping.

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4
Q

Describe what happens in cardiac septation.

A

Endocardial cushions form. Fuse at mid-line to form atrio-ventricular septum. Muscular ridge in the floor of the primitive ventricle migrates to endocardial cushions forming interventricular septum.

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5
Q

What does the ecoderm (outer layer) form?

A

Skin, nervous system, and neural crest (which contribute to cardiac outflow and coronary arteries).

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6
Q

What does the mesoderm (middle layer) form?

A

All types of muscles, most systems, kidneys, blood, bone

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7
Q

What does the endoderm (inner layer) form?

A

gastro-intestinal tract (including liver and pancreas but not smooth muscle) and endocrine glands.

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8
Q

The cardiovascular system is derived from cells situated in…

A

The mesoderm

and some contribution from the neural crest in the ectoderm

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9
Q

What layer of the tri-laminar disc forms the cardiovascular system?

A

Mesoderm

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10
Q

What does the first heart field produce?

A

The left ventricle

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11
Q

What does the second heart field produce?

A

The right ventricle, atria and outflow tracts.

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12
Q

What are the 3 types of capillaries

A

Continuous (most common),
Fenestrated (kidneys, small intestines and endocrine glands),
discontinuous (liver sinusoids)

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13
Q

What is the ligamentum teres a remnant of?

A

The umbilical vein.

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14
Q

What is the ligamentum venosus a remnant of?

A

The ductus venosus.

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15
Q

Briefly describe foetal circulation.

A

Maternal circulation - umbilical vein (oxygenated blood) - ductus venosus - IVC - RA - LA/RV - aorta - umbilical artery (deoxygenated blood) - maternal circulation.

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16
Q

What does the sinus venosus form?

A

The coronary sinus and RA.

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17
Q

What does the primitive atrium form?

A

RA and LA.

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18
Q

What does the primitive ventricle form?

A

Forms most of LV.

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19
Q

What does the bulbus cordis form?

A

Part of the ventricles.

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20
Q

What does the truncus arteriosus form?

A

The aorta and pulmonary trunk.

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21
Q

What do the 1st and 2nd aortic arches form?

A

Minor vessels in the head.

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22
Q

What does the 3rd aortic arch form?

A

The common carotid arteries.

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23
Q

What does the left and right 4th aortic arch form?

A

Left - aorta. Right - Right subclavian artery.

24
Q

What does the 5th aortic arch form?

A

There is no 5th arch!

25
Q

What does the left and right 6th aortic arch form?

A

Left - left pulmonary artery and ductus arteriosus. Right - right pulmonary artery.

26
Q

What does the 7th segmental aortic arch form?

A

Left and right subclavian arteries.

27
Q

What does the dorsal aortae form?

A

Left dorsal aortae - descending aorta. Right dorsal aortae - part of right subclavian artery.

28
Q

Where is the SAN located?

A

In the Right Atrium under the crista terminalis.

29
Q

What does the left coronary artery divide into?

A

The left anterior descending, and the circumflex.

30
Q

Why is the O2 saturation in coronary venous blood very low?

A

O2 extraction by the heart muscle is very high.

31
Q

What surface of the heart does the right coronary artery supply?

A

The inferior surface (underside) of the heart.

32
Q

What valve prevents high pressures developing in the jugular veins during ventricular systole?

A

Tricuspid valve.

33
Q

Why does an increase in LVEDV signify heart failure?

A

Heart failure is the inability to pump blood out of the heart. There is blood remaining at the end of systole. The blood therefore accumulates and so LVEDV increases.

34
Q

Which pressure is most likely to increase in left sided heart failure?

A

LV EDP.

35
Q

Which pressure is most likely to decrease in left sided heart failure?

A

Mean aortic pressure.

Less blood is being pumped into the aorta

36
Q

What is stenosis?

A

Narrowing.

37
Q

Which pressure is most likely to increase in mitral valve stenosis?

A

Left atrial end-systolic pressure.

38
Q

What does it mean if a heart valve is incompetent?

A

It is regurgitant.

39
Q

Which pressure is most likely to increase when the aortic valve is incompetent?

A

Left ventricular end-diastolic pressure.

40
Q

Pulmonary oedema is a sign of what?

A

Left heart failure.

41
Q

What can severe pulmonary hypertension cause?

A

Right heart failure.

The heart has to pump harder to get blood into the pulmonary circulation due to an increased afterload.

42
Q

Shortness of breath, severe peripheral oedema and ascites after a heart attack can indicate what?

A

Biventricular failure.

43
Q

What is ascites?

A

Accumulation of fluid in the peritoneal cavity, this can cause abdominal swelling.

44
Q

What branch does the right coronary artery give off as it reaches the inferior border of the heart?

A

The right marginal branch.

45
Q

What artery does the RCA anastomose with on the diaphragmatic surface of the heart?

A

The circumflex artery.

46
Q

What does the LAD anastomose with on the diaphragmatic surface of the heart?

A

The posterior inter-ventricular branch of the RCA.

47
Q

Where is the coronary sinus found?

A

Between the LA and LV - left atrio-ventricular sulcus.

48
Q

What does the coronary sinus drain into?

A

The RA.

49
Q

What artery arises from the RCA in 90% of hearts, the circumflex in 30% and in 20% arises from both the RCA and circumflex?

A

The posterior inter-ventricular branch.

50
Q

Define ischaemia.

A

A decrease in blood flow to a tissue.

51
Q

Define infarction.

A

No blood flow to a tissue - tissue death.

52
Q

Explain the formation of fluid exudate in inflammation.

A

Chemical mediators cause vasodilation of vessels and an increase in permeability.

53
Q

What reaction does adenyl cyclase catalyse?

A

The conversion of ATP into cAMP.

54
Q

How do muscarinic M2 receptors cause a decrease in cAMP?

A

They inhibit adenyl cyclase.

55
Q

What surface of the heart does the RCA supply?

A

Inferior.