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CPR Week 1 > 3.1.3. Cardiovascular System Development > Flashcards

3.1.3. Cardiovascular System Development Flashcards

1
Q

Define Splanchnic mesoderm

A

mesoderm that overlies the endoderm and is a layer continuous with the mesoderm covering the yolk sac; gives rise to the mesothelial covering of viscera

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2
Q

Define Crista terminalis

A

the junction between the sinus venosus and the heart in the embryo; ridge of tissue in the right atrium

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3
Q

Define the Cardiogenic field (area)

A

a horseshoe shaped area in the splanchnic mesoderm on either side of the neural plate

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4
Q

Define Septum primum

A

the septum that separates the cavity of the primitive atrium into right and left chambers

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5
Q

Define Angiogenesis

A

physiological process through which new blood vessels form from pre-existing vessels

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6
Q

Define Septum secundum

A

semilunar in shape, grows downward from the upper wall of the atrium immediately to the right of the septum primum, with which it will fuse to close the foramen ovale

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7
Q

What are the Blood islands?

A

embryological structures which lead to the development of many different parts of the circulatory system; often seen on the umbilical vesicle, allantois, connecting stalk, or chorion

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8
Q

Define Ostium primum

A

an opening between the free edge of the septum primum and the AV cushions

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9
Q

What are the Vitelline veins?

A

veins which drain blood from the yolk sac

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10
Q

Define Ostium secundum

A

a foramen in the septum primum; precursor to the interatrial septum of the embryological heart

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11
Q

What are the Cardinal veins?

A

two short transverse veins which open on either side of the sinus venosus

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12
Q

Define Foramen ovale

A

hole in the fetal heart that allows blood to enter the left atrium from the right atrium; a cardiac shunt, which allows the blood to bypass pulmonary circulation

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13
Q

What are the Umbilical veins?

A

veins present in fetal development that carries oxygenated blood from the placenta to the fetus

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14
Q

The bulbus cordis gives rise to what structures?

A

together with the primitive ventricle will give rise to the developed ventricles

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15
Q

Define Ductus venosus

A

a fetal shunt that allows a portion of the umbilical blood flow to pass directly to the inferior vena cava, thereby allowing oxygenated blood from the placenta to bypass the liver

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16
Q

What is the Truncus arteriosus?

A

an embryologic trunk that originates from both ventricles and then differentiates into the aorta and pulmonary trunk

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17
Q

What is the Dorsal mesocardium?

A

part of the mesocardium of the fetal heart that breaks down to form the transverse sinus of the pericardium

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18
Q

What is the Aortic sac?

A

a dilated structure lined by endothelial cells located just above the truncus arteriosus, will give rise to the aortic arches

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19
Q

Define Transverse sinus

A

pericardial sinus from the mesoderm that will connect with the oblique sinus to form the pericardial sac

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20
Q

What is the Bulboventricular sulcus?

A

the junction between the ventricle and the bulbus cordis in the fetal heart

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21
Q

Define Epicardium

A

a serous membrane that forms the innermost layer of the pericardium and outermost surface of the heart

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22
Q

What are the Sinus horns?

A

right and left horns which supply the sinus venosus with venous blood from the vitelline, umbilical, and common cardinal veins

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23
Q

Define Mesocardium

A

embryonic mesentery supporting the embryonic heart in the pericardial cavity

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24
Q

What is the Oblique vein?

A

the remnants of the left sinus horn at 10 weeks gestation; supplies the left atrium

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25
Q

Define Endocardium

A

innermost layer of tissue that lines the chambers of the heart; similar to endothelium

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26
Q

What is the Coronary sinus?

A

a collection of veins joined together to form a large vessel that collects blood from the heart muscle; delivers deoxygenated blood to the right atrium

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27
Q

What is the Cardiac loop?

A

the term for the embryonic heart formed by the bending and twisting of the cardiac tube

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28
Q

What are the Endocardial cushions?

A

cells that play a vital role in proper heart septation; will give rise to the heart’s valves and septa

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29
Q

What is the Sinus venosus?

A

the large quadrangular cavity which proceeds the atrium on the venous side of the fetal heart; will be incorporated into the wall of the right atrium and give rise to the SA node

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30
Q

What are BMP 2, 4?

A

secretions from the endoderm and lateral plate mesoderm which induce the transcription factor NKX2.5 to produce heart-forming region

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31
Q

What are WNT inhibitors?

A

proteins that are secreted by the neural tube and block WNT proteins, which would inhibit normal heart development

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32
Q

What is NKX-2.5?

A

transcription factor for heart formation

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33
Q

When does the vascular system appear in embryonic development?

A

The vascular system appears in the middle of the third week, when the embryo is no longer able to satisfy its nutritional requirements by diffusion alone

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34
Q
A
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35
Q

What are the tree primary vascular systems

A
  1. Vitelline (will become blood vessels of digestive tract)
  2. Cardinal
  3. Umbilical
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36
Q

Throughout the development of the heart, blood must be able to flow through the heart _ ._

A

Throughout the development of the heart, blood must be able to flow through the heart continuously.

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37
Q

Four chambered heart functions as one chamber by using two shunts, _ _ and the _ _, because the lungs are not functioning.

A

Four chambered heart functions as one chamber by using two shunts, inter-atrial and the ductus arteriosus (from pulmonary trunk to aortic arch), because the lungs are not functioning.

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38
Q

In the embryo, pressure on the right side of heart is (higher/lower) than on the left.

A

In the embryo, pressure on the right side of heart is HIGHER than on the left.

Circulation resistance is high in pulmonary system because the lungs are not functioning; systemic circulation resistance low because it includes the placenta that is low pressure.

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39
Q

After _ _ (what event) the two shunts close, blood pumps into lungs and left side empties into systemic circulation so now the pressure on the right side is LOWER than on the left side.

A

After BIRTH the two shunts close, blood pumps into lungs and left side empties into systemic circulation so now the pressure on the right side is LOWER than on the left side.

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40
Q

When does the cardiac field (cardiogenic area) appear?

A

Appears around 18 days (in utero)

41
Q

Where is the cardiogenic field in the embryo?

A
42
Q

What factors help induce formation of the cardiogenic area?

A
  • Induced by the combination of specific factors:
    • BMP 2,4
    • WNT inhibitors
    • NKX-2.5 (specific transcription factor expressed in cardiac progenitor cells)
43
Q

Angiogenic cells cluster on either side of the notochord to form the _ _ _ _ _ ._

A

Angiogenic cells cluster on either side of the notochord to form the primary heart field

44
Q

_ _ _ _ _ _ is formed by the lateral folding and fusion of the endocardial heart tubes

A

PRIMITIVE HEART TUBE is formed by the lateral folding and fusion of the endocardial heart tubes

45
Q

Lateral plate mesoderm located at the cephalic area of the embryo splits into a somatic layer and a splanchnic, thus formed the _ _ _ _

A

Lateral plate mesoderm located at the cephalic area of the embryo splits into a somatic layer and a splanchnic, thus formed the pericardial cavity

46
Q

precardiac mesoderm preferentially migrates into the splanchnic layer and forms the _ _ _ _ _ _

A

precardiac mesoderm preferentially migrates into the splanchnic layer and forms the heart forming regions (HFRs)

47
Q

hypertrophied foregut endoderm secretes _ _, which induces the sheet of mesoderm to form discontinuous vascular channels that remodel into a single endocardial tube (endocardium)

A

hypertrophied foregut endoderm secretes VEGF, which induces the sheet of mesoderm to form discontinuous vascular channels that remodel into a single endocardial tube (endocardium)

48
Q

mesoderm around the endocardium forms the myocardium, which secretes a layer of extracellular matrix proteins called

A

mesoderm around the endocardium forms the myocardium, which secretes a layer of extracellular matrix proteins called cardiac jelly

49
Q
A
50
Q
A
51
Q

the septum transversum will form portions of the _ _ and the _ _

A

the septum transversum will form portions of the diaphragm and the liver

52
Q

Mesothelial cells on the surface of the septum transversum form the _ - _ near the sinus venosus

A

Mesothelial cells on the surface of the septum transversum form the pro-epicardium near the sinus venosus

53
Q

Mesothelial cells on the surface of the septum transversum migrate over the heart to form most of the _ _

A

Mesothelial cells on the surface of the septum transversum migrate over the heart to form most of the epicardium.

54
Q

This mesothelial cell layer on the surface of the septum transversum is responsible for formation of the _ _ _ ._

A

This mesothelial cell layer on the surface of the septum transversum is responsible for formation of the coronary arteries. (endothelial lining and smooth muscle)

55
Q

The _ _ _ _ will then break down to initiate the segmentation and subdivision of the single cardiac tube

(around 22 days)

A

The dorsal mesocardium will then break down to initiate the segmentation and subdivision of the single cardiac tube

56
Q

What is the function of cardiac looping in embryos before the heart is fully formed?

A

The function of cardiac looping is to align the four presumptive chambers of the future heart so that their spatial relationships are correct

57
Q
A
58
Q

What are the five primitive heart tube dilations?

A
  • Five appear along the length of the tube
    • truncus arteriosus
    • bulbus cordis
    • primitive ventricle
    • primitive atrium
    • sinus venosus
59
Q

The primitive cardiac dilations undergo _ _ looping and develop into the adult structures of the heart

A

They undergo dextral looping and develop into the adult structures of the heart

60
Q

Cells are added to the _ _ _ _ and _ _ _ _ from the secondary heart field

A

Cells are added to the Truncus arteriosus and Bulbus cordis from the secondary heart field

61
Q

Why (mechanical reason) does the cardiac tube end up looping?

A

Ends of the tube are fixed in length, causing looping of the tube

62
Q

series of constrictions and expansions form in the heart tube; (constrictions/expansions) contribute to the different heart chambers

(which of the two)

A

series of constrictions and expansions form in the heart tube; expansions contribute to the different heart chambers

63
Q

How are portions of the cardiac tube displaced so that the inflow and outflow regions come to lie next to each other.

A
  • Bulbus cordis displaced – caudally, ventrally, and to the right
  • Primitive ventricle displaced – to the left
  • Sinus venosus displaced – dorsally and cranially
64
Q
A
65
Q

Try to imagine how the cardiac loop looks when it is colded completely.

About when does this occur?

A
66
Q
A
67
Q

Name one example of the cardiac loop folding incorrectly.

A

Dextrocardia => dextro means right; heart loops to the right rather than left

68
Q

Describe Atrioventricular septum formation

A

Dorsal AV cushion and ventral AV cushion approach each other and fuse to form the AV septum

partitions the AV canal into the right and left AV canals

69
Q

When the AV cushions fuse into the AV septum, how does blood continue to flow through the cardiac loop?

A
70
Q

Septum primum will fold towards the endocardial cushions, and fuse, resulting in the closing of the _ _ _ _; ostium secundum forms via perforations in the septum primum

A

Septum primum will fold towards the endocardial cushions, and fuse, resulting in the closing of the ostium primum; ostium secundum forms via perforations in the septum primum

71
Q

ostium secundum formed as tissue degenerates in the superior septum primum

most common ASD (atrial septal defect) is _ _ _ _ type due to excessive resorption of the septum primum or inadequate formation of the septum secundum

A

ostium secundum formed as tissue degenerates in the superior septum primum

most common ASD (atrial septal defect) is OSTIUM SECUNDUM type due to excessive resorption of the septum primum or inadequate formation of the septum secundum

72
Q

About when does atrial septum form?

A

33 days

73
Q

Septum secundum then folds towards the endocardial cushions and fuses; _ _ _ _ forms

A

Septum secundum then folds towards the endocardial cushions and fuses; foramen ovale forms

74
Q

septum secundum forms alongside the right edge of the

A

septum secundum forms alongside the right edge of the septum primum

75
Q

Foramen ovale (FO) allows blood to be shunted from _ _ _ _ to _ _ _ _ during fetal life

A

FO allows blood to be shunted from right atrium to left atrium during fetal life

76
Q

The FO closes after birth due to…

A

The FO closes after birth due to pressure in the LA

77
Q

How does pressure in the left atrium (LA) close the foramen ovale after birth?

A
78
Q

How can a too large ostium secundum or foramen ovale cause an Atrial Septal Defect (ASD) after birth?

A

the offset angles of the foramen ovale and the ostium secundum are necessary for when the pressures of the heart shift following birth; if the angles were not offset, or the foramen/ostium were formed too large, it would result in an “atrial-septal defect” resulting in blood flowing from the left atrium to the right atrium

79
Q
  • The muscular interventricular septum folds toward the atrioventricular septum
    • forms as an upward expansion of the base of the primitive ventricle; extends toward the AV septum but does not reach it; resulting gap is the _ _

​ _ _

A
  • The muscular interventricular septum folds toward the atrioventricular septum
    • forms as an upward expansion of the base of the primitive ventricle; extends toward the AV septum but does not reach it; resulting gap is the interventricular foramen
80
Q

The interventricular septum (IVS) will not close initially; must have formation of the _ _ portion of the IV septum

A

This septum will not close initially; must have formation of the membranous portion of the IV septum

81
Q

membranous IVS formed by the fusion of the _ _ septum with the muscular IVS; grows downward from the AV cushions and fuses with the muscular interventricular septum (obliterates the _ _ _ _)

A

membranous IVS formed by the fusion of the aorticopulmonary septum with the muscular IVS; grows downward from the AV cushions and fuses with the muscular interventricular septum (obliterates the interventricular foramen)

82
Q

The membranous portion of the interventricular septum contributes to the AV cushions and the _ _

_ _

A

The membranous portion of the interventricular septum contributes to the AV cushions and the conotruncal bridges/septum

83
Q

IV foramen is located between the free edge of the _ _ IV septum & the fused _ _ cushions

A

IV foramen is located between the free edge of the muscular IV septum & the fused AV cushions

84
Q
  • membranous IV septum forms by the proliferation & fusion of tissue from three sources. What are they?
A
  • membranous IV septum forms by the proliferation & fusion of tissue from three sources
    • right bulbar ridge
    • left bulbar ridge
    • AV cushions
85
Q

What is the difference between a normal heart and a heart with a VSD (ventricular septal defect)?

A
86
Q

In the _ _ (1st, 2nd, 3rd…) week, the AP septum will be remodelled to form the aorta and the pulmonary trunk

A

In the 9th week, the AP septum will be remodelled to form the aorta and the pulmonary trunk

87
Q

AP septum derived from _ _ _ _ cells that migrate to the conotruncal ridges

A

AP derived from neural crest cells that migrate to the conotruncal ridges

88
Q

What happens if the conotruncal septum doesn’t spiral?

A

If the conotruncal septum doesn’t spiral, results in “transposition of the great vessels” - results in the majority of blood bypassing the lungs;

treatment is to poke a hole in the right atrium, allows oxygenated and deoxygenated blood to mix more.

89
Q

Describe blood flow in the fetus.

A

Blood originates in the umbilical veins, and circulates throughout the body and back to the mother via the umbilical arteries

90
Q

How do the six pairs of aortic arches develop into their adult derivatives, i.e., what are the adult finalized forms of these primitive six initial aortic arch pairs?

A
91
Q

Describe the role of neural crest cells in the development of the heart.

A

The cardiac neural crest cells have a number of functions including:

creation of the muscle and connective tissue walls of large arteries and parts of the cardiac septum

They may also contribute to the creation of the carotid body, the organ which monitors oxygen in the blood and regulates breathing

92
Q

Explain the bilateral asymmetry of the recurrent laryngeal nerve

What kind of threat does this pose to hepatic surgery patients?

A
  • Whereas the right side laryngeal nerve runs directly to the larynx, the left side nerve wraps around the ductus arteriosus in the fetus and the ligamentum arteriosus in the adult
  • This poses an issue for hepatic surgery in the adult because accidental transection of the ligamentum arteriosus could result in damage to the left laryngeal nerve and paralysis of the larynx.
93
Q

What are the three embryologic venous circuits?

A

Vitelline

Umbilical

Cardinal

94
Q

What is the adult fate of the Vitelline veins?

A

Embryonic

Adult

Vitelline Veins

Right & Left

portion of the IVC, hepatic veins and sinusoids, ductus venosus, portal vein, inferior mesenteric vein, superior mesenteric vein, splenic vein

95
Q

What is the adult fate of the Umbilical veins?

A

Embryonic

Adult

Umbilical

Right

degenerates early in fetal life

Left

ligamentum teres

96
Q

What is the adult fate of the Cardinal veins?

A

Embryonic

Adult

Cardinal

Anterior

SVC, internal jugular veins

Posterior

portion of IVC, common iliac veins

Subcardinal

portion of IVC, renal veins, gonadal veins

Supracardinal

portion of IVC, intercostal veins, hemiazygos vein, azygos vein

97
Q

In the fetus, why does the majority of the blood bypass the pulmonary system?

A

When organs are developing, they need some blood to supply the development, but too much can hinder development. The lungs receive a very large amount of blood in adults, which would be damaging to fetal lungs.

98
Q

What changes in the vascular system must take place at birth so that a baby can live independently from her/his mother?

A
  • Change in blood flow
  • Closure of the ductus arteriosus

CPR Week 1 (14 decks)

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