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CR2 > 5 - Development of the heart > Flashcards

5 - Development of the heart Flashcards

1
Q

What mesoderm does the heart develop from

A

Cardiogenic mesoderm of lateral plate

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2
Q

How does the heart structure develop

A

Blood islands - hemangioblasts (blood and blood vessels)

Angiogenic cells clusters for the right and left endocardial tubes at day 20

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3
Q

What are the endocardial tubes

A

Dorsal aorta, outflow tract

Vitello-umbilical vein and inflow tract

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4
Q

What day do the endocardial tubes fuse into the primitive heart tube

A

21

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5
Q

What forms the primitive myocardium

A

Mesoderm from foregut forms the external layer

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6
Q

What day does the heart beat on

A

22

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7
Q

What divides the atria from primitive ventricle

A

Atrioventricular suclus

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8
Q

What does the primitive ventricle become

A

Expands to become the left ventricle

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9
Q

What does the interventricular suclus divide

A

Primitive ventricle from bulbus cordis

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10
Q

What day does heart looping occur

A

22-24 days

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11
Q

What is dextrocardia

A

Anomaly where the primitive heart tube folds to the left (situs invertus)

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12
Q

On what day does the septum fform AV canal

A

Day 28

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13
Q

How does the septum form the AV canal

A

2 swellings of mesenchymal tissue appear from walls of the canal (endocardial cushions)
The cushoins grow and fuse together to divide canal into R and L

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14
Q

What is septum primum and when does it develop

A

Day 28

Divides R and L atrium

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15
Q

What is ostium premum

A

Osteium (opening) formed by free edge of septum primum

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16
Q

Ostium embryologY

A

• Perforations coalesce to form ostium secundum to the right of the first ostium.
• Right  left shunting of blood via foramen ovale
• Septum primum acts as a valve
• Pressure increase in left atrium closes valve by fusing two ostium together
o Fossa ovalis in adult

17
Q

Ventricular portioning

A

After 28 days, septum develops from floor (muscular) and grows towards membranous IVS (septum) which develops from endocardial cushions, IV foramen is a temporary opening which closes when muscular and membranous septa fuse at 7th week  trabeculated appearance- diverticulum of the walls.

18
Q

What separates the aorta and pulmonary trunk?

A

Trunctus arteriosus

19
Q

What travels from baby to placenta

A

umbilical arteries (x2)internal iliac arteries, deoxygenated high pressure blood

20
Q

What travels from placenta to baby

A

umbilical vein (becomes ductus venosus, oxygenated high pressure blood)

21
Q

Foetal circulation

A

Reduced pulmonary blood flow
Ductus arteriosus from PT to Aorta(shunt)
Ductus venosus (continuation of umbilical vein)
Foramen Ovale (RA –> LA)

22
Q

Function of ductus arteriosus

A

Allows RV to strengthen
High pulmonary vascular resistance
Protects lung against circulatory overload
Bypasses lungs

23
Q

Ductus venosus

A

Connects umbilical vein to IVF
Regulated via sphincter
Conducts oxygenated blood
Will bypass the liver (80%)

24
Q

Foramen ovale

A

Shunts highly oxygenated blood
RV pumps 2/3 cardiac output
Bypass the pulmonary circulation

25
Q

Adaptations at birth

A

Umbilical vein becomes ligamentum teres
Ductus venosus constricts and forms ligamentum venosum
Foramen ovale closes
Ductus arteriosus closes to form ligamentum arteriosum

26
Q

Why does foramen ovale close

A

o Decreased flow from placenta and IVC causes lower pressure in RA
o Decreased pulmonary vascular resistance secondary to lung expansion
o Increase in pulmonary blood flow- raising LA pressure to higher than that of the IVC
(closes due to increased pressure in LA)

27
Q

Why does ductus arteriosus close

A

o Due to decreased pulmonary vascular resistance, PA pressure falls below systemic pressure and blood flow through DA is diminished
(increased pao2)

28
Q

What mediates closure of ductus arteriosus

A

Bradykinin

29
Q

What may open DA

A

Prostaglandin E2

30
Q

Tetralogy of Fallot lesions

A

Overriding aorta
Right ventricular hypertrophy
Narrow RV outflow (pulmonary stenosis)
Ventricular septal defect

31
Q

Persistent Truncus Arteriosus

A

Single artery arises from the heart
Supplies both aorta and pumonary artery
Large VSD below truncal valve allows mixing of L and R ventricular blood

32
Q

Transposition of the great vessels

A

Blue baby

Conotruncal septum fails to follow spiral course

33
Q

What are acyanotic heart lesions

A

Left to right shunting or problem with left side of heart

34
Q

What causes ASD

A

Septum primum and secundum defects

35
Q

What is the risk in patent ductus arteriosus

A

Bacterial endocarditis

36
Q

Treatment for PDA

A

Prostaglandin inhibitor (ibuprofen)

37
Q

Preductal coarctation of the aorta

A

Ductus arteriosus is persistent allowing blood flow

CR2 (34 decks)

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