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CP Test 4 > B4-046 CV Embryology > Flashcards

B4-046 CV Embryology Flashcards

1
Q

I think these cards make more sense if the first 20ish are done in order

A

happy studying :)

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2
Q

septation of the chambers

  1. septum primum grows toward endocardial cushions, narrowing
A

ostium primum

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3
Q

septation of the chambers

2) ostium secundum forms in […]

A

septum primum

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4
Q

septation of the chambers

3) septum secondum develops on right side of […]

A

septum primum

ostium secondum maintains R to L shunt

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5
Q

septation of the chambers

4) septum secundum expands and covers most of

A

ostium secundum

residual foramen is foramen ovale

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6
Q

septation of the chambers

5) remaining portion of septum primum forms one-way valve of

A

foramen ovale

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7
Q

septation of the chambers

6) septum primum closes against septum secundum sealing the […] after birth

A

foramen ovale

due to increased LA pressure and decreased RA pressure

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8
Q

what allows the foramen ovale to close shortly after birth?

A

increased LA pressure
decreased RA pressure

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9
Q

caused by failure of the septum primum and septum secundum to fuse after birth

A

patent foramen ovale

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10
Q

can lead to paradoxical emboli

venous emboli entering into arterial circulation

A

patent foramen ovale

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11
Q

ventricle formation

1) muscular interventricular septum forms, the opening is called [..]

A

interventricular foramen

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12
Q

ventricle formation

2) aorticopulmonary septum rotates and fuses with muscular ventricular septum to form

A

membranous interventricular septum

closes interventricular foramen

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13
Q

ventricle formation

3) growth of endocardial cushions separates atria from ventricles and contributes to […] and […]

2 thing

A
  • atrial septation
  • membranous portion of IV septum
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14
Q

most common congenital cardiac anomaly, usually occurs in membranous septum

A

ventricular septal defect

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15
Q

outflow tract formation

3 steps

A
  1. neural crest cell migration
  2. truncal and bulbar ridges spiral and fuse to form aorticopulmonary septum
  3. forms ascending aorta and pulmonary trunk
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16
Q

conotruncal abnormalities associated with failure of neural crest cells to migrate

3

A
  • transposition of great arteries
  • tetralogy of fallot
  • persistent truncus arteriosus
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17
Q

what valves are derived from the endocardial cushions of the outflow tract?

2

A

aortic, pulmonary

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18
Q

what valves are derived from the fused endocardial cushions of the AV canal?

2

A

mitral, tricuspid

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19
Q

this embryonic structure gives rise to what adult structure?

truncus arteriosus

A

ascending aorta and pulmonary trunk

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20
Q

this embryonic structure gives rise to what adult structure?

bulbus cordis

A

smooth parts (outflow tract) of right and left ventricles

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21
Q

this embryonic structure gives rise to what adult structure?

primitive ventricles

A

trabeculated part of left and right ventricles

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22
Q

this embryonic structure gives rise to what adult structure?

primitive atrium

A

trabeculated part of left and right atria

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23
Q

this embryonic structure gives rise to what adult structure?

left horn of sinus venosus

A

coronary sinus

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24
Q

this embryonic structure gives rise to what adult structure?

right horn of sinus venosus

A

smooth part of right atrium

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25
Q

this embryonic structure gives rise to what adult structure?

endocardial cushion

3

A
  • atrial septum
  • membranous IV septum
  • AV and semilunar valves
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26
Q

this embryonic structure gives rise to what adult structure?

right common cardinal vein and right anterior cardinal vein

A

SVC

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27
Q

this embryonic structure gives rise to what adult structure?

posterior cardinal, subcardinal, and supracardinal veins

A

IVC

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28
Q

this embryonic structure gives rise to what adult structure?

primitive pulmonary vein

A

smooth part of left atrium

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29
Q

fetal circulation

blood entering the fetus through the umbilical vein is conducted via […] into IVC

A

ductus venosus

bypasses hepatic circulation

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30
Q

fetal circulation

most of the highly oxygenated blood reaching the heart via the IVC is directed through the […] into the left atrium

A

foramen ovale

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31
Q

fetal circulation

deoxygenated blood from the SVC passes through the RA -> RV -> pulmonary artery -> […] -> descending aorta

A

ductus arteriosus

shunt due to high fetal pulmonary artery resistance

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32
Q

right to left shunt congenital diseases

3

A
  • persistent ductus arteriosus
  • transposition of great arteries
  • tetralogy of fallot
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33
Q
  • early cyanosis “blue babies”
  • diagnosed prenatally or shortly after birth
  • require urgent surgical treatment
A

right to left shunt defects

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34
Q
  • truncus arteriosus fails to divide into pulmonary trunk and aorta
  • due to failure of aorticopulmonary septum formation
A

persistent truncus arteriosus

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35
Q

due to failure of aorticopulmonary septum to spiral

A

transposition of great arteries

36
Q
  • due to anterosuperior displacement of the infundibular septum
  • most common causes of early childhood cyanosis
A

tetralogy of fallot

37
Q

left to right shunt defects

3

A
  • ventricular septal defect
  • atrial septal defect
  • patent ductus arteriosus
38
Q
  • acyanotic at presentation
  • cyanosis may occur years later
A

left to right shunt defects

39
Q

the heart first starts beating on

A

day 22

week 4

40
Q

what two changes occur in the heart/vessels at birth?

A
  • septum primum pushes against the septum secundum (closing the foramen ovale)
  • ductus arteriosus closes
41
Q

blood in the [chamber] is highly oxygenated in the fetus

A

right atrium

42
Q

neural crest cells contribute to what structures?

2

A
  • conotruncal cushions
  • membranous portion of the IV septum
43
Q

connects the umbilical vein and inferior vena cava

A

ductus venosus

44
Q

returns deoxygenated blood to the placenta

A

umbilical artery

45
Q

[…] give rise to endothelial cells

A

angioblasts

46
Q

what heart layer do the coronary arteries arise from

A

epicardium

47
Q

inflow of early heart tube

A

sinus venosus

48
Q

outflow of early heart tube

A

truncus arteriosus/aortic sac

49
Q

the cardiogenic field is established in the splanchic mesoderm in response to what transcription factor?

A

NKX2.5

50
Q

lower levels of retinoic acid near the cranial heart tube specify

A

outflow tract and ventricle segments

51
Q

higher levels of retinoic acid near caudal heart tube specify

A

atrium and sinus venosus

52
Q

abnormal levels of retinoic acid may lead to adverse effects on

3

A
  1. specification
  2. anterior-posterior patterning
  3. cardiac neural crest cell population
53
Q

IV membranous septation is very closely linked to

A

outflow tract septation

aorticopulmonary septum

54
Q

neural crest cells contribute to the […] cushions

A

conotruncal

and membranous portion of IV septum

55
Q
  • “boot shaped heart”
  • decreased pulmonary vascular markings
A

tetralogy of fallot

56
Q

right ventricular hypertrophy leads to broad upturned cardiac apex

A

tetralogy of fallot

boot shaped heart

57
Q

what would you expect on EKG for tetralogy of fallot?

A
  • tall R waves- RVH
  • prominent P waves - RA englargement
  • Right axis deviation
58
Q

what would you expect on echo in tetralogy of fallot?

A
  • VSD
  • overriding aorta
  • RVH
  • maybe pulmonary stenosis
59
Q

VSD is in the […] part of the IV septum

A

membranous

60
Q

defining features of tetralogy of fallot

A
  • pulmonary stenosis
  • overriding aorta
  • VSD
  • RVH

maybe patent ductus arteriosus as well

61
Q

in TOF, pulmonary stenosis causes a […] shunt

A

right to left

62
Q

what can be given to keep the ductus arteriosus open?

A

prostaglandins

63
Q

what things close the ductus arteriosus?

A

NSAIDs
Endomethacin

prostaglandin antagonists

64
Q

if the ductus arteriosus is closed prenatally, blood is directed from the RV…

A

to the high resistance, fluid filled lungs

65
Q

why does the knee to chest position help with hypoxia?

3

A
  • increases systemic vascular resistance
  • decreases R to L shunt
  • pulmonary flow to lungs is increased
66
Q

risk factors for TOF

A
  • rubella
  • alcohol use
  • AMA
  • family hx
  • genetics
  • idiopathic
67
Q

Right to left shunt defects

3

A
  • TOF
  • transposition of great arteries
  • patent truncus arteriosus
68
Q

left to right shunt defects

3

A
  • ASD
  • VSD
  • patent ductus arteriosus
69
Q

obstruction defects

2

A
  • coarctation of the aorta
  • valvular stenosis or atresia
70
Q

early cyanosis

A

right to left defects

71
Q

acyanotic at presentation

A

left to right defects

72
Q

can result in left to right shunt disorders when pulmonary resistance approaches systemic levels and the shunt switches to right-to-left

A

eisenmenger syndrome

73
Q

ductus arteriosus closes after birth and eventually forms

A

ligamentum arteriosum

74
Q

the final growth of the IV septum is linked to

A

final septation of the truncus arteriosus

75
Q

extensions of the atrioventricular endocardial cushions form the

A

IV septum

76
Q

during the partitioning of the embryonic atrium into the right and left atria, two septa form three openings. List the order in which the septa and openings form.

A
  1. foramen primum in the septa primum
  2. foramen secundum in the septum primum
  3. foramen ovale in the septum secundum
77
Q

connects pulmonary trunk to the arch of the aorta

A

ductus arteriosus

78
Q

connect right atrium to left atrium

A

foramen ovale

79
Q

shunts a portion of left umbilical vein blood to the vena cave, bypassing portal circulation

A

ductus venosus

80
Q

what two structures allow blood to bypass the lungs during fetal development?

A

foramen ovale
ductus arteriosus

81
Q

extensions of the […] grow along the septum to close the foramen primum

A

endocardial cushions

82
Q

partition the outflow tract

A

conotruncal ridges

83
Q

4 defining features of TOF

A

Pulmonary artery stenosis
Right ventricular hypertrophy
Overriding aorta
VSD

PROVe

84
Q

due to abnormal spiraling during the septation of the truncus arteriosus

A

TGA

85
Q

results from failure of fushion of the atrial septum primum and secundum

A

patent foramen ovale

86
Q

boot shaped heart and decreased pulmonary vascular marking on CXR

A

TOF

signal RVH and pulmonary atresia

87
Q

will prevent the ductus arteriosus from closing and reestablish ductal patency if its already closed

A

prostaglandin E1

CP Test 4 (15 decks)

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