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Pediatrics > Cardiac Embryology > Flashcards

Cardiac Embryology Flashcards

1
Q

Fertilization occurs in

A

the ampullary region of the fallopian tube

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2
Q

Sperm + Oocyte

A

= Zygote  undergoes cell divisions

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3
Q

Reaches 2 cell stage about

A

30 hours post fertilization

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4
Q

4 cell stage at about

A

40 hours post fertilization

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5
Q

12-16 cell stage at about

A

72 hours (3 days)

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6
Q

Cells are called

A

Blastomeres

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7
Q

Cells are loosely arranged until

A

8 cell stage

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8
Q

cells have maximized contact with each other after

A

3rd cleavage

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9
Q

compaction

A

Cells separate into inner and outer cells.

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10
Q

Morula

A

16 cell stage

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11
Q

morula has defined

A

inner and outer cells

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12
Q

Inner cells =

A

inner cell mass (will become the embryo)

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13
Q

outer cells=

A

outer cell mass (will become the trophoblasts, which will be the placenta)

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14
Q

called blastocyst when

A

Fluid penetrates into the intercellular spaces of Inner
Cell Mass.  Spaces become a single cavity
 Blastocele

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15
Q

Blastocyst is comprised of

A

Trophoblast – outer covering
 Formed from cells of the outer cell mass.
 Cells flatten and eventually form the epithelial wall of the blastocyst
Blastocele – Internal fluid filled space
 Embryoblast – Inner cell mass
 Located at one pole

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16
Q

Trophoblast and part of inner cell mass will become

A

the placenta

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17
Q

Rest of inner cell mass will become

A

the embryo

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18
Q

Blastocyst remains free in the uterus for

A

2 days

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19
Q

implantation occurs

A

Around day 6 (after fertilization)

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20
Q

Trophoblastic cells over the embryoblast pole penetrate

A

between the epithelial cells of the uterine wall.

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21
Q

Blastocyst attaches to

A

uterine epithelium, and subsequently the endometrium

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22
Q

blastocyst oriented so

A

inner cell mass is near the endometrium

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23
Q

Blastocyst is partially embedded at

A

day 8

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24
Q

at day 8 blastocyst differentiates into

A

Syncytiotrophoblast – multi-nucleated, outer zone  no cell boundries
 Cytotrophoblast – mononucleated cells, inner layer  distinctcells
 Both layers become part of the chorion (one of the fetal membranes)

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25
Q

ICM differentiates into

A

Hypoblastlayer  Layer of small cuboidal cells adjacent to the blastocyst cavity
 Epiblastlayer  Layer of high columnar cells adjacent to amniotic cavity

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26
Q

blastocyst completely embedded at

A

Day 11-12

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27
Q

day 11-12 cells of Syncytiotrophoblast

A

penetrate deeper into endothelial lining of maternal capillaries

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28
Q

Syncytiotrophoblast capillaries are

A

congested and dilated
 Called Sinusoids
 Causes blood to flow through the trophoblastic system
 Beginning of the uteroplacental circulation

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29
Q

Cytotrophoblast proliferates to form:

A

Amnion
 Thin Protective membrane that surrounds the developing embryo.
 AmnioticCavity  Space, eventually filled with fluid.

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30
Q

Gastrulation – starts at

A

day 8

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31
Q

Gastrulation is the process for

A

establishing 3 germ layers
 ICM differentiates.  Ectoderm  Endoderm  Mesoderm These are the major embryonic tissues from which all tissues and organs of the body develop.

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32
Q

gastrulation starts with the formation of

A

he primitive streak on the epiblast

 By day 15-16, it is clearly visible as a narrow groove.

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33
Q

which cells migrate to primitive streak

A

Cells of the epiblast

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34
Q

source of germ layers

A

epiblast

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35
Q

Inner Cell Mass now called an______ as amniotic cavity starts to form

A

Embryonic Disc

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36
Q

Layer of cells of the inner cell mass closest to the amniotic cavity.

A

ectoderm

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37
Q

layers of inner cell mass that borders the blastocele.

A

endoderm

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38
Q

Lies inbetween the ectoderm and endoderm.

A

Mesoderm

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39
Q

Ectoderm Becomes:

A

Skin, teeth, mouth glands, nervous system, some

endocrine glands.

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40
Q

Endoderm Becomes:

A

Epithelium of digestive tract, respiratory system, bladder, vagina, urethra

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41
Q

Mesoderm Becomes:

A

All connective tissue, the muscular, skeletal, lymphatic, and circulatory systems.

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42
Q

Cardiovascular System appears in the middle of the

A

3rd week. At this point the embryo is no longer able to survive via diffusion alone.

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43
Q

The Cardiovascular System reaches

A

a functional state long before any of the other systems

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44
Q

Vascular system develops from a

A

simple symmetrical plexus, into an asymmetrical complex system of arteries, veins and capillaries.

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45
Q

The size of the embryonic heart in relation to the size of the embryo

A

is enormous compared to an adult heart in an adult size body.

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46
Q

progenitor heart cells Lie in

A

Epiblast. Adjacent to the cranial end of the primitive streak
 Move through the streak and into the splanchnic layer of the mesoderm and form around day 16-18

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47
Q

Primitive Heart Field (PHF)

A

horse-shoe shaped cluster of cells

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48
Q

PHF specified on both sides to become the

A

Atria, LV, RV, Conus Cordis and Truncus Arteriosus

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49
Q

secondary ear field consists of and shows up when

A

Conus and Truncus come from the Secondary Heart field and show up around Day 20-21

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50
Q

blood island and cardiac myoblasts come from

A

Progenitor Heart Cells

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51
Q

Blood islands unite and form

A

a horse-shoe shaped tube  Endothelial cell lined
 Surrounded by myoblasts. More blood islands appear bilaterally, parallel and close
to the midline.  Will form dorsal aortas.

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52
Q

Intraembryonic Celom (Body Cavity) Formed by the joining

A

small (initially isolated) spaces

which appear in the lateral mesoderm

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53
Q

Intraembryonic Celom (Body Cavity Bilateral cavities extend

A

cranially and fuse with each other forming a horseshoe-shaped cavity
 Eventually becomes the pericardial cavity

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54
Q

Heart development starts at the and occurs in

A

end of the 3rd week of gestation. the ventral region of the embryo, inferior to the foregut.

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55
Q

Scattered masses of angiogenic cells appear

A

in the mesenchyme derived from PHF

56
Q

blood islands occur in

A

ventral (in front of) the intraembryonic celom.

57
Q

Anterior part of the celom will develop

A

the pericardial cavity.

58
Q

Angiogenic cells form

A

clusters (Blood Islands) which increase in size and number. Acquire a lumen, unite and form a plexus of blood vessels

59
Q

, bilateral endocardial tubes develop from

A

plexus of blood vessels from blood islands

60
Q

The Endocardial tubes unite to form

A

a common tube

 Primitive Heart Tube

61
Q

the single heart tube starts to beat.

A

By Day 21-22

62
Q

Cells are added from the secondary heart field to the

A

cranial end of the tube

63
Q

If lengthening doesn’t occur, where outflow tract defects

come from

A

DORT, VSD, TOF, PA, PS

64
Q

Meanwhile, Other blood islands appear inferior to the endocardial tubes
 Eventually give rise to ______ and give rise to ______

A

dorsal aortas.  Will connect with the endocardial tubes  Establish the arterial end of the heart

65
Q

Other end of the future endocardial tubes will make contact with the

A

vitelline veins (via the sinus venosus) and establish a venous pole.

66
Q

newly formed heart tube starts to bend on day

A

23

67
Q

Cephalic part bends

A

ventrally, caudally, and to the right.

68
Q

Caudal part bends

A

dorsocranially, and to the left

69
Q

attaches to dorsal wall by

A

mesoderm

70
Q

Becomes the common outflow tract

A

Dorsal Aorta and Aortic Sac

71
Q

primitive RV

A

bulbis cordis

72
Q

primitive LV

A

primitive ventricle

73
Q

Divides atria from ventricles

A

atrioventricular sulcus

74
Q

Will form common atria

A

Paired Primitive Atria

75
Q

Eventually forms the coronary sinus and oblique vein of the LA

A

sinus venosus

76
Q

Heart undergoes a series of folding that leads to the

formation of the bulboventricular loop during

A

day 23- 28

77
Q

proximal 1/3 Bulbus Cordis Will form

A

trabeculated part of RV

78
Q

Junction between the ventricle and the bulbus cordis externally is the

A

bulboventricular sulcus

79
Q

bulboventricular sulcus

A

aka primary interventricular foramen

80
Q

Atrial portions of the Heart Tube dilate  Form

A

common atrium

81
Q

Atrium “climbs up” the ______ and takes the

A

dorsal pericardial wall  TakesAtrioventricularjunctionwithit

82
Q

Diverticula appear

A

Along front of endocardial tube

 Just proximally and distal to the primary interventricular foramen

83
Q

These diverticula expand

A

the capacity of the heart. Give them the densely trabeculated appearance

84
Q

The trabeculae inside the heart leads to

A

valves, chordeae tendinae, papillary muscles, and atrioventricular valves.

85
Q

Abnormalities in Cardiac looping, is responsible for cardiac defects

A

Ventricular inversion (corrected transposition), juxtaposition of the atrial appendages, and Double outlet right ventricle.

86
Q

the sinus venosus receives blood from the right and left sinus horns during

A

the 4th week

87
Q

each horn of the sinus venosus receives blood from three veins

A

Vitelline vein  Umbilicalvein  Common Cardinal vein

88
Q

Communication between sinus and atrium is

A

wide open

89
Q

Communication between sinus and atrium will eventually______ and is caused by

A

shift to the right. Caused by shift in blood in venous system  Occurs at about 4-5 weeks.

90
Q

Obliteration of the right umbilical vein and left vitelline vein  Occurs

A

5th week. Left sinus horn loses importance

91
Q

At week 10 the left common cardinal vein become and all that remains

A

obliterated

 All that remains of the left sinus horn is the oblique vein of the left atrium and the coronary sinus

92
Q

Shunt of blood left to right enlarges

A

right sinus horn

93
Q

Right horn and vein are the only communication

A

between the original sinus venosus and the atrium

 Forms the smooth walled part of the right atrium.

94
Q

Sinuatrial orifice (entrance to the common atrium) is flanked on each side

A

by valvular folds.

95
Q

left venous valves fuse with

A

the atrial septum

96
Q

Superior part of the right venous valve

A

disappears

97
Q

Inferior part of the right venous valve becomes

A

he valve of the inferior vena cava and the valve of the coronary sinus.

98
Q

During atrial septation, the left atrium begins

A

to form sprouts of the pulmonary veins that grow towards the lungs.

99
Q

Cardiac Septation

 Starts at _____ and lasts

A

Day 27

 Lasts 10 days (Day 27-37)

100
Q

the embryo grows from _____ to _______ during septation

A

5mm to 16-17mm

101
Q

During ventricular development, 2 important processes occur simultaneously, that result in the “chamberization” of the ventricles

A

Division of the AV Canal into a Right and Left AV orifice via the endocardial cushions
 VentricularSeptation

102
Q

Endocardial Cushions

 Develop in the

A

Atrioventricular and Conotruncal regions

103
Q

endocardial cushions assist in the formation

A

of the atrial and ventricular (membranous) septa, AV Canals, Valves, Aortic and Pulmonary Channels.

104
Q

Atrioventricular endocardial cushions appear at the AV Canal.

A

at the end of week 4

105
Q

The role of the endocardial cushions is to:

A

Form a barrier between the atria and ventricles  Right –left division of the canal
 The resulting canals are eventually occupied by the mitral and tricuspid valves.

106
Q

End of week 4

 The ventricular septum is formed by the

A

outgrowth of the muscular ridge at the interventricular foramen.

107
Q

he ventricular septum grows upward from the

A

apex of the heart to the base of the heart

108
Q

Interventricular foramen is the space above

A

the membranous septum

 Shrinks when the conus septum is complete

109
Q

Outgrowth of tissue from the endocardial cushion along the top of the muscular interventricular septum

A

closes the foramen

 Fuses with the abutting part of the conus septum.

110
Q

he paired atria fuse together for form a common atrium at day

A

27-28

111
Q

Atrial septation occurs ________ with ventricular septation

A

simultaneously and in cooperation

112
Q

Atrial septation also lasts approximately

A

10 days.

113
Q

Sickle-shaped crest grows from

A

the roof of the common atrium

114
Q

Sickle-shaped crest is first part of

A

Septum Primum

115
Q

septum primum extends

A

toward the endocardial cushions in the AV Canal.

116
Q

septum primum does not connect to

A

endocardial cushions. Leaves a space called the Ostium Primum

117
Q

Ostium Primum

 Formed by the opening between

A

he lower rim of the septum primum and the endocaridal cushions.

118
Q

Extensions of the endocardial cushions grow

A

along the edge of the septum primum, closing the Ostium Primum

119
Q

Before closure, Apoptosis (cell death) makes perforations in the ________ and forms the

A

upper part of the septum primum

 FormstheOstiumSecundum  Allows for blood flow to shunt from the right to the left

120
Q

Lumen of the Right Atrium expands (result of incorporation of the sinus horns)
 New crest-shaped fold appears called

A

SeptumSecundum

121
Q

septum secundum extends

A

downward to the septum in the AV canal

 Overlaps with the Ostium Secundum  RemainingholeiscalledtheForamenOvale

122
Q

By the 5th week opposing ridges

A

appear in the truncus

123
Q

Both cushions grow toward

A

the aortic sac

124
Q

cushions form

A

aorticopulmonary septum  Divides the truncus into aortic and pulmonary channels.

125
Q

Similar cushions appear along the right dorsal and left ventral walls of

A

conus cordis. Grow toward each other and distally  Unite with the truncus septum. Divides the conus into anterolateral portion (RV outflow) and posteromedial portion (LV outflow)

126
Q

Outflow Tract Septation – Day 29

A

Partitioning of the outflow tract
 Truncus Arteriosus – Aorta  Conus Cordis – Pulmonary
Artery
 Createdbyaseptumthat forms in the outflow tract from these swellings

127
Q

Each AV orifice is surrounded by

A

local proliferations of
mesenchymal tissue. vBlood hollows out and thins the tissue on the ventricular surface
 Valves form
 Remain attached to ventricular wall by muscular cords  Muscular tissue degenerates and is replaced by connective tissue over time.

128
Q

Semilunar Valves

A

Small tubercles found on main truncus swellings  Tubercles hollow out on the upper surface

129
Q

Day 1-2:

A

fertilization

130
Q

day 6-7

A

Implantation of blastocyst into uterine wall

131
Q

day 16-20

A

Appearance of Celom and Blood Islands

132
Q

Day 20

A

Endocardial tubes are present and begin fusing

133
Q

day 22

A

Main heart tube begins to beat

134
Q

day 23-38

A

Heart Folding

135
Q

day 27-37

A

Atrial and Ventricular septation and development

136
Q

Day 29

A

Outflow tract septation

137
Q

Day 55

A

complete

Pediatrics (14 decks)

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