Cardiac embryology and congenital heart disease 1 Flashcards

1
Q

Early cardiogenesis

male and female gametes fuse –> ____

A

fertilization

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2
Q

Early cardiogenesis

Unicellular zygote goes through a _____ resulting in ___ –> morula

A

series of cleave

increased number of cells

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3
Q

Early cardiogenesis

Morula transforms into a ___

A

blastocyst

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4
Q

early cardiogenesis process

A

1) male/female gamete fuse –> fertilization
2) unicellular zygote undergoes many cleavages –> morula
3) morula transform into a blastocyst

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5
Q

3 components of blastocyst

A

1) outer cell mass = trophoblast
2) inner cell mast = embryoblast
3) central cavity = blastocyst cavity

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6
Q

what is outer cell mass in blastocyst called

A

trophoblast

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7
Q

what is inner cell mass in blastocyst called

A

embryoblast

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8
Q

2 layers of embryoblast

A

external = epiblast

internal = hypoblast

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9
Q

what do the 2 layers of embryoblast form?

A

flat disc = embryonic disc

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10
Q

where are the precardiac cells located in blastocyst stage?

A

located in epiblast on either side of primitive streak

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11
Q

what happens to epiblast cells in blastocyst stage

A

epiblast cells invaginate down thru prim streak

–> intraembryonic mesoderm

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12
Q

what do epiblast cells become after migrating through prim treak

A

intraembryonic mesoderm

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13
Q

how many layers in gastrula

what are the layers called

A

3 layers
1) external = ectoderm

2) middle = mesoderm
3) internal = endoderm

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14
Q

where are precardiac cells in gastrula

A

precardiac cells in mesoderm

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15
Q

what happens to precardiac cells in gastrula

A

precardiac cells migrate cephalically (toward head)

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16
Q

when does heart begin developing in embryo?

A

day 16

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17
Q

where are pre-cardiac cells on day 16

A

in the cardiogenic area near cranial end

derived from mesodermal cells

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18
Q

what is cardiogenic area derived from

A

mesoderm

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19
Q

what happens to precardiac cells in cardiogenic area

on day 19

A

migrate so now ventral to forebrain and foregut

coalesce to form 2 endocardial tubes

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20
Q

when do precardiac cells in cardiogenic area begin to form 2 endocardial tubes

A

day 19

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21
Q

what happens after heart tube forms on day 19

A

heart tubes become lined with endothelial cell

splanchnic mesoderm surrounds heart tube

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22
Q

what surrounds heart tubes on day 19

A

splanchnic mesoderm

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23
Q

what happens by day 21-22

A

tubes fuse together due to cephalic and lateral folding of embryo –> primitive hear ttube

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24
Q

when does heart begin to beat

A

DAY 22

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25
Q

WHAT HAPPENS AFTER PRIMITIVE heart tube formed?

A

pre-loop

loop

post-loop with septation

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26
Q

when does pre-loop stage form?

A

day 22

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27
Q

what happens in preloop stage on day 22

A

AV sulcus becomes the intraventricular septum

primitive ventricle = trabeculated portion of LV

proximal portion of bulbus cordis = trabeculated portion of RV

blood flow

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28
Q

what creates the primitive ventricle

when happens?

A

day 22

comes from trabeculated portion of LV

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29
Q

what is the proximal portion of Bulbus Cordis

A

trabeculated portion of RV

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30
Q

what is the primordium of the trabeculated portion of RV also correspond to

A

proximal Bulbus cordis

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31
Q

when does blood flow begin

A

day 22

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32
Q

what happens to inner and outer layers of hear ttube

A

inner layer = endothelial lining –> endocardium

outer layer = mesoderm (epimyocardium) –> myocardium and epicardium

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33
Q

what is in between the inner and outer layer of heart tube

A

cardiac jelly (important in looping and septation)

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34
Q

what happens in looping stage during day 23-25

A

cardiac tube grows longitudinally at faster rate than rest of embryo

heart loops to right of embryo (D-loop)

35
Q

what direct does heart loop?

A

to the right of embryo (D-loop)

36
Q

how do primitive atria rotate during looping?

A

rotate posteriorly behind the RV and LV

37
Q

how does axis of AV canal change with looping?

A

initially cephalic to caudal

–> becomes posterior to anterior

38
Q

what happens in early post-loop stage

day 26-28

A

ventricles and atria now aligned

SEPTATION BEGINS

ventricular septum visible as outpouching

39
Q

when does septation begin?

A

day 26-28

post-loop

40
Q

what is anatomic correlate of bulbis cordis

A

trabeulated portion of RV

41
Q

what is anatomic correlate of primitive ventricle

A

trabeculated portion of LV

42
Q

what is anatomic correlate of conus

A

infundibula (outflow tract) of both ventricles

43
Q

what is anatomic correlate of primtiive atria

A

left and right atrial appendages

44
Q

what is anatomic correlate of truncus

A

aortic and pulm valves

aoscending aorta

pulm trunk

45
Q

how does blood flow begin?

A

day 25

1) blood enter heart tube THROUGH SINUS VENOSUS VIA 3 SETS OF VEINS

1) umbilical vein (brings O2 blood) and disappears after birth
2) vitelline vein (brings nutrients from yolk sac)
3) cardinal vein (drains waste)

46
Q

what is sinus venosus

A

where blood flow initially enters heart tube thru 3 veins

47
Q

what is fxn of umbilical vein

A

drains blood from placenta thru sinus venosus

48
Q

what is fxn of vitelline vein

A

drains blood from yolk sac thru sinus venosus

49
Q

what is fxn of cardinal vein

A

drains blood from embryo thru sinus venosus

50
Q

how do systemic veins develop

A

1) sinus venosus communicate with primitive atria via SA orifice
2) right and left sinus venous valve prevent flow reversal into sinus venosus w/ atrial contraction

51
Q

what are components of right sinus venous valve

A

1) eustachion valve
2) IVC
3) thebsian vlave (guards coronary sinus)

52
Q

what happens to left sinus venous valve

A

absorbed into atrial septum

53
Q

what is anatomic correlate of right umbilical vein

A

disappears

54
Q

what is anatomic correlate of left umbilical vein

A

distal –> ductus venosus (disappear after birth)

55
Q

what is anatomic correlate of right vitelline vein

A

distal –> superior mesenteric artery

proximal –> suprahepatic IVC

(contribute to hepatic sinusoids)

56
Q

what is anatomic correlate of left vitelline vein

A

contribute to hepatic sinusoids

57
Q

what is anatomic correlate of right cardinal vein

A

SVC
brachiocephalic vein
inominate veins

58
Q

what is anatomic correlate of left cardinal vein

A

ligament of Marshall

59
Q

what is anatomic correlate of left sinus horn skip

A

distal –> ligament of Marshall

proximal –> coronary sinus

60
Q

what is anatomic correlate of right sinus horn skip

A

absorbed into RA

61
Q

how do pulm veins develop

A

part of splanchnic plexus –> pulm venous plexus –> pulm veins

62
Q

how does common pulm vein develop

A

endothelail projection from LA connects pulm venous plexus

63
Q

how does right and left pulm veins develop

A

lumen forms and common vein branches

64
Q

when does atrial and ventricular septation occur

A

days 28-42

65
Q

when does great artery form

A

days 35-56

66
Q

great artery formation

septation of conus

A

1) in early post-loop stage, 4 masses on inside wall of conus moving inward
- -> dextrodorsal and sinstroventral conal crests

2) conal crests (moving down) fuse with ventricular septum (moving up) caudally

67
Q

great artery formation

what are the 4 masses on inside wall of conus in septation of conus

A

dextrodorsal and sinistroventral conal crests

68
Q

great artery formation

septation of truncus

A

1) mass in truncus

dextrosuperior and sinistroinferior truncal swelling

69
Q

great artery formation

septation of truncus
what does right intercalated swelling become

A

noncoronary aortic cusp

70
Q

great artery formation

septation of truncus
what does left intercalated swelling become

A

anteiror pulm cusp

71
Q

great artery formation

spiraling of septation

A

forms in spiral
aorticopulm septum originates as extracardiac septum in aortic sac and separates aorta and pulm

superioventral conal crest continuous with sinistroinferior truncal swelling

dextrodorsal CC continuous with dextrosuperior truncal swelling

72
Q

a

A

a

73
Q

a

A

a

74
Q

view of pulmonary artery

at great artery level

A

pulm artery is posterior and to left

aorta anterior and to right

75
Q

view of pulmonary valve

at semiunar valve level

A

pulm valve is anterior and to left

aorta valve posterior to right

76
Q

view of pulmonary infundibulum

at infundibular level

A

pulm infundibulum is anterior and to right of aortic infudnibulum

aortic infundibulum is now posterior to left

77
Q

where do ascending and descending aorta come from

A

ascending aorta = aortic sac

descending aorta = left dorsal

78
Q

what is anatomic correlate of 1st aortic arch

A

1st to disappear

maxillary and external carotid arteries

79
Q

what is anatomic correlate of 2nd aortic arch

A

disappears

dorsal –> stapedial artery

80
Q

what is anatomic correlate of 3rd aortic arch

A

carotid arteries

81
Q

what is anatomic correlate of 4th aortic arch

A

right –> right brachiocephalic/right subclavian

left –> transverse aortic arch

82
Q

what is anatomic correlate of 5th aortic arch

A

disappears

83
Q

what is anatomic correlate of 6th aortic arch

A

prox, right –> prox right pulm artery

prox, left –> prox left pulm artery

distal, left –> ductus arteriosus