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0. Step Ib > Cardio Embryology + congenital tumors > Flashcards

Cardio Embryology + congenital tumors Flashcards

1
Q

Truncus arteriosus gives rise to

A

ascending aorta + pulmonary trunk

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2
Q

bulbus cordis gives rise to

A

smooth parts (outflow) tracts of L/R ventricles

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3
Q

primitive atria gives rise to

A

trabeculated part of L/R atria

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4
Q

primitive ventricle gives rise to

A

trabeculated part of L/R ventricles

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5
Q

primitive pulmonary vein gives rise to

A

smooth part of L atrium

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6
Q

L horn of sinus venosus (SV) gives rise to

A

coronary sinus - resides in the atrioventricular groove on the posterior aspect of the heart

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7
Q

R horn of sinus venosus (SV) gives rise to

A

smooth part of R atrium

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8
Q

R common cardinal vein and R anterior cardinal vein gives rise to

A

SVC

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9
Q

embryonic structures that give rise to smooth parts of the heart only

A

bulbus cordis - smooth parts (outflow) tracts of L/R ventricles
primitive pulmonary vein - smooth part of L atrium
R horn of sinus venosus (SV) - smooth part of R atrium

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10
Q

embryonic structures that give rise to trabeculated parts of the heart only

A

primitive atria - trabeculated part of L/R atria

primitive ventricle - trabeculated part of L/R ventricles

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11
Q

septum primum forms what

A

foramen secundum as it grows towards the endocardial cushions, thereby narrowing foramen primum

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12
Q

septum secundum forms what

A

forms foramen ovale as it covers most of foramen secundum

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13
Q

foramen ovale is comprised of these two structures

A

septum primum

septum secundum

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14
Q

ventricular septum is comprised of these two muscle types

A

smooth (upper) + muscular (lower) parts

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15
Q

what forms the aorticopulmonary septum? What does this go on to form?

What happens if this sequence malfunctions?

A

neural crest + endocardial cell migrations -> truncal + bulbar ridges spiral and fuse -> articopulmonary septum -> ascending aorta + pulmonary trunk

malfunction:

  • > transposition of the great vessels
  • > tetraology of fallot
  • > persistent truncus arteriosus
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16
Q

aortic valve is derived from..

A

endocardial cushions

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17
Q

mitral valve derive from…

A

fused endocardial cushions of the AV canal

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18
Q

pulmonary valve is derived from..

A

endocardial cushions

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19
Q

tricuspid valve is derived from…

A

fused endocardial cushions of the AV canal

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20
Q

valves that derive from fused endocardial cushions of the AV canal…

A

mitral + tricuspid valves

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21
Q

valves that derive from endocardial cushions

A

aortic + pulmonary valves

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22
Q

fetal hemoglobin composition, HgF

A

α2γ2

also due to β thalassemia

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23
Q

adult hemoglobin composition, HgA1 (major)

A

α2β2

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24
Q

HgH composition

A

β4, due to alpha-thalassemia (when 3 copies are deleted, causes hemolysis with hepatosplenomeagly)

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25
adult hemoglobin composition, HgA2 (minor)
α2δ2
26
Hemoglobin Barts
γ4, due to alpha-thalassemia (when all 4 copies are deleted; causes hydrops fetalis)
27
ductus venosus connects?
umbilical vein (O2 blood) to IVC; bypasses the liver
28
patent ductus arteriosus connects?
pulmonary artery to aorta
29
foramen ovale connects
L/R atria
30
fossa ovalis was once the....
foramen ovale
31
ligamentum arteriosum was once the
ductus arteriosus
32
ligamentum teres hepatis was once the..
umbilical vein
33
umbilical arteries derive from
medial umbilical ligaments
34
ligamentum venosum was once the...
ductus venosus
35
urachus-median umbilical ligament was once the
allantois
36
nucleus pulposus was once the
notochord
37
SA/AV supplied by..
RCA
38
R dominant circulation
PDA arises from RCA
39
L dominant circulation
PDA arises from LCX
40
Peak of coronary blood flow
early diastole
41
most posterior part of heart
LA
42
artery that supplies the lateral and posterior walls of LV
LCX
43
artery that supplies the - anterior 2/3 of interventricular septum - anterior papillary muscle - anterior surface of L ventricle
LAD
44
artery that supplies the R ventricle
Acute marginal artery from teh RCA
45
artery that supplies the posterior 1/3 of the interventricular septum and posterior walls of the ventricles
PDA
46
what maintains CO during early stages of exercise? | late stages?
early: HR, SV late: HR (SV plateaus, duh)
47
what shortens diastole time?
increased HR/tachycardia
48
does hyperthyroidism increase or decrease pulse pressure?
increase
49
does aortic stenosis increase or decrease pulse pressure?
decrease
50
does aortic regurgitation increase or decrease pulse pressure?
increase
51
does cardiac tamponade increase or decrease pulse pressure?
decrease
52
does cardiogenic shock increase or decrease pulse pressure?
decrease
53
does arteriosclerosis increase or decrease pulse pressure?
increase
54
does obstructive sleep apnea increase or decrease pulse pressure?
increase (due to increased sympathetic tone)
55
does exercise increase or decrease pulse pressure?
increase
56
does anemia increase or decrease pulse pressure?
increase
57
does advanced heart failure increase or decrease pulse pressure?
decrease
58
does cardiac tamponade increase or decrease pulse pressure?
decrease
59
normal EF? | how does EF change with systolic heart failure? diastolic heart failure?
normal EF: >55% systolic - decreases diastolic - normal
60
when does normal physiologic splitting occur?
during INSPIRATION (drop in intrathoracic P -> increase VR -> increases RV stroke volume -> increase RV ejection time -> delayed closure of pulmonic valve)
61
when and why does wide splitting occur? 2
conditions that delay RV emptying - pulmonic stenosis - RBBB occurs regardless of breath
62
when and why does fixed splitting occur?
ASD (L->R shunt) increases RV volumes -> pulmonic valve closure is greatly delayed occurs regardless of breath
63
when does paradoxical splitting splitting occur?
conditions that delay LV emptying - aortic stenosis - LBBB expiration: split inspiration: P2 closes later and moves closer to A2, thereby eliminating the split
64
infantile coarctation of the aorta where does it occur? associated disease?
proximal to ductus arteriosus association: Turner syndrome
65
persistent truncus arteriosus where does it occur? type of shunt formed? association?
joined pulmonary trunk and aorta, most patients have concurrent VSD right-to-left shunt association: Digeorge (22q11)
66
endocardial cushion defects are usually associated with? Give some examples
Downs syndrome ASD VSD AV septal defect
67
Eisenmenger's syndrome Pathophysiology?
Uncorrected L-> R shunt (VSD, ASD, PDA) - -> elevated pulmonary artery (PA) flow and pressures - -> PA hypertrophy + RVH - -> shunt switches to R->L shunt - -> cyanosis, clubbing, polycythemia
68
adult coarctation of the aorta where does it occur? signs and sx?
distal to ductus arteriosus signs/symptoms: rib notching, lower extremity pulses weaker than upper
69
total anomalous pulmonary venous return (TAPVR)
R->L shunt pulmonary veins drains into the R heart (SVC, coronary sinus, etc), often has concurrent ASD and PDA to allow for R-> L shunting to maintain CO
70
aortic regurgitation and dissection - association?
Marfan's syndrome
71
VSD type of shunt? sx? association?
L->R shunt harsh holosystolic murmur w/ increased pulmonary vascularity and mid diastolic rumble; thrill Down syndrome
72
Tricuspid atresia what is it? type of shunt? what is required for viability?
missing tricuspid valve, hypoplastic RV R->L shunt requires concurrent ASD and VSD for viability
73
transposition of great vessels what is it? type of shunt? what is required for viability? associations?
aorta and pulmonary artery are switched R->L shunt needs VSD, PDA, or PFO for survival association: infant of diabetic mother
74
ASD type of shunt? signs and sx? associations?
L->R shunt signs/sx: fixed split S2, loud S1, mid systolic pulmonary ejection murmur (patients usually present w/ exercise intolerance) association: Down syndrome
75
tetralogy of fallot what is it? type of shunt? signs and sx? associations?
pulmonary infundibular stenosis, RVH (boot shape), overriding aorta (emerges from both L/R ventricles), VSD R->L shunt signs/symptoms: tet spells, squatting relieves cyanosis; harsh systolic ejection murmur association: Digeorge 22q11
76
PDA type of shunt? signs and sx? treatments (open/close)? associations?
L->R shunt sx: continuous machine-like murmur treatment: indomethacin to close, PGE1, PGE2 keeps open association: rubella

0. Step Ib (19 decks)

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