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Cardio > Cardio Embryology (Khan ?'s only) > Flashcards

Cardio Embryology (Khan ?'s only) Flashcards

These are Khan's questions.

1
Q

Where is the first evidence of heart formation?

A

Splanchnic layer of lateral plate mesoderm (just said splanchnic layer in class)

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2
Q

What type of cells are within splanchnic mesoderm?

A

Cardiac Myoblasts

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3
Q

What are Cardiac Myoblasts derived from?

A

Cardiac Progenitor cells induced by underlying pharyngeal endoderm

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4
Q

What do blood islands in the Splanchnic layer form?

A

Endothelial lined tubes and transitory blood vessels, definitive blood cells come from mesoderm around aorta later from liver even later from bone marrow

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5
Q

Where does the future heart begin?

A

Cranial part of embryo, Buccopharyngeal membrane is landmark for this, it its just cranial to the buccopharyngeal membrane

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6
Q

What is the cardiogenic field?

A

Endothelial lined tubes and myoblasts formed by the previous blood islands, just cranial to the buccopharyngeal membrane

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7
Q

What is above the cardiogenic field?

A

Pericardial cavity which is derived from the embryonic cavity

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8
Q

What brings the heart into its natural anatomical position?

A

Cranial and caudal folding of the embryo brings the heart into the thoracic region

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9
Q

What forms the two endothelial lined tubes on both sides of the heart?

A

Blood islands produce angiogenic cells that dissolve into endothelial lined tubes, they eventually become endocardial regions of the heart

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10
Q

What happens to endothelial tubes?

A

Fold into the midline and fuse to form a single endocardial tube

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11
Q

What surrounds endocardial tube (cell type)?

A

Myoblasts that will become the myocardium of the heart

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12
Q

What surrounds endocardial tube and eventually disappears, & serves no function?

A

Cardiac Jelly

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13
Q

List the invaginations of the endocardial tube.

What will each of these invaginations ultimately form?

A

Truncus arteriosus -> aorta and pulmonary trunk, Bulbus cordis ->inf. Part of aorta and pulmonary trunk & adjacent parts of two ventricles, Primordial ventricles -> ventricles, primordial atria -> atria, sinus venosus-> Right horn becomes right atrium, left becomes coronary sinus

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14
Q

How does blood enter the primitive heart ? (Before Atria/Ventricle portioning)

A

Sinus venosus

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15
Q

How are the atria and ventricles partitioned?

A

Endocardial cushions grow towards each other, partitions atria from vessels and ventricles (produces a pattern with two holes penetrating septum that divides atria from ventricles)

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16
Q

Describe the formation of the AV valves

A

Dense mesenchyme and myoblasts present, cavitation occurs and cells die, some are replaced by connective tissue which becomes chordate tendinae

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17
Q

What direction is blood originally shunted in atria?

A

From right to left (mix of oxygenated and deoxygenated blood)

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18
Q

What is the crescent shape fold that grows down from the roof of the atria (initially in atrial Septation)? What related structure is formed?

A

Septum primum

Osteum primum

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19
Q

What happens after Osteum primum is formed at the top of the crescent shape fold?

A

Osteum secundum (maintains shunting after closure of osteum primum)

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20
Q

What is the second structure that grows downward from the roof of the atria?

A

Septum secundum

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21
Q

What develops in this structure?

A

Foramen ovale

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22
Q

What causes blood to be shunted from RA to LA, after heart is divided into R/L V/A?

A

Pressure in RA is higher than L, pushes blood through foramen ovale to LA

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23
Q

How is blood shunted after birth, and why?

A

Pressure changes , LA is higher and maintains valve closure if it already has not fused

24
Q

What is the function of the ductus arteriosus?

A

Short circuits lungs, sends oxygengated blood from RA directly into aorta

25
Q

What is the muscular part of the two ventricles derived from?

A

Develops from a ridge between the two ventricles

26
Q

What forms the membranous part of the two ventricles?

A

Cotruncal (spiral ) septum descending to meet the endocardial cushion in the muscular ridge

27
Q

What is probe patency of foramen ovale?

A

Foramen ovale did not fuse, no effect because it is a one way valve, present in 25% of pop.

28
Q

Describe the condition of excessive resorption of septum primum.

A

Causes L to R shunt

29
Q

Describe the condition of absence of septum secundum.

A

L to R shunt

30
Q

What is a common atrium?

A

No attempt at partitioning of atria at all, causes L to R severe shunting

31
Q

Describe defects in ventricular septum.

A

Occur in membranous part of septum:

  1. systemic blood goes back into pulmonary circuit, too much blood pushing through pulmonary trunk
  2. increased resistance
  3. hypertrophy of RV
  4. shunts blood from R to L
  5. cyanosis called Eisenmenger complex
32
Q

Defects in Septation of truncus arteriosus , describe Tetralogy of Fallot.

A

Aortic arch and pulmonary trunk are shifted to R
pulmonary trunk is smaller and aorta is much larger

*eisenmenger complex + cyanosis

33
Q

Describe persistent truncus arteriosus

A

No Septation of aorta and pulmonary trunk, only one vessel leaving heart

causes cyanosis
*always accompanied by membranous ventricular defect (otherwise would be a closed system)

34
Q

Describe transposition of the great vessels.

A

Open into wrong chambers; causes R to L shunt and cyanosis occurs when AP septum fails to spiral

35
Q

Describe patent ductus arteriosus.

A

Blood goes into pulmonary trunk and gets into aorta from ductus arteriosus, can lead to eisenmenger syndrome leads to cyanosis more quickly than atrial defects

36
Q

Before birth the ductus arteriosus provides communication between what two structures?

A

Pulmonary Trunk and Aorta

37
Q

The initial two endothelial tubes that fuse to form the heart develop in what layer?

A

Splanchnic mesoderm

38
Q

Before birth, what structure overlaps the ostium secundum and appears to close it?

A

Septum secundum

39
Q

What causes tetralogy of fallot?

A

A misaligned AP septum

40
Q

Which of the aortic arches gives rise to the pulmonary arteries?

A

6th aortic arch

41
Q

Just before birth, all blood from the placenta goes through the liver. Describe its course.

A

Passes directly through via the ductus venosus

42
Q

How many aortas does a developing embryo have ?

A

Two pairs of dorsal aortas

43
Q

How does blood exit the heart?

A

Through an aortic sac ( has L and R divisions, forms 6 arches)

44
Q

Describe the aortic arches

A

Anteriorly they communicate with a horn like structure and loop out from dorsal aorta to this structure

45
Q

What does arch 3 give rise to? 4? 6?

A

3 -> common carotid and internal carotid a.

4-> R. subclavian, and arch of aorta from l. common carotid to l. subclavian,

6-> L and R pulmonary arteries and ductus arteriosus

46
Q

Why is the r. recurrent laryngeal n superior to the L?

A

A portion of aortic arch 6 disappears on the R side, on the L side the ductus arteriosus remains

47
Q

What is preductal coartication of aorta?

A

Narrowing of aorta prior to the ductus arteriosus, => ductus arteriosus remains patent, if post ductal ductus arteriosus atrophies

48
Q

What forms the common cardial vein?

A

Anterior and post. Cardinal veins, the common cardinal vein also receives umbilical veinand two vitelline veins, sinus venosus receives common cardinal v.

49
Q

What do the vitelline veins form?

A

Hepatic sinusoids, hepatic portal v. , hepatic veins, hepatic IVC

50
Q

What happens to the R. umbilical vein?

A

Atrophies

51
Q

What does the L. umbilical vein extend through the liver as?

A

Ductus venosus

52
Q

What does the sinus venosus become?

A

Hepatic portion of IVC (later he says that the vitelline veins actually forms this, somewhat misleading from his lecture)

53
Q

What do the sup. + inf. parts of vitelline veins form?

A

Hepatic and renal veins, respectively

54
Q

Describe pre-natal circulation.

A

Path 1: Umbilical v-> ductus venosus -> IVC -> foramen ovale -> LA,LV -> aorta -> systemic -> umbilical a.

Path 2:
SVC -> RA -> RV -> Aorta (mixes oxygenated from path 1 with deoxygenated ) -> systemic -> umbilical a.

55
Q

What does the umbilical arteries and veins atrophy to?

A

Umbilical v. -> ligamentum teres hepatis Umblicial artery -> medial umbilical ligaments

Cardio (26 decks)

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