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MSS - CV Exam 1 > Cardiorespiratory Development > Flashcards

Cardiorespiratory Development Flashcards

1
Q

mesoderm types

A

paraxial, intermediate, lateral plate

and cardiac type (sort of a fourth type)

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2
Q

cardiac mesoderm

A

goes to cranial portion of embryo

-in cardiogenic field

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3
Q

two folds

A

lateral and head tail

head tail fold pulls the cardiogenic region into thorax

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4
Q

cardiac crescent

A

mesoderm organized into two tubes

lateral fold puts two heart tubes together
-they fuse

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5
Q

endocardial tube

A

fusion of two tubes

gives rise to all of heart
-except fibrous skeleton and heart valves

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6
Q

blood flow in primitive heart?

A

caudal - venous

cranial - arterial

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7
Q

around day 22?

A

starts beating and actually contracts

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8
Q

differential of heart tube?

A

caudal > cranial

sinus venosus, atrium, ventricle, bulbus cordis

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9
Q

cardiac looping

A

ventricles grow rapidly, cause heart to fold

cranial - ventral, caudal, to the right
caudal - dorsal, cranial, to the left

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10
Q

sinus venosus

A

incorporated into right atrium as sinus venarum

major venous end of heart
-to right atrium

left sinus horn regresses

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11
Q

left sinus horn

A

forms coronary sinus

venous drainage of heart

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12
Q

left atrium smooth portion

A

from pulmonary vein

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13
Q

primitive atrium

A

lined with pectinate muscles

auricles of left and right atrium

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14
Q

sinus venarum

A

right atrium

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15
Q

primitive ventricle

A

only forms trabeculated portion of left ventricle

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16
Q

three regions of bulbus cordis

A

1 trabeculated part of right ventricle

2 conus cordia

3 truncus arteriosus

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17
Q

conus cordia

A

forms smooth walled outflow tracts of both left and right ventricles
-aortic vestibule of left V and conus arteriosus of right V

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18
Q

truncus arteriosus

A

forms the two great arteries

  • pulmonary trunk from right V
  • aortic artery from left V
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19
Q

blood flow through primitive heart?

A

sinus venosus
primitive atrium
**

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20
Q

partitioning of heart

A

where most of anomalies take place**
-starts around day 30

-forms septa

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21
Q

prenatal heart

A

needs to shunt blood away from developing lungs**

lungs not functioning, but they are highly vascularized

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22
Q

ductus arteriosus

A

arterial blood shunt

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23
Q

what diverts blood around right ventricle?

A

foramen ovale
ductus arteriosus

**these must close immediately at birth

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24
Q

osteum

A

means opening

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25
Q

step 1 partitioning

A

septum primum forms in common atrium

mostly fibrous

first partition - separates right and left atrium

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26
Q

step 2 partitioning

A

ostium primum forms

-eventually closes and will fuse with atrioventricular septum

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27
Q

steps 3 and 4 or partitioning

A

as ostium primum closing, second opening (ostium secundum) forces cell death in septum primum

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28
Q

step 5 partitioning

A

septum secundum forms within right atrium
-thick and muscular

forms interartial septum

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29
Q

step 6 partitioning

A

septum secundum is incomplete
-its foramen is foramen ovale

-original septum now referred to as valve of foramen ovale

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30
Q

prenatally and postnatally

A

pre-
high pressure right side
low pressure left side
blood shunted through foramen ovale

post-
lower pressure right atrium
higher pressure left atrium
valve of oval foramen closes

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31
Q

septum primum and septum secundum

A

will fuse

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32
Q

patent foramen ovale

A

septum primum never fuses to secundum

asymptomatic - it is closed, so it functions, but it just doesn’t fuse

pressure on right side of heart can open it up

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33
Q

bulboventricular flange

A

regresses and allows opening of atrioventricular canal

so RA and RV, LA and LV can communicate

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33
Q

bulboventricular flange

A

regresses and allows opening of atrioventricular canal

so RA and RV, LA and LV can communicate

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34
Q

endocardial cushion

A

superior and inferior and two lateral parts

superior and inferior will fuse (AV septum)
-left and right halves

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34
Q

heart valves

A

form from neural crest

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34
Q

interventricular septum

A

muscular portion from muscle of ventricle wall

membranous portion from endocardial cushions

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34
Q

conotruncal ridges

A

left and right

will fuse to form conotruncal septum

separates outflow tract of heart

it spirals**
caudally to cranial 180 degrees

34
Q

importance of spiral

A

so right ventricle - pulmonary trunk
and left ventricle - aorta

if doesn’t spiral - transposition of the great vessels**

34
Q

neural crest disorder?

A

heart valve issues

34
Q

cardiac defect

A

most common congenitally

34
Q

VSD

A

ventricle septal defects (hole in the heart ventricle)

in the interventricular septum

  • muscular type
  • membranous type (more common)

symptoms depend on size of hole

will get left-right shunting of blood

  • pressure higher on left side postnatally
  • increased pulmonary blood flow
  • decreased systemic blood flow
34
Q

ectopic cordis

A

body wall defect

thoracic wall doesn’t fuse

heart herniates and forms externally

35
Q

ASD

A

atrioseptal defect (hole in heart atrium)

osteum secundum - cell death

1 excessive resorption of septum primum - lose valve, can’t close foramen ovale
2 septum secundum doesn’t close

left to right shunting of blood

35
Q

endocardial cushions form?

A

AV septum
part of atrial septum (closes ostium primum)
membranous part of interventricular septum

35
Q

endocardial cushion defects

A

neural crest defects

results in:
1 persistent AV canal
2 ASD
3 VSD

35
Q

endocardial cushions form?

A

AV septum
part of atrial septum (closes ostium primum)
membranous part of interventricular septum

36
Q

pulmonary, aortic stenosis

A

narrowing of vessels

due to abnormal valves

36
Q

tetralogy of fallot

A

conal truncal ridges form and spiral - but don’t equally divide (large aorta and small pulmonary trunk)

four features always present**
1 pulmonary stenosis (narrowing)
2 overriding aorta (very large)
3 hypertrophy (right ventricle)
4 VSD (membranous)

right ventricle hypertrophy - because of pulmonary stenosis

one of most common causes of cyanosis in newborn

36
Q

transposition of the great vessels

A

conal truncal ridges don’t spiral

aorta on right side
pulmonary on left side

37
Q

persistent truncus arteriosus

A

conotruncal ridges fail to form

cyanotic infant

mixing of blood because aorta and pulmonary arteries are all together

38
Q

dextrocardia

A

pretty rare

right sided heart

39
Q

ectopic cordis

A

body wall defect

thoracic wall doesn’t fuse

heart herniates and forms externally

40
Q

di-george syndrome

A

chromosome 22 deletion
neural crest disorder

CATCH-22

Cardiac defects
Abnormal facial features
Thymic aplasia
Cleft palate
Hypocalcemia (parathyroid deficiency)
41
Q

one question on exam

A

from one of the questions on the development of vascular system slide*****

42
Q

two ways vessels form

A

vasculogenesis

angiogenesis

43
Q

vasculogenesis

A

de novo synthesis of brand new vessels

aortic arch arteries and cardinal veins

44
Q

angiogenesis

A

postnatally

sprouts from already formed

45
Q

VEG-F

A

main signalling molecule

signals mesoderm to form blood islands which becomes vessel

46
Q

fetal vasculature?

A

yolk sac
umbilical
fetus

47
Q

major arteries of fetus

A 
aortic sac
aortic arches (6 pairs)
dorsal aorta
48
Q

major veins of fetus

A

cardinal veins (anterior, posterior to common)
umbilical vein
vitelline vein

49
Q

yolk sac system

A

gone by week 12

-vitelline vein and vitelline artery

50
Q

placental system

A

two umbilical arteries (to placenta)

one umbilical vein (oxygenated back to heart)

51
Q

aortic arches

A

truncus arteriosus > aortic sac
aortic sac gives off 6 pairs (right and left)
form cranial to caudal in the neck

drain to dorsal aorta (left and right)
-thorax they fuse to form dorsal aorta

52
Q

what happens?

A

arch 1 regresses

dorsal aorta between 3 and 4 on L and R regresses
-forms cranial and caudal blood suppliers

right branch of dorsal aortic artery regresses

arch 1, 2 and 5 regress on L and R

arch 3 - forms common carotid artery L and R
arch 4 - forms right subclavian (right side) and arch of aorta (left side)
arch 6 - ductus arteriosus (second blood shunt) on left / right regresses

53
Q

arch 3

A

forms common carotid artery L and R

-main arteries to head and neck

54
Q

arch 4

A

forms right subclavian side (right)

forma aortic arch (left)

55
Q

arch 6

A

right regresses and left forms ductus arteriosus

56
Q

look at the final organization

A

in notes**

57
Q

ductus arteriosus

A

second blood shunt

  • blood from pulmonary trunk goes to aorta
  • so it skips lungs
58
Q

postnatally ductus arteriosus

A

closes, becomes ligamentous

ligamentum arteriosum

59
Q

recurrent laryngeal nerves

A

forms with aortic arch apparatus
-forms in neck and pulled to thorax by heart

given off by vagus nerve

at level of 6th arch to get to larynx

60
Q

right recurrent laryngeal nerve?

A

loops under right subclavian

61
Q

left recurrent laryngeal artery?

A

loops under aortic arch

under ductus arteriosus (from left 6th arch)

62
Q

patent ductus arteriosus

A

ductus arteriosus doesn’t close

-left to right blood shunt (from aorta to pulmonary system)

63
Q

coarctation of the aorta

A

constriction of aorta

preductal - proximal to ductus arteriosus
-infantile (at birth, bypass closes)

postductal - distal to ductus arteriosus

  • adolescent (intercostal arteries become huge)
  • get blood back to aorta
  • upper limb HTN, lower limb low BP
64
Q

retroesophageal right subclavian artery

A

right subclavian that passes posterior to esophagus

  • 4th aortic arach regresses
  • intersegmental forms subclavian - growth puts it behind

can cause dysphagia lusoria

65
Q

dysphagia lusoria

A

difficulty swallowing because of vessel

66
Q

double aortic arch

A

constrictive loop around esophagus

-will frequently see dysphagia

get a right and left aortic arch

67
Q

respiratory diverticulum

A

aka lung bud

forms lungs

68
Q

tracheoesophageal septum

A

between trachea and esophagus

formation of this septum is cause of fistula

69
Q

fistula

A

abnormal opening between two structures

70
Q

tracheoesophageal fistula

A

septum deviates through esophagus

  • proximal ends blindly
  • distal fistula ends in trachea

babies can’t eat, immediately regurgitate

stomach distended (full of air)

71
Q

larynx

A

upper portion of lung bud

72
Q

week 5 lungs

A

to primary bronchi

then secondary, tertiary, bronchioles, alveolar ducts

walls get progressively thinner

73
Q

pseudoglandular stage

A

week 5 - 16

lung not functional

have terminal bronchiole

74
Q

canalicular stage

A

week 16-26

survivability increases rapidly

have respiratory bronchioles (capable of air exchange)

have surfactant

75
Q

surfactant

A

if its there, you can survive!

76
Q

terminal sac stage

A

week 26 weeks to birth

capable of respiration

survivability increases rapidly

77
Q

alveolar stage

A

week 32 weeks to 8 years old

form alveolus

78
Q

respiratory distress syndrome

A

not enough surfactant

  • alveoli can’t open
  • too much surface tension

can give glucocorticoids to mother
-will stimulate surfactant

79
Q

fetal circulation

A

compare prenatnal and postnatal circulation

MSS - CV Exam 1 (14 decks)

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