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*USMLE Step 1, Organ Systems > Cardiovascular > Flashcards

Cardiovascular Flashcards

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USMLE® Step 1 flashcards
1
Q

Heart primordium

- Embryonic derivative

A

Splanchnic mesoderm

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2
Q

Heart primordium

- Chambers (5)

A 
[CRANIAL]
1. Truncus arteriosus
2. Bulbus cordis
3. Primitive ventricle
4. Primitive atrium
5. Sinus venosus
[CAUDAL]
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3
Q

Heart primordium

- Direction of blood flow

A

Caudal to cranial
- Embryonic venous systems (vitelline, cardinal, and umbilical veins) drain to sinus venosus, which the drains into primitive atrium

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4
Q

Heart primordium

- Direction of blood flow

A

Caudal to cranial
- Embryonic venous systems (vitelline, cardinal, and umbilical veins) drain to sinus venosus, which the drains into primitive atrium

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5
Q

Embryonic structure:
TRUNCUS ARTERIOSUS

Gives rise to:

A

Ascending aorta and pulmonary trunk

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6
Q

Embryonic structure:
BULBUS CORDIS

Gives rise to:

A

Smooth parts (outflow tracts) of L+R ventricles

Smooth part of L ventricle =
AORTIC VESTIBULE

Smooth part of R ventricle =
CONUS ARTERIOSUS

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7
Q

Embryonic structure:
PRIMITIVE VENTRICLE

Gives rise to:

A

Trabeculated parts of L+R ventricles

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8
Q

Embryonic structure:
PRIMITIVE ATRIUM

Gives rise to:

A

Trabeculated parts of L+R atria

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9
Q

Embryonic structure:
LEFT HORN OF SINUS VENOSUS

Gives rise to:

A

Coronary sinus

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10
Q

Embryonic structure:
RIGHT HORN OF SINUS VENOSUS

Gives rise to:

A

Smooth part of R atrium (SINUS VENARUM)

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11
Q

Embryonic structure:
PRIMITIVE PULMONARY VEIN

Gives rise to:

A

Smooth part of L atrium

Note - Smooth part of L atrium formed by incorporation of primitive pulmonary vein into L atrial wall

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12
Q

Embryonic structure:
RIGHT COMMON + CARDINAL VEINS

Gives rise to:

A

Superior vena cava (SVC)

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13
Q

Embryonic venous systems (3)

A

VITELLINE VEINS

  • From yolk sak
  • Give rise to VEINS OF PORTAL SYSTEM

UMBILICAL VEINS

  • From placenta
  • Degenerate

CARDINAL VEINS

  • From head/neck
  • Give rise to VEINS OF SYSTEMIC SYSTEM
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14
Q

Embryonic venous systems (3)

A

VITELLINE VEINS

  • From yolk sak
  • Give rise to VEINS OF PORTAL SYSTEM

UMBILICAL VEINS

  • From placenta
  • Degenerate

CARDINAL VEINS

  • From head/neck
  • Give rise to VEINS OF SYSTEMIC SYSTEM
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15
Q

Aorticopulmonary septation

A

NEURAL CREST CELL MIGRATION mediates division of the TRUNCUS ARTERIOSUS into the two great arteries:

  1. ASCENDING AORTA
  2. PULMONARY ARTERY (TRUNK)

Neural crest cells migrate to the TRUNCAL and BULBAR RIDGES where they cause the ridges to fuse and thereby form the AORTICOPULMONARY SEPTUM, which then twists/spirals and partitions the truncus arteriosus into the ascending aorta and pulmonary trunk.

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16
Q

Defect in aorticopulmonary septation

- Congenital heart disease (3)

A
  1. Transposition of the great vessels
    - Defective neural crest migration such that there is non-spiral development of the aorticopulmonary septum
  2. Persistant truncus arteriosus
    - Defective neural crest migration such that there is only partial division of the aorticopulmonary septum
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17
Q

Embryonic structure:
TRUNCUS ARTERIOSUS

Gives rise to:

A

Ascending aorta and pulmonary trunk

18
Q

Defect in aorticopulmonary septation

- Congenital heart disease (3)

A
  1. Transposition of the great vessels
    - Defective neural crest migration such that there is non-spiral development of the aorticopulmonary septum
  2. Persistant truncus arteriosus
    - Defective neural crest migration such that there is only partial division of the aorticopulmonary septum
  3. Tetralogy of Fallot
19
Q

Embryonic structure:
PRIMITIVE PULMONARY VEIN

Gives rise to:

A

Smooth part of L atrium

Note - Smooth part of L atrium formed by incorporation of primitive pulmonary vein into L atrial wall

20
Q

Defect in aorticopulmonary septation

- Congenital heart disease (3)

A
  1. Transposition of the great vessels
    - Defective neural crest migration such that there is non-spiral development of the aorticopulmonary septum
  2. Persistant truncus arteriosus
    - Defective neural crest migration such that there is only partial division of the aorticopulmonary septum
  3. Tetralogy of Fallot
21
Q

Embryonic/fetal development

- Pressure in R heart > L heart

A

Lungs (pulmonary circulation) are not fully functional. This creates increased vascular resistance in pulmonary arterial circulation, and increased pressure in R heart (which supplies pulmonary arterial circulation).

22
Q

Fetal erythropoiesis

- Sites (4)

A
  1. Yolk sac
  2. Liver
  3. Spleen
  4. Bone marrow

“Young Liver Synthesizes Blood”

23
Q

Primary site for O2 exchange in fetus?

A

Chorionic villi
- Umbilical vein is derived from villus vessels

CHORIONIC VILLI ARE DERIVED FROM FETAL (NOT MATERNAL) TISSUES!

24
Q

Fetal circulation

- Ductus venosus

A

Oxygenated blood conducted via umbilical vein bypasses the liver (hepatic circulation) and enters directly into the IVC (which drains into the RA) through the ductus venosus.

25
Q

Embryonic structure:
DUCTUS ARTERIOSUS

Gives rise to:

A

Ligamentum arteriosum

26
Q

Embryonic structure:
DUCTUS VENOSUS

Gives rise to:

A

Ligamentum venosum

27
Q

Embryonic structure:
FORAMEN OVALE

Gives rise to:

A

Fossa ovalis

28
Q 
Embryonic structure:
UMBILICAL ARTERIES (2)

Gives rise to:

A

Medial umbilical ligaments (2)

29
Q 
Embryonic structure:
UMBILICAL VEIN (1)

Gives rise to:

A

Ligamentum teres hepatis, which is contained in the falciform ligament

30
Q

Embryonic structure:
URACHUS (ALLANTOIS)

Gives rise to:

A

Median umbilical ligament

31
Q

Embryonic structure:
NOTOCHORD

Gives rise to:

A

Nucleus polposus

32
Q

Embryonic structure:
NOTOCHORD

Gives rise to:

A

Nucleus polposus

33
Q

Fetal development

- Maintenance of patent ductus arteriosus

A

PGE2, a vasodilator synthesized by placenta

34
Q

Fetal pulmonary arteries

A

Low PaO2 –> Chronic vasoconstriction of pulmonary arteries –> Fetal pulmonary arteries are HYPERTROPHIED (high fetal pulmonary arterial resistance)

When baby is born, 1st breath –> Increases PaO2 –> Decreases pulmonary arterial resistance

35
Q

Closure of ductus arteriosus

- Physiologic changes at birth (2)

A
  1. First breath increases O2
  2. Separation of the placenta removes the source of PGE2, which functioned to maintain a patent ductus arteriosus during fetal development
36
Q

Medication that helps close PDA

A

Indomethacin

37
Q

Medication that helps maintain PDA

A

Prostaglandin E1 and E2

38
Q

Medication that helps maintain PDA

A

Prostaglandin E1 and E2

39
Q

Heart

- Anterior (sternocostal) surface

A

R ventricle

40
Q

Heart

- Inferior (diaphragmatic) surface

A

L + R ventricles

41
Q

Heart

- Posterior surface

A

L atrium

42
Q

Heart

- Apex

A

L ventricle

*USMLE Step 1, Organ Systems (3 decks)

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