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Anatomy > Cardiovascular Embryology > Flashcards

Cardiovascular Embryology Flashcards

1
Q

What are the cardiac lineages of the developing heart?

A

Primary heart field from intra embryonic mesoderm forms atria and left ventricle
Secondary heart field from pharyngeal splanchnic mesoderm forms most of the right ventricle and outflow tracts

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2
Q

What are the different layers in early development of the heart?

A

Formation of 2 endocardial tubes stimulated by the vascular endothelial growth factor gives the endocardium
Cardiomyocyte progenitors surround the tubes and form the myocardium
Mesothelial cells surrounds the outside and gives epicardium

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3
Q

What are the compartments of the heart tube in later development?

A

Sinus venosus, confluent of left and right sinus horns forms the smooth wall portion of right atrium
Primordial atrium forms pectinated portion of left and right atria
Primordial ventricle form trabeculated portion of left ventricle
Bulbus cordis forms right ventricle
Outflow tract made of conus arteriosus incorporated between ventricles and truncus arteriosus gives ascending aorta and pulmonary artery.

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4
Q

How does the four chambers heart form?

A

@ day 23 heart elongate and bends into C shaped structure
Further elongation and rapid growth allow heart to becomes a S-shaped structure
Reminder development is remodeling of the chambers and formation of septa and valves as well as vasculature and cardiac conducting system

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5
Q

What are the 3 major septa formed?

A

Interatrial septum—->separation of atria
Interventricular septum—->Separation of ventricles
Aorticopulmonary septum or spiral septum—->separation of outflow tracts, separation of aorta and pulmonary trunks

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6
Q

What are the steps in the partition of the heart ?

A

Occurred from weeks 4-8
Division of the AV canal by formation of the endocardial cushions which separates left and right AV canals
Partitioning of the atria
Partitioning of the ventricles

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7
Q

What are the characteristics of the partitioning of the atria?

A

Septum primum a crescentshaped mebrane that grows from the roof of the primordial atrium divides right and left atria leaving a large opening foramen primum
Foramen primum allows shunting of blood from right to left
and later is closed off by septum primum thru fusion with AV septum
Dorsal part of septum goes thru apoptosis and forms foramen secundum
Septum secundum grows towards AV septum and leaves opening=foramen ovale
At birth pressure changes closed foramen ovale and secundum
Cranial part of septum primum regresses and caudalpartbecomes valve of foramen ovale and prevents left to right shunting of blood
3 months after birth both septum fuses leaving oval fossa

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8
Q

Characteristics of sinus venosus changes?

A

Initially venous venosus opens in the middle of the primordial atrium
Left and right horns of primordial atrium receives systemic venous blood in equal proportions
Venous system remodeling causes systemic venous blood to return mostly to the right sinus horn
The left sinus horn regresses and becomes the coronary sinus

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9
Q

What are the characteristics of changes in the pulmonary vein?

A

Primordial vein develops as an outgrowth of the primordial atrium
Vein becomes incorporated in the left atrium wall as atrium expands and forms the smooth walled portion of the left atrium

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10
Q

What are the characteristics of the partitioning of the ventricles?

A

@ around 4 weeks bulboventricular sulcus forms muscular interventricular septum
Myocardium thickens and forms ridges or trabeculae
Muscular interventricular septum does not fully separated right and left ventricles-interventricular foramen
Formation of the aorticopulmonary septum separates pulmonary trunk and aorta
Aorticopulmonaryseptumfuses with membranous ventricular septum to close interventricular foramen by fusing with muscular interventricular foramen
Pulmonary trunk with right ventricle
Aorta with left ventricle

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11
Q

What are the characteristics of development of pacemaker and conduction system

A

In primordial heart myocytes initially contract spontaneously
Pacemaker activity taken over by a cluster of cells in the SA region
After SA node formation AV junction region begin to form secondary pacemaker region AV node
Formation of AV node accompanied with formation of Bundle of HIS
Purkinje fibers spread out from bundles branches

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12
Q

What are some non cyanotic heart developmental defects?

A

Ventricular septal defect
Ostium secundum defect
Cor triloculare biventriculare-complete absence of atrial septum
Aortic stenosis-fusion of aortic valve cusps

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13
Q

What are the characteristics of ventricular septal defect?

A

Involves membranous portion of the septum

Most common congenital cardiac malformation

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14
Q

What are the characteristics of ostium secundum defect?

A

Large opening between the atria
Due to:
excessive resorption of septum primum
Inadequate development of septum secundum

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15
Q

What are some cyanotic developmental heart defects?

A

Tetralogy of Fallot
Transportation of great vessels-spiral septum runs straight down
Persistent truncus arteriosus-truncal and bulbar ridges fail to fuse
Tricuspid atresia-absence or fusion of the tricuspid valve
Hypoplastic left heart syndrome

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16
Q

What are the characteristics of Tetralogy of Fallot?

A

Most common cyanotic CHD
Pulmonary infundibular stenosis (boot shaped heart)
Right ventricular hypertrophy (bulging of the acute margin)
Overriding aorta
Ventricular septal defect

17
Q

What are the 2 mechanisms of blood vessels formation?

A

Vasculogenesis

Angiogenesis

18
Q

What is vasculogenesis?

A

Formation of new blood vessels through the differentiation of angioblasts
Larger blood vessels are formed this way

19
Q

What is angiogenesis?

A

Formation of new blood vessels through budding and sprouting from existing vessels.
Smaller blood vessels formed this way

20
Q

What is the outcomes of the paired dorsal aorta?

A

Cranial end is pulled ventrally and formed the first aortic arch
Fuse dorsally to form a single dorsal aorta

21
Q

What are the outcomes of the 1st and 2nd arches?

A

Regress as later arches are formed
1st arch becomes ECA
2nd arch form stapedial artery

22
Q

What is the outcome of the 3rd arch?

A

Left and right CCA

Part of the internal carotid

23
Q

What is the outcome of the 4th arch?

A

Right side becomes proximal segment of right subclavian

Left side forms ascending part of the aorta (aortic arch)

24
Q

What is the outcome of 5th arch?

A

Never formed

25
Q

What is the outcome of the 6th arch?

A

Becomes continuous with pulmonary trunk
Lose connection with dorsal aorta on right side
Forms ductus arteriosus on left side
Ductus arteriosus allows shunting blood from the pulmonary trunk to the descending aorta and closes at birth

26
Q

What are the characteristics of the vitelline arteries?

A

Arise from vitelline plexuses in yolk sac

Form 3 main arteries: Celiac (foregut), SMA (Midgut), IMA (Hindgut)

27
Q

What are the characteristics of the lateral branches?

A

Supply the viscera
Suprarenal arteries @ upper lumbar level
Gonadal arteries initially @ T-10, as gonads descend become fixed @ L3-L4 level
Renal arteries supply the kidneys. As the kidneys ascend, the vasculature is gradually replaced. The final pair formed in the lumbar region

28
Q

What are the characteristics of the intersegmental branches?

A

Supply musculature , arise from postero-lateral surface of the dorsal aorta
Supply somites derivatives
Dorsal branches supply developing neural tube,deep muscles of the neck, back and dorsal skin
Ventral branches supply hypomeric muscles and ventral skin

29
Q

What are the characteristics of the umbilical arteries?

A

Return deoxygenated blood back to the placenta
Initially branch off aorta
During 4th week shift origin to internal iliacs
@ birth proximal part remains internal iliac and superior vesicular arteries
Dorsal part is obliterated

30
Q

What are the characteristics of the vitelline veins?

A

Derived from yolk sac and carry blood from yolk sac to the sinus venosus.
Initially paired and drained in sinus horns
Left vitelline disappears as left sinus horn regresses
Right vitelline enlarged with cranial part becoming terminal portion of IVC, and caudal part forms SMV and portal vein

31
Q

What are the characteristics of the umbilical vein?

A

Carry oxygenated blood to embryo
Initially paired
Right obliterated and left formed connection with right vitelline vein
Left umbilical vein and IVC formed connection=ductus venosus
Ductus venosus bypasses portal system

32
Q

What are the characteristics of cardinal veins?

A

Drain the body of the embryo

2 pairs- anterior and posterior

33
Q

What are the characteristics of the anterior cardinal veins?

A

Left becomes connected to right by anastomosis
Anastomosis shunt becomes left brachiocephalic vein
Right along with right common cardinal vein becomes SVC

34
Q

What are the characteristics of the posterior cardinal veins?

A

Drain caudal part of an embryo and is supplemented by other veins:
Subcardinal veins drain kidneys
Supracardinal veins- right becomes azygous, left becomes hemiazygous

35
Q

What are the different segments of IVC?

A

Hepatic-terminal segment from vitelline vein
Renal-from right subcardinal vein
Postrenal from right supracardinal
Sacral from left and right posterior cardinals

36
Q

What is the course of fetal circulation?

A

Fetus receives blood from umbilical vein (O2 rich) bypasses liver thru ductus venosus to IVC
In IVC blood mixes and goes to right atrium and via foramen ovale to left atrium and left ventricle and aorta
Blood from SVC enters right atrium, right ventricle and pulmonary trunk
Blood from pulmonary trunk goes to descending aorta via ductus arteriosus and to placenta via umbilical arteries

37
Q

What are the characteristics of the closure of the vasculature at birth?

A

Umbilical arteries close few minutes after birth and obliterate 2-3 months later
Umbilical vein closure give ligamentum teres hepatis
Ductus venosus closure gives ligamentum venosus
Ductus arteriosus closure gives ligamentum arteriosus

38
Q

What are some of the arterial defects?

A

Patent ductus arteriosus occurs with maternal rubella infection
Coarctation of the aorta can be preductal or post ductal
Double aortic arch

39
Q

What are some venous defects?

A

IVC- Double or absent

SVC- Double or left

Anatomy (20 decks)

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