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Cardiovascular system > Chapter 1- Embryology > Flashcards

Chapter 1- Embryology Flashcards

1
Q

What does the truncus arteriosus give rise to?

A

Ascending aorta

Pulmonary trunk

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2
Q

What does the bulbus cordis give rise to?

A

Smooth parts (outflow tracks) of the right and left ventricles

CONUS ARTERIOSUS- Right ventricle
AORTIC VESTIBULE- Left ventricle

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3
Q

What structures does the endocardial cushion give rise to?

A 
Atrial septum
Membranous inter-ventricular septum
Atrio-ventricular Valves (endocardial cushions of atrioventricular canal
Semilunar valves (endocardial cushions of outflow tracts)
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4
Q

What does the primitive atrium give rise to?

A

Trabeculated parts of the left and right atrium + septum primum

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5
Q

What does the primitive ventricle give rise to?

A

Trabeculated part of the left and right ventricle

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6
Q

What does the primitive pulmonary vein give rise to?

A

Smooth part of the left atrium

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7
Q

What does the left horn of sinus venous give rise to?

A

Coronary sinus

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8
Q

What does the right horn if the sinus venous give rise to?

A

Smooth part of the right atrium (Sinus venarum)

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9
Q

What structures derive the Superior vena cava

A

Right ANTERIOR CARDINAL vein + Right COMMON CARDINAL vein

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10
Q

What is the first functional organ in the vertebrate embryo?

A

Heart

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11
Q

At what week does the heart start beating spontaneously

A

4 weeks

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12
Q

When does the cardiac looping begin?

What is the orientation of its polarity?

A

4th week

Left-Right polarity

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13
Q

What is dextrocardia?

What is its etiology?

A

Dextrocardia is a congenial anomaly where in the heart points towards the right side of the chest instead of the left.

Defect in Left-Right DYNEIN

Dextrocardia can be seen in persons with KARTAGENER SYNDROME

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14
Q

What is Primary ciliary dyskinesia?

How is it related to KARTAGENER syndrome?

A

Primary ciliary dyskinesia (PCD) is a rare CILIOPATHIC, AUTOSOMAL RECESSIVE DISORDER which causes a mutation in the components of the DYNEIN arms of the cilia lining the respiratory tract (upper and lower sinuses, Eustachian tube, middle ear), Fallopian tube, flagella of sperm cells

KARTAGENER SYNDROME refers to patients with PRIMARY CILIARY DYSPLASIA +

  1. Situs inversus (reversal of the internal organs)
  2. Chronic sinusitis (due to loss of Mucociliary escalator)
  3. Bronchiectasis (permanent dilatation of the bronchi and bronchioles
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15
Q

What gives rise to the foramen primum?

A

The downward growing of the septum primum from the superior wall of the primordial atrium towards the endocardial cushion

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16
Q

What gives rise to the Foramen secundum?

What is its function

A

Foramen secundum forms as a result of apopotosis of areas in the septum primum.

These areas of apoptosis coalesce to form an opening called the Foramen secundum.

Maintains R-L shunt in Utero after obliteration of the Foramen primum

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17
Q

What gives rise to septum secundum

A

Muscular ridge from ventral and medial atrial wall, grows downward, adjacent to the septum primum.

Foramen ovale forms in the middle of septum secundum

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18
Q

What gives rise to the Foramen ovale?

What causes it to close after Birth?

A

Septum secundum

Increased LA pressure which pushes the septum primum firmly against the septum secundum.

The septum primum and secundum fuses to become the atrial septum

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19
Q

What gives rise to the VALVE of the Foramen ovale?

A

Septum primum

20
Q

What causes patent Foramen ovale?

What is its complication?

A

Failure of the septum primum and secundum to fuse after birth

Can lead to PARADOXICAL EMBOLI
Venous thrombosis emboli that enters arterial circulation (similar to those resulting from ASD)

21
Q

What contributes to the formation of the ventricular septum?

A
  1. Inter ventricular septum which grows caudal-cephalad
  2. Membranous portion of the inter ventricular septum (which is contributed to the inter ventricular septum from the aorticopulmonary septum) closing the inter-ventricular Foramen.
  3. Endocardial cushion also contributes to the membranous portion of the inter ventricular septum
22
Q

What is the most common congenital cardiac anomaly?

Where specifically does is develop?

A

Ventricular septal defect VSD

Membranous septum

23
Q

What is responsible for the septation and rotation of the truncus arteriosus?

A

Migration of NEURAL CREST CELLS (from the HINDBRAIN) & ENDOCARDIAL CELLS to the truncal and bulbar ridges (of bulbar cordis and truncus arteriosus)

Forming septation to produce pulmonary artery and ascending aorta

24
Q

Give examples of abnormalities associated with failure of neural crest cells to migrate

A
  1. Transposition of great vessels (RV-aorta; LV-pulmonary artery
  2. Tetralogy of fallot
  3. Persistent truncus arteriosus
25
Q
  1. What are they components of the tetralogy of fallot?
  2. What type of shunt is seen here?
  3. How do patients respond to a cyanotic spell?
  4. What is the characteristic x-finding if tetralogy of fallot?
  5. What causes tetralogy of fallot?
A
  1. VSD
  2. Right ventricular outflow obstruction
  3. RV hypertrophy
  4. Overriding aorta

R-L shunt leading to early cyanosis

They squat to increase systemic arterial resistance thereby blood is more likely to go from the RV through the pulmonary artery to get oxygenated in the lungs.

BOOT SHAPED APPEARANCE OF HEART

Abnormal migration of neural crest cells which leads to anterior and cephalad misalignment of the infundibular septum (muscular septum that separates aortic and pulmonary pathways)

26
Q

What is Pa02 of oxygen in umbilical vein?
What is the Sa02 of oxygen in the umbilical vein?
What is the Sa02 of oxygen in the umbilical arteries?

A

30mmHg (75-105mmHg adults)

80%

Low O2 sat

27
Q

What are the 3 important vascular shunts in Utero?

A
  1. Ductus venous (Umbilical vein–Ductus venous–IVC)
  2. Foramen ovale (O2 blood RA-RV to the systemic circulation)
  3. Ductus arteriosus (De-02 blood from PA- Aorta due to high fetal pulmonary resistance due to low 02 tension)
28
Q

What causes the closure of the shunts after birth?

A
  1. Decreased resistance in pulmonary vasculature due to 02
  2. Increase LV pressure > RA pressure closes Foramen ovale
  3. Increased 02 & Decreased prostaglandin (from placental separation) closes ductus arteriosus
29
Q

What helps close a PDA?

What keeps a PDA patent?

A
  1. INDOMETHACIN closes PDA

2. PROSTAGLANDIN E1 & E2 kEEps PDA open.

30
Q

What is the postnatal derivative of allantois-Urachus

A

allaNtois- Urachus- mediaN umbilical ligament

Urachus is part of the allantoic duct which forms a communication between the bladder and the umbilicus. It removes nitrogenous waste from the fetal bladder.

31
Q

What is the post natal derivative of the ductus arteriosus?

A

Ligamentum arteriosum

32
Q

What is the post natal derivative of the ductus venous?

A

Ligamentum venosum

33
Q

What is the post natal derivative of the Foramen ovale?

A

Fossa ovalis

34
Q

What is the post natal derivative of the notochord?

A

Nucleus pulposus (surrounded by annulus fibrosus)

35
Q

What is the post natal derivative of the umbilical arteries?

A

umbiLical arteries- mediaL umbilical ligament

36
Q

What is the post natal derivative if the umbilical vein?

A

LIGAMENTUM TERES of liver. (Contained in the falciform ligament)

37
Q

How is the primitive heart tube formed?

A

By lateral folding which directs the 2 endocardial heart tubes to fuse into a single primitive heart tube

38
Q

What is the derivative of the epicardium, myocardium and endocardium?

39
Q

What are the COMPONENTS of a Cilia?

What is the function of DYNEIN in the cilia

What are the function of other cross linking proteins in the cilia?

A
  1. 9 microtubule droplets arranged in a circle with 2 microtubules at its center (9+2) arrangement
  2. DYNEIN connects the peripheral microtubule doublets to each other and allows for ATP-induced sliding of the doublets relative to each other.
  3. Other proteins cross-link the micro-tubes and prevents simple sliding but converting the motion initiated by DYNEIN into bending of cilia.
40
Q

Complications of Primary ciliary Dyskinesia in males and females?

A
  1. Decreased fertility due to immobile sperm and dysfunctional cilia in the Fallopian tubes
  2. Dysfunctional cilia predisposes women to ectopic pregnancy
41
Q

When can trans-vaginal ultrasound detect fetal heartbeat?

A

Gestational week 6

42
Q

How many dilatations does the primitive heart tube form?

What are they?

A
  1. Five
2. 
Truncus arteriosus 
Bulbus cordis 
Primitive atrium 
Primitive ventricle 
Sinus venosus (L & R horns)
43
Q

What is the term for the junction between the smooth and trabecular surface of the RA internally?

What is the outer ridge called?

A
  1. Crista terminalis

2. Sulcus terminalis (terminal sulcus)

44
Q

From which embryonic vessels are the IVC derived?

A
  1. Vitelline veins
  2. Posterior Cardinal veins
  3. Sub-cardinal veins
  4. Supra-cardinal veins
45
Q

What are the common congenital anomalies that lead to L-R shunts?

A
  1. VSD
  2. ASD
  3. PDA
46
Q

What are the pathological sequelae of VSD

A

L-R shunt—Increased pulmonary blood flow—Pulmonary HPN

—Hyperplasia of tunica intima and hypertrophy of tunica media—narrowing of pulmonary arteries

47
Q

What complication does long standing VSD produce apart from pulmonary HPN?

A

Eisenmenger complex-

Reversal of L-R shunt to R-L shunt due to increasing pulmonary vascular resistance > Systemic peripheral vascular resistance

Shunting of deoxygenated blood into systemic circulation- Cyanosis

Cardiovascular system (3 decks)

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