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Anatomy Block 3 > Clinical Embryology > Flashcards

Clinical Embryology Flashcards

1
Q

What is Ectopia cordis and what causes it

A

condition where heart is partly or completely exposed usually on thoracic surface

results usually from failure of lateral folds to fuse in that region

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2
Q

What is Gastroschisis and what causes it

A

usually on right side, allows abdominal viscera to protrude into amniotic cavity

uncommon defect in ventral abdominal wall resulting from incomplete closure of lateral folds

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3
Q

What is pulmonary hypoplasia and what is the major cause of it

A

Lung underdevelopment

Congenital diaphragmatic hernia

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4
Q

What is a congenital diaphragmatic hernia and what usually causes it

A

Posteriolateral defects in diaphragm allowing herniation of abdominal viscera into thoracic cavity

failure of pleruoperitoneal membrane to fuse with septum transversum and or dorsal mesentery of esophagus

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5
Q

on which side is a congeneital diaphragmatic hernia almost always found

A

Left

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6
Q 
The mesodermal structure lying caudal to the pericardial cavity after folding of the head region is the
septum transversum
primitive streak
developing heart
oropharyngeal membrane
notochord
A

septum transversum

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7
Q 
A newborn infant has a congenital diaphragmatic hernia, this results from defective formation of which structures
Costodiaphragmatic recess
dorsal mesentery of the esophagus
lateral body wall
pleuroperitoneal membrane
septum transversum
A

Pleuroperitoneal membrane

failure to fuse with dorsal mesentery of esophagus and septum transversum

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8
Q

What is the most common abnormality of the lower respiratory system and what causes it

A

Tracheoesophageal fistual

iincomplete separation of the esophagus and trachea

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9
Q

What are tracheoesophageal fistulas usually associated with

A

esophageal atresia

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10
Q

What symptoms come with tracheoesophageal fistulas and esophageal atresia

A

polyhydramnios: excess amniotic fluid during pregnancy (not oligohydraminos which is too little)

excess salivation

regurgitation after feeding

abdominal distention after crying

inflammation of lungs

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11
Q

Why might you get inflammation of the lungs with tracheoesophageal fistulas and esophageal atresia

A

reflux of stomach contents into the lungs

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12
Q 
Which of the following is often associated with a tracheoesophageal fistulas and esophageal atresia
Unilateral agenesis of the lung
Laryngeal atresia
Unilateral pulmonary agenesis
polyhydramnios during pregnancy
congenital lung cysts
A

Polyhydramnios during pregnancy

because fetus is unable to swallow amniotic fluid which then accumulates because it is unable to pass to the fetal stomach and intestines for absorption

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13
Q 
What is the first indication of lower respiratory tract development in the human embryo
Bronchial bud
laryngotracheal groove
primary bronchus
bronchopulmonary segment
lung bud
A

Laryngotracheal groove

forms as an outgrowth from primitive pharyngeal floor during 4th week

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14
Q

Why would polyhydramnios occur during pregnancy with tracheoesophageal fistulas and esophageal atresia?

A

because fetus is unable to swallow amniotic fluid which then accumulates because it is unable to pass to the fetal stomach and intestines for absorption

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15
Q

Atrial Septal defects is the term for defects in formation of what 2 structures

A

septum primum and/or septum secundum

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16
Q

What causes a probe patent foramen ovale and what type of shunting does it allow

A

caused by incomplete adhesion of the foramen ovale valve with the septum secundum

Left to right shunting

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17
Q

What causes a patent foramen ovale and what type of shunting does it allow

A

Ostium secundum defects;
abnormal or excessive resorption of the septum primum or abnormal development of septum secundum

Left to right shunting

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18
Q

What causes a patent foramen primum and what type of shunting does it allow

A

Ostium primum defects involving deficiencies in the endocardial cushion and atrioventricular septum formation

Failure of septum primum to fuse with endocardial cushions to fuse

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19
Q

In what group is a patent foramen primum more common

A

those with Down syndrome

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20
Q

What is the most common congenital heart defect

A

Ventricular septal defects

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21
Q

Where do most VSD’s occur

A

defects in membranous portion of the interventricular septum

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22
Q

What type of shunting do VSD’s allow and what can they cause

A

Left to right shunting of blood

Can result in pulmonary hypertension and possible cardiac failure

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23
Q

What is the key defect in tricuspid atresia and what does it result in

A

complete occlusion of the right atrioventricular opening

results in cyanosis

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24
Q

What defects always accompany tricuspid atresia

A

underdeveloped right ventricle and usually ASD and VSD

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25
Q

What causes Persistant Truncus arteriosus

A

failure of the aorticopulmonary septum to develup and divide the truncus arteriosus into aorta and pulmonary trunk

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26
Q

What defect is always associated with Persistant Truncus arteriosus and why?

A

VSD because the membranous interventricular septum normaly merges with the aorticopulmonary septum

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27
Q

How does blood shunting occur with Persistant Truncus arteriosus

A

OVERALL RIGHT TO LEFT

VSD thats present with it allows some left to right

but Persistant Truncus arteriosus overwhelms it with right to left ( allowing blood to bypass the lungs)

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28
Q

How do you end up with transposition of the great arteries

A

when the aorticopulmonary septm fails to follow a spiral course when dividing the truncus arteriosus and bulbous cordus

29
Q

What other defects are also usually associated with transposition of the great arteries

A

ASD and VSD and possibly patent ductus arteriosus

30
Q

How does blood shunting occur with transposition of the great arteries

A

Overall Right to left

ASD and VSD permit soome left right shuntin

but most deoxy blood returning to right atrium bypasses the lungs and enters the aorta

31
Q

What is the major cause of cyanotic heart disease in newborns

A

Transposition of the great arteries

32
Q

What causes Tetralogy of Fallot

A

Unequal division of the bulbus cordis with anterior displacement of the aorticopulmonary septum

33
Q

What 4 things result from tetralogy of Fallot

A

pulmonary stenosis
overriding aorta
VSD
and hypertrophy of the right ventircle

34
Q

What is the overall shunting in Tetralogy of Fallot

A

Right to left

of poorly oxygenated blood (thus cyanosis clinical sign)

35
Q

What characterizes Coarctation of the aorta

A

constriction of varying length and usually occuriing directly opposite to the ductus arteriosus

36
Q

What is Coarctation of the aorta typically associated with

A

Turners syndrome

37
Q

When do you have Patent ductus arteriosus and what shunt does it cause

A

when the vessel fails to close and form ligamentum areriosum

Left right shunt

38
Q

In what cases is Patent Ductus areriosus commonly found

A

MATERNAL RUBELLA INFECTION DURING EARLY PREGNANCY

Premature infants and those with persitent hypoxia

39
Q 
The fetal left atrium is primarily derived from 
coronary sinus
endocardial cushion
primitive atrium
primitive pulmnoary vein
sinus venosus
A

Primative pulmonary vein

40
Q 
Which of the following defects is associated with tetralogy of Fallot
Aortic coarctation
patent foramen ovale
pulmnoary stenosis
tricuspid atresia
Patent foramen primum
A

Pulmnoary stenosis

also see overriding aorta VSD and right ventricular hypertropy

41
Q

What causes stenosis (narrowing) of the esophagus and where in the esophagus does it normally occur

A

incomplete recanalization of the lumen

usually occurs in distal third of esophagus

42
Q

What 2 ways can atresia (closing) of the esophagus occur and which is more common

A

incomplete recanalization of the lumen or
incomplete seperation of the trachea and esophagus

2nd is most common

43
Q

What causes hypertrophic pyoric stenosis and what are the symptoms in an infant?

A

Thickening of the circular pyloric musculature (instead of incomplete recanalization)

stomach markedly distended and infant has projectile vomiting

44
Q

Where does stenosis of the duodenum usually occur

A

Horizontal (3rd) and ascending (4th)

45
Q

Where does atresia of the duodenum almost always occur and sometimes occur?

A

Almost always in descending (2nd)

sometimes in horizontal (3rd)

46
Q

Atresia arises in 1/3rd of individuals with what

A

Down syndrome

47
Q

What symptom characterizes duoodenal obstruction

A

vomit containing bile

48
Q

What causes Extrahepatic biliary atresia and where does it normally occur

A

incomplete recanalization of hepatic ducts

usually at or superior to porta hepatis

49
Q

What symptom characterizes Extrahepatic biliary atresia

A

Infant develops jaundice soon after birth

50
Q

What can cause an anular pancreas and what does it cause

A

bilobed ventral pancreatic bud grows and encircles the duodendum CAUSES OBSTRUCTION

51
Q

What accounds for 50% of intestinal obstrections

A

stenosis and atresia of the ileum

52
Q

What causes most ileal atresias

A

infarctions from twistin of the intestines

53
Q

What is an omphalocele and what causes it

A

extrusion of abdominal viscera in the proximal umbilical cord

caused by failure of intestines to normally return to abdominal cavity

54
Q

What other defects is an Omphalocele associated with

A

Cardiac and neural tube defecs

55
Q

How does an Omphalocele differ from an umbilical hernia

A

umbilical hernia, intestines return to abdominal cavity and then herniate through imperfectly closed umbilicus

Omphalocele they never return to abdominal cavity

56
Q

How does an omphalocele differ from gastroschisis

A

Visera in an ophalocele are covered ny peritoneum and the amnion derived covering of the umbilical cord

57
Q

What causes most anomalies of the intestine

A

incomplete gut rotation

58
Q

What are 3 types of improper gut rotation

A

Non rotation (cecum in middle small on left)

mixed rotation ( small on left and middle colon transverse above and on right)

reversed rotation (normal layout but duodenum in front of transverse colon)

59
Q

Which two improper gut rotations is Volvus (twisting) of the intestines associated with and what can it result in

A

Nonrotation and mixed rotation

can result in gangrene of bowls

60
Q

What is an ileal (Meckel) diverticulum and what can happen to it

A

Rmnant of the proximal part of the omphaloenteric duct

can become inflamed and thus mimic symptoms of appendicitis

61
Q

where is the ileal (Meckel) diverticulum attached and by what

A

can be connected to the umbilicus by an omphaloenteric fistula or a fibrous cord

62
Q

What causes most anorectal anomalies

A

abnormal partitioning of the cloaca by the urorectal septum

63
Q

What are 5 anorectal anomalies and which 2 usually present with fistula

A 
imperforate anus
anal agenesis (usually with fistula)
anal stenosis
anorectal agenesis (usually with fistula)
rectal atresia
64
Q

What makes up 2/3rds of anorectal defects

A

anorectal agenesis (with or without a fistula)

65
Q

What is the most common cause of neonatal obstruction of the colon and what is it characterized by

A

Congenital megacolon (hirschsprung disease)

characterized by abnormal dilation of the sigmoid colon and rectum

66
Q

What causes the dilation in Congenital megacolon (hirschsprung disease)

A

neural crest cells fail to migrate into the hindgut and form parasympathetic ganglia in the gut wall

67
Q

what is characteristic of the affected bowl and the bowl proximal to it in Congenital megacolon (hirschsprung disease)

A

affected bowl has absence of peristalsis

proximal contains autonomic ganglia and consequently dilates

68
Q 
A 3 week old infant has a history of projectile vomiting. Vomit has no bile. Baby is constantly hungry but has not gained weight. Which explains the symptoms
Esophageal atresia
Ileal dierticulum
Hypertrophic pyloric stenosis
Tracheoesophageal fistula
duodenal stenosis
A

Hypertrophic pyloric stenosis

narrowing of pyloric canal and obstruction to passage of food

blockage of duodeunum associated with vomit containing no bile

69
Q 
The embryonic midgut gives rise to which of the following
duodenum
liver
sigmoid colon
head of pancreas
upper portion of anal canal
A

Duodenum

Anatomy Block 3 (16 decks)

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