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CV Module > CV Embryology Kahn > Flashcards

CV Embryology Kahn Flashcards

1
Q

Where is the first evidence of heart formation?

A

Splanchnic layer of lateral plate mesoderm (just said splanchnic later in class)

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2
Q

What type of cells are within the splanchnic mesoderm?

A

Cardiac Myoblasts

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3
Q
  1. What are these cells derived from?
A
  1. Cardiac Progenitor cells induced by underlying pharyngeal endoderm
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4
Q
  1. What do blood islands in the same region form?
A
  1. Endothelial lined tubes and transitory blood vessels, definitive blood cells come from mesoderm around aorta later from liver even later from bone marrow
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5
Q
  1. Where does the future heart begin?
A
  1. Cranial part of embryo, Buccopharyngeal membrane is landmark for this, it its just cranial to the buccopharyngeal membrane
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6
Q
  1. What is the cardiogenic field?
A
  1. Endothelial lined tubes and myoblasts formed by the previous blood islands, just cranial to the buccopharyngeal membrane
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7
Q
  1. What is above the cardiogenic field?
A
  1. Pericardial cavity which is derived from the embryonic cavity
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8
Q
  1. What brings the heart into its natural anatomical position?
A
  1. Cranial and caudal folding of the embryo brings the heart into the thoracic region
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9
Q
  1. What forms the two endothelial lined tubes on both sides of the heart?
A
  1. Blood islands produce angiogenic cells that dissolve into these endothelial lined tubes, they eventually become endocardial regions of the heart
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10
Q
  1. What happens to these tubes?
A
  1. Fold into the midline and fuse to form a single endocardial tube
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11
Q
  1. What surrounds tube (cell type)?
A
  1. Myoblasts that will become the myocardium of the heart
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12
Q
  1. What surrounds the tube and eventually disappears, & serves no function?
A
  1. Cardiac Jelly
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13
Q
  1. List the invaginations of the endocardial tube.
A
  1. Truncus arteriosus, bulbus cordis, primordial ventricles, primordial atria, sinus venosus
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14
Q
  1. What will each of these invaginations ultimately form?
A
  1. Truncus arteriosus → aorta and pulmonary trunk, Bulbus cordis →inf. Part of aorta and pulmonary trunk & adjacent parts of two ventricles, Primordial ventricles → ventricles, primordial atria → atria, sinus venosus→ Right horn becomes right atrium, left becomes coronary sinus
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15
Q
  1. How does blood enter the primitive heart? (Before Atria/Ventricle portioning)
A
  1. Sinus venosus
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16
Q
  1. How are the atria and ventricles partitioned?
A
  1. Endocardial cushions grow towards each other, partitions atria from vessels and ventricles (produces a pattern with two holes penetrating septum that divides atria from ventricles)
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17
Q
  1. Describe the formation of the AV valves
A
  1. Dense mesenchyme and myoblasts present, cavitation occurs and cells die, some are replaced by connective tissue which becomes chordate tendinae
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18
Q
  1. What direction is blood originally shunted in atria?
A
  1. From right to left (mix of oxygenated and deoxygenated blood)
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19
Q
  1. What is the crescent shape fold that grows down from the roof of the atria initially in atrial Septation.
A
  1. Septum primum
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20
Q
  1. What does this form at the bottom of the atria?
A
  1. Osteum primum
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21
Q
  1. What happens after this is formed at the top of the crescent shape fold?
A
  1. Osteum secundum (maintains shunting after closure of osteum primum)
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22
Q
  1. What is the second structure that grows downward from the roof of the atria?
A
  1. Septum secundum
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23
Q
  1. What develops in this structure?
A
  1. Foramen ovale
24
Q
  1. What now causes blood to be shunted from RA to LA?
A
  1. Pressure in RA is higher than left, pushes blood through foramen ovale into LA
25
Q
  1. What happens after birth in the case of question #24?
A
  1. Pressure changes , LA is higher and maintains valve closure if it already has not fused
26
Q
  1. What is the function of the ductus arteriosus?
A
  1. Short circuits lungs, sends oxygengated blood from RA directly into the aorta
27
Q
  1. What is the muscular part of the two ventricles derived from?
A
  1. Develops from a ridge between the two ventricles
28
Q
  1. What forms the membranous part of the two ventricles?
A
  1. Cotruncal (spiral ) septum descending to meet the endocardial cushion in the muscular ridge
29
Q
  1. What is probe patency of foramen ovale?
A
  1. Foramen ovale did not fuse, no effect because it is a one way valve, present in 25% of pop.
30
Q
  1. Describe the condition of excessive resorption of septum primum.
A
  1. Causes L to R shunt
31
Q
  1. Describe the condition of absence of septum secundum.
A
  1. Again, L to R shunt
32
Q
  1. What is a common atrium?
A
  1. No attempt at partitioning of atria at all, causes L to R severe shunting
33
Q
  1. Describe defects in ventricular septum.
A
  1. Occur in membranous part of septum, systemic blood goes back into pulmonary circuit, too much blood pushing through pulmonary trunk → increased resistance → hypertrophy of RV → shunts blood from R to L → cyanosis called Eisenmenger complex
34
Q
  1. Defects in Septation of truncus arteriosus , describe Tetralogy of Fallot.
A
  1. Aortic arch and pulmonary trunk are shifted to the R, pulmonary trunk is smaller than usual and aorta is a lot larger. Causes eisenmenger complex and cyanosis
35
Q
  1. Describe persistent truncus arteriosus
A
  1. No Septation of aorta and pulmonary trunk, only one vessel leaving heart, causes cyanosis always accompanied by membranous ventricular defect.
36
Q
  1. Describe transposition of the great vessels.
A
  1. Open into wrong chambers, causes R to L shunt and cyanosis occurs when AP septum fails to spiral
37
Q
  1. Describe patent ductus arteriosus.
A
  1. Blood goes into pulmonary trunk and gets into aorta from ductus arteriosus, can lead to eisenmenger syndrome leads to cyanosis more quickly than atrial defects
38
Q
  1. Before birth the ductus arteriosus provides communication between what two structures?
A
  1. Pulmonary Trunk and Aorta
39
Q
  1. The initial two endothelial tubes that fuse to form the heart develop in what layer?
A
  1. Splanchnic mesoderm
40
Q
  1. Before birth, what structure overlaps the ostium secundum and appears to close it?
A
  1. Septum secundum
41
Q
  1. What causes tetralogy of fallot?
A
  1. A misaligned AP septum
42
Q
  1. Which of the aortic arches gives rise to the pulmonary arteries?
A
  1. 6th aortic arch
43
Q
  1. Just before birth, all blood from the placenta goes through the liver. Describe its course through this organ.
A
  1. Passes directly through via the ductus venosus
44
Q
  1. How many aorta’s does a developing embryo have?
A
  1. Two pairs of dorsal aorta’s
45
Q
  1. How does blood exit the heart?
A
  1. Through an aortic sac ( has l and r divisions, forms 6 arches)
46
Q
  1. Describe the aortic arches
A
  1. Anteriorly they communicate with a horn like structure and loop out from dorsal aorta to this structure
47
Q
  1. What does arch 1-6 give rise to?
A
  1. 1,2 disappear, 3 → common carotid and internal carotid a. , 4→ R. subclavian, and arch of aorta from l. common carotid to l. subclavian, 6→ L and R pulmonary arteries and ductus arteriosus
48
Q
  1. Why is the r. recurrent laryngeal n superior to the left?
A

A portion of aortic arch 6 disappears on the R side, on the L side the ductus arteriosus remains

49
Q
  1. What is preductal coartication of aorta?
A
  1. Narrowing of aorta prior to the ductus arteriosus, => ductus arteriosus remains patent, if post ductal ductus arteriosus atrophies
50
Q
  1. What forms the common cardinal vein?
A
  1. Anterior and post. Cardinal veins, the common cardinal vein also receives umbilical veinand two vitelline veins, sinus venosus receives common cardinal v.
51
Q
  1. What do the vitelline veins form?
A
  1. Hepatic sinusoids, hepatic portal v. , hepatic veins, hepatic IVC
52
Q
  1. What happens to the R. umbilical vein?
A
  1. Atrophies
53
Q
  1. What does the L. umbilical vein extend through the liver as?
A
  1. Ductus venosus
54
Q
  1. What does the sinus venosus become?
A
  1. Hepatic portion of IVC (later he says that the vitelline veins actually forms this, somewhat misleading from his lecture)
55
Q
  1. What does the superior and inf. Parts of the vitelline veins become?
A
  1. Hepatic and renal veins, respectively
56
Q
  1. Describe pre-natal circulation.
A
  1. Path 1: Umbilical v→ ductus venosus → IVC → foramen ovale → LA,LV → aorta → systemic → umbilical a.
    Path 2: SVC → RA→ RV → Aorta (mixes oxygenated from path 1 with deoxygenated ) → systemic → umbilical a.
57
Q
  1. What does the umbilical arteries and veins atrophy to?
A
  1. Umbilical v. → ligamentum teres hepatis

a. Umblicial artery → medial umbilical ligaments

CV Module (5 decks)

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