CVS Flashcards

0
Q

What is the first thing to form?

A
  • Blood islands
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1
Q

Before development of the heart what does the embryo look like?

A
  • Horseshoe shaped region at cranial end - cardiogenic area

- Buccopharyngeal membrane, runs down centre of embryo - future mouth

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2
Q

How does the primitive heart tube form?

A
  • Lateral folding of embryo brings endocardial tubes in midline
  • These fuse together to form heart tube
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3
Q

What is the heart tube held in?

A
  • Heart tube is suspended in the pericardial cavity by a membrane that then degenerates
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4
Q

What are the 6 different sections of the primitive heart tube?

A
  • Aortic roots
  • Truncus arteriosus
  • Bulbus cordis
  • Ventricle
  • Primitive atrium
  • Sinus venosus
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5
Q

The primitive heart tube needs to be contained, so as it elongates how does it bend?

A
  • Cardiac looping
  • Cephalic portion: ventrally, caudally and to the right
  • Caudal portion: dorsally, cranially and to the left
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6
Q

What does the looping achieve?

A
  • Primordium of RV closest to outflow tract
  • Primordium of LV closest to inflow tract
  • Atrium dorsal to Bulbus cordis (inflow is dorsal to outflow)
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7
Q

How does the atrium communicate with the ventricle after looping?

A
  • Via an atrioventricular canal
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8
Q

How does the sinus venosus develop?

A
  • R&L sinus horns are equal in size (where inflow enters)
  • Venous return shifts to the RHS
  • Left sinus horn recedes
  • Right sinus horn is absorbed by enlarging RA
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9
Q

How does the RA develop?

A
  • Develops form most of primitive atrium (sinus venosus)

- Receives drainage from body (venae cava) and heart (coronary sinus)

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10
Q

How does the LA develop?

A
  • From small portion of primitive atrium
  • Absorbs proximal parts of pulmonary veins
  • Receives oxygenated blood from lungs
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11
Q

What is the oblique sinus?

A
  • Oblique pericardial sinus formed as LA expands absorbing pulmonary veins
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12
Q

Outline what foetal circulation looks like.

A
  • Non- functional lungs
  • Receives oxygenated blood from mother via placenta and umbilical vein
  • By-passes lungs
  • Returns to placenta via umbilical arteries
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13
Q

What is the ductus arteriosus?

A
  • Joins the PA to the descending aorta

- So is a shunt

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14
Q

What is the role of the aortic arches?

A
  • Early arterial system
  • Bilaterally symmetrical
  • Undergo remodelling to create major arteries leavening the heart
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15
Q

The 4th and 6th arches have major role what are these?

A
  • 4th: Right -> proximal part of R subclavian artery
    Left -> arch of aorta
  • 6th: Right -> R pulmonary artery
    Left -> L pulmonary artery and ductus arteriosus
16
Q

What are the nerve that correspond to the 6th aortic arch and what does the right and left section descend to?

A
  • Recurrent laryngeal nerves
  • R -> T1 and T2
  • L -> T4 and T5
17
Q

What two factors influence the course of the laryngeal nerve?

A
  • Caudal shift of developing heart and expansion of developing neck region
  • Need for a foetal shunt between PT and aorta
18
Q

What septums need to be formed during septation?

A
  • Interatrial
  • Interventricular
  • Ventricular outflow tract - pulmonary trunk
    - aorta
  • Hence the 4 chambers of the heart
19
Q

What is the first step of septation?

A
  • Endocardial cushion forming
  • Divide the developing heart into L&R channels
  • Develops atrioventricular region
20
Q

Outline the atrial septation process

A
  • Division of atrium -> 2 septa with 3 ‘holes’
  • Septum primum grows down towards the fused endocardial cushions
  • Ostium primum is the ‘hole’ present before septum primum fuses with endocardial cushions
  • Finally a 2nd crescent shaped septum, septum secundum, grows.
  • The hole in the septum secundum is the foramen ovale
21
Q

What is the foramen ovale remnant called in the adult heart?

A
  • Fossa ovalis
22
Q

What are the two different components of ventricular septation?

A
  • Muscular

- Membranous

23
Q

What happens to the muscular component of ventricular septation?

A
  • It grows up towards endocardial cushion -> small gap

- This is the primary interventricular foramen

24
Q

What happens when the primary interventricular foramen closes?

A
  • Membranous portion of interventricular septum is formed by connective tissue derived from endocardial cushions to fill the ‘gap’
25
Q

What is the name of the septum that forms during septation of the outflow tract?

A
  • Conotruncal septum
  • Endocardial cushions are in truncus arteriosus
  • As they grow towards each other and twist around each other -> spiral septum
26
Q

As the baby is born what happens to the foetal circulation?

A
  • Respiration begins
  • LA pressure increases
  • Foramen ovale closes
  • Ductus arteriosus contracts
  • Placental support is removed
  • DA closes
27
Q

How does the foramen ovale close at birth?

A
  • Pressure of the LA < RA so blood flows through foramen ovale (pre-birth)
  • Pressure LA > RA so septum primum is pushed against septum secundum (at birth) so foramen ovale is forced closed
28
Q

What are the following known as in the adult body:

  • Foramen ovale
  • Ductus arteriosus
  • Ductus venosus
  • Umbilical vein
A
  • Foramen ovale: Fossa ovalis
  • Ductus arteriosus: Ligamentum arteriosus
  • Ductus venosus: Ligamentus venosum
  • Umbilical vein: Ligamentum teres (hepatis)