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ESA2 > CVS 3 (Development) > Flashcards

CVS 3 (Development) Flashcards

1
Q

What does lateral embryonic folding do to the developing heart?

A

Creates a heart tube

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2
Q

What does craniocaudal embryonic folding do to the developing heart?

A

Brings primitive heart tube into thoracic region

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3
Q

What does embryonic folding do to the developing heart?

A

Lateral folding - Creates heart tube

Craniocaudal folding - Brings tube into thoracic region

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4
Q

What allows the primitive heart tube to freely move within the pericardial cavity?

A

It is only tethered at the cranial and caudal ends

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5
Q

Name the 6 sections of the primitive heart tube, from the inflow to the outflow:

A

1) Sinus venosus
2) Primitive atria
3) Primitive ventricle
4) Bulbus cordis
5) Truncus arteriosus
6) Aortic roots

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6
Q

Between which days after fertilisation does the looping of the primitive heart tube take place?

A

Days ~ 23-28

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7
Q

What does the sinus venosus become?

A

The vena cavae and the coronary sinus

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8
Q

In the primitive heart tube, the sinus venosus is highly symmetrical. Why does it become very distorted after folding of the heart tube?

A

The RHS of the sinus venosus is absorbed to form part of the right atrium

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9
Q

What does the right atrium develop from?

A
  • Most of the primitive atria

- RHS of sinus venosus

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10
Q

What does the left atrium develop from?

A
  • Small % of the primitive atria

- Proximal parts of pulmonary veins

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11
Q

Which vessels drain into the right atrium?

A

Superior vena cava
Inferior vena cava
Coronary sinus

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12
Q

How many pulmonary veins empty into the left atrium?

A

4

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13
Q

Name the vessel which supplies the foetus with oxygenated blood from the placenta:

A

Umbilical vein

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14
Q

Which 2 developing organs must be bypassed by the foetal circulation?

A

Lungs

Liver

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15
Q

Which foetal shunt allows the circulation to bypass the liver?

A

Ductus venosus

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16
Q

Which foetal shunt allows the circulation to bypass the lungs?

A

Ductus arteriosus

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17
Q

Which 2 blood vessels does the ductus arteriosus connect?

A

1) Pulmonary trunk

2) Aorta

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18
Q

What is the ligamentum arteriosum a derivative of?

A

Ductus arteriosus

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19
Q

How many aortic arches are present in early foetal life?

A

5: 1,2,3,4 and 6

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20
Q

From which foetal aortic arch does the adult aortic arch derive from?

A

4th arch

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21
Q

From which foetal aortic arch does the adult pulmonary arteries derive from?

A

6th arch

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22
Q

Which foetal aortic arch forms part of the ductus arteriosus?

A

6th arch

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23
Q

Each aortic arch has a corresponding nerve. Which nerves are paired with the 6th aortic arches?

A

Recurrent laryngeal nerves

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24
Q

The recurrent laryngeal nerve is a branch of which cranial nerve?

A

CN X

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25
Q

Why does the left recurrent laryngeal nerve descend further in the body than the right nerve?

A

The left recurrent laryngeal nerve hooks around the ductus arteriosus

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26
Q

The right subclavian artery is derived from which aortic arch?

A

The right 4th aortic arch

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27
Q

Which germ layer gives rise to the cardiovascular system?

A

Mesoderm

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28
Q

In which week of development does embryonic folding take place?

A

Week 4

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29
Q

What is the name of the junction between the atria and ventricle of the primitive heart?

A

Atrioventricular canal

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30
Q

What is the name of the tissue which develops to separate the atrioventricular canal into an atrium and a ventricle?

A

Endocardial cushions

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31
Q

What is the first septation to occur in the developing heart?

A

Septation between the primitive atrium and ventricle (from the atrioventricular canal)

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32
Q

Name the septa required for normal atrial septation:

A

1) Septum primum

2) Septum secondum

33
Q

Septum primum grows from ? and fuses with ?

A

From the top of the primitive atria,

fuses with the endocardial cushions (which separate the atria from the ventricle)

34
Q

What is the name of the ‘hole’ present between the atria (of a developing heart), before septum primum fuses with the endocardial cushions?

A

Ostium primum

35
Q

What is the name of the ‘hole’ present between the atria (of a developing heart), after septum primum fuses with the endocardial cushions?

A

Ostium secondum

36
Q

In which septum does the ostium secondum form?

A

Septum primum

37
Q

Describe the shape of the septum secundum:

A

Cresent-shaped

38
Q

What is the name of the ‘hole’ that forms in the septum secundum?

A

Foramen ovale

39
Q

Name the 3 ‘holes’ present in the atrial septa (at different stages of development):

A

1) Ostium primum
2) Ostium secundum
3) Foramen ovale

40
Q

Which direction does blood shunt through the foramen ovale and ostium secundum during foetal life?

A

R -> L (blood enters RA of heart)

41
Q

Why is it important that the ‘holes’ of the foetal R -> L atrial shunt are NOT ALINED?

A

After birth, the pressures in the heart change due to the pulmonary system, the 2 atrial septa are pushed together, and holes are not alined = no shunting of blood between atria.

42
Q

What are the 2 tissue components of the ventricular septum?

A

1) Large muscular component

2) Small membranous component

43
Q

The muscular part of the ventricular septum grows from ? towards ?

A

From the bottom of the ventricle upwards, towards the endocardial cushions

44
Q

The muscular part of the ventricular septum does not fuse with the endocardial cushions, forming a hole. What name is given to this hole?

A

Primary interventricular foramen

45
Q

What closes the primary interventricular foramen?

A

Membranous connective tissue, which grows downwards from the endocardial cushions to fill the gap.

46
Q

What does the conotruncal septum achieve?

A

Division of the truncus arteriosus into the aorta and pulmonary trunk, creating 2 outflow tracts from the heart

47
Q

Describe the shape of the aorticopulmonary septum:

A

Spiral

48
Q

How does the conotruncal septum grow in a spiral shape?

A

It forms form ridges either side of the truncus arteriosus, which grow towards each other in a staggered way, forming the spiral

49
Q

Once the conotruncal septum has formed, what name is given to it?

A

Aorticopulmonary septum

50
Q

Name the 4 foetal shunts:

A

1) Ductus venosus
2) Ductus arteriosus
3) Foramen ovale
4) Umbilical vein

51
Q

What does the foramen ovale become in an adult?

A

Fossa ovalis

52
Q

What does the umbilical vein become in an adult?

A

Ligamentum teres

53
Q

What part of the heart does the conus cordis form?

A

Outflow tracts of the R and L ventricles

54
Q

Approximately how many babies per 1000 births have congenital heart defects?

A

~6-8

55
Q

What is the most common heart defect?

A

Ventricle septal defect

56
Q

What are the 4 types of congenital heart defect?

A

1) Atrial septal defect
2) Ventricle septal defect
3) Transposition of great vessels
4) Tetralogy of Fallot

57
Q

What proportion of children born with Down’s syndrome also have a congenital heart defect?

A

~ 50%

58
Q

Why does Marfan syndrome cause a heart defect?

A

It causes progressive enlargement of the aorta near the aortic valve, due to the weak vessel walls and high BP. This can rupture.

59
Q

What are the 3 main types of causes of congenital heart defects?

A

1) Genetic
2) Environmental
3) Maternal infections

60
Q

What may happen to the heart of an unborn child if the mother took lithium medication?

A

Lithium may cause a congenital heart defect, as causes displaced leaflets of the tricuspid valve

61
Q

What is the %pO2 in the right side of the heart?

A

~ 67% pO2

62
Q

What is the %pO2 in the left side of the heart?

A

~ 99% pO2

63
Q

Name the 3 acyanotic left to right shunts:

A

1) Atrial septal defect
2) Ventricle septal defect
3) Patent ductus arteriosus

64
Q

Name the 4 acyanotic obstructive lesions:

A

1) Aortic stenosis
2) Pulmonary stenosis
3) Mitral stenosis
4) Coarctation of the aorta

65
Q

What is the difference between ‘aortic stenosis’, and ‘coarctation of the aorta’?

A

Aortic stenosis is narrowing of the aortic valve

Coarctation of the aorta is narrowing of the aorta either proximal or distal to the ductus arteriosus

66
Q

Name the 4 cyanotic right to left shunts:

A

1) Tetralogy of Fallot
2) Total Anomalous Pulmonary Venous Connection
3) Transposition of the Great Arteries
4) Univentricular heart

67
Q

What is Total Anomalous Pulmonary Venous Connection?

A

When the pulmonary veins drain into the right atria (instead of the left), and is associated with an ASD, resulting in cyanosis

68
Q

In an adult, pulmonary pressure (25/10mmHg) is much lower than systemic pressure (80/40mmHg). However immediately after birth this is not the case. Why?

A

Immediately after birth the pulmonary and systemic pressures must be almost equal, to force blood around the newly opened lungs.

69
Q

How does an ASD lead to right ventricular hypertrophy?

A
  • Blood moves from LA to RA due to pressure differences
  • RV volume overload
  • RV hypertrophy to compensate
70
Q

Where is the most common site of a VSD?

A

At the top of the interventricular septum, due to defective membraneous formation

71
Q

Which congenital heart defect commonly occurs in people with Down’s syndrome?

A

Atrio-ventricular septal defect

72
Q

Describe the factors of a Tetralogy of Fallot:

A

1) Pulmonary stenosis
2) Ventricular septal defect
3) Right ventricular hypertrophy
4) Over-riding aorta

73
Q

Tetralogy of Fallot is a shunt in which direction?

A

Right –> Left

74
Q

Is a Tetralogy of Fallot cyanotic or acyanotic? Why?

A

Cyanotic:

  • Not enough blood can get to the lungs to be oxygenated (pulmonary stenosis)
  • Non-oxygenated blood mixes with oxygenated blood and enters systemic circulation (VSD + over-riding aorta)
75
Q

What is tricuspid atresia?

A

Complete absence of a tricuspid valve. Therefore an ASD and VSD must be present.

76
Q

Why must there be a VSD if tricuspid atresia is present?

A

To allow L to R shunt to get blood to the lungs, for oxygenation

77
Q

What is hypoplastic left heart?

A

Hypoplasia of left ventricle and ascending aorta. Therefore ASD and PDA must be present.

78
Q

What is pulmonary atresia?

A

Absence of valve to pulmonary trunk. Therefore an ASD and PDA must be present.

ESA2 (27 decks)

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