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CV I > Development > Flashcards

Development Flashcards

1
Q

Why does the heart migrate from neck into thorax

A

because cardiogenic mesoderm migrates to cranial most part of the embryo

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2
Q

What does the heart tube arise from

A

paired endothelial lined tubes

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3
Q

at what end does the heart tube receive blood and pump blood

A

receives at the caudal end and pumps at the cranial end

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4
Q

When does cardiac looping begin and what are the 4 dilations

A 
Day 22
bulbus cordis
ventricle
atrium
sinus venosus
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5
Q

When does the heart start beating

A

Day 22

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6
Q

Why does the heart loop

A

ventricles grow faster than other regions

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7
Q

Which way does the cranial portion of the heart tube bend

A

ventrally, caudally and to the right

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8
Q

which way does the caudal portion of the heart tube bend

A

dorsally, cranially and to the left

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9
Q

What becomes of the sinus venosus

A

left sinus horn becomes coronary sinus

right sinus horn becomes part of right atrium as sinus venarum

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10
Q

What will the primitive atrium form

A

left and right auricles

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11
Q

What grows into the left atrium during final steps of development

A

the pulmonary vein

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12
Q

What is incorporated into the right atrium during final steps of development

A

sinus venosus

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13
Q

What will the primitive ventricle become

A

trabeculated portion of left ventricle

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14
Q

What are the 3 parts of the bulbus cordis

A

caudal, conus cordis and truncus cordis

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15
Q

what becomes of the caudal part of bulbus cordis

A

trabeculated region of right ventricle

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16
Q

what becomes of the conus cordis part of bulbus cordis

A

outflow of both ventricles, right= conus arteriosus and left=aortic vestibule

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17
Q

what becomes of the truncus arterioles part of bulbus cordis

A

pulmonary trunk and aorta

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18
Q

Describe pathway of blood in the developing heart around day 30

A

blood enters sinus venous-> primitive atrium -> primitive ventricle -> bulbus cordis ->aortic sac -> embryo

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19
Q

What week do coordinated contractions of the fetal heart begin

A

week 4

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20
Q

What is the first step of partitioning of the atrium

A

septum primum forms, day 30

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21
Q

What is the second step in partitioning of the atrium

A

ostium primum forms, day 30

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22
Q

what is the third step in partitioning of the atrium

A

ostium primum closes, day 33

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23
Q

What is the fourth step in partitioning of the atrium

A

ostium secundum opens via apoptosis, day 33

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24
Q

What is the fifth step in partitioning of the atrium

A

septum secundum forms, day 33

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25
Q

what is the sixth step in partitioning of the atrium

A

foramen ovale forms, because septum secundum is incomplete

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26
Q

What is the original septum primum known as in a newborn

A

the valve of foramen ovale

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27
Q

prenatally where is the pressure greatest in the heart

A

on the right side

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28
Q

postnatally where is the pressure gradient of the heart

A

on the left side

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29
Q

The heart valves form from what tissue type

A

neural crest cells, endocardial cushions

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30
Q

Why is the right ventricle not in contact with the atria like the left in development

A

bulboventricular flange regresses during week 5

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31
Q

What are the 2 portions of the interventricular septum. state their origins

A

muscular portion from mm of ventricle and membranous portion from endocardial cushions

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32
Q

When does partitioning of the ventricles take place

A

week 7

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33
Q

where are the conotruncal ridges derived form that form pulm trunk and aorta

A

neral crest cells

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34
Q

how many degress of spiraling do the conotruncal ridges undergo

A

180 degrees

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35
Q

what is the aorticopulmonary septum

A

spiraled conotruncal ridges

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36
Q

what does the conus cordis form

A

conus arteriosus and aortic vestibule aka right and left ventricles

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37
Q

what does the truncus arteriosus form

A

pulmonary trunk and ascending aorta

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38
Q

where do the semilunar valves form from

A

neural crest of conotruncal ridges

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39
Q

Ventricular septal defects account for what percent of congenital heart defects

A

30%

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40
Q

what are the 2 types of ventricular defect and which is most common

A

membranous- msot common

and muscular

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41
Q

the severity of a ventricular septal defect reflects what, and what is the usual result

A

size of defect and results in left to right blood shunting

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42
Q

Atrial septal defects account for what percent of congenital heart defects

A

10%

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43
Q

What are the various types of atrial SD

A

ostium secundum is too big
ostium primum- endocardial defect
common atrium- no atrial septum

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44
Q

what is the often result of ASDs

A

left to right blood shunting

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45
Q

What is the result of underdeveloped endocardial cushions

A

persitent atriocentricular canal
ostium primum defect
membranous interventricular septum defect

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46
Q

What percentage of congenital heart defects are Pulmonary and aortic valave stenosis

A

pulmonary- 7%

aortic 6%

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47
Q

What additional condition is likely with pulmonary and aortic valve stenosis

A

patent foramen ovale and ductus arteriosus

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48
Q

What causes tetralogy of fallot

A

unequal division of truncus arteriosus by conotruncal ridges

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49
Q

what are the 4 components of tetralogy of fallot

A

overriding aorta
pulmonary stenosis
ventricle septal defect
right ventricular hypertrophy

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50
Q

What causes transposition of Great vessels

A

conotruncal ridges fail to spiral

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51
Q

In a patient with transposition of the great vessels what else would you expect to see

A

patent ductus arteriosus and patent foramen ovale

52
Q

What causes persistent truncus arteriosus

A

conotruncal ridges fail to form

53
Q

What causes DiGeorge Syndrome

A

deletion on long arm Chromosome 22

54
Q

What is the result of a long arm chrom 22 deletion

A

abnormal neural crest development leading to many cardiac abnormalities like defects of conotruncal formation

55
Q

What are other signs of DiGeorge Syndrome

A

Craniofacial defects, thymic hypoplasia, parathyroid dysfunction- hypocalcemia, cleft palate CATCH22

56
Q

What is dextrocardia

A

heart lies in right thorax

57
Q

what causes dextrocardia

A

heart loops in opp direction

58
Q

What causes ectopic cordis

A

failure of ventral body wall to close

59
Q

what is ectopic cordis

A

heart lies on surface of chest

60
Q

What do mesodermal cells differentiate into unde VEGF

A

blood islands

61
Q

What do blood islands produce

A

hemangioblasts

62
Q

They major embryonic arterial and venous systems arise via what process

A

vasculogenesis

63
Q

What is the definition of angiogenesis

A

sprouting and growth of already existing vessels

64
Q

What are the 3 primary vascular systems of the embryo/fetus

A

Intraembryonic
Yolk sac (vitelline)
Placental

65
Q

What vessels are within the intraembryonic system

A

aortic arch aa and the cardinal veins

66
Q

what vessels are within the yolk sac system

A

vitelline artery and vein

67
Q

what vessels are within the placental system

A

2 umbilical aa and 1 umbilical vein

68
Q

How many aortic arch pairs are there originally and where do they originate from?

A

6 pairs from aortic sac(truncus arteriosus)

69
Q

Where do the aortic arch aa drain

A

dorsal aortae- paired cranially join caudally

70
Q

What does the aortic arch become

A

proximal aortic arch and the brachiocephalic artery

71
Q

What does the first aortic arch a become

A

regresses..maxillary a

72
Q

what does the second aortic arch branch become

A

regresses (stapedial)

73
Q

What does the third aortic arch artery become

A

common carotid aa

74
Q

What does the 4th aortic arch aa turn into

A

R- R subclavian a

L- portion of aortic arch

75
Q

What does the 5th aortic arch aa turn into

A

regresses completely

76
Q

What does the sixth aortic arch aa turn into

A

R- pulmonary a

L- pulmonary a and ductus arteriosus

77
Q

What does 7th intersegmental a turn into

A

R- part of right subclavian

L- left subclavian

78
Q

What does the ductus arteriosus become in an adult

A

ligamentum arteriosum

79
Q

Where does the right recurrent laryngeal n travel

A

loops around subclavian (4th branch) because 5 and 6 regress

80
Q

Where does the left recurrent laryngeal n travel

A

loops around arch of aorta near ligamentum arteriosum

81
Q

What do the vitelline aa become

A

celiac, superior mesenteric and inferior mesenteric aa

82
Q

Where are the umbilical aa in an adult

A

off common iliac aa, supply placenta

turns into medial umbilical ligament

83
Q

What is patent ductus arteriosus, results in?

A

ductus arteriosus does not close- blood shifts left to right and results in pulmonary hypertension

84
Q

Which coarctation of the aorta presents at birth

A

preductal

85
Q

why does postductal coarctation of the aorta usually present in early adolescence

A

collateral circulation is established between internal thoracic aa and intercostal aa prenatally

86
Q

What causes retroesophageal right subclavian a

A

right 4th aortic arch degenerates, leaving 7th intersegmental a to form right subclavian

87
Q

what is dysphagia lusoria

A

difficulty swallowing due to esophageal compression

88
Q

What causes a double aortic arch

A

the right dorsal aorta between original of the 7th intersegmental a and fusion with dorsal aorta persists

89
Q

does the double aortic arch usually cause constriction of esophagus

A

yes

90
Q

What happens to the umbilical veins

A

right vein degenerates

left vein carries O2blood from placenta thorugh fetal liver to heart

91
Q

What does the left umbilical v become

A

ductus venosus- bypass liver

92
Q

What cardinal veins become the azygos system

A

supracardinal

93
Q

What causes an absent inferior vena cava

A

right sub cardinal vein fails to make a connection with hepatic part of vena cava

94
Q

where does the blood drain in an absent inferior vena cava

A

azygos system

95
Q

what causes a left superior vena cava

A

left common cardinal vein persists and forms a left superior vena cava
right cardinal vein degenerates

96
Q

Where does the superior vena cava drain if it is on the left

A

righ atrium via coronary sinue

97
Q

what causes a double superior vena cava

A

left and right common cardinal vv persists

98
Q

Where do the superior vena cavas drain if there is a double

A

right- into r atrium

left- via coronary sinus to r atrium

99
Q

What does the lung bud give rise to

A

larynx, trachea, bronchi, bronchioles and alveoli

100
Q

Where does the lung bud form form and when in development

A

week 4 from foregut as ventral diverticulum

101
Q

What separates the lungbud from the esophagus

A

2 tracheoesophageal ridges

102
Q

what to the tracheoesophageal ridges form when they fuse

A

septum

103
Q

What occurs if there is an abnormal division of the cranial part of the foregut into respiratory and esophageal portions

A

tracheoesophageal fistulas

104
Q

what is the most likely cause of a tracheoesophageal fistula

A

spontaneous deviation of the tracheoesophageal septum

105
Q

What are other signs of a tracheoesophageal fistula

A

esophageal atresia(blind end) 90%, polyhydramnios, pneumonitis

106
Q

What structure remains in contact with primordial laryngeal inlet after septum forms

A

pharynx and lung bud

107
Q

Failure of the larynx to recanalize ocurrs in what time frame of development

A

between week 6 and 10

108
Q

The trachea is fully developed by what week

A

12

109
Q

describe timeframe of lung buds

A

week 5- lung bud divides into L and R
week 6- secondary bronchial buds
7th- tertiary bronchial buds
further branching continues postnatally

110
Q

What is formed by dilation of terminal bronchi? what will the lungs look like.

A

congenital lung cysts, honeycomb appearance

111
Q

Is abnormal division of the bronchial tree common

A

yes because little functional consequence

112
Q

Weeks 5-16 what stage are the lungs in

A

pseudoglandular- terminal branches there bt no respiratory bronchioles hence not viable fetus

113
Q

When do fetal breathing movements typically start

A

12th week development- amniotic fluid breathed in

114
Q

Oligohydramnios affects the lungs how

A

lung hypoplasia

115
Q

When is the canalicular stage of the lungs

A

16-26 weeks

116
Q

When have the respiratory bronchioles and alveolar ducts formed

A

24 weeks

117
Q

When do surfactant levels reach adequate amounts

A

26-28 weeks

118
Q

Why are fetuses during weeks 26-28 only 50% viable

A

underdevelopment of alveoli

119
Q

When is the terminal sac stage of lungs

A

26 weeks to 32 weeks

120
Q

Fetuses born during terminal sac have what chance survival

A

80-95%

121
Q

What are the two critical factors in derermining survival and growth of premature infants

A

sufficient surfactant production and adequate pulmonary vasculature

122
Q

When is the aveolar stage of lung development

A

32 weeks to 8 years post natally

123
Q

Why are lungs in newborns more dense in X rays

A

up to 300 million alveoli

124
Q

Lack of surfactant production puts premature infants at risk of what syndrome

A

respiratory distress syndrome (hyaline membrane disease)

125
Q

How can surfactant secretion be stimulated in utero

A

giving mom glucocorticoids

126
Q

How can we treat lack of surfactant in postnatal babies

A

exogenous surfactant

127
Q

Which structure carries oxygenated blood to the fetus

A

umbilical vein

CV I (7 decks)

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