Development of heart and great vessels Flashcards

1
Q

Where do the blood islands lie?

A

In mesoderm

on both sides

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2
Q

What are the blood islands surrounded by?

A

Cavity

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3
Q

What do the blood islands initially form?

A

Endocardial tubes

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4
Q

What do the blood islands eventually form?

A

Blood cells
Small vessels
Heart

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5
Q

What does the cavity form?

A

The pericardium

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6
Q

What happens to the endocardial tubes?

A

They meet each other in the midline
fuse together
to form the primitive heart tube
by lateral folding of the embryo

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7
Q

What are the zones of the primitive heart tube?

A
Sinus venosus
Atrium
Ventricle
Bulbous cordis
Truncus arteriosus
Aortic roots
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8
Q

What is the direction of blood flow in the primitive heart tube?

A

From the sinus venosus to the aortic roots

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9
Q

What happens to the primitive heart tube after it has formed?

A

Undergoes cardiac looping

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10
Q

Why does cardiac looping occur?

A

Primitive heart tube is growing within pericardial sac
not enough space for it to keep growing vertically
folds up to maximise its use of space in the pericardial sac

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11
Q

How does cardiac looping occur?

A

Sinus venosus and atrium move superior and posteriorly

Ventricle, bulbous cordis, truncus arteriosus, aortic roots all move anteriorly and inferiorly

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12
Q

What has cardiac looping done to the position of the atrium, ventricle, inflow and outflow vessels?

A

Placed them at correct orientation to each other

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13
Q

What happens to the primitive heart tube after cardiac looping?

A

Needs to be divided into four chambers, two atria and two ventricles

Inflow and outflow tracts need to be remodelled

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14
Q

What does the right atrium develop from?

A

Most of the primitive atrium

Small part of sinus venosus

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15
Q

What does the left atrium develop from?

A

Small part of primitive atrium

Mostly from proximal part of primitive pulmonary veins

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16
Q

What is the texture of the right atrium? And the left atrium?

A

Rough and trabeculated

Left atrium is smooth

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17
Q

Why is the left atrium smooth compared to the right atrium?

A

Because the left atrium has developed mostly from blood vessels
which have smooth walls

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18
Q

What forms the endocardial cushions? Where do they come from?

A

Neural crest cells

Migrate into the heart from elsewhere

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19
Q

Where are the endocardial cushions located in the heart?

A

Base of atrium

in middle

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20
Q

What is the function of the endocardial cushions?

A

To act as scaffold

used to form the septum

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21
Q

How does the septum primum form?

A

Grows downwards from roof of atrium to endocardial cushion

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21
Q

What shape is the septum primum?

A

Crescent shaped - contains opening

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23
Q

What is the name of the opening in the septum primum?

A

The ostium primum

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24
Q

What happens to the ostium primum?

A

The septum primum continuing to grow downwards

closing up the ostium primum

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24
Q

What happens before the ostium primum is closed?

A

Upper septum primum
cells die by apoptosis
creating a second opening

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25
Q

What is the second opening in the septum primum called?

A

The ostium secundum

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26
Q

How does the septum secundum form?

A

Grows downwards from atrium to endocardial cushions

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27
Q

Where does the septum secundum lie relative to the septum primum?

A

Are adjacent to each other

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28
Q

What does the septum secundum contain? What is an important feature of this structure?

A

Contains an opening

Importantly, it does not line up with the ostium secundum

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29
Q

The opening in the septum secundum and the ostium secundum form what?

A

The foramen ovale

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30
Q

What keeps the foramen ovale open in the foetus?

A

Blood flowing through it

pushes the septum primum and septum secundum apart

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31
Q

What is the ventricular septum made up of? Which component forms most of the septum?

A

Muscle - forms most of the septum

Membrane

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32
Q

How does the muscular portion of the septum grow?

A

Muscular septum grows up from near apex of ventricle
to endocardial cushion
leaves small gap

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33
Q

What is the name of the small gap between the endocardial cushion and the muscular septum?

A

Primary interventricular foramen

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34
Q

What type of tissue is the membranous portion of the septum?

A

Connective tissue

35
Q

How does the membranous portion of the septum grow?

A

Grows downwards from endocardial cushion

to muscular portion of septum

36
Q

What happens to the primary interventricular foramen?

A

Closed by the membranous portion of the septum

37
Q

How is the outflow tract separated into the aorta and pulmonary trunk?

A

Endocardial cushions in truncus arteriosus
grow towards each other
twist around each other
forming spiral septum

38
Q

Why are the aorta and pulmonary trunk twisted around each other?

A

Because of the endocardial cushions twisting around each other
To form a spiral septum

39
Q

Where does foetal blood become oxygenated?

A

Placenta

40
Q

What carries oxygenated blood from the placenta to the foetus?

A

The umbilical vein

41
Q

What are the three circulatory shunts in the foetus?

A

Foramen ovale
Ductus venosus
Ductus arteriosus

42
Q

What is the ductus venosus?

A

Shunt that bypasses the liver

42
Q

What circulatory shunt comes after the umbilican vein?

A

Ductus venosus

43
Q

Why is the liver bypassed in foetal circulation?

A

Very metabolically active

would consume most of oxygen and nutrients, leaving little for rest of foetus

45
Q

What carries the blood after the ductus venosus?

A

The IVC

45
Q

What circulatory shunt comes after the IVC?

A

The foramen ovale

46
Q

What direction does the blood flow through the foramen ovale?

A

RA to LA

46
Q

What is the state of the lungs in the foetus?

A

Filled with amniotic fluid

47
Q

What happens to the pulmonary vessels in the foetus? Why?

A

Lack of oxygen in the alveoli gives hypoxic pulmonary vasoconstriction

48
Q

What is the relative pulmonary vascular resistance in the foetus? Why?

A

High

due to the pulmonary vessels being vasoconstricted, decreases their radius

50
Q

Does some blood flow from the RA to the RV?

A

Yes

leaks into it from RA

51
Q

Why does blood flow from the RA to the LA in the foetal circulation?

A

RA pressure is higher than LA pressure

because of high pulmonary vascular resistance, increasing pressure in the RV and RA

51
Q

Why is it important that some blood leaks into the RV?

A

To give it blood to contract against

allowing for proper development of RV

52
Q

What happens to the blood in the RV?

A

RV contracts
ejects blood into pulmonary trunk
blood passes from pulmonary trunk to aorta through ductus arteriosus

54
Q

Why does blood move from the pulmonary trunk to the aorta?

A

High pulmonary vascular resistance

less resistance to blood flow from ductus arteriosus into aorta

55
Q

Where does blood travel after it leaves the aorta?

A

To foetal body

to placenta

55
Q

What type of blood is travelling to the placenta?

A

Deoxygenated blood

56
Q

What happens to the placental circulation after birth?

A

Removed

58
Q

What happens to systemic vascular resistance after birth? Why?

A

Increases

Because a major route of blood flow, the placental circulation, has been removed

59
Q

What happens to the ductus venosus after birth?

A

Closes up

60
Q

What happens to the pulmonary vessels after birth? Why?

A

Pulmonary vessels vasodilate

due to the presence of oxygen in the alveoli

60
Q

What happens to the lungs after birth?

A

Inflate with air

fluid is pushed out

61
Q

What happens to pulmonary vascular resistance after birth? Why?

A

Pulmonary vascular resistance decreases

because of vasodilation of pulmonary vessels

62
Q

What happens to blood flow through the pulmonary circulation after birth? Why?

A

Blood flow in pulmonary circulation increases

due to decrease in pulmonary vascular resistance

63
Q

What happens to pressure in the LA after birth? Why?

A

Increases
due to high systemic vascular resistance
and increased blood flow from pulmonary veins

64
Q

What effect does increased LA pressure have on the foreman ovale? How?

A

Increased LA pressure pushes septum primum against septum secundum
fuse together
closing foramen ovale

65
Q

Why was it important that the ostium secundum and the hole in the septum secundum didn’t align?

A

So when the septum primum is pushed against the septum secundum
Both openings are blocked

66
Q

What happens to the ductus arteriosus?

A

Contracts and closes up

67
Q

What is the remnant of the foramen ovale called?

A

Fossa ovalis

68
Q

What is the remnant of the ductus arteriosus called?

A

The ligamentum arteriosum

70
Q

What does the early arterial system look like?

A

Many arched vessels

Bilaterally symmetrical

71
Q

What happens to these arched vessels?

A

Remodelled to form the major arteries that branch off the aorta

72
Q

How many arches are there in the early arterial system?

A

6

73
Q

What does the 4th arch on the right side form?

A

Proximal part of subclavian artery

74
Q

What does the 4th arch on the left side form?

A

The aortic arch

76
Q

What does the 6th arch on the right side form?

A

Right pulmonary artery

76
Q

What does the 6th arch on the left side form?

A

Left pulmonary artery, ductus arteriosus

78
Q

What is the nerve corresponding to the 6th arch?

A

The recurrent laryngeal nerve

79
Q

What is unusual about the left recurrent laryngeal nerve?

A

It descends from the neck
Hooks around ductus arteriosus/ligamentum arteriosum
Then ascends back up to neck

81
Q

What causes the left recurrent laryngeal nerve to hook around the ductus arteriosum?

A

Tangling of nerves as heart descends from embryonic neck to thorax during development

82
Q

What is the crista dividens?

A

Border of septum secundum in the right atrium

83
Q

What is the function of the crista dividens?

A

Create two routes of blood flow in the right atrium

84
Q

What are the two routes of blood flow in the right atrium?

A

Majority of blood flow into left atrium

Small amount of blood flow into right ventricle

85
Q

Blood from what flows from the right atrium into the right ventricle?

A

Blood from the superior vena cava

86
Q

Where does the ductus arteriosus arise from the aorta?

A

After the three branches of the aortic arch

  • brachiocephalic trunk
  • left cartoid
  • left subclavian