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Cardiopulmonary Renal > Development Of Heart And Pericardium > Flashcards

Development Of Heart And Pericardium Flashcards

1
Q

What is the Foramen ovale?

A

Foramen ovale- opening between right and left atria during fetal life

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2
Q

What is septae?

A

Septae-connective tissue partition separating structures

  • Interventricular- found between the ventricles
  • Interatrial- found between the ventricles
  • Aorticopulmonary-found between the ascending aorta and pulmonary trunk
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3
Q

What is partitioning?

A

Dividing of embryological parts to enhance function

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4
Q

What is the ventricular septal defect?

A

A breach in the interventricular septum, with resultant consequences

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5
Q

What is the atrial septal defect?

A

A breach in the interarterial septum, with resultant consequences

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6
Q

What does the heart develop from?

A

Develops from carcinogenic mesoderm

Embryo folding and flexion causes repositioning of the heart and the establishment of normal anatomical relationships

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7
Q

Describe formation of the heart tubes

A

3rd week

  • Angioblastic cords/endothelial strands
  • Canalize to form two heart tubes
  • Lateral folding of the embryo occurs
  • Heart tubes fuse to form the tubular heart (a single tube )
    • Fusion occurs from the cranial to the caudal end
      • Beginning of development of pericardial cavity
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8
Q

How is the epicardium formed?

A

From mesothelium all cells arising from the external surface of the sinus venosus spreading over the myocardium

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9
Q

What is the myocardium formed from?

A

From myoblasts from the first heart field (cardiac mesoderm)

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10
Q

What is the endocardium formed from?

A

From the primitive heart tube

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11
Q

Describe the formation of transverse sinus?

A
  • Communication between both of the pericardial cavity
    • formed be degeneration of central part of dorsal mesocardium
    • In adult: pericardial reflection located posterior to aorta and pulmonary trunk, anterior to superior vena cava (SVC), superior to left atrium

Clinical significance: cardiothoracic surgeons can separate arteries from veins allowing for temporary ligation

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12
Q

What are the subdivisions of the tubular heart?

A
  • Truncus arteriosus
  • Bulbus cordis
  • Primitive ventricle
  • Primitive atrium
  • Sinus Venosus

Cephalic arterial end- continuous with aortic sac

Caudal venous end- opens into the sinus venosus
-from placenta, embryo and yolk sac

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13
Q

What does sinus venosus receive paired veins from?

A
  • The vitelline veins (omphalomesenteric vein)- from the umbilical vesicle
  • Common cardinal veins- from the embryo
  • Umbilical veins- from the chorion
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14
Q

Describe cardiac looing

A

Day 23-28

Bulbous cordis and ventricle grow faster than other regions causing it to bend itself

  • Viewed from the front the bulbus cordis and primordial ventricle undergoes a de trail loop forming the U-shaped bulboventricular loop resulting in the apex of the heart to the left
  • Primitive atrium and sinus venosus move dorsal (posterior) to truncus arteriosus, bulbus cordis and ventricle
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15
Q

What is the fate of the primitive atrium?

A

Left auricle
-Internal surface has a rough, trabeculated appearance

Right auricle
-Internal surface has a rough, trabeculated appearance

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16
Q

What is the fate of the sinus venosus?

A

Left horn- mostly obliterates
-remnants- the coronary sinus and the oblique vein of left atrium

Right horn- seen as sinus venarum
-smooth- walled part of right atrium

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17
Q

What is the fate of primitive ventricle?

A

Trabeculated part of the wall of the right and left ventricles

18
Q

What is the fate of the bulbus cordis?

A

Majorly contribute to form outflow tracts of the right and left ventricles

  • Right- conus arteriosus (infundibulum)
  • Left- Aortic vestibule
19
Q

What is the fate of truncus arteriosus?

A

Left- ascending aorta

Right- pulmonary trunk

20
Q

Explain the partitioning of the atrioventricular (AV) canal

A

-Towards the end of the 4th week

  • AV Endocardial cushions develop
    • from cardiac jelly and neural crest cells
    • forms on dorsal and ventral walls of AV canal
  • Endocardial cushions grow towards each other and fuse
    • divides canal into right and left AV canals
    • forms AV valves
    • partially separate primitive atrium from primitive ventricle
21
Q

Summarize formation of the right atrium

A

-right horn of the sinus venosus enlarges

  • Simultaneously primitive atrium enlarges
    • absorbs right horn forming right atrium
      • later becomes the sinus venarum (smooth part of the right atrium)

-Rough walled auricle is formed by primitive atrium

22
Q

Summarize the formation of the left atrium

A

Primordial pulmonary veins
Forms the left atrium
-primordial pulmonary veins persistently become incorporated into walls of the left atrium
-forms the oblique pericardial sinus
-Most of the wall is smooth
-Rough walled auricle is formed by primitive atrium

23
Q

Where is the oblique sinus?

A

Area of pericardium between the pulmonary veins

Limited by the reflection of the serous pericardium ion to the back of the heart

24
Q

Describe atrial partitioning

A

End of 4th week

Septum primum gross from the roof of atrium towards Endocardial cushions

  • Foramen primum- space between inferior edge of septum primum & the Endocardial cushions
  • Growth of septum primum closes Foramen primum
  • Foramen secundum- simultaneously perforations appear in septum primum
  • Septum secundum grows downward, eventually overlapping Foramen secundum
  • The opening between the free edges septum secundum and septum primum is called Foramen ovale or oval Foramen
25
Q

What is the function of the septum primum in atrial partitioning?

A

Septum primum (thin and flexible ) acts like a flap valve for Foramen ovale- the flap is open when right atrial pressure exceeds left atrial pressure - allowing shunting of blood from the right atrium to the left atrium

This allows the blood to bypass the lungs, which is not yet functional

26
Q

What is the cause of ostium secundum defect?

A

In the area of the fossa ovale

  • leads to patent/open Foramen ovale defect
  • disrupted or absent septa
  • Intracardiac shunting of blood (left to right)
  • most common in but least severe in ASD
27
Q

What is the sex ratio of ostium secundum defect?

A

Female to male ratio: 2:1

28
Q

What are the symptoms of ostium secundum defects?

A

Defects of both septa primum and secundum:

-excess resorption of septum primum- too short to close Foramen

  • abnormal resorption of septum primum
    • extra febestrations

-defective development of septum secundum with large fossa ovale

29
Q

Describe Endochondrial cushion defect with a Foramen primum defect

A
  • less common atrial septal defect
  • septum primum-not fused with Endocardial cushions- patent Foramen primum defect
  • Often associated with a cleft in the anterior cusp of the mitral valve
    • Fusion of Endocardial cushions forms AV valve
    • Failed fushion leads to an AV valve defect

-intracardiac shunting of blood (left to right)

30
Q

Describe sinus venous defect

A

Located in the sinus venarum
Defect:
-incomplete resorption of the right horn of sinus venosus into the right atrium

-abnormal development of the septum secundum, or a combination of these factors

Intracardiac shunting of blood (left to right)

31
Q

Describe common atrium

A
  • prevelant in patients with ostium primum, ostium secundum and sinus venosus defects
  • complete absence of interarterial septum
32
Q

What are the atrial septum defects?

A
  • common atrium
  • sinus venosus defects
  • Endocardial cushions defect with a Foramen primum defect

Ostium secundum defect

33
Q

Explain the partitioning of the common ventricle

A

Muscular interventricular (IV) septum-develops first

  • formed from myocytes from the primitive ventricle
  • has a concave superior free edge (forms the IV Foramen)
  • ventricular dilation leads to an increase in size of septum

IV foramen
-allows for communication between the right and left ventricles

  • bulbar ridges and muscular IV septum fuses with the Endocardial cushion forming membranous IV septum
  • later fuses with the articopulmonary septum
  • once membranous IV septum formed, leads to closure of the IV foramen
    • pulmonary trunk now forced to communicate with right ventricle
    • ascending aorta now forced to communicate with left ventricle
34
Q

Discuss the partitioning of Bulbus Cordis and Truncus Arteriosus by aorticopulmonary (spiral) septum

A

5th week

-Bulbar ridges from within the bulbus cordis (middle 1/3)

  • Truncal ridges develop within the truncus arteriosus
    • ridges grow towards each other, spiraling around each other (180 degrees)
      • fuses forming the aorticopulmonary septum
        • septum divides the truncus arteriosus and bulbus cordis into the pulmonary trunk and aorta
35
Q

What are the types of ventricular septal defect?

A

Muscular

Membranous

36
Q

What is common in both types of ventricular septal defect?

A

Both types of VSDs:
-more common in males than females

  • accounts for about 25% of congenital heart defects
  • intracardiac shunting of blood (left to right)
37
Q

Describe muscular ventricular septal defect

A

No muscular septum results in a common ventricle

Occurs anywhere throughout the septum
-in isolation or simultaneously (“Swiss cheese” VSD)

38
Q

Describe membranous ventricular septal disease

A

Most common type

No membranous septum- incomplete closure of the IV foramen

39
Q

How are the semilunar valves developed?

A

3 swellings of subendicardial cushion tissue around the orifices of aorta (aortic vestibule) and pulmonary trunk (infundibulum)

Hollowed out and reshaped forming three thin-walled cusps

40
Q

How are the atrioventricular valves?

A

-localized proliferations of endocardial cushion tissue around AV canals

41
Q

What are the cardiac structures derived from neural crest cells?

A
  • endocardial cushions (in the outflow tract)
  • bulbar ridges
  • truncal ridges
  • spiral septum
  • membranous interventricular septum
  • semilunar valves
  • atrioventricular valves
  • pharyngeal arches

Cardiopulmonary Renal (35 decks)

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