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CPR Exam 1 > Development Of The Great Vessels > Flashcards

Development Of The Great Vessels Flashcards

1
Q

Intraembryonic Vasculogenesis happens what day

A

Day 19

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2
Q

How does the fetal circulation bypass the liver

A

The O2 rich blood bypasses the liver and flows into the IVC and RA
MOST OF IVC —> LA (through the foramen ovale)
MOST OF SVC —> RV
*ductus venosum

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3
Q

Where do most fetal blood go after RV

A

90% goes into descending aorta through the Ductus Arteriosus
10% thought the pulmonary a to lungs

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4
Q

LV pumps blood into

A

Ascending aorta

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5
Q

What keeps the ductus arteriosus open

A

Prostaglandins

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6
Q

What causes the ductus arteriosus to close

A

The O2 tension and BF changes + prostaglandins decrease = cause SM contractions in the patents arteriosus

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7
Q

What can you get if you have an unclosed patent ductus arteriosus
And increased risk for what

A

Pulmonary congestion and congestive heart failure from LV hypertrophy
Increased risk for maternal rubella infection

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8
Q

To for PDA

A

Idomethacin or surgery

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9
Q

Coarctation

A

When the descending aorta thickens in wall and gets constricted and Ductus arteriosus remains open(this can happen before the DA or after the DA attaches)
*more common in Turner’s syndrome

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10
Q

Interrupted aortic arch is most common in what

A

DiGeorges Syndrome

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11
Q

How many aortic arches are there

A

6

5th one never truly forms

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12
Q

Which aortic arches hypertrophy

A

3,4,6

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13
Q

Which vessels are added to the aortic arches

A

External carotid, distal part of pulmonary artery

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14
Q

Initial growth of dorsal aorta is how

A

Paired which fused and grows caudally from T4

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15
Q

How is the aorta and pulmonary a formed

A

The truncus arteriosus is divided by the aorticopulmonary septum

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16
Q

Intersegmental arteries

And how many are there

A

From parasail mesoderm and they connect to the dorsal aorta

There are 7 C, 12 T, 5 L

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17
Q

Cervical Dorsal Intersegmental Arteries

A

7
All connected by longitudinal anastomoses
1-6 drop out from anastomoses and become VERTEBRAL As
7th remains on left and becomes LEFT SUBCLAVIAN A and a portion on the RIGHT subclavian A on the right

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18
Q

Thoracic Dorsal Intersegmental Arteries

A

12
Anastomoses between the inferior and superior IA become INTERNAL THORACIC As
The IA themselves become INTERCOSTAL As

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19
Q

Lumbar Dorsal Intersegmental Arteries

A

5

These anastomoses become EPIGASTRIC VESSELS + ILIAC VESSELS

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20
Q

What happens to the Aortic Arch of 1

A

Breaks up and reorganizes with AA 2

Becomes MAXILLARY A

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21
Q

What happens to the Aortic Arch of 2

A

Breaks up and reorganizes with AA1

Becomes STAPEDIAL As

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22
Q

What happens to the Aortic Arch of 3

A

Also called carotid arch *main feeder to head

Becomes the COMMON CAROTID + PROXIMAL part of INTERNAL CAROTID

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23
Q

Where does the internal carotid come from

A

The dorsal aorta

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24
Q

Where does the external carotid come from

A

The from the AA3

25
Q

What happens to the Aortic Arch of 4

Left side

A

Hypertrophied
LEFT : AORTIC ARCH in newborns.
1st part = aortic sac
2nd part = AA 4
3rd part = left dorsal aorta proximal to 7th intersegmental A
4th part = left dorsal aorta distal to 7th IA
5th part = spiral septum connects left AA 4 to the LV
*7th IA becomes the left subclavian a

26
Q

What happens to the Aortic Arch of 4

RIGTH side

A

Hypertrophied
Becomes the PROXIMAL part RIGTH SUBCLAVIAN A
*right 7th IA makes the distal part
*dorsal aorta makes middle part

27
Q

What makes up the proximal right subclavian

A

The AA 4 right side

28
Q

What makes up the right subclavian distal part

A

The right 7th IA

29
Q

What happens to the Aortic Arch of 5

A

Never forms

30
Q

What happens to the Aortic Arch of 6

A

Becomes the PULMONARY As at proximal part of AA6 and aortic sac

31
Q

AA 6 on the left side

A

DA is connected and the recurrent laryngeal N is hooked around distal AA6 = becoming the future LIGAMENTUM ARTERIOSUM

32
Q

AA 6 of the RIGTH side

A

Distal part of AA 6 (right) loosed connection with right dorsal aorta as it regresses in the fetus
= causes recurrent laryngeal N (PA 6 nerve) to hook around the future RIGTH SUBCLAVIAN A

33
Q

Dorsal Aorta has 3 parts

A
  1. Between AA 3 and AA 4 : CAROTID DUCT —> obliterated
  2. Between RIGTH 7th IA and Left dorsal aorta junction —> RIGTH dorsal aorta obliterated
  3. Caudal part of right and left Dortal Aorta : FUSE ——> Descending thoracic and abd aorta*
34
Q

Vitelline arteries

A

Vessels to YOLK SAC which become GI VASCULATURE

35
Q

Umbilical arteries

A

Paired from dorsal aorta
To PLACENTA + bladder
Connects to 5th IA lumbar
(Distal parts go to umbilicus are obliterated at birth)

36
Q

Distal Umbilical arteries

A

Obliterated and become MEDIAL UMBILICAL LIGAMENTS

37
Q

Proximal part of 5th lumber IA

A

Still stay in adult as umbilical arteries with SUPERIOR VESICULAR A branch ——> bladder

38
Q

In the fetus most O2 rich blood goes where

A

From the Ascending Aorta to the Heart, Head, Neck, and upper extremities

39
Q

Reason LV hypertrophies in PDA

A

The Pressure in the aorta is higher then the pulmonary a
To blood flows from the aorta to the pulmonary a recirculating the lungs (2-3 times) = more work for the LV to pump blood to the body

40
Q

Endothelin

A

GF released from lung endothelial cells in fetus = stimulate SM contractions to close the DA

41
Q

Reason for pulmonary congestion and congestive heart failure in PDA

A

Increased BF to the lungs = increased pulmonary resistance to limit amount going through lungs
——> pulmonary congestion and eventually backs up into the heart causing congestive heart failure (blowing type murmur)

42
Q

preductal vs postductal coarctation

A

POST: sometimes unnoticed due to well developed IA and intercostal As inde interval thoracic As collateral system
PRE : child dies unless surgery, not well developed collaterals, O2 blood doesn’t reach body

43
Q

Aberrant origin of right subclavian

A

RIGTH subclavian is made by : DISTAL right dorsal aorta + 7th IA

Right AA 4 and PROXIMAL right dorsal aorta obliterated
*difficulty swallowing + breathing (rda must cross esophagus to reach upper right limb)

44
Q

Double aortic Arch

A

Goes around the esophagus and trachea

Can cause esophageal dysfunction or strangulation of trachea

45
Q

Right Aortic Arch dysfunction

A

Left AA 4 and Left dorsal aorta are obliterated

Cause dysphagia, dyspnea (left subclavian goes behind and ligamentum arteriosum goes in front of trachea——> left side)

46
Q

Interrupted Aortic Arch

A

Right AA 4 + proximal rda obliterated (like in aberrant right subclavian)
AND LEFT AA 4 obliterated also
Ductus Arteriosus remain open (lowO2 to body)
* more likely in DiGeaorges Syndorme

47
Q

3 Venous systems in the fetus

A
  1. VITELLINE : blood from yolk sac —> sinus venosus —> septum transversum
  2. UMBILLICAL : from chorionic villli in placenta (O2 blood)
  3. CRDINAL : drains embryo body
48
Q

Where do the vitelline veins go

A

Through the sinus venosum, septum transversum, —> liver primordia ( becoming HEPATIC SINUSOIDS)
Right part of liver, veins become HEPATOCARDIAC CHANNEL —> IVC

49
Q

Inferior vitelline veins become

A

Regress except some is left ——> portal vein, superior + inferior on mesenteric vein, Splanchnic vein

50
Q

Umbilical veins travel how and connect to what

A

On either side of the liver and connect to hepatic sinusoid

*Left umbilical vein is the only one that stays and take blood from placenta to liver

51
Q

Connection between what and what make the ductus venosus

A

The left umbilical vein and right hepatocardiac channel

DV bypass blood past the hepatic sinusoidal plexus

52
Q

What happens to the left umbilical vein and ductus venosus after birth

A

The left umbilical vein —> LIGAMENTUM teres hepatis

The DV —> LIGAMENTUM venosum

53
Q

Cardinal Vein join and enter what

A

The anterior and posterior Cardinal veins join (COMMON Cardinal vein) and then inter the sinus horn

54
Q

Anterior Cardinal veins

A

Drain head and neck
Forms LEFT BRACHIOCEPHALIC VEIN
*most of left anterior cardinal vein regresses forming coronary sinus

55
Q

SVC is formed from what

A

Right common cardinal vein

56
Q

Abnormal anterior cardinal vein can cause

A

SVC to drain to the heart through the coronary sinus

57
Q

Posterior Cardinal veins

2 of them

A

Subcardinal

Supracardinal

58
Q

Subcardinal veins

A

Veins to kidney, and gonads

Forms ABD IVC

59
Q

Supra cardinal veins

A

Veins draining body wall

Forms part of IVC and AZYGOS system

CPR Exam 1 (20 decks)

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