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CVS Anatomy > Development Of The Heart > Flashcards

Development Of The Heart Flashcards

1
Q

The CVS develops in ….

A

Middle of 3rd week

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2
Q

GR: CVS has to develop very early

A

Due to that the rapidly growing embryo can no longer maintain sufficient nutrition and oxygenation of inner parts by simple diffusion.

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3
Q

Mention embryonic origin of CVS & name the process

A

Mesodermal

Angiogenesis

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4
Q

Mention steps of formation of blood vessels

A

Mesodermal angiogenic cells form blood islands which acquire lumena and form endothelial channels which become interconnected together, the surrounding mesoderm forms mucular & CT of blood vessels

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5
Q

Mention extra & intra-embryonic vessels & origin of each

A

E: vitelline vessels around youlk sac, umbilical vessels extend to chorion, originate from extra-embryonic mesoderm
I: 2 dorsal aortae, originate from intra-embryonic splanchnic mesoderm

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6
Q

Primitive blood cells develop from …..

A

Vitelline & umbilical vessels

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7
Q

Mention Intra-uterine organs of hemopoiesis & those continuing post-natal

A

Liver, spleen, bone marrow & lymph nodes

Bone marrow & lymph nodes

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8
Q

Mention shape & site of pericardial sac

A

Carnial part of U-shaped intra-embryonic coelom, between bucco-pharyngeal membrane (caudally) & septum transversum (cranially)

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9
Q

Mention shape & site of cardiogenic plate

A

Horse-shoe shaped, ventral to pericardial sac

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10
Q

Mention steps of development from cardiogenic plate to single heart tube

A

Angiogenic cell clusters develop, they acquire lumen and fuse together forming rt & lt endocardial tubes which fuse in cranio-caudal direction.

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11
Q

Mention site of myoepicardial mantle

A

Between the pericardial sac & endocardial tube

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12
Q

Mention structure separating myoepicardial mantle from heart tube

A

Cardiac jelly

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13
Q

Mention the origin of each:

  1. Endocardium
  2. Myocardium
  3. Epicardium
A
  1. Endocardial heart tube
  2. Myoepicardial tube
  3. Visceral layer of pericardial sac
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14
Q

The heart tube & pericardial sac rotate on a transverse axis …. Degrees

A

180

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15
Q

Describe position of heart tube relative to neighbouring structures following folding

A

Ventral to foregut
Cranial to septum transversum
Caudal to bucco-pharyngeal membrane
Dorsal to pericardial sac

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16
Q

The endocardial heart tube invades pericardial sac from …. Aspect

A

Dorsal

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17
Q

Absorption of dorsal mesocardium leads to formation of …..

A

Transverse sinus of pericardium

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18
Q

Mention dilatations of heart tube in cranio-caudal order

A

Truncys arteriosus, bulbus cordis, ventricle, atrium, sinus venosus

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19
Q

The first chamber to appear are ……&…. . The last is ….

A

Bulbus cordis, ventricle

Sinus venosus

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20
Q

….&… are initially outside pericardial sac

A

Atrium & sinus venosus

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21
Q

Each horn of sinus venosus recieves the following:

A
  1. Vitelline vein from yolk sac
  2. Umbilical vein from placenta
  3. Common cardinal vein from body wall
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22
Q

A total of ….. arches connect each dorsal aorta with corresponding horn.
Mention fate of 2 dorsal aorta

A

6

Their caudal parts fuse together forming single dorsal aorta

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23
Q

Mention causes of bending of heart tube

A
  1. Elongation of heart tube while its two ends are fixed
  2. Disproportionate growth of heart tube & pericardial sac
  3. Disproportionate growth of different parts of heart tube
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24
Q

Steps of bending of heart tube

A
  1. Bulbus cordis & ventricle elongate more rapidly with formation of U-shaped bulbo-ventricular loop.
  2. Cardiac loop becomes S-shaped as the atrium & sinus venosus are dragged inside pericardial sac with approximation of the arterial & venous ends of the loop.
  3. Blbus cordis shifts to right of ventricle
  4. The atrium expands transversely amd bulges on either side of bulbus cordis
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25
Q

Heart & pericardium migrate from ….. to ….

A

3rd - 4th somites

17th - 20th somites

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26
Q

Both valves of sinus venosus fuse together cranially forming …..

A

Septum spurium

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27
Q

What happens due to the left to right shunt of venous blood?

A

Right horn progressively enlarges in comparison to the diminishing body and left horn. Sino-atrial orifice moves to right opening into future right atrium

28
Q

Describe formation of smooth part of right atrium & its name

A

Sinus venarum

Right horn is incorporated into the right atrium due to wifening of sino-atrial orifice.

29
Q

Mention fate of tributaries of right horn of sinus venosus

A

The right commmon cardinal , lower part of SVC
The opening of right vitelline vein, opening of IVC
Right umbilical disappears

30
Q

Mention fate of tributaries of left horn of sinus venosus

A

Body & left horn, coronary sinus
Left common cardinal, oblique vein of left atrium
Left umbilical & vitelline veins lose their connections

31
Q

Mention fate of valve sinus venosus

A

Upper part of right vv, crista terminalis
Lower part of right vv, valves of IVC & coronary sinus
Left venous valve, inter-atrial septum

32
Q

Where do endocardial cushions appear? What do they form?

A

On ventral & dorsal walls of A-V canal

Septum intermedium which divides canal into right & keft parts

33
Q

Fate of A-V canal

A
  1. Ventricular opening develops endothelial proliferation which forms cusps of A-V valves.
  2. Share in formation of atria
  3. Membranous part of IV septum
34
Q

Compare 1, foramen primum & 2, foramen secondum

A

1, the septum primum grows from roof of atrium towards septum intermedium separated from it by foramen primum.
2, the septum primum ruptures in its center forming foramen secondum

35
Q

Mention site of septum secobdum & foramen found below it

A

Right side of septum primum

Foramen ovale

36
Q

Describe the flow of blood in fetal heart & mechnism to prevent regurge

A

It passes from right atrium to left atrium via a tortuous S-shaped course through foramen ovale then foramen secondum.
The flap-valvular action of remaining lower part of septum primum closes foramen ovale preventing regurge.

37
Q

What is the result if absorption if proximal part of pulmonary venous system

A

The four pulmonary veins open directly in the left atrium

38
Q

Mention sources of right atrium

A

The right half of primitive
The absorbed right horn of sinus venosus
The upper part of right atrio-ventricular canal

39
Q

Mention sources of left atrium

A

The left half of primitive atrium, absorbed pulmonary veins, upper part of left atrio-ventricular canal.

40
Q

Fate of lower part of bulbus cordis

A

Incorporated with common ventricle forming bulbo-ventricular chamber. It forms rough inflowing parts of both ventricles.

41
Q

Describe development if proximal part of smooth part of bulbus cordis

A

Divided by proximal bulbar septum to ventral (infundibulum of Rt ventricle) & dorsal (vestibule of Lt ventricle).
The septum shares in IV septum.

42
Q

Describe development if distal part of smooth part of bulbus cordis

A

Divided by dorsal bulbar septum into dorsal (aortic orifice) & ventral (pulmonary orifice)
Each orifice develops 3 valves (aortic, 2A & 1P,,pulmonary 2P & 1A) at the beginning, then with rotation the semilunar valves assume their normal anatomical position. They are also hollowed forming cusps.

43
Q

Mention origin of muscular part of the IV septum

A

Initially result of dilatation of both ventricles & fusion of opposing walls.
Later, active cellular proliferation

44
Q

Mention origin of membranous part of IV septum

A
  1. The septum intermedium (mainly dorsal cushion)

2. The proximal bulbar septum

45
Q

What structures result from spongework cavitation of myocardium

A

Trabeculae carneae, papillary muscles, chordae tendinae

46
Q

Name the septum dividing ascending aorta & pulmonary trunk

A

Spiral aortico-pulmonary septum

47
Q

GR: The valves are situated at the beginning of ascending aorta & pulmonary trunk

A

Because the lower border of the spiral septum fuses with distal bulbar septum.

48
Q

GR: The two great vessels are ensheathed by a single coat of serous pericardium

A

Because the pulmonary trunk and ascending aorta are developed from the same tube.

49
Q

GR; Helical arrangement of the two great vessels

A

Because of the spirality of the septum separating them

50
Q

Mention methods of formation of cardiac septa

A

Cell proliferation

Non-growing ridge between 2 expanding chambers (never divides lumen)

51
Q

All cardiac septa develop in the ……, except ….. develops in …..

A

4th week
Aortico-pulmonary septum
5th week

52
Q

Frequency of CHD is …..

They occur due to …..

A

6-8/1000 births

Genetic or environmental causes

53
Q

Mention cardiac anomalies of position

A

Dextricardia

Ectopia cordis

54
Q

Describe dextricardia & its cause

A

Right sided heart, alone or in situs inversus totalis.

Due to bending of heart to the right & not to the left

55
Q

Describe ectopia cordis & its cause

A

Heart protrudes through a median gap in chest, due to faulty development of the sternum.

56
Q

Mention variants of site of atrial septum defect and its C/P

A

A hole in middle of inter-atrial septum (site of fossa ovalis)
A hole in lower part of interatrial septum (fossa primum defect) +/- persistent A-V canal
A hole in upper part of interatrial septum
Trilocular biventricular heart
C/P cyanosis due to right-to-left shunt

57
Q

Causes of interatrial defect according to site

A

Middle:
1. Underdeveloped septum secondum
2. Excessive resorption of septum primum
3. Failure of fusion of septa (probe-patent fossa ovalis) founf in 25% of normal hearts
Lower: failure of endocardial cushions to grow and fill fossa primum +/- failure of cushions to grow together.
Upper: due to failure of absorption of sinus venosus & failure of incorporation of the venosus valve to the septum
Common atrium: failure of formation of both septa

58
Q

Mention types of atrial septal defects (4)

A
  1. Patent foramen ovale
  2. Endocardial cushion ASD
  3. Sinus venous ASD
  4. Common atrium
59
Q

Mention the VSDs their cause & description

A

Membranous VSD, persistence in IV foramen, due to failure of formation of membranous part (Roger’s disease)
Muscular VSD, a hole or mutiple holes (swiss cheese VSD) in muscypular septum due to excessive cavitation
Common ventrucle, due to failure of formation of both septa

60
Q

Mention defects if truncus arteriosus

A
  1. Persistent truncus arteriosus
  2. Tramsposition of geart vessels
  3. Congenital stenosis or atresia of pulmonary or aortic orifice
  4. Fallot’s tetralogy
61
Q

Mention description & cause of pesistent truncus arteriosus

A

One vessel recieves blood from both ventricles & distributes it to pulmonary & systemic circulations
Due to failure of formation aortico-pulmonary septum

62
Q

Mention description & cause of transposition of great vessels

A

The aorta from rt v & pulmonary trunck from lt v

Due to formation of non-spiral pulmonary septum

63
Q

Mention cause of stenosis or atresia of aortic or pulmonary orifice

A

Unequal division of truncus arteriosus

64
Q

Write a short note on Fallot’s tetralogy

A
  1. Pulmonary stenosis
  2. Hypertrophy if Rt ventricle
  3. Membranous VSD
  4. Overriding of aorta on pulmonary septum
    Caused by unequal division of truncus arteriosus with very narrow pulmonary trunk & its valve & very wide aorta & its valve, rt ventricular hypertrophy is 2ry to pulmonary stenosis.
65
Q

The most common congenital heart defect is …..

A

VSD

66
Q

… is common in males,….is common in females

A

VSD, ASD

67
Q

…… is the most common cause of neonatal cyanosis

A

Fallot’s tetralogy

CVS Anatomy (11 decks)

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