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c2 > development of the heart > Flashcards

development of the heart Flashcards

1
Q

what are the 3 germ layers?

A

endoderm
mesoderm
ectoderm

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2
Q

what is derived from the endoderm?

A

gut and associated derived tissues (liver, pancreas and lungs)

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3
Q

what is derived from the mesoderm?

A

bones, connective tissue, skeletal muscle, urogenital system, cardiovascular system

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4
Q

what is derived from the ectoderm?

A

skin, CNS, PNS, eyes, internal ear

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5
Q

what does the early heart develop from?

A

cardiogenic mesoderm (lateral plate) originally lying above the cranial end of the developing neural tube

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6
Q

what are the first stages of forming the primitive heart?

A

angiogenic cell clusters coalesce forming right and left endocardial tubes

Lateral folding of embryo results in fusing of paired endocardial tubes to form primitive heart tube

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7
Q

what is the truncus arteriosus?

A

proximal aorta and pulmonary artery

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8
Q

what is the bulbus cordis?

A

ventricular outflow tracts

right ventricle

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9
Q

what is the primitive ventricle?

A

left ventricle

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10
Q

what is the primitive atria?

A

left and right atria

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11
Q

what is the sinus venosus?

A

smooth part of right atrium and coronary sinus

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12
Q

what is the length of the endocardial tubes limited by and how?

A

limited in length by the pericardium

tube folds within the pericardium –> puts chambers and vessels into similar alignment to the adult heart

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13
Q

when does the heart tube fold into the pericardium?

A

between days 23 and 28

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14
Q

what is the first step in separating the atria and ventricles?

A

septum formation in the atrio-ventricular canal

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15
Q

how does septum formation occur in the atrio-ventricular canal and when?

A

at 28 days, 2 endocardial cushions appear from the walls of the canal
they grow and fuse together to divide canal into right and left

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16
Q

what is the septum primum?

A

grows from the top of the atria towards the endocardium cushion

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17
Q

what is the ostium primum?

A

space between the inferior edge of the septum and the cushion

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18
Q

what is the ostium secundum?

A

second hole that forms in the septum

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19
Q

when does the ostium primum close?

A

once the ostium secundum has formed

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20
Q

when does the septum secundum form?

A

when the septum primum reaches the endocardial cushions

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21
Q

what is the foramen ovale?

A

the valve from the right atrium to the left atrium that’s formed from the 2 septums that form - allows blood to bypass the pulmonary circulation

22
Q

why does the foramen ovale stay open before birth?

A

higher pressure in the RA than the LA so the septum primum is opened and the foramen ovale is open

23
Q

why does the fossa ovalis close after birth?

A

higher pressure in the left atrium so the septum primum closes and so does the fossa ovalis

24
Q

when does probe patent foramen ovale occur?

A
  • occurs when the foramen ovale doesn’t completely close

- hole is big enough to pass a probe through it

25
Q

how many people does the probe patent foramen ovale occur in?

A

25% of people

26
Q

why is a probe patent foramen ovale not very significant?

A

bc it’s a valve so as long as there’s a higher pressure in the LA then the valve won’t open

27
Q

are atrial septal defects more common in women or men?

A

women

28
Q

what part of the heart is affected in atrial septal defects?

A

defect in either the septum primum or the septum secundum

29
Q

why are atrial septal defects serious?

A

not a valve so blood flows from the left to the right side of the heart

30
Q

how does ventricular septation occur?

A

AT 28 days a muscular IVS develops from floor of primordial ventricle and grows to the endocardial cushion
- membranous components grows down from the cushion to the muscular component which is growing upwards and they fuse

31
Q

what is the most common type of cardiac defect?

A

ventricular septal defect - 25%

32
Q

how many VSDs will close spontaneously?

A

30-50%

33
Q

how many VSDs are in the membranous septum and how many are in the muscular septum?

A

90% - membranous septum

10% - muscular septum

34
Q

how does right sided hypertrophy occur?

A

• Hole in ventricular septum means blood shunts from the left to the right which causes pulmonary hypertension  right sided hypertrophy of the heart

35
Q

what is the purpose of outflow tract septation?

A

split up the aorta and the pulmonary artery

36
Q

how does outflow tract septation occur?

A

truncoconal swelling form in the truncus arteriosus and grow towards each other in a spiral structure
aorta therefore connects with the left ventricle and the pulmonary trunk with the right ventricle

37
Q

what is the function of the ductus venosus?

A

shunts blood from umbilical vein to IVC

38
Q

what does the foramen ovale become when it’s closed?

A

fossa ovalis

39
Q

what is the function of the ductus arteriosus?

A

shunts blood from pulmonary trunk to ascending aorta (bypassing lungs)

40
Q

what do the ductus arteriosus and ductus venosus fibrose to become?

A

ligamentum arteriosus and venosus

41
Q

what are acyanotic congenital heart diseases?

A

a group of cardiac diseases with a left to right shunt or left heart abnormality which doesn’t result in cyanosis (blue skin colour) of baby

42
Q

what proportion of heart diseases does ACL make up?

A

1/3 of congenital heart disease

43
Q

name common acyanotic heart lesions

A

Atrial Septal Defects (ASD), Ventricular Septal Defects (VSD), Patent Ductus Arteriosus (PDA), Coarctation of the aorta

44
Q

what does a small patent ductus arteriosus increase the risk of?

A

bacterial endocarditis

45
Q

what is the treatment for patent ductus arteriosus?

A

give prostaglandin inhibitors
e.g. ibuprofen
if it doesnt close then surgical closure with a clip is done in infants older than 3 months

46
Q

what are the types of coarction of the aorta?

A
  • Constriction may be above or below the ductus arteriosus (pre-ductal, post-ductal)
  • In pre-ductal types, ductus arteriosus persist allowing blood flow.
  • In Post-ductal collateral circulations must be established for proper perfusion of body and legs
47
Q

what are cyanotic heart lesions?

A

a group of cardiac diseases that allow deoxygenated blood to bypass the lungs and enter the systemic circulation
body tissue therefore has less oxygen than they require –> baby is cyanosed

48
Q

give examples of cyanotic congenital heart disease

A

o Tetralogy of Fallot
o Persistent truncus arteriosus
o Transposition of the great vessels

49
Q

what are the 4 different defects of the tetralogy of fallot?

A

1) Ventricular septal defect
2) Overriding aorta – sitting over the top of the VSD so you only have mixed blood going into the aorta
3) Pulmonary stenosis – narrow pulmonary trunk
4) Right ventricular hypertrophy

50
Q

what is a persistent truncus arteriosus?

A

when a single artery arises from the heart to supply both the aorta and the pulmonary artery
a large VSD below truncal valve allows mixing of the right and left ventricular blood

51
Q

what is transposition of the great vessels?

A

pulmonary trunk leads out of LV and aorta out RV

• Other defects alongside this e.g. ASD or VSD which allow some oxygenated blood to be circulated

52
Q

what intervention has to occur when a baby is blue?

A

immediate surgical intervention – catherterisation of fossa ovalis to increase mixing of pulmonary and systemic blood– buy time till infant can be operated on at a later date

c2 (37 decks)

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