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Year 1 CVS > Development of the heart and the great vessels > Flashcards

Development of the heart and the great vessels Flashcards

1
Q

Whats the world wide incidence of congenital heart defects?

A

1/100

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2
Q

What is found in the cardiogenic fields?

A

Blood islands and small vessels

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3
Q

Birth defects can be structural or complete…. of a structure

A

absence

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4
Q

What can cause congenital heart problems?

A

Genetics
Exposure to teratogens - chemicals, drugs or infections
De Novo

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5
Q

What are the three types of congenital heart defect?

A

Structural defect of chambers or vessels
Obstruction
Communication between pulmonary and systemic circulation

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6
Q

Shunting in which direction gives a cyanotic defect?

A

Right to left- deoxygenated blood mixes with oxygenated blood and passes in the systemic circulation.

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7
Q

What is formed by the endocardial heart tubes fusing?

A

The primitive heart tube

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8
Q

What has to happen to the primitive heart tube to make a heart and great vessels?

A

The tube must divide into 4 chambers and the outflow vessels must be remodelled into the greater vessels.

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9
Q

List the areas of the primative heart tube.

A 
Aortic Roots
Truncus arteriosum 
Bulbus cordis 
Ventricle 
Atrium 
Sinus venosus
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10
Q

What happens as the primitive heart tube elongates?

A

It runs out of room in the pericardial sac and so twists and fold up

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11
Q

The twisting and folding is important because…..

A

It places inflow and outflow channels in the correct orientation with respect to each other.

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12
Q

What are the three main process in cardiac embryogenesis?

A

Fusion- of the endocardial heart tubes
Folding
Differential growth

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13
Q

How do the atria form?

A

Right atrium is formed by most of the primative atrium and some of the sinus venous.

The left atrium is only a small part of the primitive atrium but it absorbs part of the pulmonary veins.

The veins involved in the development relate to the function of each atrium later.

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14
Q

What does the mature circulation need that the foetus does not?

A

Pump to lungs to oxygenate blood.

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15
Q

Name the three metal shunts we have and what they shunt between.

A 
Foramen ovale- RA ro LA (bypass pulmonary circulation)
Ductus Arteriousum- Pulmonary trunk to aorta (bypass pulmonary circulation 
Ductus venosus (placenta to IVC) to bypass liver
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16
Q

What causes the foramen oval to close at birth?

A

LA pressure increase as respiration begins

17
Q

What causes the foramen oval to close at birth?

A

LA pressure increase as respiration begins. The septum premium and septum secundum are thus pushed together and no flow can occur.

18
Q

Placental support removal closes which metal shunt?

A

Ductus venosus

19
Q

What does the aorta start off as?

A

Series of bilaterally symmetrical arched vessel

20
Q

What happens to the fourth arches?

A

R- proximal part becomes the subclavian artery

L- aortic arch

21
Q

Which arch forms the pulmonary arteries and the ductus arteriosus?

A

6th

22
Q

As the heart descends which nerve gets hooked between the pulmonary turn and the aorta?

A

Recurrent laryngeal

23
Q

What is a patent ductus arteriosum?

A

The PDA fails to shut at birth and a left to right shunt occurs between the aorta and the pulmonary artery

24
Q

Outline how the foramen ovale is formed.

A

Septum priumum descends down to endocardial cushion and has an esteem premum at the bottom.
As the septum premum meets the endocardial cushion there is apoptosis to make the osmium secundum.
Once ostium scandium is fully formed a septum secundum grows down toward the endothelial cushions with an ostium at the bottom.
This two layer two holed structure is the foramen ovale.

25
Q

What can lead to atrial septal defects?

A

Septum premium might be too short or reabsorbed.

Septum scandium could be too small.

26
Q

What is hypo plastic left heart syndrome?

A

Atresia of the left side of the heart. Might be due to anomalies in aortic or mitral valve formation or the osmium secumdum is too short. The right to left flow in utero isn’t adequate to develop the left heart.

27
Q

Name the two ventricular septal components and identify the one most effected in septal defects.

A

Muscular

Membranous- more affected

28
Q

How do the ventricles develop?

A

The muscular portion grows up toward the endocardial cushion but leaves a 1degree gap known as the inter ventricular foramen.
This foramen is then closed by connective tissue growing down from the endocardial cushions to make the membranous portion.

29
Q

Which way is predominant shunting in ventricular petal defects and is this cyanotic?

A

Left to right- acyanotic

30
Q

Where else other than at the level of the atrioventricular valves are endocardial cushions found?

A

Truncus arteriosum

31
Q

How do the great vessels end up twisted round one another in normal development?

A

The endocardial cushions grow up and join and twist around one another to spectate the great vessels.

32
Q

What is transposition of the great vessels?

A

Congenital heart defect where the aorta arises from the RV not the LV and the pulmonary trunk arises from the LV not the RV.

33
Q

What are the 4 features in tetralogy of fallow?

A

Large ventricular septal defect
Over riding aorta (takes right side hear as well as left)
RV outflow tract obstructed
Right ventricular hypertrophy

34
Q

What common teratogen can affect the neural crest and cause a conotruncal septum formation defect like tetralogy of fallow?

A

Alcohol

35
Q

Each aortic arch has a corresponding nerve, whats the 6th arches nerve?

A

recurrent laryngeal or vagus nerve

36
Q

Why and how do the paths of the recurrent laryngeal nerves differ bilaterally?

A

Right descends to T1-T2
Left descends to T4-T5 -hooks between PT and aorta.
The caudal shift of the heart and expanding neck affect the course of the nerve ad well at the need for a PT-aorta shunt in utero

Year 1 CVS (15 decks)

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