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CPM > embryological dev. of CV - Cole > Flashcards

embryological dev. of CV - Cole Flashcards

1
Q

primitive vertebrate CV plan begins.. and present by..

A

begins mid-week 3

present by week 4

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2
Q

as they migrate PHF cells specified to form left and righ t sides of heart and to form

A

atria
left ventricle
part of right ventricle

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3
Q

secondary heart field (SHF) forms

A

remainder of right ventricle

outflow tract - conus cordis and truncus arteriosus

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4
Q

the 5HT PITX2 pathway specificies .. and programs..

A

left side of body

programs heart cells in priamry and SHFs

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5
Q

master gene for left sidedness

A

PITX2

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6
Q

patterning of cardiac progenitor celsl occurs at the same time as

A

laterality (left-right sidedness) is established

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7
Q

circuit that supplies and drains the yolk sac ; separate from umbilical artery and vein; called the “nursery for blood vessels”

A

vitelline vein and artery

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8
Q

features of embryonic circuit

A
  • series of aortic arches connecting to dorsal aortae
  • d. aortae subdivides into smaller vessels to supply embryo
  • blood drained by anterior and posterior cardinal veins
  • common cardinal vein
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9
Q

bulbus cordis consists of

A

truncus arteriosus

conus cordis

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10
Q

sinus venosus gives rise to

A

smooth part of right atrium (sinus venarum)
coronary sinus
oblique vein of left atrium

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11
Q

primitive atrium gives rise to

A

trabeculated part of right and left atria (auricles)

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12
Q

primitive ventricule gives rise to

A

trabeculated part of right and left ventricles

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13
Q

bulbus cordis gives rise to

A

conus cordis: smooth part of right ventricle

aortic vestibule: smooth part of left ventricle

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14
Q

truncus arteriosus gives rise to

A

aorta, pulmonary trunk

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15
Q

blood flow in embryonic dilation

A

sinus venosus —> primitive atrium –> primitive ventricle –> bulbus cordis —> truncus arteriosus

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16
Q

more anterior structures (ventricles and outflow tract) are specified as such because of

A

lower RA concentrations

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17
Q

cardiac looping, the correct folding of heart (due to its rapid growth) is controlled by

A

PITX2 and the laterality pathway

if messed, heart could fold in different direction (could still work just fine)

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18
Q

grow the fastest during cardiac looping

A

ventricles and outflow tract

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19
Q

dextrocardia caused by - presents as - can be found with - when does it occur embryologically?

A
  • heart bends to left instead of right
  • displaced to right with transposition of heart and great vessels
  • most common positional abnormality
  • can be found with situs inversus
  • during gastrulation or later during cardiac looping
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20
Q

large ocmmunication between chambers that occurs when endocardial cushions fail to fuse – called? what does it result in? blood flow? treatment?

A

atrioventricular communis
results in common AV canal
giant atrial and ventricular septal defect
enlarged pulmonary trunk (less resistance in pulmonary circ. vs. systemic so all blood flows through there)
- Tx - put band on pulmonary artery to tie it off (lungs less congested now), then patch between right and left chambers then divide the one valve into two valves

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21
Q

formation of interventricular septum

A

2 parts:
muscular portion devleoping in midline on floor of the PV; growing upward towards ECC
- bublar ridges growing downwards to ECC

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22
Q

most VSDs occur in

A

muscular portion

but close spontaneously!

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23
Q

most commonly, surgically corrected VSD defects

A

membranous!

24
Q

opening between L & R ventricles

associated shunting of blood

A

ventricular septal defects (VSDs)

25
Q

presenting baby, signs of cyanosis at 1 year check up
right ventricle has hypertrophied; signs of pulmonary congestion and edema
auscultation and US shoe normal valves
diagnosis? disease mechanism?

A

VSD!

  • initial lung inflation, RV pressure decreases
  • get left to right shunting (acyanotic)
  • causes increased work by RV, hypertrophy and eventual, right-to-left shunting —> cyanosis
  • rate depends on size of VSD
26
Q

vsd 2 facts

A

25% of congenital heart defects

4 types based on position and severity

27
Q

which types of VSDs can have more significance for conudciton

A

central
proximal
basal

28
Q

valve of foramen ovale is derived from

A

septum primum

29
Q

foramen ovale upper boundary and lower boundary

A

upper: septum secundum (upper limb)
lower: septum primum

30
Q

foramen ovale once fused is called

A

fossa ovalis

31
Q

RA features in terms of fossa ovale

A 
limbus (septum secundum)
fossa ovale( floor, septum primum)
32
Q

LA features in terms of fossa ovale

A 
fossa ovale (floor, septum SECUNDUM)
valve of fossa ovale (septum primum)
33
Q

ASD, stats, types of defects and what they involve

A

ASD - common, 10-15% of congenital heart defects
ostium (foramen) primum defects - similar to ECC defects
secundum type - involve foramen ovale and septum primum
sinus venosus - usually near opening of SVC

34
Q

ASD is a characteristic finding in this TBX5 gene mutation

A

Holt-Oram SYndrome [ H for heart!! ]

  • abnormality of upper extremities
  • can also have VSD
35
Q

in the embryo:
nutritional circuits are
(intra) embryonic circuits are..

A

nutritional: vitelline and umbilical
intra: cardinal veins

36
Q

connects umbilical vein with IVC

A

ductus venosus

37
Q

marks division between embryonic sinus venosus and embryonic primitive atrium (auricles)

A

crista terminalis

38
Q

SVC derived from joining

A

right anterior cardinal and common cardinal v. via brachiocephalic vein anastamosis

39
Q

embryo starts out getting drained by umbilical vein, vitelline veins and common cardinal but once sinus venosus is finished developing, we are left with these 3 vessels drianing what

A

SVC - head & neck
IVC - placenta and caudal regions of embryo
coronary sinus - heart itself

40
Q

partition of this forms the aortic and pulmonary semilunar valves

A

Truncus Arteriosus!

41
Q

disease pathology of eisenmenger’s syndrome; whats failed to form/ fuse? how is the blood shunting initially? later? why?

A
  • equal division of truncus, incomplete fusions of bulbar ridges inferiorly –> VSD
  • initial L –> R shunt, increased pulmonary blood flow and hypertension
  • prolif. in intima and media to narrow lumen
  • increased pulmonary resistance causes R to L shunt and cyanosis
42
Q

tetralogy of fallot
what is IT?
components? how/ why do they develop?

A
  • pulmonary stenosis
  • VSD [blood being shunted from right to left ventricle into the aorta]
  • overriding aorta
  • rt. ventricular hypertrophy [pulmonary trunk too small so ventricle hypertrophies to compensate]
    [PS listen to H.O.V. ]
43
Q

breathing new born exhibits severe cyanosis immediately after birth and dies
- boh ventricles of normal size, no A or V septal defects
- lungs of normal size and well inflated
diagnosis?

A

transposition of great vessels

44
Q

adult derivative of umbilical vein

A

ligamentum teres hepatis

45
Q

adult derivites of vitelline vein

A 
portion of IVC
hepatic veins/ sinusoids
ductus venosus
portal
superior/ inferior mesenteric v.
splenic veins
46
Q

adult derivatives of cardinal veins

A 
SVC
internal jugular veins
portion of IVC
renal and gonadal veins
intercostals veins
hemiazygous and azygous veins
47
Q

all types of TAPVR must have this for survival

A

ASD!

for shunting of blood from right atrium to left

48
Q

rare congenital malformation in which all four pulm. veins do not connect normally to left atirum

A

total anomalous pulmonary venus return (TAPVR)

- all four drain into right atrium by abnormal connection

49
Q

types of TAPVR

A

surpacardiac TAPVR - pulmonary veins drain into right atrium via SVC
cardiac TAPVR - pulm. veins come together behind heart and drain to right atrium through coronary sinus
infracardiac TAPVR - pulm. v. drain to right atrium via hepatic veins and IVC

50
Q

Right aortic arch features

A
  • persistence of right 4th arch distal to right subclavian
  • left segment caudal to left subclavian disappears
  • isolated OR
  • may appear with situs inversus/ dextrocardia
51
Q

double aortic arch features

A
  • segment of right 4th aortic arch caudal to right subclavian
  • vascular ring aorund trache and esophagus
  • noticable in babies if crying a lot, can’t get oxygen in
52
Q

coarctation of aorta

A
  • coarc. of aorta distal to left subclavian
    typically near ductus arteriosus (postducal is adult, preductal is infantle; depending on if it comes before or after DA)
  • collateral circulation includes Internal thoracic Artery and its branches (ribs romedel, appear wavy on x ray!)
53
Q

newborn exhibiting severe cyanotic symptoms in abdomen pelvis and lower limbs but not in head, neck or upper limbs

A

coarcation of aorta!

blood getting ut into aortic arch; cyanotic only below thorax

54
Q

heart in abdomen

A

congenital cardiac exposure syndrome

55
Q

heart born completely outside of body

A

ectopia cordis!

can fix it surgically wtf

CPM (1 decks)

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