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CV exam 1 AP > Embryology > Flashcards

Embryology Flashcards

1
Q

from what type of tissue does the heart develop from

A

cardiogeneic mesoderm

this migrates in early development to the cranial-most extent of embryo

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2
Q

what is clinically significant about the heart forming at the cranial most extent of the embryo

A

as it develops, it pulls its innervation supply from the cranial portion

cervical branches of the vagus nerve and sympathetic chain innervate the heart b/c of the long migration into the thorax

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3
Q

what structures in the heart do the neural crest cells form?

A

heart valves and fibrous skeleton

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4
Q

how does the heart tube form?

what happens when the embryo begins to fold laterally?

A

initially forms as paired endothelial lined tubes

as the embryo folds laterally the paired tubes fuse forming one continuous heart tube

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5
Q

initially in the heart tube, what end is receiving venous blood and what end is pumping arterial blood to the body

A

receives venous blood at the caudal end and pumps arterial blood at the cranial end

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6
Q

as the heart begins to cardiac loop, what are the four original dilations

A

bulbus cordis
ventricle
atrium
sinus venosus

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7
Q

what actually causes the heart to loop

why is it important for the heart to loop

A

the ventricles grow faster than other regions

brings the heart into its normal heart position, brings regions of the linear heart tube into contact with regions its didn’t have before (ventricular region to the cranial bulbus cordus)

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8
Q

in which direction does the cranial portion loop

A

bends ventrally, caudually and to the right

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9
Q

in which direction does the caudal portion loop

A

dorsally, cranially and to the left

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10
Q

what is the sinus venosus composed of?

what are the common veins it receives

A

left and right venous horns
receiving blood from major veins

each side receives 3 veins
common cardinal vein (blood from body of embryo)
umbilical vein (oxygenated blood back from placenta)
Vitelin vein (nutritional support back from the yolk sac)

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11
Q

what does the left sinus horn (of the sinus venosus) form

A

coronary sinus

it regresses quite a bit and then forms the coronary sinus

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12
Q

what does the right sinus horn become incorporated into?

A

the right atrium as the sinus venarum

smooth walled portion of the right atrium

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13
Q

what does the primitive atrium form

A

the auricles of right and left atria

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14
Q

what are the final steps in development of right atrium

A

sinus venosus is incorporated into the right atrium and forms the sinus venarum

the original embryonic atrium forms the atrial auricle

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15
Q

what are the final steps in the development of the left atrium

A

proximal portions of pulmonary veins are incorporated into left atrium and forms smooth walled portion of the chamber

just doesn’t have a special name like the sinus venarum

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16
Q

what will the primitive ventricle from

A

the trabeculated portion of the left ventricle

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17
Q

when does the heart begin beating

A

day 22

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18
Q

what are the 3 portions of the bulbubs cordis

A 
caudal portion
conus cordis (mid portion)
truncus arteriosus (cranial portion)
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19
Q

what will the caudal portion of the bulbus cordis form?

A

trabeculated region of the right ventricle

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20
Q

what will the conus cordis of the bulbus cordis form

A

forms the smooth-walled outflow region of both ventricles

in the right ventricle this is the –> conus arteriosus

in the left ventricle this is called the –> aortic vestibule

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21
Q

what does the truncus arteriosus (cranial portion) of the bulbus cordis form

A

pulmonary trunk and ascending aorta

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22
Q

what is the circulation through the primitive heart

A

sinus venosus–> primitive atrium–> primitive ventricle–> bulbus cordis –> aortic sac–> embryo

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23
Q

why must partitioning of the heart take place?

A

in order to keep blood away from the lungs

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24
Q

what does ostium mean?

A

opening

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25
Q

what is the first step in partitioning of the heart

A

septum primum forms

this is a thin membranous septum

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26
Q

what is step two of partitioning of the heart

A 
Ostium primum forms
Short-lived
Fuses with developing
Atrio ventricular septum
Gone by day 33
27
Q

what is step 3 and 4 of the partitioning of the heart

A

As the ostium primum is closing (3), a second opening (ostium secundum) forms from cell death in septum primum. (4)

28
Q

what is step 5 of the partitioning of the heart

A

Septum secundum forms within right atrium

Major contributor to intra-atrial septum.

29
Q

what is step 6 of the partitioning of the heart

A

Septum secundum is incomplete. Its foramen is called the foramen ovale.

the septum primum becomes the valve of the foramen ovale

blood from the right atrium goes right to the left atrium bypassing the right ventricle

30
Q

prenatally where is there greater pressure in the heart and why is this relevant

A

greater pressure in the right side of the heart

thus blood bypasses the right ventricle via the foramen ovale

31
Q

postnatally where is there greater pressure in the heart and why is this relevant

A

pressure is greater in the left side of the heart closing the valve of the foramen ovale against the septum secundum and thus forming the fossa ovalis

32
Q

what is patent foramen ovale

A

occurs in 25 percent of population

results when the valve of the foramen ovale does not completely fuse to the septum secundum

usually asymptomatic

however, any increase in pulmonary pressure (coughing, sneezing, pulmonary hypertension) can cause the foramen ovale to re-open and a shunting of blood from right to left

33
Q

initially in the partitioning of the atrioventricular orifice what is the atria in contact with only

A

the primitive left ventricle

34
Q

what is separating the right ventiricle from the right atria initially

A

bulboventricular flange

35
Q

when does the bulboventricular flange regress and what else is happening at the same time?

what do these two events provide?

A

Bulboventricular flange regresses during 5th week; at the same time the
atrioventricular canal enlarges and shifts to the right.
d. These two events provide communication of atria with left and right ventricles.

36
Q

what are endocardial cushions derived from?

what do these do

A

NEURAL CREST CELLS

Superior and inferior endocardial cushions project into the atrioventricular canal
and fuse, separating the AV canal into right and left orifices.

37
Q

from what do atrioventricular valves form from?

A

Atrioventricular valves form from neural crest of endocardial cushions.

38
Q

what is the muscular portion of the interventricular septum derived from?

A

muscle of the ventricle walls

39
Q

what is the membranous portion of the interventricular septum derived from

A 
endocardial cushions
(neural crest cells)
40
Q

what are the conotruncal ridges derived from?

A

neural crest cells

41
Q

what do the semilunar valves form from

A

neural crest cells and conotruncal ridges

42
Q

why is it important that the conotruncal ridges spiral

A

Makes it so that the right ventricle pumps out throught pulmonary trunk and the left ventricle pumps out through the aortic channel

transposition of the great vessels could happen if this step doesn’t happen

43
Q

contruncal ridges fuse to form what?

what does the conus cordis form

what does the truncus arteriosus form

A

aorticopulmonary septum (spiral septum).

a. Conus cordis forms conus arteriosus (right ventricle) and aortic vestibule (left
ventricle) .
b. Truncus arteriosus forms pulmonary trunk and ascending aorta.

44
Q

what are VSD’s
which type are the most common
what is the result of these

A

Ventricular septal defects (VSDs)

  1. Membranous septal defect (most common)
  2. Muscular septal defect
  3. Severity depends on size of defect; often results in left-to-right blood shunt

pumonary HTN
left ventricular hypertrophy because there is decreased systemic flow

45
Q

what are ASD’s

A

atrial septal defects

46
Q

what are the types of ASD’s

A 
ostium secundum defect
ostium primum defect 
common atrium (complete loss of atrial septum and this is almost always associated with other major heart defects)

causes left to right shunt

47
Q

what are the possibilities that can go wrong with ostium secundum

A

it is a Large opening between left and right atria

b. Cause: excessive degeneration of septum primum
c. Cause: insufficient proliferation of septum secundum

48
Q

what are the problems with ostium primum

A

endocardial cushion defect

49
Q

what 3 structures does the endocardial cushions form

A

Atrioventricular septum
part of atrial septum (closes ostium primum)
mebranous interventricular septum

50
Q

what are the 3 things endocardial cushion defects result in?

A

Persistent atrioventricular canal
ASD (ostium primum defect)
Membranous VSD

51
Q

how does pulmonary/aortic valve stenosis occur because of a congenital defect

A

Pulmonary trunk or aorta very narrow or completely occluded due to malformation
of semilunar valve.

  1. Often present with both patent foramen ovale and ductus arteriosus.
52
Q

why does transposition of the great vessels happen?

A

Cause: conotruncal ridges fail to spiral.

  1. Aorta arises from right ventricle.
  2. Pulmonary trunk arises from left ventricle
  3. Usually occurs with patent ductus arteriosus, patent foramen ovale
53
Q

what is the cause of persistent truncus arteriosus

A

conotruncal ridges fail to form due to neural crest cell problem

Undivided truncus receives blood from right and left ventricles

Usually occurs with patent ductus arteriosus, patent foramen ovale

54
Q

what is DiGeorge Syndrome

A

Cause: deletion on long arm of Chromosome 22.
2. Abnormal neural crest development***

  1. Cardiac abnormalities (usually defects of conotruncal ridge formation which means persistent truncus arteriosus and valve defects)
  2. Craniofacial defects (cleft palate)
  3. Thymic hypoplasia (recurrent infections)
  4. Parathyroid dysfunction (hypocalcemia)
55
Q

what is dextrocardia

A

Heart loops in opposite direction; lies in right thorax (a mirror image).

56
Q

what is ectopic cords

A

Results from failure of ventral body wall to close

2. Heart lies on surface of chest

57
Q

what are the two ways that blood vessel development occur

A

vasculogenesis
de novo

angiogenesis (sprouting of growth of alreayd existing vessels)

58
Q

what is the signal for mesodermal cells to differentiate into blood islands

A

VEGF

blood islands give rise to hemagioblasts

the major embryonic arterial and venous systems arise via vasculogenesis

59
Q

what are the 3 primary vascular systems of embryo/fetus

A

intraembryonic system

yolk sac system

placentaal system

60
Q

what is the intrembryonic system

A

aortic arch arteries

cardinal system of veins

61
Q

what is the yolk system

A

vitelline artery

vitelline veins

62
Q

what is the placental system in the embryo

A

umbilical arteries 2

umbilical vein 1

63
Q

what are the major arteries in the embryo

A 
aortic sac
arotic arches
dorsal arches
umbilical arteries
vitelline artery

CV exam 1 AP (12 decks)

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