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SS- Cardio > Embryology and Congenital Defects > Flashcards

Embryology and Congenital Defects Flashcards

1
Q

(probe) patent foramen ovale

A

20% of people
higher pressure on left side keeps membranous flap over foramen ovale
increase right pressure above left: opens foramen ovale
deoxygeneated blood skips lungs

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2
Q

Tetralogy of Fallot

A

right to left shunt
VSD, RVH, pulmonary stenosis, overriding aorta
cyanotic
tet spell: relieved by squatting
Sx: low saturation without respiratory distress, blacker than normal lungs, cyanosis, harsh systolic ejection murmur along the right upper sternal border, looks like boot

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3
Q

eisenmenger syndrome

A

chronic left-to-right shunt that causes progressive pulmonary HTN that eventually reverses the shunt

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4
Q

truncus arteriosus

A

ascending aorta and pulmonary trunk

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5
Q

bulbus cordis

A

smooth parts of ventricles

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6
Q

primitive atrium

A

trabeculated part of atria

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7
Q

primitive ventricle

A

trabeculated part of ventricles

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8
Q

primitive pulmonary vein

A

smooth part of LEFT atrium

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9
Q

left horn of sinus venosus

A

coronary sinus

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10
Q

right horn of sinus venosus

A

smooth part of RIGHT atrium (sinus venarum)

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11
Q

right common cardinal vein an right anterior cardinal vein

A

SVC

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12
Q

fetal erythropoiesis

A

yolk sac: 3-8 weeks
liver: 6 weeks- birth
spleen: 10-28 weeks
bone marrow: 18 weeks to adult

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13
Q

ductus arteriosus

A

ligamentum arteriosum

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14
Q

ductus venosus

A

ligamentum venosum

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15
Q

foramen ovale

A

fossa ovalis

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16
Q

notochord

A

nucleus pulposus

17
Q

umbilical arteries

A

medial umbilical ligaments

18
Q

umbilical vein

A

ligamentum teres hepatis in falciform ligament

19
Q

allantois-> urachus (duct between bladder and umbilicus)

A

median umbilical ligament

20
Q

right to left shunts

A 
early cyanosis
req. urgent surgery or maintenance of PDA
start with T
1. tetralolgy of fallot
2. transposition of arteries
3. truncus arteriosus (persistent)
4. total anomalous pulmonary venous return (TAPVR)
5. tricsupid atresia
6. hypo plastic left heart
21
Q

left to right shunts

A

late cyanosis

freq. : VSD>ASD>PDA
1. ventricular septal defect
2. atrial septal defect,
3. patent ductus arteriosus
4. pulmonic stenosis
5. aortic stenosis

22
Q

persistent truncus arteriosus

A

right to left shunt
fails to divide into pulmonary trunk and aorta due to lack of aorticopulmonary septum formation
most patients have VSD too

23
Q

transposition of great vessels

A

more common in first born, male, big normal looking babies
right to left shunt
failure of aorticopulmonary trunk to spiral: aorta leaves RV and pulmonary trunk leaves LV
MUST have another defect that allows mixing of blood to survive: VSD, PDA, ASD, patent foramen ovale
Sx: cyanotic, reverse cyanosis, egg on a string CXR, LOW O2 saturation: RIGHT HAND LOWER THAN RIGHT FOOT (get some saturation due to a patent foramen oval that eventually will close)

24
Q

tricuspid atresia

A

right to left shunt
absence of tricuspid valve and hypo plastic rRV
NEED both ASD and VSD to survive

25
Q

total anomalous pulmonary venous return (TAPVR)

A

right to left shunt
pulmonary veins drain right heart into circulation
associated with ASD and sometimes PDA to maintain CO
CXR heart in a SNOW STORM

26
Q

ventricular septal defect (VSD)

A

left to right shunt
MOST common
usually membranous part of septum
ASYMPTOMATIC AT BIRTH and may remain asymptomatic for life
larger lesions: LV overload and HF
Sx: HF (growth delay and feeding intolerance), high RR and HR, head bobbing, sweats and falls asleep when feeds, low freq. holosytolic murmur across precordium (blood going from left ventricle to right), diastolic murmur in left axilla (mitral have more blood in left atrium), crackles in lungs, liver slightly large, S2 hard to hear
left heart dilatation
Small VSD: large systolic pressure difference between ventricles: high freq. holosystolic murmur

27
Q

atrial septal defect (ASD)

A 
left to right shunt
loud S, wide fixed split S2
Sx: none to HF
types: ostium secundum defect (most common), ostium primum defect (other defects often found), sinus venosus defect, common atrium
ADULT S2 SPLIT
complication: emolism
Tx: cath lab disc
28
Q

patent ductus arteriosus (PDA)

A

left to right shunt (fetal: right to left (normal then changes when lung pressure decreases at birth)
machine like murmur
Signs: CONTINOUS MURMUR: through systolic and diastolic
wide pulse pressure (diastolic drops), pulses bounding, tachycardia, low saturation of lower extremities, tachypnea, crackles in lungs (lung congestion), cardiomegaly
progressive RVH and or LVH and HF
untreated: late cyanosis of lower limbs
Tx: indomethacin
PDE will keep open
complications: less blood to organs: ischemia of intestines, intestinal necrosis, kidney insufficiency or failure; risk of endocarditis

29
Q

coarctation of aorta

A

aortic narrowing near insertion of ductus arteriosus
associated with: bicuspid valve, Turner syndrome, other heart defects
Sx: HTN in upper extremeties and weak delayed pulse in lower extremities, collateral arteries erode ribs (notches on xray); cool mottled extremities, delayed capillary refill
pre-ductal: patent ductus arteries needed
post ductal: develop collateral circulation in utero

30
Q

infant normal stats

A

HR: 140
Arm BP: 65/45
pulmonary artery BP: 25/10
O2 saturation: 96-98%

31
Q

pulmonary HTN of newborn

A

pressure too high in lungs to get blood to body; common to have tricuspid regurgitation
tachycardia, tachypnea, cyanosis, hepatomegaly, crackles in lungs, loud P2, holosystolic murmur along midsternal border
can get aspiration from mechonium aspiration: abnormal pulmonary parenchyma on CXR
want: open PDA

32
Q

innocent murmurs

A

venous hum: at clavicle looking straight ahead, blood going down SVC (goes away when turn head or press on it)
PPS: peripheral pulmonary stenosis
Still’s murmur: something with the left ventricle: musical near lower left sternal border and apex

33
Q

systolic murmurs

A 
PS: pulmonary stenosis
AS: aortic stenosis
TR: tricuspid regurgitation
MR: mitral regurgitation 
VSD: ventricular septal defect
34
Q

diastolic murmurs

A

AI: aortic insufficiency
PI: aortic insufficiency
MS: mitral stenosis
TS: tricuspid stenosis

35
Q

What heart problems might you see with DiGeorge?

A 
conotruncal anomalies
Tetralogy of Fallot
truncus arteriousus
transposition of great vessels
Sx: hypocalcemia, immunodeficiencies, developmental issues (speech and feeding), high arching soft and hard palates
36
Q

Ebstein’s anomaly

A

anomaly of tricuspid valve

WALL to WALL heart

SS- Cardio (16 decks)

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