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JazCardio > Embryology and Congenital Defects > Flashcards

Embryology and Congenital Defects Flashcards

1
Q

Primary heart field is formed around ___ from ___derm

A

wk3

mesoderm

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2
Q

Primary heart field undergoes ___ + ___ folding

A

lateral and cranio-caudal folding

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3
Q

Heart tube regions cranial > caudal

A 
truncus arteriosus
bulbus cordis
ventricle
atrium
sinus venosus
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4
Q

truncus arteriosus becomes ___

A

aorta and pulmonary trunk

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5
Q

bulbus cordis becomes ___

A

muscular/trabeculated part of RV

outflow of ventricles

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6
Q

ventricle becomes ___

A

trabeculated/muscular part of L ventricle

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7
Q

atrium becomes ___

A

trabeculated/muscular part of both atria

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8
Q

sinus venosus becomes ___

A

R horn = smooth part R atrium and IVC

L horn = coronary sinus

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9
Q

3rd aortic arches become

A

common carotid

1st part int. carotid

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10
Q

4th aortic arches become

A 
R = subclavian artery
L = part of arch of aorta
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11
Q

6th aortic arches become

A

pulmonary artery and ductus arteriosus

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12
Q

vitelline veins drain the ____

become ____

A

yolk salk

hepatic sinusoids and veins and hepatic portion of IVC

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13
Q

Part of umbilical vein that bypasses the liver

A

ductus venosus

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14
Q

Remnant of umbilical vein in adults

A

ligamentum teres

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15
Q

cardinal veins drain the ___

A

systemic venous system

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16
Q

2 umbilical arteries branch off of ___

A

iliac arteries

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17
Q

1 umbilical vein joins to ___ to => IVC

A

ductus venosus

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18
Q

Function = foetal homeostasis, gas exchange, acid-base balance, nutrient transport, waste transport, hormone productoin, IgG transport, produces PGE2

A

placenta

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19
Q

maintains patency of ductus venosus during gestation =

produced in ___

A

PGE2

placenta

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20
Q

R/L heart is of greater pressure in the foetus

A

R

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21
Q

3 foetal shunts

A

ductus venosus
foramen ovale
ductus arteriosus

22
Q

carries nutrients from umbilical vein to IVC bypassing portal circulation

A

ductus venosus

23
Q

R->L atrium shunt

A

foramen ovale

24
Q

is a link from the pulmonary bifurcation to the descending aorta

A

ductus arteriosus

25
Q

Ibruprofen in foetus =

A

PGE2 inhibited and ductus arteriosus closes

prevents aorta and carotids getting best oxygenated blood

26
Q

First breath causes the lungs to ___ => increased ___ and pulmonary vessels ___ => ____ pulmonary resistance

A

inflate ->increased pO2 => decreased pulmonary resistance

27
Q

systemic vascular resistance increases in a baby when ____

A

the umbilical cord is clamped - placenta (large, low resistance vascular bed) removed

28
Q

____ and ____ at birth cause foramen ovale to shut

A

first breath
AND
cord being clamped

29
Q

Factors that decrease PDA after birth =

A

decreased pulm resistance - less flow through
less PGE2 from placenta and more metabolised by lungs
increased O2 => SM of duct constricts

30
Q

metabolises PGE2 after birth

A

lungs

31
Q

Functional closure of PDA occurs after ___
Anatomical closure occurs at ___
becomes ____

A

hrs-days
7-10 days
ligamentum arteriosus

32
Q

In preterm PDA remains patent as ___

A

SM not developed enough

33
Q

Treatment for PDA =

A

NSAIDS

surgery - duct ligation

34
Q

congenital defect that requires PDA eg.

so give ___ to keep patent until deifinitive surgery

A

interruption of aortic arch

IV PGE2

35
Q

PPHN (persistent pulmonary hypertension of the newborn) is due to ___ =>

A

lung resistance not falling after birth => PDA and patent foramen ovale => cyanosis

36
Q

In PPHN there is a ___ in the pre(Rarm) and post (Lleg) ductal SaO2

A

big difference

37
Q

Treatment of PPHN

A

ventilate
O2 + NO inhaled - vasodilators
ECLS - extra-corporeal life support - bypasses lung

38
Q

PPHN is commoner in ___ babies due to

A

sick

sepsis, acidotic, hypoxic ischaemic insult, meconium aspiration syndrome, cold

39
Q

Congenital diaphragmatic hernia is an example of an anatomical abnormality that can cause ___

A

PPHN - persistent pulmonary hypertension of the newborn

40
Q

Congenital heart defects detected within 1-2 days of life usually present with

A

murmurs
abnormal pulses
cyanosis

41
Q

Congenital HDs detected in day 3-7 of life usually present with

A

sudden circulatory collapse, shock, cyanosis, sudden death

42
Q

Congenital HDs detected 4-6wks after birth usually present with

A

signs of HF, less feeding, SOB, sweaty

43
Q

Cyanotic congenital heart defects =

A

transposition of the great vessels
tetralogy of fallot
tricuspid atresia
pulmonary atresis with intact ventricular septum
total anomalous pulmonary venous connections

44
Q

Systemic circulation PDA dependant lesions eg.s

A

hypoplastic LH
critical aortic stenosis
interrupted aortic arch
critical coarctation of the aorta

45
Q

pulmonary circulation PDA dependant lesions eg.s

A

pulmonary or tricuspid atresia

46
Q

If have duct dependant lesion with no PDA then presents:

A 
3-5 days (if undiagnosed)
pale
tachypnoeic
pallor
prolonged cap refill
poor pulses
hepatomegaly
crepitations
47
Q

tetralogy is a(n) a/cyanotic heart defect

A

cyanotic

48
Q

ASD is a(n) a/cyanotic heart defect

A

acyanotic (initially)

49
Q

VSD is a(n) a/cyanotic heart defect

A

acyanotic (initially)

50
Q

Machine gun murmur =

A

PDA

JazCardio (15 decks)

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