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CVS-Alaa > Embryology & congenital defects > Flashcards

Embryology & congenital defects Flashcards

1
Q

Where is co2 eliminated in the fetus? Since they dont have a lung

A

Via placenta

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2
Q

What causes the foramen ovale to close up during birth

A

respiration begins, LA pressure increase and blood shunt backwards to the RA and closes up the formaen ovale (septum primum closes on secundum

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3
Q

6th arch of aortic arch forms _________

A

Pulmonary trunk

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4
Q

Which emryonic tissue gives rise to the cvs

A

Mesoderm

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5
Q

In which week of development does the embryo fold

A

4th

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6
Q

How many shunts r there in fetal circularion

A

DA
DV
foramen ovale

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7
Q

What is coarctation of the aorta? Would this increase or decrease afterload? What could this lead to

A

Narrowing of the aorta in the area of the ligamentum arteriosum.
Increase in afterload causing ventricular hypertrophy

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8
Q

What is most common congenital heart disease

A

VSD

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9
Q

What is most common cyanotic congenital heart disease

A

Tetralogy of fallot

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10
Q

When will patient develop a cyanosis

A

If Hb amount is more that 5gm/dl

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11
Q

what might u expect the femoral pulses to be like in a patient with coarctation of the aorta?

A

very weak pulses & there will be a radio-femoral delay

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12
Q

describe tetralogy of fallot, will a patient with these defects be cyanosed?

A

[4 DEFECTS]—-POVR

  • pulmonary stenosis
  • overriding aorta
  • VSD
  • RV hypertrophy
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13
Q

describe the transposition of great arteries and explain why it is compatible with life in utero but not after birth.

A

the pulmonary artery and aorta switch places> bc in utero they have the DA and foramen ovale to compensate

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14
Q

several cvs defect r associated with well known genetic defects and syndromes, describe one

A

marfan
turners
trisonomy 21

(look them up alaa)

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15
Q

what would u hear through a stethoscope in an infant with ‘patent ductus arteriosis’

A

you would hear a continuous murmur throughout systole and diastole “machinery murmur

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16
Q

Name the asynotic defects in congentital heart defects

A

LEFT >RIGHT SHUNTS

  • ASD
  • VSD
  • PDA

OBSTRUCTIVE LESIONS

  • coarctation of aorta
  • pulmonary stenosis
  • obstructive lesions
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17
Q

what is VSD? what part is this most common in?

A

abnormal opening in the inter ventricular septum

-membraneous portion

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18
Q

what is function of DA in a fetus? where is it located?

A

shunts blood from pulmonary >aorta before lungs r functioning

-attaches to the final part of the arch of aorta (the isthmus of aorta) and the first part of the pulmonary artery(where it bifurcates)

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19
Q

what is PDA? describe what happens

A

DA does not close, BF will be from aorta >pulmonary, pulmonary circulation overloaded w/ blood > pulmonary hypertension.
Due to low CO, (bc blood from aorta is moving to pulmonary) LV wants to maintain CO, so it will hypertrophy > Heart failure

20
Q

does L > R shunting cause cyanosis?

A

not really (in some cases depending extent ex; if eisenmenger occurs) but no,

21
Q

what causes pulmonary hypertension?

A

too much blood entering pulmonary circulation, arterioles hypertrophy and constrict as a compensatory mechanism causing PH.

22
Q

explain the hemodynamic effects in Atrial septal defects

A
  • O2 saturation in RA is high
  • chronic volume overload (blood coming from LA and inferior and sup vena cava)
  • increased pulmonary BF
  • RV & RA undergo hypertrophy
  • eventual heart failure
23
Q

what is eisenmenger syndrome?

A

condition of severe pulmonary vascular obstruction that results from L>R shunting. the high pulmonary vascular resistance cause a reverse in shunting R>L and systemic CYANOSIS

24
Q

what happens in AV septal defect? what type of patient r mostly associated with this?

A

problem in development in endocardial cushions, leading to deficiency of the atrioventricular septum of the heart.
1/3 of the patients r associated with DOWN SYNDROME

25
Q

ventricular septum has 2 components, name them, which one forms MOST of the septum

A

muscular, membranous

the muscular grows upwards towards the EC & forms the most

26
Q

a patient with PDA comes in with cyanosis in the lower limbs, how and why did this occur in the lower part

A

he developed eisenmenger sydrome, (R>L shunt)

bc the DA is located after the vessels that supply the head ( so the blood going to the head is safe)

27
Q

Name the cyanotic defects in CHD (star)

A 
atresia of tricuspid valves
Tetralogy of Fallot
Total anomalous pulmonary venous return
Transposition of the great arteries
Truncus arteriosus
28
Q

when can u develop cyanosis?

A

if amount of deoxyhemoglobin is less than 5gm/dl

29
Q

what r the symptoms what accompanies R>L shunt

A

(triangle) clubbing, polycyhtemia, cyanosis

30
Q

in tetralogy of fallot, why is there R>L shunt?

A

due to pulmonary stenosis, right ventricle has to work hard to push blood out> RV hypertrophy> increased pressure causes R>L shunt

31
Q

a patient with tetralogy of fallot performs a squatting position, why does this help?

A

it compresses on femoral artery>increases pressure on aorta> blood is forced to go to pulmonary artery!

32
Q

patients in cyanosed CHD, can present with secondary polycythemia, why is this so?

A

deoxygenated blood goes to kidney>casues them to release EPO> stimulates eryhtropoeiss>polycythemia

33
Q

what is meant by an over riding aorta

A

aorta makth in path mal both ventricles

34
Q

what shape is the heart with tetrology of fallot?

A

boot shaped

35
Q

describe the process of septation

A

look at picture in lecture

musular portion grows from down to up, membraneous grows from up to down

36
Q

describe formation and looping of primitive heart tubes

A

a pair of blood island appear in the cariogenic field in 2 sides, they meet each other in the midline and form the primitive heart tube

37
Q

name the regions of the developing heart

A 
aortic roots
truncus arteriosus
bulbus cordis
ventricle
atrium
sinus venosus
38
Q

describe in brief the development of great vessels

A

ss

39
Q

describe the functional importance of transposition of great arteries

A

s

40
Q

what is cortication of the aorta

A

narrowing of aortic lumen in the region of the ligament arteriosum, narrowing of aorta increases after load on LV>hypertrophy.

41
Q

describe effects of cortication of the aorta

A

Arterial hypertension in the arms w/ low blood pressure in the lower extremities
weak pulses in femoral arteries and arteries of the feet are found

42
Q

what is a hypoplastic left heart?

A

LV and Ascending aorta fail to develop properly

43
Q

what is the cardogenic field

A

zone w/in the mesoderm that has the capacity to differentiate into the CVS

44
Q

describe septation of outflow

creating a separate PT & A

A

endocardial cushions grows into the truncus arteriosis forming a spiral septum that twists upwards seperating PT & A
(look at pic)

45
Q

where the places that endocardial tissues form?

A

in truncus arteriosis and

46
Q

how is foramen oval built

A

look at lecture slides

CVS-Alaa (21 decks)

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