Embryology of vascular system Flashcards

Microanatomy

1
Q

What is the difference between vasculogenesis and angiogenesis?

A

Vasculogenesis is the formation of major vessels from the fusion of separate endothelial cavities. On the other hand, angiogenesis is the formation of the remaining vascular system by branching from major vessels.

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2
Q

What is the adult derivatives of the aortic arch I?

A

The first aortic arch mostly degenerates, except for some remnants in maxillary artery

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3
Q

What is the adult derivatives of the aortic arch II?

A

The second mostly degenerated, except for the dorsal end of the arch forms the hyoid artery, which becomes the stapedial artery, transiently, in fetal life and connects the branches of the future external carotid to the internal carotid artery.

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4
Q

Identify common malformations associated with remodeling defects in the aortic arch II?

A

A persistent stapedial artery would manifest as a pulsatile mass in the middle ear cavity, and is associated with internal carotid artery anomaly, usually in patients with trisomy 13, paget disease, otosclerosis, or thalidomide deformity.

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5
Q

What is the adult derivatives of the aortic arches III?

A

Right and left common carotids arteries and internal carotid arteries

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6
Q

What is the adult derivatives of the aortic arches IV?

A
  • Left IV aortic arch become the arch of aorta
  • Right IV aortic arch becomes the proximal right subclavian
    • notes that the distal right subclavian is from the 7th intersegmental artery and the left subclavian has an unknown origin
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7
Q

What is the adult derivatives of the aortic arches V?

A
  • Absolutely nothingness. The fifth might form transiently, but regresses right away.
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8
Q

What is the adult derivatives of the aortic arches VI?

A

(AKA pulmonary arch)

  • Right VI arch: form right pulmonary artery
  • Left VI arch: forms ductus arteriosus (ligamentum arteriosus) and some left pulmonary artery
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9
Q

Where does the recurrent laryngeal nerves branch from?

A
  • The vagus nerves. The recurrent laryngeal nerve move cranially with larynx
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10
Q

Where does the Right and Left Recurrent laryngeal nerve loop from?

A
  • Right: loops under left 6th aortic arch - ductus arteriosus
  • Left: loops under right 4th arch – right subclavian artery
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11
Q

What is the adult derivatives of the aortic sac?

A

1) Ascending aorta
2) Proximal segment of aortic arch
3) Brachiocephalic artery

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12
Q

What is Coarctation of the aorta? What are the 2 types?

A
  • a constriction of the aorta

- postductal and preductal (referring to ductus arteriosus)

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13
Q

Describe the path of the collateral circulation of a post ductal coarctation of aorta?

A

Subclavian → internal thoracic a. → 3rd to 11th anterior intercostal a → posterior intercostal → thoracic aorta
** Post ductal aorta causes rib notching because of the increase blood flow to the ribs.

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14
Q

Which is worse, preductal or postductal coarctation of aorta?

A

Preductal, of course. Deoxygenated blood is delivered shunted to the descending aorta!!!

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15
Q

What causes double aortic arch? What are the complications?

A

The right dorsal aorta fails to regress cranial to T4. The complications include the constriction of esophagus and trachea.

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16
Q

What are the 3 adult derivatives of the vitelline arteries

A

1) celiac trunk – T12 foregut structures
2) superior mesenteric – L1 midgut
3) inferior mesenteric – L3 hindgut

17
Q

What is the function of the umbilical artery? How does it relate to the proximal segment of the internal iliac arteries?

A
  • carry deoxygenated blood and waste products back to the placenta
  • The umbilical arteries arise in connecting stalk. Initially connected to dorsal aorta (4th week) and then loses connection (fifth week) and connect to the proximal segment of internal iliac arteries.
18
Q

what does the 5th intersegmental artery form?

A

Common iliac arteries, external iliac arteries, and proximal segment of internal iliac arteries.

19
Q

What happens to the umbilical artery after birth?

A
  • closes minutes after birth from smooth muscle contraction of vessels
  • permanently close by fibrous proliferation in 2-3 months
  • proximal portion: becomes distal segment of internal iliac and superior vesicle (urinary bladder) artery
  • Distal portion: obliterated and become medial umbilical ligament
20
Q

What are happens to the vitelline veins?

A
  • Right and left vitelline veins anastomose and form a plexus around duodenum to become portal vein (Splenic and sup. Mesenteric vein drain to portal vein but their origins are unknown.
  • Portal vein connects to hepatic sinusoids
  • Left vein: regresses with left sinus horn.
  • Right vein: enlarges and becomes right hepatocardiac channel (hepatic portion of IVC)
21
Q

What happens to the umbilical vein?

A
  • Right: obliterated in second month

- Left: carry oxygenated blood from placenta → ductus venosus (bypass liver sinusoids) → hepatocardiac channel → IVC

22
Q

What happens to umbilical vein and ductus venosus after birth?

A
  • become ligamentum teres hepatic and ligamentum venosum, respectively.
23
Q

What forms the left brachiocephalic vein? What is the function?

A
  • forms from the left and right ANTERIOR cardinal veins anastomoses, when the caudal part of the left anterior cardinal vein degenerates.
  • Function: shunt systemic blood from left to right
24
Q

What happens to the posterior cardinal veins?

A
  • mainly degenerates, except for some portion that forms the root of azygos vein and common iliac veins.
  • Mostly important in venous drainage of mesonephoi
  • In late period, Supra- and sub-cardinal vein takes over the role of the posterior cardinal
25
Q

What happens to the supracardinal vein?

A
  • disrupted in region of kidney. They anastomose cranial to this region to form azygos and hemiazygos
26
Q

What are the 4 segments of the IVC?

A

1) hepatic – derived form hepatocardiac channel
2) prerenal (SUPRArenal) – derived from right SUBcardinal vein
3) Renal – derived from subcardinal-supracardinal anastomoses
4) Postrenal (Infrarenal) – right SUPRAcardinal vein (controversial!!!)

27
Q

How does the SVC form?

A
  • Right common cardinal vein anastomose with right anterior cardinal vein
28
Q

What are 4 common malformations associated with remodeling defects in the venous system?

A
  • Double IVC – persistence of left supracardinal vein
  • Double SVC – Persistence of left anterior cardinal vein and failure of left brachiocephalic vein to form
  • Absence of hepatic segment - blood from caudal parts of body drains via azygos and hemiazygos vein.
  • persistent left SVC – left anterior cardinal vein fails to regress. Blood from the right drains to the right atrium via coronary sinus