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kardiaggeiako > emvr > Flashcards

emvr Flashcards

1
Q

A fetus has improper development of the bulbus cordis. Which structures will have defects as a result?

A

The smooth parts (outflow tract) of the left and right ventricles

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2
Q

A fetus has improper development of the truncus arteriosus. Which structures will have defects as a result?

A

The ascending aorta and the pulmonary trunk

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3
Q

A fetus has improper development of the primitive atrium. Which structures will have defects as a result?

A

The trabeculated part of the left and right atria

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4
Q

A fetus has improper development of the primitive ventricle. Which structures will have defects as a result?

A

The trabeculated part of the left and right ventricles

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5
Q

A fetus has improper development of the primitive pulmonary vein. Which structure will have defects as a result?

A

The smooth part of the left atrium

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6
Q

A fetus has improper development of the left horn of the sinus venosus. Which structure will have defects as a result?

A

The coronary sinus

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7
Q

A fetus has improper development of the right horn of the sinus venosus. Which structure will have defects as a result?

A

The smooth part of the right atrium (sinus venarum)

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8
Q

A fetus has improper development of the right common cardinal/right anterior cardinal veins. Which structure will have defects as a result?

A

The superior vena cava

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9
Q

What is the first functional organ in human embryos? When does this organ start to function?

A

The heart; spontaneous beats are seen by 4 weeks of development

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10
Q

Which two cardiac structures are ultimately created by neural crest and endocardial cell migrations?

A

The ascending aorta and pulmonary trunk, which are created from the truncus arteriosus

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11
Q

A patient has dextrocardia and chronic sinusitis. What caused the situs inversus observed here (see image)?

A

Kartagener syndrome (primary ciliary dyskinesia) causing a defect in left-right dynein leads to aberrant cardiac looping

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12
Q

A patient has failure of neural crest cell migration during embryonic heart development. Name three conditions she might have.

A

Transposition of great vessels, tetralogy of Fallot, and persistent truncus arteriosus

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13
Q

A woman is seen at 6 weeks’ gestation. What might she be told about the development of her fetus’ heart?

A

Cardiac looping has begun with establishment of left-right polarity, and there have been spontaneous heart beats since 4 weeks

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14
Q

What is the opening in the early muscular ventricular septum called?

A

Interventricular foramen

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15
Q

During the first step of septation of the chambers, what structure grows? What structure narrows as a result?

A

The septum primum grows toward the endocardial cushions; the foramen primum narrows

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16
Q

The ____ divides the truncus arteriosus into the aortic and pulmonary trunks.

A

Aorticopulmonary septum

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17
Q

During the second step of septation of the chambers, what foramen develops? What foramen disappears as a result?

A

The foramen secundum forms in the septum primum; the foramen primum disappears

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18
Q

The aorticopulmonary septum rotates and fuses with the muscular ventricular septum to form the ____.

A

Membranous interventricular septum

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19
Q

During the third step of septation of the chambers, what structure develops? What foramen becomes is essential to the embryo’s hemodynamics?

A

The septum secundum develops; the foramen secundum maintains a right-to-left shunt

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20
Q

The ____ forms to close the interventricular foramen and separate the two ventricles.

A

Membranous interventricular septum

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21
Q

During the fourth step of septation of the chambers, what structure expands? What foramen persists and contributes to the fetal circulation?

A

The septum secundum expands and covers most of the foramen secundum; the residual foramen is the foramen ovale

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22
Q

A newborn has failure of the aorticopulmonary septum and muscular ventricular septum to fuse. What condition is this?

A

Ventricular septal defect (most commonly occurs in the membranous septum)

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23
Q

During the fifth step of septation of the chambers, what structure is altered to become an important part of the fetal circulation?

A

The remaining portion of the septum primum forms the valve of the foramen ovale

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24
Q

Which two heart valves are derived from the endocardial cushions of the outflow tract?

A

Aortic and pulmonic

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25
Q

During the sixth step of septation of the chambers, what two structures fuse? What structure does this result in the formation of?

A

The septum secundum and septum primum fuse; forms the atrial septum

26
Q

Which two heart valves are derived from fused endocardial cushions of the AV canal?

A

Mitral and tricuspid

27
Q

During the seventh and final step of septation of the chambers, what structure closes off? When does this event take place?

A

The foramen ovale usually closes soon after birth because of increased left atrial pressure

28
Q

A patient with an Ebstein anomaly has a ____ (stenotic/displaced/atretic/regurgitant) valve anomaly.

A

Displaced

29
Q

• A newborn has failure of the endocardial cushions in the AV canal to properly form valves. This may lead to which valvular anomalies?

A

Mitral and/or tricuspid atresia

30
Q

You observe a paradox embolus in a patient causing a stroke. Which heart structure is likely defective in this patient?

A

The atrial septum is likely defective, allowing venous emboli to enter systemic arterial circulation (patent foramen ovale can cause this)

31
Q

You see an unfused opening between the septa primum/secundum in a man. This opening normally closes from more pressure in what heart chamber?

A

The unfused opening is a patent foramen ovale, which usually closes (after birth) from increased left atrial pressure

32
Q

A patient is incidentally found to have a patent foramen ovale on echocardiogram. Is it necessary to call cardiac surgery right away?

A

No, as the majority of patent foramen ovales do not require treatment and are left untreated

33
Q

During fetal erythropoiesis, when does the yolk sac produce fetal red blood cells?

A

Weeks 3–8

34
Q

During fetal erythropoiesis, when does the liver produce fetal red blood cells?

A

Week 6 to birth

35
Q

During fetal erythropoiesis, when does the spleen produce fetal red blood cells?

A

Weeks 10–28

36
Q

During fetal erythropoiesis, when does the bone marrow start producing fetal red blood cells?

A

Week 18 to adult

37
Q

You study embryos each week and note blood cells first appearing early in development. What week is it? Where are the cells made?

A

Week 3; in the yolk sac

38
Q

Identify the order in which organs become the primary site of fetal erythropoiesis.

A

Yolk sac, Liver, Spleen, Bone marrow (Young Liver Synthesizes Blood)

39
Q

What is the composition of fetal hemoglobin compared to adult hemoglobin?

A

Fetal hemoglobin (HbF) is composed of α2γ2, whereas adult hemoglobin (HbA1) is composed of α2β2

40
Q

You place adult and fetal hemoglobin in an oxygen-rich broth, then separate the two types. Oxygen content is higher on the fetal side. Why?

A

Fetal hemoglobin less avidly binds 2,3-BPG, increasing its affinity for oxygen and allowing extraction of oxygen from maternal hemoglobin

41
Q

At what point does hemoglobin composition switch from α2γ2 to α2β2?

A

Shortly after birth (Alpha Always, Beta Becomes, Gamma Goes)

42
Q

Where are the two embryonic globin subunits?

A

ε and ζ

43
Q

What is the O2 and PO2 in the blood from the placenta in the umbilical vein? How does it compare to that of umbilical arteries?

A

80% & approximately 30 mmHg; umbilical arteries have low O2 saturation

44
Q

Fetal heart chamber pressures are studied. Are pressures higher in the right or left atrium before birth? How does pressure change after?

A

Pressure in the right atrium is higher in fetal life; at birth (after the neonate takes a breath), the pressure in the left atrium is higher

45
Q

After a neonate’s first breath, O2 saturation in blood ____ (↑/↓). Placental separation causes a(n) ____ (↑/↓) in prostaglandins.

A

↑ ↓ (responsible for the closure of the ductus arteriosus)

46
Q

The ____ closes with an alteration in pressure gradient across the atria. The ____ closes from decreased prostaglandin synthesis.

A

Foramen ovale (called fossa ovalis after closure); ductus arteriosus

47
Q

An infant has a patent ductus arteriosus. The drug ____ can close the ductus arteriosus. By contrast, ____ keep the ductus arteriosus open.

A

Indomethacin; prostaglandins (E1 and E2)

48
Q

Blood entering the fetus bypasses the hepatic circulation by way of the ____, which then directly enters the ____.

A

Ductus venosus, IVC

49
Q

Oxygen-rich blood primarily travels to the fetal heart via the ____ and then passes through the ____ before going into the aorta.

A

IVC, foramen ovale

50
Q

Describe the pathway by which deoxygenated blood travels from the SVC to the descending aorta. Don’t forget the shunt(s)!

A

SVC to right atrium to right ventricle to main pulmonary artery to ductus arteriosus to descending aorta

51
Q

In a fetus, the fetal pulmonary artery resistance is high. How does this impact fetal circulation? What structure accommodates this?

A

Blood entering the main pulmonary artery; instead of entering the pulmonary vessels, goes to the descending aorta via the ductus arteriosus

52
Q

Blood entering the main pulmonary arteries in a fetus is preferentially shunted through the ductus arteriosus. What drives this finding?

A

Low blood O2 tension

53
Q

What does the umbilical vein become postnatally? In which structure is it contained?

A

The ligamentum teres hepatis; the falciform ligament

54
Q

What does the umbilical artery become postnatally?

A

The medial umbilical ligaments (from the umbilical artery)

55
Q

What does the notochord become postnatally?

A

Nucleus pulposus

56
Q

What does the foramen ovale become postnatally?

A

Fossa ovalis

57
Q

What does the ductus venosus become postnatally?

A

Ligamentum venosum

58
Q

What does the ductus arteriosus become postnatally?

A

Ligamentum arteriosum

59
Q

What does the allantois become postnatally?

A

Median umbilical ligament (from the allantois)

60
Q

A neonate has urine leaking from his umbilicus. An umbilical connection to the bladder is seen. What duct likely had defective development?

A

The allantoic duct (of which the urachus is a part)

kardiaggeiako (11 decks)

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