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CADE Exam 2 > Exam 2 Embryology and Anatomy > Flashcards

Exam 2 Embryology and Anatomy Flashcards

1
Q

The aortic sac in the embryo gives rise to…

A

the brachiocephalic artery and the right side of the aortic arch in the adult.

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2
Q

The first and second aortic arches in the embryo…

A

regress and are not present in the adult.

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3
Q

The third aortic arches in the embryo become…

A

the common carotid arteries and proximal internal carotid arteries in the adult.

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4
Q

The dorsal aorta is lost between… On the right, the dorsal aorta is lost…

A

aortic arches 3 and 4. distal to the 7th intersegmental artery

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5
Q

The left fourth aortic arch in the embryo becomes…

A

part of the aortic arch in the adult.

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6
Q

The right fourth aortic arch in the embryo becomes…

A

the proximal right subclavian artery in the adult.

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7
Q

The right sixth aortic arch in the embryo becomes…

A

the right pulmonary artery in the adult.

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8
Q

The left sixth aortic arch in the embryo becomes…

A

the left pulmonary artery and the ductus arteriosus in the adult.

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9
Q

The right seventh intersegmental artery in the embryo…

A

becomes the distal right subclavian artery in the adult.

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10
Q

The foramen ovale in the heart of the embryo becomes…

A

the fossa ovale in the heart of the adult. (located in the right atrium)

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11
Q

The ductus arteriosus between the pulmonary trunk and aorta of the embryo becomes…

A

ligamentum arteriosum in the adult.

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12
Q

The umbilical vein the embryo becomes…

A

the round ligament of the liver in the adult.

(passes from the umbilicus to the porta hepatis)

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13
Q

The umbilical arteries in the embryo become…

A

the abdominal ligaments in the adult.

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14
Q

The ductus venosus in the embryo becomes…

A

the ligamentum venosus in the adult.

(It passes through the liver from the left branch of the portal vein and attaches to the IVC)

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15
Q

The following teratogens cause which congenital heart defects?

  1. Lithium
  2. Alcohol
  3. Retinoic acid
  4. Maternal diabetes
  5. Maternal rubella
A
  1. Lithium: Ebstein’s
  2. Alcohol: VSD
  3. Reinoic acid: TGA
  4. Maternal diabetes: TGA, HCM, VSD, CoA (Coarctation of the Aorta)
  5. Maternal rubella: PDA, PS (pulmonary stenosis), AS (aortic stenosis)
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16
Q

If dextrocardia is present, which orientation of the organs will result in the least amount of complications?

A

Dextrocardia with situs inversus totalis (total reverse order of organs in thorax and abdomen)

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17
Q

Atrial Septal Defect (ASD)

  • What is it?
  • Most common type?
  • Cause?
  • Symptoms?
A
  • Communication between the right and left atria
  • Ostium secundum atrial septal defect (80% prevalence)
  • Septum secundum is too short to cover forament secundum completely or foramen secundum is too large.
  • Many are asymptomatic. Can cause cryptogenic stroke if embolism present in systemic circulation.
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18
Q

Ventricular Septal Defect (VSD)

  • What is it?
  • Causes?
  • Symptoms?
A
  • Persistent communication between right and left ventricles
    • It is the MOST common congenital heart disease
  • Caused by:
    • Deficient development of bulbar ridges
    • Failure of dorsal and ventral endocardial cushions to fuse
    • Deficient development of interventricular muscular septum.
  • LOUD MURMUR at birth or shortly after
    • if left untreated, Eisenmenger’s syndrome (cyanosis) can occur
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19
Q

Atrioventricular Canal (AVC)

  • What is it?
  • Causes
  • Correlations
A
  • Open canal between right and left atria and right and left ventricles. Atria and ventricles separated by common valve.
  • Results from faulty endocardial cushion development
  • Correlated with trisomy, more specifically trisomy 21 (Down’s syndrome)
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20
Q

Truncus Arteriosus (TA)

  • What is it?
  • Causes?
  • Correlations?
  • Symptoms?
A
  • Single arterial trunk arises from heart and supplies systemic, pulmonary, and coronary circulations
  • Caused by abnormal migration of neural crest cells - failure of the truncal ridges and aorticopulmonary septum to develop normally
    • There is always a VSD present with TA
  • Correlated with DiGeorge syndrome (CATCH22)
    • Cardiac abnormality
    • Abnormal facies
    • Thymic aplasia
    • Cleft palate
    • Hypoparathyroidism
  • Symptoms include cyanosis, congestive heart failure, murmr, and pulmonary hypertension early on.
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21
Q

Transposition of the Great Arteries (TGA)

  • What is it?
  • Causes?
  • Symptoms?
A
  • Aorta arises from right ventricle and pulmonary trunk arises from left ventricle
    • most common cyanotic lesion in newborns
    • Systemic and pulmonary circulations are parallel
  • Caused by failure of the AP septum to spiral
    • Interatrial connection (ASD or PFO) is most often present
  • Severe cyanosis occurs since birth, “egg on a string” appearance of heart on chest Xray
22
Q

Tetralogy of Fallot (TOF)

  • What is it?
  • Causes?
  • Symptoms?
A
  • Pulmonary stenosis, VSD, overriding aorta, and right ventricular hypertrophy present
    • most common cyanotic lesion beyond neonatal period
  • Caused by abnormal neural crst migration into truncal and bulbar ridges
    • causes misalignment of the aortopulmonary septum
  • Symptoms include murmur from pulmonary stenosis, hypoxic cyanotic spell during crying or feeding, boot shaped heart seen in chest xray
23
Q

Ebstein’s Anomaly

  • What is it?
  • Causes?
  • Symptoms?
A
  • RA becomes enlarged and part of RV becomes atrialized
  • Caused by abnormally developed and positioned tricuspid valve (anterior cusp in enlarged)
  • Symptoms include ASD (in 80% of cases)
    • cyanosis
    • decreased pulmonary blood flow
    • CHF
    • cardiomegaly that can cause airway obstruction and lung compression
    • Arrhythmias
24
Q

Coarcation of the Aorta (CoA)

  • What is it?
  • Causes?
  • Symptoms?
A
  • Aortic constriction of variable length and location
    • Common association with Turner syndrom
  • Caused by:
    • abnormal migration of cells into aortic wall next to DA
    • abnormal hemodynamics resulting in abnormal growth of left 4th aortic arch
  • Post-ductal CoA is usually diagnosed later in life. It shows signs and symptoms of decreased perfusion in distal vascular territories, difference in BP b/w upper and lower extremities, rib notching shown on chest xray
  • Pre-ductal CoA shows differential diagnosis (upper part of body pink, lower part blue), difference in BP and pulses
25
Q

Patent Ductus Arteriosus (PDA)

  • What is it?
  • Correlations?
  • Symptoms?
A
  • Persistence of ductus arteriosus
  • Correlated with maternal rubella infection
  • Symptoms include decreased lung compliance, worsening respiratory status
26
Q

Total anomalous pulmonary venous return (TAPVR)

  • What is it?
  • Causes?
  • Symptoms?
A
  • All pulmonary veins return via various pathways to RA intead of LA
    • Blood keeps circulating withing pulmonary circuit (increased PBF, pulmonary edema)
  • Caused by defect in formation of pulmonary veins in LA wall
  • Symptoms include respiratory distress and cyanosis
    • ASD/VSD needed for systemic blood flow
27
Q

The five cyanotic diseases are:

A
  1. Truncus arteriosus
  2. Transposition of the great vessels
  3. Tricuspid atresia
  4. Tetralogy of Fallot
  5. TAPVR
28
Q

Tracheoesophageal fistula (TEF)

  • What is it?
  • Causes?
  • VACTERL
  • Symptoms
A
  • Abnormal connection between trachea and esophagus that often results in a blind esophagus as well.
  • Caused by incomplete fusion of tracheoesophageal folds that prevents foregut to separate completely into trachea and esophagus
  • VACTERL: Vertebral anomalies, Anal atresia, Cardiac defects, Tracheoesophageal fistula/Esophageal atresia, Renal anomalies, Limb anomalies
  • Symptoms include inability to swallow, frequent drooling, immediately regurgitate milk when fed, choking/aspiration due to reflux from stomach
    • Associated with polyhydramnios, coiled tube will show up on CXR
29
Q

Types of TEF

  • Most common
  • Least symptomatic
A
  • Most common: Type C - upper portion of esophagus ending in blind pouch and lower segment forming fistula with trachea
  • Least symptomatic: Type H - TEF without esophageal atresia; often diagnosed later in life
30
Q

Respiratory Distress Syndrome

  • What is it?
  • Symptoms?
A
  • Caused by inadequate production of surfactant
  • Severe labored breathing and cyanosis shortly after birth
    • CXR shows ground glass (diffuse fine granular pattern)
31
Q

Hereditary Surfactant Protein B Deficiency

A
  • Autosomal recessive disease that causes complete absence of one of genes encoding surfactant protein B
  • Fatal disease
32
Q
A
33
Q

Pulmonary Hypoplasia

  • What is it?
  • Causes?
  • Potter’s sequence
A
  • Lung underdevelopment
  • Caused by oligohydramnios and/or congenital diaphragmatic hernia
    • Often associated with renal agenesis or amniotic sac rupture
  • Potter’s sequence: deformed limbs; wrinkly, dry skin; abnormal facies (wide-set eyes and infraorbital skin creases, beak nose, recessed chin, low-set ears)
    • caused by oligohydramnios from bilateral renal agenesis
34
Q

Congenital Diaphragmatic Hernia

  • What is it?
  • Symptoms
A
  • Herniation of abdominal contents into thoracic cavity
  • Causes defective formation and/or fusion of pleuroperitoneal membranes with other three parts of diaphragm
    • Causes lung hypoplasia due to compression by abdominal viscera
    • Also pushes heart anteriorly and to the right
  • Immediately after birth, babies present with respiratory distress, cyanosis, decreased breath sounds on hernia side, and scaphoid abdomen
35
Q

The primitive atrium in the embryo becomes…

A

the auricles of the right and left atria in the adult.

36
Q

The right horn of the sinus venosus in the embryo becomes…

A

the sinus venarum in the adult.

37
Q

The left horn of sinus venosus in the embryo becomes…

A

the coronary sinus in the adult.

38
Q

The primitive pulmonary veins in the embryo become…

A

the smooth part of the left atrium.

39
Q

The conus cordis (upper bulbis cordis) in the embryo becomes…

A

the conus arteriosus in the right ventricle and the aortic vestibule in the left ventricle in the adult.

40
Q
A
41
Q

The bulbis cordis in the embryo becomes…

A

the trabeculated right ventricle in the adult.

42
Q

The primitive ventricle in the embryo becomes…

A

the trabeculated left ventricle.

43
Q

The truncus arteriosus in the embryo becomes…

A

the ascending aorta and pulmonary trunk in the adult.

44
Q

The division of the AV canal in the embryo heart occurs by the…

A

endocardial cushions (create R and L AV canals)

45
Q

The atrial septum is formed by what? (and where do these septa form from?)

A
  1. Septum primum: grows from roof of common atrium
    1. Foramen primum closes as septum primum fuses with endcardial cushions
    2. Foramen secundum forms in septum primum following cell death
  2. Sepum secundum: grows from roof of atrium immediately to right of septum primum
46
Q

The aorticopulmonary septum is formed from…

What is the origin of these cells?

A

truncal ridges from the walls of the truncus arteriosus and bulbar ridges from the bulbis cordis.

These ridges contain neural crest cells

47
Q

/What structures does the right coronary artery supply?

Right coronary artery branches and structures it supplies.

A
  • The right coronary artery supplies the right atrium and right ventricle
  • Posterior interventricular artery
    • Supplies left and right ventricles and interventricular septum
  • Right marginal artery
    • Supplies right ventricle
48
Q

What structures does the left coronary artery supply?

Branches of left coronary artery and what structures do they supply?

A
  • Left coronary artery supplies the left atrium and ventricle
  • Anterior interventricular artery
    • Supplies left and right ventricles and interventricular septum
  • Circumflex artery
    • Suppies left ventricle posteriorly
  • Diagonal artery
    • Supplies left ventricle anteriorly
  • Left marginal artery
    • Supplies left ventricle anteriorly
49
Q

The veins that run with the right coronary artery are…

A
  • Small cardiac vein
  • Anterior cardiac vein (drapes over right coronary artery)
50
Q

The vein that runs with the circumflex artery and the anterior interventricular artery is…

A

the great cardiac vein

51
Q

The vein that runs with the anterior interventricular artery is…

A

middle cardiac vein.

52
Q

What structure do all the cardiac veins drain into before draining into the right atrium?

What is the exception?

A

The coronary sinus

The anterior cardiac veins drain directly into the right atrium

CADE Exam 2 (1 decks)

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