Exam 2 - Lecture 29 (Cardio & Urinary Systems) Flashcards

1
Q

What is the purpose of atrial partitioning?

A

To initially allow blood flow in utero from R –> L, but eventually shut that flow off postnatally.

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2
Q

How many septa and foramina form during atrial partitioning?

A

2 septa

3 foramina

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3
Q

What develops first in atrial partitioning?

A

septum 1

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4
Q

What is the opening between septum 1 and the endocardial cushion?

A

foramen 1

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5
Q

What are the 6 steps in atrial partitioning?

A
  1. Septum 1 forms on dorsal side w/foramen 1 between it and the endocardial cushion
  2. Septum 1 grows ventrally to meet the endocardial cushion
  3. FORAMEN 1 IS OBLITERATED!!!
  4. Foramen 2 forms as a result of apoptosis to keep flow of atrial blood from R –> L
  5. Septum 2 forms and grows ventrally
  6. Foramen ovale forms within septum 2
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6
Q

After atrial partitioning, what is the flow of blood from R atrium to L atrium?

A

R atrium –> oval foramen –> between septums 1 and 2 –> foramen 2 –> L atrium

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7
Q

What 2 things are formed during outflow separation?

A
  1. Aorta

2. Pulmonary trunk

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8
Q

From where are the aorta and pulmonary trunk derived?

A

Trucus arteriosus and small part of bulbus cordis

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9
Q

What divides the outflow of blood during outflow separation?

A

Spiral septum

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10
Q

What are the 2 steps of outflow partitioning?

A
  1. Cushions on periphery of truncus arteriosus grow together and fuse (@ different locations)
  2. Spiral septum forms to divide outflow
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11
Q

Why do the aorta and pulmonary trunk wind around each other?

A

Because of spiral septum formation

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12
Q

What is the division between the L and R ventricles during partitioning?

A

interventricular septum

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13
Q

What is the space between the IV septum and the endocardial cushion during partitioning?

A

interventricular foramen

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14
Q

What 3 things must happen during ventricular partitioning?

A
  1. IV septum projects dorsally
  2. Endocardial cushion grows ventrally
  3. Spiral septum projects to close IV foramen
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15
Q

What are the 4 examples of heart malformations discussed in lecture?

A
  1. Ectopic cordis
  2. Dextrocardia (situs inversus)
  3. Valvular defects (stenosis, insufficiency, dysplasia)
  4. Partitioning
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16
Q

What is ectopic cordis?

A

Heart is in an abnormal location

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17
Q

What is dextrocardia?

A

Situs inversus; adult heart is a mirror image of normal

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18
Q

What is valvular stenosis?

A

Narrowing across the heart valve

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19
Q

What is valvular insufficiency?

A

Valve did not form correctly

20
Q

What is valvular dysplasia?

A

Abnormal growth of valve

21
Q

What 4 things need to happen in order to have Tetralogy of Fallot?

A
  1. IV septal defect
  2. Pulmonary stenosis
  3. Dextroposition of aorta (overriding)
  4. R ventricular hypertrophy
22
Q

How does R ventricular hypertrophy come about?

A

Response of muscle to increased pressure of the L ventricle due to septal defect

23
Q

What is the purpose of the aorta receiving blood from both ventricles in fetal circulation?

A

To cover developing fetus and all of the placental membranes

24
Q

What 5 things are done away with from the fetal circulation postnatally?

A
  1. Umbilical artery
  2. Ductus arteriosus
  3. Oval foramen
  4. Ductus venosus
  5. Umbilical vein
25
Q

How does the umbilical artery disappear from the fetus?

A

Collapses/tightly coils down on itself and closes off

26
Q

How does the umbilical vein disappear from fetal circulation?

A

Blood no longer coming from placenta; drop in BP; drop in PGE2 to constrict vessels.

27
Q

How does the ductus venosus disappear from fetal circulation?

A

Blood no longer coming from placenta; drop in BP; drop in PGE2 to constrict vessels.
(Usually disappears at birth, sometimes postnatally)

28
Q

Which atrium has higher BP in intrauterine life and why?

A

Right; due to venus return that it is taking it

29
Q

How does the oval foramen disappear from fetal circulation?

A

BP in RA vs. LA swap (RA goes from high BP to low; LA goes from low BP to high), causing septum 1 and septum 2 to push against each other.

30
Q

How does the ductus arteriosus disappear from fetal circulation?

A

BP in pulmonary trunk drops; PGE2 levels from placenta drops; increased [O2] (causes further systemic drop of PGE2)

31
Q

What happens to PGE2 levels when [O2] rises?

A

Drops

32
Q

Which part of fetal circulation takes the longest to shut down?

A

Ductus arteriosus

33
Q

What are the 3 basic structures present at the beginning of embryonic circulation?

A
  1. Heart in cardiac loop
  2. 2 ventral aortae fuse together and 2 dorsal aortae fuse at level of heart
  3. Aortic arches pass ventral –> dorsal to join the dorsal and ventral aortae
34
Q

What arches are present in the mammalian embryo?

A

1, 2, 3, 4, 6

35
Q

What animals have the 5th aortic arch?

A

Lower vertebrates (if mammals do develop it, it is rudimentary)

36
Q

What do the numbers of the aortic arches represent?

A

The order in which they appear

37
Q

Are all of the aortic arches present at the same time? Why?

A

No; 1st arch begins to degenerate as the 6th one develops

38
Q

Between what 2 arches does aortic breakdown occur?

A

3rd and 4th

39
Q

What do the 3rd and 4th aortic arches supply?

A
3rd = head
4th = rest of body
40
Q

What are the 4 steps in aortic arch formation?

A
  1. Arches develop in order from 1-6 (#5 absent)
  2. Arches #1 and 2 begin to degenerate as last one forms 3. Breakdown of aorta occurs between 3rd and 4th arches
  3. Remaining arches give rise to different structures
41
Q

What do the 3rd R and L aortic arches give rise to?

A

R and L internal carotid arteries

42
Q

What does the 4th L aortic arch give rise to?

A

aortic arch

43
Q

What does the 4th R aortic arch give rise to?

A

R subclavian artery

44
Q

What does the 6th L aortic arch give rise to?

A

Ductus arteriosus

45
Q

What happens to the 6th R aortic arch?

A

Separates from common aorta to allow GI tract to leave from that area

46
Q

What are the 3 examples of aortic arch malformation we discussed in lecture?

A
  1. Patent ductus arteriosus
  2. Aortic coarctation (constriction)
  3. Vascular ring anomalies