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CP-1 > Great Arteries and Veins Embryology > Flashcards

Great Arteries and Veins Embryology Flashcards

1
Q

What is vasculogenesis?

A

formation of new vascular channels by assembly of angioblasts
from mesoderm

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2
Q

What is angiogenesis?

A

development of blood vessels from pre-existing vessels

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3
Q

What is arteriogenesis?

A

remodeling of existing arteries in response to changes

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4
Q

What does vasculogenesis begin?

A

end of third week

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5
Q

What is the general sequence of cell changes during vasculogenesis?

A

undifferentiated mesoderm –> hemangioblasts –> form HSCs and endothelial precursors –> blood islands form–> capillaries w/ primitive erythrocytes

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6
Q

Where do the channels w/ hematopoietic stem cells form?

A

in extraembryonic splanchnic mesoderm around umbilical vessel
AGM

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7
Q

What is a capillary hemangioma?

A

excessive growth of small capillary networks

cherry angiomas

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8
Q

What is a cavernous hemangioma?

A

proliferation of large dilated vascular chanels

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9
Q

What are hemangiomas of infancy?

A

benign tumors affecting up to 10% caucasian infants
due to abnormalities in vasculogenesis
consist of many endothelial cells

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10
Q

What do you see in the great veins in the fourth week?

A

first aortic arch formed –> supplies first pharyngeal arch

paired dorsal aorta that fuse in abdomen

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11
Q

What are the branches off the fused dorsal aorta?

A

ventral segmental arteries –> gut
lateral segmental arteries –> kidneys and gonads
dorsal intersegmental arteries –> supply derivatives of somites

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12
Q

What type of embryologic tissues do the ventral segmental arteries supply?

A

splanchnic layer of lateral plate mesoderm and endoderm (gut)

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13
Q

what do the dorsal intersegmental arteries become?

A

intercostal As

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14
Q

When does the formation of aortic arches 2-6 occur?

A

days 26-32

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15
Q

How in general do the aortic arches form?

A

one after the other, with the previous arch degenerating once the next one forms

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16
Q

When is the formation of the aortic arches completed?

A

days 32-37

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17
Q

What are the derivatives of the 1st pharyngeal arch?

A

external carotid, maxillary

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18
Q

What are the derivatives of the 2nd pharyngeal arch?

A

stems of stapedial arteries

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19
Q

What are the derivatives of the aortic sac?

A

brachiocephalic artery

base of arch of aorta

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20
Q

What are the derivatives of the 3rd pharyngeal arch?

A

common carotid

internal carotid

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21
Q

What are the derivatives of the 4th pharyngeal arch?

A

left: medial portion of arch of aorta
right: proximal Rt subclavian A

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22
Q

What are the derivatives of the 6th pharyngeal arch?

A

pulmonary arteries (lungs and larynx)
Left: distal ductus arteriosus
Right: distal degenerates

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23
Q

What are the derivatives of the 7th pharyngeal arch?

A

right: distal part of right subclavian
left: entire left subclavian artery

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24
Q

What are the derivatives of the dorsal aorta?

A

right: portion of right subclavian A
left: descending aorta

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25
Q

How does the development of the arteries contribute to the position of recurrent laryngeal nerves?

A

Distal half of R 6th arch degrades , so right recurrent goes back up earlier
L distal 6th arch turns into ductus arteriosus –> left recurrent laryngeal N continues down and wraps around it

26
Q

What is the ductus venosus?

A

V that allows placental blood to bypass liver and go straight from umbilical vein to inferior vena cava

27
Q

Where does oxygen rich fetal blood typically go once it reaches the R atrium?

A

likes to go straight to L atrium –> L ventricle –> aorta

some blood will go normal adult path and then go from pulmonary A to aorta –> blood from this route is less oxygenated and goes to lower extremity

28
Q

What part of the body gets the most oxygen rich blood?

A

the brain

29
Q

When should the ductus arteriosus close?

A

72 hours after birth

30
Q

What causes the foramen ovale to close after birth?

A

Higher pressure in the L atrium

31
Q

What happens at birth in the lungs?

A

decrease in pulmonary vascular resistance
increase in pulmonary blood flow
thinning of walls of pulmonary arteries

32
Q

What happens to the ductus venosus after birth?

A

spincter constricts –> turns into ligamentum venosum

33
Q

What causes the sphincter of ductus venosus to close after birth?

A

increased O2 –> decreased prostaglandins –> more bradykinin –> smooth muscle contracts

34
Q

What is coarctation of the aorta?

What are the two types?

A

constriction of the aorta
preductal
postductal

35
Q

What happens in postductal coarctation of the aorta?

A

fetus will develop collateral circulation to the body

36
Q

Clinically, what would you see in a baby w/ coarctation of the aorta?
How would you treat it?

A

higher pulses and BP in upper limbs
lower bp and weaker pulse in lower limbs
give prostaglandins to help open

37
Q

What causes coarctation of the aorta?

A

we think: smooth muscle abnormally migrates to aorta –> closes it off
OR: abnormal remodeling of vasculature

38
Q

How does a double aortic arch occur?

Where do you find it?

A

persistence of the distal portion of the right dorsal aorta

forms a vascular ring around the trachea and esophagus

39
Q

What do pts present with if they have a double aortic arch?

A

trouble breathing, stridor
esophageal complaints also
(due to aortic ring around these two structures that can compress them)

40
Q

What causes an interrupted aortic arch?

A

both right and left 4th aortic arches are obliterated –> distal R aorta is retained

41
Q

What do babies present w/ if they have an interrupted aortic arch?

A

weakness, fatigue, poor feeding
rapid breathing and heart rate
low O2 levels especially in LE

42
Q

DiGeorge’ syndrome is associated with what cardiac abnormality?

A

interrupted aortic arch

43
Q

What happens in abnormal origin of right subclavian artery?

A

R 4th aortic arch and proximal part of the R dorsal aorta obliterate –> subclavian arises from 7th intersegmental A and distal part of R dorsal aorta
ends up behind esophagus and trachea

44
Q

How does a right aortic arch occur?

A

L fourth arch and L dorsal aorta are obliterated and replaced by the corresponding vessels on the right side

45
Q

Clinically, what can affect swallowing in right aortic arch?

A

if ligamentum arteriosum lies on the L side and passes behind esophagus

46
Q

What does the right horn of the sinus venosus give rise to?

A

sinus venerum and crista terminalis of R atrium

47
Q

What does the L horn of the sinus venosus give rise to?

A

coronary sinus

48
Q

When does veinous flow to the heart remodeling occur?

A

weeks 4-8

49
Q

What happens to the vitelline veins proximal to the heart?

A

Right: persists
Left: degenerates

50
Q

What happens to the the vitelline veins in the liver?

A

right –> hepatic vein

R and L –> form portal vein from gut

51
Q

What happens to the Rt umbilical vein?

A

degenerates entirely

52
Q

What happens to the L umbilical vein?

A

proximal degenerates
anastomoses w/ ductus venosus
distal persists in embryo for placental return

53
Q

What happens to the anterior cardinal Vs?

A

right –> internal jugular and superior vena cava

Left –> left brachiocephalic V

54
Q

What happens to the posterior cardinal Vs?

A

drains from body wall
degenerates except for root of azygos and common iliac Vs
replaced by subcardinal and supracardinal Vs

55
Q

What happens in Left superior vena cava?

A

persistence of left anterior cardinal v and obliteration of the common cardinal and proximal part of anterior cardinal vs on the R

56
Q

What happens in double superior vena cava?

A

L anterior cardinal V persists

L brachiocephalic vein fails to form

57
Q

What does the hepatic segment of the inferior vena cava arise from?

A

vitelline/hepatic veins and sinuses

58
Q

What does the prerenal inferior vena cava arise from?

A

Rt SUBcardinal V

59
Q

What does the renal vena cava arise from?

A

subcardinal-supracardinal anastomosis

60
Q

What does the postrenal vena cava arise from?

A

Rt SUPRAcardinal V

61
Q

What is the round ligamentum teres/round ligament of the liver?

A

remnant of the umbilical vein

62
Q

How does a fetus compensate for a preductal coarctation?

A

can bypass through the ductus arteriosus (but this won’t work after birth when this closes)

CP-1 (32 decks)

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