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Cardiopulm Midterm > Great Vessel Development > Flashcards

Great Vessel Development Flashcards

1
Q

What are the major mechanisms by which the vascular plexus expands?

A

vasculogenesis
angiogenesis
intussuption

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2
Q

vasculogenesis

A

new vessels

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3
Q

angiogenesis

A

branching

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4
Q

intussuption

A

splitting

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5
Q

angiomas

A

abnormal blood vessels and lymph growth

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6
Q

capillary hemangioma

A

small capillary network

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7
Q

cavernous hemangioma

A

venous sinuses

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8
Q

hemangiomas of infancy

A

benign endothelial cell tumors

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9
Q

What are pharyngeal arches made of?

A

outgrowths of head and neck mesenchyme

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10
Q

What do pharyngeal arches contain?

A

cranial nerve and artery – aortic arches

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11
Q

What do aortic arches (AA) arise from?

A

aortic sac - expansion at distal most portion of truncus arteriosus

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12
Q

What do the aortic arches connect?

A

aortic sac with dorsal aorta

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13
Q

What are the aortic arches formed by?

A

angiogenesis and vasculogenesis

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14
Q

What aortic arches hypertrophy?

A

3, 4, 6

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15
Q

What vessels are added to primitive aortic arch system?

A

external carotid, distal part of pulmonary artery

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16
Q

What aortic arches are lost?

A

1, 2 [5 never forms]

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17
Q

What level do paired dorsal aorta fuse?

A

T4

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18
Q

What divides the aorta and pulmonary artery?

A

aorticopulmonary septum

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19
Q

How do intersegmental arteries form?

A

vasculogenesis within mesoderm

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20
Q

How many intersegmental arteries are there in each section?

A

7 cervical
12 thoracic
5 lumbar

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21
Q

What happens to the 7 cervical intersegmental arteries?

A

lose roots of 1-6, longitudinal anastamosis becomes vetebral arteries
left 7th intersegmental artery - forms subclavian artery
right 7th intersegmental artery - forms part of subclavian artery with AA IV

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22
Q

What happens to the 12 thoracic intersegmental arteries?

A

superior/inferior anastamoses fofrm internal thoracic arteries
intersegmental arteries form intercostal arteries

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23
Q

What happens to the 5 lumbar intersegmental arteries?

A

anastamosis makes epigastric and iliac vessels

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24
Q

What happens to AA I and II?

A

break up and reorganize
I - maxillary A
II - stapedial A

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25
Q

What happens to AA III?

A

main feeder to head, forms common carotid and proximal portion of internal carotid
remainder becomes dorsal aorta
sprouts to form external carotid

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26
Q

What happens to AA IV? Left? Right?

A

hypertrophies
Left - forms part of aortic arch (2nd part)
Right - proximal part of subclavian A

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27
Q

What insures connection of left AA IV to left ventricle?

A

spiral septum of outflow tract

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28
Q

What forms the aortic arch in the newborn?

A

Aortic sac, AA IV, left dorsal aorta proximal to 7th intersegmental, left dorsal aorta distal to 7th intersegmental

29
Q

What happens to AA V?

A

never forms

30
Q

What happens to AA VI?

A

pulmonary arteries (along with aortic sac)

31
Q

Where does the heart start to grow?

A

cervical region

32
Q

Where does the heart end up?

A

thorax

33
Q

What causes the laryngeal nerve to become hooked around the future right subclavian?

A

regression of distal part of right AA VI (loss of connection to right dorsal aorta)

34
Q

What is the connection between the dorsal aorta and AA VI called on the left?

A

ductus arteriosus

35
Q

What nerve is hooked around the distal AA VI?

A

recurrent laryngeal N

36
Q

What happens to the left distal AA VI?

A

ligamentum arteriosum

37
Q

What happens to the dorsal aorta?

A 
carotid duct (portion between AA III & AA IV) disappears. 
Right dorsal aorta disappears btwn right 7th intersegmental A and junction with left dorssal aorta. 
remaining segments fuse to form descending thoracic and abdominal aorta.
38
Q

What do the vitelline arteries form?

A

GI vasculature

39
Q

What do umbilical arteries form?

A

developing bladder arteries
distal end disappear after birth and become medial umbilical ligaments
proximal 5th lumbar intersegmental arteries - referred to as umbilical arteries in adult

40
Q

What causes the ductus arteriosus to close after birth? When does it close?

A

changes in blood oxygen tension, sudden drop in prostaglandin, increase in endothelin release from newborn lungs.
10-15 hours after birth

41
Q

Patent ductus arteriosus

A

1/3-1/2 blood traveling via aorta will enter pulmonary artery b/c systemic BP is higher. blood will circulate 2-3 times. LV hypertrophy. Pulmonary congestion and CHF. Blowing murmur after 1-3 years.

42
Q

What increases the risk for patent ductus arteriosus?

A

maternal rubella infection during early pregnancy

43
Q

What is the treatment for patent ductus arteriosus?

A

prostiglandin inhibitors (indomethacin) or surgery

44
Q

What is coarctation of the aorta?

A

narrowed aortic lumen below left subclavian A due to abnormal thickening of aortic wall

45
Q

____ is more frequent in Turner’s syndrome.

A

Coarctation of the aorta

46
Q

postductal coarctation of the aorta

A

sometimes not noticed b/c collateral circulation is established through intercostal arteries

47
Q

preductal coarctation of the aorta

A

collaterals not well developed, little or no blood to lower body and legs unless ductus arteriosus remains open (and even then O2 poor from RV). Death if severe w/o surgery.

48
Q

What forms wrong in aberrant origin of right heart?
What disappears?
Symptoms?
Why?

A

subclavian formed by distal portion of right dorsal aorta and 7th intersegmental A instead of 7th intersegmental A and right AA IV
Right AA IV and right dorsal aorta disappear
symptoms: dysphagia and dyspnea
right dorsal aorta crosses esophagus to right UE

49
Q

What causes double aortic arch?

Symptoms?

A

vascular ring surrounding trachea and esophagus

symptoms: esophageal dysfunction and strangulation of trachea

50
Q

What causes right aortic arch?
symptoms?
What causes symptoms?

A

left AA IV and left dorsal aorta gone and replaced with right
symptoms: dysphagia and dyspnea if left subclavian A passes behind esophagus and ligamentum arteriosum passes in front of trachea

51
Q

What causes interrupted aortic arch?
What is this associated with?
Is it life threatening?

A

AA IV disappears and proximal part of right dorsal aorta disappears
ductus arteriosus remains open
low O2 in descending aorta and subclavian As
DiGeorge syndrome
yes

52
Q

What do the vitelline veins drain?

A

yolk sac

53
Q

What do the vitelline veins form?

A

vascular plexus hepatic sinusoids within liver primordia

54
Q

What does the right proximal vitelline vein turn into?

A

right hepatic cardiac channel then terminal part of inferior vena cava

55
Q

What does the left proximal vitelline vein turn into?

A

nothing, disappears

56
Q

What does the left inferior vitelline vein turn into?

A

portal vein, superior and inferior mesenteric veins, splenic veins

57
Q

What is the function of the umbilical veins?

A

carry oxygenated blood from the placenta to the fetal heart

58
Q

What is the channel between the left umbilical vein and right hepatocardiac channel?

A

ductus venosus

59
Q

What is the function of the ductus venosus?

A

oxygenated blood bypasses sinoidal plexus of liver

60
Q

What keeps the ductus venosus open?

A

prostaglandins

61
Q

What happens to the left umbilical vein and ductus venosus after birth?

A

disappears forming ligamentum teres hepatis and ligamentum venosum

62
Q

What drains the blood from the head and neck into the cardinal veins on the right side?

A

anastamoses between left and right anterior cardinal veins

63
Q

What does the anterior cardinal vein form?

A

anastomoses between right and left - left brachiocephalic vein
right common cardinal vein - SVC

64
Q

What makes the coronary sinus?

A

left cardinal vein and left sinus horn

65
Q

What can abnormal anterior cardinal vein development lead to?

A

superior vena cava draining into the heart via coronary sinus

66
Q

What do the posterior cardinal veins connect?

A

subcardinal and supracardinal veins

67
Q

What do the subcardinal veins form?

A

kidney and gonal veins, abdominal IVC

68
Q

Whta do the supracardinal veins form?

A

portions of IVC, azygos system, and veins draining body wall

Cardiopulm Midterm (6 decks)

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