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Cardiopulm Exam 1 > Great Vessel Development > Flashcards

Great Vessel Development Flashcards

1
Q

What is vasculogenesis?

A

Formation of new vascular channels by assembly of individual cell precursors called angioblasts/hemangioblasts (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

When does vasculogenesis begin and what do they form?

A

It begins in the third week and they form plexuses

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5
Q

What do angioblasts differentiate into?

A

Hematopoietic stem cells and endothelial precursors

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6
Q

What do blood islands form from?

A

They form from endothelial precursors on the outside and hematopoietic stem cells on the inside

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7
Q

Where do blood islands form?

A

In the area of the extraembryonic splanchnic mesoderm (which surrounds the yolk sac) and in the aortic gonad mesonephros region (AGM).

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8
Q

What do blood islands eventually form?

A

Plexuses, which then form channels, which then unite to form arteries and veins

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9
Q

What is Nevus Vascularis/capillary hemangioma?

A

It is a condition where there is an excessive growth of small capillary networks forming cherry angiomas

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10
Q

What is a cavernous hemangioma?

A

Due to the excessive formation of large vascular channels due to endothelial cell proliferation

Pathology in vasculogenesis, not angiogenesis

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11
Q

What sections of the body does the dorsal aorta fuse and remain paired?

A

Fuses in the abd, and remains paired in the thorax

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12
Q

What do the ventral segmental arteries supply?

A

They supply structures that come from the splanchnic layer of the lateral plate mesoderm and endoderm

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13
Q

What do the ventral segmental arteries become?

A

Abdominal arteries, celiac trunk, superior and inferior mesenteric arteries

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14
Q

What do the lateral segmental arteries become?

A

The renal arteries and gonadal arteries (ovarian and testicular)

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15
Q

What do the lateral segmental arteries supply?

A

They supply structures coming from the intermediate mesoderm (gonads and kidneys)

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16
Q

What do the dorsal segmental arteries become?

A

They become intersegmental arteries (intercostal arteries) and lumbar arteries

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17
Q

What do the dorsal segmental arteries supply?

A

Arteries supply derivatives of the somites

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18
Q

Where do all of the aortic arches travel to?

A

To the head

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19
Q

What is the order of formation and disintegration of the aortic arches?

A

1 forms, then 2, then as 3 forms, 1 disintegrates. As 4 forms, 2 disintegrates, etc.

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20
Q

What does the aortic arch 1 become and where does it travel to?

A

External Carotid and Maxillary arteries

Travels to the jaw and cheek

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21
Q

What does aortic arch 2 become and where does it travel to?

A

Travels to the ear

Becomes the stems of the stapedial arteries

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22
Q

What does the aortic sac become?

A

The brachiocephalic artery and the base of the arch of the aorta

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23
Q

What does aortic arch 3 become and where does it travel to?

A

Travels to the neck

Becomes the common carotid and the internal carotid

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24
Q

What does aortic arch 4 become?

A

Left part makes the left portion of the arch of the aorta

Right part makes the proximal right subclavian

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25
Q

What does aortic arch 6 become and where does it travel to?

A

Becomes the pulmonary arteries

Left side becomes the distal ductus arteriosus
Right side degenerates

Travels to the lungs and larynx

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26
Q

What does the 7th segmental artery become?

A

Right: distal part of the right subclavian (proximal came from arch 4)

Left: makes the entire left subclavian

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27
Q

What does the dorsal aorta make?

A

Right: portion of the right subclavian artery (helps 4 and 7) and the rest disintegrates

Left: makes the descending aorta

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28
Q

What is the path of the left recurrent laryngeal nerve?

A

It wraps around the ligamentum arteriosum and under the arch of the aorta

29
Q

What is the path of the right recurrent laryngeal nerve?

A

It wraps around the 6th aortic arch, but then the 6th aortic arch degenerates, which allows the right recurrent to ascend and wrap around the right subclavian artery

30
Q

Where does well-oxygenated blood travel through in fetal circulation?

A

From the left umbilical vein to the inferior vena cava through the foramen ovale to the left atrium to the left ventricle into the aorta and then systemically

31
Q

What is the function of the ductus venosus?

A

It bypasses the liver so that oxygenated blood can go to the IVC

Not necessary to be filtered by the liver because the mother filters toxin with her own liver

32
Q

What is the purpose of the sphincter in the fetal liver?

A

It closes if the pressure of the blood returning from the placenta would damage the fetal heart and shunts it to the sinusoids of the fetal liver

33
Q

Where does blood get preferentially shunted in the fetus?

A

To the head

34
Q

What does the left umbilical vein become?

A

It becomes a remnant called the round ligament of the liver or ligamentum teres

35
Q

What does the ductus venosus become and what does it interact with?

A

It becomes the ligamentum venosum and interacts with the ligamentum teres

36
Q

What chemokine keeps ductus arteriosus open?

A

Prostaglandins

37
Q

What chemokine closes the ductus arteriosus?

A

Bradykinin

38
Q

What chemical leads to increase in bradykinin and decrease in prostaglandins?

A

Oxygen

39
Q

Where does a preductal aortic constriction take place? How about a postductal aortic constriction?

A

Preductal is before the ductus arteriosus

Postductal is after the ductus arteriosus

40
Q

Why are preductal coarctations worse than postductal?

A

With postductal coarctation, typically collateral circulation arises to get blood to the lower extremity

41
Q

What do children with aortic coarctations present with?

A

High BP and pulses in the upper extremity and low BP and pulses in the lower extremity

42
Q

What is a double aortic arch?

A

The persistence of the distal portion of the right dorsal aorta which forms a vascular ring around the trachea and esophagus

43
Q

What sx do children with double aortic arch present with?

A

Stridor, respiratory infections and distress, wheezing, cough, dysphagia, feeding difficulty, and vomiting

44
Q

What is interrupted aortic arch?

A

The abnormal disintegration of both of the 4th aortic arch arteries which leads to an interrupted aortic arch , but the distal right dorsal aorta is retained

45
Q

How do children with interrupted aortic arch syndrome survive?

A

They have a VSD and PDA to allow blood flow to enter the lower extremity

Right side of the body will always get O2, but the left upper body may or may not

46
Q

What occurs when there is an abnormal origin of right subclavian artery?

A

The subclavian artery develops abnormally from the distal part of the right dorsal aorta and the 7th intersegmental artery while the right 4th aortic arch and proximal part of the right dorsal aorta are obliterated

Long story short: right subclavian originates on the left and hooks around the esophagus and trachea

47
Q

How does a right aortic arch form?

A

the left 4th arch and left dorsal aorta are obliterated and replaced by the corresponding vessels on the right side

48
Q

What can be a complication with a right aortic arch?

A

Depending on how it forms, the ligamentum arteriosum can lie behind the esophagus which can lead to dysphagia, but most cases form with the ligamentum arteriosum anterior to the esophagus

49
Q

When does remodeling of the inflow to the heart occur?

A

Weeks 4-8

50
Q

What are the three cardinal veins and what do they do?

A

Anterior, posterior, and common

They bring oxygen-poor blood from the body back to the heart

51
Q

What do the vitelline veins do?

A

They surround the yolk sac and liver, and return blood from the yolk s ac and liver back to the heart

52
Q

What do umbilical veins do?

A

Carry oxygen-rich blood from the placenta to the heart

53
Q

What occurs to the left vitelline vein near the heart?

A

It degenerates

54
Q

What occurs to the right vitelline vein near the heart?

A

It persists

55
Q

What occurs to the right and left vitelline veins near the liver?

A

Right: forms the hepatic vein, which is connected to the IVC

Right and left: form the portal vein

56
Q

What happens to the right umbilical vein?

A

It degenerates entirely

57
Q

What happens to the left umbilical vein?

A

Proximal portion degenerates

Distal portion: persists and anastomoses with ductus venosus in the liver

58
Q

What does the Anterior Cardinal Vein do and become?

A

Drains cranial territory

Right forms internal jugular vein and SVC

Left forms the brachiocephalic vein

59
Q

What does the Posterior Cardinal Vein become?

A

Degenerates, leaving only the root of azygos vein and common iliac vein

Replaced by sub/supracardinal veins

60
Q

How does a Left superior vena cava form?

A

When the right common cardinal and proximal part of the right anterior cardinal vein disintegrates, so it has to come from the left anterior cardinal vein and drains into the coronary sinus

61
Q

How does double superior vena cava form?

A

Due to a failure of the left brachiocephalic vein to form

So instead of there being a left brachiocephalic, it becomes another vena cava which drain into the coronary sinus

62
Q

What are the segments of the IVC from superior to inferior?

A

Hepatic, prerenal, renal, postrenal

63
Q

What forms the hepatic segment of the IVC?

A

the hepatic and right vitelline veins

64
Q

What forms the prerenal segment of the IVC?

A

Right subcardinal

65
Q

What forms the renal segment of the IVC?

A

Subcardinal-supracardinal anastomosis

66
Q

What forms the postrenal segment of the IVC?

A

Right supracardinal vein

67
Q

What does the supracardinal vein become?

A

Hemiazygos vein and caudal part of azygos vein

68
Q

What does the right supracardinal vein become?

A

The right common iliac vein, and a contribution to the IVC

69
Q

What does the left supracardinal vein become?

A

Left common iliac vein

Cardiopulm Exam 1 (4 decks)

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