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CP Exam 1 > Great Vessels Embryo > Flashcards

Great Vessels Embryo Flashcards

1
Q

What is the difference between splanchnic mesoderm and mesenchyme?

A

Mesenchyme is embryonic connective tissue which is mainly mesoderm and has some neural crest.

Lung is made up of splanchnic mesoderm while heart is made of mesenchyme: splanchnic mesoderm and neural crest which help make bulbar ridges and the aorticopulmonary septum

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2
Q

Undifferentiated mesoderm differentiates into angioblasts/hemangioblasts which give rise to which two cells?

A

Hematopoetic Stem Cells (HSC)

Endothelial Precursor Cells (EPC)

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3
Q

Hemangioblasts aggregate and form blood islands which have the EPCs forming the vessels and channels, and inside the EPCs youll find the?

A

Hematopoietic Stem cells, BLOOD ISLANDS

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4
Q

Vasculogenesis

A

Formation of vascular channels using hemangioblasts/angioblasts, which are derived from mesoderm.

  1. Undifferentiated mesoderm will become angioblasts/hemangioblsts.
  2. Hemangioblasts –> hematapoietic stem cells and endothelial precursor cells (EPC)
  3. HSC and EPC –> hemangioblastic aggregates
  4. Hemangioblastic aggregates –> blood islands; EPCs with hematapoetic progenitory cells inside.
  5. Blood island will accumulate to form plexes
  6. Channels form within the plexe to carry blood.
  7. Channels enlarge and unite to form [arteries and veins]
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5
Q

What is angiogenesis?

A

Developing blood vessels from pre-existing vessels.

This occurs in adults and cancers.

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6
Q

What is arteriogenesis?

A

Existing arteries are remodeled in response to changes.

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7
Q

What does vasculogenesis begin?

A

End of the third week

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8
Q

During vasculogenesis, what can go wrong?

A

Hemagioma

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9
Q

What is capillary hemagioma (nevus vascularis)?

A

Small capillary networks grow excessively, resulting in cherry angiomas (Campbell de Morgan spots)

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10
Q

What are cavernous hemagiomas?

A

Proliferation of large dilated vascular channels.

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11
Q

What is hemanioma of infancy?

A

A benign tumor that consists of many endothelial cells.

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12
Q

Where do the blood islands form? (HPCs)

A

The extraembryonic mesoderm that surrounds the umbilical vessel/ yoke sack and in the region of the aortic gonad mesenephrose (AGM)

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13
Q

Once the blood islands form, they accumulate and form plexuses. Channels within the plexus enlarge to form?

A

The arteries and the veins

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14
Q

Paired dorsal aorta is formed bringing two heart tubes together.

What is the flow of blood during the fourth week?

A

Bulbus cordis –> trucus arteriosus –> aortic sac –>pharyngeal arch arteries (1-2-3-4-6) –> aortic arch–> drains into dorsal aorta.

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15
Q

The paired dorsal aorta fuse in the region of the abdomen, and in the region of the thorax they?

A

remained paired so they can be remodeled to form blood vessels

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16
Q

What are the three branches off of the fused abdominal dorsal aorta?

A
  1. Ventral segemental arteries
  2. Lateral segmental arteries
  3. Dorsal segmental arteries
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17
Q

What do the ventral segmental arteries supply?

A

Structures that came from the splanchnic layer of the lateral plate mesoderm and endoderm.

Such as: celiac trunk, superior mesenteric artery and the IMA.

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18
Q

What do the lateral segmental arteries supply structures that came from the _________________________.

A

Intermediate mesoderm.

–> Renal and gonadal arteries

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19
Q

Dorsal segmental arteries supply __________

A

derivates of somites.

Ex.- intersegmental arteries such as intercostal arteries and lumbar arteries.

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20
Q

As aortic arches form during days 26-32,

1 forms first, then second and third, and as third forms, one degrades, and as fourth forms?

A

second degrades, as 6 forms, third degrades.

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21
Q

When are the formation of the aortic arches complete?

A

Days 32-37.

They then give off branches to the developing head.

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22
Q

The 1st aortic arch/ pharyngeal arch gives rise to?

A
  1. External carotid A
  2. Maxillary A
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23
Q

The 2nd aortic arch gives rise to?

A

Stems of the stapedial arteries in the ear

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24
Q

The aortic sac gives rise to?

A

1. Brachiocephalic artery

2. Base of arch of aorta

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25
Q

The 3rd pharygeal arch/aortic arches gives rise to?

A

1. Common carotid A

2. Internal carotid A

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26
Q

The 4th pharyngeal arch/aortic arch gives rise to?

A

Left: medial portion of arch of aorta

right: proximal right subclavian A

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27
Q

The 6th arch gives rise to?

A

LUNGS AND LARYNX

Pulmonary arteries

left: ductus arteriosus

right: distal part degenerates

28
Q

What does the 7th intersegemental artery give rise to?

A

Right- distal part of right subcalvian A

Left- entire left subclavian artery

29
Q

What does the dorsal aorta give rise to?

A

Right: part of the right subclavian A

Left: descending aorta

30
Q

Left recurrent laryngeal N wraps around ligamentum arteriosus and goes back up. What happens on the right side?

A

It did wrap around 6th aortic arch, however the distal part of the 6th arch degenerates.

So the right recurrent goes under the right subclavian A

31
Q

Fetal circulation

A

O2 rich blood from placenta–> left umbilical vein–> liver, where there is a sphincter, if the pressure from the placenta is high, the sphincter constricts and shunts blood into sinusoids of the liver.

The rest of the blood from the sphincter bypasses liver via ductus venosus***.

–> inferior vena cava, (usually will go through liver but moms blood is already cleaned)–> Right atrium –>majority goes to formane ovale and foramen secundum –> left atrium–> left ventricle –> aorta and go to the head first.

32
Q

In fetal circulation; some blood can go from the RA–> RV. What happens then?

A

Pulomonary trunk –> lungs, but we only need enough blood to help them develop.

Pulmonary constriction can constrict to make sure there isnt too much blood in lungs, rest of blood goes through the ductus arteriosus and send medium o2 content blood to the rest of the body.

33
Q

What is different about neonatal circulation?

A

It is a fluid to air interface.

34
Q

Neonatal circulation: Fluid interface to air interface. At birth you get aeration of the lungs which causes what? (3)

A
  1. Decrease of pulmonary vascular resistance, because we send to more blood to the lungs
  2. Increase in pulmonary blood flow
  3. Thinning of the walls of the pulmonary arteries.
35
Q

In neonatal circulation, we do not need blood supply from mom. Thus, left umbilical vein turns into?

A

ligamentum teres (round ligament of the liver)

36
Q

What does the ductus venosus turn into once the baby is born?

A

Ligamentum venosum

37
Q

What occurs due to the high pressure in the left atrium in neonates?

A

Septum primum fuses with foramen ovale, forming the fossa ovalis

(ductus arteriosus –> ligamentum arteriosum within 72 hours)

38
Q

In neonates, we do not need the umbillical A anymore. What does it turn into?

A

Medial umbilical ligament

39
Q

Now that neonates are exposed to air. There will be an increased in O2. What are the feffects of this?

A

1. Decreased prostaglandin

2. Increased bradykinin

causes ductus arteriosus–> ligamentum arteriosum

40
Q

In neonates, do we still bypass the liver via ductus venosus?

A

No.

The sphincter in ductus venosus will constrict and all blood will go through the liver.

41
Q

What is coarctation of the aorta?

A

Aortic construction. There are two kinds, determined by where are occur in comparison to the ductus arteriosis.

  1. Preductal
  2. Post ductal
42
Q

If postductal coarctation, fetus develops a collateral circulation so blood goes to lower extremeties.

What happesn with preductal coarctation?

A

Fetal life is okay because bypassed by ductus arteriosus.

Neonatal, it closes and then there are problems.

There will be normal/high pulses in upper limb d/t brachiocepahlic, subclavian and carotid being before the constriction.

Pulses in the lower limbs would be decreased or absent.

CYANOTIC

43
Q

What would you give to baby is the baby is sweating and blue post birth?

How does this occur embryologically?

A

PGE2 to keep ductus arteriosus open so we can fix it by surgery.

  1. Smooth muscle abnormally goes into aorta, constricts
  2. When aortic arches are remodeling, there was a narrowing of the artery
44
Q

Double aortic arch:

A

Persistence of the distal portion of the right dorsal aorta (which wouldve disinegrated) which forms a vascular ring around the trachea and esophagus.

45
Q

Sx of a double aortic arch

A
  1. Stridor
  2. Resp infections
  3. Wheezing,

Esophogeal complains

46
Q

Interupted aortic arch, both right and left 4th aortic arch arteries are obliterated/degenerated, what is retained?

A

distal right aorta is retained

47
Q

What usually occurs with interupted aortic arch?

A

VSD/PDA to keep the baby alive.

Within first two days, weakness, fatigue, tachypnea, low O2 levels, esp in the legs and feet.

Right is always getting oxygen, left side is not sometimes, but d/t PDA/VSD O2 blood can still get to places.

Most severe form of coarctation

48
Q

What is the suspected causes of interupted aortic arch?

A

1. Low calcium

2. Development delay

3. NC cell migration abnormalities (DIGEORGE SYNDROME)

49
Q

Abnormal orgin of the right subclavian artery arises from the distal part of the right dorsal aorta and the 7th intersegmental artery. What happens with the right 4th aortic arch and right subclavian?

A

r 4th aortic arch and proximal part of the right dorsal aorta obliterate, right subclavian passes behind the esophagus and trachea

50
Q

What can be caused be abnormal origin of the r subclavian passing behind the trachea and esophagus?

A

Constricts esophagus, dysphasia, can’t swallow pressure on vertebra, lower pulse/BP on right upper extremity

51
Q

Right aortic arch

  • L 4th arch and L dorsa aorta= GONE.*
  • Replaced by vessels on the R*

What happens if the ligamentum arteriosum is on the left side?

A

Passes behind the esophagus and swallowing can be affected,

most of cases form with ligamentum arteriosum anterior

52
Q

Sinus venosus (where venous imput is coming in) is incorporated into the atria.

left horn gives rise to?

How about the right horn?

A

Left horn gives rise to smooth wall and coronary sinus

Right horn gives rise to crista terminalis, orificies of inferior vena cava, coronary sinus

53
Q

What are our 3 types of veins?

A
  1. Cardinal (anterior, posterior and common)
  2. Vitelline
  3. Umbilical
54
Q

What do cardinal veins do?

A

Take o2 poor blood to the heart

55
Q

What do vitelline veins do?

A

Take O2 poor blood from yolk sac and liver–> heart

56
Q

Umbilical Veins

A

O2 rich blood from the placenta–> heart

57
Q

The vitelline are in the yoke sac and liver.

Proixmal to the heart and within the liver, what happens to vitelline veins?

A

Proximal:

left vein–> degenerates, right vein–> persists

Liver:

right–> hepatic vein (part of the inferior vena cava part)

right/left merge–> portal vein (from gut)

58
Q

The umbilical veins do what? Right/left side

A

Right degenerates entirely

Left persists:

Proximal part degenerates but the distal part will asnastomose with the ductus venosus in the liver, to bring O2 rich blood into the heart.

59
Q

Anterior cardinals.

Where do they drain from?

What do the L and R form?

A

Anterior cardinals drain from the cranial region

Right–> R internal jugular vein and SVC

Left–> forms the L brachiocephalic v

60
Q

Posterior cardinal vein drain from body wall, how is it remodeled?

A

Posterior system degenerates except for root of azygous and common iliac.

REPLACED by subcardinal and supracardinal veins

61
Q

Veins are made in week four to give blood supply to many places due to growth occuring rapidly during this period. What does she want us to realize?

A

VEINS DONT FOLLOW THE BEWK subcardinal veins become supracardinal veins which is replaced by IVC and more

62
Q

What occurs when there is a persistence of the left anterior cardinal vein and obliteration of the common cardinal and proximal part of the anterior cardinal veins on the right?

A

Left superior vena cava: blood needs to go into coronary sinus in order to get into right atrium

63
Q

What happened:

  • Left anterior cardinal vein persists
  • Left brachiocephalic vein did not form.
A

Double superior vena cava:

right SVC–> RA

left SVC –> coronary sinus –> RA

64
Q

Inferior Vena Cava

What is each segmental made from?

Hepatic segment:

Prerenal:

Renal:

Postrenal:

A

Hepatic: Right vitelline/hepatic veins and sinuses

Prerenal: right subcardinals

Renal: subcardinal-supracardinal anastamosis

Postrenal: Right supracardinal

65
Q

Malformation of the IVC: double inferior vena cava due to?

A

Persistence of the left sacrocardinal vein, resulting in two IVCs dumping into the renal vein (GI)

CP Exam 1 (29 decks)

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