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CPR > Heart Development > Flashcards

Heart Development Flashcards

1
Q

What makes up the first heart field?

A

Endothelial Precursor Cells (EPCs) clusters in splanchnic mesoderm + adjacent mesoderm

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2
Q

For the first heart field, EPC clusters in splanchnic mesoderm differentiate into?

A

Endothelial cells

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3
Q

Once the EPC clusters in the first heart field differentiate into endothelial cells. What will they form?

A

2 Endocardial tubes

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4
Q

What takes place to move the 2 Endocardial tubes towards the midline?

A

Lateral body folding

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5
Q

The 2 Endocardial tubes will ____ to form the simple tubular heart

A

Fuse

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6
Q

What 3 layers does the primitive heart (tube) walls consist of from innermost to outermost?

A
  1. Endocardium
  2. Cardiac jelly
  3. Myocardium
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7
Q

What is the cardiac jelly made of?

A

Extracellular matrix

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8
Q

Inflow of blood into the primitive heart is done by what 3 veins?

A
  1. Common cardinal vein
  2. Vitelline vein
  3. Umbilical vein
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9
Q

The 3 veins that bring blood to the primitive heart empty into sinus horns. Describe the pathway through the primitive heart from there.

A 
Sinus Horns
Sinus Venosus (L and R sinus horns)
Primitive atrium
AV region
Primitive ventricle 
Outflow tract
Aortic sac
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10
Q

Function of Dorsal Mesocardium?

A

Suspends the heart tube

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11
Q

What does the rupturing of the dorsal mesocardium create?

A

Transverse sinus (seen in adults)

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12
Q

What are the remnants of the dorsal mesocardium?

A

Proepicardial organ

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13
Q

What will cells in the proepicardial organ form?

A

Epicardium

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14
Q

What structural changes occur as the heart tube continues to grow?

A

Cardiac looping

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15
Q

Before cardiac looping takes place, describe the order of the heart tube from inferior to superior

A 
Sinus horns
Sinus venosus
Primitive atrium
Primitive ventricle
Outflow tract
Aortic sac
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16
Q

With cardiac looping, the primitive atrium will move where?

A

Cranially and dorsally to sit between the outflow tract and the dorsal pericardial wall

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17
Q

With cardiac looping, the outflow tract bends which way to create what?

A

Bends to the right to create the right ventricle

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18
Q

With cardiac looping, what is added to the cranial end?

A

Myocardium

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19
Q

With cardiac looping, what is created when myocardium is added to the cranial end?

A
  1. Conus Arteriosus

2. Truncus Arteriosus

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20
Q

Outflow of both ventricles occurs at the?

A

Conus Arteriosus

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21
Q

Outflow - aorta and pulmonary artery occurs at the?

A

Truncus Arteriosus

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22
Q

Development of a ______ lengthens the heart tube at both ends and is also required for cardiac looping

A

Second heart field

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23
Q

Where does the second heart field form?

A

Both ends of the rupturing dorsal mesocardium

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24
Q

What cell type in the PA region is necessary to maintain cardiogenic mesoderm proliferation in the second heart field?

A

NCCs

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25
Q

With the second heart field, what tissue type is proliferating?

A

Cardiogenic mesoderm

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26
Q

Ventricular inversion

A

Primitive ventricle folds to the right and the outflow tract folds to the left
= results in a right-sided, left ventricle

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27
Q

Heterotaxia

A

Any abnormal left-right development

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28
Q

Situs inversus

A

COMPLETE reverse symmetry of the heart AND GI organs!!

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29
Q

Is situs inversus asymptomatic?

A

YES

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30
Q

Situs ambiguous

A

Reversal of SOME organs (partial)

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31
Q

What is a type of situs ambiguous?

A

Visceroatrial heterotaxia

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32
Q

Visceroatrial heterotaxia

A

Right-sided heart with NORMAL GI tract

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33
Q

Is situs ambiguous (visceroatrial heterotaxia) asymptomatic?

A

NO - can be life - threatening

34
Q

The sinus venosus opens into the?

A

Primitive atrium

35
Q

The sinus venosus shifts toward the ____

A

Right

36
Q

All that remains of the left sinus horn becomes the?

A

Coronary sinus

37
Q

As the atrium enlarges, the sinus venosus only opens into the right atrium and is now called?

A

Sinoatrial orifice

38
Q

The Right Common Cardinal Vein becomes the?

A

Superior vena cava

39
Q

The Right Vitelline vein becomes?

A

Part of the Inferior vena cava

40
Q

Tissue flaps develop on either side of the opening of the sinoatrial orifice and are known as?

A

Venous valves

41
Q

The fold of the left sinus horn is a valve of?

A

Coronary sinus

42
Q

Left valvular fold is a valve of?

A

Inferior Vena Cava

43
Q

What form the SA node?

A

Right sinus horn and Right common cardinal vein

44
Q

What form to partition the heart into 4 chambers and by what 2 mechanisms?

A

Septa

  1. Differential growth
  2. New tissue - endocardial cushion tissue
45
Q

Differential growth makes which septa and what portion of them?

A

Atrial septum and Interventricular septum

- Muscular portions

46
Q

Differential growth never fully _____ lumen

A

Closes

47
Q

Describe how endocardial cushion tissue is made

A
  • Myocardium secretes molecules into cardiac jelly
  • Induces formation and proliferation of new mesenchymal cells derived from endocardium
    = Endocardial cushion tissue
48
Q

Endocardial Cushion Tissue makes what portion of septa and ridges in outflow tract?

A

Fibrous portions

49
Q

AV septum separates?

A

Atrium from ventricle

50
Q

What fuse to create the AV septum?

A

Superior and inferior endocardial cushion tissues

51
Q

Endocardial cushion tissues also form what valves?

A

Tricuspid and Bicuspid valves

52
Q

Conotruncal ridges in the outflow tract are made of what 2 things?

A
  1. NCCs

2. Endocardial cushion tissue

53
Q

Why must the conus arteriosus be divided by a conotruncal ridge?

A

So blood exits the left and right ventricle through different vessels

54
Q

What does the division of the truncus arteriosus by a conotruncal ridge create?

A

Aorta and Pulmonary artery

55
Q

Persistent AV canal

A

Failure of AV septum fusion (superior and inferior endocardial cushion tissue) and NO AV valves

56
Q

What disease is a persistent AV canal associated with and what are a few symptoms?

A

Down’s syndrome

- Intolerance to exercise, shortness of breath, cardiac congestion

57
Q

During gestation, the blood entering the right atrium must bypass the lungs and enter the left atrium. Septa form that extend from the atrial wall to the?

A

AV region

58
Q

Septum primum receives contribution from?

A

Dorsal Mesenchymal Protrusion (DMP)

59
Q

Septum primum - Ostium primum

A

Hole near the AV region of the septum

- It is filled in and closed by DMP and endocardial cushion tissue

60
Q

Septum primum - Ostium secundum

A

New hole forms near the superior region of the septum

61
Q

Septum secundum is ____ than the Septum primum

A

Thicker

62
Q

As the Septum secundum grows what does it overlap?

A

Ostium secundum

63
Q

An opening that remains in the septum secundum?

A

Formen Ovale

64
Q

Where is the foramen ovale?

A

Just above the AV septum in the septum secundum

65
Q

What overlaps the foramen ovale?

A

Septum primum

66
Q

What creates a 1-way flutter valve allowing right atrial blood into the left atrium but not the reversal?

A

Septum primum

67
Q

After birth, pressures on the left side of the heart are&raquo_space;> pressures on the right side of the heart. This pushes septum primum up against septum secundum and eventually?

A

Seals - closes foramen ovale

68
Q

Describe the pathway of events for atrial septal defects if blood is allowed to move from left to right

A 
Increased blood to right ventricle
Increased blood to the lungs
Lung damage
Pulmonary resistance
Right ventricle hypertrophy
Blood moves from right to left = cyanosis
69
Q

Ostium 2 (high atrial defect)

A

Hole due to excessive absorption of septum primum or inadequate development of septum secundum

70
Q

Ostium 1 (low atrial defect)

A

Failure to fill in ostium primum with DMP and cushion tissue

71
Q

What causes cyanosis?

A

Mixing of deoxygenated and oxygenated blood due to low O2 saturation of blood

72
Q

Signs of cyanosis?

A

Clubbing of fingers
Bluish tint to skin, fingernail beds, lips
Fatigue

73
Q

The AV canal shifts to the?

A

Right

74
Q

AV canal shifts through what mechanism?

A

Myocardialization - outer myocardial wall thinned and further remodeling through apoptosis

75
Q

Double outlet right ventricle

A

Both aorta and pulmonary artery exit the right ventricle accompanied by a VSD (ventricular septal defect)

76
Q

Double outlet right ventricle is due to?

A

Insufficient AV canal shifting or cardiac looping

77
Q

Conotruncal ridges are made of?

A

Cushion tissue

78
Q

Conotruncal ridges spiral down ______ to ventricular septum

A

Outflow tract

79
Q

Conotruncal ridges fuse to form?

A

Conotruncal septum

80
Q

What are the cells involved in the conotruncal ridges?

A

NCCs and Endocardial cushion tissue

81
Q

What does the Conotruncal septum divide?

A

Outflow tract:
Right ventricle -> Pulmonary artery
Left ventricle -> Aorta

82
Q

What does complete closure/separates of outflow tract require?

A

Downgrowth of AV septum
Formation of conotruncal ridges
Interventricular muscular septum formation

CPR (48 decks)

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