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CVS > Heart Development, Congenital Defects > Flashcards

Heart Development, Congenital Defects Flashcards

1
Q

What are the 2 effects of the 2 folding types

A

Lateral: Creates a heart tube

Cephalocaudal: brings tube into thoracic region

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2
Q

Name the 6 sections of the primitive heart tube

Use pneumonic

A

All The Best Vacuums Are Silver

Aortic roots
Truncus Ateriosus
Bulbus Cordis
Ventricle 
Atrium 
Sinus Venosus
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3
Q

Describe the formation of the primitive heart tube in 3 steps

A
  1. Cardiogenic field lies at cranial end of embryo
  2. In week 3, endocardial tubes are formed
  3. Endocardial tubes bought together during folding, and fuse in mid-line to create the Primitive Heart Tube
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4
Q

Describe looping of the primitive heart tube

A

Both inflow and outflow vessels cranially, with inflow vessels dorsal to outflow

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5
Q

How does the Sinus Venosus develop in 3 steps

What does the Right sinus horn develop into
What does the Left sinus horn develop into

A
  1. Right and left sinus horns are equal in size
  2. Venous return shifts to Right side, so left Sinus horn recedes
  3. Right sinus horn is absorbed by the enlarging Right atrium
  • Coronary Sinus
  • Superior/ Inferior Vena Cava
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6
Q

What does the right atrium form from

A
  • Most of the primitive atrium

- Sinus Venosus

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7
Q

What does the left atrium form from

A
  • Small portion of primitive atrium

- Aborbs proximal parts of pulmonary veins

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8
Q

Which process forms the Transverse Pericardial Sinus

Which process forms the Oblique Pericardial Sinus

A
  • Looping—> Transverse

- LA expands while absorbing pulmonary veins-> Oblique

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9
Q

Illustrate the route taken by blood in a fetus. Include the shunts involved.

Start at the Aorta

A
  1. Aorta
  2. Body
  3. Placenta
    - DUCTUS VENOSUS
  4. Inferior Vena Cava
  5. Right Atrium

A small amount of blood enters the RV then into PT then THROUGH DUCTUS ATERIOSUS into Aorta

Rest of blood from RA enters LA through FORAMEN OVALE. Then into LV into Aorta

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10
Q

Explain how the Fetal Circulatory Shunts change after birth

A

LA pressure increases

  • Foramen Ovale closes
  • Ductus Venosus closes
  • Ductus Arteriosus contracts
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11
Q

Describe the development of the great vessels

A

Each arterial system begins as a bilaterally symmetrical system of arched vessels

Undergo extensive remodelling to create the major armies leaving the heart

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12
Q

Do humans have a 5th aortic arch?

A

No, but other animals do

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13
Q

What do the Right and Left 4th Aortic Arch derive into

A

Right: Proximal part of right subclavian artery

Left: Arch of Aorta

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14
Q

What do the Right and Left 6th Aortic Arch derive into

A

Right: Right pulmonary artery
Left: Left Pulmonary artery + Ductus Arteriosus

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15
Q

Which nerve corresponds to the 6th Aortic arch

A

Recurrent Laryngeal Nerve

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16
Q

Define Septation

A

The process in which the primitive heart tube is divided into chambers and outflow tract is split Ito aorta and pulmonary trunk

17
Q

What is the first step in Septation

What is the heart divided into

A

Endocardial cushions form in the atrioventricular region

Right ad left channels

18
Q

Explain formation of the Foramen Ovale

A
  1. Septum Primum grows down towards fused endocardial cushions. Ostium Primum is the hole already present
  2. Ostium Secundum grows in SP, before OP closes
  3. Septum Secundum grows downwards, with a hole in it called the Foramen Ovale
19
Q

How is the Foramen Ovale opened

How is it closed

A
  1. LA pressure< RA pressure, so blood flows from RA to LA

2. At first breath, LA Pressure> RA pressure, so septum Primum s pushed against septum secundum

20
Q

Name 4 Atrial Septal defects

A
  1. Ostium Secundum defect
  2. Resborbed septum primum
  3. Short septum primum
  4. Small Septum Secundum
21
Q

What is Hypoplastic Left Heart Syndrome

What 2 shunts are needed for life

A

Left Ventricle is underdeveloped and ascending Aorta is small so right to left blood flow in Utero is inadequate

ASD/ PFO- for blood to enter Pulmonary Trunk
PDA- For blood to enter Aorta

22
Q

Although the cause of hypolastic left hart syndrome isn’t known, suggest 2 possible causes

What does one of these cause

A
  • Defect in Mitral and Aortic valve development (Causes limited flow and atresia)
  • Ostium Secundum too small
23
Q

How does ventricular Septation occur in 2 steps

A
  1. Muscular portion grows upwards towards fused endocardial cushions, but doesn’t go all the way leaving a gap (Primary inter-ventricular foramen)
  2. Membrane portion grows down from cushions to fill the gap
24
Q

What is a patent foramen Ovale

A

A condition where the foramen Ovale doesn’t close and persists after birth

25
Q

What is an Atrial Septal Defect, ASD

Why is it not life threatening

A

An opening in the septum between 2 atria that persists after birth

Blood flows left—>Right, so deoxygenated blood doesn’t mix with oxygenated

26
Q

What is a Ventricular Septal Defect, VSD

A

An abnormal opening in the septum between ventricles, most commonly in membranous portion

27
Q

Explain the separation of the outflow tract

What is formed

A

Endocardial cushions appear in the truncus Arteriosus, and twist around each other, while growing, forming a Spiral Septum

This causes one outflow tube to split into Aorta and Pulomary Trunk

28
Q

What is Transposition of the Great Arteries

What is a symptom?
How can it be treated

A

When the Aorta arises from the RV and the Pulmonary trunk arises from the LV

Cyanosis
Surgery

29
Q

What is Tetralogy of the Fallot?

A

A Ventricular Septal Defect where;

The Aorta is overriding (Sits on both ventricles)
RV outflow tract is obstructed (Pulmonary Stenosis)
RV Hypertrophy is present

30
Q

What cells needed to make Endocardial cushions

A

Neural crest cells

31
Q

What are 3 causes of congenital heart defects

A

Genetics
Environmental
Maternal infections

32
Q

Explain 4 effects of an Atrial Septal Defect

A

Blood flows from left to right atrium , due to higher pressure

  1. Increased pulmonary flow
  2. RV Hypertrophy
  3. Pulmonary hypertension
  4. Eventual Right Heart Failure
33
Q

Explain 3 effects of Ventral Septal Defects

A
  1. Blood enters right ventricle from left, eventually having a larger pressure than left, so eventually blood enters left from right, causing LV Hypertrophy, thus eventually becoming cyanotic
  2. Pulmonary Venous Extension
  3. Eventual Pulmonary Hypertension
34
Q

What is an Atrioventricular-Ventricular Septal defect?

In who, is it common

A

Hole above and below valve

Common in Downs’ Syndrome patients

35
Q

What is Tricupsid Atresia and what does it result in

What 2 things are needed for life

A

Lack of development of the tricuspid valve-> No RV inlet

Right to left shunt (ASD/ PFO) for blood to enter LA
VSD or PDA for blood to reach lungs

36
Q

What is coarctation of the aorta
What can it lead to

Which parts of the body are affected/ not affected and why

A
  • Narrowing of aortic lumen in the region of the Ligamentum Arteriosus.
  • Leads to LV Hypertrophy
  • Vessels to head and upper limbs are proximal to coarctation so not affected
  • Blood flow to rest of body is reduced
37
Q

Identify 2 symptoms of Coarctation of aorta

A

Hypertension in Upper Extremities

Hypotension in Lower Extremities

CVS (15 decks)

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