Heart Devo

Question 1

The initial primitive heart tube is the _______________.

Answer 1

Primitive left ventricle

Question 2

The ___________ forms from the proepicardial organ.

Answer 2

Epicardium

Question 3

_______________ is the first step in chamber formation and partitioning.

Answer 3

Cardiac looping

Question 4

The developing heart normally loops to the ______.

Answer 4

Right

Question 5

Dextrocardia

Answer 5

Right-sided mirror image heart - associated w/ situs inversus

Defect in cilia - problems rotating and folding

Question 6

What drives looping?

Answer 6

Addition of cardiac precursors from the secondary heart field

Question 7

During looping the atria and ventricular chambers ________ due to ___________.

Answer 7

Expand

Ballooning

Question 8

What is the result of looping?

Answer 8

Proper anatomical relationships between segments and septa

Question 9

Heart begins to beat at _________.

Answer 9

21-22 days

Question 10

The precursor tissue of the heart develops from the _______________.

Answer 10

Splanchnic Mesoderm

Question 11

The smooth part of the left atrium are derived from ________________. while the appendage is derived from the __________.

Answer 11

1. Absorption of the pulmonary veins

2. Primordial atrium

Question 12

The common AV opening expands/shifts due to ______________.

Answer 12

Myocardialization of the inner curvature

Question 13

Atrial septum operates as a ________ allowing unidirectional blood flow form _______ to ______.

Answer 13

1. Flapper valve
2. Right
3. Left

Question 14

What is a fixed S2 split indicative of?

Answer 14

ASD - 90% occur w/ secundum at fossa ovalis

Question 15

What is the most common congenital heart anomaly?

Answer 15

VSD - membranous at septum (90%)

Question 16

What does a harsh, continuous “machinery like murmur” indicate?

Answer 16

PDA

Question 17

What congenital defect is commonly seen in Down syndrome?

Answer 17

AVSD

Question 18

What is the most common form of cyanotic congenital HD?

Answer 18

Tetralogy of Fallot

Question 19

A boot shaped heart indicates what congenital defect?

Answer 19

Tetralogy of Fallot - DiGeorge and Trisomy 21

Question 20

What is tetralogy of Fallot?

Answer 20

1. VSD
2. Subpulmonary stenosis
3. Overriding aorta
4. RV Hypertrophy

Question 21

Who is TGA more common in?

Answer 21

Male children and with diabetic mothers

Question 22

How does the heart remodel in TGA?

Answer 22

Stable w/ VSD (35%)
RV Hypertrophy, pulmonary HTN
Ovall/egg-shaped cardiac silhouette
Mild cardiomegaly

Question 23

What two congenital heart defects are associated with DiGeorge Syndrome?

Answer 23

Tetralogy of Fallot and Truncus arteriosus

Question 24

Tricuspid atresia needs what two defects to coexist?

Answer 24

1. ASD/PFO

2. VSD

Question 25

In total anomalous pulmonary venous return how does oxygenated blood get to the circulation?

Answer 25

1. ASD or PFO

Question 26

What genetic disorder predisposes to Aortic Coarctation?

Answer 26

Turners

Question 27

A systolic crescendo-decrescendo murmur is indicative of what?

Answer 27

AV stenosis (80% isolated)

Question 28

Ebstein Anomaly of Tricuspid Valve

Answer 28

Inferiorly displaced and adherent septal and posterior leaflets – RV and RA dilation
Arrhythmias - WPW Syndrome

Question 29

What are four late effects of congenital heart disease?

Answer 29

1. Endocarditis
2. Hyperviscosity
3. Childbearing risk
4. Residual surgical pathology