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CPRS > L26, L27: Development Of The Heart > Flashcards

L26, L27: Development Of The Heart Flashcards

1
Q

Heart development

A
  1. Primary and secondary heart field formation (Day 18: Primary, Day 20: Secondary)
  2. Position of heart tube
  3. Cardiac looping (Day 23-28)
  4. Chamber septation (Day 27-37)
  5. Outflow tract division and valves formation
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2
Q

Heart derived from

A

Splanchnic lateral plate mesoderm

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3
Q

Primary heart field

A

Heart progenitor cells migrate through primitive streak
—> Cranial-lateral direction (向上兩側) within splanchnic mesoderm
—> Cardiomyoblast + Haemangioblast (vessel + blood cells)
—> horseshoe-shaped cluster of cells: Primary heart field (lateral to neural fold)
—> unite to form Heart tube (surrounded by cardiomyoblast)
—> cardiac crescent
—> L atria, R atria, L ventricle

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4
Q

3 layers of Heart tube

A
  1. Endocardium —> internal endothelial lining of heart
  2. Myocardium —> muscular wall
  3. Epicardium —> from pro-epicardial organ near sinus venosus
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6
Q

Secondary heart field

A

Derived from pharyngeal mesoderm
—> within splanchnic mesoderm ventral to pharynx
—> R ventricle, outflow tract, part of atrium

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7
Q

Positioning of heart tube

A
  1. Cephalic folding
    - Central portion of heart tube is anterior to oropharyngeal membrane and neural plate
    - Cephalic folding bring heart tube first to cervical region then thorax region
  2. Lateral folding
    - single heart tube (endocardial tube) received venous blood from caudal pole —> pump blood out into first Aortic arch —> Dorsal aorta at cranial pole
    - Lateral folding bring 2 endocardial tubes together —> fuse to form Primitive Heart Tube
    - Primitive heart tube remains attached to dorsal side of percardial cavity by Dorsal mesocardium (ventral to foregut)
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8
Q

Formation of cardiac loop

A

Cranial portion of heart tube: (Ventricle)
bends ventrally, caudally and to the right (向前向下向右)

Caudal portion of heart tube: (Sinus venosus)
bends dorsally, cranially and to the left (向後向上向左) and incorporated into pericardial cavity

—> complete by day 28

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9
Q

Dextrocardia

A

Heart on right side
—> defect with laterality establishment during gastrulation / during cardiac loop when heart tube looses to the left instead of right

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10
Q

2 mechanisms of septum formation

A
  1. Fusion of endocardial cushion
    —> develop from upper side (superiorly) and lower side (inferiorly) in AV canal
    —> fuse to separate AV canal into 2 orifices / 2 AV canals
  2. Passive expansion of chambers
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11
Q

Septum Formation in common atrium

A
  1. Septum primum (in atrium) grow towards endocardial cushion in AV canal
    —> opening called Ostium primum
  2. Cell deaths producing perforations in upper Septum primum
    —> coalesce to form Ostium secundum
    —> allow blood to go from R atrium to L atrium
  3. Growth of R atrium
    —> invagination of atrial roof to form Septum secundum
    —> grow towards endocardial cushion and cover Ostium secundum
    —> opening: Foramen ovale
    —> Septum primum gradually disappears
    —> valve of Foramen ovale
    —> oxygenated blood from placenta —> IVC —> shunted from R atrium to L atrium (via foramen ovale)
    —> at birth: L atrial pressure > R atrial pressure —> valve close against Septum secundum
    —> separate L and R atria (Fossa ovalis)
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12
Q

Septum formation in AV canal

A

Bulbus cordis: Truncus arteriosus + Conus cordis + trabeculated part of R ventricle

  1. AV canal originally supplies only L ventricle (separated from Bulbus cordis by bulboventricular flange)
  2. Bulboventricular flange regress half way through along base of superior endocardial cushion + AV canal enlargement to the right
  3. Fusion of anterior (superior) and posterior (inferior) endocardial cushion —> divide AV canal into left and right by 5th week
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13
Q

Formation of AV valves

A

Each AV canal surrounded by local proliferation of mesenchymal tissue (AV cushion tissue)
—> bloodstream hollows and thins mesenchymal tissue (Cavitation)
—> valves form and attach to ventricular wall by Muscular cords
—> Muscular cords degenerate and replaced by dense CT (Chordae tendineae)
—> valves attached by Chordae tendineae to papillary muscle of ventricles

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14
Q

Atrial septal defect

A
  • 2:1 female to male
  • excessive resorption of septum primum
  • inadequate development of septum secundum
  • blood flows from L atrium to R atrium (left to right shunt)
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15
Q

Tricuspid atresia

A
  • obliteration of right AV canal —> absence/fusion of tricuspid valve
  • R ventricle underdevelopment + L ventricle hypertrophy
  • NO blood flow to lung
  • hole between R and L atria —> mixing of oxygenated/deoxygenated blood
  • bluish skin colour, SOB, fatigue
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16
Q

Septum formation in Truncus arteriosus (Aorticopulmonary septum)

A
  • opposing swelling in Truncus arteriosus (truncus swelling) by Cardiac neural crest cells
  • grow toward Aortic sac and twist around each other —> spiral closure of future septum
  • complete fusion of swellings —> Aorticopulmonary septum —> divide Truncus arteriosus —> Aorta + Pulmonary trunk
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17
Q

Septum formation in Conus cordis

A
  • Swellings from right and left ventral walls of Conus cordis
  • fusion of Conus swellings unite with Truncus septum
  • divide Conus cordis —> right and left outflow tract of ventricles
  • R outflow tract connect with pulmonary artery, L outflow tract connect with aorta
18
Q

Septum formation in the ventricles

A
  • Medial walls of expanding ventricles apposed and gradually merge
    —> Muscular interventricular septum
  • Aorticopulmonary septum fuse with posterior AV cushion —> close the space between free edge of Muscular interventricular septum and endocardial cushion
    —> Membranous part of interventricular septum
19
Q

Formation of semilunar valves

A
  • small tubercles (minor truncus swelling) on main truncus swelling
  • three tubercles each on pulmonary and aortic channel
  • hollow out at upper surface —> 3 triangular valve leaflets —> semilunar valve
20
Q

Overall partitioning of outflow tract

A

2 Truncoconal swelling (truncus swelling + conus swelling) grow toward each other
—> fuse at truncoconal transition
—> zip distally (towards outflow tract) and proximally (towards ventricles)
—> Right hand twist
—> pulmonary trunk anterior to aorta

21
Q

Ventricular septal defect

A
  • most common congenital heart defect
  • defect in Muscular (80%) or membranous part of septum
  • mixing of oxygenated and deoxygenated blood
  • fatigue, fast breathing, lack of appetite
22
Q

Tetralogy of Fallot

A

Combination of

  1. Overriding aorta (aorta positioned directly over VSD —> receive blood from LV and RV)
  2. Ventricular septal defect (VSD)
  3. Pulmonic stenosis (narrowing of pulmonary valve)
  4. Right ventricular hypertrophy
  • low oxygen in blood
  • bluish skin, fingertips (cyanosis)
  • SOB
  • tiredness
23
Q

Persistent truncus arteriosus

A
  • fail to form conotruncal ridges —> no septation in outflow tract
  • always accompanied by VSD (since conotruncal ridges contribute to interventricular septum)
24
Q

Transposition of great vessels

A
  • conotruncal septum fails to follow spiral course (runs straight down)
  • Aorta and pulmonary artery are transposed
  • decreased oxygen in blood
25
Q

Aortic valvular stenosis

A

Narrowing of aortic valve —> obstructs blood flow from heart to body

26
Q

Cardiac neural crest cells

A
  • Vascular smooth muscle cell
  • Cardiac neurone
  • Aorticopulmonary septum
  • etc.

CPRS (75 decks)

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