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Year 1: 08. CPR Exam 1 > Lecture 9: Heart Development > Flashcards

Lecture 9: Heart Development Flashcards

1
Q

Where does hematopoiesis begin?

A

Yolk sac (extra-embryonic splanchnic mesoderm): Day 17

  • source of early RBC and macrophages
  • forms blood islands
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2
Q

By day 23, what structure do early hematopoietic cells populate?

A

Liver

-need to meet immediate need for blood cells

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3
Q

What is the significance of the aortic-gonadal-mesonephric (AGM) region?

A

Where definitive hematopoietic stem cells are programmed

-eventually will seed the liver to give rise to proper RBC and WBC

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4
Q

After the liver programs proper RBC and WBC, what structures do these cells populate?

A

Lymph organs

Bone marrow

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5
Q

Is intraembryonic vasculogenesis coupled with hematopoiesis?

A

No

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6
Q

With intraembryonic vasculogenesis, what does the splanchnopleuric mesoderm differentiate into?

A

Endothelial precursor cells (aka angioblasts)

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7
Q

What is the function of angioblasts?

A

1) Continue to proliferate as EPC
2) Angiogenesis: make new blood vessels from existing ones
3) Intussusception: splitting of blood vessels
4) Recruitment of new mesodermal cells into walls of existing vessels

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8
Q

What are angiomas?

A

Abnormal blood vessels and lymphatic capillary growth via vasculogenesis

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9
Q

On day 19, the first heart field or cardiac crest forms. What composes this?

A

EPC clusters from intraembryonic splanchnic mesoderm

Adjacent mesoderm

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10
Q

How does the primitive tubular heart form?

A

Two endocardial tubes are formed from EPC. Due to body folding, they are fused to make a single tubular heart with myocardium and endocardium.

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11
Q

From where does the primitive tubular heart dangle from?

A

Dorsal mesocardium

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12
Q

Why does the dorsal mesocardium eventually have to rupture?

A

To allow the heart to loop

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13
Q

What happens to the remnants of dorsal mesocardium?

A

Forms the proepicardial organ

-epicardium that covers simple tubular heart

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14
Q

What is the sinus venosus?

A

Where the inflow of primitive blood confluence

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15
Q

What does the primitive ventricle give rise to?

A

Left Ventricle

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16
Q

What does the outflow tract give rise to?

A

Right Ventricle

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17
Q

What happens to the atrium when cardiac looping begins?

A

Moves cranially and dorsally

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18
Q

What is the function of the conus arteriosus?

A

Proximal outflow of both ventricles

-Is divided so blood from LV and RV go out different vessels

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19
Q

What is the function of truncus arteriosus?

A

Distal outflow tract

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20
Q

What does the truncus arteriosus eventually become?

A

Aorta

Pulmonary Artery

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21
Q

Describe the second heart field.

A

Initially inhibited due to its proximity to notochord. After body folding, it is farther away and can start proliferating by adding cells to both ends of the primitive heart tube.
-drives cardiac looping

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22
Q

What is the role of neural crest cells in terms of cardiac looping?

A

-Regulates FGF 8 and drives growth of cells in primitive heart
-Maintains cardiogenic mesoderm proliferation and proper
myocardial cell specification within the second heart field
-Plays important role in regulating cardiac looping

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23
Q

What is ventricular inversion?

A

Reverse cardiac looping –> right-sided left ventricle

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24
Q

What is heterotaxia?

A

Any abnormal left-right development of either some or all

organs

25
Q

What is visceroatrial heterotaxia?

A

Condition whereby the heart and GI tract are asymmetrically arranged from one another

  • right-sided heart with normal GI tract
  • left-sided heart with right-sided GI tract

*Causes problems with inflow and outflow tract development and can be life threatening

26
Q

What are the branches of the sinus horns?

A

Umbilical Vein
Vitelline Vein
Common Cardinal Vein

27
Q

How do the right and left atria begin to form?

A

With the expansion of the atrium, there is a shift of the left sinus venosus and left horn since it is much more pronounced on the left side.

This causes a net shift in the amount of blood returning to the right side of the common atrium.

28
Q

What does the left sinus horn eventually become?

A

Coronary sinus

29
Q

What does the right vitelline vein become?

A

Inferior Vena Cava

30
Q

What does the right common cardinal vein become?

A

Superior Vena Cava

31
Q

What happens to the right sinus horn and remaining parts of the veins in the right sinus horn?

A

Incorporated into posterior wall of right atrium

32
Q

Where is the smooth part of the right atrium wall from?

A

Sinus venosum

33
Q

Where is the rough part of the right atrium wall from?

A

Primitive atrium

34
Q

What does differential growth form?

A

Muscular interventricular septum: separates ventricles

Muscular atrial septum: separates atria

35
Q

What does endocardial cushion tissue due?

A

Induce formation of mesenchymal cells to close off openings.

36
Q

How do endocardial cushion tissues work?

A

Myocardium produces ECM that sucks up water, causing it to swell.
Endocardium is pushed into lumen and the cells start to delaminate, filling in the lumen.

37
Q

Where are endocardial cushion tissues found?

A

Between atria and ventricles

Between ventricles and outflow tract

38
Q

What is a persistent AV canal?

A

Failure of the superior and inferior cushions to fuse, resulting in all four chambers of the heart to talk to each other

39
Q

Describe septum primum and secundum.

A

1) Septum primum is near the AV septum and has a hole, ostium primum.
2) Ostium primum is replaced by foramen secundum, which is much higher up.
3) . Eventually, Septum Secundum will overlap foramen secundum and has its own hole - foramen ovale.

40
Q

What is the purpose of all the holes (e.g. osteum primum, foramen secundum, foramen ovale)?

A

Oxygenated blood from umbilical vein can bypass the lungs and pulmonary trunk and enter systemic circulation.

41
Q

What is another structure that allows oxygenated blood to bypass lungs and pulmonary trunk to enter systemic circulation?

A

Ductus arteriosus

42
Q

How does the right atrium eventually pump blood into the lungs?

A

After birth, the pressure in the left side of the heart greatly increases while the pressure in right side of the heart decreases.
It is easier for the right side to pump to lungs. Eventually, foramen ovale should close off w/in three months of the birth.

43
Q

What can cause some atrial septal defects?

A

1) Too much resorption of septum primum that cannot be covered by septum secundum
2) Absence of septum secundum
3) Ostium primum never covered from due to failure of up-growth of AV cushion tissue from AV septum

44
Q

What is cyanosis?

A

Low levels of oxygen saturation in blood that can result from mixing of oxygen-rich and oxygen-poor blood
-can lead to blue skin

45
Q

How does the AV canal shift?

A

Myocardialization: outer myocardial wall is thinned and replaced by cushion cells

46
Q

What can happen after the AV canal shifts?

A

Separation of right and left ventricle

47
Q

What is double outlet right syndrome?

A

Both aorta and pulmonary artery exit via right ventricle due to insufficient shifting of AV septum or issues with cardiac looping
-cyanotic

48
Q

What structures does neural crest cells contribute to?

A

Aortic-pulmonary septum

Semilunar valve

49
Q

Describe ventricular septal defects.

A

Improper closure of ventricular septum

  • starts acyanotic (left to right shunt)
  • right ventricle hypertrophies due to increased workload
  • becomes cyanotic after birth (right to left shunt)
50
Q

Describe persistent truncus arteriosus.

A

Outflow tract is not divided between the two ventricles

  • mixing of oxygenated and de-oxygenated blood
  • will have VSD
  • cyanotic
51
Q

Describe tetralogy of fallout.

A

Unequal division of pulmonary trunk and aorta

  • Will have VSD
  • Pulmonary infundibular stenosis
  • Overriding aorta
  • Pulmonary artery is very small causing right ventricle to hypertrophy
  • cyanotic
52
Q

Describe transposition of great vessels.

A

Pulmonary artery is connected to left ventricle while aorta is connected to right ventricle

  • due to improper spiraling of conotruncal ridges
  • cyanotic
53
Q

Describe pulmonary valvular atresia.

A

Semilunar valves are fused leading to right ventricle hypoplasia. Foramen ovale is the only way for blood to reach left side of heart.
-if there is VSD, mixing of blood can give patient chance to live

54
Q

Describe aortic valvular stenosis.

A

Heart’s aortic valve narrows

-hypertrophy of LV that can lead to cardiac failure and pulmonary hypertension

55
Q

Describe aortic valvular atresia.

A

Congenital absence of the normal valvular opening from the left ventricle of the heart into the aorta

56
Q

Describe bicuspid aortic valve.

A

Aortic valve that only has two leaflets instead of three

  • can cause regurgitation of blood back into heart
  • lead to LV hypertrophy
  • can cause stenosis of aortic valve
57
Q

Describe tricuspid atresia.

A

Tricuspid heart valve is missing or abnormally developed, leading to improper blood flow between right atrium and right ventricle.

58
Q

Describe a hypoplastic left ventricle.

A

Underdeveloped left side of heart along with abnormal bicuspid and aortic valves
-right ventricle is doing all the work

Year 1: 08. CPR Exam 1 (29 decks)

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