Test 1 Flashcards
Ventricular Septal Defects
Left to right shunting of blood in ventricles. More blood is pumped to the lungs. R. ventricle hypertrophy develops if untreated. Increase in R side pressure over L side. Cyanosis visible.
Persistent Truncus Arteriosus
Failure of conotruncal ridge formation and fusion causing VSD. Mild cyanosis.
Tetralogy of Fallot
PROV 1. Pulmonary stenosis 2. R. ventricular hypertrophy 3. Overriding aorta 4. VSD Most common defect at birth
Transposition of the great vessels
No spiraling of the conotruncal ridges leading to improper connection. Aorta is connected to R ventricle and Pulmonary A is connected to L ventricle. Linked to maternal diabetes
Pulmonary Valvular atresia
Fusion of the pulmonary valve. Hypoplastic R ventricle and hypertrophy L ventricle. ASD and patent ductus arteriosis allows for any O2 exchange.
Aortic Valvular Stenosis
1-2% incidence with prevalence in 4:1 male to female ratio. Hypertrophy of L ventricle
Aortic Valvular Atresia
No outlet for L ventricle. Potentially large patent ductus arteriosis with L to R atrial shunting via ASD.
Bicuspid Aortic Valve
2 leaflets instead of 3 within the aorta. Can be asymptomatic but can develop L ventricle hypertrophy. Aortic aneurysms associated with disease.
Tricuspid Atresia
Hypoplastic R ventricle. Patent foramen ovale and ductus arteriosis allows for exchange. Sometimes VSD present
Hypoplastic Left Ventricle
LV is underdeveloped. Mitral valve is not formed/very small. Ascending aorta is underdeveloped. Patent foramen ovale and ductus arteriosis allows for exchange. Heart works as a univentricular heart with RV doing all the work.
Extraembryonic Vasculogenesis and early hematopoiesis timeline
Day 17: Begins in yolk sac. Hemangioblasts differentiate and form hematopoietic progenitor and endothelial precursor cells.
Day 18: Intraembryonic vasculogenesis
Day 23: Early hematopoietic cells populate the developing liver
Day 27: Hematopoietic stem cells are programmed from hemogenic endothelial cells in the AGM region of the dorsal aorta.
Day 30: Programmed cells seed liver.
Day 40: Cells disappear from AGM region.
Angiomas
Abnormal blood vessel and lymphatic capillary growth via vasculogenesis.
Hemangioma
excessive formation of capillaries (capillary hemangioma) or venous sinuses (cavernous hemangioma). In infancy they are benign and usually resolve themselves naturally
Ventricular inversion
reverse cardiac looping. VSD usually present, right-sided L ventricle
Heterotaxia
Symmetry anomaly. Situs inversus (total reversal of organs) or situs ambiguous (some organ reversal)
Coronary sinus develops from…
the L sinus horn
The superior vena cava develops from…
the R common cardinal vein
The inferior vena cava develops from…
the R vitelline vein
SA node develops from…
Part of the R sinus horn and R common cardinal V
AV node develops from…
L sinus horn
Tricuspid/Bicuspid valves and the AV septum develop from…
Endocardial cushion tissue
Truncus Arteriosis
Divides the aorta and pulmonary artery. Derived cells include neural crest cells and endocardial cushion tissue
Atrial septal defects
2:1 prevalence in females to males. Most ASDs result in an initial L to R atrial shunting leading to pulmonary damage, increase in pulmonary resistance and R ventricle hypertrophy causing R to L shunting, cyanosis and congestive heart failure.
Heart sounds: 4 is…
1 is…
2 is…
3 is…
4 - Atrial topping off ventricle (end of atrial systole)
1 - AV valves closing and blood hitting closed valves during isovolumetric contraction of ventricles.
2 - Aortic and pulmonary valves closing
3 - Rapid filling of ventricles
QRS wave corresponds with what on an EKG
Closing of the mitral valve before ventricular contraction
Systolic vs Diastolic murmur
Systolic: Mitral regurgitation and aorta/pulmonary A. stenosis
Diastolic: aorta/pulmonary A. regurgitation and mitral/tricuspid stenosis
Chronotropic
Changes in heart rate.
Positive effect increases heart rate and negative effect slows.
Inotropic and Lusitropic
Strength of muscular contraction and rate of muscle relaxation.
Dromotropic
Speed of conductance.
Parasympathetic Stim.
Vagus nerve using ACh neurotransmitter and M2/M3 muscarinic receptors. Generally slows heart rate (neg. chronotropic and dromotropic effects). ATRIAL ONLY
Sympathetic Stim.
Norepi. neurotransmitter and Beta1-adrenergic receptors. Generally speeds up heart rate (pos. chronotropic, dromotropic and inotropic/lusitropic effects).
Cardiac Output
Heart rate x stroke volume
approximately 5L/min
Preload
Wall tension in L ventricle just before contraction is initiated.
Afterload
Pressure required to open aortic valve
Stroke volume
End diastolic vol. – End systolic vol.
approximately 70ml
Ejection Fraction
Stroke volume/End diastolic vol.
approximately 55%
Persistent AV Canal
Linked to Down’s syndrome. Failure of AV septum fusion.
Sympathetic effect on juxtaglomerular apparatus
Increases blood volume. Beta 1 receptor increases renin releases causing release of angiotensin -> angiotensin 2 -> aldosterone -> reabsorption of Na+ and release of ADH increasing H2O absorption
The sinus venarum and pulmonary v’s develop from
The right horn of the sinus venosis
Di George syndrome (22q11) is linked to
Tetralogy of Fallot and truncus arteriosis
Down’s Syndrome is linked to
ASDs, VSDs and arrhythmias
Transposition of the great vessels is linked to
maternal diabetes
Coarctation of the aorta is linked to
Turner’s Syndrome, monosomy (X )
Aortic atresia is linked to
Marfan’s Syndrome
What is Ectopia cordis
the heart is located abnormally outside the thoracic cavity commonly caused by failure of fusion of the lateral folds in forming the thoracic wall.
Congenital heart defects are common problems caused by
teratogens, rubella virus or single-gene factors/chromosomal abnormalities
The aortic arch develops from
the 4th aortic arch on the L side. It develops into the brachiocephalic trunk and subclavian A’s on the R.
What structure is the ductus arteriosus derived from?
6th aortic arch?
PDA symptoms
Enlarged pulmonary A’s, murmur during auscultation with normal heart valves, increased atrial pressure.
What nerve is solely responsible for the pericardium
Phrenic nerve
What nerve radiates pain to the arm during an MI?
Intercostobrachial
The proximal ascending aorta and pulmonary trunk develop from the
Truncus arteriosus
Tge ascending aorta and R brachiocephalic trunk are derived from the
aortic sac
The L and R common carotid and internal carotid A’s come from
the 3rd arch
Arch 4 becomes
on the R -> right subclavian A and the L -> aortic arch
arch 6 becomes
the R -> R pulmonary artery and L -> L pulmonary A and ductus arteriosus
Beck's Triad: 1. Distant heart sounds 2. Jugular distention 3. Hypotension (Low BP) (+/- signs of shock)
Cardiac Tamponade
Kerley B lines are indicative of
Pulmonary edema or lymphoma.
Kerley A lines suggest distention of lymphatic anastomoses
