Heart Development

Question 1

The primary heart field appears around day?
What creates the primary heart field?
What arises from the primary heart fields?

Answer 1

1) 19
2) EPCs in splanchnic mesoderm
3) Left and right atria, as well as the left ventricle

Question 2

As the primary heart field and coelom become folded beneath the embryo, the EPCs form?
These structures form?

Answer 2

1) Endocardial tubes

2) Tubular heart

Question 3

The tubular heart’s first rhythmic contraction begins abou day?
Blood flow starts about day?

Answer 3

1) 22

2) 24

Question 4

Cardiac looping is driven by the second heart field, what forms it?

Answer 4

Rupture of the dorsal mesocardium

Question 5

During cardiac looping the addition of myocardium at the cranial end forms?
At the distal most end?

Answer 5

1) Conus arteriosus (proximal outflow tract)

2) Truncus arteriosus (distal outflow tract)

Question 6

What does the conus arteriosus become?

The truncus arteriosus?

Answer 6

1) Outflow portion of both ventricles

2) Forms aorta and pulmonary artery

Question 7

What does ventricular inversion lead to?

Answer 7

Right-sided left ventricle

Question 8

Where does the sinus venarum and crista terminalis specifically come from?

Answer 8

Right horn of the sinus venosus

Question 9

Where does the coronary sinus come from?

Answer 9

Left horn of sinus venosus

Question 10

What openings come from the right horn of the sinus venosus?

Answer 10

1) Openings for the superior and inferior vena cava

2) Opening for the coronary sinus

Question 11

What is the SVC derived from?

What is the IVC derived from?

Answer 11

1) Right common cardinal vein

2) Right vitelline vein

Question 12

Almost all of the heart comes from what layer of embryonic tissue?

Answer 12

Splanchnic mesoderm

Question 13

What does the remnants of dorsal mesocardium (proepicardial organ) become in the adult heart?

Answer 13

Epicardium

Question 14

What is responsible for forming the fibrous portions of the AV septum and outflow tract?

Answer 14

Endocardial cushion tissue

Question 15

In septa formation the outflow tract is derived from?

Answer 15

1) Endocardial cushion tissue

2) NCC

Question 16

What does atrial septation start with?

Answer 16

Septum primum that grows from atria towards endocardial cushion and AV septum

Question 17

What is the hole in septum primum near AV septum?

Answer 17

Foramen primum

Question 18

What gives rise to foramen secundum?

Answer 18

1) AV septum from endocardial cushion fills foramen primum

2) Apoptosis occurs at cranial end of septum primum

Question 19

What grows toward AV region and overlaps the majority of septum primum?
The leftover hole created is called?

Answer 19

1) Septum secundum

2) Foramen ovale

Question 20

Foramen ovale should close after birth due to?

Answer 20

Infant taking their first breath and increasing pressure in LA so septum fuses

Question 21

What is the presentation for Tetralogy of Fallot?

Answer 21

1) Pulmonary stenosis
2) Right ventricular hypertrophy
3) Overriding aorta
4) VSD

(PROVe)

Question 22

Which shunt direction leads to early cyanosis?

Which shunt direction is acyanotic at birth?

Answer 22

1) Right to left

2) Left to right

Question 23

What shunt direction is VSD?
What does it lead to?
Acyanotic or cyanotic at birth?
How prevalent is it?

Answer 23

1) Left to right
2) RV hypertrophy
3) Acyanotic
4) Most common congenital cardiac defect

Question 24

What shunt direction is persistent truncus arteriosus?
What does it lead to?
Acyanotic or cyanotic at birth?
Patients also have?

Answer 24

1) Right to left
2) Outflow tract doesn’t get divided
3) Cyanotic
4) VSD

Question 25

What shunt direction is Tetralogy of Fallot?
What does it lead to?
Acyanotic or cyanotic at birth?
It is associated with what else?

Answer 25

1) Right to left
2) PROVe
3) Cyanosis caused by crying, fever, exercise
4) DiGeorge syndrome

Question 26

What shunt direction is Transposition of great vessels?
What does it lead to?
Acyanotic or cyanotic at birth?
What causes it?

Answer 26

1) Right to left
2) Aorta/pulmonary artery connect to wrong ventricles
3) Cyanotic
4) No spiraling of the conotruncal ridges

Question 27

What is in Aortic valvular defects?

What does it lead to?

Answer 27

1) Stenosis or atresia

2) LV hypertrophy

Question 28

What does hypoplastic LV lead to?
Acyanotic or cyanotic at birth?
What is it caused by?

Answer 28

1) Heart is univentricle
2) Cyanotic
3) Critical aortic stenosis

Question 29

What shunt direction is Tricuspid atresia?
What does it lead to?
Acyanotic or cyanotic at birth?

Answer 29

1) Right to left shunt
2) Hypoplastic RV
3) Cyanotic

Question 30

A chromosome 22q11 deletion is often seen with?

Answer 30

Tetralogy of Fallot (DiGeorge)

Question 31

Atrioventricular septal defect is caused by?
It is often associated with?
What further complications are you worried about?

Answer 31

1) Failure of AV septum fusion
2) Trisomy 21 (Down syndrome)
3) Pulmonary hypertension and risk of endocarditis

Question 32

Left ventricular hypertrophy is four times more common in what sex?

Answer 32

Men

Question 33

What is the congenital heart defect that causes an abdominal aortic aneurysm?

Answer 33

Bicuspid aortic valve defect

Question 34

What cardiac “defect” is necessary for life in ToF patients?

Answer 34

Patent ductus arteriosus

Question 35

If a neonatal patient turns cyanotic after crying, what diagnosis can be expected?

Answer 35

ToF (Tet spell)

Question 36

What is the embryological basis for the tetralogy of fallot?

Answer 36

Abnormal septation of the outflow tract

Question 37

What is the embryological basis for an atrioventricular septal defect?

Answer 37

Failure of the endocardial cushions to fuse

Question 38

What defects must patients with hypoplastic left heart syndrome have to survive?

Answer 38

Patent ductus arteriosus