Cardio Embryology + congenital tumors Flashcards Preview

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Flashcards in Cardio Embryology + congenital tumors Deck (76)
1

Truncus arteriosus gives rise to

ascending aorta + pulmonary trunk

2

bulbus cordis gives rise to

smooth parts (outflow) tracts of L/R ventricles

3

primitive atria gives rise to

trabeculated part of L/R atria

4

primitive ventricle gives rise to

trabeculated part of L/R ventricles

5

primitive pulmonary vein gives rise to

smooth part of L atrium

6

L horn of sinus venosus (SV) gives rise to

coronary sinus - resides in the atrioventricular groove on the posterior aspect of the heart

7

R horn of sinus venosus (SV) gives rise to

smooth part of R atrium

8

R common cardinal vein and R anterior cardinal vein gives rise to

SVC

9

embryonic structures that give rise to smooth parts of the heart only

bulbus cordis - smooth parts (outflow) tracts of L/R ventricles
primitive pulmonary vein - smooth part of L atrium
R horn of sinus venosus (SV) - smooth part of R atrium

10

embryonic structures that give rise to trabeculated parts of the heart only

primitive atria - trabeculated part of L/R atria
primitive ventricle - trabeculated part of L/R ventricles

11

septum primum forms what

foramen secundum as it grows towards the endocardial cushions, thereby narrowing foramen primum

12

septum secundum forms what

forms foramen ovale as it covers most of foramen secundum

13

foramen ovale is comprised of these two structures

septum primum
septum secundum

14

ventricular septum is comprised of these two muscle types

smooth (upper) + muscular (lower) parts

15

what forms the aorticopulmonary septum? What does this go on to form?

What happens if this sequence malfunctions?

neural crest + endocardial cell migrations -> truncal + bulbar ridges spiral and fuse -> articopulmonary septum -> ascending aorta + pulmonary trunk

malfunction:
-> transposition of the great vessels
-> tetraology of fallot
-> persistent truncus arteriosus

16

aortic valve is derived from..

endocardial cushions

17

mitral valve derive from...

fused endocardial cushions of the AV canal

18

pulmonary valve is derived from..

endocardial cushions

19

tricuspid valve is derived from...

fused endocardial cushions of the AV canal

20

valves that derive from fused endocardial cushions of the AV canal...

mitral + tricuspid valves

21

valves that derive from endocardial cushions

aortic + pulmonary valves

22

fetal hemoglobin composition, HgF

α2γ2

also due to β thalassemia

23

adult hemoglobin composition, HgA1 (major)

α2β2

24

HgH composition

β4, due to alpha-thalassemia (when 3 copies are deleted, causes hemolysis with hepatosplenomeagly)

25

adult hemoglobin composition, HgA2 (minor)

α2δ2

26

Hemoglobin Barts

γ4, due to alpha-thalassemia (when all 4 copies are deleted; causes hydrops fetalis)

27

ductus venosus connects?

umbilical vein (O2 blood) to IVC; bypasses the liver

28

patent ductus arteriosus connects?

pulmonary artery to aorta

29

foramen ovale connects

L/R atria

30

fossa ovalis was once the....

foramen ovale

31

ligamentum arteriosum was once the

ductus arteriosus

32

ligamentum teres hepatis was once the..

umbilical vein

33

umbilical arteries derive from

medial umbilical ligaments

34

ligamentum venosum was once the...

ductus venosus

35

urachus-median umbilical ligament was once the

allantois

36

nucleus pulposus was once the

notochord

37

SA/AV supplied by..

RCA

38

R dominant circulation

PDA arises from RCA

39

L dominant circulation

PDA arises from LCX

40

Peak of coronary blood flow

early diastole

41

most posterior part of heart

LA

42

artery that supplies the lateral and posterior walls of LV

LCX

43

artery that supplies the
- anterior 2/3 of interventricular septum
- anterior papillary muscle
- anterior surface of L ventricle

LAD

44

artery that supplies the R ventricle

Acute marginal artery from teh RCA

45

artery that supplies the posterior 1/3 of the interventricular septum and posterior walls of the ventricles

PDA

46

what maintains CO during early stages of exercise?
late stages?

early: HR, SV
late: HR (SV plateaus, duh)

47

what shortens diastole time?

increased HR/tachycardia

48

does hyperthyroidism increase or decrease pulse pressure?

increase

49

does aortic stenosis increase or decrease pulse pressure?

decrease

50

does aortic regurgitation increase or decrease pulse pressure?

increase

51

does cardiac tamponade increase or decrease pulse pressure?

decrease

52

does cardiogenic shock increase or decrease pulse pressure?

decrease

53

does arteriosclerosis increase or decrease pulse pressure?

increase

54

does obstructive sleep apnea increase or decrease pulse pressure?

increase (due to increased sympathetic tone)

55

does exercise increase or decrease pulse pressure?

increase

56

does anemia increase or decrease pulse pressure?

increase

57

does advanced heart failure increase or decrease pulse pressure?

decrease

58

does cardiac tamponade increase or decrease pulse pressure?

decrease

59

normal EF?
how does EF change with systolic heart failure? diastolic heart failure?

normal EF: >55%

systolic - decreases
diastolic - normal

60

when does normal physiologic splitting occur?

during INSPIRATION (drop in intrathoracic P -> increase VR -> increases RV stroke volume -> increase RV ejection time -> delayed closure of pulmonic valve)

61

when and why does wide splitting occur? 2

conditions that delay RV emptying
- pulmonic stenosis
- RBBB

occurs regardless of breath

62

when and why does fixed splitting occur?

ASD (L->R shunt) increases RV volumes -> pulmonic valve closure is greatly delayed

occurs regardless of breath

63

when does paradoxical splitting splitting occur?

conditions that delay LV emptying
- aortic stenosis
- LBBB
expiration: split
inspiration: P2 closes later and moves closer to A2, thereby eliminating the split

64

infantile coarctation of the aorta

where does it occur?
associated disease?

proximal to ductus arteriosus

association: Turner syndrome

65

persistent truncus arteriosus

where does it occur?
type of shunt formed?
association?

joined pulmonary trunk and aorta, most patients have concurrent VSD

right-to-left shunt

association: Digeorge (22q11)

66

endocardial cushion defects are usually associated with?

Give some examples

Downs syndrome

ASD
VSD
AV septal defect

67

Eisenmenger's syndrome

Pathophysiology?

Uncorrected L-> R shunt (VSD, ASD, PDA)
--> elevated pulmonary artery (PA) flow and pressures
--> PA hypertrophy + RVH
--> shunt switches to R->L shunt
--> cyanosis, clubbing, polycythemia

68

adult coarctation of the aorta

where does it occur?
signs and sx?

distal to ductus arteriosus

signs/symptoms: rib notching, lower extremity pulses weaker than upper

69

total anomalous pulmonary venous return (TAPVR)

R->L shunt

pulmonary veins drains into the R heart (SVC, coronary sinus, etc), often has concurrent ASD and PDA to allow for R-> L shunting to maintain CO

70

aortic regurgitation and dissection - association?

Marfan's syndrome

71

VSD

type of shunt?
sx?
association?

L->R shunt

harsh holosystolic murmur w/ increased pulmonary vascularity and mid diastolic rumble; thrill

Down syndrome

72

Tricuspid atresia
what is it?
type of shunt?
what is required for viability?

missing tricuspid valve, hypoplastic RV

R->L shunt

requires concurrent ASD and VSD for viability

73

transposition of great vessels

what is it?
type of shunt?
what is required for viability?
associations?

aorta and pulmonary artery are switched

R->L shunt

needs VSD, PDA, or PFO for survival

association: infant of diabetic mother

74

ASD

type of shunt?
signs and sx?
associations?

L->R shunt

signs/sx: fixed split S2, loud S1, mid systolic pulmonary ejection murmur (patients usually present w/ exercise intolerance)

association: Down syndrome

75

tetralogy of fallot

what is it?
type of shunt?
signs and sx?
associations?

pulmonary infundibular stenosis, RVH (boot shape), overriding aorta (emerges from both L/R ventricles), VSD

R->L shunt

signs/symptoms: tet spells, squatting relieves cyanosis; harsh systolic ejection murmur

association: Digeorge 22q11

76

PDA

type of shunt?
signs and sx?
treatments (open/close)?
associations?

L->R shunt

sx: continuous machine-like murmur

treatment: indomethacin to close, PGE1, PGE2 keeps open

association: rubella