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1

primitive vertebrate CV plan begins.. and present by..

begins mid-week 3
present by week 4

2

as they migrate PHF cells specified to form left and righ t sides of heart and to form

atria
left ventricle
part of right ventricle

3

secondary heart field (SHF) forms

remainder of right ventricle
outflow tract - conus cordis and truncus arteriosus

4

the 5HT PITX2 pathway specificies .. and programs..

left side of body
programs heart cells in priamry and SHFs

5

master gene for left sidedness

PITX2

6

patterning of cardiac progenitor celsl occurs at the same time as

laterality (left-right sidedness) is established

7

circuit that supplies and drains the yolk sac ; separate from umbilical artery and vein; called the "nursery for blood vessels"

vitelline vein and artery

8

features of embryonic circuit

- series of aortic arches connecting to dorsal aortae
- d. aortae subdivides into smaller vessels to supply embryo
- blood drained by anterior and posterior cardinal veins
- common cardinal vein

9

bulbus cordis consists of

truncus arteriosus
conus cordis

10

sinus venosus gives rise to

smooth part of right atrium (sinus venarum)
coronary sinus
oblique vein of left atrium

11

primitive atrium gives rise to

trabeculated part of right and left atria (auricles)

12

primitive ventricule gives rise to

trabeculated part of right and left ventricles

13

bulbus cordis gives rise to

conus cordis: smooth part of right ventricle
aortic vestibule: smooth part of left ventricle

14

truncus arteriosus gives rise to

aorta, pulmonary trunk

15

blood flow in embryonic dilation

sinus venosus ---> primitive atrium --> primitive ventricle --> bulbus cordis ---> truncus arteriosus

16

more anterior structures (ventricles and outflow tract) are specified as such because of

lower RA concentrations

17

cardiac looping, the correct folding of heart (due to its rapid growth) is controlled by

PITX2 and the laterality pathway
if messed, heart could fold in different direction (could still work just fine)

18

grow the fastest during cardiac looping

ventricles and outflow tract

19

dextrocardia caused by - presents as - can be found with - when does it occur embryologically?

- heart bends to left instead of right
- displaced to right with transposition of heart and great vessels
- most common positional abnormality
- can be found with situs inversus
- during gastrulation or later during cardiac looping

20

large ocmmunication between chambers that occurs when endocardial cushions fail to fuse -- called? what does it result in? blood flow? treatment?

atrioventricular communis
results in common AV canal
giant atrial and ventricular septal defect
enlarged pulmonary trunk (less resistance in pulmonary circ. vs. systemic so all blood flows through there)
- Tx - put band on pulmonary artery to tie it off (lungs less congested now), then patch between right and left chambers then divide the one valve into two valves

21

formation of interventricular septum

2 parts:
muscular portion devleoping in midline on floor of the PV; growing upward towards ECC
- bublar ridges growing downwards to ECC

22

most VSDs occur in

muscular portion
but close spontaneously!

23

most commonly, surgically corrected VSD defects

membranous!

24

opening between L & R ventricles
associated shunting of blood

ventricular septal defects (VSDs)

25

presenting baby, signs of cyanosis at 1 year check up
right ventricle has hypertrophied; signs of pulmonary congestion and edema
auscultation and US shoe normal valves
diagnosis? disease mechanism?

VSD!
- initial lung inflation, RV pressure decreases
- get left to right shunting (acyanotic)
- causes increased work by RV, hypertrophy and eventual, right-to-left shunting ---> cyanosis
- rate depends on size of VSD

26

vsd 2 facts

25% of congenital heart defects
4 types based on position and severity

27

which types of VSDs can have more significance for conudciton

central
proximal
basal

28

valve of foramen ovale is derived from

septum primum

29

foramen ovale upper boundary and lower boundary

upper: septum secundum (upper limb)
lower: septum primum

30

foramen ovale once fused is called

fossa ovalis