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Cardiopulmonary Exam 1 > Embryological Development of Cardiovascular system Dr. Cole > Flashcards

Embryological Development of Cardiovascular system Dr. Cole Flashcards

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1
Q

Timeline: cardiovascular plan begin week ___ and present by week _____

A

3 and present by week 4

first system to develop

embryo can no longer meet nutritional or oxygen needs by diffusion

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2
Q

Development of CVS begins with the migration of _____ cells toward the _____

A

epiblast cells toward the primary heart field

cardiac progenitor cells = epiblast cells

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3
Q

where is the primary heart field?

A

surrounding the cranial neural folds

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4
Q

PHF cell migration

A

during migration they are specified to form left AND right sides:

this includes atria, left ventricle and some of the right ventricles

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5
Q

PHF forms the

A

atria, left ventricle and some of the right ventricle

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6
Q

SHG

A

secondary heart field, responsible for forming outflow tract

consisting of conus cordis amd truncus arteriosus

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7
Q

patterning of cardiac progenitor cells

A

occurs at the same time patterning of the rest of the embryo does

PITX2 programs heart cells in the primary and SHFs

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8
Q

gene/transcription factor PW that leads to development of PHF and SHF

A

5HT –> FGF8 –> Nodal/Lefty –> PitX2

PITX2 master gene for left sidedness

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9
Q

PITX2 problems —> (causes and outcomes)

A

SSRIs taken by new mothers —> interrupt PITX2 leding to heart defects

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10
Q

“a horseshoe shaped endothelial lined tube surrounded by myoblasts”

A

cardiogenic center formed when blood islands merge

this process begins when PHF progenitor cells are induced to form blood islands and cardiac myoblasts.

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11
Q

_____ tubes fuse to form a single primitive heart tube

A

endocardial

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12
Q

Embryonic circuit

A

series of aortic arches that connect to dorsal aortae

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13
Q

Cardinal veins

A

anterior and posterior cardinal veins drain developing embryo

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14
Q

“nursery for blood cells”

A

yolk sac

vitelline: supply and drain yolk sac “nursery for blood cells”

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15
Q

what veins drain into the sinus venosus

A

the anterior and posterior cardinal veins –> common cardinal vein –> sinus venosus

umbilical veins —> sinus venosus
vitelline —> sinus venosus

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16
Q

the embryonic vascular circuit is converted into

A

system and pulmonary portions

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17
Q

Embryonic structure and adult derivative

Truncus arteriosus —>

A

aorta, pulmonary trunk

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18
Q

Embryonic structure and adult derivative

Bulbus cordis —>

A

smooth part of right ventricle (conus cordis)

smooth part of the left ventricle (aortic vestibule (arotic vestibule)

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19
Q

Embryonic structure and adult derivative

Primitive ventricle

A

trabeculated part of left and right ventricles

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20
Q

Embryonic structure and adult derivative

Primitive atrium

A

Trabeculated part of right and left atria (auricles)

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21
Q

Embryonic structure and adult derivative

Sinus venosus

A

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

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22
Q

Blood flow through embryo

1 —> sinus venosus –> 2 —> 3 —-> 4

A 
umbilical veins (from placenta)
common cardinal vein (embryo)
vitelline veins (yolk sac)
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23
Q

endocardial tube formation

Venous end is specified by

A

RA

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24
Q

endocardial tube formation

lower concentrations of RA specify

A

more anterior structures; ventricles amd outflow tract

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25
by day 22, the fastest growing structures are
the truncus arteriosis bulbus cordis primitive ventricle
26
endocardial tube formation what is it, and what does it become and how does it relate to the heart
it's a primitive tube that arises out of blood islands combining
27
Day 23: the day the
endocardial tube begins to loop under the influecne of PITX2
28
the primitive ventricle and aorta bend around one another in which directions?
the ventricle bends inferiorly and the aorta bends superiorly making an S shape
29
the "shape" of the cardiac looping goes from ___ to ___
C to S
30
where is the fulcrum of bending in the primitive heart occur?
in the primitive ventricle: makes a V around an invisible fulcrum
31
Dextrocardia
heart is supposed to bend toward the left but in this condition the heart bends to the right and there is transposition of the great vessels most common positional abnormality
32
Dextrocardia can occur at two times
during gastrulation or cardiac looping
33
Endocardial cushions
after folding, there is a narrow passage between PA and PV dorsal and ventral blocks of tissue grow together
34
development of the tricuspid and bicuspid valves
the narrow AV cannel is formed after looping. dorsal and ventral masses fuse and separate Left and Right AV canals "endocardial cushions" are the masses that
35
the critical "first step" in the formation of the 4 chambered heart
atrioventricular communis: fusion of endocardial cushions
36
Atrioventricular communis:
defect that occurs when the endocardial cushions fail to fuse, limits amount of blood that reaches the lungs
37
the effects of a common AV canal
enlargened pulmonary artery, decreased pulmonary resistance than in systemic circulation
38
Interventricular septum formation
Two parts: muscular portion devleoping in the midline of the floor of the primitive ventricle grows upward towards endocardial cushions and down toward bulbar ridges
39
what defect results when the muscular midline of the interventricular septum fails to fuse
the r and l ventricles are not separated
40
most ventricular septal defects occur in the
the muscular portion (which are supposed to spontaneously close)
41
what kind of ventricular septum defect is most often correct by surgery?
membranous defect
42
VSD
ventricular septal defect
43
VSD causes
left to right ventricular shunting
44
acyanotic
(left to right shunting)
45
VSD pressure causes
increased blood flow to heart causes LF to fill ---> | pressure causes blood to go into R ventricle ---> R ventricle compensates by having to work harder and hypertrophying
46
Conduction effects associated with VSD
VSD doesnt effect the ventricular bundle branches almost at all. it is very rare.
47
Atrial septum formation: primums
foramen primum is the duct connecting the early atrias | the septum primum is the outgrowing walling superior to the atria
48
Atrial septum formation: secundum
the second event is a mass in the middle of the atria primum creating two new openings between the atria foramen secundum and foramen primum
49
Atrial septum formation: endocardial cushion
grow up to merge with the primum, leaving a secundum
50
sequence of foramen formation
foramen primum ---> foramen primum + foramen secundum ---> foramen secundum + outgrowing septum primum ---> foramen ovale + upper and lower septum secundum
51
what structures make up the formane ovale?
the upper and lower arms of the septum secundum
52
Before birth there's a foramen ovale. describe the pressure differentials allowing it to work
Right atrium has greater pressure causing the foramen ovale shunt to open to the left atrium, which has a lower pressure
53
What is the "valve" between the atria that opens and closes before birth? What are the walls?
the arm of the septum primum = valve | upper/lower arms of septum secundum = walls of shunt
54
Foramen ovale ---> adult structure
fossa ovalis
55
adult heart, LIMBUS =
septum secundum
56
adult heart, Fossa ovale =
septum primum, the floor
57
valve of the fossa ovale is the ____ while the floor of the fossa ovale is the
septum primum septum secundum
58
atrial septal defects (ASD) : 3 kinds
defect in the foramen primum "ostium primum" defect is similar to one in endocardial cushion defect in secundum: foramen ovael and septum primum defect in sinus venosus, usually near openings of SVC
59
Mutations in TBX5 cause
thumb anomaly and atrial septal defects. can also impact VSD
60
Sinus Venosus: the changes, and components
initially opens dorsally into the primitive atrium, L/R equl then the R gets bigger L --> R Shunts involve "nutritional" and embryonic circuits
61
nutritional circuits include
vitelline and umbilical
62
embryonic circuit includes
cardinal veins
63
Shunt 1 Vitelline Veins
liver develops in septum transversum, and is flanked on both sides by vitelline veins veins grow into liver initially as hepatic sinusoids, veins, IVC, and some GI
64
Shunt 2 Umbilical
no direct connection with the heart by converting its liver connection into the ligamentum teres heptis
65
Umbilical vein ---> ______ ---> ______
ductus venosus ---> IVC bypasses liver and directs blood to heart
66
ductus venosus
connects umbilical vein with IVC
67
which horn of the sinus venosus enlargens
Right horn
68
what primitive structure does the "future superior vena cava" grow into?
right horn of the sinus venosum
69
what happens to the sinus venosus?
vitelline veins are absorbed into the GI system umbilical veins are re-routed to utilize the ductus venosus to bypass the liver without having a direct connection to the right atrium
70
what happens to the cardinal veins?
Anterior cardinal veins become connected, anastomosis becomes left brachiocephalic vein right anterior cardinal and common cardinal become SVC
71
why does the right horn of the sinus venosus get larger?
because there's shunting of the blood to the right atrium
72
Coronary sinus =
remnant of Left Horn of sinus venosus
73
sinus venosus becomes the
smooth part of the right atrium
74
left horn of sinus venosus
becomes coronary sinus, oblique vein of the left atrium
75
Crista terminalis marks the
division between sinus venosus and embryonic primitive atrium and auricles
76
truncus arteriosus becomes partitioned to become
the aortic and pulmonary semilunar valves
77
partition of the AV canal will form the
bicuspid and tricuspid valves
78
neural crest cells migrate to ridges of truncus arteriosus
here they contribute to formation of truncus ateriosus | and bulbis cordis
79
Aorticopulmonary septum
it twists like a pretzl, making the twisting arrangement of the pulmonic trunk and the aorta
80
the distal aspect of the aorticopulmonary septum has to connect to the
endocardial cushions and interventricular septum
81
Eisenmenger's Syndrome
incomplete fusions of bulbar ridges ---> inferior VSD
82
there's a proliferation in intima and media that narrows the lumen in
eisenmenger's syndrome, causes increased pulmonary resistance, causes R-->L shunt cyanosis
83
Tetralogy of Fallot
Pulmonary stenosis, VSD overriding aorta Rt. Ventricular hypertrophy ventricular defect that causes septal in R atrium to remain unfused, so blood is shunted directly into the aorta
84
Arterial System: aortic arches
6 pairs of aortic arches connect the aortic sac and truncus arteriosus to the dorsal aortae pharyngeal arches organize development of head and neck
85
Aortic Arche 1
Contribute to maxillary arteries
86
Aortic Arche 2
produce stapedial and hyoid arteries
87
Aortic Arche 3
Common Carotid arteries and proximal portion of the internal carotid arteries
88
Aortic Arche 4
persists after birth to connect dorsal aorta to ventral aorta = aortic arch on the right it forms the proximal portion of the right subclavian artery
89
Aortic Arch 5
lost, does not develop into anything known
90
Aortic Arch 6
Proximal portions develop into pulmonary arteries; distal portion develops into the ductus arteriosus
91
Ductus Arteriosus: what compound is required to sustain it during development?
PGE2, prostaglandin 2 by the ductus
92
what kind of medication would a pregnant woman avoid in order to prevent the ductus arteriosus from closing off?
NSAIDs: they interfere with prostaglandins
93
Patent Ductus Arteriosus
failure of ductus arteriosus to close after birth
94
Branches of the Aorta cervical intersegmentals --->
vertebral arteries
95
Branches of the Aorta seventh intersegmentals --->
subclavian arteries
96
Branches of the Aorta thoracic intersegmentals --->
intercostal arteries
97
Branches of the Aorta lumbar intercostals --->
iliac arteries
98
Branches of the Aorta lateral segmental branches --->
adrenals, renal, gonadal arteries
99
Branches of the Aorta ventral segmental branches (vitelline and allantoic) ---->
vitelline ---> GI, celiac, superior and inferior mesenteric arteries allantoic ---> umbilical arteries
100
Vitellin veins become the
part of IVC, hepatic veins/sinusoids, ductus venosus, portal, superior/inferior mesenteric ans splenic veins
101
TAPVR
Total Anomalous Pulmonary Return
102
TAPVR: supracardiac
pulmonary veins drain to the right atrium via superior vena cava
103
TAPVR: Cardiac
pulmonary veins come together behind heart, drain into right atrium via coronary sinus
104
TAPVR: Infracardiac
pulmonary veins drain to the right atrium via hepatic liver veins and IVC
105
All TAPVRs have AT LEAST an
ASD
106
what happens to an embryo with a TAPVR who lacks an ASD?
baby will die because blood cant be shunted to left side of the heart
107
Right Aortic Arch malformation
persistence of right 4th arch distal to the right subclavian left segment is caudal to left subclavian disappears isolated situs inversus complex
108
Doubt Aortic Arch
4th aortic arch caudal to right subclavian persists ,creating a vascular ring around trachea and esophagus
109
Coarctation of Aorta
Aorta narrows right near ductus arteriosus
110
once PHF cells are established, what happens
underlying pharyngeal endoderm induces the cells to form cardiac myoblasts and blood islands through the process of vasculogenesis
111
why do blood islands unite?
to form the horseshoe shaped endothelial lined tune surrounded by myocytes called the "cardiogenic region"

Cardiopulmonary Exam 1 (21 decks)

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