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<3 > Great Vessel Development > Flashcards

Great Vessel Development Flashcards

1
Q

What do the aortic arches arise from?

A

Arteries that arise from aortic sac

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2
Q

What was the aortic sac an expansion of?

A

The most distal portion of the Truncus Arteriosus

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3
Q

How many “pairs” of aortic arches are there?

A

6 -but really 5

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4
Q

Where are aortic arches formed within and how?

A

W/in PAs by vasculogenesis and angiogenesis

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5
Q

What are the 3 changes made to the primitive system to get to the adult system?

A
  1. Hypertrophy of some vessels (AAs 3,4,6)
  2. Addition of new vessels
  3. Loss of some vessel segments
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6
Q

Where will the paired dorsal aorta begin to fuse at ?

A

At T4 axial level and continues caudally

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7
Q

How is the truncus arteriosus divided?

What into

A

By aorticopulmonary septum

Into aorta and pulmonary a.

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8
Q

How do intersegmental arteries form? Where?

A

Via vasculogenesis w/in paraspinal mesodern

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9
Q

What do intersegmental as. Run b/w?

A

B/w somites

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10
Q

How many cervical, thoracic, and lumbar intersegmental as. Are there?

A

Cervical: 7

Thoracic: 12

Lumbar: 5

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11
Q

How are the cervical intersegmentals united?

A

By longitudinal anastomosis

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12
Q

Which cervical intersegmentals go away?

A

Roots of 1-6

Only root of 7 remains

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13
Q

Where vessels are derived from the longitudinal anastomoses of the cervical intersegmentals?

A

Vertebral As.

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14
Q

What will the LEFT 7th cervical intersegmental a. Form?

A

L. Subclavian

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15
Q

What will the RIGHT 7th cervical intersegmental form?

A

Portion of R. Subclavian

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16
Q

What will the anastomosis b/w supeiror and inferior thoracic intersegmentals form?

A

Internal thoracic as.

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17
Q

What do the anastomoses b/w thoracic intersegmentals themselves form?

A

Posterior and anterior intercostal as.

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18
Q

What will the lumbar intersegmental anastomoses make?

A

Epigastric and Iliac vessels

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19
Q

What will AA1 form?

A

Maxillary a.

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20
Q

What will AA2 form?

A

Stapedial a.

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21
Q

What will AA 3 form?

What is this arch called?

A

Carotid arch

-forms common carotid with split leading to Internal Carotid and External Carotid

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22
Q

What will happen to AA 4?

A

Will hypertrophy so has both L and R side

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23
Q

What will the L. AA 4 form?

A

Part of aortic arch

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24
Q

What else helps to form the aorta?

A

Aortic sac - asc. Aorta

AA4 - artic arch

L. Dorsal aorta —> desc. And thoracic

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25
Q

What will connect the L. AA 4 with the LV?

A

Spiral septum of outflow tract (conotruncal ridges)

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26
Q

What does the RIGHT AA 4 form?

A

Proximal part of right subclavian

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27
Q

What 3 things help make the RIght subclavian a.?

A
  1. R. AA 4
  2. Dorsal aorta
  3. . R. 7th intersegmental a.
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28
Q

What will AA 6 form?

A

Pulmonary As. (Also some help from aortic sac)

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29
Q

Where will outgrowths of AA6 go to?

A

Enters mesenchyme of lung

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30
Q

The R. AA6 connection to the dorsal aorta disappears, but what will the L. One form?

A

Will form ductus arteriosus (and eventually ligamentum arteriosum)

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31
Q

Why does the recurrent laryngeal n. From vagus appear to arise at 2 different axial levels? (One around aortic arch and one around r. Subclavian)

A

Bc. Heart moves to thorax as embryo grows and carotid lengthen so that subclavian ends up lower now

  • connect from R AA 6 to dorsal aorta lost, R. Recurrent laryngeal now wrapped around r. Subclavian a.
  • ductus arteriosus there, so L. Recurrent laryngeal around aortic arch and L. Art.
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32
Q

What are the vitelline arteries?

What will they eventually form?

A

◦ Vessels supplying yolk sac

eventually form the GI vasculature

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33
Q

What are the umbilical as.?

A

◦ Paired ventral branches of dorsal aorta that course

to placenta and have connections w/ developing bladder

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34
Q

What will the 5th lumbar A. Form ? (2)

A
  • internal iliac a.

- connection b/w it and umbilical a.

35
Q

What birth what will the distal end of the Umbilical a. Form?

A

Will becomes medial umbilical Ls.

36
Q

What arteries branch off the 5th lumbar intersegmental As. (Iliac vessles) in adults?

To supply what?

A

Superior vesicular arteries to supply bladder

37
Q

What are the 3 main vein systems in the embryo?

A
  1. Vitelline
  2. Umbilical
  3. Cardinal
38
Q

What i the function of vitelline veins?

A

• Carries blood from yolk sac —> sinus venosus (primordium of RA)

39
Q

What is the function of the umbilical system?

Where does it originate ?

A

• Originates in chorionic villi of placenta carrying O2-rich blood

40
Q

What is the funciton of the cardinal vein system?

A

Drains the body of the embryo

41
Q

What is the path of the Vitelline veins after they empty into the sinus horns?

A

Pass thru septum transversum where they become surrounded by liver primordia

42
Q

What happens to the Vitelline veins as the liver develops?

A

Veins will form vascular pelxus of HEPTIC SINUSOIDS w/in liver primordia

43
Q

What happens to the L. Vitelline and umbilical veins?

A

Channeled toward r. Side w/in liver with proximal portion disappearing

44
Q

What will the r. Vitelline v. Form? And that will eventually become?

A

Right hepatocardiac channel

Eventually becomes terminal part of the IVC

45
Q

What is the only vein that carries placental blood to liver?

A

Left umbical vein

46
Q

What will the Left Umbilical V. Connect w/?

Forming what?

A

Will connect w/ the Right Hepatocardiac channel

Ductus venosus

47
Q

What is the funciton of the ductus venosus?

What maintains its patency during fetal life?

A

Allows most blood to bypass sinusoids plexus of liver

Prostaglandins

48
Q

What will the happen to the L. Umbilical V. And Ductus Venosus after birth?

A

Both disappear, leave remnants

L. Umbilical v. —> Ligamentum Teres Hepatis

Ductus Venosus —> Ligamentous Venosum

49
Q

What will the anterior and posterior cardinal v. Join to form?

A

Form common cardinal V.

50
Q

What do the L. And R. Anterior cardinal veins drain blood from?

A

Drain most of blood from head and neck

51
Q

What will the anastomosis b/w

Right and Left Cardinal Vs. form?

A

L. Brachiocephalic V.

52
Q

What will remnants of the L. Cardinal V. Form?

A

Coronary sinus (along w/ left sinus horn)

53
Q

What will the RIght Common Cardinal v. Form? (Common = anterior & post)

A

Superior Vena Cava

54
Q

What can happen is there is abnormal development of the ANteiror Cardinal v.?

A

Can lead to SVC draining into heart via the coronary sinus

55
Q

What do the posterior cardinal veins connect to?

A

Parallel sets of vins called the Subcardinal and Supracardinal veins

56
Q

What will the Subcardinal veins form?

A

Form veins primarily associated w/ kidney and gonads and contributors to formation of abdominal IVC

57
Q

What will the Supracardinal veins form?

A

Portions of IVC and Azygos system and veins draining BODY WALL

58
Q

How does O2 rich blood bypass the liver? To go to where?

A

Bypass via ductus Venosum

To get to IVC and RA

59
Q

Where will most blood from IVC go thru?

A

Thru foramen ovale to get to LA

60
Q

Where will a small portion of blood entering the IVC and most blood entering thru SVC go to?

A

To RV

61
Q

What percentage o blood flow in the developing fetus goes to lungs?

A

10%

62
Q

What receive blood from the asc. Aorta in the developing fetus? What is the O2 content of this blood?

A

To arteries of heart, head, neck and UEs

-contain highest level of oxygen content

63
Q

What is the relative blood O2 levels present in blood from the RV?

A

Medium oxygen content

Will go to lung or thru ductus arteriosus

64
Q

What is the relative blood O2 levels present in blood from the LEs, portal vein, SVC?

A

Poor oxygen content

65
Q

What happens after birth that affects ductus arteriosus?

A

Changes in Blood O2 tension

  • drop in prostaglandin
  • increase in endothelin (a GF) release from newborn lungs

-stimulates smooth muscle contraction of ductus arteriosus

66
Q

How long does it take for the ductus arteriosus to close?

A

W/in 10-15 hours of birth

67
Q

What happens if there is a Patent ductus arteriosus (8/10,000)?

A

1/3-1/2 of blood will enter pulmonary a. And will be circulated thru lungs 2-3 times (increases pulmonary resistance) for every one time it enters systemic circulation

=increased workload for LV = LV hypertrophy

-increased pulm. Rest. = pulmonary congestion = congestive Heart failure

68
Q

With a Patent Ductus arteriosus what can you hear?

A

Can hear a blowing type of murmur

69
Q

What increases the risk of a patent ductus arteriosus?

A

Maternal rubella infection during early pregnancy

70
Q

What is the tx for a patent ductus arteriosus?

A

Prostaglandin inhibitors

Or

Surgery

71
Q

What is a Coarctation of the Aorta?

A

Aortic lumen below the origin of the L. Subcl. A. Is NARROWED due to abnormal thickening of aortic wall

72
Q

What syndrome is Coarctation of the aorta more common in?

A

More frequent in Turner’s syndrome

73
Q

What are the 2 types of Aortic Coarctation seen?

Which one is not as dangerous ?

A
  1. Post-ductal -not bad

2. Pre-ductal - severe

74
Q

What is a Post-ductal Aortic Coarctation?

A

Narrowing that occurs AFTER the ductus arteriosus

  • allows for collateral circulation to be established thru intercostal arteries and internal thoracic as.
75
Q

What is a Pre-Ductal Aorta Coarctation?

A

Narrowing that occurs BEFORE ductus arteriosus

  • collateral circulation is not well developed
  • little to no blood to LEs unless ductus arteriosus remains open (and even then it is O2 poor blood from RV)
76
Q

What causes an ABnormal origin of the R. Subclavian A.?

A

Only formed by 7th intersegmental and distal portion of R. Dorsal aorta

-the RIght AA 4 and proximal part of R. Dorsal aorta are gone

77
Q

What are the symptoms of an Abnormal R. Subclavian?

A

May caus difficulting in swallowing and resp. (Dysphagia and dyspnea)

Due to the R. Dorsal aorta crossing esophagus to reach R. UE

78
Q

What is a double aortic arch?

Sxs?

A

Vascular ring surrounding trachea and esophagus

  • Esophageal dysfunction and strangulation of trachea
79
Q

What causes a Right Aortic Arch?

A

L. AA 4 and L. Dorsal aorta are obliterated and replaced by vessels on right

80
Q

What are the sxs of a Right Aortic Arch?

A

‣ Complains of dysphagia and dyspnea if left subclavian a. Passes behind esophagus and Ligamentous Arteriosum passes in front of trachea to reach right side

81
Q

What is an Interrupted Aortic Arch caused by?

What will remain open?

A

L. And R. AA 4 are gone and proximal R. Dorsal aorta

(L. AA 4 formed aortic arch)

-but ductus arteriosus remains open so descending aorta and subclavian as. Are supplied w/ o2 poor blood

82
Q

What will the aortic trunk supply in “interrupted aortic arch syndrome”?

A

Supplies 2 common carotid arteries

83
Q

What syndrome in Interrupted Aortic Arch seen w/?

A

DiGeorge Syndrome

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