أسئلة ريتين الـ CVS Embryology (قبل التعديل)

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Questions and Answers

What are the two main types of atrial septal defects (ASDs)?

Persistent ostium primum and persistent ostium secundum.

How is a patent foramen ovale clinically significant?

It allows blood to pass to the left side under increased pressure conditions.

What is the primary defect in Roger disease?

A persistent inter-ventricular foramen.

What portion of the interventricular septum develops from the floor of the primitive ventricle?

<p>The muscular part.</p> Signup and view all the answers

What unfortunate outcome can occur due to premature closure of the foramen ovale?

<p>Fetal death.</p> Signup and view all the answers

What forms the right limb of the developing heart tube?

<p>The right limb is formed by the truncus arteriosus and bulbus cordis.</p> Signup and view all the answers

What structures do the bulbar cushions contribute to during development?

<p>They form the septum that divides the bulbus cordis into right and left halves.</p> Signup and view all the answers

What condition is characterized by the heart lying as a mirror image of its normal position?

<p>This condition is known as dextrocardia.</p> Signup and view all the answers

What is a characteristic of a trilocuar biventricular heart anomaly?

<p>Failure of septum premium and septum secundum development.</p> Signup and view all the answers

In which part of the heart development do the infundibulum of the right ventricle and vestibule of the left ventricle arise from?

<p>The middle part of the bulbus cordis.</p> Signup and view all the answers

What are the two primary sources of blood entering the sinus venosus?

<p>The umbilical veins carrying O2 blood and the vitelline veins carrying deO2 blood.</p> Signup and view all the answers

What happens to the right horn of the sinus venosus during development?

<p>The right horn enlarges and forms the posterior smooth part of the right atrium.</p> Signup and view all the answers

How is the atrio-ventricular canal divided during embryonic development?

<p>It is divided into right and left halves by anterior and posterior cushions.</p> Signup and view all the answers

What is the fate of the left horn of the sinus venosus?

<p>The left horn and body form the coronary sinus.</p> Signup and view all the answers

What defines ectopia cordis?

<p>Ectopia cordis is when the chest wall fails to close, exposing the heart through a defect in the sternum.</p> Signup and view all the answers

What valves are formed from the right sino-atrial valve?

<p>The right sino-atrial valve contributes to the crista terminalis, valves of the inferior vena cava (IVC), and valve of the coronary sinus.</p> Signup and view all the answers

What is the role of the septum intermedium in the heart's embryological development?

<p>The septum intermedium contributes to the formation of the inter-atrial and membranous inter-ventricular septa.</p> Signup and view all the answers

How do tricuspid stenosis and mitral regurgitation affect the septum intermedium?

<p>In cases of tricuspid stenosis and mitral regurgitation, the septum intermedium deviates to the right side.</p> Signup and view all the answers

What happens to the ostium primum during the development of the inter-atrial septum?

<p>The ostium primum is initially present but closes as the septum primum grows towards the septum intermedium.</p> Signup and view all the answers

Describe the fate of the foramen ovale after birth.

<p>After birth, the septum primum and septum secundum fuse, closing the foramen ovale, while the septum primum forms the fossa ovalis.</p> Signup and view all the answers

What separates the septum primum from the septum secundum?

<p>The septum primum and septum secundum are separated by a passage known as the foramen ovale.</p> Signup and view all the answers

What embryological origins contribute to the formation of the inter-atrial septum?

<p>The inter-atrial septum is formed from the septum intermedium, septum primum, septum secundum, left sino-atrial valve, and neural crest cells.</p> Signup and view all the answers

What causes the septum intermedium to deviate to the left side?

<p>The deviation to the left side occurs in cases of tricuspid regurgitation and mitral stenosis.</p> Signup and view all the answers

What two structures close after birth to form the fossa ovalis?

<p>The structures that close to form the fossa ovalis are the septum primum and the septum secundum.</p> Signup and view all the answers

What is the pathway of oxygenated blood from the placenta to the fetus?

<p>Oxygenated blood travels from the placenta through the left umbilical vein to the liver, ductus venosus, inferior vena cava (IVC), and into the right atrium.</p> Signup and view all the answers

What two major changes occur in the circulatory system immediately after birth?

<p>The foramen ovale closes due to increased pressure in the left atrium, and the ductus arteriosus closes due to strong contraction of its muscle layer.</p> Signup and view all the answers

What anatomical structures are formed from the left umbilical vein and ductus venosus after birth?

<p>The left umbilical vein transforms into the ligamentum teres, and the ductus venosus becomes the ligamentum venosum.</p> Signup and view all the answers

Which structure allows blood to bypass the lungs in fetal circulation?

<p>The ductus arteriosus allows blood to bypass the lungs by connecting the pulmonary trunk to the descending aorta.</p> Signup and view all the answers

How is blood mixed in the right atrium during fetal circulation?

<p>The right atrium receives blood via the superior vena cava (SVC) from the upper body and mixed blood from the inferior vena cava (IVC).</p> Signup and view all the answers

When does the development of the cardiovascular system begin in relation to the central nervous system?

<p>The cardiovascular system is the second system to develop, following the central nervous system (CNS).</p> Signup and view all the answers

At what point is the fetal heartbeat first detected by ultrasound?

<p>The fetal heartbeat can first be detected by ultrasound at the 6th week of gestation.</p> Signup and view all the answers

What embryological origin is responsible for the formation of the heart tube?

<p>The heart tube originates from angioplastic cells and the myo-epithelial mantle of the cardiogenic mesoderm.</p> Signup and view all the answers

What is the commonest cyanotic heart disease and its primary features?

<p>Fallot's tetralogy, characterized by pulmonary stenosis, right ventricular hypertrophy, ventricular septal defect (VSD), and overriding aorta.</p> Signup and view all the answers

Describe the fate of the aortic sac during development.

<p>The aortic sac forms the aortic arch proximal to the brachiocephalic artery, with the right horn forming the brachiocephalic artery and the left horn forming the aortic arch.</p> Signup and view all the answers

What structures do the 3rd aortic arch develop into?

<p>The 3rd aortic arch forms the common carotid artery and the proximal part of the internal carotid artery.</p> Signup and view all the answers

What happens to the 5th aortic arch during development?

<p>The 5th aortic arch degenerates and does not form any significant structures.</p> Signup and view all the answers

What are the two main parts that form the right ventricle?

<p>The right ventricle consists of a rough inflowing part and a smooth outflowing wall.</p> Signup and view all the answers

Which structures result from the 4th aortic arch on the right and left sides?

<p>The right 4th aortic arch forms part of the right subclavian artery, while the left forms the aortic arch between the left common carotid and left subclavian arteries.</p> Signup and view all the answers

Describe the developmental origin of the left ventricle.

<p>The left ventricle develops from the rough inflowing part and the smooth outflowing wall.</p> Signup and view all the answers

What does the 6th aortic arch develop into on both sides?

<p>The proximal part forms the pulmonary artery on both sides; the right's distal part degenerates while the left's distal part forms ductus arteriosus.</p> Signup and view all the answers

Explain the significance of the recurrent laryngeal nerve in relation to the 6th aortic arch.

<p>The recurrent laryngeal nerve initially hooks around the distal part of the 6th aortic arch, which is significant for its pathway.</p> Signup and view all the answers

What is the role of the endocardial cushions in the development of the semilunar valves?

<p>Endocardial cushions develop in the upper part of the bulbus cordis and help form the semilunar valves.</p> Signup and view all the answers

What are the primary characteristics of Fallot's Pentalogy?

<p>Fallot's Pentalogy includes the features of Fallot's tetralogy plus an atrial septal defect (ASD).</p> Signup and view all the answers

Explain the significance of the spiral course of the aortico-pulmonary septum.

<p>The spiral course of the aortico-pulmonary septum is crucial as it divides the truncus arteriosus into the pulmonary trunk and ascending aorta.</p> Signup and view all the answers

What is persistent truncus arteriosus and what causes it?

<p>Persistent truncus arteriosus is due to the failure of aortico-pulmonary septum formation.</p> Signup and view all the answers

Describe how transposition of the great vessels occurs.

<p>Transposition of the great vessels occurs when the aortico-pulmonary septum follows a straight course instead of a spiral course.</p> Signup and view all the answers

What structures develop in the bulbus cordis to contribute to the formation of the semilunar valves?

<p>Two ridges grow from the endocardial cushions in the bulbus cordis to form the cusps of the semilunar valves.</p> Signup and view all the answers

What anomalies are associated with the development of the semilunar valves?

<p>Anomalies include pulmonary stenosis, aortic stenosis, pulmonary atresia, and aortic atresia.</p> Signup and view all the answers

What is the primary consequence of the failure of septum primum and secundum to fuse during fetal development?

<p>It leads to a patent foramen ovale, allowing blood to pass to the left side when pressure increases in the right atrium.</p> Signup and view all the answers

What part of the interventricular septum is most commonly affected in Roger disease?

<p>The defect occurs in the membranous part of the interventricular septum.</p> Signup and view all the answers

Describe the fate of the proximal part of the bulbus cordis during heart development.

<p>It forms the muscular parts of the right and left ventricles.</p> Signup and view all the answers

What is the main embryological cause of a trilocuar biventricular heart anomaly?

<p>It is caused by the failure of the interventricular septum to develop properly.</p> Signup and view all the answers

What are the implications of persistent inter-ventricular foramen on cardiac function?

<p>It leads to mixing of oxygenated and deoxygenated blood, potentially causing heart failure symptoms.</p> Signup and view all the answers

How does the development of the muscular and membranous parts of the interventricular septum differ?

<p>The muscular part arises from the floor of the primitive ventricle, while the membranous part arises from the septum intermedium and bulbar septum.</p> Signup and view all the answers

What leads to premature closure of the foramen ovale during intra-uterine life?

<p>It can occur due to abnormal pressures or blood flow dynamics in the fetal heart.</p> Signup and view all the answers

In the context of anomalies, what is significant about a probe patent foramen ovale?

<p>It occurs in 20-30% of people and generally has no clinical significance.</p> Signup and view all the answers

What role do the anterior and posterior cushions play in the division of the atrio-ventricular canal?

<p>They facilitate the division of the canal into right and left halves.</p> Signup and view all the answers

Describe how the growth of the right horn of the sinus venosus affects its structure.

<p>The right horn enlarges at the expense of the body and left horn, becoming the larger component that structures the posterior smooth part of the right atrium.</p> Signup and view all the answers

Explain the relationship between ectopia cordis and the heart's exposure through the chest wall.

<p>Ectopia cordis occurs when the chest wall fails to close, exposing the heart.</p> Signup and view all the answers

What structures form the fate of the left horn and body of the sinus venosus?

<p>They form the coronary sinus.</p> Signup and view all the answers

What is the significance of the sino-atrial valve regarding blood flow within the heart?

<p>The sino-atrial valve guards the opening of the right horn into the atrium, regulating blood flow.</p> Signup and view all the answers

What happens to the upper part of the atrio-ventricular canal during development?

<p>It is absorbed into the atria.</p> Signup and view all the answers

In what way does the right sino-atrial valve contribute to cardiac anatomy?

<p>It contributes to forming the crista terminalis, valves of IVC, and valve of the coronary sinus.</p> Signup and view all the answers

How does the lateral displacement of blood to the right side during liver development affect the right horn of the sinus venosus?

<p>It causes the right horn to become larger than the left horn.</p> Signup and view all the answers

What causes the functional closure of the foramen ovale immediately after birth?

<p>Increased pressure in the left atrium and decreased pressure in the right atrium cause the functional closure of the foramen ovale.</p> Signup and view all the answers

What anatomical change occurs to the ductus arteriosus after birth?

<p>The ductus arteriosus undergoes functional closure due to strong contraction of its muscle layer, eventually forming the ligamentum arteriosum.</p> Signup and view all the answers

Describe the pathway of blood flow through the fetal circulation.

<p>Oxygenated blood flows from the placenta through the left umbilical vein to the right atrium, with most passing to the left atrium through the foramen ovale.</p> Signup and view all the answers

What are the fates of the umbilical arteries after birth?

<p>The distal parts of the umbilical arteries become the medial umbilical ligaments, and the proximal parts form the superior vesical artery.</p> Signup and view all the answers

What changes in pressure cause the ductus venosus to close after birth?

<p>The ductus venosus closes due to a decrease in blood flow from the placenta and changes in systemic circulation.</p> Signup and view all the answers

How does the right atrium receive mixed blood during fetal circulation?

<p>The right atrium receives mixed blood from the superior vena cava (SVC) and inferior vena cava (IVC), combining oxygenated and deoxygenated blood.</p> Signup and view all the answers

What embryological structures contribute to the formation of the heart tube?

<p>The heart tube is formed from angioblastic cells and the myo-epithelial mantle of the cardiogenic mesoderm.</p> Signup and view all the answers

What is the significance of the changes that occur in the cardiovascular system immediately after birth?

<p>These changes ensure proper oxygenation of blood through the lungs and redirect blood flow from the placenta to systemic circulation.</p> Signup and view all the answers

What anatomical structures contribute to the formation of the inter-atrial septum?

<p>The inter-atrial septum is formed by the septum intermedium, septum primum, septum secundum, left sino-atrial valve, and some neural crest cells.</p> Signup and view all the answers

How does tricuspid regurgitation and mitral stenosis affect the positioning of the septum intermedium?

<p>They cause the septum intermedium to deviate to the left side.</p> Signup and view all the answers

What happens to the septum primum and septum secundum after birth regarding the foramen ovale?

<p>They fuse to close the foramen ovale.</p> Signup and view all the answers

What is the fate of the lower edge of the septum secundum after birth?

<p>It forms the annulus ovalis.</p> Signup and view all the answers

What are the consequences of tricuspid stenosis combined with mitral regurgitation on the heart's septal structure?

<p>They result in the septum intermedium deviating to the right side.</p> Signup and view all the answers

Describe the contribution of the AV canal in the formation of the inter-atrial septum.

<p>The mesodermal cushion in the AV canal, known as the septum intermedium, plays a crucial role in septal development.</p> Signup and view all the answers

What is the significance of the foramen ovale in fetal circulation?

<p>The foramen ovale allows blood to bypass the non-functioning fetal lungs.</p> Signup and view all the answers

What is the relationship between the ostium primum and septum primum during inter-atrial septum development?

<p>The ostium primum forms as the septum primum grows toward the septum intermedium.</p> Signup and view all the answers

What determines the division of the truncus arteriosus into the pulmonary trunk and ascending aorta?

<p>The growth of two cushions in a spiral manner forms the aortico-pulmonary septum.</p> Signup and view all the answers

What characterizes persistent truncus arteriosus in embryological development?

<p>Persistent truncus arteriosus is characterized by the failure of aortico-pulmonary septum formation, often accompanied by membranous VSD.</p> Signup and view all the answers

How does the configuration of the aortico-pulmonary septum influence the position of the pulmonary trunk relative to the ascending aorta?

<p>Initially, the pulmonary trunk lies anterior to the ascending aorta, then shifts to the right, and finally moves posterior.</p> Signup and view all the answers

What are the four primary defects associated with Fallot's Tetralogy?

<p>Pulmonary stenosis, right ventricular hypertrophy, ventricular septal defect (VSD), and overriding aorta.</p> Signup and view all the answers

What is the significance of the hollowing out of the upper surface of the semilunar valve cusps during development?

<p>The hollowing out allows the cusp to properly open and close during the cardiac cycle.</p> Signup and view all the answers

What role does the left horn of the aortic sac play in embryological heart development?

<p>The left horn of the aortic sac forms the aortic arch between the brachiocephalic artery and the left common carotid artery.</p> Signup and view all the answers

What are the potential anomalies resulting from improper development of the semilunar valves?

<p>Anomalies include pulmonary stenosis, aortic stenosis, pulmonary atresia, and aortic atresia.</p> Signup and view all the answers

In the context of cardiac development, what is the role of the endocardial cushions?

<p>Endocardial cushions are critical in forming the semilunar valves and dividing the heart chambers.</p> Signup and view all the answers

Explain the outcome of the right 6th aortic arch during development.

<p>It forms the proximal part of the pulmonary artery while its distal part degenerates.</p> Signup and view all the answers

What occurs to the 5th aortic arch during embryological development?

<p>The 5th aortic arch degenerates.</p> Signup and view all the answers

What is transposition of the great vessels, and what causes this condition in embryonic development?

<p>Transposition of the great vessels occurs when the aortico-pulmonary septum follows a straight course instead of a spiral one.</p> Signup and view all the answers

What parts of the heart are formed by the rough inflowing and smooth outflowing portions of the right and left ventricles?

<p>The right ventricle consists of a rough inflowing part from the right primitive ventricle and a smooth outflowing infundibulum.</p> Signup and view all the answers

Describe the primary characteristic of Fallot's pentalogy.

<p>Fallot's pentalogy includes the defects of Fallot's tetralogy plus an atrial septal defect (ASD).</p> Signup and view all the answers

What is the significance of the recurrent laryngeal nerve in embryonic heart development?

<p>It initially hooks around the distal part of the 6th aortic arch during development.</p> Signup and view all the answers

What vessels arise from the 4th aortic arch on both sides?

<p>The right 4th aortic arch forms part of the right subclavian artery, while the left forms the aortic arch between the left common carotid and left subclavian arteries.</p> Signup and view all the answers

What was the initial fate of the aortic sac during the development of the cardiovascular system?

<p>The aortic sac forms the aortic arch proximal to the brachiocephalic artery.</p> Signup and view all the answers

Flashcards

Fetal circulation

The passage of blood through the fetus before birth.

Oxygenated blood flow in fetal circulation

The oxygenated blood from the placenta enters the fetus through the left umbilical vein, travels to the liver, then through the ductus venosus, and finally to the inferior vena cava.

Ductus arteriosus

The ductus arteriosus is a blood vessel that connects the pulmonary artery to the aorta, allowing blood to bypass the lungs in the fetus.

Foramen ovale

The foramen ovale is an opening between the right and left atria of the heart, allowing blood to bypass the lungs in the fetus.

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Postnatal cardiovascular changes

The process of changes that occur in the cardiovascular system immediately after birth.

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Functional closure of the foramen ovale

The functional closure of the foramen ovale is due to an increase in pressure in the left atrium and a decrease in pressure in the right atrium.

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Functional closure of the ductus arteriosus

The ductus arteriosus functionally closes due to the contraction of its muscle layer.

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Development of the Cardiovascular System (CVS)

The development of the circulatory system begins early in embryonic development.',

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Septum Intermedium

A structure that contributes to both the inter-atrial and membranous inter-ventricular septa during heart development.

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Tricuspid Stenosis

A condition where the tricuspid valve narrows, restricting blood flow from the right atrium to the right ventricle. This can lead to a shift of the septum intermedium to the right.

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Mitral Regurgitation

A condition where the mitral valve doesn't close properly, allowing blood to leak back into the left atrium.

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Tricuspid Regurgitation

A condition where the tricuspid valve doesn't close properly, allowing blood to leak back into the right atrium.

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Mitral Atresia

A condition where the mitral valve doesn't form properly, leading to an obstruction of blood flow from the left atrium to the left ventricle.

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Septum Primum

A C-shaped membrane that develops in the atrial wall. It grows towards the septum intermedium, leaving an opening called the ostium primum.

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Septum Secundum

A thinner membrane that forms to the right of the septum primum in the developing heart. This creates a passage called the foramen ovale.

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What are the three parts of the developing heart tube?

The heart tube bends into an S-shape during development, forming three distinct parts: the right limb (formed by the truncus arteriosus and bulbus cordis), the transverse limb (formed by the primitive ventricle), and the left limb (formed by the primitive atrium and sinus venosus).

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What is dextrocardia?

A condition where the heart is positioned as a mirror image of its normal position, sometimes accompanied by reversal of all abdominal organs.

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What is ectopia cordis?

A birth defect where the chest wall fails to close completely, leaving the heart exposed through a hole in the sternum.

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Describe the development of the sinus venosus.

The sinus venosus develops from a body and two horns. The right horn becomes larger than the left, and the sino-atrial valve becomes vertical due to blood shift and liver development on the right side.

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What are the fates of the sinus venosus components?

The sinus venosus contributes to the formation of various structures: the right horn becomes the posterior smooth part of the right atrium, the left horn and body form the coronary sinus, and the left sino-atrial valve is absorbed into the interatrial septum. The right sino-atrial valve becomes the crista terminalis, valves of the inferior vena cava, and the valve of the coronary sinus.

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How does the atrio-ventricular canal become divided?

The atrio-ventricular canal is divided into right and left halves by anterior and posterior cushions during development.

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What are the fates of the different parts of the atrio-ventricular canal?

The upper part of the atrio-ventricular canal is absorbed into the atria, the lower part is absorbed into the ventricles, and the central part contributes to the formation of the tricuspid and mitral valves.

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Explain the importance of the bending and division of the heart tube during development.

The developing heart tube undergoes bending and division, leading to the formation of distinct chambers and valves. This process is crucial for creating the functional heart.

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What is Tetralogy of Fallot?

A common congenital heart defect characterized by a narrowing of the pulmonary valve, thickening of the right ventricle wall, a hole between the ventricles known as a ventricular septal defect, and the aorta originating above the ventricular septal defect.

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What is Pentalogy of Fallot?

A rare variation of Tetralogy of Fallot where in addition to the four defects, there is an atrial septal defect, a hole in the wall between the atria of the heart.

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What does the left horn of the aortic sac form?

The structure that forms the proximal part of the aortic arch between the brachiocephalic artery and the left common carotid artery.

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What does the right horn of the aortic sac form?

The structure that forms the brachiocephalic artery.

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What does the sixth aortic arch form on the left side?

The artery that forms from the proximal part of the sixth aortic arch on the left side.

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What does the sixth aortic arch form on the left side (distal part)?

The artery that forms from the distal part of the sixth aortic arch on the left side.

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What does the sixth aortic arch form on the right side?

The artery that forms from the proximal part of the sixth aortic arch on the right side.

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What does the sixth aortic arch form on the right side (distal part)?

The artery formed by the degeneration of the distal part of the sixth aortic arch on the right side.

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Patent Foramen Ovale (PFO)

A congenital heart defect that occurs when the foramen ovale, a hole between the right and left atria of the heart, fails to close after birth. Oxygenated blood can leak to the right atrium, bypassing the lungs.

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Trilocuar Biventricular Heart

This rare condition occurs when the septum primum and septum secundum, two parts of the interatrial septum, fail to fuse completely, resulting in a heart with three chambers instead of the usual four.

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Ventricular Septal Defect (VSD)

A congenital heart defect characterized by a persistent opening between the right and left ventricles, commonly in the membranous part of the interventricular septum. It is the second most common type of congenital heart defect.

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Muscular Ventricular Septal Defect

This type of VSD occurs when the muscular portion of the interventricular septum fails to develop properly.

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Persistent Interventricular Foramen (Roger Disease)

A type of interventricular septal defect that occurs when the interventricular foramen, the opening between the right and left ventricles, fails to close. This is a common type of VSD and is also known as 'Roger Disease'.

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Interventricular Septum: Muscular & Membranous

The interventricular septum is a wall that separates the right and left ventricles of the heart. It has two parts: a muscular part and a membranous part.

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Bulbus Cordis Development

Two bulbar cushions develop and fuse to form a septum, dividing the bulbus cordis into right and left halves. This septum contributes to the formation of the ventricles.

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Bulbus Cordis Fate

The septum formed in the bulbus cordis contributes to the formation of important parts of the ventricles. The proximal part forms the muscular parts, while the middle part forms the infundibulum and vestibule.

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What do the aortic and pulmonary valves develop from?

The distal end of the bulbus cordis develops into the aortic and pulmonary valves.

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How does the right ventricle develop?

The right ventricle develops from the right half of the primitive ventricle, the absorbed part of the right atrioventricular canal, and a smooth outflowing wall formed from the bulbus cordis.

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How does the left ventricle develop?

The left ventricle develops from the left half of the primitive ventricle, the absorbed part of the left atrioventricular canal, and a smooth outflowing wall formed from the bulbus cordis.

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How do the pulmonary and aortic orifices form?

The endocardial cushions develop in the upper part of the bulbus cordis, fusing to form the pulmonary and aortic orifices.

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What are some anomalies that can occur with the development of the semilunar valves?

Pulmonary stenosis or atresia, and aortic stenosis or atresia are anomalies that can occur in the development of the semilunar valves.

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How does the truncus arteriosus divide into the pulmonary trunk and ascending aorta?

Two cushions grow spirally in the truncus arteriosus, forming the aortico-pulmonary septum and dividing the truncus into the pulmonary trunk and ascending aorta.

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Describe the positional changes of the pulmonary trunk and ascending aorta during development.

The spiral course of the aortico-pulmonary septum explains the changing positions of the pulmonary trunk and ascending aorta. At first, the pulmonary trunk is anterior to the ascending aorta. Then the pulmonary trunk is to the right of the ascending aorta. Finally, the pulmonary trunk is posterior to the ascending aorta.

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What is persistent truncus arteriosus (PTA)?

Persistent truncus arteriosus (PTA) is a condition where the aortico-pulmonary septum fails to form, resulting in a single truncus arteriosus and a membranous ventricular septal defect (VSD).

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Functional closure of fetal pathways

The foramen ovale closes due to higher pressure in the left atrium and lower pressure in the right atrium, while the ductus arteriosus closes due to muscle contraction.

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Mixing of oxygenated and deoxygenated blood in the aorta

The aorta, the main artery that transports blood to the body, receives blood from both the left ventricle (oxygenated) and the ductus arteriosus (partially oxygenated).

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Heart development timing

The heart is the second organ system to develop, starting to beat on the 22nd day of pregnancy.

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Origin of the heart tube

The heart tube develops from specialized cells called angioplastic cells and myo-epithelial mantle cells.

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Segments of the developing heart

The heart tube forms five distinct segments: sinus venosus, primitive atrium, primitive ventricle, bulbus cordis, and truncus arteriosus.

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Atrial septum formation

The septum primum and septum secundum, two membranes in the atrial wall, eventually fuse to form the interatrial septum, separating the atria.

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Atrioventricular canal division

The atrioventricular canal is divided into right and left parts by two cushion-like structures, forming the openings for the tricuspid and mitral valves.

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Describe the development of the bulbus cordis.

Two bulbar cushions develop and fuse to form a septum, dividing the bulbus cordis into right and left halves. This septum contributes to the formation of the ventricles.

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Fossa Ovalis

The remnant of the septum primum after the foramen ovale closes. You can see it as a depression in the right atrium.

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Annulus Ovalis

The lower edge of the septum secundum after the foramen ovale closes. It's like a ring or a border around the fossa ovalis.

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Bulbus cordis and valve formation

The distal part of the bulbus cordis, a structure that forms the ventricles, gives rise to the aortic and pulmonary valves, which control blood flow out of the heart.

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Right Ventricle Formation

The right ventricle is formed from several parts, including the right half of the primitive ventricle, a portion of the right atrioventricular canal, and a smooth outflowing wall derived from the bulbus cordis, which forms the infundibulum.

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Left Ventricle Formation

The left ventricle is formed by the left half of the primitive ventricle, a portion of the left atrioventricular canal, and a smooth outflowing wall from the bulbus cordis which forms the vestibule.

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Semilunar Valve Development

Endocardial cushions develop in the bulbus cordis and fuse, creating two orifices: the pulmonary orifice and the aortic orifice. These orifices are the beginnings of the pulmonary valve and the aortic valve.

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Truncus Arteriosus Division

The truncus arteriosus, which is a single vessel before splitting, is divided into the pulmonary trunk and the ascending aorta by a spirally-growing structure called the aortico-pulmonary septum.

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Persistent Truncus Arteriosus (PTA)

Persistent truncus arteriosus (PTA) occurs when the aortico-pulmonary septum fails to form completely. This leads to a single vessel connecting the ventricles to the major arteries of the body, along with a membranous ventricular septal defect (VSD).

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Transposition of Great Vessels (TGA)

The aortico-pulmonary septum grows in a straight line instead of its normal spiral shape. This means the aorta connects to the right ventricle and the pulmonary trunk connects to the left ventricle, which is the opposite of their normal arrangement.

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Functional Closure of Foramen Ovale

The foramen ovale, a passageway between the atria, closes due to increased pressure in the left atrium and decreased pressure in the right atrium.

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What does the sixth aortic arch form on the left side (proximal part)?

The artery that forms from the proximal part of the sixth aortic arch on the left side.

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What does the sixth aortic arch form on the right side (proximal part)?

The artery that forms from the proximal part of the sixth aortic arch on the right side.

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Study Notes

Embryology of the CVS

  • The cardiovascular system (CVS) is the second system to develop after the central nervous system (CNS).
  • The first heartbeat is detected at 22 days (4th week) in utero.
  • Fetal circulation involves oxygenated blood from the placenta traveling via the umbilical vein to the liver, then through the ductus venosus to the inferior vena cava (IVC).
  • Additional blood enters the right atrium from the superior vena cava (SVC).
  • Most of the blood from the right atrium flows to the left atrium through the foramen ovale.
  • A smaller amount flows into the right ventricle and then into the pulmonary trunk (directed towards the lungs).
  • Blood from the right ventricle then bypasses the lungs through the ductus arteriosus to the descending aorta.
  • The less oxygenated blood is transported through the umbilical arteries.
  • Blood mixing occurs in the liver sinusoids, IVC, right atrium, and left atrium.
  • The heart tube develops from the cardiogenic mesoderm and fuses to form a single tube.
  • The tube is divided into five segments: sinus venosus, primitive atrium, primitive ventricle, bulbus cordis, and truncus arteriosus.
  • The heart tube bends into an S-shape as it develops, forming the right and left limbs.
  • The right limb involves the truncus arteriosus and bulbus cordis.
  • The transverse limb arises from the primitive ventricle.
  • The left limb involves the primitive atrium and sinus venosus.
  • The sinus venosus develops into the posterior smooth part of the right atrium.
  • The left horn and body of the sinus venosus become the coronary sinus.
  • The atrioventricular (AV) canal is divided into right and left halves by anterior and posterior cushions.
  • The upper part of the AV canal is absorbed into the atria.
  • The lower part of the AV canal is absorbed into the ventricles.
  • The central part of the AV canal contributes to the formation of tricuspid and mitral valves.
  • The interatrial septum is formed of mesodermal cushions.
  • A C-shaped septum primum grows towards the septum intermedium with an ostium primum.
  • The ostium primum closes, and an ostium secundum appears later.
  • A septum secundum forms a passage called the foramen ovale.
  • The right atrium is formed from the right half of the primitive atrium and absorbed portions of the right AV canal and sinus venosus.
  • The left atrium develops from the left half of the primitive atrium and absorbed sections of the left AV canal and pulmonary veins.
  • The interventricular septum is formed by muscular and membranous parts.
  • The bulbus cordis differentiates into right and left ventricles, as well as the infundibulum of the right and the vestibule of the left ventricle.
  • The development of the semilunar valve involves endocardial cushions within the bulbus cordis.
  • The development of aortic arches begins with the aortic sac which forms parts of the great vessels and eventually the arch of the aorta.
  • Aortic arches also form various arteries.
  • The fetal ductus arteriosus and foramen ovale close after birth. The ductus arteriosus contributes to the development of the ligamentum arteriosum.

Anomalies

  • Dextrocardia: The heart is in the mirror image position.
  • Ectopia cordis: The heart is exposed outside the thorax.
  • ASD (atrial septal defect): Persistent ostium primum or secundum, persistent ostium secundum.
  • VSD (ventricular septal defect): The interventricular septum fails to close, persistent interventricular foramen.
  • PTA (persistent truncus arteriosus): Failure of the aorticopulmonary septum formation.
  • TGA (transposition of the great vessels): Abnormalities in the connection of the aorta and the pulmonary trunk from the ventricles, straight course of aorticopulmonary septum, aorta connected to right ventricle and pulmonary trunk connecting to left ventricle.
  • Fallot's tetralogy: Includes pulmonary stenosis, right ventricular hypertrophy, a ventricular septal defect (VSD), overriding aorta and a variable right ventricular outflow obstruction.
  • Persistent ductus arteriosus: The duct connecting the aorta and the pulmonary artery persists.
  • Aortic coarctation: Narrowing of the aorta. There are pre-ductal and post-ductal types. Pre-ductal coarctation is proximal to the ductus arteriosus; post-ductal is distal.

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