Podcast
Questions and Answers
Which structure allows blood to flow directly from the right atrium to the left atrium, bypassing the right ventricle?
Which structure allows blood to flow directly from the right atrium to the left atrium, bypassing the right ventricle?
- Portal vein
- Foramen ovale (correct)
- Ductus venosus
- Ductus arteriosus
What is the postnatal derivative of the umbilical vein?
What is the postnatal derivative of the umbilical vein?
- Medial umbilical ligaments
- Median umbilical ligament
- Fossa ovalis
- Ligamentum teres hepatis (correct)
Which vein carries blood with high oxygen saturation from the placenta to the fetus?
Which vein carries blood with high oxygen saturation from the placenta to the fetus?
- Superior vena cava
- Umbilical vein (correct)
- Portal vein
- Inferior vena cava
What is the fate of the ductus arteriosus after birth?
What is the fate of the ductus arteriosus after birth?
Where does the blood from the superior vena cava travel to in fetal circulation?
Where does the blood from the superior vena cava travel to in fetal circulation?
Which fetal structure transforms into the median umbilical ligament after birth?
Which fetal structure transforms into the median umbilical ligament after birth?
At what week of development does the heart begin to beat spontaneously in vertebrate embryos?
At what week of development does the heart begin to beat spontaneously in vertebrate embryos?
What structure develops to maintain right-to-left shunt in the heart during septation?
What structure develops to maintain right-to-left shunt in the heart during septation?
When do the septum primum and septum secundum typically fuse completely?
When do the septum primum and septum secundum typically fuse completely?
What is the main consequence of a patent foramen ovale?
What is the main consequence of a patent foramen ovale?
What is a potential risk associated with atrial septal defects (ASD)?
What is a potential risk associated with atrial septal defects (ASD)?
Which structure grows towards the endocardial cushions during septation of the chambers?
Which structure grows towards the endocardial cushions during septation of the chambers?
What is the formula for resistance in a blood vessel?
What is the formula for resistance in a blood vessel?
How does the resistance of blood vessels vary with the radius?
How does the resistance of blood vessels vary with the radius?
Which blood vessels have the highest total cross-sectional area and the lowest flow velocity?
Which blood vessels have the highest total cross-sectional area and the lowest flow velocity?
Which of the following accounts for most of the total peripheral resistance (TPR) in the circulatory system?
Which of the following accounts for most of the total peripheral resistance (TPR) in the circulatory system?
What happens to viscosity in hyperproteinemic states?
What happens to viscosity in hyperproteinemic states?
What changes in venous return alter stroke volume (SV) and cardiac output (CO)?
What changes in venous return alter stroke volume (SV) and cardiac output (CO)?
What is an example of a positive inotropic agent?
What is an example of a positive inotropic agent?
How does exercise affect total peripheral resistance (TPR)?
How does exercise affect total peripheral resistance (TPR)?
Which part of the heart is the most posterior?
Which part of the heart is the most posterior?
What symptom can enlargement of the left atrium cause due to compression of the left recurrent laryngeal nerve?
What symptom can enlargement of the left atrium cause due to compression of the left recurrent laryngeal nerve?
Which layer of the pericardium is innervated by the phrenic nerve?
Which layer of the pericardium is innervated by the phrenic nerve?
Which artery most commonly supplies the AV and SA nodes?
Which artery most commonly supplies the AV and SA nodes?
In right-dominant circulation, which artery does the posterior descending artery arise from?
In right-dominant circulation, which artery does the posterior descending artery arise from?
Which artery is most commonly occluded in coronary artery disease?
Which artery is most commonly occluded in coronary artery disease?
Where does the coronary sinus drain into?
Where does the coronary sinus drain into?
What percentage of the inferior (diaphragmatic) surface of the heart does the left ventricle comprise?
What percentage of the inferior (diaphragmatic) surface of the heart does the left ventricle comprise?
What forms the membranous interventricular septum?
What forms the membranous interventricular septum?
Which structure is derived from the endocardial cushions of the outflow tract?
Which structure is derived from the endocardial cushions of the outflow tract?
Which congenital cardiac anomaly is most common?
Which congenital cardiac anomaly is most common?
What artery is derived from the 4th aortic arch on the right side?
What artery is derived from the 4th aortic arch on the right side?
What structure contributes to the formation of both the atrial and ventricular septa?
What structure contributes to the formation of both the atrial and ventricular septa?
The 3rd aortic arch gives rise to which arteries?
The 3rd aortic arch gives rise to which arteries?
Which condition is NOT associated with the failure of neural crest cells to migrate?
Which condition is NOT associated with the failure of neural crest cells to migrate?
What does the 1st aortic arch become?
What does the 1st aortic arch become?
Which equation correctly represents stroke volume?
Which equation correctly represents stroke volume?
What does the Fick principle for cardiac output (CO) involve?
What does the Fick principle for cardiac output (CO) involve?
Which factor directly influences pulse pressure (PP)?
Which factor directly influences pulse pressure (PP)?
How is mean arterial pressure (MAP) calculated using cardiac output (CO) and total peripheral resistance (TPR)?
How is mean arterial pressure (MAP) calculated using cardiac output (CO) and total peripheral resistance (TPR)?
Which condition is associated with an increase in pulse pressure (PP)?
Which condition is associated with an increase in pulse pressure (PP)?
In which situation would you observe a decreased pulse pressure (PP)?
In which situation would you observe a decreased pulse pressure (PP)?
What is the effect of increased heart rate (HR) on diastole?
What is the effect of increased heart rate (HR) on diastole?
How is cardiac output (CO) maintained in the later stages of exercise?
How is cardiac output (CO) maintained in the later stages of exercise?
Which factor is proportional to the force of contraction of the heart?
Which factor is proportional to the force of contraction of the heart?
Which of the following is a positive inotrope?
Which of the following is a positive inotrope?
Which embryonic structure gives rise to the ascending aorta and pulmonary trunk?
Which embryonic structure gives rise to the ascending aorta and pulmonary trunk?
What does the primitive ventricle give rise to?
What does the primitive ventricle give rise to?
Which veins contribute to the formation of the inferior vena cava (IVC)?
Which veins contribute to the formation of the inferior vena cava (IVC)?
What does the endocardial cushion give rise to?
What does the endocardial cushion give rise to?
Which structure gives rise to both atria?
Which structure gives rise to both atria?
Which of the following conditions is associated with an increased preload?
Which of the following conditions is associated with an increased preload?
What is the main factor that approximates afterload?
What is the main factor that approximates afterload?
Which medication is known to decrease afterload?
Which medication is known to decrease afterload?
Which of the following increases myocardial oxygen demand?
Which of the following increases myocardial oxygen demand?
Which of the following substances increases contractility by inhibiting the Na+/K+ pump?
Which of the following substances increases contractility by inhibiting the Na+/K+ pump?
Which condition is likely to decrease contractility?
Which condition is likely to decrease contractility?
What defines wall stress in the context of Laplace's law?
What defines wall stress in the context of Laplace's law?
Which of the following decreases preload?
Which of the following decreases preload?
During which phase does the period of highest oxygen consumption occur?
During which phase does the period of highest oxygen consumption occur?
What heart sound is associated with the rapid ventricular filling phase?
What heart sound is associated with the rapid ventricular filling phase?
Which heart sound is normally loudest at the mitral area?
Which heart sound is normally loudest at the mitral area?
When does the 'v wave' in the jugular venous pulse occur?
When does the 'v wave' in the jugular venous pulse occur?
In which condition is the S4 heart sound commonly found?
In which condition is the S4 heart sound commonly found?
Which phase of the cardiac cycle immediately follows the aortic valve closing?
Which phase of the cardiac cycle immediately follows the aortic valve closing?
What does the 'x descent' in the jugular venous pulse signify?
What does the 'x descent' in the jugular venous pulse signify?
Which heart sound is heard during late diastole?
Which heart sound is heard during late diastole?
Study Notes
Embryonic Structure and Development
- Truncus arteriosus gives rise to ascening aorta and pulmonary trunk
- Bulbus cordis gives rise to smooth parts (outflow tract) of left and right ventricles
- Primitive ventricle gives rise to trabeculated part of left and right atria
- Endocardial cushion gives rise to atrial septum, membranous interventricular septum, AV and semilunar valves
- Right common cardinal vein and right anterior cardinal vein give rise to superior vena cava (SVC)
- Posterior cardinal, subcardinal, and supracardinal veins give rise to inferior vena cava (IVC)
- Primitive heart tube gives rise to both atria
- Sinus horn gives rise to right aortic roots
- Aortic roots give rise to left aortic roots
- Pericardial sac gives rise to pericardium
- Sinoatrial node gives rise to SA node
- Atrioventricular node gives rise to AV node
- Primitive ventricles give rise to ventricles
Cardiac Output Equations
- Stroke volume (SV) is equal to EDV - ESV
- Ejection fraction (EF) is equal to SV / EDV = (EDV - ESV) / EDV
- Cardiac output (CO) is equal to SV * HR
- Fick principle: CO = (rate of O2 consumption) / (arterial O2 content - venous O2 content)
- Pulse pressure (PP) is equal to systolic blood pressure (SBP) - diastolic blood pressure (DBP)
- Mean arterial pressure (MAP) is equal to CO * total peripheral resistance (TPR)
Starling Curves
- Normal (exercise)
- Normal (rest)
- Heart failure + positive inotrope
- Myocardial contractility
- Heart failure
Cardiovascular Physiology
- Isovolumetric contraction is the period between mitral valve closing and aortic valve opening
- Systolic ejection is the period between aortic valve opening and closing
- Isovolumetric relaxation is the period between aortic valve closing and mitral valve opening
- Rapid filling is the period just after mitral valve opening
- Reduced filling is the period just before mitral valve closing
Cardiac Cycle
- S1: mitral and tricuspid valve closure, loudest at mitral area
- S2: aortic and pulmonary valve closure, loudest at left upper sternal border
- S3: in early diastole during rapid ventricular filling phase, best heard at apex with patient in left lateral decubitus position
- S4: in late diastole ("atrial kick"), best heard at apex with patient in left lateral decubitus position
Jugular Venous Pulse (JVP)
- a wave: atrial contraction, prominent in AV dissociation (cannon a wave), absent in atrial fibrillation
- c wave: RV contraction (closed tricuspid valve bulging into atrium)
- x descent: atrial relaxation and downward displacement of closed tricuspid valve during rapid ventricular ejection phase, reduced or absent in tricuspid regurgitation and right HF
- v wave: increased RA pressure due to volume against closed tricuspid valve
- y descent: RA emptying into RV, prominent in constrictive pericarditis, absent in cardiac tamponade
Resistance, Pressure, Flow
- Volumetric flow rate (Q) is equal to flow velocity (v) x cross-sectional area (A)
- Resistance is equal to driving pressure (ΔΡ) / 8η (viscosity) x length / πr4
- Q α r4
- R α 1/r4
- Total resistance of vessels in series: R = R1 + R2 + R3 +...
- Total resistance of vessels in parallel: 1/R = 1/R1 + 1/R2 + 1/R3 +...
Cardiac and Vascular Function Curves
- Inotropy: changes in contractility → altered SV → altered CO/VR and RA pressure (RAP)
- Venous Return: changes in circulating volume → altered RAP → altered SV → change in CO
- Total Peripheral Resistance: changes in TPR → altered CO, change in RAP unpredictable
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Description
This quiz covers the formation of different heart structures from embryonic components. Learn about the development of aorta, ventricles, atria, and valves from their embryonic origins.
