Podcast
Questions and Answers
Failure of the ductus arteriosus to close after birth is most commonly observed in which population?
Failure of the ductus arteriosus to close after birth is most commonly observed in which population?
- Infants with chromosomal abnormalities
- Premature infants (correct)
- Full-term infants
- Infants with congenital heart defects
Which of the following structures is responsible for directing blood from the umbilical vein to the inferior vena cava (IVC) in fetal circulation?
Which of the following structures is responsible for directing blood from the umbilical vein to the inferior vena cava (IVC) in fetal circulation?
- Ductus venosus (correct)
- Umbilical artery
- Foramen ovale
- Ductus arteriosus
In fetal circulation, what is the primary function of the foramen ovale?
In fetal circulation, what is the primary function of the foramen ovale?
- To bypass the ventricles
- To direct blood from the umbilical vein to the inferior vena cava
- To allow blood to flow from the right atrium to the left atrium (correct)
- To shunt blood from the pulmonary artery to the aorta
Which of the following cardiac events occurs earliest during embryonic development?
Which of the following cardiac events occurs earliest during embryonic development?
During which week of embryonic development does the heartbeat typically begin?
During which week of embryonic development does the heartbeat typically begin?
Which of the following best describes the direction of cardiac looping during embryonic development?
Which of the following best describes the direction of cardiac looping during embryonic development?
What is the origin of the heart tissue during embryonic development?
What is the origin of the heart tissue during embryonic development?
Which of the following best describes the function of the endocardial cushions in heart development?
Which of the following best describes the function of the endocardial cushions in heart development?
A newborn is diagnosed with persistent fetal circulation. Which fetal shunt failed to close properly?
A newborn is diagnosed with persistent fetal circulation. Which fetal shunt failed to close properly?
A baby is born with only one umbilical artery. This condition raises concern for:
A baby is born with only one umbilical artery. This condition raises concern for:
A child is diagnosed with Tetralogy of Fallot (TOF). Which of the following is NOT a component of TOF?
A child is diagnosed with Tetralogy of Fallot (TOF). Which of the following is NOT a component of TOF?
Which heart sound correlates with the closure of the mitral and tricuspid valves?
Which heart sound correlates with the closure of the mitral and tricuspid valves?
In which area of the chest is S1 typically heard best?
In which area of the chest is S1 typically heard best?
What causes cyanosis in right-to-left shunting?
What causes cyanosis in right-to-left shunting?
What physiological process leads to pulmonary hypertension in left-to-right shunting?
What physiological process leads to pulmonary hypertension in left-to-right shunting?
Which of the following terms best describes the sound produced by turbulent blood flow in the heart?
Which of the following terms best describes the sound produced by turbulent blood flow in the heart?
Which of the following is NOT a cause of heart murmurs?
Which of the following is NOT a cause of heart murmurs?
Which of the following is a category of cyanotic heart diseases?
Which of the following is a category of cyanotic heart diseases?
A patient is diagnosed with tricuspid atresia. What does this condition entail?
A patient is diagnosed with tricuspid atresia. What does this condition entail?
A Still's murmur is most commonly heard in children of what age range?
A Still's murmur is most commonly heard in children of what age range?
When auscultating a Still's murmur, what action typically makes the murmur disappear or soften?
When auscultating a Still's murmur, what action typically makes the murmur disappear or soften?
What is a key characteristic of a venous hum that distinguishes it from other murmurs?
What is a key characteristic of a venous hum that distinguishes it from other murmurs?
What physical action typically makes a venous hum disappear?
What physical action typically makes a venous hum disappear?
A peripheral pulmonic stenosis murmur in a newborn is characterized by radiation to which areas?
A peripheral pulmonic stenosis murmur in a newborn is characterized by radiation to which areas?
What is the typical cause of pulmonary and aortic flow murmurs?
What is the typical cause of pulmonary and aortic flow murmurs?
Under what conditions are pulmonary and aortic flow murmurs most likely to be heard?
Under what conditions are pulmonary and aortic flow murmurs most likely to be heard?
A clinician detects a heart murmur described as 'sensitive, short duration, soft, single, small, sweet, and systolic'. Which of the following is the most likely type of murmur?
A clinician detects a heart murmur described as 'sensitive, short duration, soft, single, small, sweet, and systolic'. Which of the following is the most likely type of murmur?
A newborn presents with cyanosis shortly after birth. The echocardiogram reveals a single vessel leaving the heart. Which cyanotic heart defect is most likely?
A newborn presents with cyanosis shortly after birth. The echocardiogram reveals a single vessel leaving the heart. Which cyanotic heart defect is most likely?
A newborn presents with cyanosis. Upon examination, it is determined that the aorta arises from the right ventricle and the pulmonary artery arises from the left ventricle. Which congenital heart defect is most likely?
A newborn presents with cyanosis. Upon examination, it is determined that the aorta arises from the right ventricle and the pulmonary artery arises from the left ventricle. Which congenital heart defect is most likely?
Which of the following is a cyanotic heart defect characterized by the absence of a tricuspid valve, resulting in no direct communication between the right atrium and right ventricle?
Which of the following is a cyanotic heart defect characterized by the absence of a tricuspid valve, resulting in no direct communication between the right atrium and right ventricle?
During an examination of a child, a physician identifies the classic components of Tetralogy of Fallot (TOF). Which of the following defects is included in this tetralogy?
During an examination of a child, a physician identifies the classic components of Tetralogy of Fallot (TOF). Which of the following defects is included in this tetralogy?
A neonate is diagnosed with Total Anomalous Pulmonary Venous Return (TAPVR). What is the key characteristic of this condition?
A neonate is diagnosed with Total Anomalous Pulmonary Venous Return (TAPVR). What is the key characteristic of this condition?
Which of the following defects is associated with the abnormal movement of blood from the aorta to the pulmonary artery?
Which of the following defects is associated with the abnormal movement of blood from the aorta to the pulmonary artery?
In Coarctation of the Aorta, where is the aorta narrowed?
In Coarctation of the Aorta, where is the aorta narrowed?
What condition is defined by the presence of two aortic arches surrounding the trachea and esophagus?
What condition is defined by the presence of two aortic arches surrounding the trachea and esophagus?
What abnormality is indicated by the terms double or absent IVC (Inferior Vena Cava) or SVC ( Superior Vena Cava)?
What abnormality is indicated by the terms double or absent IVC (Inferior Vena Cava) or SVC ( Superior Vena Cava)?
What does PFO stand for, in the context of circulatory system defects?
What does PFO stand for, in the context of circulatory system defects?
Where might you find a click, when listening to heart sounds?
Where might you find a click, when listening to heart sounds?
What does S2 correlate with?
What does S2 correlate with?
Flashcards
Heart Origin
Heart Origin
Develops from mesoderm and is the first functional organ.
Endocardial Cushions
Endocardial Cushions
Divide to form the left/right AV canals and develop into valves.
Day 18-20
Day 18-20
Heart appears.
Day 20
Day 20
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Day 21
Day 21
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Day 22
Day 22
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Day 22-23
Day 22-23
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Day 23-28
Day 23-28
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Week 4
Week 4
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Week 4
Week 4
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Week 5
Week 5
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Umbilical Cord (Week 5)
Umbilical Cord (Week 5)
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Week 8
Week 8
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Foramen Ovale
Foramen Ovale
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Ductus Arteriosus
Ductus Arteriosus
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Ductus Venosus
Ductus Venosus
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Endocardial cushion/septal defects
Endocardial cushion/septal defects
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One Umbilical Artery
One Umbilical Artery
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Arterial Defects
Arterial Defects
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Venous Defects
Venous Defects
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S1 Heart Sound
S1 Heart Sound
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S2 Heart Sound
S2 Heart Sound
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Heart Clicks
Heart Clicks
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Right-to-Left Shunt
Right-to-Left Shunt
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Left-to-Right Shunt
Left-to-Right Shunt
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Heart Murmur
Heart Murmur
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Cyanotic Heart Diseases
Cyanotic Heart Diseases
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Still's Murmur
Still's Murmur
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Venous Hum
Venous Hum
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Peripheral Pulmonic Stenosis
Peripheral Pulmonic Stenosis
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Pulmonary and Aortic Flow Murmur
Pulmonary and Aortic Flow Murmur
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Study Notes
- The heart is the first organ to functionally develop, originating from the mesoderm.
- Endocardial cushions develop to separate the heart into left, right, upper, and lower chambers.
- These cushions divide into left and right atrioventricular canals and thin to form the valves.
- Heart development timeline:
- 18-20 days: Heart appears.
- 20 days: Two separate heart tubes.
- 21 days: Fused heart tubes.
- 22 days: Fused heart tubes with primitive atrium and ventricles.
- 22-23 days: Heartbeat starts.
- 23-28 days: Cardiac looping (to the right, out counterclockwise).
- 28 days (4th week): Blood circulation begins.
- Week 4: Atrial septation, ventricular septation.
- Week 5: Truncus swelling, umbilical cord development.
- Week 8: Fully functioning, fully formed heart.
Umbilical Cord Composition
- Two umbilical arteries carry depleted blood from fetus to mother.
- One umbilical vein carries oxygenated blood from mother to fetus.
- Wharton's jelly surrounds and protects these vessels.
Fetal Shunts
- Foramen ovale: Shunts blood from right atrium to left atrium, bypassing the right ventricle.
- Ductus arteriosus: Shunts blood from pulmonary artery to aorta. Failure to close is common in premature infants.
- Ductus venosus: Shunts blood from umbilical vein to inferior vena cava (IVC) and right atrium.
Endocardial Cushion/Septal Defects
- Atrial Septal Defect (ASD).
- Ventricular Septal Defect (VSD).
- Tetralogy of Fallot (TOF).
- Transposition of the Great Vessels (TGA).
Circulatory System Defects
- One umbilical artery is linked to chromosomal abnormalities and congenital defects.
- Arterial defects include:
- Patent Ductus Arteriosus (PDA).
- Coarctation of the aorta.
- Double aortic arch.
- Venous defects include double or absent IVC or SVC.
- Patent Foramen Ovale (PFO).
Heart Sounds
- S1: Closure of mitral and tricuspid valves; heard at the lower left sternal border or apex.
- S2: Closure of semilunar valves.
- Clicks: Associated with valvular disease.
Shunting
- Right-to-left shunting: Causes cyanosis because blood bypasses the lungs.
- Left-to-right shunting: Causes back leak of blood from systemic to pulmonary circulation, leading to pulmonary hypertension.
Murmurs
- Whooshing or swishing sounds caused by:
- Increased flow.
- Obstructed flow.
- Regurgitant flow.
- Turbulent flow of blood.
- The "seven S's" of murmurs: Sensitive, Short duration, Soft, Single, Small, Sweet, Systolic.
Cyanotic Diseases
- Truncus arteriosus: One vessel leaves the heart instead of two.
- Transposition of the Great Arteries (TGA): Great vessels are transposed.
- Tricuspid atresia: Tricuspid valve fails to form.
- Tetralogy of Fallot (TOF): Four heart defects occur together.
- Total Anomalous Pulmonary Venous Return (TAPVR): No pulmonary artery.
Murmur Characteristics by Type
- Stills murmur:
- Age range: 2-8 years old.
- Grade 1-3 murmur.
- Loud in supine position.
- Most common innocent murmur.
- Goes away with bearing down.
- Venous hum:
- Age range: 2-5 years old.
- Grade 1-3 murmur.
- Soft, continuous sound.
- Heard while sitting down.
- Disappears in supine position or with neck extension.
- Peripheral pulmonic stenosis:
- Newborns to 6 months.
- Grade 1-3 murmur.
- Radiation to axilla and back.
- Turbulent flow across pulmonary arteries.
- Pulmonary and aortic flow murmur:
- Any age.
- Grade 1-2 murmur.
- Can happen with fever, dehydration, or anemia.
- Occurs after illness.
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