types of cells that make up the fetus skin, hair, teeth, nervous system:
Ectoderm
types of cells that make up the fetus gut and all of the glands
endoderm
types of cells that make up the fetus heart
Mesoderm
the ____ is the first organ to complete its development.
heart
How many days does it take to develop a complete heart?
43 days
List the anatomy of the heart tube.
The sinus venosus
The common atrium
The common ventricle
Conus cordis
Truncus arteriosus
What part of the heart tube develops into the Aorta and Pulmonary Artery?
The truncus arteriosus
What part of the heart tube develops into the bulbus cordis?
Outlet of ventricles
What part of the heart tube develops into the inlet of ventricles?
The primitive/common ventricle
What part of the heart tube form the TV and the MV?
The Atrioventricular canal
What part of the hear tube develop the right and left atria?
The primitive atria
What part of the heart tube develops into the part of the right atrium?
The sinus venosus
What type of looping is normal?
Dextro or Levo
Dextro or d-looping is normal
the anterior portion loops to the right
What type of looping is abnormal?
Dextro or Levo
Levo or L-looping
Septation begins to take place about the 30th or 31st day. What develops first, the atria or the ventricles?
The atria
Endocardial cushions are also developing
During fetal development, when are the atria completely separated?
At no time during fetal development are the atria completely separated.
What is the opening that shunts blood between the right and left atria called?
The foramen ovale.
There is a flap that forms that covers the foramen ovale. In which atrium is this anchored?
LA
What possible defect develops if the septum in atria does not fuse?
ASD's
A.located near the atrioventricular valves, usually has valvular involvement.
B.located in the middle of the septum. Most common.
C. Located high in the atrium
A. Ostium primum
B. Ostium secundum
C. Sinus Venosus
When does the primitive ventricle grows and dilates?
There is communication between ventricles.
End of fourth week
What is the most common type of VSD?
Perimembranous – those defects that are located above the crista supraventricularis. Of the VSD’s 80% are this type. The communication is between the LV and RA.
What is the most common defect in infants?
VSD's
9- perimembranous
12- infracristal
3- supracristal
What defect can develop when the cushions fail to fuse?
What valves will be affected?
A persistent atrioventricular canal defect
The mitral and tricuspid valve
What defect is highly associated with Down's syndrome?
C. Endocardial cushion defect
The right atrium becomes exceptionally large and the right ventricle becomes small. There can be complete disruption of the conduction system resulting in a right bundle branch block. An anomalous pathway across the tricuspid valve can develop resulting in the Wolff-Parkinson-white syndrome.
Ebstein's Anomaly
The most frequent abnormality seen in this region occurs when there is unequal division of the conus, which results in a narrowed right ventricular outflow tract and a VSD. This is known as:
Tetralogy of Fallot. It makes up 10% of all congenital cases.
4 abnormalities that result in Tetralogy of Fallot
1. Infundibular stenosis aka narrowing of the PA
2.Ventricular septal defect
3.Right ventricular hypertrophy
4.Overriding aorta or dextropositioned aorta
Children will exhibit bluish skin during episodes of crying or feeding. This is known as:
A Tet spell
Toddlers will know when they are not oxygenating well enough and they will squat.
Defect where the Aortic Valve and the Pulmonic Valve are flip flopped. The shunt is in the RA.
What is given to a newborn to keep the heart shunt open?
Prostaglandins.
Transposition of the Great Arteries is more common in males or females?
Males
What surgical procedure is used to correct the transposition of the great arteries?
The Norwood procedure
This defect occurs when the loops does not twist to the right/left.
Right.
In the Corrected Transposition of the Great Arteries:
If it twists to the left, the anatomical right ventricle will be displaced ______ and _____. It becomes the arterial ventricle.
posteriorly and leftward.
In the Corrected Transposition of the Great Arteries:
The anatomical left ventricle will be displaced _____ and _____.
It becomes the venous ventricle.
anteriorly and rightward
Corrected Transposition of the Great Arteries
The EKG will represent what?
A complete heart block like the atria and ventricle are beating independently.
Not one of the pulmonary veins are connected
Total anomalous pulmonary venous return
One or more of the pulmonary veins does not go in to the left atrium.
aka PAPVR
Partial anomalous pulmonary venous return
Interruption of aortic arch- duct dependant lesion
Coarctation of the Aorta
3 types of coarctation's of the aorta
1.Preductal coarctation- have to the PDA open
2.Postductal coarctation- isthmus area
3. At the ductus
Prostaglandins keep the _____ _____ open when there is a coarctation.n
ductus arteriosus
What else occurs with the coarctation of the aorta?
Bicuspid AV- 50%
VSD w/ coarctation
more common in males
4 Types of Pulmonary Stenosis
Type 1: single, central stenosis
Type 2: Bifurcation stenosis
Type 3: Multiple, peripheral stenosis
Type 4: Central+peripheral stenosis
The patient is dependent on the ductus remaining open. Blood supply to the cerebral vessels and the coronary arteries is merely by retrograde flow. The right ventricle acts as the systemic ventricle due to the left ventricle being extremely small.
Hypoplastic Left Heart Syndrome
The majority of the IVC blood entering the right atrium is directed to a the left atrium though the _____ _____.
foramen ovale
__% goes to the coronary arteries and perfuses the myocardium.
__% travels in the carotid and subclavian vessels to upper body and brain.
__% passes into the descending aorta and is distributed to rest of body.
9
62
29
3 types of gestational shunts
1. Ductus venosus
2. Foramen ovale
3. Ductus arteriosus
Know how blood flows
While the baby is in utero, pulmonary vascular resistance is high or low?
High.
Pulmonary resistance is high so that blood goes through the ductus and out to the body.
After birth:
As the umbilical cord is clamped, or constricts naturally, the low-resistance placental flow is removed from the system, resulting in an increase in systemic vascular resistance.
