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When does the vascular system begin to develop
Week 3
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Blood vessel formation begins in what areas
Embryo and yolk sac
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The initial connection of the embryo to the placenta happens by when
Week 4
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The early vessels for the embryo and yolk sac are derived from
Splanchnic mesoderm
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What are the primitive cells that line cavities called, and what do they form
Angioblasts, endothelial lining of blood vessels
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What develops into the blood cells
Hemangioblasts
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What is vasculogenesis
Formation of blood vessels from no pre-existing vessels
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Angiogenesis
Branching of major vessels to form new vessels
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What is VEGF
Vascular Endothelial Growth factor, stimulates vessel growth
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What five paired arteries develop in association with pharyngeal/branchial arches
Aortic arches (cranio-caudal) 1,2,3,4,6 and attach to the truncus arteriosus
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Where do the aortic arches arise from and connect to
They arise cranially from the aortic sac on the distal part of the truncus arteriosus, and connect to the left and right dorsal aortae
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The dorsal aortae stay separate in the region of the aortic arches but fuse on the caudal portion to form what
Descending aorta (Fused from T4-L4)
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The first aortic arche develops into
Maxillary arteries (Internal axillary art.) but most of the arch degenerates before this
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The second aortic arch develops into
Hyoid artery with stapedial arteries arising from them
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The stapedial artery is transiently present in fetal life but connects what branches
Future external carotid artery to the internal carotid artery
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Persistent stapedial artery (PSA)
Is a condition that is usually manifest as a mass in the middle ear cavity
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The 3rd aortic arch develops into
Common carotid arteries and internal carotid arteries
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Asymmetry occurs with the aortic arch first in what branch and how
4th, Left side becomes arch of aorta, right side becomes right subclavian artery
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What is the distal portion of the right subclavian derived from
7th intersegmental artery
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What arises from the fifth aortic arch
Nothing
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Sixth aortic arch (asymmetric) develops into what
- Right side forms the right pulmonary artery
- Left side forms the ductus arteriosus and some of the left pulmonary artery
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The ductus arteriosus is known after birth as
Ligamentum arteriosum
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What nerve loops under the 6th aortic arch (Ductus Arteriosus)
Left recurrent laryngeal nerve
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What nerve branches at the ductus arteriosus
Vegus nerve, branches into the left vegus and left recurrent pharyngeal nerve
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What nerve loops under the right 4th aortic arch (right subclavian)
Right recurrent laryngeal, a branch of the right vegus nerve
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Coarctation of the aorta (CoA)
- A constriction or narrowing of the aorta, most commonly found distal to the left subclavian artery
- It can be classified however as pre or postductal
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If a patient has the condition of Coarctation Aorta that is preductal, what happens in the vasculature
- Patent Ductus arteriosus permits continuous blood flow to the inferior of the body by its connection to the pulmonary artery and then to the aorta below the constriction
- Most die within a few months
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Preductal Coarctation Aorta has what manifestations in the ventricles and why
RV hypertrophy due to the extra flow needed in the pulmonary artery, this leads to pulmonary hypertension
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Postductal Coarctation has what changes in vascularity to compensate
Collateral branches form via intercostal and thoracic arteries, fed by the internal thoracic artery
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Double aortic arch is when
Failure of the right dorsal aorta to regress making two dorsal aortae, this can cause a constriction of the esophagus and trachea
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When the yolk sac regresses, what happens to the vitelline arteries
- They form an anastomoses with the dorsal aorta and eventually develop into
- Celiac
- Superior mesenteric
- Inferior mesenteric
- "It's Vital to watch CSI"
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What are the umbilical arteries initially connected to
Dorsal Aortae in sacral region
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What happens to the umbilical arteries in the fifth week of development
They change from being connected to the dorsal aorta, and connect to internal iliac arteries
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What circulatory changes happen to the umbilical arteries at birth
- Umbilical arteries close a few minutes after birth (permanently 2-3 months)
- Proximal Umbilical art. are retained to form superior vesicle arteries (internal illiac)
- Distal parts are obliterated to yield medial umbilical ligaments
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What do the vitelline veins eventually form
- A plexus around the duodenum (portal vein)
- Left vitelline disintegrates
- Right vitelline enlarges and becomes the hepatic portion of the inferior vena cava
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What happens to the cardinal veins at the seventh week of development
- New cardinal veins develop
- Supracardinal - Drain body wall
- Subcardinal - Drain kidneys
- Sacrocardinal - Drain lower extremities
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The cardinal veins give rise to
Renal, Adrenal, gonadal, azygos, and hemiazygos veins.
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The inferior vena cava consists of what three segments
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What does the hepatic segment of the inferior vena cava derive from
Right vitelline vein
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What does the renal segment of the inferior vena cava derive from
Right subcardinal vein
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What does the postrenal vein derive from
Right sacrocardinal vein
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What does the superior vena cava form from
Anastomoses between the right common cardinal vein and the right anterior cardinal vein
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What does the left brachiocephalic do, and what vein is it derived from
- Functions to shunt systematic blood form the left to the right side of the body
- Anastomoses between the left and right anterior cardinal veins.
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What happens in blood circulation if the inferior vena cava and the hepatic segment fail to form
Blood from the caudal parts of the body drains via the azygos and hemiazygos veins into the superior vena cava
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What causes a double inferior vena cava
The left sacrocardinal vein fails to lose its connection with the left subcardinal vein
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What causes a left superior vena cava
Failure of the left anterior cardinal vein to obliterate
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What causes a double superior vena cava
The persistence of the left anterior cardinal vein and failure of left brachiocephalic vein to form
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What are the three shunts in the fetal circulation
- Ductus arteriosis (bypass lungs)
- Foramen ovale (bypass right ventricle)
- Ductus venosus (bypass liver)
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In an adult what does the ductus arteriosus end up forming
Ligamentum arteriosum
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What is the adult derivative of the ductus venosus, and umbilical vein
- Ligamentum venosum
- Ligamentum teres hepatic
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