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Heart Defects
Medical School Biochemistry
46
Other
Graduate
10/20/2011

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Cards

Term
What developmental process fails to give valve stenosis?
Definition
Apoptosis
Term
What can be the effect on the ventrical below the valve with stenosis?
Definition
Hypertrophy
Term
An atrial septal defect causes blood to flow in which direction?
Definition
left atrium to right.

Remember in infants their is, by design, a shunt in the atrial wall that flows right to left to circumvent the pulmonary system
Term
If an atrial septal defect is strong enough, what kind of presentation can be seen?
Definition
Cyanosis from poor perfusion
Term
What is a probe patent foramen ovale?
Definition
This is an atrial septal defect that results from poor fusion of the septum primum and secundum
Term
What is an ostium secondum atrial septal defect?
Definition
This is when the apoptotic event that forms the Ostium Secundum is misplaced resulting in open communication between atria
Term
What is the clinical effect on fetuses with atrial septal defects?
Definition
Nothing. Remember fetuses should have communication between atria. This becomes once fetus is born
Term
Ventricular Septal defects result in blood flow where?
Definition
from left ventricle into right ventricle
Term
What is the effect on the ventricles of a patient with a ventricular septal defect?
Definition
Right ventricular hypertrophy which can continue into heart failure if left alone for long enough
Term
What is a persistent atrioventricular canal?
Definition
This is when valves fail to form between atria-ventricles
Term
Persistant Atriventricular Canal is a defect associated with a failure of what developmental cells?
Definition
Endocardial cushions
Term
What is Pulmonary Atresia?
Definition
asymetric division of conus truncus. Results in a small and insufficent pulmonary artery
Term
How does transposition of the great vessels occur?
Definition
Insufficient spiraling of conal truncal ridge
Term
What is transposition of the great vessels?
Definition
When the outflow tracks (aorta and pulmonary artery) connect to the incorrect ventricle making two closed loops of circulation
Term
What is the clinical effect of a transposition of great vessels to a fetus?
Definition
Does not have a large impact since the fetus has an atrial shunt
Term
What is the tetralogy of fallot?
Definition
A set of four presenting congenital heart defects:

1: Pulmonary stenosis
2: Right ventricular hypertrophy
3: Overriding aorta
4: Ventricular septal defect

overriding aorta: overly large aorta that recieves blood flow from both ventricles
Term
What conducting system node develops first?
Definition
SA node
Term
Which node develops branches that provide the right and left ventricle?
Definition
AV node
Term
The cells that form the conductive system are differentiated?
Definition
Cardiac Myocytes
Term
What are the adult derivatives of the vitelline arteries?
Definition
GI and mesentary

specifically:
splenic, gastroduodenal, superior and inferior mesenteric and portal
Term
What are the adult derivatives of the umbilical arteries?
Definition
internal iliac and superior vesical arteries

also the medial umbilical ligaments
Term
What are the derivatives of the third aortic arch?
Definition
Common carotid and proximal internal carotid
Term
What are the derivatives of the fourth aortic arch?
Definition
Aorta (around the descending/arch area)
Term
What are the derivatives of the 6th aortic arch?
Definition
Ductus arteriosis
Term
What do the vitelline veins develop into?
Definition
Will connect to the liver and eventually form the portal venous system.

The umbilical vein will also connect into this system
Term
What is the ductus venosus?
Definition
a vessel that shunts blood from the placenta to the heart, bypassing the liver
Term
What are the veins that first develop centrally to the cardinal veins?
Definition
subcardinal veins
Term
What veins develop between the subcardinal and cardinal veins?
Definition
supracardinal veins
Term
What are the adult derivatives of the anterior cardinal veins?
Definition
brachiocephalic, jugular, superior vena cava, and subclavian
Term
What is the inferior vena cava derived from?
Definition
Vitelline, subcardinal, supracardinal, and cardinal veins
Term
What do supracardinal veins differentiate into?
Definition
Azygos and hemiazygos venous system
Term
What does the posterior cardinal vein develop into?
Definition
illiac and femoral veins
Term
From where do the coronary vessels come from?
Definition
The aorta with some contribution from epicardial cells
Term
In fetal circulation what has a higher PO2, the left atrium or the right ventricle?
Definition
Left atrium
Term
What happens to pulmonary vascular resistance after birth?
Definition
Drops, more markedly at the beginning
Term
What happens to pulmonary blood flow after birth?
Definition
marked increase
Term
What happens with Pulmonary and Aortic pressure after the closing of the ductus arteriosis?
Definition
Pulmonary artery pressure drops and aortic blood pressure increases.
Term
What atrium has higher pressure in a fetus, what about in a newborn?
Definition
In the fetus the right atrium will have a higher pressure

In the newborn the right atrium will have lower pressure

this makes sense as it allows for the foramen ovale to function in the fetus and close off in the newborn
Term
What is the effect of PGE2 (prostaglandins) on the ductus arteriosis?
Definition
maintain the shunt
Term
What is the effect of Bradykinin on the dutus arteriosis?
Definition
constriction
Term
What is the effect of indomethacin on the ductus arteriosis?
Definition
promotes ductal closure (inhibits prostaglandins)
Term
What drug would you administer to a newborn who has a congenital heart defect that does not affect the baby as a fetus?
Definition
Prostaglandins
Term
What coarctation will promote compensatory internal thoracic dilation?
Definition
post-ductal coarctation.

Preductal will not develop this affect
Term
What clinical presentation can a patient with a double aorta have?
Definition
Dysphagia and dyspnea

This is caused by the double aorta wrapping around and constricting the esophagus/trachea
Term
What can happen to a patient with a right aortic arch?
Definition
Constriction of aorta due to the ligamentum arteriosum
Term
What is an interupted aortic arch?
Definition
surgically repairable condition in which the

ascending aorta connects to left ventricle

descending aorta connects to right ventricle
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