CV TEST 2 - Severson

Heart pain, coming from visceral sensory nerve fibers running with the sympathetic nerves, may be referred to the ____ and _____

The fetal heart tube bends to the ______ and acquires the general external appearance of the adult heart

What is the condition called when the heart bends the other way?

What is Dextrocardia with situs inversus?

When the developing heart tube bends to the left rather than to the right, the developmental anomaly is referred to as:

Developmental anomalies associated with abnormal ___________ cushion development

Mitral atresia
Tricuspid atresia
Persistent atrioventricular canal
Atrial septal defect (ASD) (patent primary foramen)
Ventricular septal defect (VSD)

The endocardial cushions contribute to the development of all of the following heart structures EXCEPT the:

foramen ovale.
interatrial septum.
interventricular septum.
mitral valve.
tricuspid valve.

The primary atrial septum grows down toward the ________ cushion – the primary foramen is eventually closed off when the primary septum reaches the cushion, before that happens the top of the primary septum degenerates and makes ________ foramen

Then secondary septum grows to the ________ of the primary septum and makes foramen ovale – the primary septum serves as valve

Which of the following structures contributes to the formation of the valve of the foramen ovale?

Endocardial cushion
Interventricular septum
Primary septum
Secondary septum
Sinus venosus

Spiraling of the aorticopulmonary septum (_______ and ________ ridge tissue) divides the bulbus cordis and truncus arteriosus into ascending _______ and ________ trunk

The bulbar and truncal ridges are derived primarily from:

endocardial cushions.
neural crest mesenchyme.
sinus venosus.
somatic mesoderm.
splanchnic mesoderm.

The aorticopulmonary septum is derived from the:
bulbar and truncal ridges.
endocardial cushions.
interatrial septum.
interventricular septum.
myoblasts.

Primitive ventricle divided by the muscular and membranous interventricular septum

Muscular portion derived from _________

Membranous portion formed by the endocardial cushions and their fusion with the _____________ septum

Left 4th aortic arch contributes to the __________ ________
Right 4th aortic arch contributes to right _______ ___________

Which forms the ductus arteriosus?

Right 6th aortic arch (proximal portion)
Left 6th aortic arch (proximal portion)
Left 6th aortic arch (distal portion)
Right 6th aortic arch (distal portion)

Which degenerates?

Right 6th aortic arch (proximal portion)
Left 6th aortic arch (proximal portion)
Left 6th aortic arch (distal portion)
Right 6th aortic arch (distal portion)

Which becomes the ligamentum arteriosum?

Right 6th aortic arch (proximal portion)
Left 6th aortic arch (proximal portion)
Left 6th aortic arch (distal portion)
Right 6th aortic arch (distal portion)

Which becomes the proximal part of right pulmonary artery

Right 6th aortic arch (proximal portion)
Left 6th aortic arch (proximal portion)
Left 6th aortic arch (distal portion)
Right 6th aortic arch (distal portion)

In the fetus, the ductus __________ shunts blood from left umbilical vein directly through the ______ and into the inferior vena cava

In the fetus, most blood from the right ventricle goes through the ductus __________ and into the aorta, with only 5 - 10% going to the lungs

cyanosis early in postnatal life

_______ to _______ shunts

cyanosis later in life

_______ to _______ shunts

Left to right - cyanosis several months or years after birth
________ or ________ septal defect
_______(persistent) ductus arteriosus

Right to left shunts - cyanosis early in postnatal life
Tetralogy of ________
Transposition of the great arteries (TGA)
Truncus _________ (persistent)

Atrial septal defects

Excessive resorption of the primary septum (fenestrated oval fossa or large ________ foramen)

Incompetent foramen ovale due to hypoplastic growth of the _________septum

In general, left to right shunting of blood occurs in all ______ septal defects

Physiology
________ blood flow may be 2 to 4 times normal

Complications
__ failure
Paradoxical embolism (and brain infarction or abscess)

Most common congenital heart abnormality (40%) is ___________Septal Defect

Are murmurs heard in Ventricular Septal Defects?

Ventricular septal defects (VSDs) account for 40% of congenital heart defects. Which of the following is responsible for most forms of VSDs?
Abnormal formation of the endocardial cushions and aorticopulmonary septum
Absence of the primary interatrial septum
Atrophy of cardiac myoblasts
Failure of the muscular septum to form
Sinus venosus defect

If the ductus remains patent after birth, the direction of blood flow is from the ______ to the ________

Patent (Persistent) Ductus Arteriosus is a congenital cardiovascular abnormality commonly associated with maternal _________ (German measles) during early pregnancy

Machinery-like" murmur is associated with what?

Prostaglandins are responsible for keeping a Patent (Persistent) Ductus Arteriosus open. What could you give to close it?

Tetralogy of Fallot (TF)(Cyanotic – R to L)

Defects:
(1) ________ septal defect
(2) __________ stenosis
(3) Overriding (large) _______
(4) Right ventricular hypertrophy

Tetralogy of Fallot is associated with a small opening of the _________ and a large opening for the __________

What causes the murmur in Tetralogy of Fallot?

Tetralogy of Fallot is a cardiac malformation that involves which of the following septa?
Aorticopulmonary septum
Atrioventricular septum
Atrial septum
Ventricular septum

Transposition of the Great Arteries (TGA)(Cyanotic – R to L)

The aorta originates from the _______ ventricle and the pulmonary artery from the ______ventricle

Which disease is caused by a failure of the normal spiraling of the aorticopulmonary septum?

This disease is incompatible with life unless an atrial and ventricular septal defect and an associated patent ductus arteriosus are present.

Truncus Arteriosus (Persistent)(Cyanotic – R to L)

A common aorticopulmonary outlet, receiving blood from both ventricles

Due to failure of the _______ and _________l ridges to develop

In Truncus Arteriosus (Persistent)(Cyanotic – R to L)

Aortic or pulmonary _________ results from asymmetrical division or spiraling of the aorticopulmonary septum (bulbar and truncal ridge tissue)

Which of the following does not involve the bulbar and truncal ridges?
Atrial septal defect
Common or persistent truncus
Tetralogy of Fallot
Transposition of the great arteries (TGA)

Coarctation of Aorta is cyanotic/acyontic?

This disease is characterized by a narrowed aortic lumen (Obstructive congenital heart disease) – infolding of the aorta opposite the closed ductus arteriosus (DA)

Coarctation of Aorta

Characterized by a narrowed aortic lumen (Obstructive congenital heart disease) – infolding of the aorta opposite the closed __________ _________

Name this disease:

BP arms increased, legs decreased
Intercostal artery blood flow increased (notched ribs)
Hypertension in upper extremities; weak pulse and lower blood pressure in the lower extremities

Cyanosis, lower body
normal in head and arms

Whats the diagnosis?

A 13-year-old boy on physical examination reveals no femoral pulses, increased blood pressure in the upper extremities, and enlarged intercostal vessels. Which of the following abnormalities would be suspected?

Coarctation of the aorta
Postductal - BP higher in upper extremity than in lower extremity
Preductal - Patent ductus arteriosus and _________ in lower body

Which of the following congenital defects would NOT be associated with “blue babies”?
Patent ductus arteriosus
Tetralogy of Fallot
Transposition of great vessels
Truncus arteriosus (persistent or common trunk)