heart development dr. nimir. objectives: understand early development of blood vessels. basic...
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Heart Development
Dr. Nimir
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• Objectives:
• Understand early development of blood vessels.
• Basic understanding of the early stages of heart development.
• Describe the formation and position of the heart tube.
• Discus the development of sinus venosus.
• Describe partioning by septa and chambers formation.
• Discus congenital malformations.
• Gain knowledge of fetal circulation.
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1. Development of Early Blood Vessels1.1 Yolk sac → blood islands → endothelia → vessels primitive blood cells.
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1.2 Chorion, body stalk, embryonic body → blood vessels → 3 separate circulations: vitelline, chorionic, and intraembryonic.
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2. Development of Primitive Heart Tube2.1 Primordium: Cardiogenic area → •Intraembryonic coelom → pericardial coelom; •2 lateral cardiogenic plates →endocardial heart tubes.
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2.2 Primitive heart tube1) Lateral fold: 2 heart tubes → single heart tube.
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2) Head fold: pericardial coelom → ventral to heart tube ↘caudal to oropharyngeal membrane
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3) Wall of primitive heart tube •Endocardial heart tube → endocardium•Myoepicardial mentle → myocardium, epicardium•Cardiac jelly → subendocardial tissue
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3. Formation of Heart Loop
3.1 Heart tube → bulbus cordis, ventricle, atrium → truncus arteriosus, conus cordis, ventricle, atrium, sinus venosus
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3.2 Bulboventricular portion → bulboventricular loop → cephalic portion bends ventrally, caudally and slightly to the right
3.3 Atrium → dorsocranially and bulges laterally on each side of bulbus
3.4 Proximal part of bulbus → primitive right ventricle
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4. Partitioning of Heart Chambers
4.1 Division of atrioventricular canal
Subendocardial tissue → 2 endocardial cushions → fuse → right and left canals
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Formation of atrioventricular valves
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4.2 Partitioning of primitive atrium
1) Septum primum → endocardial cushions → foramen primum.
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2) Septum primum absorbed → foramen secundum → foramen primum closing
3) Septum secundum → cover the foramen secundum → foramen ovale
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4) Blood from right to left atriumforamen ovale
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4.3 Development of sinus venosus
1) Right horn enlarges (due to left-to-right shunts of blood in venous system)
•Sinus-atrial orifice → right;
•Receives sup. and inf. vena cava;
•Right horn → right atrium (smooth walled part).
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2) Left horn degenerates → coronary sinus, oblique vein of left atrium;
•Pulmonary vein and its branches → left atrium (smooth walled part)
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4.4 Partitioning of the primitive ventricle
1) Apical ventricle wall → muscular interventricular septum → interventricular foramen
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2) Endocardial cushion, right and left bulbar ridges → membranous interventricular septum → interventricular foramen closed
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4.5 Division of truncus and bulbus 1) Truncal ridges + Bulbar ridges →aorticopulmonary septum
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2) Aorticopulmonary septum → spiral course → • pulmonary trunk → right ventricle• aorta → left ventricle
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3) Truncus swellings → hollowed out at upper surface → semilunar valves
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5. Circulation before and after Birth
5.1 Circulation before birth
•Placental circulation: umbilical A. & V.
•ductus venosus
•foramen ovale
•ductus arteriosus
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5.2 Changes after birth
•Umbilical arteries → lateral umbilical ligaments
•Umbilical vein → ligamentum teres hepatis
•Ductus venosus → venous ligament
•Ductus arteriosus → arterial ligament
•Foramen ovale → oval fossa
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6. Congenital Malformations
6.1 Atrial septal defect
•Excessive resorption of the septum primum;
•Inadequate development of the septum secundum.
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6.2 Ventricular septal defect
•Defect of the membranous septum, isolated or associated with other abnormalities.
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6.3 Tetralogy of Fallot
•Unequal division of conus cordis;
•4 defects: pulmonary stenosis, overriding aorta, ventricular septal defect, hypertrophy of right ventricle;
•Causing cyanosis.
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6.4 Persistent truncus arteriosus
•Truncoconal ridges fail to fuse and descend;
•Truncus overrides both ventricles;
•Accompanied by ventricular septal defect;
•Cyanosis, blood to lungs increased.
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6.5 Transposition of great vessels
•Truncoconal septum failing to follow its spiral course and descending straight downward;
•Aorta originates from right ventricle, pulmonary artery from left;
•Usually combined with patent ductus arteriosus.
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6.6 Patent ductus arteriosus
•Ductus arteriosus fails to be closed after birth;
•Isolated or combined with other defects.
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6.7 Tricuspid atresia
•Absence or fusion of tricuspid valves;
•Patent oval foramen & ventricular septal defect;
•Underdeveloped right ventricle
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6.8 Pulmonary valvular atresia (or stenosis)
•Pulmonary valves are fused for variable distance;
•Hypoplastic right heart;
•Patent oval foramen and patent ductus arteriosus.
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6.9 Aortic valvular atresia and stenosis
•Aortic valves are fused for variable distance;
•Aorta, left ventricle, left atrium underdeveloped;
•Accompanied by patent ductus arteriosus.
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Thank You