Embryology

assignment -5

Submitted by
Mohammed aathif
6-04-2016

Abstract:
Cardiovascular system is the organ system that permits the blood to circulate
and transport nutrients,hormones ,cellular waste products to and form the cell to
give nourishment against the disease and helps to maintain the homeostasis.The
heart is a muscular pumping organ located medial to the lungs along the bodys
midline in the thoracic region. The bottom tip of the heart, known as its apex, is
turned to the left, so that about 2/3 of the heart is located on the bodys left side

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with the other 1/3 on right. The top of the heart, known as the hearts base,
connects to the great blood vessels of the body the aorta, vena cava, pulmonary
trunk, and pulmonary veins. .

Cardiovascular system is the first system begins to start functioning, which

occurs about 21-28 days
The primordial heart and the vascular system develop in the middle of the
third week
Primordial heart is formed from the splanchnic mesoderm ( cardiogenic
region)
During 22-24 day the heart begins to beat
In 2-3 weeks the pair of thin walled tubes develop
In the 3rd week there is truncus arteriosus outflow, heart contracting and
the paired heart tube fuse .
In the 4th week the heart tube elongates and curves to form s shape.
In the 5th week there is a formation of the atria and ventricular septum and
the foramen ovale
At the 37th week the difference in the pressure closes the foramen ovale
and leaving a fossa ovalis .

Formation of aorticopulmonary septum:

Aorticopulmonary septum is formed from the neural crest cells and
actively separates the aorta and the pulmonary arteries and fuse with
interventricular septum in the heart
Neural crest cells migrate through pharyngeal plexus 3,4,6 and invade
both the bulbar ridges and the truncal ridges from the hind brain
Bulbar and truncal ridges grow and twist around each other fuse to form
the aorticopulmonary septum
This aorticopulmonary septum divides the truncus arteriosus and the
bulbus cordis into aorta and pulmonary trunk

TERALOGY OF FALLOT:
Embryological basis :

It is caused because of the abnormal migration of the neural crest cells it

cause due to the skewed development of the auricopulmonary septum
Tetralogy of the fallot leads to the shortest diameter of the pulmonary trunk
and the longest diameter of the aorta
There are four types in the tetralogy of the fallot
a. A large ventricular septal defect (VSD)

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 b. Pulmonary stenosis
c. Right ventricular hypertrophy
d. An overriding aorta

Ventricular septal defect:

The heart has 4 chambers , they are right atrium, right ventricle, left
atrium and the left ventricle .
The septum prevents the blood from mixing between the two sides of the
heart
Ventricular septal defect leads to the hole in the interventricular septum.
This leads to the mixing of the deoxygenated and the oxygenated blood
from the right ventricle and the left ventricle.

Pulmonary stenosis:
Pulmonary stenosis defect leads to the narrowing in the pulmonary valve
and the block in passage to the pulmonary artery
In the pulmonary stenosis the pulmonary valve doesnt open completely.
As the result of this , enough blood doesnt pass through the lungs .
Right ventricular hypertrophy :
In this defect the muscle of the right ventricle is thick than outside
In this defect the heart works harder to pump the blood .
Overriding aorta:
this defect occurs in the aorta
In healthy heart , the aorta comes from the left ventricle
In the tetralogy of the fallot the aorta arises inbetween the left ventricle and
the right ventricle

3The above figure shows the difference between the normal heart and the
tetralogy of the fallot

Formation of the atrial septum:

In the roof of the primitive atrium ,there is formation of the crescent
shaped septum primum and grows towards the atrioventricular canal
Foramen primum is formed between the septum primum and the
atrioventricular cushions
Foramen secundum is found in the center of the septum primum
The formen ovale is the opening between the upper limb and the lower
limb of the septum secundum
4 Functional closure of the foramen ovale is facilitated by decrease in the
right atrial pressure from the occlusion of the placental circulation and by
increase in the left atrial pressure due to the increased pulmonary venous
return.
After some time the septum secundum and the septum primum fuse
completely to form the atrial septum
If there is an incomplete fusion of the septum secundum and the septum
primum it leads to the atrial septal defects.

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 Atrial septal defects are
a) Probe patency of the foramen ovale
b) Premature closure of the foramen ovale
c) Foramen secundum defect

Probe patency of the foramen ovale:

Incomplete anatomical fusion of the septum primum and the septum secundum

Premature closure of the foramen ovale:

There is an hypertrophy in right side of the heart and there is undevelopment in
the left side of the heart

Foramen secundum defect:

It is caused by excessive resorbtion of the septum secundum,septum

5The above image shows the normal heart and the heart with the atrial septal
defect

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Patent ductus arteriosus:
It is the congenital heart defect where the ductus arteriosus(
connection between the pulmonary artery and the aorta ) fails to
close after the birth
Normally patent ductus arteriosus closes soon after 12-18 hours
birth through the smooth muscle contraction and forms the
ligamentum arteriosum
If it remains open the aortic blood will be shunted into the
pulmonary artery
This opening is because of the decresed oxygen level( hypoxia )
and the immaturity
It can be treated by using the prostaglandins synthesis inhibitors
like indomethacin which helps to promote the closure
Patent ductus arteriosus is the most commonly found birth defect
affecting the maternal with the rubella infection
Tachycardia, dyspnea, cardiomegaly, heart murmur, respiratory
problems , widened pulse pressure are the common symptoms for
the patent ductus arteriosus

The above image shows the patent ductus arteriosus .

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Postductal coarctation:
Postductal coarctation occurs if there is an abnormal constriction of the
Aorta.
A postductal coarctation is found distal to the origin of the left subclavian
arteryand found inferior to the ductus arteriosus
Symptoms are the increased blood pressure ion the upper extremities ,
high risk of the cerebral haemorrhage , bacterial endocarditis, lack of
pulse in the femoral artery and the turner syndrome.

8The above image shows the postductal defect

Formation of atrioventricular septum:

The dorsal and the ventral atrioventricular cushions fuse together to form
the atrioventricular septum
The atrioventricularseptum partition the atrioventrricular canal into right
and left atrioventricular canal
Failure of this fusion leads to several defect like
a) Left and the right shunting
b) Mitral valve regurgitation

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 c) Elisteins anomaly

Left and right shunting:

It is the shunting of blood from the left atrium to the right atrium.
It leadsto the enlarged right atrium and ventricle.

6 The above image shows the defect in the atrioventricular septum

Reference:
1. https://www.google.gy/?gws_rd=cr,ssl&ei=OZIGV7HuEMS
8ed68jCA#q=tetralogy+of+fallot+pictures

2. https://www.google.com/search?q=atrial+septal+defects+imag
es.&tbm=isch&tbo=u&source=univ&sa=X&ved=0ahUKEwj46K7t
_vjLAhVGNxQKHVhTBr4QsAQIJA&biw=1138&bih=529#imgrc=
o3k7gZ-qyvvMqM%3A
3. https://www.google.com/imgres?imgurl=https://classconnectio
n.s3.amazonaws.com/562/flashcards/1178562/gif/vsd13490280
91255.gif&imgrefurl=https://www.studyblue.com/notes/note/n/

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 exam-
ii/deck/3833022&h=225&w=288&tbnid=GDU1WpNMQV3-
fM:&docid=5XcakZYWIKxIXM&ei=EhoFV9PcG8eyesyAubAC&t
bm=isch
4. https://www.google.com/search?q=patent+ductus+arteriosus&
source=lnms&tbm=isch&sa=X&ved=0ahUKEwjAwo6hovrLAhXF
bB4KHVIhCSUQ_AUIBygB&biw=1366&bih=657#imgrc=pxaY5I8
FrEgdvM%3A
5. https://www.google.com/search?q=postductal+coarctation&so
urce=lnms&tbm=isch&sa=X&ved=0ahUKEwjNwa-
jpvrLAhVClB4KHZM4BCUQ_AUIBygB&biw=1366&bih=657#img
rc=bi6pq-p_9e_ZFM%3A
6. https://www.google.gy/search?q=tetralogy+of+fallot+pictures
&biw=1024&bih=653&source=lnms&tbm=isch&sa=X&ved=0ah
UKEwiRrKCrgP3LAhWH2R4KHfbMDAIQ_AUIBigB#imgrc=yJtxJZ
4tWSp_uM%3A