Embryology - User contributions [en-gb]

2010 Lecture 21

2010-10-10T22:37:27Z

Z3267024: /* Vascular Remodeling */

<div style="background:#F5FFFA; border: 1px solid #CEF2E0; padding: 1em; margin: auto; width: 95%; float:left;"><div style="margin:0;background-color:#cef2e0;font-family:sans-serif;font-size:120%;font-weight:bold;border:1px solid #a3bfb1;text-align:left;color:#000;padding-left:0.4em;padding-top:0.2em;padding-bottom:0.2em;">Lecture Notice - Dr Nalini Pather</div> Final lecture pages can also be printed out using the "printable version" lefthand menu.</div>

==Introduction==
[[File:Gray0473.gif|300px|right]]

In [[2010 Lecture 7|lecture 7 - Early Vascular Development]], the early development of the cardiovascular system was discussed. This second lecture will now focus on the extensive remodeling that occurs in both the heart and vascular system during later development. In addition, there will be discussion on the major cardiovascular abnormalities. The laboratory this week will also give you the opportunity to work through some of these concepts using a new online teaching module.

This material is also presented in an online [[Cardiac_Embryology|Cardiac Embryology tutorial]].

[[File:Basic_Heart_Development_Timeline.jpg|400px|Link=Cardiac_Embryology]]

{{Template:Heart Links}}

:'''Lecture Audio'''

==Lecture Objectives==
* Describe the development of primary and secondary atrial septa and the ventricular septum.
* Explain the changes occurring in the bulbis cordis and truncus arteriosus in its transformation from a single to a double tube.
* Describe the development of the aortic arches on the right and left sides from the fetus to the adult.
* Describe the development of arteries and veins.
* Describe the major cardiovascular developmental abnormalities.

==Textbook references==

* Human Embryology (3rd ed.) Larson Chapter 7 p151-188 Heart, Chapter 8 p189-228 Vasculature
* The Developing Human: Clinically Oriented Embryology (6th ed.) Chapter 14: p304-349

'''Other textbooks'''
* Before we Are Born (5th ed.) Moore and Persaud Chapter 12; p241-254
* Essentials of Human Embryology Larson Chapter 7 p97-122 Heart, Chapter 8 p123-146 Vasculature
* Human Embryology Fitzgerald and Fitzgerald Chapter 13-17: p77-111

'''Recent reviews'''
* Yutzey KE, Kirby ML. Wherefore heart thou? Embryonic origins of cardiogenic mesoderm. Dev Dyn. 2002 Mar;223(3):307-20. Review. [http://www.ncbi.nlm.nih.gov/pubmed/11891982?dopt=Abstract PMID: 11891982]
* Three-dimensional reconstruction of gene expression patterns during cardiac development. Soufan AT, Ruijter JM, van den Hoff MJ, de Boer PA, Hagoort J, Moorman AF. Physiol Genomics. 2003 May 13;13(3):187-95. Review. [http://www.ncbi.nlm.nih.gov/pubmed/12746463 PMID: 12746463]
* Moorman A, Webb S, Brown NA, Lamers W, Anderson RH. Development of the heart: (1) formation of the cardiac chambers and arterial trunks. Heart. 2003 Jul;89(7):806-14. [http://www.ncbi.nlm.nih.gov/pubmed/12807866?dopt=Abstract PMID: 12807866]
* Bruneau BG. Transcriptional regulation of vertebrate cardiac morphogenesis. Circ Res. 2002 Mar 22;90(5):509-19. Review. [http://www.ncbi.nlm.nih.gov/pubmed/11909814?dopt=Abstract PMID: 11909814]

----

==Heart Development==
[[File:Gray0462.gif|thumb|200px|Day 14 Heart tube]]
[[File:Heart_Tube_Fusion.jpg|400px|Early Human Heart Tube Development]]

* [[E#endocardial tube|endocardial tube]] in [[P#pericardial cavity|pericardial cavity]]
** dorsal mesentry (mesocardial) attachment lost
** attached at cranial (arterial) and caudal (venous) ends
* tube elongation - bending and series of expansions

Bulbus Cordis
* refers to the outflow tract in early embryo
* 3 parts
** distal - forms [[T#truncus arteriosus|truncus arteriosus]] (aorta and pulmonary artery)
** middle - [[C#conus arteriosus|conus arteriosus]] ventricular outflow tract
** proximal - right ventricle trabeculate part
[[File:Heart-cartoon-001.jpg|300px|right|Adult Heart blood flow]]
{| border=1

|-
! Fetal Structure
! Adult Structure
|-
| Truncus arteriosus
| aorta
pulmonary trunk
|-
| Conus arteriosus
| right ventricle - smooth part
|-
| Primitive ventricle
| right ventricle - trabecular part
left ventricle - trabecular part
|-
| Primitive atrium
| right atrium - trabecular part
left atrium - trabecular part
|-
| Sinus venosus
| right atrium - smooth part (sinus venarum)
coronary sinus
oblique vein of left atrium
|}

===Heart Layers===
* '''pericardium''' - covers the heart, formed by 3 layers consisting of a fibrous pericardium and a double layered serous pericardium (parietal layer and visceral epicardium layer).
* '''myocardium''' - muscular wall of the heart, thickest layer formed by spirally arranged cardiac muscle cells.
* '''endocardium''' - lines the heart, epithelial (endothelial) tissue lining the inner surface of heart chambers and valves.

===Embryonic Heart Rate===

* Stage 9-10 2 mm embryo (gestational sac diameter of 20 mm) EHR at least 75 beats / minute
* Stage 11-12 5 mm embryo (gestational sac diameter of 30 mm) EHR at least 100 beats / minute
* Stage 16 10 mm embryo EHR at least 120 beats / minute
* Stage 18 15 mm embryo EHR at least 130 beats / minute

[http://embryology.med.unsw.edu.au/Movies/usound/Hum12wkFHR.htm Week 12 fetal heart rate doppler] [http://embryology.med.unsw.edu.au/Notes/heart8.htm Week 17 fetal heart rate audio]

==Separation of the Atria from the Venticles==
[[File:AV Canal Division.jpg|thumb|200px|Separation of the atrioventricular canal]]
===Endocardial Cushions===
* form initial division of atria and ventricles
* form on dorsal and ventral wall of atrioventcular canals
* grow into canal - meet and fuse to separate atrioventricular canal into right and left channels
* anterior and posterior cushions fuse; lateral cushions remain unfused

==Atrial Septation==
[[File:Heart1_atrium icon.jpg|90px|link=Development_Animation_-_Heart Atrial Septation]]

[[File:Stage13 C7L.jpg|thumb|Heart (Carnegie stage 13)]]

Through all development blood shunts from right to left atrium (bypass lungs)

===Septum Primum===
[http://embryology.med.unsw.edu.au/wwwpig/pigc/c1l.htm Stage 13 Septum Primum] [http://embryology.med.unsw.edu.au/wwwhuman/lowpower/HumE/E2L.htm Stage 22 Septum Primum]

* dorso-cranial wall, crescentric-shaped membranous extension
* grows downward towards endocardial cushions
* opening is '''foramen primum''' (ostium primum)- serves as a shunt
* a series of perforations develop in cranial end - coalesce to form '''foramen secundum''' (ostium secundum)
* septum primum fuses with endocardial cushions - obliterates foramen primum

===Septum Secundum===
* crescentric septum secundum begins to form to the right of septum primum
* grows as septum primum downwards, does not fuse with endocardial cushion, opening is '''foramen ovale'''
* arrangement of the two septa facilitates a one-way valve

[[File:Atrial Septation.jpg|200px|Atrial septation]]
[[File:Atrial & Ventricular Septation 1.jpg|200px|Early -atrial and ventricular septation]]
[[File:Atrial & Ventricular Septation 2.jpg|200px|Late-atrial and ventricular septation]]

===Right Atrium===
[[File:Gray0476.jpg|thumb|sinus venosus and tributaries]]
* with heart looping and formation of interatrial septa, the sinus venosus shifts completely to right atrium
* right sinus horn incorporates into dorsal wall of right atrium
* left sinus horn becomes the coronary sinus
* sinoatrial opening - has 2 flaps, left fuses with septum secundum, right forms valve to inferior vena cava and coronary sinus. [http://embryology.med.unsw.edu.au/wwwpig/pigc/c3l.htm Stage 13 - right venous valve] [http://embryology.med.unsw.edu.au/wwwhuman/lowpower/HumE/E2L.htm Stage 22 - right venous valve]

===Left Atrium===
* posterior wall - outgrowth forms single pulmonary vein, divided into 4 branches
* incorporation into the wall leads to 4 openings in posterior wall
* later moves to the right aligns with atrioventricular canal.

==Ventricular Septation==
[[File:Stage13 C7L.jpg|thumb|Heart (Carnegie stage 13)]]
[[File:Gray0498.jpg|thumb|Ventricular septum]]
[[File:Heart1_realign icon.jpg|90px|link=Development_Animation_-_Heart Realign]]

* 2 separate components - superior membranous, inferior muscular
===Muscular Septum===
[[File:Gray0470.jpg|muscular septum]]
* growth of inferior wall
* fusion of 3 components - right and left bulbar ridges and dorsal endocardial cushion

===Membranous Septum===
* above the muscular septum, fusion continuous with septation of the outflow tract

[[File:Heart-ventricular-septum-01.jpg‎]][[File:Heart-ventricular-septum-02.jpg‎]][[File:Heart-ventricular-septum-03.jpg‎]]

==Outflow Tract Septation==

[[File:heart1 ventricle icon.jpg|90px|link=Development_Animation_-_Heart Outflow Septation]]

* in early development, outflow tract is a single tube, bulbus cordis
* elongates to form proximal conus arteriosus and distal truncus arteriosus
* 2 growths from wall in spiral pattern, inferior upwards - separate tract into 2 channels [http://embryology.med.unsw.edu.au/wwwpig/pigb/b5l.htm Stage 13 truncus arteriousus]
* mesenchyme and neural crest contribute to this septation process
* fusion of outgrowths separate aortic and pulmonary outflow

{| border='0px'

|-
| [[File:Chick_Heart_001-icon.jpg|90px|link=Movie_-_Normal Chick Heart]]
| [[File:Chick_Heart_002-icon.jpg|90px|link=Movie_-_Abnormal Chick Heart]]
| [[File:Chick_Heart_002-icon.jpg|90px|link=Movie_-_Abnormal Chick Heart 2]]
|-
| [[Movie_-_Normal Chick Heart|Normal Heart]]
| [[Movie_-_Abnormal Chick Heart|Abnormal Heart]]
| [[Movie_-_Abnormal Chick Heart 2|Abnormal Heart 2]]
|-
|}

==Vascular Remodeling==

[[File:Pulmonary circulation cartoon.jpg|500px|fetal heart circulation]]

===Arterial System===
[[File:Gray0474.jpg|thumb|pharyngeal arch arteries]]
* Aortic sac - remodels forming 2 horns, R forms brachiocephalic artery, L forms common carotid artery

Pharyngeal arch arteries
* pharyngeal arch artery 1 and 2 regress
* pharyngeal arch artery 3 and the associated dorsal aorta form the paired internal carotid arteries, these in turn generate the external carotids
* Left pharyngeal arch artery 4 – forms the aortic arch

* paraxial mesoderm forms paired dorsal aorta
** head mesenchyme forms aortic arches
** connecting stalk contains unbilical (placental) arteries
** dorsal aortas give rise to
** vitelline arteries which connect to capillaries on yolk sac
** intersegmental arteries between somites

===Venous System===
Cardinal veins contribute nearly all systemic venous system.

<gallery>
File:Gray0477.jpg
File:Gray0478.jpg
File:Gray0479.jpg
File:Gray0480.jpg
</gallery>

common cardinal veins - ducts of Cuvier

hepatic veins - drain de-oxygenated blood from the liver into the inferior vena cava.

internal iliac vein - hypogastric vein

==Birth Changes==
[[File:Fetal_circulation1.jpg|thumb|Fetal circulation]]
At birth, cutting the umbilical cord and changes in the lungs after the first breaths trigger major functional adaptations in the fetal circulatory system.

* blood flow through ductus venosus is eliminated
* pulmonary circulation bed expands - reducing blood flow through ductus arteriosus
* physiological closure of interatrial shunt
* closure of ductus venosus in liver is prolonged

{| border=1

|-
! Fetal Structure
! Adult Structure
|-
| foramen ovale
| fossa ovalis
|-
| umbilical vein (intra-abdominal part)
| ligamentum teres
|-
| ductus venosus
| ligamentum venosum
|-
| umbilical arteries
| distal part -lateral umbilical ligaments; proximal part - superior vesical artery (supplies bladder)
|-
| ductus arteriosus
| ligamentum arteriosum
|}

==Abnormalities==
There are many different cardiac abnormalities, some more common than others, and only a few will be described in this lecture.

'''Major Abnormalities:''' Aortic Stenosis, Atrial Septal Defects, Coarctation of Aorta, Dextrocardia, Hypoplastic Left Heart, Long QT Syndrome, Patent Ductus Arteriosus, Pulmonary Atresia, Pulmonary Stenosis, Tetralogy of Fallot, Transposition of Great Vessels, Tricuspid Atresia, Total Anomalous Pulmonary Venous Connection, Ventricular Septal Defect, Abnormalities of Conducting System.

Links: [http://embryology.med.unsw.edu.au/Notes/heart2.htm Cardiovascular Development Abnormalities]

[[File:Abnormal81-92-heart.png|thumb]]

[[File:Statistics-Utah heart defects.jpg|thumb]]
===Atrial Septal Defects===

{| border='0px'
|-
| [[File:HeartILP_draft_asd.jpg|Atrial Septal Defect]]
|
* Atrial Septal Defects (ASD) are a group of common (1% of cardiac) congenital anomalies defects occurring in a number of different forms and more often in females.
* patent foramen ovale - allows a continuation of the atrial shunting of blood, in 25% of people a probe patent foramen ovale (allowing a probe to bypassed from one atria to the other) exists.
* ostium secundum defect
* endocardial cushion defect involving ostium primum
* sinus venosus defect - contributes about 10% of all ASDs and occurs mainly in a common and less common form. Common ("usual type") - in upper atrial septum which is contiguous with the superior vena cava. Less common - at junction of the right atrium and inferior vena cava.
* common atrium
|-
|}

===Ventricular Septal Defects===
{| border='0px'
|-
| [[File:HeartILP_draft_vsd.jpg|Ventricular Septal Defect]]
|
* The Ventricular Septal Defect (VSD) usually occurs in the membranous (perimembranous) (70%) rather than muscular interventricular septum, and is more frequent in males that females.
* Perimembranous defects are located close to the aortic and tricuspid valves and adjacent to atrioventricular conduction bundle.
* The defect allows left-right shunting of blood, this shunting depends upon the size of the defect. Small defects may close spontaneously, larger defects result in infant congestive heart failure.
* Clinically repaired by coils or tissue-adapted devices like muscular or perimembranous occluders.
|-
|}
(V.S.D.)

===Patent Ductus Arteriosus===

{| border='0px'

|-
| [[File:HeartILP_draft_patentda.jpg|Patent Ductus Arteriosus]]
|
* Patent Ductus Arteriosus (PDA) occurs commonly in preterm infants, can close spontaneously (by day three in 60% of normal term neonates) the remainder are ligated simply and with little risk.
* The operation is always recommended even in the absence of cardiac failure and can often be deferred until early childhood.

|-
|}

===Tetralogy of Fallot===
{| border='0px'
|-
| [[File:HeartILP_draft_tetralogyoffallot.jpg|Tetralogy of Fallot]]
|
* Named after Etienne-Louis Arthur Fallot (1888) who described it as "la maladie blue" and is a common developmental cardiac defect.
* The syndrome consists of a number of a number of cardiac defects possibly stemming from abnormal neural crest migration. The basic defect in a tetralogy of Fallot is an asymmetrical fusion of the truncoconal ridges and a malalignment of the aortic and pulmonary valves. This results in the typical 4 features seen in this defect: 1. pulmonary stenosis, 2. overriding aorta, 3. ventricular septal defect, and 4. right ventricular hypertrophy.
|-
|}

==Movies==

{| border='0px'

|-
| [[File:Heart1_looping icon.jpg|90px|link=Development_Animation_-_Heart Looping]]
| [[File:Heart1_realign icon.jpg|90px|link=Development_Animation_-_Heart Realign]]
| [[File:Heart1_atrium icon.jpg|90px|link=Development_Animation_-_Heart Atrial Septation]]
| [[File:heart1 ventricle icon.jpg|90px|link=Development_Animation_-_Heart Outflow Septation]]
|-
| [[Development_Animation_-_Heart Looping|Heart Looping]]
| [[Development_Animation_-_Heart Realign|Heart Realign]]
| [[Development_Animation_-_Heart Atrial Septation|Heart Atrial Septation]]
| [[Development_Animation_-_Heart Outflow Septation|Heart Outflow Septation]]
|-
|}

'''Link:''' [[Flash Movies]]

{{Template:2009ANAT2341}}

[[Category:2009ANAT2341]] [[Category:Science-Undergraduate]]

[[Category:Cardiovascular]] [[Category:Heart]]

2010 Lecture 21

2010-10-10T22:37:07Z

Z3267024: /* Vascular Remodeling */

<div style="background:#F5FFFA; border: 1px solid #CEF2E0; padding: 1em; margin: auto; width: 95%; float:left;"><div style="margin:0;background-color:#cef2e0;font-family:sans-serif;font-size:120%;font-weight:bold;border:1px solid #a3bfb1;text-align:left;color:#000;padding-left:0.4em;padding-top:0.2em;padding-bottom:0.2em;">Lecture Notice - Dr Nalini Pather</div> Final lecture pages can also be printed out using the "printable version" lefthand menu.</div>

==Introduction==
[[File:Gray0473.gif|300px|right]]

In [[2010 Lecture 7|lecture 7 - Early Vascular Development]], the early development of the cardiovascular system was discussed. This second lecture will now focus on the extensive remodeling that occurs in both the heart and vascular system during later development. In addition, there will be discussion on the major cardiovascular abnormalities. The laboratory this week will also give you the opportunity to work through some of these concepts using a new online teaching module.

This material is also presented in an online [[Cardiac_Embryology|Cardiac Embryology tutorial]].

[[File:Basic_Heart_Development_Timeline.jpg|400px|Link=Cardiac_Embryology]]

{{Template:Heart Links}}

:'''Lecture Audio'''

==Lecture Objectives==
* Describe the development of primary and secondary atrial septa and the ventricular septum.
* Explain the changes occurring in the bulbis cordis and truncus arteriosus in its transformation from a single to a double tube.
* Describe the development of the aortic arches on the right and left sides from the fetus to the adult.
* Describe the development of arteries and veins.
* Describe the major cardiovascular developmental abnormalities.

==Textbook references==

* Human Embryology (3rd ed.) Larson Chapter 7 p151-188 Heart, Chapter 8 p189-228 Vasculature
* The Developing Human: Clinically Oriented Embryology (6th ed.) Chapter 14: p304-349

'''Other textbooks'''
* Before we Are Born (5th ed.) Moore and Persaud Chapter 12; p241-254
* Essentials of Human Embryology Larson Chapter 7 p97-122 Heart, Chapter 8 p123-146 Vasculature
* Human Embryology Fitzgerald and Fitzgerald Chapter 13-17: p77-111

'''Recent reviews'''
* Yutzey KE, Kirby ML. Wherefore heart thou? Embryonic origins of cardiogenic mesoderm. Dev Dyn. 2002 Mar;223(3):307-20. Review. [http://www.ncbi.nlm.nih.gov/pubmed/11891982?dopt=Abstract PMID: 11891982]
* Three-dimensional reconstruction of gene expression patterns during cardiac development. Soufan AT, Ruijter JM, van den Hoff MJ, de Boer PA, Hagoort J, Moorman AF. Physiol Genomics. 2003 May 13;13(3):187-95. Review. [http://www.ncbi.nlm.nih.gov/pubmed/12746463 PMID: 12746463]
* Moorman A, Webb S, Brown NA, Lamers W, Anderson RH. Development of the heart: (1) formation of the cardiac chambers and arterial trunks. Heart. 2003 Jul;89(7):806-14. [http://www.ncbi.nlm.nih.gov/pubmed/12807866?dopt=Abstract PMID: 12807866]
* Bruneau BG. Transcriptional regulation of vertebrate cardiac morphogenesis. Circ Res. 2002 Mar 22;90(5):509-19. Review. [http://www.ncbi.nlm.nih.gov/pubmed/11909814?dopt=Abstract PMID: 11909814]

----

==Heart Development==
[[File:Gray0462.gif|thumb|200px|Day 14 Heart tube]]
[[File:Heart_Tube_Fusion.jpg|400px|Early Human Heart Tube Development]]

* [[E#endocardial tube|endocardial tube]] in [[P#pericardial cavity|pericardial cavity]]
** dorsal mesentry (mesocardial) attachment lost
** attached at cranial (arterial) and caudal (venous) ends
* tube elongation - bending and series of expansions

Bulbus Cordis
* refers to the outflow tract in early embryo
* 3 parts
** distal - forms [[T#truncus arteriosus|truncus arteriosus]] (aorta and pulmonary artery)
** middle - [[C#conus arteriosus|conus arteriosus]] ventricular outflow tract
** proximal - right ventricle trabeculate part
[[File:Heart-cartoon-001.jpg|300px|right|Adult Heart blood flow]]
{| border=1

|-
! Fetal Structure
! Adult Structure
|-
| Truncus arteriosus
| aorta
pulmonary trunk
|-
| Conus arteriosus
| right ventricle - smooth part
|-
| Primitive ventricle
| right ventricle - trabecular part
left ventricle - trabecular part
|-
| Primitive atrium
| right atrium - trabecular part
left atrium - trabecular part
|-
| Sinus venosus
| right atrium - smooth part (sinus venarum)
coronary sinus
oblique vein of left atrium
|}

===Heart Layers===
* '''pericardium''' - covers the heart, formed by 3 layers consisting of a fibrous pericardium and a double layered serous pericardium (parietal layer and visceral epicardium layer).
* '''myocardium''' - muscular wall of the heart, thickest layer formed by spirally arranged cardiac muscle cells.
* '''endocardium''' - lines the heart, epithelial (endothelial) tissue lining the inner surface of heart chambers and valves.

===Embryonic Heart Rate===

* Stage 9-10 2 mm embryo (gestational sac diameter of 20 mm) EHR at least 75 beats / minute
* Stage 11-12 5 mm embryo (gestational sac diameter of 30 mm) EHR at least 100 beats / minute
* Stage 16 10 mm embryo EHR at least 120 beats / minute
* Stage 18 15 mm embryo EHR at least 130 beats / minute

[http://embryology.med.unsw.edu.au/Movies/usound/Hum12wkFHR.htm Week 12 fetal heart rate doppler] [http://embryology.med.unsw.edu.au/Notes/heart8.htm Week 17 fetal heart rate audio]

==Separation of the Atria from the Venticles==
[[File:AV Canal Division.jpg|thumb|200px|Separation of the atrioventricular canal]]
===Endocardial Cushions===
* form initial division of atria and ventricles
* form on dorsal and ventral wall of atrioventcular canals
* grow into canal - meet and fuse to separate atrioventricular canal into right and left channels
* anterior and posterior cushions fuse; lateral cushions remain unfused

==Atrial Septation==
[[File:Heart1_atrium icon.jpg|90px|link=Development_Animation_-_Heart Atrial Septation]]

[[File:Stage13 C7L.jpg|thumb|Heart (Carnegie stage 13)]]

Through all development blood shunts from right to left atrium (bypass lungs)

===Septum Primum===
[http://embryology.med.unsw.edu.au/wwwpig/pigc/c1l.htm Stage 13 Septum Primum] [http://embryology.med.unsw.edu.au/wwwhuman/lowpower/HumE/E2L.htm Stage 22 Septum Primum]

* dorso-cranial wall, crescentric-shaped membranous extension
* grows downward towards endocardial cushions
* opening is '''foramen primum''' (ostium primum)- serves as a shunt
* a series of perforations develop in cranial end - coalesce to form '''foramen secundum''' (ostium secundum)
* septum primum fuses with endocardial cushions - obliterates foramen primum

===Septum Secundum===
* crescentric septum secundum begins to form to the right of septum primum
* grows as septum primum downwards, does not fuse with endocardial cushion, opening is '''foramen ovale'''
* arrangement of the two septa facilitates a one-way valve

[[File:Atrial Septation.jpg|200px|Atrial septation]]
[[File:Atrial & Ventricular Septation 1.jpg|200px|Early -atrial and ventricular septation]]
[[File:Atrial & Ventricular Septation 2.jpg|200px|Late-atrial and ventricular septation]]

===Right Atrium===
[[File:Gray0476.jpg|thumb|sinus venosus and tributaries]]
* with heart looping and formation of interatrial septa, the sinus venosus shifts completely to right atrium
* right sinus horn incorporates into dorsal wall of right atrium
* left sinus horn becomes the coronary sinus
* sinoatrial opening - has 2 flaps, left fuses with septum secundum, right forms valve to inferior vena cava and coronary sinus. [http://embryology.med.unsw.edu.au/wwwpig/pigc/c3l.htm Stage 13 - right venous valve] [http://embryology.med.unsw.edu.au/wwwhuman/lowpower/HumE/E2L.htm Stage 22 - right venous valve]

===Left Atrium===
* posterior wall - outgrowth forms single pulmonary vein, divided into 4 branches
* incorporation into the wall leads to 4 openings in posterior wall
* later moves to the right aligns with atrioventricular canal.

==Ventricular Septation==
[[File:Stage13 C7L.jpg|thumb|Heart (Carnegie stage 13)]]
[[File:Gray0498.jpg|thumb|Ventricular septum]]
[[File:Heart1_realign icon.jpg|90px|link=Development_Animation_-_Heart Realign]]

* 2 separate components - superior membranous, inferior muscular
===Muscular Septum===
[[File:Gray0470.jpg|muscular septum]]
* growth of inferior wall
* fusion of 3 components - right and left bulbar ridges and dorsal endocardial cushion

===Membranous Septum===
* above the muscular septum, fusion continuous with septation of the outflow tract

[[File:Heart-ventricular-septum-01.jpg‎]][[File:Heart-ventricular-septum-02.jpg‎]][[File:Heart-ventricular-septum-03.jpg‎]]

==Outflow Tract Septation==

[[File:heart1 ventricle icon.jpg|90px|link=Development_Animation_-_Heart Outflow Septation]]

* in early development, outflow tract is a single tube, bulbus cordis
* elongates to form proximal conus arteriosus and distal truncus arteriosus
* 2 growths from wall in spiral pattern, inferior upwards - separate tract into 2 channels [http://embryology.med.unsw.edu.au/wwwpig/pigb/b5l.htm Stage 13 truncus arteriousus]
* mesenchyme and neural crest contribute to this septation process
* fusion of outgrowths separate aortic and pulmonary outflow

{| border='0px'

|-
| [[File:Chick_Heart_001-icon.jpg|90px|link=Movie_-_Normal Chick Heart]]
| [[File:Chick_Heart_002-icon.jpg|90px|link=Movie_-_Abnormal Chick Heart]]
| [[File:Chick_Heart_002-icon.jpg|90px|link=Movie_-_Abnormal Chick Heart 2]]
|-
| [[Movie_-_Normal Chick Heart|Normal Heart]]
| [[Movie_-_Abnormal Chick Heart|Abnormal Heart]]
| [[Movie_-_Abnormal Chick Heart 2|Abnormal Heart 2]]
|-
|}

==Vascular Remodeling==

[[File:Pulmonary circulation cartoon.jpg|300px|fetal heart circulation]]

===Arterial System===
[[File:Gray0474.jpg|thumb|pharyngeal arch arteries]]
* Aortic sac - remodels forming 2 horns, R forms brachiocephalic artery, L forms common carotid artery

Pharyngeal arch arteries
* pharyngeal arch artery 1 and 2 regress
* pharyngeal arch artery 3 and the associated dorsal aorta form the paired internal carotid arteries, these in turn generate the external carotids
* Left pharyngeal arch artery 4 – forms the aortic arch

* paraxial mesoderm forms paired dorsal aorta
** head mesenchyme forms aortic arches
** connecting stalk contains unbilical (placental) arteries
** dorsal aortas give rise to
** vitelline arteries which connect to capillaries on yolk sac
** intersegmental arteries between somites

===Venous System===
Cardinal veins contribute nearly all systemic venous system.

<gallery>
File:Gray0477.jpg
File:Gray0478.jpg
File:Gray0479.jpg
File:Gray0480.jpg
</gallery>

common cardinal veins - ducts of Cuvier

hepatic veins - drain de-oxygenated blood from the liver into the inferior vena cava.

internal iliac vein - hypogastric vein

==Birth Changes==
[[File:Fetal_circulation1.jpg|thumb|Fetal circulation]]
At birth, cutting the umbilical cord and changes in the lungs after the first breaths trigger major functional adaptations in the fetal circulatory system.

* blood flow through ductus venosus is eliminated
* pulmonary circulation bed expands - reducing blood flow through ductus arteriosus
* physiological closure of interatrial shunt
* closure of ductus venosus in liver is prolonged

{| border=1

|-
! Fetal Structure
! Adult Structure
|-
| foramen ovale
| fossa ovalis
|-
| umbilical vein (intra-abdominal part)
| ligamentum teres
|-
| ductus venosus
| ligamentum venosum
|-
| umbilical arteries
| distal part -lateral umbilical ligaments; proximal part - superior vesical artery (supplies bladder)
|-
| ductus arteriosus
| ligamentum arteriosum
|}

==Abnormalities==
There are many different cardiac abnormalities, some more common than others, and only a few will be described in this lecture.

'''Major Abnormalities:''' Aortic Stenosis, Atrial Septal Defects, Coarctation of Aorta, Dextrocardia, Hypoplastic Left Heart, Long QT Syndrome, Patent Ductus Arteriosus, Pulmonary Atresia, Pulmonary Stenosis, Tetralogy of Fallot, Transposition of Great Vessels, Tricuspid Atresia, Total Anomalous Pulmonary Venous Connection, Ventricular Septal Defect, Abnormalities of Conducting System.

Links: [http://embryology.med.unsw.edu.au/Notes/heart2.htm Cardiovascular Development Abnormalities]

[[File:Abnormal81-92-heart.png|thumb]]

[[File:Statistics-Utah heart defects.jpg|thumb]]
===Atrial Septal Defects===

{| border='0px'
|-
| [[File:HeartILP_draft_asd.jpg|Atrial Septal Defect]]
|
* Atrial Septal Defects (ASD) are a group of common (1% of cardiac) congenital anomalies defects occurring in a number of different forms and more often in females.
* patent foramen ovale - allows a continuation of the atrial shunting of blood, in 25% of people a probe patent foramen ovale (allowing a probe to bypassed from one atria to the other) exists.
* ostium secundum defect
* endocardial cushion defect involving ostium primum
* sinus venosus defect - contributes about 10% of all ASDs and occurs mainly in a common and less common form. Common ("usual type") - in upper atrial septum which is contiguous with the superior vena cava. Less common - at junction of the right atrium and inferior vena cava.
* common atrium
|-
|}

===Ventricular Septal Defects===
{| border='0px'
|-
| [[File:HeartILP_draft_vsd.jpg|Ventricular Septal Defect]]
|
* The Ventricular Septal Defect (VSD) usually occurs in the membranous (perimembranous) (70%) rather than muscular interventricular septum, and is more frequent in males that females.
* Perimembranous defects are located close to the aortic and tricuspid valves and adjacent to atrioventricular conduction bundle.
* The defect allows left-right shunting of blood, this shunting depends upon the size of the defect. Small defects may close spontaneously, larger defects result in infant congestive heart failure.
* Clinically repaired by coils or tissue-adapted devices like muscular or perimembranous occluders.
|-
|}
(V.S.D.)

===Patent Ductus Arteriosus===

{| border='0px'

|-
| [[File:HeartILP_draft_patentda.jpg|Patent Ductus Arteriosus]]
|
* Patent Ductus Arteriosus (PDA) occurs commonly in preterm infants, can close spontaneously (by day three in 60% of normal term neonates) the remainder are ligated simply and with little risk.
* The operation is always recommended even in the absence of cardiac failure and can often be deferred until early childhood.

|-
|}

===Tetralogy of Fallot===
{| border='0px'
|-
| [[File:HeartILP_draft_tetralogyoffallot.jpg|Tetralogy of Fallot]]
|
* Named after Etienne-Louis Arthur Fallot (1888) who described it as "la maladie blue" and is a common developmental cardiac defect.
* The syndrome consists of a number of a number of cardiac defects possibly stemming from abnormal neural crest migration. The basic defect in a tetralogy of Fallot is an asymmetrical fusion of the truncoconal ridges and a malalignment of the aortic and pulmonary valves. This results in the typical 4 features seen in this defect: 1. pulmonary stenosis, 2. overriding aorta, 3. ventricular septal defect, and 4. right ventricular hypertrophy.
|-
|}

==Movies==

{| border='0px'

|-
| [[File:Heart1_looping icon.jpg|90px|link=Development_Animation_-_Heart Looping]]
| [[File:Heart1_realign icon.jpg|90px|link=Development_Animation_-_Heart Realign]]
| [[File:Heart1_atrium icon.jpg|90px|link=Development_Animation_-_Heart Atrial Septation]]
| [[File:heart1 ventricle icon.jpg|90px|link=Development_Animation_-_Heart Outflow Septation]]
|-
| [[Development_Animation_-_Heart Looping|Heart Looping]]
| [[Development_Animation_-_Heart Realign|Heart Realign]]
| [[Development_Animation_-_Heart Atrial Septation|Heart Atrial Septation]]
| [[Development_Animation_-_Heart Outflow Septation|Heart Outflow Septation]]
|-
|}

'''Link:''' [[Flash Movies]]

{{Template:2009ANAT2341}}

[[Category:2009ANAT2341]] [[Category:Science-Undergraduate]]

[[Category:Cardiovascular]] [[Category:Heart]]

2010 Lecture 21

2010-10-10T22:33:15Z

Z3267024: /* Ventricular Septation */

<div style="background:#F5FFFA; border: 1px solid #CEF2E0; padding: 1em; margin: auto; width: 95%; float:left;"><div style="margin:0;background-color:#cef2e0;font-family:sans-serif;font-size:120%;font-weight:bold;border:1px solid #a3bfb1;text-align:left;color:#000;padding-left:0.4em;padding-top:0.2em;padding-bottom:0.2em;">Lecture Notice - Dr Nalini Pather</div> Final lecture pages can also be printed out using the "printable version" lefthand menu.</div>

==Introduction==
[[File:Gray0473.gif|300px|right]]

In [[2010 Lecture 7|lecture 7 - Early Vascular Development]], the early development of the cardiovascular system was discussed. This second lecture will now focus on the extensive remodeling that occurs in both the heart and vascular system during later development. In addition, there will be discussion on the major cardiovascular abnormalities. The laboratory this week will also give you the opportunity to work through some of these concepts using a new online teaching module.

This material is also presented in an online [[Cardiac_Embryology|Cardiac Embryology tutorial]].

[[File:Basic_Heart_Development_Timeline.jpg|400px|Link=Cardiac_Embryology]]

{{Template:Heart Links}}

:'''Lecture Audio'''

==Lecture Objectives==
* Describe the development of primary and secondary atrial septa and the ventricular septum.
* Explain the changes occurring in the bulbis cordis and truncus arteriosus in its transformation from a single to a double tube.
* Describe the development of the aortic arches on the right and left sides from the fetus to the adult.
* Describe the development of arteries and veins.
* Describe the major cardiovascular developmental abnormalities.

==Textbook references==

* Human Embryology (3rd ed.) Larson Chapter 7 p151-188 Heart, Chapter 8 p189-228 Vasculature
* The Developing Human: Clinically Oriented Embryology (6th ed.) Chapter 14: p304-349

'''Other textbooks'''
* Before we Are Born (5th ed.) Moore and Persaud Chapter 12; p241-254
* Essentials of Human Embryology Larson Chapter 7 p97-122 Heart, Chapter 8 p123-146 Vasculature
* Human Embryology Fitzgerald and Fitzgerald Chapter 13-17: p77-111

'''Recent reviews'''
* Yutzey KE, Kirby ML. Wherefore heart thou? Embryonic origins of cardiogenic mesoderm. Dev Dyn. 2002 Mar;223(3):307-20. Review. [http://www.ncbi.nlm.nih.gov/pubmed/11891982?dopt=Abstract PMID: 11891982]
* Three-dimensional reconstruction of gene expression patterns during cardiac development. Soufan AT, Ruijter JM, van den Hoff MJ, de Boer PA, Hagoort J, Moorman AF. Physiol Genomics. 2003 May 13;13(3):187-95. Review. [http://www.ncbi.nlm.nih.gov/pubmed/12746463 PMID: 12746463]
* Moorman A, Webb S, Brown NA, Lamers W, Anderson RH. Development of the heart: (1) formation of the cardiac chambers and arterial trunks. Heart. 2003 Jul;89(7):806-14. [http://www.ncbi.nlm.nih.gov/pubmed/12807866?dopt=Abstract PMID: 12807866]
* Bruneau BG. Transcriptional regulation of vertebrate cardiac morphogenesis. Circ Res. 2002 Mar 22;90(5):509-19. Review. [http://www.ncbi.nlm.nih.gov/pubmed/11909814?dopt=Abstract PMID: 11909814]

----

==Heart Development==
[[File:Gray0462.gif|thumb|200px|Day 14 Heart tube]]
[[File:Heart_Tube_Fusion.jpg|400px|Early Human Heart Tube Development]]

* [[E#endocardial tube|endocardial tube]] in [[P#pericardial cavity|pericardial cavity]]
** dorsal mesentry (mesocardial) attachment lost
** attached at cranial (arterial) and caudal (venous) ends
* tube elongation - bending and series of expansions

Bulbus Cordis
* refers to the outflow tract in early embryo
* 3 parts
** distal - forms [[T#truncus arteriosus|truncus arteriosus]] (aorta and pulmonary artery)
** middle - [[C#conus arteriosus|conus arteriosus]] ventricular outflow tract
** proximal - right ventricle trabeculate part
[[File:Heart-cartoon-001.jpg|300px|right|Adult Heart blood flow]]
{| border=1

|-
! Fetal Structure
! Adult Structure
|-
| Truncus arteriosus
| aorta
pulmonary trunk
|-
| Conus arteriosus
| right ventricle - smooth part
|-
| Primitive ventricle
| right ventricle - trabecular part
left ventricle - trabecular part
|-
| Primitive atrium
| right atrium - trabecular part
left atrium - trabecular part
|-
| Sinus venosus
| right atrium - smooth part (sinus venarum)
coronary sinus
oblique vein of left atrium
|}

===Heart Layers===
* '''pericardium''' - covers the heart, formed by 3 layers consisting of a fibrous pericardium and a double layered serous pericardium (parietal layer and visceral epicardium layer).
* '''myocardium''' - muscular wall of the heart, thickest layer formed by spirally arranged cardiac muscle cells.
* '''endocardium''' - lines the heart, epithelial (endothelial) tissue lining the inner surface of heart chambers and valves.

===Embryonic Heart Rate===

* Stage 9-10 2 mm embryo (gestational sac diameter of 20 mm) EHR at least 75 beats / minute
* Stage 11-12 5 mm embryo (gestational sac diameter of 30 mm) EHR at least 100 beats / minute
* Stage 16 10 mm embryo EHR at least 120 beats / minute
* Stage 18 15 mm embryo EHR at least 130 beats / minute

[http://embryology.med.unsw.edu.au/Movies/usound/Hum12wkFHR.htm Week 12 fetal heart rate doppler] [http://embryology.med.unsw.edu.au/Notes/heart8.htm Week 17 fetal heart rate audio]

==Separation of the Atria from the Venticles==
[[File:AV Canal Division.jpg|thumb|200px|Separation of the atrioventricular canal]]
===Endocardial Cushions===
* form initial division of atria and ventricles
* form on dorsal and ventral wall of atrioventcular canals
* grow into canal - meet and fuse to separate atrioventricular canal into right and left channels
* anterior and posterior cushions fuse; lateral cushions remain unfused

==Atrial Septation==
[[File:Heart1_atrium icon.jpg|90px|link=Development_Animation_-_Heart Atrial Septation]]

[[File:Stage13 C7L.jpg|thumb|Heart (Carnegie stage 13)]]

Through all development blood shunts from right to left atrium (bypass lungs)

===Septum Primum===
[http://embryology.med.unsw.edu.au/wwwpig/pigc/c1l.htm Stage 13 Septum Primum] [http://embryology.med.unsw.edu.au/wwwhuman/lowpower/HumE/E2L.htm Stage 22 Septum Primum]

* dorso-cranial wall, crescentric-shaped membranous extension
* grows downward towards endocardial cushions
* opening is '''foramen primum''' (ostium primum)- serves as a shunt
* a series of perforations develop in cranial end - coalesce to form '''foramen secundum''' (ostium secundum)
* septum primum fuses with endocardial cushions - obliterates foramen primum

===Septum Secundum===
* crescentric septum secundum begins to form to the right of septum primum
* grows as septum primum downwards, does not fuse with endocardial cushion, opening is '''foramen ovale'''
* arrangement of the two septa facilitates a one-way valve

[[File:Atrial Septation.jpg|200px|Atrial septation]]
[[File:Atrial & Ventricular Septation 1.jpg|200px|Early -atrial and ventricular septation]]
[[File:Atrial & Ventricular Septation 2.jpg|200px|Late-atrial and ventricular septation]]

===Right Atrium===
[[File:Gray0476.jpg|thumb|sinus venosus and tributaries]]
* with heart looping and formation of interatrial septa, the sinus venosus shifts completely to right atrium
* right sinus horn incorporates into dorsal wall of right atrium
* left sinus horn becomes the coronary sinus
* sinoatrial opening - has 2 flaps, left fuses with septum secundum, right forms valve to inferior vena cava and coronary sinus. [http://embryology.med.unsw.edu.au/wwwpig/pigc/c3l.htm Stage 13 - right venous valve] [http://embryology.med.unsw.edu.au/wwwhuman/lowpower/HumE/E2L.htm Stage 22 - right venous valve]

===Left Atrium===
* posterior wall - outgrowth forms single pulmonary vein, divided into 4 branches
* incorporation into the wall leads to 4 openings in posterior wall
* later moves to the right aligns with atrioventricular canal.

==Ventricular Septation==
[[File:Stage13 C7L.jpg|thumb|Heart (Carnegie stage 13)]]
[[File:Gray0498.jpg|thumb|Ventricular septum]]
[[File:Heart1_realign icon.jpg|90px|link=Development_Animation_-_Heart Realign]]

* 2 separate components - superior membranous, inferior muscular
===Muscular Septum===
[[File:Gray0470.jpg|muscular septum]]
* growth of inferior wall
* fusion of 3 components - right and left bulbar ridges and dorsal endocardial cushion

===Membranous Septum===
* above the muscular septum, fusion continuous with septation of the outflow tract

[[File:Heart-ventricular-septum-01.jpg‎]][[File:Heart-ventricular-septum-02.jpg‎]][[File:Heart-ventricular-septum-03.jpg‎]]

==Outflow Tract Septation==

[[File:heart1 ventricle icon.jpg|90px|link=Development_Animation_-_Heart Outflow Septation]]

* in early development, outflow tract is a single tube, bulbus cordis
* elongates to form proximal conus arteriosus and distal truncus arteriosus
* 2 growths from wall in spiral pattern, inferior upwards - separate tract into 2 channels [http://embryology.med.unsw.edu.au/wwwpig/pigb/b5l.htm Stage 13 truncus arteriousus]
* mesenchyme and neural crest contribute to this septation process
* fusion of outgrowths separate aortic and pulmonary outflow

{| border='0px'

|-
| [[File:Chick_Heart_001-icon.jpg|90px|link=Movie_-_Normal Chick Heart]]
| [[File:Chick_Heart_002-icon.jpg|90px|link=Movie_-_Abnormal Chick Heart]]
| [[File:Chick_Heart_002-icon.jpg|90px|link=Movie_-_Abnormal Chick Heart 2]]
|-
| [[Movie_-_Normal Chick Heart|Normal Heart]]
| [[Movie_-_Abnormal Chick Heart|Abnormal Heart]]
| [[Movie_-_Abnormal Chick Heart 2|Abnormal Heart 2]]
|-
|}

==Vascular Remodeling==
===Arterial System===
[[File:Gray0474.jpg|thumb|pharyngeal arch arteries]]
* Aortic sac - remodels forming 2 horns, R forms brachiocephalic artery, L forms common carotid artery

Pharyngeal arch arteries
* pharyngeal arch artery 1 and 2 regress
* pharyngeal arch artery 3 and the associated dorsal aorta form the paired internal carotid arteries, these in turn generate the external carotids
* Left pharyngeal arch artery 4 – forms the aortic arch

* paraxial mesoderm forms paired dorsal aorta
** head mesenchyme forms aortic arches
** connecting stalk contains unbilical (placental) arteries
** dorsal aortas give rise to
** vitelline arteries which connect to capillaries on yolk sac
** intersegmental arteries between somites

===Venous System===
Cardinal veins contribute nearly all systemic venous system.

<gallery>
File:Gray0477.jpg
File:Gray0478.jpg
File:Gray0479.jpg
File:Gray0480.jpg
</gallery>

common cardinal veins - ducts of Cuvier

hepatic veins - drain de-oxygenated blood from the liver into the inferior vena cava.

internal iliac vein - hypogastric vein

==Birth Changes==
[[File:Fetal_circulation1.jpg|thumb|Fetal circulation]]
At birth, cutting the umbilical cord and changes in the lungs after the first breaths trigger major functional adaptations in the fetal circulatory system.

* blood flow through ductus venosus is eliminated
* pulmonary circulation bed expands - reducing blood flow through ductus arteriosus
* physiological closure of interatrial shunt
* closure of ductus venosus in liver is prolonged

{| border=1

|-
! Fetal Structure
! Adult Structure
|-
| foramen ovale
| fossa ovalis
|-
| umbilical vein (intra-abdominal part)
| ligamentum teres
|-
| ductus venosus
| ligamentum venosum
|-
| umbilical arteries
| distal part -lateral umbilical ligaments; proximal part - superior vesical artery (supplies bladder)
|-
| ductus arteriosus
| ligamentum arteriosum
|}

==Abnormalities==
There are many different cardiac abnormalities, some more common than others, and only a few will be described in this lecture.

'''Major Abnormalities:''' Aortic Stenosis, Atrial Septal Defects, Coarctation of Aorta, Dextrocardia, Hypoplastic Left Heart, Long QT Syndrome, Patent Ductus Arteriosus, Pulmonary Atresia, Pulmonary Stenosis, Tetralogy of Fallot, Transposition of Great Vessels, Tricuspid Atresia, Total Anomalous Pulmonary Venous Connection, Ventricular Septal Defect, Abnormalities of Conducting System.

Links: [http://embryology.med.unsw.edu.au/Notes/heart2.htm Cardiovascular Development Abnormalities]

[[File:Abnormal81-92-heart.png|thumb]]

[[File:Statistics-Utah heart defects.jpg|thumb]]
===Atrial Septal Defects===

{| border='0px'
|-
| [[File:HeartILP_draft_asd.jpg|Atrial Septal Defect]]
|
* Atrial Septal Defects (ASD) are a group of common (1% of cardiac) congenital anomalies defects occurring in a number of different forms and more often in females.
* patent foramen ovale - allows a continuation of the atrial shunting of blood, in 25% of people a probe patent foramen ovale (allowing a probe to bypassed from one atria to the other) exists.
* ostium secundum defect
* endocardial cushion defect involving ostium primum
* sinus venosus defect - contributes about 10% of all ASDs and occurs mainly in a common and less common form. Common ("usual type") - in upper atrial septum which is contiguous with the superior vena cava. Less common - at junction of the right atrium and inferior vena cava.
* common atrium
|-
|}

===Ventricular Septal Defects===
{| border='0px'
|-
| [[File:HeartILP_draft_vsd.jpg|Ventricular Septal Defect]]
|
* The Ventricular Septal Defect (VSD) usually occurs in the membranous (perimembranous) (70%) rather than muscular interventricular septum, and is more frequent in males that females.
* Perimembranous defects are located close to the aortic and tricuspid valves and adjacent to atrioventricular conduction bundle.
* The defect allows left-right shunting of blood, this shunting depends upon the size of the defect. Small defects may close spontaneously, larger defects result in infant congestive heart failure.
* Clinically repaired by coils or tissue-adapted devices like muscular or perimembranous occluders.
|-
|}
(V.S.D.)

===Patent Ductus Arteriosus===

{| border='0px'

|-
| [[File:HeartILP_draft_patentda.jpg|Patent Ductus Arteriosus]]
|
* Patent Ductus Arteriosus (PDA) occurs commonly in preterm infants, can close spontaneously (by day three in 60% of normal term neonates) the remainder are ligated simply and with little risk.
* The operation is always recommended even in the absence of cardiac failure and can often be deferred until early childhood.

|-
|}

===Tetralogy of Fallot===
{| border='0px'
|-
| [[File:HeartILP_draft_tetralogyoffallot.jpg|Tetralogy of Fallot]]
|
* Named after Etienne-Louis Arthur Fallot (1888) who described it as "la maladie blue" and is a common developmental cardiac defect.
* The syndrome consists of a number of a number of cardiac defects possibly stemming from abnormal neural crest migration. The basic defect in a tetralogy of Fallot is an asymmetrical fusion of the truncoconal ridges and a malalignment of the aortic and pulmonary valves. This results in the typical 4 features seen in this defect: 1. pulmonary stenosis, 2. overriding aorta, 3. ventricular septal defect, and 4. right ventricular hypertrophy.
|-
|}

==Movies==

{| border='0px'

|-
| [[File:Heart1_looping icon.jpg|90px|link=Development_Animation_-_Heart Looping]]
| [[File:Heart1_realign icon.jpg|90px|link=Development_Animation_-_Heart Realign]]
| [[File:Heart1_atrium icon.jpg|90px|link=Development_Animation_-_Heart Atrial Septation]]
| [[File:heart1 ventricle icon.jpg|90px|link=Development_Animation_-_Heart Outflow Septation]]
|-
| [[Development_Animation_-_Heart Looping|Heart Looping]]
| [[Development_Animation_-_Heart Realign|Heart Realign]]
| [[Development_Animation_-_Heart Atrial Septation|Heart Atrial Septation]]
| [[Development_Animation_-_Heart Outflow Septation|Heart Outflow Septation]]
|-
|}

'''Link:''' [[Flash Movies]]

{{Template:2009ANAT2341}}

[[Category:2009ANAT2341]] [[Category:Science-Undergraduate]]

[[Category:Cardiovascular]] [[Category:Heart]]

2010 Lecture 21

2010-10-10T22:18:59Z

Z3267024: /* Separation of the Atria from the Venticles */

<div style="background:#F5FFFA; border: 1px solid #CEF2E0; padding: 1em; margin: auto; width: 95%; float:left;"><div style="margin:0;background-color:#cef2e0;font-family:sans-serif;font-size:120%;font-weight:bold;border:1px solid #a3bfb1;text-align:left;color:#000;padding-left:0.4em;padding-top:0.2em;padding-bottom:0.2em;">Lecture Notice - Dr Nalini Pather</div> Final lecture pages can also be printed out using the "printable version" lefthand menu.</div>

==Introduction==
[[File:Gray0473.gif|300px|right]]

In [[2010 Lecture 7|lecture 7 - Early Vascular Development]], the early development of the cardiovascular system was discussed. This second lecture will now focus on the extensive remodeling that occurs in both the heart and vascular system during later development. In addition, there will be discussion on the major cardiovascular abnormalities. The laboratory this week will also give you the opportunity to work through some of these concepts using a new online teaching module.

This material is also presented in an online [[Cardiac_Embryology|Cardiac Embryology tutorial]].

[[File:Basic_Heart_Development_Timeline.jpg|400px|Link=Cardiac_Embryology]]

{{Template:Heart Links}}

:'''Lecture Audio'''

==Lecture Objectives==
* Describe the development of primary and secondary atrial septa and the ventricular septum.
* Explain the changes occurring in the bulbis cordis and truncus arteriosus in its transformation from a single to a double tube.
* Describe the development of the aortic arches on the right and left sides from the fetus to the adult.
* Describe the development of arteries and veins.
* Describe the major cardiovascular developmental abnormalities.

==Textbook references==

* Human Embryology (3rd ed.) Larson Chapter 7 p151-188 Heart, Chapter 8 p189-228 Vasculature
* The Developing Human: Clinically Oriented Embryology (6th ed.) Chapter 14: p304-349

'''Other textbooks'''
* Before we Are Born (5th ed.) Moore and Persaud Chapter 12; p241-254
* Essentials of Human Embryology Larson Chapter 7 p97-122 Heart, Chapter 8 p123-146 Vasculature
* Human Embryology Fitzgerald and Fitzgerald Chapter 13-17: p77-111

'''Recent reviews'''
* Yutzey KE, Kirby ML. Wherefore heart thou? Embryonic origins of cardiogenic mesoderm. Dev Dyn. 2002 Mar;223(3):307-20. Review. [http://www.ncbi.nlm.nih.gov/pubmed/11891982?dopt=Abstract PMID: 11891982]
* Three-dimensional reconstruction of gene expression patterns during cardiac development. Soufan AT, Ruijter JM, van den Hoff MJ, de Boer PA, Hagoort J, Moorman AF. Physiol Genomics. 2003 May 13;13(3):187-95. Review. [http://www.ncbi.nlm.nih.gov/pubmed/12746463 PMID: 12746463]
* Moorman A, Webb S, Brown NA, Lamers W, Anderson RH. Development of the heart: (1) formation of the cardiac chambers and arterial trunks. Heart. 2003 Jul;89(7):806-14. [http://www.ncbi.nlm.nih.gov/pubmed/12807866?dopt=Abstract PMID: 12807866]
* Bruneau BG. Transcriptional regulation of vertebrate cardiac morphogenesis. Circ Res. 2002 Mar 22;90(5):509-19. Review. [http://www.ncbi.nlm.nih.gov/pubmed/11909814?dopt=Abstract PMID: 11909814]

----

==Heart Development==
[[File:Gray0462.gif|thumb|200px|Day 14 Heart tube]]
[[File:Heart_Tube_Fusion.jpg|400px|Early Human Heart Tube Development]]

* [[E#endocardial tube|endocardial tube]] in [[P#pericardial cavity|pericardial cavity]]
** dorsal mesentry (mesocardial) attachment lost
** attached at cranial (arterial) and caudal (venous) ends
* tube elongation - bending and series of expansions

Bulbus Cordis
* refers to the outflow tract in early embryo
* 3 parts
** distal - forms [[T#truncus arteriosus|truncus arteriosus]] (aorta and pulmonary artery)
** middle - [[C#conus arteriosus|conus arteriosus]] ventricular outflow tract
** proximal - right ventricle trabeculate part
[[File:Heart-cartoon-001.jpg|300px|right|Adult Heart blood flow]]
{| border=1

|-
! Fetal Structure
! Adult Structure
|-
| Truncus arteriosus
| aorta
pulmonary trunk
|-
| Conus arteriosus
| right ventricle - smooth part
|-
| Primitive ventricle
| right ventricle - trabecular part
left ventricle - trabecular part
|-
| Primitive atrium
| right atrium - trabecular part
left atrium - trabecular part
|-
| Sinus venosus
| right atrium - smooth part (sinus venarum)
coronary sinus
oblique vein of left atrium
|}

===Heart Layers===
* '''pericardium''' - covers the heart, formed by 3 layers consisting of a fibrous pericardium and a double layered serous pericardium (parietal layer and visceral epicardium layer).
* '''myocardium''' - muscular wall of the heart, thickest layer formed by spirally arranged cardiac muscle cells.
* '''endocardium''' - lines the heart, epithelial (endothelial) tissue lining the inner surface of heart chambers and valves.

===Embryonic Heart Rate===

* Stage 9-10 2 mm embryo (gestational sac diameter of 20 mm) EHR at least 75 beats / minute
* Stage 11-12 5 mm embryo (gestational sac diameter of 30 mm) EHR at least 100 beats / minute
* Stage 16 10 mm embryo EHR at least 120 beats / minute
* Stage 18 15 mm embryo EHR at least 130 beats / minute

[http://embryology.med.unsw.edu.au/Movies/usound/Hum12wkFHR.htm Week 12 fetal heart rate doppler] [http://embryology.med.unsw.edu.au/Notes/heart8.htm Week 17 fetal heart rate audio]

==Separation of the Atria from the Venticles==
[[File:AV Canal Division.jpg|thumb|200px|Separation of the atrioventricular canal]]
===Endocardial Cushions===
* form initial division of atria and ventricles
* form on dorsal and ventral wall of atrioventcular canals
* grow into canal - meet and fuse to separate atrioventricular canal into right and left channels
* anterior and posterior cushions fuse; lateral cushions remain unfused

==Atrial Septation==
[[File:Heart1_atrium icon.jpg|90px|link=Development_Animation_-_Heart Atrial Septation]]

[[File:Stage13 C7L.jpg|thumb|Heart (Carnegie stage 13)]]

Through all development blood shunts from right to left atrium (bypass lungs)

===Septum Primum===
[http://embryology.med.unsw.edu.au/wwwpig/pigc/c1l.htm Stage 13 Septum Primum] [http://embryology.med.unsw.edu.au/wwwhuman/lowpower/HumE/E2L.htm Stage 22 Septum Primum]

* dorso-cranial wall, crescentric-shaped membranous extension
* grows downward towards endocardial cushions
* opening is '''foramen primum''' (ostium primum)- serves as a shunt
* a series of perforations develop in cranial end - coalesce to form '''foramen secundum''' (ostium secundum)
* septum primum fuses with endocardial cushions - obliterates foramen primum

===Septum Secundum===
* crescentric septum secundum begins to form to the right of septum primum
* grows as septum primum downwards, does not fuse with endocardial cushion, opening is '''foramen ovale'''
* arrangement of the two septa facilitates a one-way valve

[[File:Atrial Septation.jpg|200px|Atrial septation]]
[[File:Atrial & Ventricular Septation 1.jpg|200px|Early -atrial and ventricular septation]]
[[File:Atrial & Ventricular Septation 2.jpg|200px|Late-atrial and ventricular septation]]

===Right Atrium===
[[File:Gray0476.jpg|thumb|sinus venosus and tributaries]]
* with heart looping and formation of interatrial septa, the sinus venosus shifts completely to right atrium
* right sinus horn incorporates into dorsal wall of right atrium
* left sinus horn becomes the coronary sinus
* sinoatrial opening - has 2 flaps, left fuses with septum secundum, right forms valve to inferior vena cava and coronary sinus. [http://embryology.med.unsw.edu.au/wwwpig/pigc/c3l.htm Stage 13 - right venous valve] [http://embryology.med.unsw.edu.au/wwwhuman/lowpower/HumE/E2L.htm Stage 22 - right venous valve]

===Left Atrium===
* posterior wall - outgrowth forms single pulmonary vein, divided into 4 branches
* incorporation into the wall leads to 4 openings in posterior wall
* later moves to the right aligns with atrioventricular canal.

==Ventricular Septation==
[[File:Stage13 C7L.jpg|thumb|Heart (Carnegie stage 13)]]
[[File:Gray0498.jpg|thumb|Ventricular septum]]
[[File:Heart1_realign icon.jpg|90px|link=Development_Animation_-_Heart Realign]]

* 2 separate components - superior membranous, inferior muscular
===Muscular Septum===
[[File:Gray0470.jpg|thumb|muscular septum]]
* growth of inferior wall
* fusion of 3 components - right and left bulbar ridges and dorsal endocardial cushion

===Membranous Septum===
* above the muscular septum, fusion continuous with septation of the outflow tract

[[File:Heart-ventricular-septum-01.jpg‎]][[File:Heart-ventricular-septum-02.jpg‎]][[File:Heart-ventricular-septum-03.jpg‎]]

==Outflow Tract Septation==

[[File:heart1 ventricle icon.jpg|90px|link=Development_Animation_-_Heart Outflow Septation]]

* in early development, outflow tract is a single tube, bulbus cordis
* elongates to form proximal conus arteriosus and distal truncus arteriosus
* 2 growths from wall in spiral pattern, inferior upwards - separate tract into 2 channels [http://embryology.med.unsw.edu.au/wwwpig/pigb/b5l.htm Stage 13 truncus arteriousus]
* mesenchyme and neural crest contribute to this septation process
* fusion of outgrowths separate aortic and pulmonary outflow

{| border='0px'

|-
| [[File:Chick_Heart_001-icon.jpg|90px|link=Movie_-_Normal Chick Heart]]
| [[File:Chick_Heart_002-icon.jpg|90px|link=Movie_-_Abnormal Chick Heart]]
| [[File:Chick_Heart_002-icon.jpg|90px|link=Movie_-_Abnormal Chick Heart 2]]
|-
| [[Movie_-_Normal Chick Heart|Normal Heart]]
| [[Movie_-_Abnormal Chick Heart|Abnormal Heart]]
| [[Movie_-_Abnormal Chick Heart 2|Abnormal Heart 2]]
|-
|}

==Vascular Remodeling==
===Arterial System===
[[File:Gray0474.jpg|thumb|pharyngeal arch arteries]]
* Aortic sac - remodels forming 2 horns, R forms brachiocephalic artery, L forms common carotid artery

Pharyngeal arch arteries
* pharyngeal arch artery 1 and 2 regress
* pharyngeal arch artery 3 and the associated dorsal aorta form the paired internal carotid arteries, these in turn generate the external carotids
* Left pharyngeal arch artery 4 – forms the aortic arch

* paraxial mesoderm forms paired dorsal aorta
** head mesenchyme forms aortic arches
** connecting stalk contains unbilical (placental) arteries
** dorsal aortas give rise to
** vitelline arteries which connect to capillaries on yolk sac
** intersegmental arteries between somites

===Venous System===
Cardinal veins contribute nearly all systemic venous system.

<gallery>
File:Gray0477.jpg
File:Gray0478.jpg
File:Gray0479.jpg
File:Gray0480.jpg
</gallery>

common cardinal veins - ducts of Cuvier

hepatic veins - drain de-oxygenated blood from the liver into the inferior vena cava.

internal iliac vein - hypogastric vein

==Birth Changes==
[[File:Fetal_circulation1.jpg|thumb|Fetal circulation]]
At birth, cutting the umbilical cord and changes in the lungs after the first breaths trigger major functional adaptations in the fetal circulatory system.

* blood flow through ductus venosus is eliminated
* pulmonary circulation bed expands - reducing blood flow through ductus arteriosus
* physiological closure of interatrial shunt
* closure of ductus venosus in liver is prolonged

{| border=1

|-
! Fetal Structure
! Adult Structure
|-
| foramen ovale
| fossa ovalis
|-
| umbilical vein (intra-abdominal part)
| ligamentum teres
|-
| ductus venosus
| ligamentum venosum
|-
| umbilical arteries
| distal part -lateral umbilical ligaments; proximal part - superior vesical artery (supplies bladder)
|-
| ductus arteriosus
| ligamentum arteriosum
|}

==Abnormalities==
There are many different cardiac abnormalities, some more common than others, and only a few will be described in this lecture.

'''Major Abnormalities:''' Aortic Stenosis, Atrial Septal Defects, Coarctation of Aorta, Dextrocardia, Hypoplastic Left Heart, Long QT Syndrome, Patent Ductus Arteriosus, Pulmonary Atresia, Pulmonary Stenosis, Tetralogy of Fallot, Transposition of Great Vessels, Tricuspid Atresia, Total Anomalous Pulmonary Venous Connection, Ventricular Septal Defect, Abnormalities of Conducting System.

Links: [http://embryology.med.unsw.edu.au/Notes/heart2.htm Cardiovascular Development Abnormalities]

[[File:Abnormal81-92-heart.png|thumb]]

[[File:Statistics-Utah heart defects.jpg|thumb]]
===Atrial Septal Defects===

{| border='0px'
|-
| [[File:HeartILP_draft_asd.jpg|Atrial Septal Defect]]
|
* Atrial Septal Defects (ASD) are a group of common (1% of cardiac) congenital anomalies defects occurring in a number of different forms and more often in females.
* patent foramen ovale - allows a continuation of the atrial shunting of blood, in 25% of people a probe patent foramen ovale (allowing a probe to bypassed from one atria to the other) exists.
* ostium secundum defect
* endocardial cushion defect involving ostium primum
* sinus venosus defect - contributes about 10% of all ASDs and occurs mainly in a common and less common form. Common ("usual type") - in upper atrial septum which is contiguous with the superior vena cava. Less common - at junction of the right atrium and inferior vena cava.
* common atrium
|-
|}

===Ventricular Septal Defects===
{| border='0px'
|-
| [[File:HeartILP_draft_vsd.jpg|Ventricular Septal Defect]]
|
* The Ventricular Septal Defect (VSD) usually occurs in the membranous (perimembranous) (70%) rather than muscular interventricular septum, and is more frequent in males that females.
* Perimembranous defects are located close to the aortic and tricuspid valves and adjacent to atrioventricular conduction bundle.
* The defect allows left-right shunting of blood, this shunting depends upon the size of the defect. Small defects may close spontaneously, larger defects result in infant congestive heart failure.
* Clinically repaired by coils or tissue-adapted devices like muscular or perimembranous occluders.
|-
|}
(V.S.D.)

===Patent Ductus Arteriosus===

{| border='0px'

|-
| [[File:HeartILP_draft_patentda.jpg|Patent Ductus Arteriosus]]
|
* Patent Ductus Arteriosus (PDA) occurs commonly in preterm infants, can close spontaneously (by day three in 60% of normal term neonates) the remainder are ligated simply and with little risk.
* The operation is always recommended even in the absence of cardiac failure and can often be deferred until early childhood.

|-
|}

===Tetralogy of Fallot===
{| border='0px'
|-
| [[File:HeartILP_draft_tetralogyoffallot.jpg|Tetralogy of Fallot]]
|
* Named after Etienne-Louis Arthur Fallot (1888) who described it as "la maladie blue" and is a common developmental cardiac defect.
* The syndrome consists of a number of a number of cardiac defects possibly stemming from abnormal neural crest migration. The basic defect in a tetralogy of Fallot is an asymmetrical fusion of the truncoconal ridges and a malalignment of the aortic and pulmonary valves. This results in the typical 4 features seen in this defect: 1. pulmonary stenosis, 2. overriding aorta, 3. ventricular septal defect, and 4. right ventricular hypertrophy.
|-
|}

==Movies==

{| border='0px'

|-
| [[File:Heart1_looping icon.jpg|90px|link=Development_Animation_-_Heart Looping]]
| [[File:Heart1_realign icon.jpg|90px|link=Development_Animation_-_Heart Realign]]
| [[File:Heart1_atrium icon.jpg|90px|link=Development_Animation_-_Heart Atrial Septation]]
| [[File:heart1 ventricle icon.jpg|90px|link=Development_Animation_-_Heart Outflow Septation]]
|-
| [[Development_Animation_-_Heart Looping|Heart Looping]]
| [[Development_Animation_-_Heart Realign|Heart Realign]]
| [[Development_Animation_-_Heart Atrial Septation|Heart Atrial Septation]]
| [[Development_Animation_-_Heart Outflow Septation|Heart Outflow Septation]]
|-
|}

'''Link:''' [[Flash Movies]]

{{Template:2009ANAT2341}}

[[Category:2009ANAT2341]] [[Category:Science-Undergraduate]]

[[Category:Cardiovascular]] [[Category:Heart]]

2010 Lecture 21

2010-10-10T22:06:15Z

Z3267024:

<div style="background:#F5FFFA; border: 1px solid #CEF2E0; padding: 1em; margin: auto; width: 95%; float:left;"><div style="margin:0;background-color:#cef2e0;font-family:sans-serif;font-size:120%;font-weight:bold;border:1px solid #a3bfb1;text-align:left;color:#000;padding-left:0.4em;padding-top:0.2em;padding-bottom:0.2em;">Lecture Notice - Dr Nalini Pather</div> Final lecture pages can also be printed out using the "printable version" lefthand menu.</div>

==Introduction==
[[File:Gray0473.gif|300px|right]]

In [[2010 Lecture 7|lecture 7 - Early Vascular Development]], the early development of the cardiovascular system was discussed. This second lecture will now focus on the extensive remodeling that occurs in both the heart and vascular system during later development. In addition, there will be discussion on the major cardiovascular abnormalities. The laboratory this week will also give you the opportunity to work through some of these concepts using a new online teaching module.

This material is also presented in an online [[Cardiac_Embryology|Cardiac Embryology tutorial]].

[[File:Basic_Heart_Development_Timeline.jpg|400px|Link=Cardiac_Embryology]]

{{Template:Heart Links}}

:'''Lecture Audio'''

==Lecture Objectives==
* Describe the development of primary and secondary atrial septa and the ventricular septum.
* Explain the changes occurring in the bulbis cordis and truncus arteriosus in its transformation from a single to a double tube.
* Describe the development of the aortic arches on the right and left sides from the fetus to the adult.
* Describe the development of arteries and veins.
* Describe the major cardiovascular developmental abnormalities.

==Textbook references==

* Human Embryology (3rd ed.) Larson Chapter 7 p151-188 Heart, Chapter 8 p189-228 Vasculature
* The Developing Human: Clinically Oriented Embryology (6th ed.) Chapter 14: p304-349

'''Other textbooks'''
* Before we Are Born (5th ed.) Moore and Persaud Chapter 12; p241-254
* Essentials of Human Embryology Larson Chapter 7 p97-122 Heart, Chapter 8 p123-146 Vasculature
* Human Embryology Fitzgerald and Fitzgerald Chapter 13-17: p77-111

'''Recent reviews'''
* Yutzey KE, Kirby ML. Wherefore heart thou? Embryonic origins of cardiogenic mesoderm. Dev Dyn. 2002 Mar;223(3):307-20. Review. [http://www.ncbi.nlm.nih.gov/pubmed/11891982?dopt=Abstract PMID: 11891982]
* Three-dimensional reconstruction of gene expression patterns during cardiac development. Soufan AT, Ruijter JM, van den Hoff MJ, de Boer PA, Hagoort J, Moorman AF. Physiol Genomics. 2003 May 13;13(3):187-95. Review. [http://www.ncbi.nlm.nih.gov/pubmed/12746463 PMID: 12746463]
* Moorman A, Webb S, Brown NA, Lamers W, Anderson RH. Development of the heart: (1) formation of the cardiac chambers and arterial trunks. Heart. 2003 Jul;89(7):806-14. [http://www.ncbi.nlm.nih.gov/pubmed/12807866?dopt=Abstract PMID: 12807866]
* Bruneau BG. Transcriptional regulation of vertebrate cardiac morphogenesis. Circ Res. 2002 Mar 22;90(5):509-19. Review. [http://www.ncbi.nlm.nih.gov/pubmed/11909814?dopt=Abstract PMID: 11909814]

----

==Heart Development==
[[File:Gray0462.gif|thumb|200px|Day 14 Heart tube]]
[[File:Heart_Tube_Fusion.jpg|400px|Early Human Heart Tube Development]]

* [[E#endocardial tube|endocardial tube]] in [[P#pericardial cavity|pericardial cavity]]
** dorsal mesentry (mesocardial) attachment lost
** attached at cranial (arterial) and caudal (venous) ends
* tube elongation - bending and series of expansions

Bulbus Cordis
* refers to the outflow tract in early embryo
* 3 parts
** distal - forms [[T#truncus arteriosus|truncus arteriosus]] (aorta and pulmonary artery)
** middle - [[C#conus arteriosus|conus arteriosus]] ventricular outflow tract
** proximal - right ventricle trabeculate part
[[File:Heart-cartoon-001.jpg|300px|right|Adult Heart blood flow]]
{| border=1

|-
! Fetal Structure
! Adult Structure
|-
| Truncus arteriosus
| aorta
pulmonary trunk
|-
| Conus arteriosus
| right ventricle - smooth part
|-
| Primitive ventricle
| right ventricle - trabecular part
left ventricle - trabecular part
|-
| Primitive atrium
| right atrium - trabecular part
left atrium - trabecular part
|-
| Sinus venosus
| right atrium - smooth part (sinus venarum)
coronary sinus
oblique vein of left atrium
|}

===Heart Layers===
* '''pericardium''' - covers the heart, formed by 3 layers consisting of a fibrous pericardium and a double layered serous pericardium (parietal layer and visceral epicardium layer).
* '''myocardium''' - muscular wall of the heart, thickest layer formed by spirally arranged cardiac muscle cells.
* '''endocardium''' - lines the heart, epithelial (endothelial) tissue lining the inner surface of heart chambers and valves.

===Embryonic Heart Rate===

* Stage 9-10 2 mm embryo (gestational sac diameter of 20 mm) EHR at least 75 beats / minute
* Stage 11-12 5 mm embryo (gestational sac diameter of 30 mm) EHR at least 100 beats / minute
* Stage 16 10 mm embryo EHR at least 120 beats / minute
* Stage 18 15 mm embryo EHR at least 130 beats / minute

[http://embryology.med.unsw.edu.au/Movies/usound/Hum12wkFHR.htm Week 12 fetal heart rate doppler] [http://embryology.med.unsw.edu.au/Notes/heart8.htm Week 17 fetal heart rate audio]

==Separation of the Atria from the Venticles==
[[File:AV Canal Division.jpg|thumb|200px|Separation of the atrioventricular canal]]
===Endocardial Cushions===
* form initial division of atria and ventricles
* form on dorsal and ventral wall of atrioventcular canals
* grow into canal - meet and fuse to separate atrioventricular canal into right and left channels.

==Atrial Septation==
[[File:Heart1_atrium icon.jpg|90px|link=Development_Animation_-_Heart Atrial Septation]]

[[File:Stage13 C7L.jpg|thumb|Heart (Carnegie stage 13)]]

Through all development blood shunts from right to left atrium (bypass lungs)

===Septum Primum===
[http://embryology.med.unsw.edu.au/wwwpig/pigc/c1l.htm Stage 13 Septum Primum] [http://embryology.med.unsw.edu.au/wwwhuman/lowpower/HumE/E2L.htm Stage 22 Septum Primum]

* dorso-cranial wall, crescentric-shaped membranous extension
* grows downward towards endocardial cushions
* opening is '''foramen primum''' (ostium primum)- serves as a shunt
* a series of perforations develop in cranial end - coalesce to form '''foramen secundum''' (ostium secundum)
* septum primum fuses with endocardial cushions - obliterates foramen primum

===Septum Secundum===
* crescentric septum secundum begins to form to the right of septum primum
* grows as septum primum downwards, does not fuse with endocardial cushion, opening is '''foramen ovale'''
* arrangement of the two septa facilitates a one-way valve

[[File:Atrial Septation.jpg|200px|Atrial septation]]
[[File:Atrial & Ventricular Septation 1.jpg|200px|Early -atrial and ventricular septation]]
[[File:Atrial & Ventricular Septation 2.jpg|200px|Late-atrial and ventricular septation]]

===Right Atrium===
[[File:Gray0476.jpg|thumb|sinus venosus and tributaries]]
* with heart looping and formation of interatrial septa, the sinus venosus shifts completely to right atrium
* right sinus horn incorporates into dorsal wall of right atrium
* left sinus horn becomes the coronary sinus
* sinoatrial opening - has 2 flaps, left fuses with septum secundum, right forms valve to inferior vena cava and coronary sinus. [http://embryology.med.unsw.edu.au/wwwpig/pigc/c3l.htm Stage 13 - right venous valve] [http://embryology.med.unsw.edu.au/wwwhuman/lowpower/HumE/E2L.htm Stage 22 - right venous valve]

===Left Atrium===
* posterior wall - outgrowth forms single pulmonary vein, divided into 4 branches
* incorporation into the wall leads to 4 openings in posterior wall
* later moves to the right aligns with atrioventricular canal.

==Ventricular Septation==
[[File:Stage13 C7L.jpg|thumb|Heart (Carnegie stage 13)]]
[[File:Gray0498.jpg|thumb|Ventricular septum]]
[[File:Heart1_realign icon.jpg|90px|link=Development_Animation_-_Heart Realign]]

* 2 separate components - superior membranous, inferior muscular
===Muscular Septum===
[[File:Gray0470.jpg|thumb|muscular septum]]
* growth of inferior wall
* fusion of 3 components - right and left bulbar ridges and dorsal endocardial cushion

===Membranous Septum===
* above the muscular septum, fusion continuous with septation of the outflow tract

[[File:Heart-ventricular-septum-01.jpg‎]][[File:Heart-ventricular-septum-02.jpg‎]][[File:Heart-ventricular-septum-03.jpg‎]]

==Outflow Tract Septation==

[[File:heart1 ventricle icon.jpg|90px|link=Development_Animation_-_Heart Outflow Septation]]

* in early development, outflow tract is a single tube, bulbus cordis
* elongates to form proximal conus arteriosus and distal truncus arteriosus
* 2 growths from wall in spiral pattern, inferior upwards - separate tract into 2 channels [http://embryology.med.unsw.edu.au/wwwpig/pigb/b5l.htm Stage 13 truncus arteriousus]
* mesenchyme and neural crest contribute to this septation process
* fusion of outgrowths separate aortic and pulmonary outflow

{| border='0px'

|-
| [[File:Chick_Heart_001-icon.jpg|90px|link=Movie_-_Normal Chick Heart]]
| [[File:Chick_Heart_002-icon.jpg|90px|link=Movie_-_Abnormal Chick Heart]]
| [[File:Chick_Heart_002-icon.jpg|90px|link=Movie_-_Abnormal Chick Heart 2]]
|-
| [[Movie_-_Normal Chick Heart|Normal Heart]]
| [[Movie_-_Abnormal Chick Heart|Abnormal Heart]]
| [[Movie_-_Abnormal Chick Heart 2|Abnormal Heart 2]]
|-
|}

==Vascular Remodeling==
===Arterial System===
[[File:Gray0474.jpg|thumb|pharyngeal arch arteries]]
* Aortic sac - remodels forming 2 horns, R forms brachiocephalic artery, L forms common carotid artery

Pharyngeal arch arteries
* pharyngeal arch artery 1 and 2 regress
* pharyngeal arch artery 3 and the associated dorsal aorta form the paired internal carotid arteries, these in turn generate the external carotids
* Left pharyngeal arch artery 4 – forms the aortic arch

* paraxial mesoderm forms paired dorsal aorta
** head mesenchyme forms aortic arches
** connecting stalk contains unbilical (placental) arteries
** dorsal aortas give rise to
** vitelline arteries which connect to capillaries on yolk sac
** intersegmental arteries between somites

===Venous System===
Cardinal veins contribute nearly all systemic venous system.

<gallery>
File:Gray0477.jpg
File:Gray0478.jpg
File:Gray0479.jpg
File:Gray0480.jpg
</gallery>

common cardinal veins - ducts of Cuvier

hepatic veins - drain de-oxygenated blood from the liver into the inferior vena cava.

internal iliac vein - hypogastric vein

==Birth Changes==
[[File:Fetal_circulation1.jpg|thumb|Fetal circulation]]
At birth, cutting the umbilical cord and changes in the lungs after the first breaths trigger major functional adaptations in the fetal circulatory system.

* blood flow through ductus venosus is eliminated
* pulmonary circulation bed expands - reducing blood flow through ductus arteriosus
* physiological closure of interatrial shunt
* closure of ductus venosus in liver is prolonged

{| border=1

|-
! Fetal Structure
! Adult Structure
|-
| foramen ovale
| fossa ovalis
|-
| umbilical vein (intra-abdominal part)
| ligamentum teres
|-
| ductus venosus
| ligamentum venosum
|-
| umbilical arteries
| distal part -lateral umbilical ligaments; proximal part - superior vesical artery (supplies bladder)
|-
| ductus arteriosus
| ligamentum arteriosum
|}

==Abnormalities==
There are many different cardiac abnormalities, some more common than others, and only a few will be described in this lecture.

'''Major Abnormalities:''' Aortic Stenosis, Atrial Septal Defects, Coarctation of Aorta, Dextrocardia, Hypoplastic Left Heart, Long QT Syndrome, Patent Ductus Arteriosus, Pulmonary Atresia, Pulmonary Stenosis, Tetralogy of Fallot, Transposition of Great Vessels, Tricuspid Atresia, Total Anomalous Pulmonary Venous Connection, Ventricular Septal Defect, Abnormalities of Conducting System.

Links: [http://embryology.med.unsw.edu.au/Notes/heart2.htm Cardiovascular Development Abnormalities]

[[File:Abnormal81-92-heart.png|thumb]]

[[File:Statistics-Utah heart defects.jpg|thumb]]
===Atrial Septal Defects===

{| border='0px'
|-
| [[File:HeartILP_draft_asd.jpg|Atrial Septal Defect]]
|
* Atrial Septal Defects (ASD) are a group of common (1% of cardiac) congenital anomalies defects occurring in a number of different forms and more often in females.
* patent foramen ovale - allows a continuation of the atrial shunting of blood, in 25% of people a probe patent foramen ovale (allowing a probe to bypassed from one atria to the other) exists.
* ostium secundum defect
* endocardial cushion defect involving ostium primum
* sinus venosus defect - contributes about 10% of all ASDs and occurs mainly in a common and less common form. Common ("usual type") - in upper atrial septum which is contiguous with the superior vena cava. Less common - at junction of the right atrium and inferior vena cava.
* common atrium
|-
|}

===Ventricular Septal Defects===
{| border='0px'
|-
| [[File:HeartILP_draft_vsd.jpg|Ventricular Septal Defect]]
|
* The Ventricular Septal Defect (VSD) usually occurs in the membranous (perimembranous) (70%) rather than muscular interventricular septum, and is more frequent in males that females.
* Perimembranous defects are located close to the aortic and tricuspid valves and adjacent to atrioventricular conduction bundle.
* The defect allows left-right shunting of blood, this shunting depends upon the size of the defect. Small defects may close spontaneously, larger defects result in infant congestive heart failure.
* Clinically repaired by coils or tissue-adapted devices like muscular or perimembranous occluders.
|-
|}
(V.S.D.)

===Patent Ductus Arteriosus===

{| border='0px'

|-
| [[File:HeartILP_draft_patentda.jpg|Patent Ductus Arteriosus]]
|
* Patent Ductus Arteriosus (PDA) occurs commonly in preterm infants, can close spontaneously (by day three in 60% of normal term neonates) the remainder are ligated simply and with little risk.
* The operation is always recommended even in the absence of cardiac failure and can often be deferred until early childhood.

|-
|}

===Tetralogy of Fallot===
{| border='0px'
|-
| [[File:HeartILP_draft_tetralogyoffallot.jpg|Tetralogy of Fallot]]
|
* Named after Etienne-Louis Arthur Fallot (1888) who described it as "la maladie blue" and is a common developmental cardiac defect.
* The syndrome consists of a number of a number of cardiac defects possibly stemming from abnormal neural crest migration. The basic defect in a tetralogy of Fallot is an asymmetrical fusion of the truncoconal ridges and a malalignment of the aortic and pulmonary valves. This results in the typical 4 features seen in this defect: 1. pulmonary stenosis, 2. overriding aorta, 3. ventricular septal defect, and 4. right ventricular hypertrophy.
|-
|}

==Movies==

{| border='0px'

|-
| [[File:Heart1_looping icon.jpg|90px|link=Development_Animation_-_Heart Looping]]
| [[File:Heart1_realign icon.jpg|90px|link=Development_Animation_-_Heart Realign]]
| [[File:Heart1_atrium icon.jpg|90px|link=Development_Animation_-_Heart Atrial Septation]]
| [[File:heart1 ventricle icon.jpg|90px|link=Development_Animation_-_Heart Outflow Septation]]
|-
| [[Development_Animation_-_Heart Looping|Heart Looping]]
| [[Development_Animation_-_Heart Realign|Heart Realign]]
| [[Development_Animation_-_Heart Atrial Septation|Heart Atrial Septation]]
| [[Development_Animation_-_Heart Outflow Septation|Heart Outflow Septation]]
|-
|}

'''Link:''' [[Flash Movies]]

{{Template:2009ANAT2341}}

[[Category:2009ANAT2341]] [[Category:Science-Undergraduate]]

[[Category:Cardiovascular]] [[Category:Heart]]

2010 Lecture 21

2010-10-10T22:05:39Z

Z3267024:

<div style="background:#F5FFFA; border: 1px solid #CEF2E0; padding: 1em; margin: auto; width: 95%; float:left;"><div style="margin:0;background-color:#cef2e0;font-family:sans-serif;font-size:120%;font-weight:bold;border:1px solid #a3bfb1;text-align:left;color:#000;padding-left:0.4em;padding-top:0.2em;padding-bottom:0.2em;">Lecture Notice - Dr Nalini Pather</div>This online lecture page will contain the content required when attending the lecture. Final lecture pages can also be printed out using the "printable version" lefthand menu.</div>

==Introduction==
[[File:Gray0473.gif|300px|right]]

In [[2010 Lecture 7|lecture 7 - Early Vascular Development]], the early development of the cardiovascular system was discussed. This second lecture will now focus on the extensive remodeling that occurs in both the heart and vascular system during later development. In addition, there will be discussion on the major cardiovascular abnormalities. The laboratory this week will also give you the opportunity to work through some of these concepts using a new online teaching module.

This material is also presented in an online [[Cardiac_Embryology|Cardiac Embryology tutorial]].

[[File:Basic_Heart_Development_Timeline.jpg|400px|Link=Cardiac_Embryology]]

{{Template:Heart Links}}

:'''Lecture Audio'''

==Lecture Objectives==
* Describe the development of primary and secondary atrial septa and the ventricular septum.
* Explain the changes occurring in the bulbis cordis and truncus arteriosus in its transformation from a single to a double tube.
* Describe the development of the aortic arches on the right and left sides from the fetus to the adult.
* Describe the development of arteries and veins.
* Describe the major cardiovascular developmental abnormalities.

==Textbook references==

* Human Embryology (3rd ed.) Larson Chapter 7 p151-188 Heart, Chapter 8 p189-228 Vasculature
* The Developing Human: Clinically Oriented Embryology (6th ed.) Chapter 14: p304-349

'''Other textbooks'''
* Before we Are Born (5th ed.) Moore and Persaud Chapter 12; p241-254
* Essentials of Human Embryology Larson Chapter 7 p97-122 Heart, Chapter 8 p123-146 Vasculature
* Human Embryology Fitzgerald and Fitzgerald Chapter 13-17: p77-111

'''Recent reviews'''
* Yutzey KE, Kirby ML. Wherefore heart thou? Embryonic origins of cardiogenic mesoderm. Dev Dyn. 2002 Mar;223(3):307-20. Review. [http://www.ncbi.nlm.nih.gov/pubmed/11891982?dopt=Abstract PMID: 11891982]
* Three-dimensional reconstruction of gene expression patterns during cardiac development. Soufan AT, Ruijter JM, van den Hoff MJ, de Boer PA, Hagoort J, Moorman AF. Physiol Genomics. 2003 May 13;13(3):187-95. Review. [http://www.ncbi.nlm.nih.gov/pubmed/12746463 PMID: 12746463]
* Moorman A, Webb S, Brown NA, Lamers W, Anderson RH. Development of the heart: (1) formation of the cardiac chambers and arterial trunks. Heart. 2003 Jul;89(7):806-14. [http://www.ncbi.nlm.nih.gov/pubmed/12807866?dopt=Abstract PMID: 12807866]
* Bruneau BG. Transcriptional regulation of vertebrate cardiac morphogenesis. Circ Res. 2002 Mar 22;90(5):509-19. Review. [http://www.ncbi.nlm.nih.gov/pubmed/11909814?dopt=Abstract PMID: 11909814]

----

==Heart Development==
[[File:Gray0462.gif|thumb|200px|Day 14 Heart tube]]
[[File:Heart_Tube_Fusion.jpg|400px|Early Human Heart Tube Development]]

* [[E#endocardial tube|endocardial tube]] in [[P#pericardial cavity|pericardial cavity]]
** dorsal mesentry (mesocardial) attachment lost
** attached at cranial (arterial) and caudal (venous) ends
* tube elongation - bending and series of expansions

Bulbus Cordis
* refers to the outflow tract in early embryo
* 3 parts
** distal - forms [[T#truncus arteriosus|truncus arteriosus]] (aorta and pulmonary artery)
** middle - [[C#conus arteriosus|conus arteriosus]] ventricular outflow tract
** proximal - right ventricle trabeculate part
[[File:Heart-cartoon-001.jpg|300px|right|Adult Heart blood flow]]
{| border=1

|-
! Fetal Structure
! Adult Structure
|-
| Truncus arteriosus
| aorta
pulmonary trunk
|-
| Conus arteriosus
| right ventricle - smooth part
|-
| Primitive ventricle
| right ventricle - trabecular part
left ventricle - trabecular part
|-
| Primitive atrium
| right atrium - trabecular part
left atrium - trabecular part
|-
| Sinus venosus
| right atrium - smooth part (sinus venarum)
coronary sinus
oblique vein of left atrium
|}

===Heart Layers===
* '''pericardium''' - covers the heart, formed by 3 layers consisting of a fibrous pericardium and a double layered serous pericardium (parietal layer and visceral epicardium layer).
* '''myocardium''' - muscular wall of the heart, thickest layer formed by spirally arranged cardiac muscle cells.
* '''endocardium''' - lines the heart, epithelial (endothelial) tissue lining the inner surface of heart chambers and valves.

===Embryonic Heart Rate===

* Stage 9-10 2 mm embryo (gestational sac diameter of 20 mm) EHR at least 75 beats / minute
* Stage 11-12 5 mm embryo (gestational sac diameter of 30 mm) EHR at least 100 beats / minute
* Stage 16 10 mm embryo EHR at least 120 beats / minute
* Stage 18 15 mm embryo EHR at least 130 beats / minute

[http://embryology.med.unsw.edu.au/Movies/usound/Hum12wkFHR.htm Week 12 fetal heart rate doppler] [http://embryology.med.unsw.edu.au/Notes/heart8.htm Week 17 fetal heart rate audio]

==Separation of the Atria from the Venticles==
[[File:AV Canal Division.jpg|thumb|200px|Separation of the atrioventricular canal]]
===Endocardial Cushions===
* form initial division of atria and ventricles
* form on dorsal and ventral wall of atrioventcular canals
* grow into canal - meet and fuse to separate atrioventricular canal into right and left channels.

==Atrial Septation==
[[File:Heart1_atrium icon.jpg|90px|link=Development_Animation_-_Heart Atrial Septation]]

[[File:Stage13 C7L.jpg|thumb|Heart (Carnegie stage 13)]]

Through all development blood shunts from right to left atrium (bypass lungs)

===Septum Primum===
[http://embryology.med.unsw.edu.au/wwwpig/pigc/c1l.htm Stage 13 Septum Primum] [http://embryology.med.unsw.edu.au/wwwhuman/lowpower/HumE/E2L.htm Stage 22 Septum Primum]

* dorso-cranial wall, crescentric-shaped membranous extension
* grows downward towards endocardial cushions
* opening is '''foramen primum''' (ostium primum)- serves as a shunt
* a series of perforations develop in cranial end - coalesce to form '''foramen secundum''' (ostium secundum)
* septum primum fuses with endocardial cushions - obliterates foramen primum

===Septum Secundum===
* crescentric septum secundum begins to form to the right of septum primum
* grows as septum primum downwards, does not fuse with endocardial cushion, opening is '''foramen ovale'''
* arrangement of the two septa facilitates a one-way valve

[[File:Atrial Septation.jpg|200px|Atrial septation]]
[[File:Atrial & Ventricular Septation 1.jpg|200px|Early -atrial and ventricular septation]]
[[File:Atrial & Ventricular Septation 2.jpg|200px|Late-atrial and ventricular septation]]

===Right Atrium===
[[File:Gray0476.jpg|thumb|sinus venosus and tributaries]]
* with heart looping and formation of interatrial septa, the sinus venosus shifts completely to right atrium
* right sinus horn incorporates into dorsal wall of right atrium
* left sinus horn becomes the coronary sinus
* sinoatrial opening - has 2 flaps, left fuses with septum secundum, right forms valve to inferior vena cava and coronary sinus. [http://embryology.med.unsw.edu.au/wwwpig/pigc/c3l.htm Stage 13 - right venous valve] [http://embryology.med.unsw.edu.au/wwwhuman/lowpower/HumE/E2L.htm Stage 22 - right venous valve]

===Left Atrium===
* posterior wall - outgrowth forms single pulmonary vein, divided into 4 branches
* incorporation into the wall leads to 4 openings in posterior wall
* later moves to the right aligns with atrioventricular canal.

==Ventricular Septation==
[[File:Stage13 C7L.jpg|thumb|Heart (Carnegie stage 13)]]
[[File:Gray0498.jpg|thumb|Ventricular septum]]
[[File:Heart1_realign icon.jpg|90px|link=Development_Animation_-_Heart Realign]]

* 2 separate components - superior membranous, inferior muscular
===Muscular Septum===
[[File:Gray0470.jpg|thumb|muscular septum]]
* growth of inferior wall
* fusion of 3 components - right and left bulbar ridges and dorsal endocardial cushion

===Membranous Septum===
* above the muscular septum, fusion continuous with septation of the outflow tract

[[File:Heart-ventricular-septum-01.jpg‎]][[File:Heart-ventricular-septum-02.jpg‎]][[File:Heart-ventricular-septum-03.jpg‎]]

==Outflow Tract Septation==

[[File:heart1 ventricle icon.jpg|90px|link=Development_Animation_-_Heart Outflow Septation]]

* in early development, outflow tract is a single tube, bulbus cordis
* elongates to form proximal conus arteriosus and distal truncus arteriosus
* 2 growths from wall in spiral pattern, inferior upwards - separate tract into 2 channels [http://embryology.med.unsw.edu.au/wwwpig/pigb/b5l.htm Stage 13 truncus arteriousus]
* mesenchyme and neural crest contribute to this septation process
* fusion of outgrowths separate aortic and pulmonary outflow

{| border='0px'

|-
| [[File:Chick_Heart_001-icon.jpg|90px|link=Movie_-_Normal Chick Heart]]
| [[File:Chick_Heart_002-icon.jpg|90px|link=Movie_-_Abnormal Chick Heart]]
| [[File:Chick_Heart_002-icon.jpg|90px|link=Movie_-_Abnormal Chick Heart 2]]
|-
| [[Movie_-_Normal Chick Heart|Normal Heart]]
| [[Movie_-_Abnormal Chick Heart|Abnormal Heart]]
| [[Movie_-_Abnormal Chick Heart 2|Abnormal Heart 2]]
|-
|}

==Vascular Remodeling==
===Arterial System===
[[File:Gray0474.jpg|thumb|pharyngeal arch arteries]]
* Aortic sac - remodels forming 2 horns, R forms brachiocephalic artery, L forms common carotid artery

Pharyngeal arch arteries
* pharyngeal arch artery 1 and 2 regress
* pharyngeal arch artery 3 and the associated dorsal aorta form the paired internal carotid arteries, these in turn generate the external carotids
* Left pharyngeal arch artery 4 – forms the aortic arch

* paraxial mesoderm forms paired dorsal aorta
** head mesenchyme forms aortic arches
** connecting stalk contains unbilical (placental) arteries
** dorsal aortas give rise to
** vitelline arteries which connect to capillaries on yolk sac
** intersegmental arteries between somites

===Venous System===
Cardinal veins contribute nearly all systemic venous system.

<gallery>
File:Gray0477.jpg
File:Gray0478.jpg
File:Gray0479.jpg
File:Gray0480.jpg
</gallery>

common cardinal veins - ducts of Cuvier

hepatic veins - drain de-oxygenated blood from the liver into the inferior vena cava.

internal iliac vein - hypogastric vein

==Birth Changes==
[[File:Fetal_circulation1.jpg|thumb|Fetal circulation]]
At birth, cutting the umbilical cord and changes in the lungs after the first breaths trigger major functional adaptations in the fetal circulatory system.

* blood flow through ductus venosus is eliminated
* pulmonary circulation bed expands - reducing blood flow through ductus arteriosus
* physiological closure of interatrial shunt
* closure of ductus venosus in liver is prolonged

{| border=1

|-
! Fetal Structure
! Adult Structure
|-
| foramen ovale
| fossa ovalis
|-
| umbilical vein (intra-abdominal part)
| ligamentum teres
|-
| ductus venosus
| ligamentum venosum
|-
| umbilical arteries
| distal part -lateral umbilical ligaments; proximal part - superior vesical artery (supplies bladder)
|-
| ductus arteriosus
| ligamentum arteriosum
|}

==Abnormalities==
There are many different cardiac abnormalities, some more common than others, and only a few will be described in this lecture.

'''Major Abnormalities:''' Aortic Stenosis, Atrial Septal Defects, Coarctation of Aorta, Dextrocardia, Hypoplastic Left Heart, Long QT Syndrome, Patent Ductus Arteriosus, Pulmonary Atresia, Pulmonary Stenosis, Tetralogy of Fallot, Transposition of Great Vessels, Tricuspid Atresia, Total Anomalous Pulmonary Venous Connection, Ventricular Septal Defect, Abnormalities of Conducting System.

Links: [http://embryology.med.unsw.edu.au/Notes/heart2.htm Cardiovascular Development Abnormalities]

[[File:Abnormal81-92-heart.png|thumb]]

[[File:Statistics-Utah heart defects.jpg|thumb]]
===Atrial Septal Defects===

{| border='0px'
|-
| [[File:HeartILP_draft_asd.jpg|Atrial Septal Defect]]
|
* Atrial Septal Defects (ASD) are a group of common (1% of cardiac) congenital anomalies defects occurring in a number of different forms and more often in females.
* patent foramen ovale - allows a continuation of the atrial shunting of blood, in 25% of people a probe patent foramen ovale (allowing a probe to bypassed from one atria to the other) exists.
* ostium secundum defect
* endocardial cushion defect involving ostium primum
* sinus venosus defect - contributes about 10% of all ASDs and occurs mainly in a common and less common form. Common ("usual type") - in upper atrial septum which is contiguous with the superior vena cava. Less common - at junction of the right atrium and inferior vena cava.
* common atrium
|-
|}

===Ventricular Septal Defects===
{| border='0px'
|-
| [[File:HeartILP_draft_vsd.jpg|Ventricular Septal Defect]]
|
* The Ventricular Septal Defect (VSD) usually occurs in the membranous (perimembranous) (70%) rather than muscular interventricular septum, and is more frequent in males that females.
* Perimembranous defects are located close to the aortic and tricuspid valves and adjacent to atrioventricular conduction bundle.
* The defect allows left-right shunting of blood, this shunting depends upon the size of the defect. Small defects may close spontaneously, larger defects result in infant congestive heart failure.
* Clinically repaired by coils or tissue-adapted devices like muscular or perimembranous occluders.
|-
|}
(V.S.D.)

===Patent Ductus Arteriosus===

{| border='0px'

|-
| [[File:HeartILP_draft_patentda.jpg|Patent Ductus Arteriosus]]
|
* Patent Ductus Arteriosus (PDA) occurs commonly in preterm infants, can close spontaneously (by day three in 60% of normal term neonates) the remainder are ligated simply and with little risk.
* The operation is always recommended even in the absence of cardiac failure and can often be deferred until early childhood.

|-
|}

===Tetralogy of Fallot===
{| border='0px'
|-
| [[File:HeartILP_draft_tetralogyoffallot.jpg|Tetralogy of Fallot]]
|
* Named after Etienne-Louis Arthur Fallot (1888) who described it as "la maladie blue" and is a common developmental cardiac defect.
* The syndrome consists of a number of a number of cardiac defects possibly stemming from abnormal neural crest migration. The basic defect in a tetralogy of Fallot is an asymmetrical fusion of the truncoconal ridges and a malalignment of the aortic and pulmonary valves. This results in the typical 4 features seen in this defect: 1. pulmonary stenosis, 2. overriding aorta, 3. ventricular septal defect, and 4. right ventricular hypertrophy.
|-
|}

==Movies==

{| border='0px'

|-
| [[File:Heart1_looping icon.jpg|90px|link=Development_Animation_-_Heart Looping]]
| [[File:Heart1_realign icon.jpg|90px|link=Development_Animation_-_Heart Realign]]
| [[File:Heart1_atrium icon.jpg|90px|link=Development_Animation_-_Heart Atrial Septation]]
| [[File:heart1 ventricle icon.jpg|90px|link=Development_Animation_-_Heart Outflow Septation]]
|-
| [[Development_Animation_-_Heart Looping|Heart Looping]]
| [[Development_Animation_-_Heart Realign|Heart Realign]]
| [[Development_Animation_-_Heart Atrial Septation|Heart Atrial Septation]]
| [[Development_Animation_-_Heart Outflow Septation|Heart Outflow Septation]]
|-
|}

'''Link:''' [[Flash Movies]]

{{Template:2009ANAT2341}}

[[Category:2009ANAT2341]] [[Category:Science-Undergraduate]]

[[Category:Cardiovascular]] [[Category:Heart]]

2010 Lecture 21

2010-10-10T22:04:29Z

Z3267024: /* Heart Development */

<div style="background:#F5FFFA; border: 1px solid #CEF2E0; padding: 1em; margin: auto; width: 95%; float:left;"><div style="margin:0;background-color:#cef2e0;font-family:sans-serif;font-size:120%;font-weight:bold;border:1px solid #a3bfb1;text-align:left;color:#000;padding-left:0.4em;padding-top:0.2em;padding-bottom:0.2em;">Lecture Notice - Dr Nalini Pather</div>This online lecture page will contain the content required when attending the lecture. Final lecture pages can also be printed out using the "printable version" lefthand menu.</div>

==Introduction==
[[File:Gray0473.gif|300px|right]]

In [[2010 Lecture 7|lecture 7 - Early Vascular Development]], the early development of the cardiovascular system was discussed. This second lecture will now focus on the extensive remodeling that occurs in both the heart and vascular system during later development. In addition, there will be discussion on the major cardiovascular abnormalities. The laboratory this week will also give you the opportunity to work through some of these concepts using a new online teaching module.

This material is also presented in an online [[Cardiac_Embryology|Cardiac Embryology tutorial]].

[[File:Basic_Heart_Development_Timeline.jpg|400px|Link=Cardiac_Embryology]]

{{Template:Heart Links}}

:'''Lecture Audio'''

==Lecture Objectives==
* Describe the development of primary and secondary atrial septa and the ventricular septum.
* Explain the changes occurring in the bulbis cordis and truncus arteriosus in its transformation from a single to a double tube.
* Describe the development of the aortic arches on the right and left sides from the fetus to the adult.
* Describe the development of arteries and veins.
* Describe the major cardiovascular developmental abnormalities.

==Textbook references==

* Human Embryology (3rd ed.) Larson Chapter 7 p151-188 Heart, Chapter 8 p189-228 Vasculature
* The Developing Human: Clinically Oriented Embryology (6th ed.) Chapter 14: p304-349

'''Other textbooks'''
* Before we Are Born (5th ed.) Moore and Persaud Chapter 12; p241-254
* Essentials of Human Embryology Larson Chapter 7 p97-122 Heart, Chapter 8 p123-146 Vasculature
* Human Embryology Fitzgerald and Fitzgerald Chapter 13-17: p77-111

'''Recent reviews'''
* Yutzey KE, Kirby ML. Wherefore heart thou? Embryonic origins of cardiogenic mesoderm. Dev Dyn. 2002 Mar;223(3):307-20. Review. [http://www.ncbi.nlm.nih.gov/pubmed/11891982?dopt=Abstract PMID: 11891982]
* Three-dimensional reconstruction of gene expression patterns during cardiac development. Soufan AT, Ruijter JM, van den Hoff MJ, de Boer PA, Hagoort J, Moorman AF. Physiol Genomics. 2003 May 13;13(3):187-95. Review. [http://www.ncbi.nlm.nih.gov/pubmed/12746463 PMID: 12746463]
* Moorman A, Webb S, Brown NA, Lamers W, Anderson RH. Development of the heart: (1) formation of the cardiac chambers and arterial trunks. Heart. 2003 Jul;89(7):806-14. [http://www.ncbi.nlm.nih.gov/pubmed/12807866?dopt=Abstract PMID: 12807866]
* Bruneau BG. Transcriptional regulation of vertebrate cardiac morphogenesis. Circ Res. 2002 Mar 22;90(5):509-19. Review. [http://www.ncbi.nlm.nih.gov/pubmed/11909814?dopt=Abstract PMID: 11909814]

----

==Heart Development==
[[File:Gray0462.gif|thumb|200px|Day 14 Heart tube]]
[[File:Heart_Tube_Fusion.jpg|400px|Early Human Heart Tube Development]]

* [[E#endocardial tube|endocardial tube]] in [[P#pericardial cavity|pericardial cavity]]
** dorsal mesentry (mesocardial) attachment lost
** attached at cranial (arterial) and caudal (venous) ends
* tube elongation - bending and series of expansions

Bulbus Cordis
* refers to the outflow tract in early embryo
* 3 parts
** distal - forms [[T#truncus arteriosus|truncus arteriosus]] (aorta and pulmonary artery)
** middle - [[C#conus arteriosus|conus arteriosus]] ventricular outflow tract
** proximal - right ventricle trabeculate part
[[File:Heart-cartoon-001.jpg|300px|Adult Heart blood flow]]
{| border=1

|-
! Fetal Structure
! Adult Structure
|-
| Truncus arteriosus
| aorta
pulmonary trunk
|-
| Conus arteriosus
| right ventricle - smooth part
|-
| Primitive ventricle
| right ventricle - trabecular part
left ventricle - trabecular part
|-
| Primitive atrium
| right atrium - trabecular part
left atrium - trabecular part
|-
| Sinus venosus
| right atrium - smooth part (sinus venarum)
coronary sinus
oblique vein of left atrium
|}

===Heart Layers===
* '''pericardium''' - covers the heart, formed by 3 layers consisting of a fibrous pericardium and a double layered serous pericardium (parietal layer and visceral epicardium layer).
* '''myocardium''' - muscular wall of the heart, thickest layer formed by spirally arranged cardiac muscle cells.
* '''endocardium''' - lines the heart, epithelial (endothelial) tissue lining the inner surface of heart chambers and valves.

===Embryonic Heart Rate===

* Stage 9-10 2 mm embryo (gestational sac diameter of 20 mm) EHR at least 75 beats / minute
* Stage 11-12 5 mm embryo (gestational sac diameter of 30 mm) EHR at least 100 beats / minute
* Stage 16 10 mm embryo EHR at least 120 beats / minute
* Stage 18 15 mm embryo EHR at least 130 beats / minute

[http://embryology.med.unsw.edu.au/Movies/usound/Hum12wkFHR.htm Week 12 fetal heart rate doppler] [http://embryology.med.unsw.edu.au/Notes/heart8.htm Week 17 fetal heart rate audio]

==Separation of the Atria from the Venticles==
[[File:AV Canal Division.jpg|thumb|200px|Separation of the atrioventricular canal]]
===Endocardial Cushions===
* form initial division of atria and ventricles
* form on dorsal and ventral wall of atrioventcular canals
* grow into canal - meet and fuse to separate atrioventricular canal into right and left channels.

==Atrial Septation==
[[File:Heart1_atrium icon.jpg|90px|link=Development_Animation_-_Heart Atrial Septation]]

[[File:Stage13 C7L.jpg|thumb|Heart (Carnegie stage 13)]]

Through all development blood shunts from right to left atrium (bypass lungs)

===Septum Primum===
[http://embryology.med.unsw.edu.au/wwwpig/pigc/c1l.htm Stage 13 Septum Primum] [http://embryology.med.unsw.edu.au/wwwhuman/lowpower/HumE/E2L.htm Stage 22 Septum Primum]

* dorso-cranial wall, crescentric-shaped membranous extension
* grows downward towards endocardial cushions
* opening is '''foramen primum''' (ostium primum)- serves as a shunt
* a series of perforations develop in cranial end - coalesce to form '''foramen secundum''' (ostium secundum)
* septum primum fuses with endocardial cushions - obliterates foramen primum

===Septum Secundum===
* crescentric septum secundum begins to form to the right of septum primum
* grows as septum primum downwards, does not fuse with endocardial cushion, opening is '''foramen ovale'''
* arrangement of the two septa facilitates a one-way valve

[[File:Atrial Septation.jpg|200px|Atrial septation]]
[[File:Atrial & Ventricular Septation 1.jpg|200px|Early -atrial and ventricular septation]]
[[File:Atrial & Ventricular Septation 2.jpg|200px|Late-atrial and ventricular septation]]

===Right Atrium===
[[File:Gray0476.jpg|thumb|sinus venosus and tributaries]]
* with heart looping and formation of interatrial septa, the sinus venosus shifts completely to right atrium
* right sinus horn incorporates into dorsal wall of right atrium
* left sinus horn becomes the coronary sinus
* sinoatrial opening - has 2 flaps, left fuses with septum secundum, right forms valve to inferior vena cava and coronary sinus. [http://embryology.med.unsw.edu.au/wwwpig/pigc/c3l.htm Stage 13 - right venous valve] [http://embryology.med.unsw.edu.au/wwwhuman/lowpower/HumE/E2L.htm Stage 22 - right venous valve]

===Left Atrium===
* posterior wall - outgrowth forms single pulmonary vein, divided into 4 branches
* incorporation into the wall leads to 4 openings in posterior wall
* later moves to the right aligns with atrioventricular canal.

==Ventricular Septation==
[[File:Stage13 C7L.jpg|thumb|Heart (Carnegie stage 13)]]
[[File:Gray0498.jpg|thumb|Ventricular septum]]
[[File:Heart1_realign icon.jpg|90px|link=Development_Animation_-_Heart Realign]]

* 2 separate components - superior membranous, inferior muscular
===Muscular Septum===
[[File:Gray0470.jpg|thumb|muscular septum]]
* growth of inferior wall
* fusion of 3 components - right and left bulbar ridges and dorsal endocardial cushion

===Membranous Septum===
* above the muscular septum, fusion continuous with septation of the outflow tract

[[File:Heart-ventricular-septum-01.jpg‎]][[File:Heart-ventricular-septum-02.jpg‎]][[File:Heart-ventricular-septum-03.jpg‎]]

==Outflow Tract Septation==

[[File:heart1 ventricle icon.jpg|90px|link=Development_Animation_-_Heart Outflow Septation]]

* in early development, outflow tract is a single tube, bulbus cordis
* elongates to form proximal conus arteriosus and distal truncus arteriosus
* 2 growths from wall in spiral pattern, inferior upwards - separate tract into 2 channels [http://embryology.med.unsw.edu.au/wwwpig/pigb/b5l.htm Stage 13 truncus arteriousus]
* mesenchyme and neural crest contribute to this septation process
* fusion of outgrowths separate aortic and pulmonary outflow

{| border='0px'

|-
| [[File:Chick_Heart_001-icon.jpg|90px|link=Movie_-_Normal Chick Heart]]
| [[File:Chick_Heart_002-icon.jpg|90px|link=Movie_-_Abnormal Chick Heart]]
| [[File:Chick_Heart_002-icon.jpg|90px|link=Movie_-_Abnormal Chick Heart 2]]
|-
| [[Movie_-_Normal Chick Heart|Normal Heart]]
| [[Movie_-_Abnormal Chick Heart|Abnormal Heart]]
| [[Movie_-_Abnormal Chick Heart 2|Abnormal Heart 2]]
|-
|}

==Vascular Remodeling==
===Arterial System===
[[File:Gray0474.jpg|thumb|pharyngeal arch arteries]]
* Aortic sac - remodels forming 2 horns, R forms brachiocephalic artery, L forms common carotid artery

Pharyngeal arch arteries
* pharyngeal arch artery 1 and 2 regress
* pharyngeal arch artery 3 and the associated dorsal aorta form the paired internal carotid arteries, these in turn generate the external carotids
* Left pharyngeal arch artery 4 – forms the aortic arch

* paraxial mesoderm forms paired dorsal aorta
** head mesenchyme forms aortic arches
** connecting stalk contains unbilical (placental) arteries
** dorsal aortas give rise to
** vitelline arteries which connect to capillaries on yolk sac
** intersegmental arteries between somites

===Venous System===
Cardinal veins contribute nearly all systemic venous system.

<gallery>
File:Gray0477.jpg
File:Gray0478.jpg
File:Gray0479.jpg
File:Gray0480.jpg
</gallery>

common cardinal veins - ducts of Cuvier

hepatic veins - drain de-oxygenated blood from the liver into the inferior vena cava.

internal iliac vein - hypogastric vein

==Birth Changes==
[[File:Fetal_circulation1.jpg|thumb|Fetal circulation]]
At birth, cutting the umbilical cord and changes in the lungs after the first breaths trigger major functional adaptations in the fetal circulatory system.

* blood flow through ductus venosus is eliminated
* pulmonary circulation bed expands - reducing blood flow through ductus arteriosus
* physiological closure of interatrial shunt
* closure of ductus venosus in liver is prolonged

{| border=1

|-
! Fetal Structure
! Adult Structure
|-
| foramen ovale
| fossa ovalis
|-
| umbilical vein (intra-abdominal part)
| ligamentum teres
|-
| ductus venosus
| ligamentum venosum
|-
| umbilical arteries
| distal part -lateral umbilical ligaments; proximal part - superior vesical artery (supplies bladder)
|-
| ductus arteriosus
| ligamentum arteriosum
|}

==Abnormalities==
There are many different cardiac abnormalities, some more common than others, and only a few will be described in this lecture.

'''Major Abnormalities:''' Aortic Stenosis, Atrial Septal Defects, Coarctation of Aorta, Dextrocardia, Hypoplastic Left Heart, Long QT Syndrome, Patent Ductus Arteriosus, Pulmonary Atresia, Pulmonary Stenosis, Tetralogy of Fallot, Transposition of Great Vessels, Tricuspid Atresia, Total Anomalous Pulmonary Venous Connection, Ventricular Septal Defect, Abnormalities of Conducting System.

Links: [http://embryology.med.unsw.edu.au/Notes/heart2.htm Cardiovascular Development Abnormalities]

[[File:Abnormal81-92-heart.png|thumb]]

[[File:Statistics-Utah heart defects.jpg|thumb]]
===Atrial Septal Defects===

{| border='0px'
|-
| [[File:HeartILP_draft_asd.jpg|Atrial Septal Defect]]
|
* Atrial Septal Defects (ASD) are a group of common (1% of cardiac) congenital anomalies defects occurring in a number of different forms and more often in females.
* patent foramen ovale - allows a continuation of the atrial shunting of blood, in 25% of people a probe patent foramen ovale (allowing a probe to bypassed from one atria to the other) exists.
* ostium secundum defect
* endocardial cushion defect involving ostium primum
* sinus venosus defect - contributes about 10% of all ASDs and occurs mainly in a common and less common form. Common ("usual type") - in upper atrial septum which is contiguous with the superior vena cava. Less common - at junction of the right atrium and inferior vena cava.
* common atrium
|-
|}

===Ventricular Septal Defects===
{| border='0px'
|-
| [[File:HeartILP_draft_vsd.jpg|Ventricular Septal Defect]]
|
* The Ventricular Septal Defect (VSD) usually occurs in the membranous (perimembranous) (70%) rather than muscular interventricular septum, and is more frequent in males that females.
* Perimembranous defects are located close to the aortic and tricuspid valves and adjacent to atrioventricular conduction bundle.
* The defect allows left-right shunting of blood, this shunting depends upon the size of the defect. Small defects may close spontaneously, larger defects result in infant congestive heart failure.
* Clinically repaired by coils or tissue-adapted devices like muscular or perimembranous occluders.
|-
|}
(V.S.D.)

===Patent Ductus Arteriosus===

{| border='0px'

|-
| [[File:HeartILP_draft_patentda.jpg|Patent Ductus Arteriosus]]
|
* Patent Ductus Arteriosus (PDA) occurs commonly in preterm infants, can close spontaneously (by day three in 60% of normal term neonates) the remainder are ligated simply and with little risk.
* The operation is always recommended even in the absence of cardiac failure and can often be deferred until early childhood.

|-
|}

===Tetralogy of Fallot===
{| border='0px'
|-
| [[File:HeartILP_draft_tetralogyoffallot.jpg|Tetralogy of Fallot]]
|
* Named after Etienne-Louis Arthur Fallot (1888) who described it as "la maladie blue" and is a common developmental cardiac defect.
* The syndrome consists of a number of a number of cardiac defects possibly stemming from abnormal neural crest migration. The basic defect in a tetralogy of Fallot is an asymmetrical fusion of the truncoconal ridges and a malalignment of the aortic and pulmonary valves. This results in the typical 4 features seen in this defect: 1. pulmonary stenosis, 2. overriding aorta, 3. ventricular septal defect, and 4. right ventricular hypertrophy.
|-
|}

==Movies==

{| border='0px'

|-
| [[File:Heart1_looping icon.jpg|90px|link=Development_Animation_-_Heart Looping]]
| [[File:Heart1_realign icon.jpg|90px|link=Development_Animation_-_Heart Realign]]
| [[File:Heart1_atrium icon.jpg|90px|link=Development_Animation_-_Heart Atrial Septation]]
| [[File:heart1 ventricle icon.jpg|90px|link=Development_Animation_-_Heart Outflow Septation]]
|-
| [[Development_Animation_-_Heart Looping|Heart Looping]]
| [[Development_Animation_-_Heart Realign|Heart Realign]]
| [[Development_Animation_-_Heart Atrial Septation|Heart Atrial Septation]]
| [[Development_Animation_-_Heart Outflow Septation|Heart Outflow Septation]]
|-
|}

'''Link:''' [[Flash Movies]]

{{Template:2009ANAT2341}}

[[Category:2009ANAT2341]] [[Category:Science-Undergraduate]]

[[Category:Cardiovascular]] [[Category:Heart]]

2010 Lecture 21

2010-10-10T21:53:59Z

Z3267024: /* Separation of the Atria from the Venticles */

<div style="background:#F5FFFA; border: 1px solid #CEF2E0; padding: 1em; margin: auto; width: 95%; float:left;"><div style="margin:0;background-color:#cef2e0;font-family:sans-serif;font-size:120%;font-weight:bold;border:1px solid #a3bfb1;text-align:left;color:#000;padding-left:0.4em;padding-top:0.2em;padding-bottom:0.2em;">Lecture Notice - Dr Nalini Pather</div>This online lecture page will contain the content required when attending the lecture. Final lecture pages can also be printed out using the "printable version" lefthand menu.</div>

==Introduction==
[[File:Gray0473.gif|300px|right]]

In [[2010 Lecture 7|lecture 7 - Early Vascular Development]], the early development of the cardiovascular system was discussed. This second lecture will now focus on the extensive remodeling that occurs in both the heart and vascular system during later development. In addition, there will be discussion on the major cardiovascular abnormalities. The laboratory this week will also give you the opportunity to work through some of these concepts using a new online teaching module.

This material is also presented in an online [[Cardiac_Embryology|Cardiac Embryology tutorial]].

[[File:Basic_Heart_Development_Timeline.jpg|400px|Link=Cardiac_Embryology]]

{{Template:Heart Links}}

:'''Lecture Audio'''

==Lecture Objectives==
* Describe the development of primary and secondary atrial septa and the ventricular septum.
* Explain the changes occurring in the bulbis cordis and truncus arteriosus in its transformation from a single to a double tube.
* Describe the development of the aortic arches on the right and left sides from the fetus to the adult.
* Describe the development of arteries and veins.
* Describe the major cardiovascular developmental abnormalities.

==Textbook references==

* Human Embryology (3rd ed.) Larson Chapter 7 p151-188 Heart, Chapter 8 p189-228 Vasculature
* The Developing Human: Clinically Oriented Embryology (6th ed.) Chapter 14: p304-349

'''Other textbooks'''
* Before we Are Born (5th ed.) Moore and Persaud Chapter 12; p241-254
* Essentials of Human Embryology Larson Chapter 7 p97-122 Heart, Chapter 8 p123-146 Vasculature
* Human Embryology Fitzgerald and Fitzgerald Chapter 13-17: p77-111

'''Recent reviews'''
* Yutzey KE, Kirby ML. Wherefore heart thou? Embryonic origins of cardiogenic mesoderm. Dev Dyn. 2002 Mar;223(3):307-20. Review. [http://www.ncbi.nlm.nih.gov/pubmed/11891982?dopt=Abstract PMID: 11891982]
* Three-dimensional reconstruction of gene expression patterns during cardiac development. Soufan AT, Ruijter JM, van den Hoff MJ, de Boer PA, Hagoort J, Moorman AF. Physiol Genomics. 2003 May 13;13(3):187-95. Review. [http://www.ncbi.nlm.nih.gov/pubmed/12746463 PMID: 12746463]
* Moorman A, Webb S, Brown NA, Lamers W, Anderson RH. Development of the heart: (1) formation of the cardiac chambers and arterial trunks. Heart. 2003 Jul;89(7):806-14. [http://www.ncbi.nlm.nih.gov/pubmed/12807866?dopt=Abstract PMID: 12807866]
* Bruneau BG. Transcriptional regulation of vertebrate cardiac morphogenesis. Circ Res. 2002 Mar 22;90(5):509-19. Review. [http://www.ncbi.nlm.nih.gov/pubmed/11909814?dopt=Abstract PMID: 11909814]

----

==Heart Development==
[[File:Gray0462.gif|thumb|200px|Day 14 Heart tube]]
[[File:Heart_Tube_Fusion.jpg|400px|Early Human Heart Tube Development]]

* [[E#endocardial tube|endocardial tube]] in [[P#pericardial cavity|pericardial cavity]]
** dorsal mesentry (mesocardial) attachment lost
** attached at cranial (arterial) and caudal (venous) ends
* tube elongation - bending and series of expansions
[[File:Heart-cartoon-001.jpg|thumb|Adult Heart blood flow]]
Bulbus Cordis
* refers to the outflow tract in early embryo
* 3 parts
** distal - forms [[T#truncus arteriosus|truncus arteriosus]] (aorta and pulmonary artery)
** middle - [[C#conus arteriosus|conus arteriosus]] ventricular outflow tract
** proximal - right ventricle trabeculate part

{| border=1

|-
! Fetal Structure
! Adult Structure
|-
| Truncus arteriosus
| aorta
pulmonary trunk
|-
| Conus arteriosus
| right ventricle - smooth part
|-
| Primitive ventricle
| right ventricle - trabecular part
left ventricle - trabecular part
|-
| Primitive atrium
| right atrium - trabecular part
left atrium - trabecular part
|-
| Sinus venosus
| right atrium - smooth part (sinus venarum)
coronary sinus
oblique vein of left atrium
|}

===Heart Layers===
* '''pericardium''' - covers the heart, formed by 3 layers consisting of a fibrous pericardium and a double layered serous pericardium (parietal layer and visceral epicardium layer).
* '''myocardium''' - muscular wall of the heart, thickest layer formed by spirally arranged cardiac muscle cells.
* '''endocardium''' - lines the heart, epithelial (endothelial) tissue lining the inner surface of heart chambers and valves.

===Embryonic Heart Rate===

* Stage 9-10 2 mm embryo (gestational sac diameter of 20 mm) EHR at least 75 beats / minute
* Stage 11-12 5 mm embryo (gestational sac diameter of 30 mm) EHR at least 100 beats / minute
* Stage 16 10 mm embryo EHR at least 120 beats / minute
* Stage 18 15 mm embryo EHR at least 130 beats / minute

[http://embryology.med.unsw.edu.au/Movies/usound/Hum12wkFHR.htm Week 12 fetal heart rate doppler] [http://embryology.med.unsw.edu.au/Notes/heart8.htm Week 17 fetal heart rate audio]

==Separation of the Atria from the Venticles==
[[File:AV Canal Division.jpg|thumb|200px|Separation of the atrioventricular canal]]
===Endocardial Cushions===
* form initial division of atria and ventricles
* form on dorsal and ventral wall of atrioventcular canals
* grow into canal - meet and fuse to separate atrioventricular canal into right and left channels.

==Atrial Septation==
[[File:Heart1_atrium icon.jpg|90px|link=Development_Animation_-_Heart Atrial Septation]]

[[File:Stage13 C7L.jpg|thumb|Heart (Carnegie stage 13)]]

Through all development blood shunts from right to left atrium (bypass lungs)

===Septum Primum===
[http://embryology.med.unsw.edu.au/wwwpig/pigc/c1l.htm Stage 13 Septum Primum] [http://embryology.med.unsw.edu.au/wwwhuman/lowpower/HumE/E2L.htm Stage 22 Septum Primum]

* dorso-cranial wall, crescentric-shaped membranous extension
* grows downward towards endocardial cushions
* opening is '''foramen primum''' (ostium primum)- serves as a shunt
* a series of perforations develop in cranial end - coalesce to form '''foramen secundum''' (ostium secundum)
* septum primum fuses with endocardial cushions - obliterates foramen primum

===Septum Secundum===
* crescentric septum secundum begins to form to the right of septum primum
* grows as septum primum downwards, does not fuse with endocardial cushion, opening is '''foramen ovale'''
* arrangement of the two septa facilitates a one-way valve

[[File:Atrial Septation.jpg|200px|Atrial septation]]
[[File:Atrial & Ventricular Septation 1.jpg|200px|Early -atrial and ventricular septation]]
[[File:Atrial & Ventricular Septation 2.jpg|200px|Late-atrial and ventricular septation]]

===Right Atrium===
[[File:Gray0476.jpg|thumb|sinus venosus and tributaries]]
* with heart looping and formation of interatrial septa, the sinus venosus shifts completely to right atrium
* right sinus horn incorporates into dorsal wall of right atrium
* left sinus horn becomes the coronary sinus
* sinoatrial opening - has 2 flaps, left fuses with septum secundum, right forms valve to inferior vena cava and coronary sinus. [http://embryology.med.unsw.edu.au/wwwpig/pigc/c3l.htm Stage 13 - right venous valve] [http://embryology.med.unsw.edu.au/wwwhuman/lowpower/HumE/E2L.htm Stage 22 - right venous valve]

===Left Atrium===
* posterior wall - outgrowth forms single pulmonary vein, divided into 4 branches
* incorporation into the wall leads to 4 openings in posterior wall
* later moves to the right aligns with atrioventricular canal.

==Ventricular Septation==
[[File:Stage13 C7L.jpg|thumb|Heart (Carnegie stage 13)]]
[[File:Gray0498.jpg|thumb|Ventricular septum]]
[[File:Heart1_realign icon.jpg|90px|link=Development_Animation_-_Heart Realign]]

* 2 separate components - superior membranous, inferior muscular
===Muscular Septum===
[[File:Gray0470.jpg|thumb|muscular septum]]
* growth of inferior wall
* fusion of 3 components - right and left bulbar ridges and dorsal endocardial cushion

===Membranous Septum===
* above the muscular septum, fusion continuous with septation of the outflow tract

[[File:Heart-ventricular-septum-01.jpg‎]][[File:Heart-ventricular-septum-02.jpg‎]][[File:Heart-ventricular-septum-03.jpg‎]]

==Outflow Tract Septation==

[[File:heart1 ventricle icon.jpg|90px|link=Development_Animation_-_Heart Outflow Septation]]

* in early development, outflow tract is a single tube, bulbus cordis
* elongates to form proximal conus arteriosus and distal truncus arteriosus
* 2 growths from wall in spiral pattern, inferior upwards - separate tract into 2 channels [http://embryology.med.unsw.edu.au/wwwpig/pigb/b5l.htm Stage 13 truncus arteriousus]
* mesenchyme and neural crest contribute to this septation process
* fusion of outgrowths separate aortic and pulmonary outflow

{| border='0px'

|-
| [[File:Chick_Heart_001-icon.jpg|90px|link=Movie_-_Normal Chick Heart]]
| [[File:Chick_Heart_002-icon.jpg|90px|link=Movie_-_Abnormal Chick Heart]]
| [[File:Chick_Heart_002-icon.jpg|90px|link=Movie_-_Abnormal Chick Heart 2]]
|-
| [[Movie_-_Normal Chick Heart|Normal Heart]]
| [[Movie_-_Abnormal Chick Heart|Abnormal Heart]]
| [[Movie_-_Abnormal Chick Heart 2|Abnormal Heart 2]]
|-
|}

==Vascular Remodeling==
===Arterial System===
[[File:Gray0474.jpg|thumb|pharyngeal arch arteries]]
* Aortic sac - remodels forming 2 horns, R forms brachiocephalic artery, L forms common carotid artery

Pharyngeal arch arteries
* pharyngeal arch artery 1 and 2 regress
* pharyngeal arch artery 3 and the associated dorsal aorta form the paired internal carotid arteries, these in turn generate the external carotids
* Left pharyngeal arch artery 4 – forms the aortic arch

* paraxial mesoderm forms paired dorsal aorta
** head mesenchyme forms aortic arches
** connecting stalk contains unbilical (placental) arteries
** dorsal aortas give rise to
** vitelline arteries which connect to capillaries on yolk sac
** intersegmental arteries between somites

===Venous System===
Cardinal veins contribute nearly all systemic venous system.

<gallery>
File:Gray0477.jpg
File:Gray0478.jpg
File:Gray0479.jpg
File:Gray0480.jpg
</gallery>

common cardinal veins - ducts of Cuvier

hepatic veins - drain de-oxygenated blood from the liver into the inferior vena cava.

internal iliac vein - hypogastric vein

==Birth Changes==
[[File:Fetal_circulation1.jpg|thumb|Fetal circulation]]
At birth, cutting the umbilical cord and changes in the lungs after the first breaths trigger major functional adaptations in the fetal circulatory system.

* blood flow through ductus venosus is eliminated
* pulmonary circulation bed expands - reducing blood flow through ductus arteriosus
* physiological closure of interatrial shunt
* closure of ductus venosus in liver is prolonged

{| border=1

|-
! Fetal Structure
! Adult Structure
|-
| foramen ovale
| fossa ovalis
|-
| umbilical vein (intra-abdominal part)
| ligamentum teres
|-
| ductus venosus
| ligamentum venosum
|-
| umbilical arteries
| distal part -lateral umbilical ligaments; proximal part - superior vesical artery (supplies bladder)
|-
| ductus arteriosus
| ligamentum arteriosum
|}

==Abnormalities==
There are many different cardiac abnormalities, some more common than others, and only a few will be described in this lecture.

'''Major Abnormalities:''' Aortic Stenosis, Atrial Septal Defects, Coarctation of Aorta, Dextrocardia, Hypoplastic Left Heart, Long QT Syndrome, Patent Ductus Arteriosus, Pulmonary Atresia, Pulmonary Stenosis, Tetralogy of Fallot, Transposition of Great Vessels, Tricuspid Atresia, Total Anomalous Pulmonary Venous Connection, Ventricular Septal Defect, Abnormalities of Conducting System.

Links: [http://embryology.med.unsw.edu.au/Notes/heart2.htm Cardiovascular Development Abnormalities]

[[File:Abnormal81-92-heart.png|thumb]]

[[File:Statistics-Utah heart defects.jpg|thumb]]
===Atrial Septal Defects===

{| border='0px'
|-
| [[File:HeartILP_draft_asd.jpg|Atrial Septal Defect]]
|
* Atrial Septal Defects (ASD) are a group of common (1% of cardiac) congenital anomalies defects occurring in a number of different forms and more often in females.
* patent foramen ovale - allows a continuation of the atrial shunting of blood, in 25% of people a probe patent foramen ovale (allowing a probe to bypassed from one atria to the other) exists.
* ostium secundum defect
* endocardial cushion defect involving ostium primum
* sinus venosus defect - contributes about 10% of all ASDs and occurs mainly in a common and less common form. Common ("usual type") - in upper atrial septum which is contiguous with the superior vena cava. Less common - at junction of the right atrium and inferior vena cava.
* common atrium
|-
|}

===Ventricular Septal Defects===
{| border='0px'
|-
| [[File:HeartILP_draft_vsd.jpg|Ventricular Septal Defect]]
|
* The Ventricular Septal Defect (VSD) usually occurs in the membranous (perimembranous) (70%) rather than muscular interventricular septum, and is more frequent in males that females.
* Perimembranous defects are located close to the aortic and tricuspid valves and adjacent to atrioventricular conduction bundle.
* The defect allows left-right shunting of blood, this shunting depends upon the size of the defect. Small defects may close spontaneously, larger defects result in infant congestive heart failure.
* Clinically repaired by coils or tissue-adapted devices like muscular or perimembranous occluders.
|-
|}
(V.S.D.)

===Patent Ductus Arteriosus===

{| border='0px'

|-
| [[File:HeartILP_draft_patentda.jpg|Patent Ductus Arteriosus]]
|
* Patent Ductus Arteriosus (PDA) occurs commonly in preterm infants, can close spontaneously (by day three in 60% of normal term neonates) the remainder are ligated simply and with little risk.
* The operation is always recommended even in the absence of cardiac failure and can often be deferred until early childhood.

|-
|}

===Tetralogy of Fallot===
{| border='0px'
|-
| [[File:HeartILP_draft_tetralogyoffallot.jpg|Tetralogy of Fallot]]
|
* Named after Etienne-Louis Arthur Fallot (1888) who described it as "la maladie blue" and is a common developmental cardiac defect.
* The syndrome consists of a number of a number of cardiac defects possibly stemming from abnormal neural crest migration. The basic defect in a tetralogy of Fallot is an asymmetrical fusion of the truncoconal ridges and a malalignment of the aortic and pulmonary valves. This results in the typical 4 features seen in this defect: 1. pulmonary stenosis, 2. overriding aorta, 3. ventricular septal defect, and 4. right ventricular hypertrophy.
|-
|}

==Movies==

{| border='0px'

|-
| [[File:Heart1_looping icon.jpg|90px|link=Development_Animation_-_Heart Looping]]
| [[File:Heart1_realign icon.jpg|90px|link=Development_Animation_-_Heart Realign]]
| [[File:Heart1_atrium icon.jpg|90px|link=Development_Animation_-_Heart Atrial Septation]]
| [[File:heart1 ventricle icon.jpg|90px|link=Development_Animation_-_Heart Outflow Septation]]
|-
| [[Development_Animation_-_Heart Looping|Heart Looping]]
| [[Development_Animation_-_Heart Realign|Heart Realign]]
| [[Development_Animation_-_Heart Atrial Septation|Heart Atrial Septation]]
| [[Development_Animation_-_Heart Outflow Septation|Heart Outflow Septation]]
|-
|}

'''Link:''' [[Flash Movies]]

{{Template:2009ANAT2341}}

[[Category:2009ANAT2341]] [[Category:Science-Undergraduate]]

[[Category:Cardiovascular]] [[Category:Heart]]

2010 Lecture 21

2010-10-10T21:53:07Z

Z3267024:

<div style="background:#F5FFFA; border: 1px solid #CEF2E0; padding: 1em; margin: auto; width: 95%; float:left;"><div style="margin:0;background-color:#cef2e0;font-family:sans-serif;font-size:120%;font-weight:bold;border:1px solid #a3bfb1;text-align:left;color:#000;padding-left:0.4em;padding-top:0.2em;padding-bottom:0.2em;">Lecture Notice - Dr Nalini Pather</div>This online lecture page will contain the content required when attending the lecture. Final lecture pages can also be printed out using the "printable version" lefthand menu.</div>

==Introduction==
[[File:Gray0473.gif|300px|right]]

In [[2010 Lecture 7|lecture 7 - Early Vascular Development]], the early development of the cardiovascular system was discussed. This second lecture will now focus on the extensive remodeling that occurs in both the heart and vascular system during later development. In addition, there will be discussion on the major cardiovascular abnormalities. The laboratory this week will also give you the opportunity to work through some of these concepts using a new online teaching module.

This material is also presented in an online [[Cardiac_Embryology|Cardiac Embryology tutorial]].

[[File:Basic_Heart_Development_Timeline.jpg|400px|Link=Cardiac_Embryology]]

{{Template:Heart Links}}

:'''Lecture Audio'''

==Lecture Objectives==
* Describe the development of primary and secondary atrial septa and the ventricular septum.
* Explain the changes occurring in the bulbis cordis and truncus arteriosus in its transformation from a single to a double tube.
* Describe the development of the aortic arches on the right and left sides from the fetus to the adult.
* Describe the development of arteries and veins.
* Describe the major cardiovascular developmental abnormalities.

==Textbook references==

* Human Embryology (3rd ed.) Larson Chapter 7 p151-188 Heart, Chapter 8 p189-228 Vasculature
* The Developing Human: Clinically Oriented Embryology (6th ed.) Chapter 14: p304-349

'''Other textbooks'''
* Before we Are Born (5th ed.) Moore and Persaud Chapter 12; p241-254
* Essentials of Human Embryology Larson Chapter 7 p97-122 Heart, Chapter 8 p123-146 Vasculature
* Human Embryology Fitzgerald and Fitzgerald Chapter 13-17: p77-111

'''Recent reviews'''
* Yutzey KE, Kirby ML. Wherefore heart thou? Embryonic origins of cardiogenic mesoderm. Dev Dyn. 2002 Mar;223(3):307-20. Review. [http://www.ncbi.nlm.nih.gov/pubmed/11891982?dopt=Abstract PMID: 11891982]
* Three-dimensional reconstruction of gene expression patterns during cardiac development. Soufan AT, Ruijter JM, van den Hoff MJ, de Boer PA, Hagoort J, Moorman AF. Physiol Genomics. 2003 May 13;13(3):187-95. Review. [http://www.ncbi.nlm.nih.gov/pubmed/12746463 PMID: 12746463]
* Moorman A, Webb S, Brown NA, Lamers W, Anderson RH. Development of the heart: (1) formation of the cardiac chambers and arterial trunks. Heart. 2003 Jul;89(7):806-14. [http://www.ncbi.nlm.nih.gov/pubmed/12807866?dopt=Abstract PMID: 12807866]
* Bruneau BG. Transcriptional regulation of vertebrate cardiac morphogenesis. Circ Res. 2002 Mar 22;90(5):509-19. Review. [http://www.ncbi.nlm.nih.gov/pubmed/11909814?dopt=Abstract PMID: 11909814]

----

==Heart Development==
[[File:Gray0462.gif|thumb|200px|Day 14 Heart tube]]
[[File:Heart_Tube_Fusion.jpg|400px|Early Human Heart Tube Development]]

* [[E#endocardial tube|endocardial tube]] in [[P#pericardial cavity|pericardial cavity]]
** dorsal mesentry (mesocardial) attachment lost
** attached at cranial (arterial) and caudal (venous) ends
* tube elongation - bending and series of expansions
[[File:Heart-cartoon-001.jpg|thumb|Adult Heart blood flow]]
Bulbus Cordis
* refers to the outflow tract in early embryo
* 3 parts
** distal - forms [[T#truncus arteriosus|truncus arteriosus]] (aorta and pulmonary artery)
** middle - [[C#conus arteriosus|conus arteriosus]] ventricular outflow tract
** proximal - right ventricle trabeculate part

{| border=1

|-
! Fetal Structure
! Adult Structure
|-
| Truncus arteriosus
| aorta
pulmonary trunk
|-
| Conus arteriosus
| right ventricle - smooth part
|-
| Primitive ventricle
| right ventricle - trabecular part
left ventricle - trabecular part
|-
| Primitive atrium
| right atrium - trabecular part
left atrium - trabecular part
|-
| Sinus venosus
| right atrium - smooth part (sinus venarum)
coronary sinus
oblique vein of left atrium
|}

===Heart Layers===
* '''pericardium''' - covers the heart, formed by 3 layers consisting of a fibrous pericardium and a double layered serous pericardium (parietal layer and visceral epicardium layer).
* '''myocardium''' - muscular wall of the heart, thickest layer formed by spirally arranged cardiac muscle cells.
* '''endocardium''' - lines the heart, epithelial (endothelial) tissue lining the inner surface of heart chambers and valves.

===Embryonic Heart Rate===

* Stage 9-10 2 mm embryo (gestational sac diameter of 20 mm) EHR at least 75 beats / minute
* Stage 11-12 5 mm embryo (gestational sac diameter of 30 mm) EHR at least 100 beats / minute
* Stage 16 10 mm embryo EHR at least 120 beats / minute
* Stage 18 15 mm embryo EHR at least 130 beats / minute

[http://embryology.med.unsw.edu.au/Movies/usound/Hum12wkFHR.htm Week 12 fetal heart rate doppler] [http://embryology.med.unsw.edu.au/Notes/heart8.htm Week 17 fetal heart rate audio]

==Separation of the Atria from the Venticles==
[[File:AV Canal Division.jpg|thumb|100px|Separation of the atrioventricular canal]]
===Endocardial Cushions===
* form initial division of atria and ventricles
* form on dorsal and ventral wall of atrioventcular canals
* grow into canal - meet and fuse to separate atrioventricular canal into right and left channels.

==Atrial Septation==
[[File:Heart1_atrium icon.jpg|90px|link=Development_Animation_-_Heart Atrial Septation]]

[[File:Stage13 C7L.jpg|thumb|Heart (Carnegie stage 13)]]

Through all development blood shunts from right to left atrium (bypass lungs)

===Septum Primum===
[http://embryology.med.unsw.edu.au/wwwpig/pigc/c1l.htm Stage 13 Septum Primum] [http://embryology.med.unsw.edu.au/wwwhuman/lowpower/HumE/E2L.htm Stage 22 Septum Primum]

* dorso-cranial wall, crescentric-shaped membranous extension
* grows downward towards endocardial cushions
* opening is '''foramen primum''' (ostium primum)- serves as a shunt
* a series of perforations develop in cranial end - coalesce to form '''foramen secundum''' (ostium secundum)
* septum primum fuses with endocardial cushions - obliterates foramen primum

===Septum Secundum===
* crescentric septum secundum begins to form to the right of septum primum
* grows as septum primum downwards, does not fuse with endocardial cushion, opening is '''foramen ovale'''
* arrangement of the two septa facilitates a one-way valve

[[File:Atrial Septation.jpg|200px|Atrial septation]]
[[File:Atrial & Ventricular Septation 1.jpg|200px|Early -atrial and ventricular septation]]
[[File:Atrial & Ventricular Septation 2.jpg|200px|Late-atrial and ventricular septation]]

===Right Atrium===
[[File:Gray0476.jpg|thumb|sinus venosus and tributaries]]
* with heart looping and formation of interatrial septa, the sinus venosus shifts completely to right atrium
* right sinus horn incorporates into dorsal wall of right atrium
* left sinus horn becomes the coronary sinus
* sinoatrial opening - has 2 flaps, left fuses with septum secundum, right forms valve to inferior vena cava and coronary sinus. [http://embryology.med.unsw.edu.au/wwwpig/pigc/c3l.htm Stage 13 - right venous valve] [http://embryology.med.unsw.edu.au/wwwhuman/lowpower/HumE/E2L.htm Stage 22 - right venous valve]

===Left Atrium===
* posterior wall - outgrowth forms single pulmonary vein, divided into 4 branches
* incorporation into the wall leads to 4 openings in posterior wall
* later moves to the right aligns with atrioventricular canal.

==Ventricular Septation==
[[File:Stage13 C7L.jpg|thumb|Heart (Carnegie stage 13)]]
[[File:Gray0498.jpg|thumb|Ventricular septum]]
[[File:Heart1_realign icon.jpg|90px|link=Development_Animation_-_Heart Realign]]

* 2 separate components - superior membranous, inferior muscular
===Muscular Septum===
[[File:Gray0470.jpg|thumb|muscular septum]]
* growth of inferior wall
* fusion of 3 components - right and left bulbar ridges and dorsal endocardial cushion

===Membranous Septum===
* above the muscular septum, fusion continuous with septation of the outflow tract

[[File:Heart-ventricular-septum-01.jpg‎]][[File:Heart-ventricular-septum-02.jpg‎]][[File:Heart-ventricular-septum-03.jpg‎]]

==Outflow Tract Septation==

[[File:heart1 ventricle icon.jpg|90px|link=Development_Animation_-_Heart Outflow Septation]]

* in early development, outflow tract is a single tube, bulbus cordis
* elongates to form proximal conus arteriosus and distal truncus arteriosus
* 2 growths from wall in spiral pattern, inferior upwards - separate tract into 2 channels [http://embryology.med.unsw.edu.au/wwwpig/pigb/b5l.htm Stage 13 truncus arteriousus]
* mesenchyme and neural crest contribute to this septation process
* fusion of outgrowths separate aortic and pulmonary outflow

{| border='0px'

|-
| [[File:Chick_Heart_001-icon.jpg|90px|link=Movie_-_Normal Chick Heart]]
| [[File:Chick_Heart_002-icon.jpg|90px|link=Movie_-_Abnormal Chick Heart]]
| [[File:Chick_Heart_002-icon.jpg|90px|link=Movie_-_Abnormal Chick Heart 2]]
|-
| [[Movie_-_Normal Chick Heart|Normal Heart]]
| [[Movie_-_Abnormal Chick Heart|Abnormal Heart]]
| [[Movie_-_Abnormal Chick Heart 2|Abnormal Heart 2]]
|-
|}

==Vascular Remodeling==
===Arterial System===
[[File:Gray0474.jpg|thumb|pharyngeal arch arteries]]
* Aortic sac - remodels forming 2 horns, R forms brachiocephalic artery, L forms common carotid artery

Pharyngeal arch arteries
* pharyngeal arch artery 1 and 2 regress
* pharyngeal arch artery 3 and the associated dorsal aorta form the paired internal carotid arteries, these in turn generate the external carotids
* Left pharyngeal arch artery 4 – forms the aortic arch

* paraxial mesoderm forms paired dorsal aorta
** head mesenchyme forms aortic arches
** connecting stalk contains unbilical (placental) arteries
** dorsal aortas give rise to
** vitelline arteries which connect to capillaries on yolk sac
** intersegmental arteries between somites

===Venous System===
Cardinal veins contribute nearly all systemic venous system.

<gallery>
File:Gray0477.jpg
File:Gray0478.jpg
File:Gray0479.jpg
File:Gray0480.jpg
</gallery>

common cardinal veins - ducts of Cuvier

hepatic veins - drain de-oxygenated blood from the liver into the inferior vena cava.

internal iliac vein - hypogastric vein

==Birth Changes==
[[File:Fetal_circulation1.jpg|thumb|Fetal circulation]]
At birth, cutting the umbilical cord and changes in the lungs after the first breaths trigger major functional adaptations in the fetal circulatory system.

* blood flow through ductus venosus is eliminated
* pulmonary circulation bed expands - reducing blood flow through ductus arteriosus
* physiological closure of interatrial shunt
* closure of ductus venosus in liver is prolonged

{| border=1

|-
! Fetal Structure
! Adult Structure
|-
| foramen ovale
| fossa ovalis
|-
| umbilical vein (intra-abdominal part)
| ligamentum teres
|-
| ductus venosus
| ligamentum venosum
|-
| umbilical arteries
| distal part -lateral umbilical ligaments; proximal part - superior vesical artery (supplies bladder)
|-
| ductus arteriosus
| ligamentum arteriosum
|}

==Abnormalities==
There are many different cardiac abnormalities, some more common than others, and only a few will be described in this lecture.

'''Major Abnormalities:''' Aortic Stenosis, Atrial Septal Defects, Coarctation of Aorta, Dextrocardia, Hypoplastic Left Heart, Long QT Syndrome, Patent Ductus Arteriosus, Pulmonary Atresia, Pulmonary Stenosis, Tetralogy of Fallot, Transposition of Great Vessels, Tricuspid Atresia, Total Anomalous Pulmonary Venous Connection, Ventricular Septal Defect, Abnormalities of Conducting System.

Links: [http://embryology.med.unsw.edu.au/Notes/heart2.htm Cardiovascular Development Abnormalities]

[[File:Abnormal81-92-heart.png|thumb]]

[[File:Statistics-Utah heart defects.jpg|thumb]]
===Atrial Septal Defects===

{| border='0px'
|-
| [[File:HeartILP_draft_asd.jpg|Atrial Septal Defect]]
|
* Atrial Septal Defects (ASD) are a group of common (1% of cardiac) congenital anomalies defects occurring in a number of different forms and more often in females.
* patent foramen ovale - allows a continuation of the atrial shunting of blood, in 25% of people a probe patent foramen ovale (allowing a probe to bypassed from one atria to the other) exists.
* ostium secundum defect
* endocardial cushion defect involving ostium primum
* sinus venosus defect - contributes about 10% of all ASDs and occurs mainly in a common and less common form. Common ("usual type") - in upper atrial septum which is contiguous with the superior vena cava. Less common - at junction of the right atrium and inferior vena cava.
* common atrium
|-
|}

===Ventricular Septal Defects===
{| border='0px'
|-
| [[File:HeartILP_draft_vsd.jpg|Ventricular Septal Defect]]
|
* The Ventricular Septal Defect (VSD) usually occurs in the membranous (perimembranous) (70%) rather than muscular interventricular septum, and is more frequent in males that females.
* Perimembranous defects are located close to the aortic and tricuspid valves and adjacent to atrioventricular conduction bundle.
* The defect allows left-right shunting of blood, this shunting depends upon the size of the defect. Small defects may close spontaneously, larger defects result in infant congestive heart failure.
* Clinically repaired by coils or tissue-adapted devices like muscular or perimembranous occluders.
|-
|}
(V.S.D.)

===Patent Ductus Arteriosus===

{| border='0px'

|-
| [[File:HeartILP_draft_patentda.jpg|Patent Ductus Arteriosus]]
|
* Patent Ductus Arteriosus (PDA) occurs commonly in preterm infants, can close spontaneously (by day three in 60% of normal term neonates) the remainder are ligated simply and with little risk.
* The operation is always recommended even in the absence of cardiac failure and can often be deferred until early childhood.

|-
|}

===Tetralogy of Fallot===
{| border='0px'
|-
| [[File:HeartILP_draft_tetralogyoffallot.jpg|Tetralogy of Fallot]]
|
* Named after Etienne-Louis Arthur Fallot (1888) who described it as "la maladie blue" and is a common developmental cardiac defect.
* The syndrome consists of a number of a number of cardiac defects possibly stemming from abnormal neural crest migration. The basic defect in a tetralogy of Fallot is an asymmetrical fusion of the truncoconal ridges and a malalignment of the aortic and pulmonary valves. This results in the typical 4 features seen in this defect: 1. pulmonary stenosis, 2. overriding aorta, 3. ventricular septal defect, and 4. right ventricular hypertrophy.
|-
|}

==Movies==

{| border='0px'

|-
| [[File:Heart1_looping icon.jpg|90px|link=Development_Animation_-_Heart Looping]]
| [[File:Heart1_realign icon.jpg|90px|link=Development_Animation_-_Heart Realign]]
| [[File:Heart1_atrium icon.jpg|90px|link=Development_Animation_-_Heart Atrial Septation]]
| [[File:heart1 ventricle icon.jpg|90px|link=Development_Animation_-_Heart Outflow Septation]]
|-
| [[Development_Animation_-_Heart Looping|Heart Looping]]
| [[Development_Animation_-_Heart Realign|Heart Realign]]
| [[Development_Animation_-_Heart Atrial Septation|Heart Atrial Septation]]
| [[Development_Animation_-_Heart Outflow Septation|Heart Outflow Septation]]
|-
|}

'''Link:''' [[Flash Movies]]

{{Template:2009ANAT2341}}

[[Category:2009ANAT2341]] [[Category:Science-Undergraduate]]

[[Category:Cardiovascular]] [[Category:Heart]]

2010 Lecture 21

2010-10-10T11:17:37Z

Z3267024: /* Septum Secundum */

<div style="background:#F5FFFA; border: 1px solid #CEF2E0; padding: 1em; margin: auto; width: 95%; float:left;"><div style="margin:0;background-color:#cef2e0;font-family:sans-serif;font-size:120%;font-weight:bold;border:1px solid #a3bfb1;text-align:left;color:#000;padding-left:0.4em;padding-top:0.2em;padding-bottom:0.2em;">Lecture Notice - Dr Nalini Pather</div>This online lecture page will contain the content required when attending the lecture. Currently this page is only a template and will be updated before the lecture (this notice removed when completed). Final lecture pages can also be printed out using the "printable version" lefthand menu.</div>

==Introduction==
[[File:Gray0473.gif|300px|right]]

In [[2010 Lecture 7|lecture 7 - Early Vascular Development]], the early development of the cardiovascular system was discussed. This second lecture will now focus on the extensive remodeling that occurs in both the heart and vascular system during later development. In addition, there will be discussion on the major cardiovascular abnormalities. The laboratory this week will also give you the opportunity to work through some of these concepts using a new online teaching module.

This material is also presented in an online [[Cardiac_Embryology|Cardiac Embryology tutorial]].

[[File:Basic_Heart_Development_Timeline.jpg|400px|Link=Cardiac_Embryology]]

{{Template:Heart Links}}

:'''Lecture Audio'''

==Lecture Objectives==
* Describe the development of primary and secondary atrial septa and the ventricular septum.
* Explain the changes occurring in the bulbis cordis and truncus arteriosus in its transformation from a single to a double tube.
* Describe the development of the aortic arches on the right and left sides from the fetus to the adult.
* Describe the development of arteries and veins.
* Describe the major cardiovascular developmental abnormalities.

==Textbook references==

* Human Embryology (3rd ed.) Larson Chapter 7 p151-188 Heart, Chapter 8 p189-228 Vasculature
* The Developing Human: Clinically Oriented Embryology (6th ed.) Chapter 14: p304-349

'''Other textbooks'''
* Before we Are Born (5th ed.) Moore and Persaud Chapter 12; p241-254
* Essentials of Human Embryology Larson Chapter 7 p97-122 Heart, Chapter 8 p123-146 Vasculature
* Human Embryology Fitzgerald and Fitzgerald Chapter 13-17: p77-111

'''Recent reviews'''
* Yutzey KE, Kirby ML. Wherefore heart thou? Embryonic origins of cardiogenic mesoderm. Dev Dyn. 2002 Mar;223(3):307-20. Review. [http://www.ncbi.nlm.nih.gov/pubmed/11891982?dopt=Abstract PMID: 11891982]
* Three-dimensional reconstruction of gene expression patterns during cardiac development. Soufan AT, Ruijter JM, van den Hoff MJ, de Boer PA, Hagoort J, Moorman AF. Physiol Genomics. 2003 May 13;13(3):187-95. Review. [http://www.ncbi.nlm.nih.gov/pubmed/12746463 PMID: 12746463]
* Moorman A, Webb S, Brown NA, Lamers W, Anderson RH. Development of the heart: (1) formation of the cardiac chambers and arterial trunks. Heart. 2003 Jul;89(7):806-14. [http://www.ncbi.nlm.nih.gov/pubmed/12807866?dopt=Abstract PMID: 12807866]
* Bruneau BG. Transcriptional regulation of vertebrate cardiac morphogenesis. Circ Res. 2002 Mar 22;90(5):509-19. Review. [http://www.ncbi.nlm.nih.gov/pubmed/11909814?dopt=Abstract PMID: 11909814]

----

==Heart Development==
[[File:Gray0462.gif|thumb|200px|Day 14 Heart tube]]
[[File:Heart_Tube_Fusion.jpg|400px|Early Human Heart Tube Development]]

* [[E#endocardial tube|endocardial tube]] in [[P#pericardial cavity|pericardial cavity]]
** dorsal mesentry (mesocardial) attachment lost
** attached at cranial (arterial) and caudal (venous) ends
* tube elongation - bending and series of expansions
[[File:Heart-cartoon-001.jpg|thumb|Adult Heart blood flow]]
Bulbus Cordis
* refers to the outflow tract in early embryo
* 3 parts
** distal - forms [[T#truncus arteriosus|truncus arteriosus]] (aorta and pulmonary artery)
** middle - [[C#conus arteriosus|conus arteriosus]] ventricular outflow tract
** proximal - right ventricle trabeculate part

{| border=1

|-
! Fetal Structure
! Adult Structure
|-
| Truncus arteriosus
| aorta
pulmonary trunk
|-
| Conus arteriosus
| right ventricle - smooth part
|-
| Primitive ventricle
| right ventricle - trabecular part
left ventricle - trabecular part
|-
| Primitive atrium
| right atrium - trabecular part
left atrium - trabecular part
|-
| Sinus venosus
| right atrium - smooth part (sinus venarum)
coronary sinus
oblique vein of left atrium
|}

===Heart Layers===
* '''pericardium''' - covers the heart, formed by 3 layers consisting of a fibrous pericardium and a double layered serous pericardium (parietal layer and visceral epicardium layer).
* '''myocardium''' - muscular wall of the heart, thickest layer formed by spirally arranged cardiac muscle cells.
* '''endocardium''' - lines the heart, epithelial (endothelial) tissue lining the inner surface of heart chambers and valves.

===Embryonic Heart Rate===

* Stage 9-10 2 mm embryo (gestational sac diameter of 20 mm) EHR at least 75 beats / minute
* Stage 11-12 5 mm embryo (gestational sac diameter of 30 mm) EHR at least 100 beats / minute
* Stage 16 10 mm embryo EHR at least 120 beats / minute
* Stage 18 15 mm embryo EHR at least 130 beats / minute

[http://embryology.med.unsw.edu.au/Movies/usound/Hum12wkFHR.htm Week 12 fetal heart rate doppler] [http://embryology.med.unsw.edu.au/Notes/heart8.htm Week 17 fetal heart rate audio]

==Separation of the Atria from the Venticles==
[[File:AV Canal Division.jpg|thumb|100px|Separation of the atrioventricular canal]]
===Endocardial Cushions===
* form initial division of atria and ventricles
* form on dorsal and ventral wall of atrioventcular canals
* grow into canal - meet and fuse to separate atrioventricular canal into right and left channels.

==Atrial Septation==
[[File:Heart1_atrium icon.jpg|90px|link=Development_Animation_-_Heart Atrial Septation]]

[[File:Stage13 C7L.jpg|thumb|Heart (Carnegie stage 13)]]

Through all development blood shunts from right to left atrium (bypass lungs)

===Septum Primum===
[http://embryology.med.unsw.edu.au/wwwpig/pigc/c1l.htm Stage 13 Septum Primum] [http://embryology.med.unsw.edu.au/wwwhuman/lowpower/HumE/E2L.htm Stage 22 Septum Primum]

* dorso-cranial wall, crescentric-shaped membranous extension
* grows downward towards endocardial cushions
* opening is '''foramen primum''' (ostium primum)- serves as a shunt
* a series of perforations develop in cranial end - coalesce to form '''foramen secundum''' (ostium secundum)
* septum primum fuses with endocardial cushions - obliterates foramen primum

===Septum Secundum===
* crescentric septum secundum begins to form to the right of septum primum
* grows as septum primum downwards, does not fuse with endocardial cushion, opening is '''foramen ovale'''
* arrangement of the two septa facilitates a one-way valve

[[File:Atrial Septation.jpg|200px|Atrial septation]]
[[File:Atrial & Ventricular Septation 1.jpg|200px|Early -atrial and ventricular septation]]
[[File:Atrial & Ventricular Septation 2.jpg|200px|Late-atrial and ventricular septation]]

===Right Atrium===
[[File:Gray0476.jpg|thumb|sinus venosus and tributaries]]
* with heart looping and formation of interatrial septa, the sinus venosus shifts completely to right atrium
* right sinus horn incorporates into dorsal wall of right atrium
* left sinus horn becomes the coronary sinus
* sinoatrial opening - has 2 flaps, left fuses with septum secundum, right forms valve to inferior vena cava and coronary sinus. [http://embryology.med.unsw.edu.au/wwwpig/pigc/c3l.htm Stage 13 - right venous valve] [http://embryology.med.unsw.edu.au/wwwhuman/lowpower/HumE/E2L.htm Stage 22 - right venous valve]

===Left Atrium===
* posterior wall - outgrowth forms single pulmonary vein, divided into 4 branches
* incorporation into the wall leads to 4 openings in posterior wall
* later moves to the right aligns with atrioventricular canal.

==Ventricular Septation==
[[File:Stage13 C7L.jpg|thumb|Heart (Carnegie stage 13)]]
[[File:Gray0498.jpg|thumb|Ventricular septum]]
[[File:Heart1_realign icon.jpg|90px|link=Development_Animation_-_Heart Realign]]

* 2 separate components - superior membranous, inferior muscular
===Muscular Septum===
[[File:Gray0470.jpg|thumb|muscular septum]]
* growth of inferior wall
* fusion of 3 components - right and left bulbar ridges and dorsal endocardial cushion

===Membranous Septum===
* above the muscular septum, fusion continuous with septation of the outflow tract

[[File:Heart-ventricular-septum-01.jpg‎]][[File:Heart-ventricular-septum-02.jpg‎]][[File:Heart-ventricular-septum-03.jpg‎]]

==Outflow Tract Septation==

[[File:heart1 ventricle icon.jpg|90px|link=Development_Animation_-_Heart Outflow Septation]]

* in early development, outflow tract is a single tube, bulbus cordis
* elongates to form proximal conus arteriosus and distal truncus arteriosus
* 2 growths from wall in spiral pattern, inferior upwards - separate tract into 2 channels [http://embryology.med.unsw.edu.au/wwwpig/pigb/b5l.htm Stage 13 truncus arteriousus]
* mesenchyme and neural crest contribute to this septation process
* fusion of outgrowths separate aortic and pulmonary outflow

{| border='0px'

|-
| [[File:Chick_Heart_001-icon.jpg|90px|link=Movie_-_Normal Chick Heart]]
| [[File:Chick_Heart_002-icon.jpg|90px|link=Movie_-_Abnormal Chick Heart]]
| [[File:Chick_Heart_002-icon.jpg|90px|link=Movie_-_Abnormal Chick Heart 2]]
|-
| [[Movie_-_Normal Chick Heart|Normal Heart]]
| [[Movie_-_Abnormal Chick Heart|Abnormal Heart]]
| [[Movie_-_Abnormal Chick Heart 2|Abnormal Heart 2]]
|-
|}

==Vascular Remodeling==
===Arterial System===
[[File:Gray0474.jpg|thumb|pharyngeal arch arteries]]
* Aortic sac - remodels forming 2 horns, R forms brachiocephalic artery, L forms common carotid artery

Pharyngeal arch arteries
* pharyngeal arch artery 1 and 2 regress
* pharyngeal arch artery 3 and the associated dorsal aorta form the paired internal carotid arteries, these in turn generate the external carotids
* Left pharyngeal arch artery 4 – forms the aortic arch

* paraxial mesoderm forms paired dorsal aorta
** head mesenchyme forms aortic arches
** connecting stalk contains unbilical (placental) arteries
** dorsal aortas give rise to
** vitelline arteries which connect to capillaries on yolk sac
** intersegmental arteries between somites

===Venous System===
Cardinal veins contribute nearly all systemic venous system.

<gallery>
File:Gray0477.jpg
File:Gray0478.jpg
File:Gray0479.jpg
File:Gray0480.jpg
</gallery>

common cardinal veins - ducts of Cuvier

hepatic veins - drain de-oxygenated blood from the liver into the inferior vena cava.

internal iliac vein - hypogastric vein

==Birth Changes==
[[File:Fetal_circulation1.jpg|thumb|Fetal circulation]]
At birth, cutting the umbilical cord and changes in the lungs after the first breaths trigger major functional adaptations in the fetal circulatory system.

* blood flow through ductus venosus is eliminated
* pulmonary circulation bed expands - reducing blood flow through ductus arteriosus
* physiological closure of interatrial shunt
* closure of ductus venosus in liver is prolonged

{| border=1

|-
! Fetal Structure
! Adult Structure
|-
| foramen ovale
| fossa ovalis
|-
| umbilical vein (intra-abdominal part)
| ligamentum teres
|-
| ductus venosus
| ligamentum venosum
|-
| umbilical arteries
| distal part -lateral umbilical ligaments; proximal part - superior vesical artery (supplies bladder)
|-
| ductus arteriosus
| ligamentum arteriosum
|}

==Abnormalities==
There are many different cardiac abnormalities, some more common than others, and only a few will be described in this lecture.

'''Major Abnormalities:''' Aortic Stenosis, Atrial Septal Defects, Coarctation of Aorta, Dextrocardia, Hypoplastic Left Heart, Long QT Syndrome, Patent Ductus Arteriosus, Pulmonary Atresia, Pulmonary Stenosis, Tetralogy of Fallot, Transposition of Great Vessels, Tricuspid Atresia, Total Anomalous Pulmonary Venous Connection, Ventricular Septal Defect, Abnormalities of Conducting System.

Links: [http://embryology.med.unsw.edu.au/Notes/heart2.htm Cardiovascular Development Abnormalities]

[[File:Abnormal81-92-heart.png|thumb]]

[[File:Statistics-Utah heart defects.jpg|thumb]]
===Atrial Septal Defects===

{| border='0px'
|-
| [[File:HeartILP_draft_asd.jpg|Atrial Septal Defect]]
|
* Atrial Septal Defects (ASD) are a group of common (1% of cardiac) congenital anomalies defects occurring in a number of different forms and more often in females.
* patent foramen ovale - allows a continuation of the atrial shunting of blood, in 25% of people a probe patent foramen ovale (allowing a probe to bypassed from one atria to the other) exists.
* ostium secundum defect
* endocardial cushion defect involving ostium primum
* sinus venosus defect - contributes about 10% of all ASDs and occurs mainly in a common and less common form. Common ("usual type") - in upper atrial septum which is contiguous with the superior vena cava. Less common - at junction of the right atrium and inferior vena cava.
* common atrium
|-
|}

===Ventricular Septal Defects===
{| border='0px'
|-
| [[File:HeartILP_draft_vsd.jpg|Ventricular Septal Defect]]
|
* The Ventricular Septal Defect (VSD) usually occurs in the membranous (perimembranous) (70%) rather than muscular interventricular septum, and is more frequent in males that females.
* Perimembranous defects are located close to the aortic and tricuspid valves and adjacent to atrioventricular conduction bundle.
* The defect allows left-right shunting of blood, this shunting depends upon the size of the defect. Small defects may close spontaneously, larger defects result in infant congestive heart failure.
* Clinically repaired by coils or tissue-adapted devices like muscular or perimembranous occluders.
|-
|}
(V.S.D.)

===Patent Ductus Arteriosus===

{| border='0px'

|-
| [[File:HeartILP_draft_patentda.jpg|Patent Ductus Arteriosus]]
|
* Patent Ductus Arteriosus (PDA) occurs commonly in preterm infants, can close spontaneously (by day three in 60% of normal term neonates) the remainder are ligated simply and with little risk.
* The operation is always recommended even in the absence of cardiac failure and can often be deferred until early childhood.

|-
|}

===Tetralogy of Fallot===
{| border='0px'
|-
| [[File:HeartILP_draft_tetralogyoffallot.jpg|Tetralogy of Fallot]]
|
* Named after Etienne-Louis Arthur Fallot (1888) who described it as "la maladie blue" and is a common developmental cardiac defect.
* The syndrome consists of a number of a number of cardiac defects possibly stemming from abnormal neural crest migration. The basic defect in a tetralogy of Fallot is an asymmetrical fusion of the truncoconal ridges and a malalignment of the aortic and pulmonary valves.
|-
|}

==Movies==

{| border='0px'

|-
| [[File:Heart1_looping icon.jpg|90px|link=Development_Animation_-_Heart Looping]]
| [[File:Heart1_realign icon.jpg|90px|link=Development_Animation_-_Heart Realign]]
| [[File:Heart1_atrium icon.jpg|90px|link=Development_Animation_-_Heart Atrial Septation]]
| [[File:heart1 ventricle icon.jpg|90px|link=Development_Animation_-_Heart Outflow Septation]]
|-
| [[Development_Animation_-_Heart Looping|Heart Looping]]
| [[Development_Animation_-_Heart Realign|Heart Realign]]
| [[Development_Animation_-_Heart Atrial Septation|Heart Atrial Septation]]
| [[Development_Animation_-_Heart Outflow Septation|Heart Outflow Septation]]
|-
|}

'''Link:''' [[Flash Movies]]

{{Template:2009ANAT2341}}

[[Category:2009ANAT2341]] [[Category:Science-Undergraduate]]

[[Category:Cardiovascular]] [[Category:Heart]]

2010 Lecture 21

2010-10-10T11:16:10Z

Z3267024: /* Atrial Septation */

<div style="background:#F5FFFA; border: 1px solid #CEF2E0; padding: 1em; margin: auto; width: 95%; float:left;"><div style="margin:0;background-color:#cef2e0;font-family:sans-serif;font-size:120%;font-weight:bold;border:1px solid #a3bfb1;text-align:left;color:#000;padding-left:0.4em;padding-top:0.2em;padding-bottom:0.2em;">Lecture Notice - Dr Nalini Pather</div>This online lecture page will contain the content required when attending the lecture. Currently this page is only a template and will be updated before the lecture (this notice removed when completed). Final lecture pages can also be printed out using the "printable version" lefthand menu.</div>

==Introduction==
[[File:Gray0473.gif|300px|right]]

In [[2010 Lecture 7|lecture 7 - Early Vascular Development]], the early development of the cardiovascular system was discussed. This second lecture will now focus on the extensive remodeling that occurs in both the heart and vascular system during later development. In addition, there will be discussion on the major cardiovascular abnormalities. The laboratory this week will also give you the opportunity to work through some of these concepts using a new online teaching module.

This material is also presented in an online [[Cardiac_Embryology|Cardiac Embryology tutorial]].

[[File:Basic_Heart_Development_Timeline.jpg|400px|Link=Cardiac_Embryology]]

{{Template:Heart Links}}

:'''Lecture Audio'''

==Lecture Objectives==
* Describe the development of primary and secondary atrial septa and the ventricular septum.
* Explain the changes occurring in the bulbis cordis and truncus arteriosus in its transformation from a single to a double tube.
* Describe the development of the aortic arches on the right and left sides from the fetus to the adult.
* Describe the development of arteries and veins.
* Describe the major cardiovascular developmental abnormalities.

==Textbook references==

* Human Embryology (3rd ed.) Larson Chapter 7 p151-188 Heart, Chapter 8 p189-228 Vasculature
* The Developing Human: Clinically Oriented Embryology (6th ed.) Chapter 14: p304-349

'''Other textbooks'''
* Before we Are Born (5th ed.) Moore and Persaud Chapter 12; p241-254
* Essentials of Human Embryology Larson Chapter 7 p97-122 Heart, Chapter 8 p123-146 Vasculature
* Human Embryology Fitzgerald and Fitzgerald Chapter 13-17: p77-111

'''Recent reviews'''
* Yutzey KE, Kirby ML. Wherefore heart thou? Embryonic origins of cardiogenic mesoderm. Dev Dyn. 2002 Mar;223(3):307-20. Review. [http://www.ncbi.nlm.nih.gov/pubmed/11891982?dopt=Abstract PMID: 11891982]
* Three-dimensional reconstruction of gene expression patterns during cardiac development. Soufan AT, Ruijter JM, van den Hoff MJ, de Boer PA, Hagoort J, Moorman AF. Physiol Genomics. 2003 May 13;13(3):187-95. Review. [http://www.ncbi.nlm.nih.gov/pubmed/12746463 PMID: 12746463]
* Moorman A, Webb S, Brown NA, Lamers W, Anderson RH. Development of the heart: (1) formation of the cardiac chambers and arterial trunks. Heart. 2003 Jul;89(7):806-14. [http://www.ncbi.nlm.nih.gov/pubmed/12807866?dopt=Abstract PMID: 12807866]
* Bruneau BG. Transcriptional regulation of vertebrate cardiac morphogenesis. Circ Res. 2002 Mar 22;90(5):509-19. Review. [http://www.ncbi.nlm.nih.gov/pubmed/11909814?dopt=Abstract PMID: 11909814]

----

==Heart Development==
[[File:Gray0462.gif|thumb|200px|Day 14 Heart tube]]
[[File:Heart_Tube_Fusion.jpg|400px|Early Human Heart Tube Development]]

* [[E#endocardial tube|endocardial tube]] in [[P#pericardial cavity|pericardial cavity]]
** dorsal mesentry (mesocardial) attachment lost
** attached at cranial (arterial) and caudal (venous) ends
* tube elongation - bending and series of expansions
[[File:Heart-cartoon-001.jpg|thumb|Adult Heart blood flow]]
Bulbus Cordis
* refers to the outflow tract in early embryo
* 3 parts
** distal - forms [[T#truncus arteriosus|truncus arteriosus]] (aorta and pulmonary artery)
** middle - [[C#conus arteriosus|conus arteriosus]] ventricular outflow tract
** proximal - right ventricle trabeculate part

{| border=1

|-
! Fetal Structure
! Adult Structure
|-
| Truncus arteriosus
| aorta
pulmonary trunk
|-
| Conus arteriosus
| right ventricle - smooth part
|-
| Primitive ventricle
| right ventricle - trabecular part
left ventricle - trabecular part
|-
| Primitive atrium
| right atrium - trabecular part
left atrium - trabecular part
|-
| Sinus venosus
| right atrium - smooth part (sinus venarum)
coronary sinus
oblique vein of left atrium
|}

===Heart Layers===
* '''pericardium''' - covers the heart, formed by 3 layers consisting of a fibrous pericardium and a double layered serous pericardium (parietal layer and visceral epicardium layer).
* '''myocardium''' - muscular wall of the heart, thickest layer formed by spirally arranged cardiac muscle cells.
* '''endocardium''' - lines the heart, epithelial (endothelial) tissue lining the inner surface of heart chambers and valves.

===Embryonic Heart Rate===

* Stage 9-10 2 mm embryo (gestational sac diameter of 20 mm) EHR at least 75 beats / minute
* Stage 11-12 5 mm embryo (gestational sac diameter of 30 mm) EHR at least 100 beats / minute
* Stage 16 10 mm embryo EHR at least 120 beats / minute
* Stage 18 15 mm embryo EHR at least 130 beats / minute

[http://embryology.med.unsw.edu.au/Movies/usound/Hum12wkFHR.htm Week 12 fetal heart rate doppler] [http://embryology.med.unsw.edu.au/Notes/heart8.htm Week 17 fetal heart rate audio]

==Separation of the Atria from the Venticles==
[[File:AV Canal Division.jpg|thumb|100px|Separation of the atrioventricular canal]]
===Endocardial Cushions===
* form initial division of atria and ventricles
* form on dorsal and ventral wall of atrioventcular canals
* grow into canal - meet and fuse to separate atrioventricular canal into right and left channels.

==Atrial Septation==
[[File:Heart1_atrium icon.jpg|90px|link=Development_Animation_-_Heart Atrial Septation]]

[[File:Stage13 C7L.jpg|thumb|Heart (Carnegie stage 13)]]

Through all development blood shunts from right to left atrium (bypass lungs)

===Septum Primum===
[http://embryology.med.unsw.edu.au/wwwpig/pigc/c1l.htm Stage 13 Septum Primum] [http://embryology.med.unsw.edu.au/wwwhuman/lowpower/HumE/E2L.htm Stage 22 Septum Primum]

* dorso-cranial wall, crescentric-shaped membranous extension
* grows downward towards endocardial cushions
* opening is '''foramen primum''' (ostium primum)- serves as a shunt
* a series of perforations develop in cranial end - coalesce to form '''foramen secundum''' (ostium secundum)
* septum primum fuses with endocardial cushions - obliterates foramen primum

===Septum Secundum===
* crescentric septum secundum begins to form to the right of septum primum
* grows as septum primum downward, does not fuse with endocardial cushion, opening is '''foramen ovale'''
* arrangement of the two septa allows them to act as a one-way valve

[[File:Atrial Septation.jpg|200px|Atrial septation]]
[[File:Atrial & Ventricular Septation 1.jpg|200px|Early -atrial and ventricular septation]]
[[File:Atrial & Ventricular Septation 2.jpg|200px|Late-atrial and ventricular septation]]

===Right Atrium===
[[File:Gray0476.jpg|thumb|sinus venosus and tributaries]]
* with heart looping and formation of interatrial septa, the sinus venosus shifts completely to right atrium
* right sinus horn incorporates into dorsal wall of right atrium
* left sinus horn becomes the coronary sinus
* sinoatrial opening - has 2 flaps, left fuses with septum secundum, right forms valve to inferior vena cava and coronary sinus. [http://embryology.med.unsw.edu.au/wwwpig/pigc/c3l.htm Stage 13 - right venous valve] [http://embryology.med.unsw.edu.au/wwwhuman/lowpower/HumE/E2L.htm Stage 22 - right venous valve]

===Left Atrium===
* posterior wall - outgrowth forms single pulmonary vein, divided into 4 branches
* incorporation into the wall leads to 4 openings in posterior wall
* later moves to the right aligns with atrioventricular canal.

==Ventricular Septation==
[[File:Stage13 C7L.jpg|thumb|Heart (Carnegie stage 13)]]
[[File:Gray0498.jpg|thumb|Ventricular septum]]
[[File:Heart1_realign icon.jpg|90px|link=Development_Animation_-_Heart Realign]]

* 2 separate components - superior membranous, inferior muscular
===Muscular Septum===
[[File:Gray0470.jpg|thumb|muscular septum]]
* growth of inferior wall
* fusion of 3 components - right and left bulbar ridges and dorsal endocardial cushion

===Membranous Septum===
* above the muscular septum, fusion continuous with septation of the outflow tract

[[File:Heart-ventricular-septum-01.jpg‎]][[File:Heart-ventricular-septum-02.jpg‎]][[File:Heart-ventricular-septum-03.jpg‎]]

==Outflow Tract Septation==

[[File:heart1 ventricle icon.jpg|90px|link=Development_Animation_-_Heart Outflow Septation]]

* in early development, outflow tract is a single tube, bulbus cordis
* elongates to form proximal conus arteriosus and distal truncus arteriosus
* 2 growths from wall in spiral pattern, inferior upwards - separate tract into 2 channels [http://embryology.med.unsw.edu.au/wwwpig/pigb/b5l.htm Stage 13 truncus arteriousus]
* mesenchyme and neural crest contribute to this septation process
* fusion of outgrowths separate aortic and pulmonary outflow

{| border='0px'

|-
| [[File:Chick_Heart_001-icon.jpg|90px|link=Movie_-_Normal Chick Heart]]
| [[File:Chick_Heart_002-icon.jpg|90px|link=Movie_-_Abnormal Chick Heart]]
| [[File:Chick_Heart_002-icon.jpg|90px|link=Movie_-_Abnormal Chick Heart 2]]
|-
| [[Movie_-_Normal Chick Heart|Normal Heart]]
| [[Movie_-_Abnormal Chick Heart|Abnormal Heart]]
| [[Movie_-_Abnormal Chick Heart 2|Abnormal Heart 2]]
|-
|}

==Vascular Remodeling==
===Arterial System===
[[File:Gray0474.jpg|thumb|pharyngeal arch arteries]]
* Aortic sac - remodels forming 2 horns, R forms brachiocephalic artery, L forms common carotid artery

Pharyngeal arch arteries
* pharyngeal arch artery 1 and 2 regress
* pharyngeal arch artery 3 and the associated dorsal aorta form the paired internal carotid arteries, these in turn generate the external carotids
* Left pharyngeal arch artery 4 – forms the aortic arch

* paraxial mesoderm forms paired dorsal aorta
** head mesenchyme forms aortic arches
** connecting stalk contains unbilical (placental) arteries
** dorsal aortas give rise to
** vitelline arteries which connect to capillaries on yolk sac
** intersegmental arteries between somites

===Venous System===
Cardinal veins contribute nearly all systemic venous system.

<gallery>
File:Gray0477.jpg
File:Gray0478.jpg
File:Gray0479.jpg
File:Gray0480.jpg
</gallery>

common cardinal veins - ducts of Cuvier

hepatic veins - drain de-oxygenated blood from the liver into the inferior vena cava.

internal iliac vein - hypogastric vein

==Birth Changes==
[[File:Fetal_circulation1.jpg|thumb|Fetal circulation]]
At birth, cutting the umbilical cord and changes in the lungs after the first breaths trigger major functional adaptations in the fetal circulatory system.

* blood flow through ductus venosus is eliminated
* pulmonary circulation bed expands - reducing blood flow through ductus arteriosus
* physiological closure of interatrial shunt
* closure of ductus venosus in liver is prolonged

{| border=1

|-
! Fetal Structure
! Adult Structure
|-
| foramen ovale
| fossa ovalis
|-
| umbilical vein (intra-abdominal part)
| ligamentum teres
|-
| ductus venosus
| ligamentum venosum
|-
| umbilical arteries
| distal part -lateral umbilical ligaments; proximal part - superior vesical artery (supplies bladder)
|-
| ductus arteriosus
| ligamentum arteriosum
|}

==Abnormalities==
There are many different cardiac abnormalities, some more common than others, and only a few will be described in this lecture.

'''Major Abnormalities:''' Aortic Stenosis, Atrial Septal Defects, Coarctation of Aorta, Dextrocardia, Hypoplastic Left Heart, Long QT Syndrome, Patent Ductus Arteriosus, Pulmonary Atresia, Pulmonary Stenosis, Tetralogy of Fallot, Transposition of Great Vessels, Tricuspid Atresia, Total Anomalous Pulmonary Venous Connection, Ventricular Septal Defect, Abnormalities of Conducting System.

Links: [http://embryology.med.unsw.edu.au/Notes/heart2.htm Cardiovascular Development Abnormalities]

[[File:Abnormal81-92-heart.png|thumb]]

[[File:Statistics-Utah heart defects.jpg|thumb]]
===Atrial Septal Defects===

{| border='0px'
|-
| [[File:HeartILP_draft_asd.jpg|Atrial Septal Defect]]
|
* Atrial Septal Defects (ASD) are a group of common (1% of cardiac) congenital anomalies defects occurring in a number of different forms and more often in females.
* patent foramen ovale - allows a continuation of the atrial shunting of blood, in 25% of people a probe patent foramen ovale (allowing a probe to bypassed from one atria to the other) exists.
* ostium secundum defect
* endocardial cushion defect involving ostium primum
* sinus venosus defect - contributes about 10% of all ASDs and occurs mainly in a common and less common form. Common ("usual type") - in upper atrial septum which is contiguous with the superior vena cava. Less common - at junction of the right atrium and inferior vena cava.
* common atrium
|-
|}

===Ventricular Septal Defects===
{| border='0px'
|-
| [[File:HeartILP_draft_vsd.jpg|Ventricular Septal Defect]]
|
* The Ventricular Septal Defect (VSD) usually occurs in the membranous (perimembranous) (70%) rather than muscular interventricular septum, and is more frequent in males that females.
* Perimembranous defects are located close to the aortic and tricuspid valves and adjacent to atrioventricular conduction bundle.
* The defect allows left-right shunting of blood, this shunting depends upon the size of the defect. Small defects may close spontaneously, larger defects result in infant congestive heart failure.
* Clinically repaired by coils or tissue-adapted devices like muscular or perimembranous occluders.
|-
|}
(V.S.D.)

===Patent Ductus Arteriosus===

{| border='0px'

|-
| [[File:HeartILP_draft_patentda.jpg|Patent Ductus Arteriosus]]
|
* Patent Ductus Arteriosus (PDA) occurs commonly in preterm infants, can close spontaneously (by day three in 60% of normal term neonates) the remainder are ligated simply and with little risk.
* The operation is always recommended even in the absence of cardiac failure and can often be deferred until early childhood.

|-
|}

===Tetralogy of Fallot===
{| border='0px'
|-
| [[File:HeartILP_draft_tetralogyoffallot.jpg|Tetralogy of Fallot]]
|
* Named after Etienne-Louis Arthur Fallot (1888) who described it as "la maladie blue" and is a common developmental cardiac defect.
* The syndrome consists of a number of a number of cardiac defects possibly stemming from abnormal neural crest migration. The basic defect in a tetralogy of Fallot is an asymmetrical fusion of the truncoconal ridges and a malalignment of the aortic and pulmonary valves.
|-
|}

==Movies==

{| border='0px'

|-
| [[File:Heart1_looping icon.jpg|90px|link=Development_Animation_-_Heart Looping]]
| [[File:Heart1_realign icon.jpg|90px|link=Development_Animation_-_Heart Realign]]
| [[File:Heart1_atrium icon.jpg|90px|link=Development_Animation_-_Heart Atrial Septation]]
| [[File:heart1 ventricle icon.jpg|90px|link=Development_Animation_-_Heart Outflow Septation]]
|-
| [[Development_Animation_-_Heart Looping|Heart Looping]]
| [[Development_Animation_-_Heart Realign|Heart Realign]]
| [[Development_Animation_-_Heart Atrial Septation|Heart Atrial Septation]]
| [[Development_Animation_-_Heart Outflow Septation|Heart Outflow Septation]]
|-
|}

'''Link:''' [[Flash Movies]]

{{Template:2009ANAT2341}}

[[Category:2009ANAT2341]] [[Category:Science-Undergraduate]]

[[Category:Cardiovascular]] [[Category:Heart]]

2010 Lecture 21

2010-10-10T11:06:29Z

Z3267024: /* Heart Development */

<div style="background:#F5FFFA; border: 1px solid #CEF2E0; padding: 1em; margin: auto; width: 95%; float:left;"><div style="margin:0;background-color:#cef2e0;font-family:sans-serif;font-size:120%;font-weight:bold;border:1px solid #a3bfb1;text-align:left;color:#000;padding-left:0.4em;padding-top:0.2em;padding-bottom:0.2em;">Lecture Notice - Dr Nalini Pather</div>This online lecture page will contain the content required when attending the lecture. Currently this page is only a template and will be updated before the lecture (this notice removed when completed). Final lecture pages can also be printed out using the "printable version" lefthand menu.</div>

==Introduction==
[[File:Gray0473.gif|300px|right]]

In [[2010 Lecture 7|lecture 7 - Early Vascular Development]], the early development of the cardiovascular system was discussed. This second lecture will now focus on the extensive remodeling that occurs in both the heart and vascular system during later development. In addition, there will be discussion on the major cardiovascular abnormalities. The laboratory this week will also give you the opportunity to work through some of these concepts using a new online teaching module.

This material is also presented in an online [[Cardiac_Embryology|Cardiac Embryology tutorial]].

[[File:Basic_Heart_Development_Timeline.jpg|400px|Link=Cardiac_Embryology]]

{{Template:Heart Links}}

:'''Lecture Audio'''

==Lecture Objectives==
* Describe the development of primary and secondary atrial septa and the ventricular septum.
* Explain the changes occurring in the bulbis cordis and truncus arteriosus in its transformation from a single to a double tube.
* Describe the development of the aortic arches on the right and left sides from the fetus to the adult.
* Describe the development of arteries and veins.
* Describe the major cardiovascular developmental abnormalities.

==Textbook references==

* Human Embryology (3rd ed.) Larson Chapter 7 p151-188 Heart, Chapter 8 p189-228 Vasculature
* The Developing Human: Clinically Oriented Embryology (6th ed.) Chapter 14: p304-349

'''Other textbooks'''
* Before we Are Born (5th ed.) Moore and Persaud Chapter 12; p241-254
* Essentials of Human Embryology Larson Chapter 7 p97-122 Heart, Chapter 8 p123-146 Vasculature
* Human Embryology Fitzgerald and Fitzgerald Chapter 13-17: p77-111

'''Recent reviews'''
* Yutzey KE, Kirby ML. Wherefore heart thou? Embryonic origins of cardiogenic mesoderm. Dev Dyn. 2002 Mar;223(3):307-20. Review. [http://www.ncbi.nlm.nih.gov/pubmed/11891982?dopt=Abstract PMID: 11891982]
* Three-dimensional reconstruction of gene expression patterns during cardiac development. Soufan AT, Ruijter JM, van den Hoff MJ, de Boer PA, Hagoort J, Moorman AF. Physiol Genomics. 2003 May 13;13(3):187-95. Review. [http://www.ncbi.nlm.nih.gov/pubmed/12746463 PMID: 12746463]
* Moorman A, Webb S, Brown NA, Lamers W, Anderson RH. Development of the heart: (1) formation of the cardiac chambers and arterial trunks. Heart. 2003 Jul;89(7):806-14. [http://www.ncbi.nlm.nih.gov/pubmed/12807866?dopt=Abstract PMID: 12807866]
* Bruneau BG. Transcriptional regulation of vertebrate cardiac morphogenesis. Circ Res. 2002 Mar 22;90(5):509-19. Review. [http://www.ncbi.nlm.nih.gov/pubmed/11909814?dopt=Abstract PMID: 11909814]

----

==Heart Development==
[[File:Gray0462.gif|thumb|200px|Day 14 Heart tube]]
[[File:Heart_Tube_Fusion.jpg|400px|Early Human Heart Tube Development]]

* [[E#endocardial tube|endocardial tube]] in [[P#pericardial cavity|pericardial cavity]]
** dorsal mesentry (mesocardial) attachment lost
** attached at cranial (arterial) and caudal (venous) ends
* tube elongation - bending and series of expansions
[[File:Heart-cartoon-001.jpg|thumb|Adult Heart blood flow]]
Bulbus Cordis
* refers to the outflow tract in early embryo
* 3 parts
** distal - forms [[T#truncus arteriosus|truncus arteriosus]] (aorta and pulmonary artery)
** middle - [[C#conus arteriosus|conus arteriosus]] ventricular outflow tract
** proximal - right ventricle trabeculate part

{| border=1

|-
! Fetal Structure
! Adult Structure
|-
| Truncus arteriosus
| aorta
pulmonary trunk
|-
| Conus arteriosus
| right ventricle - smooth part
|-
| Primitive ventricle
| right ventricle - trabecular part
left ventricle - trabecular part
|-
| Primitive atrium
| right atrium - trabecular part
left atrium - trabecular part
|-
| Sinus venosus
| right atrium - smooth part (sinus venarum)
coronary sinus
oblique vein of left atrium
|}

===Heart Layers===
* '''pericardium''' - covers the heart, formed by 3 layers consisting of a fibrous pericardium and a double layered serous pericardium (parietal layer and visceral epicardium layer).
* '''myocardium''' - muscular wall of the heart, thickest layer formed by spirally arranged cardiac muscle cells.
* '''endocardium''' - lines the heart, epithelial (endothelial) tissue lining the inner surface of heart chambers and valves.

===Embryonic Heart Rate===

* Stage 9-10 2 mm embryo (gestational sac diameter of 20 mm) EHR at least 75 beats / minute
* Stage 11-12 5 mm embryo (gestational sac diameter of 30 mm) EHR at least 100 beats / minute
* Stage 16 10 mm embryo EHR at least 120 beats / minute
* Stage 18 15 mm embryo EHR at least 130 beats / minute

[http://embryology.med.unsw.edu.au/Movies/usound/Hum12wkFHR.htm Week 12 fetal heart rate doppler] [http://embryology.med.unsw.edu.au/Notes/heart8.htm Week 17 fetal heart rate audio]

==Separation of the Atria from the Venticles==
[[File:AV Canal Division.jpg|thumb|100px|Separation of the atrioventricular canal]]
===Endocardial Cushions===
* form initial division of atria and ventricles
* form on dorsal and ventral wall of atrioventcular canals
* grow into canal - meet and fuse to separate atrioventricular canal into right and left channels.

==Atrial Septation==
[[File:Heart1_atrium icon.jpg|90px|link=Development_Animation_-_Heart Atrial Septation]]

[[File:Stage13 C7L.jpg|thumb|Heart (Carnegie stage 13)]]

Through all development blood shunts from right to left atrium (bypass lungs)

===Septum Primum===
[http://embryology.med.unsw.edu.au/wwwpig/pigc/c1l.htm Stage 13 Septum Primum] [http://embryology.med.unsw.edu.au/wwwhuman/lowpower/HumE/E2L.htm Stage 22 Septum Primum]

* dorso-cranial wall, crescentric-shaped membranous extension
* grows downward towards endocardial cushions
* opening is '''foramen primum''' (ostium primum)- serves at a shunt
* a series of perforations develop in cranial end - coalesce to form '''foramen secundum''' (ostium secundum)
* septum primum fuses with endocardial cushions - obliterates foramen primum

===Septum Secundum===
* crescentric septum secundum begins to form to the right of septum primum
* grows as septum primum downward, does not fuse with endocardial cushion, opening is '''foramen ovale'''
* arrangement of the two septa allows them to act as a one-way valve

[[File:Atrial Septation.jpg|200px|Atrial septation]]
[[File:Atrial & Ventricular Septation 1.jpg|200px|Early -atrial and ventricular septation]]
[[File:Atrial & Ventricular Septation 2.jpg|200px|Late-atrial and ventricular septation]]

===Right Atrium===
[[File:Gray0476.jpg|thumb|sinus venosus and tributaries]]
* with heart looping and formation of interatrial septa, the sinus venosus shifts completely to right atrium
* right sinus horn incorporates into dorsal wall of right atrium
* left sinus horn becomes the coronary sinus
* sinoatrial opening - has 2 flaps, left fuses with septum secundum, right forms valve to inferior vena cava and coronary sinus. [http://embryology.med.unsw.edu.au/wwwpig/pigc/c3l.htm Stage 13 - right venous valve] [http://embryology.med.unsw.edu.au/wwwhuman/lowpower/HumE/E2L.htm Stage 22 - right venous valve]

===Left Atrium===
* posterior wall - outgrowth forms single pulmonary vein, divided into 4 branches
* incorporation into the wall leads to 4 openings in posterior wall
* later moves to the right aligns with atrioventricular canal.

==Ventricular Septation==
[[File:Stage13 C7L.jpg|thumb|Heart (Carnegie stage 13)]]
[[File:Gray0498.jpg|thumb|Ventricular septum]]
[[File:Heart1_realign icon.jpg|90px|link=Development_Animation_-_Heart Realign]]

* 2 separate components - superior membranous, inferior muscular
===Muscular Septum===
[[File:Gray0470.jpg|thumb|muscular septum]]
* growth of inferior wall
* fusion of 3 components - right and left bulbar ridges and dorsal endocardial cushion

===Membranous Septum===
* above the muscular septum, fusion continuous with septation of the outflow tract

[[File:Heart-ventricular-septum-01.jpg‎]][[File:Heart-ventricular-septum-02.jpg‎]][[File:Heart-ventricular-septum-03.jpg‎]]

==Outflow Tract Septation==

[[File:heart1 ventricle icon.jpg|90px|link=Development_Animation_-_Heart Outflow Septation]]

* in early development, outflow tract is a single tube, bulbus cordis
* elongates to form proximal conus arteriosus and distal truncus arteriosus
* 2 growths from wall in spiral pattern, inferior upwards - separate tract into 2 channels [http://embryology.med.unsw.edu.au/wwwpig/pigb/b5l.htm Stage 13 truncus arteriousus]
* mesenchyme and neural crest contribute to this septation process
* fusion of outgrowths separate aortic and pulmonary outflow

{| border='0px'

|-
| [[File:Chick_Heart_001-icon.jpg|90px|link=Movie_-_Normal Chick Heart]]
| [[File:Chick_Heart_002-icon.jpg|90px|link=Movie_-_Abnormal Chick Heart]]
| [[File:Chick_Heart_002-icon.jpg|90px|link=Movie_-_Abnormal Chick Heart 2]]
|-
| [[Movie_-_Normal Chick Heart|Normal Heart]]
| [[Movie_-_Abnormal Chick Heart|Abnormal Heart]]
| [[Movie_-_Abnormal Chick Heart 2|Abnormal Heart 2]]
|-
|}

==Vascular Remodeling==
===Arterial System===
[[File:Gray0474.jpg|thumb|pharyngeal arch arteries]]
* Aortic sac - remodels forming 2 horns, R forms brachiocephalic artery, L forms common carotid artery

Pharyngeal arch arteries
* pharyngeal arch artery 1 and 2 regress
* pharyngeal arch artery 3 and the associated dorsal aorta form the paired internal carotid arteries, these in turn generate the external carotids
* Left pharyngeal arch artery 4 – forms the aortic arch

* paraxial mesoderm forms paired dorsal aorta
** head mesenchyme forms aortic arches
** connecting stalk contains unbilical (placental) arteries
** dorsal aortas give rise to
** vitelline arteries which connect to capillaries on yolk sac
** intersegmental arteries between somites

===Venous System===
Cardinal veins contribute nearly all systemic venous system.

<gallery>
File:Gray0477.jpg
File:Gray0478.jpg
File:Gray0479.jpg
File:Gray0480.jpg
</gallery>

common cardinal veins - ducts of Cuvier

hepatic veins - drain de-oxygenated blood from the liver into the inferior vena cava.

internal iliac vein - hypogastric vein

==Birth Changes==
[[File:Fetal_circulation1.jpg|thumb|Fetal circulation]]
At birth, cutting the umbilical cord and changes in the lungs after the first breaths trigger major functional adaptations in the fetal circulatory system.

* blood flow through ductus venosus is eliminated
* pulmonary circulation bed expands - reducing blood flow through ductus arteriosus
* physiological closure of interatrial shunt
* closure of ductus venosus in liver is prolonged

{| border=1

|-
! Fetal Structure
! Adult Structure
|-
| foramen ovale
| fossa ovalis
|-
| umbilical vein (intra-abdominal part)
| ligamentum teres
|-
| ductus venosus
| ligamentum venosum
|-
| umbilical arteries
| distal part -lateral umbilical ligaments; proximal part - superior vesical artery (supplies bladder)
|-
| ductus arteriosus
| ligamentum arteriosum
|}

==Abnormalities==
There are many different cardiac abnormalities, some more common than others, and only a few will be described in this lecture.

'''Major Abnormalities:''' Aortic Stenosis, Atrial Septal Defects, Coarctation of Aorta, Dextrocardia, Hypoplastic Left Heart, Long QT Syndrome, Patent Ductus Arteriosus, Pulmonary Atresia, Pulmonary Stenosis, Tetralogy of Fallot, Transposition of Great Vessels, Tricuspid Atresia, Total Anomalous Pulmonary Venous Connection, Ventricular Septal Defect, Abnormalities of Conducting System.

Links: [http://embryology.med.unsw.edu.au/Notes/heart2.htm Cardiovascular Development Abnormalities]

[[File:Abnormal81-92-heart.png|thumb]]

[[File:Statistics-Utah heart defects.jpg|thumb]]
===Atrial Septal Defects===

{| border='0px'
|-
| [[File:HeartILP_draft_asd.jpg|Atrial Septal Defect]]
|
* Atrial Septal Defects (ASD) are a group of common (1% of cardiac) congenital anomalies defects occurring in a number of different forms and more often in females.
* patent foramen ovale - allows a continuation of the atrial shunting of blood, in 25% of people a probe patent foramen ovale (allowing a probe to bypassed from one atria to the other) exists.
* ostium secundum defect
* endocardial cushion defect involving ostium primum
* sinus venosus defect - contributes about 10% of all ASDs and occurs mainly in a common and less common form. Common ("usual type") - in upper atrial septum which is contiguous with the superior vena cava. Less common - at junction of the right atrium and inferior vena cava.
* common atrium
|-
|}

===Ventricular Septal Defects===
{| border='0px'
|-
| [[File:HeartILP_draft_vsd.jpg|Ventricular Septal Defect]]
|
* The Ventricular Septal Defect (VSD) usually occurs in the membranous (perimembranous) (70%) rather than muscular interventricular septum, and is more frequent in males that females.
* Perimembranous defects are located close to the aortic and tricuspid valves and adjacent to atrioventricular conduction bundle.
* The defect allows left-right shunting of blood, this shunting depends upon the size of the defect. Small defects may close spontaneously, larger defects result in infant congestive heart failure.
* Clinically repaired by coils or tissue-adapted devices like muscular or perimembranous occluders.
|-
|}
(V.S.D.)

===Patent Ductus Arteriosus===

{| border='0px'

|-
| [[File:HeartILP_draft_patentda.jpg|Patent Ductus Arteriosus]]
|
* Patent Ductus Arteriosus (PDA) occurs commonly in preterm infants, can close spontaneously (by day three in 60% of normal term neonates) the remainder are ligated simply and with little risk.
* The operation is always recommended even in the absence of cardiac failure and can often be deferred until early childhood.

|-
|}

===Tetralogy of Fallot===
{| border='0px'
|-
| [[File:HeartILP_draft_tetralogyoffallot.jpg|Tetralogy of Fallot]]
|
* Named after Etienne-Louis Arthur Fallot (1888) who described it as "la maladie blue" and is a common developmental cardiac defect.
* The syndrome consists of a number of a number of cardiac defects possibly stemming from abnormal neural crest migration. The basic defect in a tetralogy of Fallot is an asymmetrical fusion of the truncoconal ridges and a malalignment of the aortic and pulmonary valves.
|-
|}

==Movies==

{| border='0px'

|-
| [[File:Heart1_looping icon.jpg|90px|link=Development_Animation_-_Heart Looping]]
| [[File:Heart1_realign icon.jpg|90px|link=Development_Animation_-_Heart Realign]]
| [[File:Heart1_atrium icon.jpg|90px|link=Development_Animation_-_Heart Atrial Septation]]
| [[File:heart1 ventricle icon.jpg|90px|link=Development_Animation_-_Heart Outflow Septation]]
|-
| [[Development_Animation_-_Heart Looping|Heart Looping]]
| [[Development_Animation_-_Heart Realign|Heart Realign]]
| [[Development_Animation_-_Heart Atrial Septation|Heart Atrial Septation]]
| [[Development_Animation_-_Heart Outflow Septation|Heart Outflow Septation]]
|-
|}

'''Link:''' [[Flash Movies]]

{{Template:2009ANAT2341}}

[[Category:2009ANAT2341]] [[Category:Science-Undergraduate]]

[[Category:Cardiovascular]] [[Category:Heart]]

2010 Lecture 21

2010-10-10T11:05:14Z

Z3267024: /* Heart Development */

<div style="background:#F5FFFA; border: 1px solid #CEF2E0; padding: 1em; margin: auto; width: 95%; float:left;"><div style="margin:0;background-color:#cef2e0;font-family:sans-serif;font-size:120%;font-weight:bold;border:1px solid #a3bfb1;text-align:left;color:#000;padding-left:0.4em;padding-top:0.2em;padding-bottom:0.2em;">Lecture Notice - Dr Nalini Pather</div>This online lecture page will contain the content required when attending the lecture. Currently this page is only a template and will be updated before the lecture (this notice removed when completed). Final lecture pages can also be printed out using the "printable version" lefthand menu.</div>

==Introduction==
[[File:Gray0473.gif|300px|right]]

In [[2010 Lecture 7|lecture 7 - Early Vascular Development]], the early development of the cardiovascular system was discussed. This second lecture will now focus on the extensive remodeling that occurs in both the heart and vascular system during later development. In addition, there will be discussion on the major cardiovascular abnormalities. The laboratory this week will also give you the opportunity to work through some of these concepts using a new online teaching module.

This material is also presented in an online [[Cardiac_Embryology|Cardiac Embryology tutorial]].

[[File:Basic_Heart_Development_Timeline.jpg|400px|Link=Cardiac_Embryology]]

{{Template:Heart Links}}

:'''Lecture Audio'''

==Lecture Objectives==
* Describe the development of primary and secondary atrial septa and the ventricular septum.
* Explain the changes occurring in the bulbis cordis and truncus arteriosus in its transformation from a single to a double tube.
* Describe the development of the aortic arches on the right and left sides from the fetus to the adult.
* Describe the development of arteries and veins.
* Describe the major cardiovascular developmental abnormalities.

==Textbook references==

* Human Embryology (3rd ed.) Larson Chapter 7 p151-188 Heart, Chapter 8 p189-228 Vasculature
* The Developing Human: Clinically Oriented Embryology (6th ed.) Chapter 14: p304-349

'''Other textbooks'''
* Before we Are Born (5th ed.) Moore and Persaud Chapter 12; p241-254
* Essentials of Human Embryology Larson Chapter 7 p97-122 Heart, Chapter 8 p123-146 Vasculature
* Human Embryology Fitzgerald and Fitzgerald Chapter 13-17: p77-111

'''Recent reviews'''
* Yutzey KE, Kirby ML. Wherefore heart thou? Embryonic origins of cardiogenic mesoderm. Dev Dyn. 2002 Mar;223(3):307-20. Review. [http://www.ncbi.nlm.nih.gov/pubmed/11891982?dopt=Abstract PMID: 11891982]
* Three-dimensional reconstruction of gene expression patterns during cardiac development. Soufan AT, Ruijter JM, van den Hoff MJ, de Boer PA, Hagoort J, Moorman AF. Physiol Genomics. 2003 May 13;13(3):187-95. Review. [http://www.ncbi.nlm.nih.gov/pubmed/12746463 PMID: 12746463]
* Moorman A, Webb S, Brown NA, Lamers W, Anderson RH. Development of the heart: (1) formation of the cardiac chambers and arterial trunks. Heart. 2003 Jul;89(7):806-14. [http://www.ncbi.nlm.nih.gov/pubmed/12807866?dopt=Abstract PMID: 12807866]
* Bruneau BG. Transcriptional regulation of vertebrate cardiac morphogenesis. Circ Res. 2002 Mar 22;90(5):509-19. Review. [http://www.ncbi.nlm.nih.gov/pubmed/11909814?dopt=Abstract PMID: 11909814]

----

==Heart Development==
[[File:Gray0462.gif|thumb|200px|Day 14 Heart tube]]
[[File:Heart_Tube_Fusion.jpg|400px|Early Human Heart Tube Development]]

* [[E#endocardial tube|endocardial tube]] in [[P#pericardial cavity|pericardial cavity]]
** dorsal mesentry (mesocardial) attachment lost
** attached at cranial (arterial) and caudal (venous) ends
* tube elongation - bending and series of expansions
[[File:Heart-cartoon-001.jpg|thumb|Adult Heart blood flow]]
Bulbus Cordis
* refers to the outflow tract in early embryo
* 3 parts
** distal - forms [[T#truncus arteriosus|truncus arteriosus]] (aorta and pulmonary artery)
** middle - [[C#conus arteriosus|conus arteriosus]] ventricular outflow tract
** proximal - right ventricle trabeculate part

{| border=1

|-
! Fetal Structure
! Adult Structure
|-
| Truncus arteriosus
| aorta
pulmonary trunk
|-
| Conus arteriosus
| right ventricle - smooth part [left ventricle - smooth part (aortic vestibule)]
|-
| Primitive ventricle
| right ventricle - trabecular part
left ventricle - trabecular part
|-
| Primitive atrium
| right atrium - trabecular part
left atrium - trabecular part
|-
| Sinus venosus
| right atrium - smooth part (sinus venarum)
coronary sinus
oblique vein of left atrium
|}

===Heart Layers===
* '''pericardium''' - covers the heart, formed by 3 layers consisting of a fibrous pericardium and a double layered serous pericardium (parietal layer and visceral epicardium layer).
* '''myocardium''' - muscular wall of the heart, thickest layer formed by spirally arranged cardiac muscle cells.
* '''endocardium''' - lines the heart, epithelial (endothelial) tissue lining the inner surface of heart chambers and valves.

===Embryonic Heart Rate===

* Stage 9-10 2 mm embryo (gestational sac diameter of 20 mm) EHR at least 75 beats / minute
* Stage 11-12 5 mm embryo (gestational sac diameter of 30 mm) EHR at least 100 beats / minute
* Stage 16 10 mm embryo EHR at least 120 beats / minute
* Stage 18 15 mm embryo EHR at least 130 beats / minute

[http://embryology.med.unsw.edu.au/Movies/usound/Hum12wkFHR.htm Week 12 fetal heart rate doppler] [http://embryology.med.unsw.edu.au/Notes/heart8.htm Week 17 fetal heart rate audio]

==Separation of the Atria from the Venticles==
[[File:AV Canal Division.jpg|thumb|100px|Separation of the atrioventricular canal]]
===Endocardial Cushions===
* form initial division of atria and ventricles
* form on dorsal and ventral wall of atrioventcular canals
* grow into canal - meet and fuse to separate atrioventricular canal into right and left channels.

==Atrial Septation==
[[File:Heart1_atrium icon.jpg|90px|link=Development_Animation_-_Heart Atrial Septation]]

[[File:Stage13 C7L.jpg|thumb|Heart (Carnegie stage 13)]]

Through all development blood shunts from right to left atrium (bypass lungs)

===Septum Primum===
[http://embryology.med.unsw.edu.au/wwwpig/pigc/c1l.htm Stage 13 Septum Primum] [http://embryology.med.unsw.edu.au/wwwhuman/lowpower/HumE/E2L.htm Stage 22 Septum Primum]

* dorso-cranial wall, crescentric-shaped membranous extension
* grows downward towards endocardial cushions
* opening is '''foramen primum''' (ostium primum)- serves at a shunt
* a series of perforations develop in cranial end - coalesce to form '''foramen secundum''' (ostium secundum)
* septum primum fuses with endocardial cushions - obliterates foramen primum

===Septum Secundum===
* crescentric septum secundum begins to form to the right of septum primum
* grows as septum primum downward, does not fuse with endocardial cushion, opening is '''foramen ovale'''
* arrangement of the two septa allows them to act as a one-way valve

[[File:Atrial Septation.jpg|200px|Atrial septation]]
[[File:Atrial & Ventricular Septation 1.jpg|200px|Early -atrial and ventricular septation]]
[[File:Atrial & Ventricular Septation 2.jpg|200px|Late-atrial and ventricular septation]]

===Right Atrium===
[[File:Gray0476.jpg|thumb|sinus venosus and tributaries]]
* with heart looping and formation of interatrial septa, the sinus venosus shifts completely to right atrium
* right sinus horn incorporates into dorsal wall of right atrium
* left sinus horn becomes the coronary sinus
* sinoatrial opening - has 2 flaps, left fuses with septum secundum, right forms valve to inferior vena cava and coronary sinus. [http://embryology.med.unsw.edu.au/wwwpig/pigc/c3l.htm Stage 13 - right venous valve] [http://embryology.med.unsw.edu.au/wwwhuman/lowpower/HumE/E2L.htm Stage 22 - right venous valve]

===Left Atrium===
* posterior wall - outgrowth forms single pulmonary vein, divided into 4 branches
* incorporation into the wall leads to 4 openings in posterior wall
* later moves to the right aligns with atrioventricular canal.

==Ventricular Septation==
[[File:Stage13 C7L.jpg|thumb|Heart (Carnegie stage 13)]]
[[File:Gray0498.jpg|thumb|Ventricular septum]]
[[File:Heart1_realign icon.jpg|90px|link=Development_Animation_-_Heart Realign]]

* 2 separate components - superior membranous, inferior muscular
===Muscular Septum===
[[File:Gray0470.jpg|thumb|muscular septum]]
* growth of inferior wall
* fusion of 3 components - right and left bulbar ridges and dorsal endocardial cushion

===Membranous Septum===
* above the muscular septum, fusion continuous with septation of the outflow tract

[[File:Heart-ventricular-septum-01.jpg‎]][[File:Heart-ventricular-septum-02.jpg‎]][[File:Heart-ventricular-septum-03.jpg‎]]

==Outflow Tract Septation==

[[File:heart1 ventricle icon.jpg|90px|link=Development_Animation_-_Heart Outflow Septation]]

* in early development, outflow tract is a single tube, bulbus cordis
* elongates to form proximal conus arteriosus and distal truncus arteriosus
* 2 growths from wall in spiral pattern, inferior upwards - separate tract into 2 channels [http://embryology.med.unsw.edu.au/wwwpig/pigb/b5l.htm Stage 13 truncus arteriousus]
* mesenchyme and neural crest contribute to this septation process
* fusion of outgrowths separate aortic and pulmonary outflow

{| border='0px'

|-
| [[File:Chick_Heart_001-icon.jpg|90px|link=Movie_-_Normal Chick Heart]]
| [[File:Chick_Heart_002-icon.jpg|90px|link=Movie_-_Abnormal Chick Heart]]
| [[File:Chick_Heart_002-icon.jpg|90px|link=Movie_-_Abnormal Chick Heart 2]]
|-
| [[Movie_-_Normal Chick Heart|Normal Heart]]
| [[Movie_-_Abnormal Chick Heart|Abnormal Heart]]
| [[Movie_-_Abnormal Chick Heart 2|Abnormal Heart 2]]
|-
|}

==Vascular Remodeling==
===Arterial System===
[[File:Gray0474.jpg|thumb|pharyngeal arch arteries]]
* Aortic sac - remodels forming 2 horns, R forms brachiocephalic artery, L forms common carotid artery

Pharyngeal arch arteries
* pharyngeal arch artery 1 and 2 regress
* pharyngeal arch artery 3 and the associated dorsal aorta form the paired internal carotid arteries, these in turn generate the external carotids
* Left pharyngeal arch artery 4 – forms the aortic arch

* paraxial mesoderm forms paired dorsal aorta
** head mesenchyme forms aortic arches
** connecting stalk contains unbilical (placental) arteries
** dorsal aortas give rise to
** vitelline arteries which connect to capillaries on yolk sac
** intersegmental arteries between somites

===Venous System===
Cardinal veins contribute nearly all systemic venous system.

<gallery>
File:Gray0477.jpg
File:Gray0478.jpg
File:Gray0479.jpg
File:Gray0480.jpg
</gallery>

common cardinal veins - ducts of Cuvier

hepatic veins - drain de-oxygenated blood from the liver into the inferior vena cava.

internal iliac vein - hypogastric vein

==Birth Changes==
[[File:Fetal_circulation1.jpg|thumb|Fetal circulation]]
At birth, cutting the umbilical cord and changes in the lungs after the first breaths trigger major functional adaptations in the fetal circulatory system.

* blood flow through ductus venosus is eliminated
* pulmonary circulation bed expands - reducing blood flow through ductus arteriosus
* physiological closure of interatrial shunt
* closure of ductus venosus in liver is prolonged

{| border=1

|-
! Fetal Structure
! Adult Structure
|-
| foramen ovale
| fossa ovalis
|-
| umbilical vein (intra-abdominal part)
| ligamentum teres
|-
| ductus venosus
| ligamentum venosum
|-
| umbilical arteries
| distal part -lateral umbilical ligaments; proximal part - superior vesical artery (supplies bladder)
|-
| ductus arteriosus
| ligamentum arteriosum
|}

==Abnormalities==
There are many different cardiac abnormalities, some more common than others, and only a few will be described in this lecture.

'''Major Abnormalities:''' Aortic Stenosis, Atrial Septal Defects, Coarctation of Aorta, Dextrocardia, Hypoplastic Left Heart, Long QT Syndrome, Patent Ductus Arteriosus, Pulmonary Atresia, Pulmonary Stenosis, Tetralogy of Fallot, Transposition of Great Vessels, Tricuspid Atresia, Total Anomalous Pulmonary Venous Connection, Ventricular Septal Defect, Abnormalities of Conducting System.

Links: [http://embryology.med.unsw.edu.au/Notes/heart2.htm Cardiovascular Development Abnormalities]

[[File:Abnormal81-92-heart.png|thumb]]

[[File:Statistics-Utah heart defects.jpg|thumb]]
===Atrial Septal Defects===

{| border='0px'
|-
| [[File:HeartILP_draft_asd.jpg|Atrial Septal Defect]]
|
* Atrial Septal Defects (ASD) are a group of common (1% of cardiac) congenital anomalies defects occurring in a number of different forms and more often in females.
* patent foramen ovale - allows a continuation of the atrial shunting of blood, in 25% of people a probe patent foramen ovale (allowing a probe to bypassed from one atria to the other) exists.
* ostium secundum defect
* endocardial cushion defect involving ostium primum
* sinus venosus defect - contributes about 10% of all ASDs and occurs mainly in a common and less common form. Common ("usual type") - in upper atrial septum which is contiguous with the superior vena cava. Less common - at junction of the right atrium and inferior vena cava.
* common atrium
|-
|}

===Ventricular Septal Defects===
{| border='0px'
|-
| [[File:HeartILP_draft_vsd.jpg|Ventricular Septal Defect]]
|
* The Ventricular Septal Defect (VSD) usually occurs in the membranous (perimembranous) (70%) rather than muscular interventricular septum, and is more frequent in males that females.
* Perimembranous defects are located close to the aortic and tricuspid valves and adjacent to atrioventricular conduction bundle.
* The defect allows left-right shunting of blood, this shunting depends upon the size of the defect. Small defects may close spontaneously, larger defects result in infant congestive heart failure.
* Clinically repaired by coils or tissue-adapted devices like muscular or perimembranous occluders.
|-
|}
(V.S.D.)

===Patent Ductus Arteriosus===

{| border='0px'

|-
| [[File:HeartILP_draft_patentda.jpg|Patent Ductus Arteriosus]]
|
* Patent Ductus Arteriosus (PDA) occurs commonly in preterm infants, can close spontaneously (by day three in 60% of normal term neonates) the remainder are ligated simply and with little risk.
* The operation is always recommended even in the absence of cardiac failure and can often be deferred until early childhood.

|-
|}

===Tetralogy of Fallot===
{| border='0px'
|-
| [[File:HeartILP_draft_tetralogyoffallot.jpg|Tetralogy of Fallot]]
|
* Named after Etienne-Louis Arthur Fallot (1888) who described it as "la maladie blue" and is a common developmental cardiac defect.
* The syndrome consists of a number of a number of cardiac defects possibly stemming from abnormal neural crest migration. The basic defect in a tetralogy of Fallot is an asymmetrical fusion of the truncoconal ridges and a malalignment of the aortic and pulmonary valves.
|-
|}

==Movies==

{| border='0px'

|-
| [[File:Heart1_looping icon.jpg|90px|link=Development_Animation_-_Heart Looping]]
| [[File:Heart1_realign icon.jpg|90px|link=Development_Animation_-_Heart Realign]]
| [[File:Heart1_atrium icon.jpg|90px|link=Development_Animation_-_Heart Atrial Septation]]
| [[File:heart1 ventricle icon.jpg|90px|link=Development_Animation_-_Heart Outflow Septation]]
|-
| [[Development_Animation_-_Heart Looping|Heart Looping]]
| [[Development_Animation_-_Heart Realign|Heart Realign]]
| [[Development_Animation_-_Heart Atrial Septation|Heart Atrial Septation]]
| [[Development_Animation_-_Heart Outflow Septation|Heart Outflow Septation]]
|-
|}

'''Link:''' [[Flash Movies]]

{{Template:2009ANAT2341}}

[[Category:2009ANAT2341]] [[Category:Science-Undergraduate]]

[[Category:Cardiovascular]] [[Category:Heart]]

2010 Lecture 21

2010-10-10T11:00:16Z

Z3267024: /* Heart Development */

<div style="background:#F5FFFA; border: 1px solid #CEF2E0; padding: 1em; margin: auto; width: 95%; float:left;"><div style="margin:0;background-color:#cef2e0;font-family:sans-serif;font-size:120%;font-weight:bold;border:1px solid #a3bfb1;text-align:left;color:#000;padding-left:0.4em;padding-top:0.2em;padding-bottom:0.2em;">Lecture Notice - Dr Nalini Pather</div>This online lecture page will contain the content required when attending the lecture. Currently this page is only a template and will be updated before the lecture (this notice removed when completed). Final lecture pages can also be printed out using the "printable version" lefthand menu.</div>

==Introduction==
[[File:Gray0473.gif|300px|right]]

In [[2010 Lecture 7|lecture 7 - Early Vascular Development]], the early development of the cardiovascular system was discussed. This second lecture will now focus on the extensive remodeling that occurs in both the heart and vascular system during later development. In addition, there will be discussion on the major cardiovascular abnormalities. The laboratory this week will also give you the opportunity to work through some of these concepts using a new online teaching module.

This material is also presented in an online [[Cardiac_Embryology|Cardiac Embryology tutorial]].

[[File:Basic_Heart_Development_Timeline.jpg|400px|Link=Cardiac_Embryology]]

{{Template:Heart Links}}

:'''Lecture Audio'''

==Lecture Objectives==
* Describe the development of primary and secondary atrial septa and the ventricular septum.
* Explain the changes occurring in the bulbis cordis and truncus arteriosus in its transformation from a single to a double tube.
* Describe the development of the aortic arches on the right and left sides from the fetus to the adult.
* Describe the development of arteries and veins.
* Describe the major cardiovascular developmental abnormalities.

==Textbook references==

* Human Embryology (3rd ed.) Larson Chapter 7 p151-188 Heart, Chapter 8 p189-228 Vasculature
* The Developing Human: Clinically Oriented Embryology (6th ed.) Chapter 14: p304-349

'''Other textbooks'''
* Before we Are Born (5th ed.) Moore and Persaud Chapter 12; p241-254
* Essentials of Human Embryology Larson Chapter 7 p97-122 Heart, Chapter 8 p123-146 Vasculature
* Human Embryology Fitzgerald and Fitzgerald Chapter 13-17: p77-111

'''Recent reviews'''
* Yutzey KE, Kirby ML. Wherefore heart thou? Embryonic origins of cardiogenic mesoderm. Dev Dyn. 2002 Mar;223(3):307-20. Review. [http://www.ncbi.nlm.nih.gov/pubmed/11891982?dopt=Abstract PMID: 11891982]
* Three-dimensional reconstruction of gene expression patterns during cardiac development. Soufan AT, Ruijter JM, van den Hoff MJ, de Boer PA, Hagoort J, Moorman AF. Physiol Genomics. 2003 May 13;13(3):187-95. Review. [http://www.ncbi.nlm.nih.gov/pubmed/12746463 PMID: 12746463]
* Moorman A, Webb S, Brown NA, Lamers W, Anderson RH. Development of the heart: (1) formation of the cardiac chambers and arterial trunks. Heart. 2003 Jul;89(7):806-14. [http://www.ncbi.nlm.nih.gov/pubmed/12807866?dopt=Abstract PMID: 12807866]
* Bruneau BG. Transcriptional regulation of vertebrate cardiac morphogenesis. Circ Res. 2002 Mar 22;90(5):509-19. Review. [http://www.ncbi.nlm.nih.gov/pubmed/11909814?dopt=Abstract PMID: 11909814]

----

==Heart Development==
[[File:Gray0462.gif|thumb|200px|Day 14 Heart tube]]
[[File:Heart_Tube_Fusion.jpg|400px|Early Human Heart Tube Development]]

* [[E#endocardial tube|endocardial tube]] in [[P#pericardial cavity|pericardial cavity]]
** dorsal mesentry (mesocardial) attachment lost
** attached at cranial (arterial) and caudal (venous) ends
* tube elongation - bending and series of expansions
[[File:Heart-cartoon-001.jpg|thumb|Adult Heart blood flow]]
Bulbus Cordis
* refers to the outflow tract in early embryo
* 3 parts
** distal - forms [[T#truncus arteriosus|truncus arteriosus]] (aorta and pulmonary artery)
** middle - [[C#conus arteriosus|conus arteriosus]] ventricular outflow tract
** proximal - right ventricle trabeculate part

{| border=1

|-
! Fetal Structure
! Adult Structure
|-
| Truncus arteriosus
| aorta
pulmonary trunk
|-
| Conus arteriosus
| right ventricle - smooth part (conus arteriosus)
left ventricle - smooth part (aortic vestibule
|-
| Primitive ventricle
| right ventricle - trabecular part
left ventricle - trabecular part
|-
| Primitive atrium
| right atrium - trabecular part
left atrium - trabecular part
|-
| Sinus venosus
| right atrium - smooth part (sinus venarum)
coronary sinus
oblique vein of left atrium
|}

===Heart Layers===
* '''pericardium''' - covers the heart, formed by 3 layers consisting of a fibrous pericardium and a double layered serous pericardium (parietal layer and visceral epicardium layer).
* '''myocardium''' - muscular wall of the heart, thickest layer formed by spirally arranged cardiac muscle cells.
* '''endocardium''' - lines the heart, epithelial (endothelial) tissue lining the inner surface of heart chambers and valves.

===Embryonic Heart Rate===

* Stage 9-10 2 mm embryo (gestational sac diameter of 20 mm) EHR at least 75 beats / minute
* Stage 11-12 5 mm embryo (gestational sac diameter of 30 mm) EHR at least 100 beats / minute
* Stage 16 10 mm embryo EHR at least 120 beats / minute
* Stage 18 15 mm embryo EHR at least 130 beats / minute

[http://embryology.med.unsw.edu.au/Movies/usound/Hum12wkFHR.htm Week 12 fetal heart rate doppler] [http://embryology.med.unsw.edu.au/Notes/heart8.htm Week 17 fetal heart rate audio]

==Separation of the Atria from the Venticles==
[[File:AV Canal Division.jpg|thumb|100px|Separation of the atrioventricular canal]]
===Endocardial Cushions===
* form initial division of atria and ventricles
* form on dorsal and ventral wall of atrioventcular canals
* grow into canal - meet and fuse to separate atrioventricular canal into right and left channels.

==Atrial Septation==
[[File:Heart1_atrium icon.jpg|90px|link=Development_Animation_-_Heart Atrial Septation]]

[[File:Stage13 C7L.jpg|thumb|Heart (Carnegie stage 13)]]

Through all development blood shunts from right to left atrium (bypass lungs)

===Septum Primum===
[http://embryology.med.unsw.edu.au/wwwpig/pigc/c1l.htm Stage 13 Septum Primum] [http://embryology.med.unsw.edu.au/wwwhuman/lowpower/HumE/E2L.htm Stage 22 Septum Primum]

* dorso-cranial wall, crescentric-shaped membranous extension
* grows downward towards endocardial cushions
* opening is '''foramen primum''' (ostium primum)- serves at a shunt
* a series of perforations develop in cranial end - coalesce to form '''foramen secundum''' (ostium secundum)
* septum primum fuses with endocardial cushions - obliterates foramen primum

===Septum Secundum===
* crescentric septum secundum begins to form to the right of septum primum
* grows as septum primum downward, does not fuse with endocardial cushion, opening is '''foramen ovale'''
* arrangement of the two septa allows them to act as a one-way valve

[[File:Atrial Septation.jpg|200px|Atrial septation]]
[[File:Atrial & Ventricular Septation 1.jpg|200px|Early -atrial and ventricular septation]]
[[File:Atrial & Ventricular Septation 2.jpg|200px|Late-atrial and ventricular septation]]

===Right Atrium===
[[File:Gray0476.jpg|thumb|sinus venosus and tributaries]]
* with heart looping and formation of interatrial septa, the sinus venosus shifts completely to right atrium
* right sinus horn incorporates into dorsal wall of right atrium
* left sinus horn becomes the coronary sinus
* sinoatrial opening - has 2 flaps, left fuses with septum secundum, right forms valve to inferior vena cava and coronary sinus. [http://embryology.med.unsw.edu.au/wwwpig/pigc/c3l.htm Stage 13 - right venous valve] [http://embryology.med.unsw.edu.au/wwwhuman/lowpower/HumE/E2L.htm Stage 22 - right venous valve]

===Left Atrium===
* posterior wall - outgrowth forms single pulmonary vein, divided into 4 branches
* incorporation into the wall leads to 4 openings in posterior wall
* later moves to the right aligns with atrioventricular canal.

==Ventricular Septation==
[[File:Stage13 C7L.jpg|thumb|Heart (Carnegie stage 13)]]
[[File:Gray0498.jpg|thumb|Ventricular septum]]
[[File:Heart1_realign icon.jpg|90px|link=Development_Animation_-_Heart Realign]]

* 2 separate components - superior membranous, inferior muscular
===Muscular Septum===
[[File:Gray0470.jpg|thumb|muscular septum]]
* growth of inferior wall
* fusion of 3 components - right and left bulbar ridges and dorsal endocardial cushion

===Membranous Septum===
* above the muscular septum, fusion continuous with septation of the outflow tract

[[File:Heart-ventricular-septum-01.jpg‎]][[File:Heart-ventricular-septum-02.jpg‎]][[File:Heart-ventricular-septum-03.jpg‎]]

==Outflow Tract Septation==

[[File:heart1 ventricle icon.jpg|90px|link=Development_Animation_-_Heart Outflow Septation]]

* in early development, outflow tract is a single tube, bulbus cordis
* elongates to form proximal conus arteriosus and distal truncus arteriosus
* 2 growths from wall in spiral pattern, inferior upwards - separate tract into 2 channels [http://embryology.med.unsw.edu.au/wwwpig/pigb/b5l.htm Stage 13 truncus arteriousus]
* mesenchyme and neural crest contribute to this septation process
* fusion of outgrowths separate aortic and pulmonary outflow

{| border='0px'

|-
| [[File:Chick_Heart_001-icon.jpg|90px|link=Movie_-_Normal Chick Heart]]
| [[File:Chick_Heart_002-icon.jpg|90px|link=Movie_-_Abnormal Chick Heart]]
| [[File:Chick_Heart_002-icon.jpg|90px|link=Movie_-_Abnormal Chick Heart 2]]
|-
| [[Movie_-_Normal Chick Heart|Normal Heart]]
| [[Movie_-_Abnormal Chick Heart|Abnormal Heart]]
| [[Movie_-_Abnormal Chick Heart 2|Abnormal Heart 2]]
|-
|}

==Vascular Remodeling==
===Arterial System===
[[File:Gray0474.jpg|thumb|pharyngeal arch arteries]]
* Aortic sac - remodels forming 2 horns, R forms brachiocephalic artery, L forms common carotid artery

Pharyngeal arch arteries
* pharyngeal arch artery 1 and 2 regress
* pharyngeal arch artery 3 and the associated dorsal aorta form the paired internal carotid arteries, these in turn generate the external carotids
* Left pharyngeal arch artery 4 – forms the aortic arch

* paraxial mesoderm forms paired dorsal aorta
** head mesenchyme forms aortic arches
** connecting stalk contains unbilical (placental) arteries
** dorsal aortas give rise to
** vitelline arteries which connect to capillaries on yolk sac
** intersegmental arteries between somites

===Venous System===
Cardinal veins contribute nearly all systemic venous system.

<gallery>
File:Gray0477.jpg
File:Gray0478.jpg
File:Gray0479.jpg
File:Gray0480.jpg
</gallery>

common cardinal veins - ducts of Cuvier

hepatic veins - drain de-oxygenated blood from the liver into the inferior vena cava.

internal iliac vein - hypogastric vein

==Birth Changes==
[[File:Fetal_circulation1.jpg|thumb|Fetal circulation]]
At birth, cutting the umbilical cord and changes in the lungs after the first breaths trigger major functional adaptations in the fetal circulatory system.

* blood flow through ductus venosus is eliminated
* pulmonary circulation bed expands - reducing blood flow through ductus arteriosus
* physiological closure of interatrial shunt
* closure of ductus venosus in liver is prolonged

{| border=1

|-
! Fetal Structure
! Adult Structure
|-
| foramen ovale
| fossa ovalis
|-
| umbilical vein (intra-abdominal part)
| ligamentum teres
|-
| ductus venosus
| ligamentum venosum
|-
| umbilical arteries
| distal part -lateral umbilical ligaments; proximal part - superior vesical artery (supplies bladder)
|-
| ductus arteriosus
| ligamentum arteriosum
|}

==Abnormalities==
There are many different cardiac abnormalities, some more common than others, and only a few will be described in this lecture.

'''Major Abnormalities:''' Aortic Stenosis, Atrial Septal Defects, Coarctation of Aorta, Dextrocardia, Hypoplastic Left Heart, Long QT Syndrome, Patent Ductus Arteriosus, Pulmonary Atresia, Pulmonary Stenosis, Tetralogy of Fallot, Transposition of Great Vessels, Tricuspid Atresia, Total Anomalous Pulmonary Venous Connection, Ventricular Septal Defect, Abnormalities of Conducting System.

Links: [http://embryology.med.unsw.edu.au/Notes/heart2.htm Cardiovascular Development Abnormalities]

[[File:Abnormal81-92-heart.png|thumb]]

[[File:Statistics-Utah heart defects.jpg|thumb]]
===Atrial Septal Defects===

{| border='0px'
|-
| [[File:HeartILP_draft_asd.jpg|Atrial Septal Defect]]
|
* Atrial Septal Defects (ASD) are a group of common (1% of cardiac) congenital anomalies defects occurring in a number of different forms and more often in females.
* patent foramen ovale - allows a continuation of the atrial shunting of blood, in 25% of people a probe patent foramen ovale (allowing a probe to bypassed from one atria to the other) exists.
* ostium secundum defect
* endocardial cushion defect involving ostium primum
* sinus venosus defect - contributes about 10% of all ASDs and occurs mainly in a common and less common form. Common ("usual type") - in upper atrial septum which is contiguous with the superior vena cava. Less common - at junction of the right atrium and inferior vena cava.
* common atrium
|-
|}

===Ventricular Septal Defects===
{| border='0px'
|-
| [[File:HeartILP_draft_vsd.jpg|Ventricular Septal Defect]]
|
* The Ventricular Septal Defect (VSD) usually occurs in the membranous (perimembranous) (70%) rather than muscular interventricular septum, and is more frequent in males that females.
* Perimembranous defects are located close to the aortic and tricuspid valves and adjacent to atrioventricular conduction bundle.
* The defect allows left-right shunting of blood, this shunting depends upon the size of the defect. Small defects may close spontaneously, larger defects result in infant congestive heart failure.
* Clinically repaired by coils or tissue-adapted devices like muscular or perimembranous occluders.
|-
|}
(V.S.D.)

===Patent Ductus Arteriosus===

{| border='0px'

|-
| [[File:HeartILP_draft_patentda.jpg|Patent Ductus Arteriosus]]
|
* Patent Ductus Arteriosus (PDA) occurs commonly in preterm infants, can close spontaneously (by day three in 60% of normal term neonates) the remainder are ligated simply and with little risk.
* The operation is always recommended even in the absence of cardiac failure and can often be deferred until early childhood.

|-
|}

===Tetralogy of Fallot===
{| border='0px'
|-
| [[File:HeartILP_draft_tetralogyoffallot.jpg|Tetralogy of Fallot]]
|
* Named after Etienne-Louis Arthur Fallot (1888) who described it as "la maladie blue" and is a common developmental cardiac defect.
* The syndrome consists of a number of a number of cardiac defects possibly stemming from abnormal neural crest migration. The basic defect in a tetralogy of Fallot is an asymmetrical fusion of the truncoconal ridges and a malalignment of the aortic and pulmonary valves.
|-
|}

==Movies==

{| border='0px'

|-
| [[File:Heart1_looping icon.jpg|90px|link=Development_Animation_-_Heart Looping]]
| [[File:Heart1_realign icon.jpg|90px|link=Development_Animation_-_Heart Realign]]
| [[File:Heart1_atrium icon.jpg|90px|link=Development_Animation_-_Heart Atrial Septation]]
| [[File:heart1 ventricle icon.jpg|90px|link=Development_Animation_-_Heart Outflow Septation]]
|-
| [[Development_Animation_-_Heart Looping|Heart Looping]]
| [[Development_Animation_-_Heart Realign|Heart Realign]]
| [[Development_Animation_-_Heart Atrial Septation|Heart Atrial Septation]]
| [[Development_Animation_-_Heart Outflow Septation|Heart Outflow Septation]]
|-
|}

'''Link:''' [[Flash Movies]]

{{Template:2009ANAT2341}}

[[Category:2009ANAT2341]] [[Category:Science-Undergraduate]]

[[Category:Cardiovascular]] [[Category:Heart]]

2010 Lecture 21

2010-10-10T08:28:44Z

Z3267024: /* Septum Secundum */

<div style="background:#F5FFFA; border: 1px solid #CEF2E0; padding: 1em; margin: auto; width: 95%; float:left;"><div style="margin:0;background-color:#cef2e0;font-family:sans-serif;font-size:120%;font-weight:bold;border:1px solid #a3bfb1;text-align:left;color:#000;padding-left:0.4em;padding-top:0.2em;padding-bottom:0.2em;">Lecture Notice - Dr Nalini Pather</div>This online lecture page will contain the content required when attending the lecture. Currently this page is only a template and will be updated before the lecture (this notice removed when completed). Final lecture pages can also be printed out using the "printable version" lefthand menu.</div>

==Introduction==
[[File:Gray0473.gif|300px|right]]

In [[2010 Lecture 7|lecture 7 - Early Vascular Development]], the early development of the cardiovascular system was discussed. This second lecture will now focus on the extensive remodeling that occurs in both the heart and vascular system during later development. In addition, there will be discussion on the major cardiovascular abnormalities. The laboratory this week will also give you the opportunity to work through some of these concepts using a new online teaching module.

This material is also presented in an online [[Cardiac_Embryology|Cardiac Embryology tutorial]].

[[File:Basic_Heart_Development_Timeline.jpg|400px|Link=Cardiac_Embryology]]

{{Template:Heart Links}}

:'''Lecture Audio'''

==Lecture Objectives==
* Describe the development of primary and secondary atrial septa and the ventricular septum.
* Explain the changes occurring in the bulbis cordis and truncus arteriosus in its transformation from a single to a double tube.
* Describe the development of the aortic arches on the right and left sides from the fetus to the adult.
* Describe the development of arteries and veins.
* Describe the major cardiovascular developmental abnormalities.

==Textbook references==

* Human Embryology (3rd ed.) Larson Chapter 7 p151-188 Heart, Chapter 8 p189-228 Vasculature
* The Developing Human: Clinically Oriented Embryology (6th ed.) Chapter 14: p304-349

'''Other textbooks'''
* Before we Are Born (5th ed.) Moore and Persaud Chapter 12; p241-254
* Essentials of Human Embryology Larson Chapter 7 p97-122 Heart, Chapter 8 p123-146 Vasculature
* Human Embryology Fitzgerald and Fitzgerald Chapter 13-17: p77-111

'''Recent reviews'''
* Yutzey KE, Kirby ML. Wherefore heart thou? Embryonic origins of cardiogenic mesoderm. Dev Dyn. 2002 Mar;223(3):307-20. Review. [http://www.ncbi.nlm.nih.gov/pubmed/11891982?dopt=Abstract PMID: 11891982]
* Three-dimensional reconstruction of gene expression patterns during cardiac development. Soufan AT, Ruijter JM, van den Hoff MJ, de Boer PA, Hagoort J, Moorman AF. Physiol Genomics. 2003 May 13;13(3):187-95. Review. [http://www.ncbi.nlm.nih.gov/pubmed/12746463 PMID: 12746463]
* Moorman A, Webb S, Brown NA, Lamers W, Anderson RH. Development of the heart: (1) formation of the cardiac chambers and arterial trunks. Heart. 2003 Jul;89(7):806-14. [http://www.ncbi.nlm.nih.gov/pubmed/12807866?dopt=Abstract PMID: 12807866]
* Bruneau BG. Transcriptional regulation of vertebrate cardiac morphogenesis. Circ Res. 2002 Mar 22;90(5):509-19. Review. [http://www.ncbi.nlm.nih.gov/pubmed/11909814?dopt=Abstract PMID: 11909814]

----

==Heart Development==
[[File:Gray0462.gif|thumb|100px|Day 14 Heart tube]]
[[File:Heart_Tube_Fusion.jpg|400px|Early Human Heart Tube Development]]

* [[E#endocardial tube|endocardial tube]] in [[P#pericardial cavity|pericardial cavity]]
** dorsal mesentry (mesocardial) attachment lost
** attached at cranial (arterial) and caudal (venous) ends
* tube elongation - bending and series of expansions
[[File:Heart-cartoon-001.jpg|thumb|Adult Heart blood flow]]
Bulbus Cordis
* refers to the outflow tract in early embryo
* 3 parts
** distal - forms [[T#truncus arteriosus|truncus arteriosus]] (aorta and pulmonary artery)
** middle - [[C#conus arteriosus|conus arteriosus]] ventricular outflow tract
** proximal - right ventricle trabeculate part

{| border=1

|-
! Fetal Structure
! Adult Structure
|-
| Truncus arteriosus
| aorta
pulmonary trunk
|-
| Conus arteriosus
| right ventricle - smooth part (conus arteriosus)
left ventricle - smooth part (aortic vestibule
|-
| Primitive ventricle
| right ventricle - trabecular part
left ventricle - trabecular part
|-
| Primitive atrium
| right atrium - trabecular part
left atrium - trabecular part
|-
| Sinus venosus
| right atrium - smooth part (sinus venarum)
coronary sinus
oblique vein of left atrium
|}

===Heart Layers===
* '''pericardium''' - covers the heart, formed by 3 layers consisting of a fibrous pericardium and a double layered serous pericardium (parietal layer and visceral epicardium layer).
* '''myocardium''' - muscular wall of the heart, thickest layer formed by spirally arranged cardiac muscle cells.
* '''endocardium''' - lines the heart, epithelial (endothelial) tissue lining the inner surface of heart chambers and valves.

===Embryonic Heart Rate===

* Stage 9-10 2 mm embryo (gestational sac diameter of 20 mm) EHR at least 75 beats / minute
* Stage 11-12 5 mm embryo (gestational sac diameter of 30 mm) EHR at least 100 beats / minute
* Stage 16 10 mm embryo EHR at least 120 beats / minute
* Stage 18 15 mm embryo EHR at least 130 beats / minute

[http://embryology.med.unsw.edu.au/Movies/usound/Hum12wkFHR.htm Week 12 fetal heart rate doppler] [http://embryology.med.unsw.edu.au/Notes/heart8.htm Week 17 fetal heart rate audio]

==Separation of the Atria from the Venticles==
[[File:AV Canal Division.jpg|thumb|100px|Separation of the atrioventricular canal]]
===Endocardial Cushions===
* form initial division of atria and ventricles
* form on dorsal and ventral wall of atrioventcular canals
* grow into canal - meet and fuse to separate atrioventricular canal into right and left channels.

==Atrial Septation==
[[File:Heart1_atrium icon.jpg|90px|link=Development_Animation_-_Heart Atrial Septation]]

[[File:Stage13 C7L.jpg|thumb|Heart (Carnegie stage 13)]]

Through all development blood shunts from right to left atrium (bypass lungs)

===Septum Primum===
[http://embryology.med.unsw.edu.au/wwwpig/pigc/c1l.htm Stage 13 Septum Primum] [http://embryology.med.unsw.edu.au/wwwhuman/lowpower/HumE/E2L.htm Stage 22 Septum Primum]

* dorso-cranial wall, crescentric-shaped membranous extension
* grows downward towards endocardial cushions
* opening is '''foramen primum''' (ostium primum)- serves at a shunt
* a series of perforations develop in cranial end - coalesce to form '''foramen secundum''' (ostium secundum)
* septum primum fuses with endocardial cushions - obliterates foramen primum

===Septum Secundum===
* crescentric septum secundum begins to form to the right of septum primum
* grows as septum primum downward, does not fuse with endocardial cushion, opening is '''foramen ovale'''
* arrangement of the two septa allows them to act as a one-way valve

[[File:Atrial Septation.jpg|200px|Atrial septation]]
[[File:Atrial & Ventricular Septation 1.jpg|200px|Early -atrial and ventricular septation]]
[[File:Atrial & Ventricular Septation 2.jpg|200px|Late-atrial and ventricular septation]]

===Right Atrium===
[[File:Gray0476.jpg|thumb|sinus venosus and tributaries]]
* with heart looping and formation of interatrial septa, the sinus venosus shifts completely to right atrium
* right sinus horn incorporates into dorsal wall of right atrium
* left sinus horn becomes the coronary sinus
* sinoatrial opening - has 2 flaps, left fuses with septum secundum, right forms valve to inferior vena cava and coronary sinus. [http://embryology.med.unsw.edu.au/wwwpig/pigc/c3l.htm Stage 13 - right venous valve] [http://embryology.med.unsw.edu.au/wwwhuman/lowpower/HumE/E2L.htm Stage 22 - right venous valve]

===Left Atrium===
* posterior wall - outgrowth forms single pulmonary vein, divided into 4 branches
* incorporation into the wall leads to 4 openings in posterior wall
* later moves to the right aligns with atrioventricular canal.

==Ventricular Septation==
[[File:Stage13 C7L.jpg|thumb|Heart (Carnegie stage 13)]]
[[File:Gray0498.jpg|thumb|Ventricular septum]]
[[File:Heart1_realign icon.jpg|90px|link=Development_Animation_-_Heart Realign]]

* 2 separate components - superior membranous, inferior muscular
===Muscular Septum===
[[File:Gray0470.jpg|thumb|muscular septum]]
* growth of inferior wall
* fusion of 3 components - right and left bulbar ridges and dorsal endocardial cushion

===Membranous Septum===
* above the muscular septum, fusion continuous with septation of the outflow tract

[[File:Heart-ventricular-septum-01.jpg‎]][[File:Heart-ventricular-septum-02.jpg‎]][[File:Heart-ventricular-septum-03.jpg‎]]

==Outflow Tract Septation==

[[File:heart1 ventricle icon.jpg|90px|link=Development_Animation_-_Heart Outflow Septation]]

* in early development, outflow tract is a single tube, bulbus cordis
* elongates to form proximal conus arteriosus and distal truncus arteriosus
* 2 growths from wall in spiral pattern, inferior upwards - separate tract into 2 channels [http://embryology.med.unsw.edu.au/wwwpig/pigb/b5l.htm Stage 13 truncus arteriousus]
* mesenchyme and neural crest contribute to this septation process
* fusion of outgrowths separate aortic and pulmonary outflow

{| border='0px'

|-
| [[File:Chick_Heart_001-icon.jpg|90px|link=Movie_-_Normal Chick Heart]]
| [[File:Chick_Heart_002-icon.jpg|90px|link=Movie_-_Abnormal Chick Heart]]
| [[File:Chick_Heart_002-icon.jpg|90px|link=Movie_-_Abnormal Chick Heart 2]]
|-
| [[Movie_-_Normal Chick Heart|Normal Heart]]
| [[Movie_-_Abnormal Chick Heart|Abnormal Heart]]
| [[Movie_-_Abnormal Chick Heart 2|Abnormal Heart 2]]
|-
|}

==Vascular Remodeling==
===Arterial System===
[[File:Gray0474.jpg|thumb|pharyngeal arch arteries]]
* Aortic sac - remodels forming 2 horns, R forms brachiocephalic artery, L forms common carotid artery

Pharyngeal arch arteries
* pharyngeal arch artery 1 and 2 regress
* pharyngeal arch artery 3 and the associated dorsal aorta form the paired internal carotid arteries, these in turn generate the external carotids
* Left pharyngeal arch artery 4 – forms the aortic arch

* paraxial mesoderm forms paired dorsal aorta
** head mesenchyme forms aortic arches
** connecting stalk contains unbilical (placental) arteries
** dorsal aortas give rise to
** vitelline arteries which connect to capillaries on yolk sac
** intersegmental arteries between somites

===Venous System===
Cardinal veins contribute nearly all systemic venous system.

<gallery>
File:Gray0477.jpg
File:Gray0478.jpg
File:Gray0479.jpg
File:Gray0480.jpg
</gallery>

common cardinal veins - ducts of Cuvier

hepatic veins - drain de-oxygenated blood from the liver into the inferior vena cava.

internal iliac vein - hypogastric vein

==Birth Changes==
[[File:Fetal_circulation1.jpg|thumb|Fetal circulation]]
At birth, cutting the umbilical cord and changes in the lungs after the first breaths trigger major functional adaptations in the fetal circulatory system.

* blood flow through ductus venosus is eliminated
* pulmonary circulation bed expands - reducing blood flow through ductus arteriosus
* physiological closure of interatrial shunt
* closure of ductus venosus in liver is prolonged

{| border=1

|-
! Fetal Structure
! Adult Structure
|-
| foramen ovale
| fossa ovalis
|-
| umbilical vein (intra-abdominal part)
| ligamentum teres
|-
| ductus venosus
| ligamentum venosum
|-
| umbilical arteries
| distal part -lateral umbilical ligaments; proximal part - superior vesical artery (supplies bladder)
|-
| ductus arteriosus
| ligamentum arteriosum
|}

==Abnormalities==
There are many different cardiac abnormalities, some more common than others, and only a few will be described in this lecture.

'''Major Abnormalities:''' Aortic Stenosis, Atrial Septal Defects, Coarctation of Aorta, Dextrocardia, Hypoplastic Left Heart, Long QT Syndrome, Patent Ductus Arteriosus, Pulmonary Atresia, Pulmonary Stenosis, Tetralogy of Fallot, Transposition of Great Vessels, Tricuspid Atresia, Total Anomalous Pulmonary Venous Connection, Ventricular Septal Defect, Abnormalities of Conducting System.

Links: [http://embryology.med.unsw.edu.au/Notes/heart2.htm Cardiovascular Development Abnormalities]

[[File:Abnormal81-92-heart.png|thumb]]

[[File:Statistics-Utah heart defects.jpg|thumb]]
===Atrial Septal Defects===

{| border='0px'
|-
| [[File:HeartILP_draft_asd.jpg|Atrial Septal Defect]]
|
* Atrial Septal Defects (ASD) are a group of common (1% of cardiac) congenital anomalies defects occurring in a number of different forms and more often in females.
* patent foramen ovale - allows a continuation of the atrial shunting of blood, in 25% of people a probe patent foramen ovale (allowing a probe to bypassed from one atria to the other) exists.
* ostium secundum defect
* endocardial cushion defect involving ostium primum
* sinus venosus defect - contributes about 10% of all ASDs and occurs mainly in a common and less common form. Common ("usual type") - in upper atrial septum which is contiguous with the superior vena cava. Less common - at junction of the right atrium and inferior vena cava.
* common atrium
|-
|}

===Ventricular Septal Defects===
{| border='0px'
|-
| [[File:HeartILP_draft_vsd.jpg|Ventricular Septal Defect]]
|
* The Ventricular Septal Defect (VSD) usually occurs in the membranous (perimembranous) (70%) rather than muscular interventricular septum, and is more frequent in males that females.
* Perimembranous defects are located close to the aortic and tricuspid valves and adjacent to atrioventricular conduction bundle.
* The defect allows left-right shunting of blood, this shunting depends upon the size of the defect. Small defects may close spontaneously, larger defects result in infant congestive heart failure.
* Clinically repaired by coils or tissue-adapted devices like muscular or perimembranous occluders.
|-
|}
(V.S.D.)

===Patent Ductus Arteriosus===

{| border='0px'

|-
| [[File:HeartILP_draft_patentda.jpg|Patent Ductus Arteriosus]]
|
* Patent Ductus Arteriosus (PDA) occurs commonly in preterm infants, can close spontaneously (by day three in 60% of normal term neonates) the remainder are ligated simply and with little risk.
* The operation is always recommended even in the absence of cardiac failure and can often be deferred until early childhood.

|-
|}

===Tetralogy of Fallot===
{| border='0px'
|-
| [[File:HeartILP_draft_tetralogyoffallot.jpg|Tetralogy of Fallot]]
|
* Named after Etienne-Louis Arthur Fallot (1888) who described it as "la maladie blue" and is a common developmental cardiac defect.
* The syndrome consists of a number of a number of cardiac defects possibly stemming from abnormal neural crest migration. The basic defect in a tetralogy of Fallot is an asymmetrical fusion of the truncoconal ridges and a malalignment of the aortic and pulmonary valves.
|-
|}

==Movies==

{| border='0px'

|-
| [[File:Heart1_looping icon.jpg|90px|link=Development_Animation_-_Heart Looping]]
| [[File:Heart1_realign icon.jpg|90px|link=Development_Animation_-_Heart Realign]]
| [[File:Heart1_atrium icon.jpg|90px|link=Development_Animation_-_Heart Atrial Septation]]
| [[File:heart1 ventricle icon.jpg|90px|link=Development_Animation_-_Heart Outflow Septation]]
|-
| [[Development_Animation_-_Heart Looping|Heart Looping]]
| [[Development_Animation_-_Heart Realign|Heart Realign]]
| [[Development_Animation_-_Heart Atrial Septation|Heart Atrial Septation]]
| [[Development_Animation_-_Heart Outflow Septation|Heart Outflow Septation]]
|-
|}

'''Link:''' [[Flash Movies]]

{{Template:2009ANAT2341}}

[[Category:2009ANAT2341]] [[Category:Science-Undergraduate]]

[[Category:Cardiovascular]] [[Category:Heart]]

2010 Lecture 21

2010-10-10T08:24:13Z

Z3267024: /* Septum Secundum */

<div style="background:#F5FFFA; border: 1px solid #CEF2E0; padding: 1em; margin: auto; width: 95%; float:left;"><div style="margin:0;background-color:#cef2e0;font-family:sans-serif;font-size:120%;font-weight:bold;border:1px solid #a3bfb1;text-align:left;color:#000;padding-left:0.4em;padding-top:0.2em;padding-bottom:0.2em;">Lecture Notice - Dr Nalini Pather</div>This online lecture page will contain the content required when attending the lecture. Currently this page is only a template and will be updated before the lecture (this notice removed when completed). Final lecture pages can also be printed out using the "printable version" lefthand menu.</div>

==Introduction==
[[File:Gray0473.gif|300px|right]]

In [[2010 Lecture 7|lecture 7 - Early Vascular Development]], the early development of the cardiovascular system was discussed. This second lecture will now focus on the extensive remodeling that occurs in both the heart and vascular system during later development. In addition, there will be discussion on the major cardiovascular abnormalities. The laboratory this week will also give you the opportunity to work through some of these concepts using a new online teaching module.

This material is also presented in an online [[Cardiac_Embryology|Cardiac Embryology tutorial]].

[[File:Basic_Heart_Development_Timeline.jpg|400px|Link=Cardiac_Embryology]]

{{Template:Heart Links}}

:'''Lecture Audio'''

==Lecture Objectives==
* Describe the development of primary and secondary atrial septa and the ventricular septum.
* Explain the changes occurring in the bulbis cordis and truncus arteriosus in its transformation from a single to a double tube.
* Describe the development of the aortic arches on the right and left sides from the fetus to the adult.
* Describe the development of arteries and veins.
* Describe the major cardiovascular developmental abnormalities.

==Textbook references==

* Human Embryology (3rd ed.) Larson Chapter 7 p151-188 Heart, Chapter 8 p189-228 Vasculature
* The Developing Human: Clinically Oriented Embryology (6th ed.) Chapter 14: p304-349

'''Other textbooks'''
* Before we Are Born (5th ed.) Moore and Persaud Chapter 12; p241-254
* Essentials of Human Embryology Larson Chapter 7 p97-122 Heart, Chapter 8 p123-146 Vasculature
* Human Embryology Fitzgerald and Fitzgerald Chapter 13-17: p77-111

'''Recent reviews'''
* Yutzey KE, Kirby ML. Wherefore heart thou? Embryonic origins of cardiogenic mesoderm. Dev Dyn. 2002 Mar;223(3):307-20. Review. [http://www.ncbi.nlm.nih.gov/pubmed/11891982?dopt=Abstract PMID: 11891982]
* Three-dimensional reconstruction of gene expression patterns during cardiac development. Soufan AT, Ruijter JM, van den Hoff MJ, de Boer PA, Hagoort J, Moorman AF. Physiol Genomics. 2003 May 13;13(3):187-95. Review. [http://www.ncbi.nlm.nih.gov/pubmed/12746463 PMID: 12746463]
* Moorman A, Webb S, Brown NA, Lamers W, Anderson RH. Development of the heart: (1) formation of the cardiac chambers and arterial trunks. Heart. 2003 Jul;89(7):806-14. [http://www.ncbi.nlm.nih.gov/pubmed/12807866?dopt=Abstract PMID: 12807866]
* Bruneau BG. Transcriptional regulation of vertebrate cardiac morphogenesis. Circ Res. 2002 Mar 22;90(5):509-19. Review. [http://www.ncbi.nlm.nih.gov/pubmed/11909814?dopt=Abstract PMID: 11909814]

----

==Heart Development==
[[File:Gray0462.gif|thumb|100px|Day 14 Heart tube]]
[[File:Heart_Tube_Fusion.jpg|400px|Early Human Heart Tube Development]]

* [[E#endocardial tube|endocardial tube]] in [[P#pericardial cavity|pericardial cavity]]
** dorsal mesentry (mesocardial) attachment lost
** attached at cranial (arterial) and caudal (venous) ends
* tube elongation - bending and series of expansions
[[File:Heart-cartoon-001.jpg|thumb|Adult Heart blood flow]]
Bulbus Cordis
* refers to the outflow tract in early embryo
* 3 parts
** distal - forms [[T#truncus arteriosus|truncus arteriosus]] (aorta and pulmonary artery)
** middle - [[C#conus arteriosus|conus arteriosus]] ventricular outflow tract
** proximal - right ventricle trabeculate part

{| border=1

|-
! Fetal Structure
! Adult Structure
|-
| Truncus arteriosus
| aorta
pulmonary trunk
|-
| Conus arteriosus
| right ventricle - smooth part (conus arteriosus)
left ventricle - smooth part (aortic vestibule
|-
| Primitive ventricle
| right ventricle - trabecular part
left ventricle - trabecular part
|-
| Primitive atrium
| right atrium - trabecular part
left atrium - trabecular part
|-
| Sinus venosus
| right atrium - smooth part (sinus venarum)
coronary sinus
oblique vein of left atrium
|}

===Heart Layers===
* '''pericardium''' - covers the heart, formed by 3 layers consisting of a fibrous pericardium and a double layered serous pericardium (parietal layer and visceral epicardium layer).
* '''myocardium''' - muscular wall of the heart, thickest layer formed by spirally arranged cardiac muscle cells.
* '''endocardium''' - lines the heart, epithelial (endothelial) tissue lining the inner surface of heart chambers and valves.

===Embryonic Heart Rate===

* Stage 9-10 2 mm embryo (gestational sac diameter of 20 mm) EHR at least 75 beats / minute
* Stage 11-12 5 mm embryo (gestational sac diameter of 30 mm) EHR at least 100 beats / minute
* Stage 16 10 mm embryo EHR at least 120 beats / minute
* Stage 18 15 mm embryo EHR at least 130 beats / minute

[http://embryology.med.unsw.edu.au/Movies/usound/Hum12wkFHR.htm Week 12 fetal heart rate doppler] [http://embryology.med.unsw.edu.au/Notes/heart8.htm Week 17 fetal heart rate audio]

==Separation of the Atria from the Venticles==
[[File:AV Canal Division.jpg|thumb|100px|Separation of the atrioventricular canal]]
===Endocardial Cushions===
* form initial division of atria and ventricles
* form on dorsal and ventral wall of atrioventcular canals
* grow into canal - meet and fuse to separate atrioventricular canal into right and left channels.

==Atrial Septation==
[[File:Heart1_atrium icon.jpg|90px|link=Development_Animation_-_Heart Atrial Septation]]

[[File:Stage13 C7L.jpg|thumb|Heart (Carnegie stage 13)]]

Through all development blood shunts from right to left atrium (bypass lungs)

===Septum Primum===
[http://embryology.med.unsw.edu.au/wwwpig/pigc/c1l.htm Stage 13 Septum Primum] [http://embryology.med.unsw.edu.au/wwwhuman/lowpower/HumE/E2L.htm Stage 22 Septum Primum]

* dorso-cranial wall, crescentric-shaped membranous extension
* grows downward towards endocardial cushions
* opening is '''foramen primum''' (ostium primum)- serves at a shunt
* a series of perforations develop in cranial end - coalesce to form '''foramen secundum''' (ostium secundum)
* septum primum fuses with endocardial cushions - obliterates foramen primum

===Septum Secundum===
* crescentric septum secundum begins to form to the right of septum primum
* grows as septum primum downward, does not fuse with endocardial cushion, opening is '''foramen ovale'''
* arrangement of the two septa allows them to act as a one-way valve

[[File:Atrial & Ventricular Septation 1.jpg|250px|Early -atrial and ventricular septation]]
[[File:Atrial & Ventricular Septation 2.jpg|250px|Late-atrial and ventricular septation]]

===Right Atrium===
[[File:Gray0476.jpg|thumb|sinus venosus and tributaries]]
* with heart looping and formation of interatrial septa, the sinus venosus shifts completely to right atrium
* right sinus horn incorporates into dorsal wall of right atrium
* left sinus horn becomes the coronary sinus
* sinoatrial opening - has 2 flaps, left fuses with septum secundum, right forms valve to inferior vena cava and coronary sinus. [http://embryology.med.unsw.edu.au/wwwpig/pigc/c3l.htm Stage 13 - right venous valve] [http://embryology.med.unsw.edu.au/wwwhuman/lowpower/HumE/E2L.htm Stage 22 - right venous valve]

===Left Atrium===
* posterior wall - outgrowth forms single pulmonary vein, divided into 4 branches
* incorporation into the wall leads to 4 openings in posterior wall
* later moves to the right aligns with atrioventricular canal.

==Ventricular Septation==
[[File:Stage13 C7L.jpg|thumb|Heart (Carnegie stage 13)]]
[[File:Gray0498.jpg|thumb|Ventricular septum]]
[[File:Heart1_realign icon.jpg|90px|link=Development_Animation_-_Heart Realign]]

* 2 separate components - superior membranous, inferior muscular
===Muscular Septum===
[[File:Gray0470.jpg|thumb|muscular septum]]
* growth of inferior wall
* fusion of 3 components - right and left bulbar ridges and dorsal endocardial cushion

===Membranous Septum===
* above the muscular septum, fusion continuous with septation of the outflow tract

[[File:Heart-ventricular-septum-01.jpg‎]][[File:Heart-ventricular-septum-02.jpg‎]][[File:Heart-ventricular-septum-03.jpg‎]]

==Outflow Tract Septation==

[[File:heart1 ventricle icon.jpg|90px|link=Development_Animation_-_Heart Outflow Septation]]

* in early development, outflow tract is a single tube, bulbus cordis
* elongates to form proximal conus arteriosus and distal truncus arteriosus
* 2 growths from wall in spiral pattern, inferior upwards - separate tract into 2 channels [http://embryology.med.unsw.edu.au/wwwpig/pigb/b5l.htm Stage 13 truncus arteriousus]
* mesenchyme and neural crest contribute to this septation process
* fusion of outgrowths separate aortic and pulmonary outflow

{| border='0px'

|-
| [[File:Chick_Heart_001-icon.jpg|90px|link=Movie_-_Normal Chick Heart]]
| [[File:Chick_Heart_002-icon.jpg|90px|link=Movie_-_Abnormal Chick Heart]]
| [[File:Chick_Heart_002-icon.jpg|90px|link=Movie_-_Abnormal Chick Heart 2]]
|-
| [[Movie_-_Normal Chick Heart|Normal Heart]]
| [[Movie_-_Abnormal Chick Heart|Abnormal Heart]]
| [[Movie_-_Abnormal Chick Heart 2|Abnormal Heart 2]]
|-
|}

==Vascular Remodeling==
===Arterial System===
[[File:Gray0474.jpg|thumb|pharyngeal arch arteries]]
* Aortic sac - remodels forming 2 horns, R forms brachiocephalic artery, L forms common carotid artery

Pharyngeal arch arteries
* pharyngeal arch artery 1 and 2 regress
* pharyngeal arch artery 3 and the associated dorsal aorta form the paired internal carotid arteries, these in turn generate the external carotids
* Left pharyngeal arch artery 4 – forms the aortic arch

* paraxial mesoderm forms paired dorsal aorta
** head mesenchyme forms aortic arches
** connecting stalk contains unbilical (placental) arteries
** dorsal aortas give rise to
** vitelline arteries which connect to capillaries on yolk sac
** intersegmental arteries between somites

===Venous System===
Cardinal veins contribute nearly all systemic venous system.

<gallery>
File:Gray0477.jpg
File:Gray0478.jpg
File:Gray0479.jpg
File:Gray0480.jpg
</gallery>

common cardinal veins - ducts of Cuvier

hepatic veins - drain de-oxygenated blood from the liver into the inferior vena cava.

internal iliac vein - hypogastric vein

==Birth Changes==
[[File:Fetal_circulation1.jpg|thumb|Fetal circulation]]
At birth, cutting the umbilical cord and changes in the lungs after the first breaths trigger major functional adaptations in the fetal circulatory system.

* blood flow through ductus venosus is eliminated
* pulmonary circulation bed expands - reducing blood flow through ductus arteriosus
* physiological closure of interatrial shunt
* closure of ductus venosus in liver is prolonged

{| border=1

|-
! Fetal Structure
! Adult Structure
|-
| foramen ovale
| fossa ovalis
|-
| umbilical vein (intra-abdominal part)
| ligamentum teres
|-
| ductus venosus
| ligamentum venosum
|-
| umbilical arteries
| distal part -lateral umbilical ligaments; proximal part - superior vesical artery (supplies bladder)
|-
| ductus arteriosus
| ligamentum arteriosum
|}

==Abnormalities==
There are many different cardiac abnormalities, some more common than others, and only a few will be described in this lecture.

'''Major Abnormalities:''' Aortic Stenosis, Atrial Septal Defects, Coarctation of Aorta, Dextrocardia, Hypoplastic Left Heart, Long QT Syndrome, Patent Ductus Arteriosus, Pulmonary Atresia, Pulmonary Stenosis, Tetralogy of Fallot, Transposition of Great Vessels, Tricuspid Atresia, Total Anomalous Pulmonary Venous Connection, Ventricular Septal Defect, Abnormalities of Conducting System.

Links: [http://embryology.med.unsw.edu.au/Notes/heart2.htm Cardiovascular Development Abnormalities]

[[File:Abnormal81-92-heart.png|thumb]]

[[File:Statistics-Utah heart defects.jpg|thumb]]
===Atrial Septal Defects===

{| border='0px'
|-
| [[File:HeartILP_draft_asd.jpg|Atrial Septal Defect]]
|
* Atrial Septal Defects (ASD) are a group of common (1% of cardiac) congenital anomalies defects occurring in a number of different forms and more often in females.
* patent foramen ovale - allows a continuation of the atrial shunting of blood, in 25% of people a probe patent foramen ovale (allowing a probe to bypassed from one atria to the other) exists.
* ostium secundum defect
* endocardial cushion defect involving ostium primum
* sinus venosus defect - contributes about 10% of all ASDs and occurs mainly in a common and less common form. Common ("usual type") - in upper atrial septum which is contiguous with the superior vena cava. Less common - at junction of the right atrium and inferior vena cava.
* common atrium
|-
|}

===Ventricular Septal Defects===
{| border='0px'
|-
| [[File:HeartILP_draft_vsd.jpg|Ventricular Septal Defect]]
|
* The Ventricular Septal Defect (VSD) usually occurs in the membranous (perimembranous) (70%) rather than muscular interventricular septum, and is more frequent in males that females.
* Perimembranous defects are located close to the aortic and tricuspid valves and adjacent to atrioventricular conduction bundle.
* The defect allows left-right shunting of blood, this shunting depends upon the size of the defect. Small defects may close spontaneously, larger defects result in infant congestive heart failure.
* Clinically repaired by coils or tissue-adapted devices like muscular or perimembranous occluders.
|-
|}
(V.S.D.)

===Patent Ductus Arteriosus===

{| border='0px'

|-
| [[File:HeartILP_draft_patentda.jpg|Patent Ductus Arteriosus]]
|
* Patent Ductus Arteriosus (PDA) occurs commonly in preterm infants, can close spontaneously (by day three in 60% of normal term neonates) the remainder are ligated simply and with little risk.
* The operation is always recommended even in the absence of cardiac failure and can often be deferred until early childhood.

|-
|}

===Tetralogy of Fallot===
{| border='0px'
|-
| [[File:HeartILP_draft_tetralogyoffallot.jpg|Tetralogy of Fallot]]
|
* Named after Etienne-Louis Arthur Fallot (1888) who described it as "la maladie blue" and is a common developmental cardiac defect.
* The syndrome consists of a number of a number of cardiac defects possibly stemming from abnormal neural crest migration. The basic defect in a tetralogy of Fallot is an asymmetrical fusion of the truncoconal ridges and a malalignment of the aortic and pulmonary valves.
|-
|}

==Movies==

{| border='0px'

|-
| [[File:Heart1_looping icon.jpg|90px|link=Development_Animation_-_Heart Looping]]
| [[File:Heart1_realign icon.jpg|90px|link=Development_Animation_-_Heart Realign]]
| [[File:Heart1_atrium icon.jpg|90px|link=Development_Animation_-_Heart Atrial Septation]]
| [[File:heart1 ventricle icon.jpg|90px|link=Development_Animation_-_Heart Outflow Septation]]
|-
| [[Development_Animation_-_Heart Looping|Heart Looping]]
| [[Development_Animation_-_Heart Realign|Heart Realign]]
| [[Development_Animation_-_Heart Atrial Septation|Heart Atrial Septation]]
| [[Development_Animation_-_Heart Outflow Septation|Heart Outflow Septation]]
|-
|}

'''Link:''' [[Flash Movies]]

{{Template:2009ANAT2341}}

[[Category:2009ANAT2341]] [[Category:Science-Undergraduate]]

[[Category:Cardiovascular]] [[Category:Heart]]

2010 Lecture 21

2010-10-10T08:23:27Z

Z3267024: /* Septum Secundum */

<div style="background:#F5FFFA; border: 1px solid #CEF2E0; padding: 1em; margin: auto; width: 95%; float:left;"><div style="margin:0;background-color:#cef2e0;font-family:sans-serif;font-size:120%;font-weight:bold;border:1px solid #a3bfb1;text-align:left;color:#000;padding-left:0.4em;padding-top:0.2em;padding-bottom:0.2em;">Lecture Notice - Dr Nalini Pather</div>This online lecture page will contain the content required when attending the lecture. Currently this page is only a template and will be updated before the lecture (this notice removed when completed). Final lecture pages can also be printed out using the "printable version" lefthand menu.</div>

==Introduction==
[[File:Gray0473.gif|300px|right]]

In [[2010 Lecture 7|lecture 7 - Early Vascular Development]], the early development of the cardiovascular system was discussed. This second lecture will now focus on the extensive remodeling that occurs in both the heart and vascular system during later development. In addition, there will be discussion on the major cardiovascular abnormalities. The laboratory this week will also give you the opportunity to work through some of these concepts using a new online teaching module.

This material is also presented in an online [[Cardiac_Embryology|Cardiac Embryology tutorial]].

[[File:Basic_Heart_Development_Timeline.jpg|400px|Link=Cardiac_Embryology]]

{{Template:Heart Links}}

:'''Lecture Audio'''

==Lecture Objectives==
* Describe the development of primary and secondary atrial septa and the ventricular septum.
* Explain the changes occurring in the bulbis cordis and truncus arteriosus in its transformation from a single to a double tube.
* Describe the development of the aortic arches on the right and left sides from the fetus to the adult.
* Describe the development of arteries and veins.
* Describe the major cardiovascular developmental abnormalities.

==Textbook references==

* Human Embryology (3rd ed.) Larson Chapter 7 p151-188 Heart, Chapter 8 p189-228 Vasculature
* The Developing Human: Clinically Oriented Embryology (6th ed.) Chapter 14: p304-349

'''Other textbooks'''
* Before we Are Born (5th ed.) Moore and Persaud Chapter 12; p241-254
* Essentials of Human Embryology Larson Chapter 7 p97-122 Heart, Chapter 8 p123-146 Vasculature
* Human Embryology Fitzgerald and Fitzgerald Chapter 13-17: p77-111

'''Recent reviews'''
* Yutzey KE, Kirby ML. Wherefore heart thou? Embryonic origins of cardiogenic mesoderm. Dev Dyn. 2002 Mar;223(3):307-20. Review. [http://www.ncbi.nlm.nih.gov/pubmed/11891982?dopt=Abstract PMID: 11891982]
* Three-dimensional reconstruction of gene expression patterns during cardiac development. Soufan AT, Ruijter JM, van den Hoff MJ, de Boer PA, Hagoort J, Moorman AF. Physiol Genomics. 2003 May 13;13(3):187-95. Review. [http://www.ncbi.nlm.nih.gov/pubmed/12746463 PMID: 12746463]
* Moorman A, Webb S, Brown NA, Lamers W, Anderson RH. Development of the heart: (1) formation of the cardiac chambers and arterial trunks. Heart. 2003 Jul;89(7):806-14. [http://www.ncbi.nlm.nih.gov/pubmed/12807866?dopt=Abstract PMID: 12807866]
* Bruneau BG. Transcriptional regulation of vertebrate cardiac morphogenesis. Circ Res. 2002 Mar 22;90(5):509-19. Review. [http://www.ncbi.nlm.nih.gov/pubmed/11909814?dopt=Abstract PMID: 11909814]

----

==Heart Development==
[[File:Gray0462.gif|thumb|100px|Day 14 Heart tube]]
[[File:Heart_Tube_Fusion.jpg|400px|Early Human Heart Tube Development]]

* [[E#endocardial tube|endocardial tube]] in [[P#pericardial cavity|pericardial cavity]]
** dorsal mesentry (mesocardial) attachment lost
** attached at cranial (arterial) and caudal (venous) ends
* tube elongation - bending and series of expansions
[[File:Heart-cartoon-001.jpg|thumb|Adult Heart blood flow]]
Bulbus Cordis
* refers to the outflow tract in early embryo
* 3 parts
** distal - forms [[T#truncus arteriosus|truncus arteriosus]] (aorta and pulmonary artery)
** middle - [[C#conus arteriosus|conus arteriosus]] ventricular outflow tract
** proximal - right ventricle trabeculate part

{| border=1

|-
! Fetal Structure
! Adult Structure
|-
| Truncus arteriosus
| aorta
pulmonary trunk
|-
| Conus arteriosus
| right ventricle - smooth part (conus arteriosus)
left ventricle - smooth part (aortic vestibule
|-
| Primitive ventricle
| right ventricle - trabecular part
left ventricle - trabecular part
|-
| Primitive atrium
| right atrium - trabecular part
left atrium - trabecular part
|-
| Sinus venosus
| right atrium - smooth part (sinus venarum)
coronary sinus
oblique vein of left atrium
|}

===Heart Layers===
* '''pericardium''' - covers the heart, formed by 3 layers consisting of a fibrous pericardium and a double layered serous pericardium (parietal layer and visceral epicardium layer).
* '''myocardium''' - muscular wall of the heart, thickest layer formed by spirally arranged cardiac muscle cells.
* '''endocardium''' - lines the heart, epithelial (endothelial) tissue lining the inner surface of heart chambers and valves.

===Embryonic Heart Rate===

* Stage 9-10 2 mm embryo (gestational sac diameter of 20 mm) EHR at least 75 beats / minute
* Stage 11-12 5 mm embryo (gestational sac diameter of 30 mm) EHR at least 100 beats / minute
* Stage 16 10 mm embryo EHR at least 120 beats / minute
* Stage 18 15 mm embryo EHR at least 130 beats / minute

[http://embryology.med.unsw.edu.au/Movies/usound/Hum12wkFHR.htm Week 12 fetal heart rate doppler] [http://embryology.med.unsw.edu.au/Notes/heart8.htm Week 17 fetal heart rate audio]

==Separation of the Atria from the Venticles==
[[File:AV Canal Division.jpg|thumb|100px|Separation of the atrioventricular canal]]
===Endocardial Cushions===
* form initial division of atria and ventricles
* form on dorsal and ventral wall of atrioventcular canals
* grow into canal - meet and fuse to separate atrioventricular canal into right and left channels.

==Atrial Septation==
[[File:Heart1_atrium icon.jpg|90px|link=Development_Animation_-_Heart Atrial Septation]]

[[File:Stage13 C7L.jpg|thumb|Heart (Carnegie stage 13)]]

Through all development blood shunts from right to left atrium (bypass lungs)

===Septum Primum===
[http://embryology.med.unsw.edu.au/wwwpig/pigc/c1l.htm Stage 13 Septum Primum] [http://embryology.med.unsw.edu.au/wwwhuman/lowpower/HumE/E2L.htm Stage 22 Septum Primum]

* dorso-cranial wall, crescentric-shaped membranous extension
* grows downward towards endocardial cushions
* opening is '''foramen primum''' (ostium primum)- serves at a shunt
* a series of perforations develop in cranial end - coalesce to form '''foramen secundum''' (ostium secundum)
* septum primum fuses with endocardial cushions - obliterates foramen primum

===Septum Secundum===
* crescentric septum secundum begins to form to the right of septum primum
* grows as septum primum downward, does not fuse with endocardial cushion, opening is '''foramen ovale'''
* arrangement of the two septa allows them to act as a one-way valve

[[File:Atrial & Ventricular Septation 1.jpg|300px|Early -atrial and ventricular septation]]
[[File:Atrial & Ventricular Septation 2.jpg|300px|Late-atrial and ventricular septation]]

===Right Atrium===
[[File:Gray0476.jpg|thumb|sinus venosus and tributaries]]
* with heart looping and formation of interatrial septa, the sinus venosus shifts completely to right atrium
* right sinus horn incorporates into dorsal wall of right atrium
* left sinus horn becomes the coronary sinus
* sinoatrial opening - has 2 flaps, left fuses with septum secundum, right forms valve to inferior vena cava and coronary sinus. [http://embryology.med.unsw.edu.au/wwwpig/pigc/c3l.htm Stage 13 - right venous valve] [http://embryology.med.unsw.edu.au/wwwhuman/lowpower/HumE/E2L.htm Stage 22 - right venous valve]

===Left Atrium===
* posterior wall - outgrowth forms single pulmonary vein, divided into 4 branches
* incorporation into the wall leads to 4 openings in posterior wall
* later moves to the right aligns with atrioventricular canal.

==Ventricular Septation==
[[File:Stage13 C7L.jpg|thumb|Heart (Carnegie stage 13)]]
[[File:Gray0498.jpg|thumb|Ventricular septum]]
[[File:Heart1_realign icon.jpg|90px|link=Development_Animation_-_Heart Realign]]

* 2 separate components - superior membranous, inferior muscular
===Muscular Septum===
[[File:Gray0470.jpg|thumb|muscular septum]]
* growth of inferior wall
* fusion of 3 components - right and left bulbar ridges and dorsal endocardial cushion

===Membranous Septum===
* above the muscular septum, fusion continuous with septation of the outflow tract

[[File:Heart-ventricular-septum-01.jpg‎]][[File:Heart-ventricular-septum-02.jpg‎]][[File:Heart-ventricular-septum-03.jpg‎]]

==Outflow Tract Septation==

[[File:heart1 ventricle icon.jpg|90px|link=Development_Animation_-_Heart Outflow Septation]]

* in early development, outflow tract is a single tube, bulbus cordis
* elongates to form proximal conus arteriosus and distal truncus arteriosus
* 2 growths from wall in spiral pattern, inferior upwards - separate tract into 2 channels [http://embryology.med.unsw.edu.au/wwwpig/pigb/b5l.htm Stage 13 truncus arteriousus]
* mesenchyme and neural crest contribute to this septation process
* fusion of outgrowths separate aortic and pulmonary outflow

{| border='0px'

|-
| [[File:Chick_Heart_001-icon.jpg|90px|link=Movie_-_Normal Chick Heart]]
| [[File:Chick_Heart_002-icon.jpg|90px|link=Movie_-_Abnormal Chick Heart]]
| [[File:Chick_Heart_002-icon.jpg|90px|link=Movie_-_Abnormal Chick Heart 2]]
|-
| [[Movie_-_Normal Chick Heart|Normal Heart]]
| [[Movie_-_Abnormal Chick Heart|Abnormal Heart]]
| [[Movie_-_Abnormal Chick Heart 2|Abnormal Heart 2]]
|-
|}

==Vascular Remodeling==
===Arterial System===
[[File:Gray0474.jpg|thumb|pharyngeal arch arteries]]
* Aortic sac - remodels forming 2 horns, R forms brachiocephalic artery, L forms common carotid artery

Pharyngeal arch arteries
* pharyngeal arch artery 1 and 2 regress
* pharyngeal arch artery 3 and the associated dorsal aorta form the paired internal carotid arteries, these in turn generate the external carotids
* Left pharyngeal arch artery 4 – forms the aortic arch

* paraxial mesoderm forms paired dorsal aorta
** head mesenchyme forms aortic arches
** connecting stalk contains unbilical (placental) arteries
** dorsal aortas give rise to
** vitelline arteries which connect to capillaries on yolk sac
** intersegmental arteries between somites

===Venous System===
Cardinal veins contribute nearly all systemic venous system.

<gallery>
File:Gray0477.jpg
File:Gray0478.jpg
File:Gray0479.jpg
File:Gray0480.jpg
</gallery>

common cardinal veins - ducts of Cuvier

hepatic veins - drain de-oxygenated blood from the liver into the inferior vena cava.

internal iliac vein - hypogastric vein

==Birth Changes==
[[File:Fetal_circulation1.jpg|thumb|Fetal circulation]]
At birth, cutting the umbilical cord and changes in the lungs after the first breaths trigger major functional adaptations in the fetal circulatory system.

* blood flow through ductus venosus is eliminated
* pulmonary circulation bed expands - reducing blood flow through ductus arteriosus
* physiological closure of interatrial shunt
* closure of ductus venosus in liver is prolonged

{| border=1

|-
! Fetal Structure
! Adult Structure
|-
| foramen ovale
| fossa ovalis
|-
| umbilical vein (intra-abdominal part)
| ligamentum teres
|-
| ductus venosus
| ligamentum venosum
|-
| umbilical arteries
| distal part -lateral umbilical ligaments; proximal part - superior vesical artery (supplies bladder)
|-
| ductus arteriosus
| ligamentum arteriosum
|}

==Abnormalities==
There are many different cardiac abnormalities, some more common than others, and only a few will be described in this lecture.

'''Major Abnormalities:''' Aortic Stenosis, Atrial Septal Defects, Coarctation of Aorta, Dextrocardia, Hypoplastic Left Heart, Long QT Syndrome, Patent Ductus Arteriosus, Pulmonary Atresia, Pulmonary Stenosis, Tetralogy of Fallot, Transposition of Great Vessels, Tricuspid Atresia, Total Anomalous Pulmonary Venous Connection, Ventricular Septal Defect, Abnormalities of Conducting System.

Links: [http://embryology.med.unsw.edu.au/Notes/heart2.htm Cardiovascular Development Abnormalities]

[[File:Abnormal81-92-heart.png|thumb]]

[[File:Statistics-Utah heart defects.jpg|thumb]]
===Atrial Septal Defects===

{| border='0px'
|-
| [[File:HeartILP_draft_asd.jpg|Atrial Septal Defect]]
|
* Atrial Septal Defects (ASD) are a group of common (1% of cardiac) congenital anomalies defects occurring in a number of different forms and more often in females.
* patent foramen ovale - allows a continuation of the atrial shunting of blood, in 25% of people a probe patent foramen ovale (allowing a probe to bypassed from one atria to the other) exists.
* ostium secundum defect
* endocardial cushion defect involving ostium primum
* sinus venosus defect - contributes about 10% of all ASDs and occurs mainly in a common and less common form. Common ("usual type") - in upper atrial septum which is contiguous with the superior vena cava. Less common - at junction of the right atrium and inferior vena cava.
* common atrium
|-
|}

===Ventricular Septal Defects===
{| border='0px'
|-
| [[File:HeartILP_draft_vsd.jpg|Ventricular Septal Defect]]
|
* The Ventricular Septal Defect (VSD) usually occurs in the membranous (perimembranous) (70%) rather than muscular interventricular septum, and is more frequent in males that females.
* Perimembranous defects are located close to the aortic and tricuspid valves and adjacent to atrioventricular conduction bundle.
* The defect allows left-right shunting of blood, this shunting depends upon the size of the defect. Small defects may close spontaneously, larger defects result in infant congestive heart failure.
* Clinically repaired by coils or tissue-adapted devices like muscular or perimembranous occluders.
|-
|}
(V.S.D.)

===Patent Ductus Arteriosus===

{| border='0px'

|-
| [[File:HeartILP_draft_patentda.jpg|Patent Ductus Arteriosus]]
|
* Patent Ductus Arteriosus (PDA) occurs commonly in preterm infants, can close spontaneously (by day three in 60% of normal term neonates) the remainder are ligated simply and with little risk.
* The operation is always recommended even in the absence of cardiac failure and can often be deferred until early childhood.

|-
|}

===Tetralogy of Fallot===
{| border='0px'
|-
| [[File:HeartILP_draft_tetralogyoffallot.jpg|Tetralogy of Fallot]]
|
* Named after Etienne-Louis Arthur Fallot (1888) who described it as "la maladie blue" and is a common developmental cardiac defect.
* The syndrome consists of a number of a number of cardiac defects possibly stemming from abnormal neural crest migration. The basic defect in a tetralogy of Fallot is an asymmetrical fusion of the truncoconal ridges and a malalignment of the aortic and pulmonary valves.
|-
|}

==Movies==

{| border='0px'

|-
| [[File:Heart1_looping icon.jpg|90px|link=Development_Animation_-_Heart Looping]]
| [[File:Heart1_realign icon.jpg|90px|link=Development_Animation_-_Heart Realign]]
| [[File:Heart1_atrium icon.jpg|90px|link=Development_Animation_-_Heart Atrial Septation]]
| [[File:heart1 ventricle icon.jpg|90px|link=Development_Animation_-_Heart Outflow Septation]]
|-
| [[Development_Animation_-_Heart Looping|Heart Looping]]
| [[Development_Animation_-_Heart Realign|Heart Realign]]
| [[Development_Animation_-_Heart Atrial Septation|Heart Atrial Septation]]
| [[Development_Animation_-_Heart Outflow Septation|Heart Outflow Septation]]
|-
|}

'''Link:''' [[Flash Movies]]

{{Template:2009ANAT2341}}

[[Category:2009ANAT2341]] [[Category:Science-Undergraduate]]

[[Category:Cardiovascular]] [[Category:Heart]]

2010 Lecture 21

2010-10-10T08:22:53Z

Z3267024: /* Atrial Septation */

<div style="background:#F5FFFA; border: 1px solid #CEF2E0; padding: 1em; margin: auto; width: 95%; float:left;"><div style="margin:0;background-color:#cef2e0;font-family:sans-serif;font-size:120%;font-weight:bold;border:1px solid #a3bfb1;text-align:left;color:#000;padding-left:0.4em;padding-top:0.2em;padding-bottom:0.2em;">Lecture Notice - Dr Nalini Pather</div>This online lecture page will contain the content required when attending the lecture. Currently this page is only a template and will be updated before the lecture (this notice removed when completed). Final lecture pages can also be printed out using the "printable version" lefthand menu.</div>

==Introduction==
[[File:Gray0473.gif|300px|right]]

In [[2010 Lecture 7|lecture 7 - Early Vascular Development]], the early development of the cardiovascular system was discussed. This second lecture will now focus on the extensive remodeling that occurs in both the heart and vascular system during later development. In addition, there will be discussion on the major cardiovascular abnormalities. The laboratory this week will also give you the opportunity to work through some of these concepts using a new online teaching module.

This material is also presented in an online [[Cardiac_Embryology|Cardiac Embryology tutorial]].

[[File:Basic_Heart_Development_Timeline.jpg|400px|Link=Cardiac_Embryology]]

{{Template:Heart Links}}

:'''Lecture Audio'''

==Lecture Objectives==
* Describe the development of primary and secondary atrial septa and the ventricular septum.
* Explain the changes occurring in the bulbis cordis and truncus arteriosus in its transformation from a single to a double tube.
* Describe the development of the aortic arches on the right and left sides from the fetus to the adult.
* Describe the development of arteries and veins.
* Describe the major cardiovascular developmental abnormalities.

==Textbook references==

* Human Embryology (3rd ed.) Larson Chapter 7 p151-188 Heart, Chapter 8 p189-228 Vasculature
* The Developing Human: Clinically Oriented Embryology (6th ed.) Chapter 14: p304-349

'''Other textbooks'''
* Before we Are Born (5th ed.) Moore and Persaud Chapter 12; p241-254
* Essentials of Human Embryology Larson Chapter 7 p97-122 Heart, Chapter 8 p123-146 Vasculature
* Human Embryology Fitzgerald and Fitzgerald Chapter 13-17: p77-111

'''Recent reviews'''
* Yutzey KE, Kirby ML. Wherefore heart thou? Embryonic origins of cardiogenic mesoderm. Dev Dyn. 2002 Mar;223(3):307-20. Review. [http://www.ncbi.nlm.nih.gov/pubmed/11891982?dopt=Abstract PMID: 11891982]
* Three-dimensional reconstruction of gene expression patterns during cardiac development. Soufan AT, Ruijter JM, van den Hoff MJ, de Boer PA, Hagoort J, Moorman AF. Physiol Genomics. 2003 May 13;13(3):187-95. Review. [http://www.ncbi.nlm.nih.gov/pubmed/12746463 PMID: 12746463]
* Moorman A, Webb S, Brown NA, Lamers W, Anderson RH. Development of the heart: (1) formation of the cardiac chambers and arterial trunks. Heart. 2003 Jul;89(7):806-14. [http://www.ncbi.nlm.nih.gov/pubmed/12807866?dopt=Abstract PMID: 12807866]
* Bruneau BG. Transcriptional regulation of vertebrate cardiac morphogenesis. Circ Res. 2002 Mar 22;90(5):509-19. Review. [http://www.ncbi.nlm.nih.gov/pubmed/11909814?dopt=Abstract PMID: 11909814]

----

==Heart Development==
[[File:Gray0462.gif|thumb|100px|Day 14 Heart tube]]
[[File:Heart_Tube_Fusion.jpg|400px|Early Human Heart Tube Development]]

* [[E#endocardial tube|endocardial tube]] in [[P#pericardial cavity|pericardial cavity]]
** dorsal mesentry (mesocardial) attachment lost
** attached at cranial (arterial) and caudal (venous) ends
* tube elongation - bending and series of expansions
[[File:Heart-cartoon-001.jpg|thumb|Adult Heart blood flow]]
Bulbus Cordis
* refers to the outflow tract in early embryo
* 3 parts
** distal - forms [[T#truncus arteriosus|truncus arteriosus]] (aorta and pulmonary artery)
** middle - [[C#conus arteriosus|conus arteriosus]] ventricular outflow tract
** proximal - right ventricle trabeculate part

{| border=1

|-
! Fetal Structure
! Adult Structure
|-
| Truncus arteriosus
| aorta
pulmonary trunk
|-
| Conus arteriosus
| right ventricle - smooth part (conus arteriosus)
left ventricle - smooth part (aortic vestibule
|-
| Primitive ventricle
| right ventricle - trabecular part
left ventricle - trabecular part
|-
| Primitive atrium
| right atrium - trabecular part
left atrium - trabecular part
|-
| Sinus venosus
| right atrium - smooth part (sinus venarum)
coronary sinus
oblique vein of left atrium
|}

===Heart Layers===
* '''pericardium''' - covers the heart, formed by 3 layers consisting of a fibrous pericardium and a double layered serous pericardium (parietal layer and visceral epicardium layer).
* '''myocardium''' - muscular wall of the heart, thickest layer formed by spirally arranged cardiac muscle cells.
* '''endocardium''' - lines the heart, epithelial (endothelial) tissue lining the inner surface of heart chambers and valves.

===Embryonic Heart Rate===

* Stage 9-10 2 mm embryo (gestational sac diameter of 20 mm) EHR at least 75 beats / minute
* Stage 11-12 5 mm embryo (gestational sac diameter of 30 mm) EHR at least 100 beats / minute
* Stage 16 10 mm embryo EHR at least 120 beats / minute
* Stage 18 15 mm embryo EHR at least 130 beats / minute

[http://embryology.med.unsw.edu.au/Movies/usound/Hum12wkFHR.htm Week 12 fetal heart rate doppler] [http://embryology.med.unsw.edu.au/Notes/heart8.htm Week 17 fetal heart rate audio]

==Separation of the Atria from the Venticles==
[[File:AV Canal Division.jpg|thumb|100px|Separation of the atrioventricular canal]]
===Endocardial Cushions===
* form initial division of atria and ventricles
* form on dorsal and ventral wall of atrioventcular canals
* grow into canal - meet and fuse to separate atrioventricular canal into right and left channels.

==Atrial Septation==
[[File:Heart1_atrium icon.jpg|90px|link=Development_Animation_-_Heart Atrial Septation]]

[[File:Stage13 C7L.jpg|thumb|Heart (Carnegie stage 13)]]

Through all development blood shunts from right to left atrium (bypass lungs)

===Septum Primum===
[http://embryology.med.unsw.edu.au/wwwpig/pigc/c1l.htm Stage 13 Septum Primum] [http://embryology.med.unsw.edu.au/wwwhuman/lowpower/HumE/E2L.htm Stage 22 Septum Primum]

* dorso-cranial wall, crescentric-shaped membranous extension
* grows downward towards endocardial cushions
* opening is '''foramen primum''' (ostium primum)- serves at a shunt
* a series of perforations develop in cranial end - coalesce to form '''foramen secundum''' (ostium secundum)
* septum primum fuses with endocardial cushions - obliterates foramen primum

===Septum Secundum===
* crescentric septum secundum begins to form to the right of septum primum
* grows as septum primum downward, does not fuse with endocardial cushion, opening is '''foramen ovale'''
* arrangement of the two septa allows them to act as a one-way valve

[[File:Atrial & Ventricular Septation 1.jpg|200px|Early -atrial and ventricular septation]]
[[File:Atrial & Ventricular Septation 2.jpg|200px|Late-atrial and ventricular septation]]

===Right Atrium===
[[File:Gray0476.jpg|thumb|sinus venosus and tributaries]]
* with heart looping and formation of interatrial septa, the sinus venosus shifts completely to right atrium
* right sinus horn incorporates into dorsal wall of right atrium
* left sinus horn becomes the coronary sinus
* sinoatrial opening - has 2 flaps, left fuses with septum secundum, right forms valve to inferior vena cava and coronary sinus. [http://embryology.med.unsw.edu.au/wwwpig/pigc/c3l.htm Stage 13 - right venous valve] [http://embryology.med.unsw.edu.au/wwwhuman/lowpower/HumE/E2L.htm Stage 22 - right venous valve]

===Left Atrium===
* posterior wall - outgrowth forms single pulmonary vein, divided into 4 branches
* incorporation into the wall leads to 4 openings in posterior wall
* later moves to the right aligns with atrioventricular canal.

==Ventricular Septation==
[[File:Stage13 C7L.jpg|thumb|Heart (Carnegie stage 13)]]
[[File:Gray0498.jpg|thumb|Ventricular septum]]
[[File:Heart1_realign icon.jpg|90px|link=Development_Animation_-_Heart Realign]]

* 2 separate components - superior membranous, inferior muscular
===Muscular Septum===
[[File:Gray0470.jpg|thumb|muscular septum]]
* growth of inferior wall
* fusion of 3 components - right and left bulbar ridges and dorsal endocardial cushion

===Membranous Septum===
* above the muscular septum, fusion continuous with septation of the outflow tract

[[File:Heart-ventricular-septum-01.jpg‎]][[File:Heart-ventricular-septum-02.jpg‎]][[File:Heart-ventricular-septum-03.jpg‎]]

==Outflow Tract Septation==

[[File:heart1 ventricle icon.jpg|90px|link=Development_Animation_-_Heart Outflow Septation]]

* in early development, outflow tract is a single tube, bulbus cordis
* elongates to form proximal conus arteriosus and distal truncus arteriosus
* 2 growths from wall in spiral pattern, inferior upwards - separate tract into 2 channels [http://embryology.med.unsw.edu.au/wwwpig/pigb/b5l.htm Stage 13 truncus arteriousus]
* mesenchyme and neural crest contribute to this septation process
* fusion of outgrowths separate aortic and pulmonary outflow

{| border='0px'

|-
| [[File:Chick_Heart_001-icon.jpg|90px|link=Movie_-_Normal Chick Heart]]
| [[File:Chick_Heart_002-icon.jpg|90px|link=Movie_-_Abnormal Chick Heart]]
| [[File:Chick_Heart_002-icon.jpg|90px|link=Movie_-_Abnormal Chick Heart 2]]
|-
| [[Movie_-_Normal Chick Heart|Normal Heart]]
| [[Movie_-_Abnormal Chick Heart|Abnormal Heart]]
| [[Movie_-_Abnormal Chick Heart 2|Abnormal Heart 2]]
|-
|}

==Vascular Remodeling==
===Arterial System===
[[File:Gray0474.jpg|thumb|pharyngeal arch arteries]]
* Aortic sac - remodels forming 2 horns, R forms brachiocephalic artery, L forms common carotid artery

Pharyngeal arch arteries
* pharyngeal arch artery 1 and 2 regress
* pharyngeal arch artery 3 and the associated dorsal aorta form the paired internal carotid arteries, these in turn generate the external carotids
* Left pharyngeal arch artery 4 – forms the aortic arch

* paraxial mesoderm forms paired dorsal aorta
** head mesenchyme forms aortic arches
** connecting stalk contains unbilical (placental) arteries
** dorsal aortas give rise to
** vitelline arteries which connect to capillaries on yolk sac
** intersegmental arteries between somites

===Venous System===
Cardinal veins contribute nearly all systemic venous system.

<gallery>
File:Gray0477.jpg
File:Gray0478.jpg
File:Gray0479.jpg
File:Gray0480.jpg
</gallery>

common cardinal veins - ducts of Cuvier

hepatic veins - drain de-oxygenated blood from the liver into the inferior vena cava.

internal iliac vein - hypogastric vein

==Birth Changes==
[[File:Fetal_circulation1.jpg|thumb|Fetal circulation]]
At birth, cutting the umbilical cord and changes in the lungs after the first breaths trigger major functional adaptations in the fetal circulatory system.

* blood flow through ductus venosus is eliminated
* pulmonary circulation bed expands - reducing blood flow through ductus arteriosus
* physiological closure of interatrial shunt
* closure of ductus venosus in liver is prolonged

{| border=1

|-
! Fetal Structure
! Adult Structure
|-
| foramen ovale
| fossa ovalis
|-
| umbilical vein (intra-abdominal part)
| ligamentum teres
|-
| ductus venosus
| ligamentum venosum
|-
| umbilical arteries
| distal part -lateral umbilical ligaments; proximal part - superior vesical artery (supplies bladder)
|-
| ductus arteriosus
| ligamentum arteriosum
|}

==Abnormalities==
There are many different cardiac abnormalities, some more common than others, and only a few will be described in this lecture.

'''Major Abnormalities:''' Aortic Stenosis, Atrial Septal Defects, Coarctation of Aorta, Dextrocardia, Hypoplastic Left Heart, Long QT Syndrome, Patent Ductus Arteriosus, Pulmonary Atresia, Pulmonary Stenosis, Tetralogy of Fallot, Transposition of Great Vessels, Tricuspid Atresia, Total Anomalous Pulmonary Venous Connection, Ventricular Septal Defect, Abnormalities of Conducting System.

Links: [http://embryology.med.unsw.edu.au/Notes/heart2.htm Cardiovascular Development Abnormalities]

[[File:Abnormal81-92-heart.png|thumb]]

[[File:Statistics-Utah heart defects.jpg|thumb]]
===Atrial Septal Defects===

{| border='0px'
|-
| [[File:HeartILP_draft_asd.jpg|Atrial Septal Defect]]
|
* Atrial Septal Defects (ASD) are a group of common (1% of cardiac) congenital anomalies defects occurring in a number of different forms and more often in females.
* patent foramen ovale - allows a continuation of the atrial shunting of blood, in 25% of people a probe patent foramen ovale (allowing a probe to bypassed from one atria to the other) exists.
* ostium secundum defect
* endocardial cushion defect involving ostium primum
* sinus venosus defect - contributes about 10% of all ASDs and occurs mainly in a common and less common form. Common ("usual type") - in upper atrial septum which is contiguous with the superior vena cava. Less common - at junction of the right atrium and inferior vena cava.
* common atrium
|-
|}

===Ventricular Septal Defects===
{| border='0px'
|-
| [[File:HeartILP_draft_vsd.jpg|Ventricular Septal Defect]]
|
* The Ventricular Septal Defect (VSD) usually occurs in the membranous (perimembranous) (70%) rather than muscular interventricular septum, and is more frequent in males that females.
* Perimembranous defects are located close to the aortic and tricuspid valves and adjacent to atrioventricular conduction bundle.
* The defect allows left-right shunting of blood, this shunting depends upon the size of the defect. Small defects may close spontaneously, larger defects result in infant congestive heart failure.
* Clinically repaired by coils or tissue-adapted devices like muscular or perimembranous occluders.
|-
|}
(V.S.D.)

===Patent Ductus Arteriosus===

{| border='0px'

|-
| [[File:HeartILP_draft_patentda.jpg|Patent Ductus Arteriosus]]
|
* Patent Ductus Arteriosus (PDA) occurs commonly in preterm infants, can close spontaneously (by day three in 60% of normal term neonates) the remainder are ligated simply and with little risk.
* The operation is always recommended even in the absence of cardiac failure and can often be deferred until early childhood.

|-
|}

===Tetralogy of Fallot===
{| border='0px'
|-
| [[File:HeartILP_draft_tetralogyoffallot.jpg|Tetralogy of Fallot]]
|
* Named after Etienne-Louis Arthur Fallot (1888) who described it as "la maladie blue" and is a common developmental cardiac defect.
* The syndrome consists of a number of a number of cardiac defects possibly stemming from abnormal neural crest migration. The basic defect in a tetralogy of Fallot is an asymmetrical fusion of the truncoconal ridges and a malalignment of the aortic and pulmonary valves.
|-
|}

==Movies==

{| border='0px'

|-
| [[File:Heart1_looping icon.jpg|90px|link=Development_Animation_-_Heart Looping]]
| [[File:Heart1_realign icon.jpg|90px|link=Development_Animation_-_Heart Realign]]
| [[File:Heart1_atrium icon.jpg|90px|link=Development_Animation_-_Heart Atrial Septation]]
| [[File:heart1 ventricle icon.jpg|90px|link=Development_Animation_-_Heart Outflow Septation]]
|-
| [[Development_Animation_-_Heart Looping|Heart Looping]]
| [[Development_Animation_-_Heart Realign|Heart Realign]]
| [[Development_Animation_-_Heart Atrial Septation|Heart Atrial Septation]]
| [[Development_Animation_-_Heart Outflow Septation|Heart Outflow Septation]]
|-
|}

'''Link:''' [[Flash Movies]]

{{Template:2009ANAT2341}}

[[Category:2009ANAT2341]] [[Category:Science-Undergraduate]]

[[Category:Cardiovascular]] [[Category:Heart]]

2010 Lecture 21

2010-10-10T08:13:56Z

Z3267024:

<div style="background:#F5FFFA; border: 1px solid #CEF2E0; padding: 1em; margin: auto; width: 95%; float:left;"><div style="margin:0;background-color:#cef2e0;font-family:sans-serif;font-size:120%;font-weight:bold;border:1px solid #a3bfb1;text-align:left;color:#000;padding-left:0.4em;padding-top:0.2em;padding-bottom:0.2em;">Lecture Notice - Dr Nalini Pather</div>This online lecture page will contain the content required when attending the lecture. Currently this page is only a template and will be updated before the lecture (this notice removed when completed). Final lecture pages can also be printed out using the "printable version" lefthand menu.</div>

==Introduction==
[[File:Gray0473.gif|300px|right]]

In [[2010 Lecture 7|lecture 7 - Early Vascular Development]], the early development of the cardiovascular system was discussed. This second lecture will now focus on the extensive remodeling that occurs in both the heart and vascular system during later development. In addition, there will be discussion on the major cardiovascular abnormalities. The laboratory this week will also give you the opportunity to work through some of these concepts using a new online teaching module.

This material is also presented in an online [[Cardiac_Embryology|Cardiac Embryology tutorial]].

[[File:Basic_Heart_Development_Timeline.jpg|400px|Link=Cardiac_Embryology]]

{{Template:Heart Links}}

:'''Lecture Audio'''

==Lecture Objectives==
* Describe the development of primary and secondary atrial septa and the ventricular septum.
* Explain the changes occurring in the bulbis cordis and truncus arteriosus in its transformation from a single to a double tube.
* Describe the development of the aortic arches on the right and left sides from the fetus to the adult.
* Describe the development of arteries and veins.
* Describe the major cardiovascular developmental abnormalities.

==Textbook references==

* Human Embryology (3rd ed.) Larson Chapter 7 p151-188 Heart, Chapter 8 p189-228 Vasculature
* The Developing Human: Clinically Oriented Embryology (6th ed.) Chapter 14: p304-349

'''Other textbooks'''
* Before we Are Born (5th ed.) Moore and Persaud Chapter 12; p241-254
* Essentials of Human Embryology Larson Chapter 7 p97-122 Heart, Chapter 8 p123-146 Vasculature
* Human Embryology Fitzgerald and Fitzgerald Chapter 13-17: p77-111

'''Recent reviews'''
* Yutzey KE, Kirby ML. Wherefore heart thou? Embryonic origins of cardiogenic mesoderm. Dev Dyn. 2002 Mar;223(3):307-20. Review. [http://www.ncbi.nlm.nih.gov/pubmed/11891982?dopt=Abstract PMID: 11891982]
* Three-dimensional reconstruction of gene expression patterns during cardiac development. Soufan AT, Ruijter JM, van den Hoff MJ, de Boer PA, Hagoort J, Moorman AF. Physiol Genomics. 2003 May 13;13(3):187-95. Review. [http://www.ncbi.nlm.nih.gov/pubmed/12746463 PMID: 12746463]
* Moorman A, Webb S, Brown NA, Lamers W, Anderson RH. Development of the heart: (1) formation of the cardiac chambers and arterial trunks. Heart. 2003 Jul;89(7):806-14. [http://www.ncbi.nlm.nih.gov/pubmed/12807866?dopt=Abstract PMID: 12807866]
* Bruneau BG. Transcriptional regulation of vertebrate cardiac morphogenesis. Circ Res. 2002 Mar 22;90(5):509-19. Review. [http://www.ncbi.nlm.nih.gov/pubmed/11909814?dopt=Abstract PMID: 11909814]

----

==Heart Development==
[[File:Gray0462.gif|thumb|100px|Day 14 Heart tube]]
[[File:Heart_Tube_Fusion.jpg|400px|Early Human Heart Tube Development]]

* [[E#endocardial tube|endocardial tube]] in [[P#pericardial cavity|pericardial cavity]]
** dorsal mesentry (mesocardial) attachment lost
** attached at cranial (arterial) and caudal (venous) ends
* tube elongation - bending and series of expansions
[[File:Heart-cartoon-001.jpg|thumb|Adult Heart blood flow]]
Bulbus Cordis
* refers to the outflow tract in early embryo
* 3 parts
** distal - forms [[T#truncus arteriosus|truncus arteriosus]] (aorta and pulmonary artery)
** middle - [[C#conus arteriosus|conus arteriosus]] ventricular outflow tract
** proximal - right ventricle trabeculate part

{| border=1

|-
! Fetal Structure
! Adult Structure
|-
| Truncus arteriosus
| aorta
pulmonary trunk
|-
| Conus arteriosus
| right ventricle - smooth part (conus arteriosus)
left ventricle - smooth part (aortic vestibule
|-
| Primitive ventricle
| right ventricle - trabecular part
left ventricle - trabecular part
|-
| Primitive atrium
| right atrium - trabecular part
left atrium - trabecular part
|-
| Sinus venosus
| right atrium - smooth part (sinus venarum)
coronary sinus
oblique vein of left atrium
|}

===Heart Layers===
* '''pericardium''' - covers the heart, formed by 3 layers consisting of a fibrous pericardium and a double layered serous pericardium (parietal layer and visceral epicardium layer).
* '''myocardium''' - muscular wall of the heart, thickest layer formed by spirally arranged cardiac muscle cells.
* '''endocardium''' - lines the heart, epithelial (endothelial) tissue lining the inner surface of heart chambers and valves.

===Embryonic Heart Rate===

* Stage 9-10 2 mm embryo (gestational sac diameter of 20 mm) EHR at least 75 beats / minute
* Stage 11-12 5 mm embryo (gestational sac diameter of 30 mm) EHR at least 100 beats / minute
* Stage 16 10 mm embryo EHR at least 120 beats / minute
* Stage 18 15 mm embryo EHR at least 130 beats / minute

[http://embryology.med.unsw.edu.au/Movies/usound/Hum12wkFHR.htm Week 12 fetal heart rate doppler] [http://embryology.med.unsw.edu.au/Notes/heart8.htm Week 17 fetal heart rate audio]

==Separation of the Atria from the Venticles==
[[File:AV Canal Division.jpg|thumb|100px|Separation of the atrioventricular canal]]
===Endocardial Cushions===
* form initial division of atria and ventricles
* form on dorsal and ventral wall of atrioventcular canals
* grow into canal - meet and fuse to separate atrioventricular canal into right and left channels.

==Atrial Septation==
[[File:Heart1_atrium icon.jpg|90px|link=Development_Animation_-_Heart Atrial Septation]]

[[File:Stage13 C7L.jpg|thumb|Heart (Carnegie stage 13)]]

Through all development blood shunts from right to left atrium (bypass lungs)

===Septum Primum===
[http://embryology.med.unsw.edu.au/wwwpig/pigc/c1l.htm Stage 13 Septum Primum] [http://embryology.med.unsw.edu.au/wwwhuman/lowpower/HumE/E2L.htm Stage 22 Septum Primum]

* dorso-cranial wall, crescentric-shaped membranous extension
* grows downward towards endocardial cushions
* opening is '''foramen primum''' (ostium primum)- serves at a shunt
* a series of perforations develop in cranial end - coalesce to form '''foramen secundum''' (ostium secundum)
* septum primum fuses with endocardial cushions - obliterates foramen primum

===Septum Secundum===
[[File:Gray0467.jpg|thumb|Septum Secundum]]
* crescentric septum secundum begins to form to the right of septum primum
* grows as septum primum downward, does not fuse with endocardial cushion, opening is '''foramen ovale'''
* arrangement of the two septa allows them to act as a one-way valve

===Right Atrium===
[[File:Gray0476.jpg|thumb|sinus venosus and tributaries]]
* with heart looping and formation of interatrial septa, the sinus venosus shifts completely to right atrium
* right sinus horn incorporates into dorsal wall of right atrium
* left sinus horn becomes the coronary sinus
* sinoatrial opening - has 2 flaps, left fuses with septum secundum, right forms valve to inferior vena cava and coronary sinus. [http://embryology.med.unsw.edu.au/wwwpig/pigc/c3l.htm Stage 13 - right venous valve] [http://embryology.med.unsw.edu.au/wwwhuman/lowpower/HumE/E2L.htm Stage 22 - right venous valve]

===Left Atrium===
* posterior wall - outgrowth forms single pulmonary vein, divided into 4 branches
* incorporation into the wall leads to 4 openings in posterior wall
* later moves to the right aligns with atrioventricular canal.

==Ventricular Septation==
[[File:Stage13 C7L.jpg|thumb|Heart (Carnegie stage 13)]]
[[File:Gray0498.jpg|thumb|Ventricular septum]]
[[File:Heart1_realign icon.jpg|90px|link=Development_Animation_-_Heart Realign]]

* 2 separate components - superior membranous, inferior muscular
===Muscular Septum===
[[File:Gray0470.jpg|thumb|muscular septum]]
* growth of inferior wall
* fusion of 3 components - right and left bulbar ridges and dorsal endocardial cushion

===Membranous Septum===
* above the muscular septum, fusion continuous with septation of the outflow tract

[[File:Heart-ventricular-septum-01.jpg‎]][[File:Heart-ventricular-septum-02.jpg‎]][[File:Heart-ventricular-septum-03.jpg‎]]

==Outflow Tract Septation==

[[File:heart1 ventricle icon.jpg|90px|link=Development_Animation_-_Heart Outflow Septation]]

* in early development, outflow tract is a single tube, bulbus cordis
* elongates to form proximal conus arteriosus and distal truncus arteriosus
* 2 growths from wall in spiral pattern, inferior upwards - separate tract into 2 channels [http://embryology.med.unsw.edu.au/wwwpig/pigb/b5l.htm Stage 13 truncus arteriousus]
* mesenchyme and neural crest contribute to this septation process
* fusion of outgrowths separate aortic and pulmonary outflow

{| border='0px'

|-
| [[File:Chick_Heart_001-icon.jpg|90px|link=Movie_-_Normal Chick Heart]]
| [[File:Chick_Heart_002-icon.jpg|90px|link=Movie_-_Abnormal Chick Heart]]
| [[File:Chick_Heart_002-icon.jpg|90px|link=Movie_-_Abnormal Chick Heart 2]]
|-
| [[Movie_-_Normal Chick Heart|Normal Heart]]
| [[Movie_-_Abnormal Chick Heart|Abnormal Heart]]
| [[Movie_-_Abnormal Chick Heart 2|Abnormal Heart 2]]
|-
|}

==Vascular Remodeling==
===Arterial System===
[[File:Gray0474.jpg|thumb|pharyngeal arch arteries]]
* Aortic sac - remodels forming 2 horns, R forms brachiocephalic artery, L forms common carotid artery

Pharyngeal arch arteries
* pharyngeal arch artery 1 and 2 regress
* pharyngeal arch artery 3 and the associated dorsal aorta form the paired internal carotid arteries, these in turn generate the external carotids
* Left pharyngeal arch artery 4 – forms the aortic arch

* paraxial mesoderm forms paired dorsal aorta
** head mesenchyme forms aortic arches
** connecting stalk contains unbilical (placental) arteries
** dorsal aortas give rise to
** vitelline arteries which connect to capillaries on yolk sac
** intersegmental arteries between somites

===Venous System===
Cardinal veins contribute nearly all systemic venous system.

<gallery>
File:Gray0477.jpg
File:Gray0478.jpg
File:Gray0479.jpg
File:Gray0480.jpg
</gallery>

common cardinal veins - ducts of Cuvier

hepatic veins - drain de-oxygenated blood from the liver into the inferior vena cava.

internal iliac vein - hypogastric vein

==Birth Changes==
[[File:Fetal_circulation1.jpg|thumb|Fetal circulation]]
At birth, cutting the umbilical cord and changes in the lungs after the first breaths trigger major functional adaptations in the fetal circulatory system.

* blood flow through ductus venosus is eliminated
* pulmonary circulation bed expands - reducing blood flow through ductus arteriosus
* physiological closure of interatrial shunt
* closure of ductus venosus in liver is prolonged

{| border=1

|-
! Fetal Structure
! Adult Structure
|-
| foramen ovale
| fossa ovalis
|-
| umbilical vein (intra-abdominal part)
| ligamentum teres
|-
| ductus venosus
| ligamentum venosum
|-
| umbilical arteries
| distal part -lateral umbilical ligaments; proximal part - superior vesical artery (supplies bladder)
|-
| ductus arteriosus
| ligamentum arteriosum
|}

==Abnormalities==
There are many different cardiac abnormalities, some more common than others, and only a few will be described in this lecture.

'''Major Abnormalities:''' Aortic Stenosis, Atrial Septal Defects, Coarctation of Aorta, Dextrocardia, Hypoplastic Left Heart, Long QT Syndrome, Patent Ductus Arteriosus, Pulmonary Atresia, Pulmonary Stenosis, Tetralogy of Fallot, Transposition of Great Vessels, Tricuspid Atresia, Total Anomalous Pulmonary Venous Connection, Ventricular Septal Defect, Abnormalities of Conducting System.

Links: [http://embryology.med.unsw.edu.au/Notes/heart2.htm Cardiovascular Development Abnormalities]

[[File:Abnormal81-92-heart.png|thumb]]

[[File:Statistics-Utah heart defects.jpg|thumb]]
===Atrial Septal Defects===

{| border='0px'
|-
| [[File:HeartILP_draft_asd.jpg|Atrial Septal Defect]]
|
* Atrial Septal Defects (ASD) are a group of common (1% of cardiac) congenital anomalies defects occurring in a number of different forms and more often in females.
* patent foramen ovale - allows a continuation of the atrial shunting of blood, in 25% of people a probe patent foramen ovale (allowing a probe to bypassed from one atria to the other) exists.
* ostium secundum defect
* endocardial cushion defect involving ostium primum
* sinus venosus defect - contributes about 10% of all ASDs and occurs mainly in a common and less common form. Common ("usual type") - in upper atrial septum which is contiguous with the superior vena cava. Less common - at junction of the right atrium and inferior vena cava.
* common atrium
|-
|}

===Ventricular Septal Defects===
{| border='0px'
|-
| [[File:HeartILP_draft_vsd.jpg|Ventricular Septal Defect]]
|
* The Ventricular Septal Defect (VSD) usually occurs in the membranous (perimembranous) (70%) rather than muscular interventricular septum, and is more frequent in males that females.
* Perimembranous defects are located close to the aortic and tricuspid valves and adjacent to atrioventricular conduction bundle.
* The defect allows left-right shunting of blood, this shunting depends upon the size of the defect. Small defects may close spontaneously, larger defects result in infant congestive heart failure.
* Clinically repaired by coils or tissue-adapted devices like muscular or perimembranous occluders.
|-
|}
(V.S.D.)

===Patent Ductus Arteriosus===

{| border='0px'

|-
| [[File:HeartILP_draft_patentda.jpg|Patent Ductus Arteriosus]]
|
* Patent Ductus Arteriosus (PDA) occurs commonly in preterm infants, can close spontaneously (by day three in 60% of normal term neonates) the remainder are ligated simply and with little risk.
* The operation is always recommended even in the absence of cardiac failure and can often be deferred until early childhood.

|-
|}

===Tetralogy of Fallot===
{| border='0px'
|-
| [[File:HeartILP_draft_tetralogyoffallot.jpg|Tetralogy of Fallot]]
|
* Named after Etienne-Louis Arthur Fallot (1888) who described it as "la maladie blue" and is a common developmental cardiac defect.
* The syndrome consists of a number of a number of cardiac defects possibly stemming from abnormal neural crest migration. The basic defect in a tetralogy of Fallot is an asymmetrical fusion of the truncoconal ridges and a malalignment of the aortic and pulmonary valves.
|-
|}

==Movies==

{| border='0px'

|-
| [[File:Heart1_looping icon.jpg|90px|link=Development_Animation_-_Heart Looping]]
| [[File:Heart1_realign icon.jpg|90px|link=Development_Animation_-_Heart Realign]]
| [[File:Heart1_atrium icon.jpg|90px|link=Development_Animation_-_Heart Atrial Septation]]
| [[File:heart1 ventricle icon.jpg|90px|link=Development_Animation_-_Heart Outflow Septation]]
|-
| [[Development_Animation_-_Heart Looping|Heart Looping]]
| [[Development_Animation_-_Heart Realign|Heart Realign]]
| [[Development_Animation_-_Heart Atrial Septation|Heart Atrial Septation]]
| [[Development_Animation_-_Heart Outflow Septation|Heart Outflow Septation]]
|-
|}

'''Link:''' [[Flash Movies]]

{{Template:2009ANAT2341}}

[[Category:2009ANAT2341]] [[Category:Science-Undergraduate]]

[[Category:Cardiovascular]] [[Category:Heart]]

2010 Lecture 21

2010-10-10T08:05:47Z

Z3267024: /* Heart Development */

<div style="background:#F5FFFA; border: 1px solid #CEF2E0; padding: 1em; margin: auto; width: 95%; float:left;"><div style="margin:0;background-color:#cef2e0;font-family:sans-serif;font-size:120%;font-weight:bold;border:1px solid #a3bfb1;text-align:left;color:#000;padding-left:0.4em;padding-top:0.2em;padding-bottom:0.2em;">Lecture Notice - Dr Nalini Pather</div>This online lecture page will contain the content required when attending the lecture. Currently this page is only a template and will be updated before the lecture (this notice removed when completed). Final lecture pages can also be printed out using the "printable version" lefthand menu.</div>

==Introduction==
[[File:Gray0473.gif|300px|right]]

In [[2010 Lecture 7|lecture 7 - Early Vascular Development]], the early development of the cardiovascular system was discussed. This second lecture will now focus on the extensive remodeling that occurs in both the heart and vascular system during later development. In addition, there will be discussion on the major cardiovascular abnormalities. The laboratory this week will also give you the opportunity to work through some of these concepts using a new online teaching module.

This material is also presented in an online [[Cardiac_Embryology|Cardiac Embryology tutorial]].

[[File:Basic_Heart_Development_Timeline.jpg|400px|Link=Cardiac_Embryology]]

{{Template:Heart Links}}

:'''Lecture Audio'''

==Lecture Objectives==
* Describe the development of primary and secondary atrial septa and the ventricular septum.
* Explain the changes occurring in the bulbis cordis and truncus arteriosus in its transformation from a single to a double tube.
* Describe the development of the aortic arches on the right and left sides from the fetus to the adult.
* Describe the development of arteries and veins.
* Describe the major cardiovascular developmental abnormalities.

==Textbook references==

* Human Embryology (3rd ed.) Larson Chapter 7 p151-188 Heart, Chapter 8 p189-228 Vasculature
* The Developing Human: Clinically Oriented Embryology (6th ed.) Chapter 14: p304-349

'''Other textbooks'''
* Before we Are Born (5th ed.) Moore and Persaud Chapter 12; p241-254
* Essentials of Human Embryology Larson Chapter 7 p97-122 Heart, Chapter 8 p123-146 Vasculature
* Human Embryology Fitzgerald and Fitzgerald Chapter 13-17: p77-111

'''Recent reviews'''
* Yutzey KE, Kirby ML. Wherefore heart thou? Embryonic origins of cardiogenic mesoderm. Dev Dyn. 2002 Mar;223(3):307-20. Review. [http://www.ncbi.nlm.nih.gov/pubmed/11891982?dopt=Abstract PMID: 11891982]
* Three-dimensional reconstruction of gene expression patterns during cardiac development. Soufan AT, Ruijter JM, van den Hoff MJ, de Boer PA, Hagoort J, Moorman AF. Physiol Genomics. 2003 May 13;13(3):187-95. Review. [http://www.ncbi.nlm.nih.gov/pubmed/12746463 PMID: 12746463]
* Moorman A, Webb S, Brown NA, Lamers W, Anderson RH. Development of the heart: (1) formation of the cardiac chambers and arterial trunks. Heart. 2003 Jul;89(7):806-14. [http://www.ncbi.nlm.nih.gov/pubmed/12807866?dopt=Abstract PMID: 12807866]
* Bruneau BG. Transcriptional regulation of vertebrate cardiac morphogenesis. Circ Res. 2002 Mar 22;90(5):509-19. Review. [http://www.ncbi.nlm.nih.gov/pubmed/11909814?dopt=Abstract PMID: 11909814]

----

==Heart Development==
[[File:Gray0462.gif|thumb|100px|Day 14 Heart tube]]
[[File:Heart_Tube_Fusion.jpg|400px|Early Human Heart Tube Development]]

* [[E#endocardial tube|endocardial tube]] in [[P#pericardial cavity|pericardial cavity]]
** dorsal mesentry (mesocardial) attachment lost
** attached at cranial (arterial) and caudal (venous) ends
* tube elongation - bending and series of expansions
[[File:Heart-cartoon-001.jpg|thumb|Adult Heart blood flow]]
Bulbus Cordis
* refers to the outflow tract in early embryo
* 3 parts
** distal - forms [[T#truncus arteriosus|truncus arteriosus]] (aorta and pulmonary artery)
** middle - [[C#conus arteriosus|conus arteriosus]] ventricular outflow tract
** proximal - right ventricle trabeculate part

{| border=1

|-
! Fetal Structure
! Adult Structure
|-
| Truncus arteriosus
| aorta
pulmonary trunk
|-
| Conus arteriosus
| right ventricle - smooth part (conus arteriosus)
left ventricle - smooth part (aortic vestibule
|-
| Primitive ventricle
| right ventricle - trabecular part
left ventricle - trabecular part
|-
| Primitive atrium
| right atrium - trabecular part
left atrium - trabecular part
|-
| Sinus venosus
| right atrium - smooth part (sinus venarum)
coronary sinus
oblique vein of left atrium
|}

===Heart Layers===
* '''pericardium''' - covers the heart, formed by 3 layers consisting of a fibrous pericardium and a double layered serous pericardium (parietal layer and visceral epicardium layer).
* '''myocardium''' - muscular wall of the heart, thickest layer formed by spirally arranged cardiac muscle cells.
* '''endocardium''' - lines the heart, epithelial (endothelial) tissue lining the inner surface of heart chambers and valves.

===Embryonic Heart Rate===

* Stage 9-10 2 mm embryo (gestational sac diameter of 20 mm) EHR at least 75 beats / minute
* Stage 11-12 5 mm embryo (gestational sac diameter of 30 mm) EHR at least 100 beats / minute
* Stage 16 10 mm embryo EHR at least 120 beats / minute
* Stage 18 15 mm embryo EHR at least 130 beats / minute

[http://embryology.med.unsw.edu.au/Movies/usound/Hum12wkFHR.htm Week 12 fetal heart rate doppler] [http://embryology.med.unsw.edu.au/Notes/heart8.htm Week 17 fetal heart rate audio]

==Separation of the Atria from the Venticles==

===Endocardial Cushions===
* form initial division of atria and ventricles
* form on dorsal and ventral wall of atrioventcular canals
* grow into canal - meet and fuse to separate atrioventricular canal into right and left channels.

==Atrial Septation==
[[File:Heart1_atrium icon.jpg|90px|link=Development_Animation_-_Heart Atrial Septation]]

[[File:Stage13 C7L.jpg|thumb|Heart (Carnegie stage 13)]]

Through all development blood shunts from right to left atrium (bypass lungs)

===Septum Primum===
[http://embryology.med.unsw.edu.au/wwwpig/pigc/c1l.htm Stage 13 Septum Primum] [http://embryology.med.unsw.edu.au/wwwhuman/lowpower/HumE/E2L.htm Stage 22 Septum Primum]

* dorso-cranial wall, crescentric-shaped membranous extension
* grows downward towards endocardial cushions
* opening is '''foramen primum''' (ostium primum)- serves at a shunt
* a series of perforations develop in cranial end - coalesce to form '''foramen secundum''' (ostium secundum)
* septum primum fuses with endocardial cushions - obliterates foramen primum

===Septum Secundum===
[[File:Gray0467.jpg|thumb|Septum Secundum]]
* crescentric septum secundum begins to form to the right of septum primum
* grows as septum primum downward, does not fuse with endocardial cushion, opening is '''foramen ovale'''
* arrangement of the two septa allows them to act as a one-way valve

===Right Atrium===
[[File:Gray0476.jpg|thumb|sinus venosus and tributaries]]
* with heart looping and formation of interatrial septa, the sinus venosus shifts completely to right atrium
* right sinus horn incorporates into dorsal wall of right atrium
* left sinus horn becomes the coronary sinus
* sinoatrial opening - has 2 flaps, left fuses with septum secundum, right forms valve to inferior vena cava and coronary sinus. [http://embryology.med.unsw.edu.au/wwwpig/pigc/c3l.htm Stage 13 - right venous valve] [http://embryology.med.unsw.edu.au/wwwhuman/lowpower/HumE/E2L.htm Stage 22 - right venous valve]

===Left Atrium===
* posterior wall - outgrowth forms single pulmonary vein, divided into 4 branches
* incorporation into the wall leads to 4 openings in posterior wall
* later moves to the right aligns with atrioventricular canal.

==Ventricular Septation==
[[File:Stage13 C7L.jpg|thumb|Heart (Carnegie stage 13)]]
[[File:Gray0498.jpg|thumb|Ventricular septum]]
[[File:Heart1_realign icon.jpg|90px|link=Development_Animation_-_Heart Realign]]

* 2 separate components - superior membranous, inferior muscular
===Muscular Septum===
[[File:Gray0470.jpg|thumb|muscular septum]]
* growth of inferior wall
* fusion of 3 components - right and left bulbar ridges and dorsal endocardial cushion

===Membranous Septum===
* above the muscular septum, fusion continuous with septation of the outflow tract

[[File:Heart-ventricular-septum-01.jpg‎]][[File:Heart-ventricular-septum-02.jpg‎]][[File:Heart-ventricular-septum-03.jpg‎]]

==Outflow Tract Septation==

[[File:heart1 ventricle icon.jpg|90px|link=Development_Animation_-_Heart Outflow Septation]]

* in early development, outflow tract is a single tube, bulbus cordis
* elongates to form proximal conus arteriosus and distal truncus arteriosus
* 2 growths from wall in spiral pattern, inferior upwards - separate tract into 2 channels [http://embryology.med.unsw.edu.au/wwwpig/pigb/b5l.htm Stage 13 truncus arteriousus]
* mesenchyme and neural crest contribute to this septation process
* fusion of outgrowths separate aortic and pulmonary outflow

{| border='0px'

|-
| [[File:Chick_Heart_001-icon.jpg|90px|link=Movie_-_Normal Chick Heart]]
| [[File:Chick_Heart_002-icon.jpg|90px|link=Movie_-_Abnormal Chick Heart]]
| [[File:Chick_Heart_002-icon.jpg|90px|link=Movie_-_Abnormal Chick Heart 2]]
|-
| [[Movie_-_Normal Chick Heart|Normal Heart]]
| [[Movie_-_Abnormal Chick Heart|Abnormal Heart]]
| [[Movie_-_Abnormal Chick Heart 2|Abnormal Heart 2]]
|-
|}

==Vascular Remodeling==
===Arterial System===
[[File:Gray0474.jpg|thumb|pharyngeal arch arteries]]
* Aortic sac - remodels forming 2 horns, R forms brachiocephalic artery, L forms common carotid artery

Pharyngeal arch arteries
* pharyngeal arch artery 1 and 2 regress
* pharyngeal arch artery 3 and the associated dorsal aorta form the paired internal carotid arteries, these in turn generate the external carotids
* Left pharyngeal arch artery 4 – forms the aortic arch

* paraxial mesoderm forms paired dorsal aorta
** head mesenchyme forms aortic arches
** connecting stalk contains unbilical (placental) arteries
** dorsal aortas give rise to
** vitelline arteries which connect to capillaries on yolk sac
** intersegmental arteries between somites

===Venous System===
Cardinal veins contribute nearly all systemic venous system.

<gallery>
File:Gray0477.jpg
File:Gray0478.jpg
File:Gray0479.jpg
File:Gray0480.jpg
</gallery>

common cardinal veins - ducts of Cuvier

hepatic veins - drain de-oxygenated blood from the liver into the inferior vena cava.

internal iliac vein - hypogastric vein

==Birth Changes==
[[File:Fetal_circulation1.jpg|thumb|Fetal circulation]]
At birth, cutting the umbilical cord and changes in the lungs after the first breaths trigger major functional adaptations in the fetal circulatory system.

* blood flow through ductus venosus is eliminated
* pulmonary circulation bed expands - reducing blood flow through ductus arteriosus
* physiological closure of interatrial shunt
* closure of ductus venosus in liver is prolonged

{| border=1

|-
! Fetal Structure
! Adult Structure
|-
| foramen ovale
| fossa ovalis
|-
| umbilical vein (intra-abdominal part)
| ligamentum teres
|-
| ductus venosus
| ligamentum venosum
|-
| umbilical arteries
| distal part -lateral umbilical ligaments; proximal part - superior vesical artery (supplies bladder)
|-
| ductus arteriosus
| ligamentum arteriosum
|}

==Abnormalities==
There are many different cardiac abnormalities, some more common than others, and only a few will be described in this lecture.

'''Major Abnormalities:''' Aortic Stenosis, Atrial Septal Defects, Coarctation of Aorta, Dextrocardia, Hypoplastic Left Heart, Long QT Syndrome, Patent Ductus Arteriosus, Pulmonary Atresia, Pulmonary Stenosis, Tetralogy of Fallot, Transposition of Great Vessels, Tricuspid Atresia, Total Anomalous Pulmonary Venous Connection, Ventricular Septal Defect, Abnormalities of Conducting System.

Links: [http://embryology.med.unsw.edu.au/Notes/heart2.htm Cardiovascular Development Abnormalities]

[[File:Abnormal81-92-heart.png|thumb]]

[[File:Statistics-Utah heart defects.jpg|thumb]]
===Atrial Septal Defects===

{| border='0px'
|-
| [[File:HeartILP_draft_asd.jpg|Atrial Septal Defect]]
|
* Atrial Septal Defects (ASD) are a group of common (1% of cardiac) congenital anomalies defects occurring in a number of different forms and more often in females.
* patent foramen ovale - allows a continuation of the atrial shunting of blood, in 25% of people a probe patent foramen ovale (allowing a probe to bypassed from one atria to the other) exists.
* ostium secundum defect
* endocardial cushion defect involving ostium primum
* sinus venosus defect - contributes about 10% of all ASDs and occurs mainly in a common and less common form. Common ("usual type") - in upper atrial septum which is contiguous with the superior vena cava. Less common - at junction of the right atrium and inferior vena cava.
* common atrium
|-
|}

===Ventricular Septal Defects===
{| border='0px'
|-
| [[File:HeartILP_draft_vsd.jpg|Ventricular Septal Defect]]
|
* The Ventricular Septal Defect (VSD) usually occurs in the membranous (perimembranous) (70%) rather than muscular interventricular septum, and is more frequent in males that females.
* Perimembranous defects are located close to the aortic and tricuspid valves and adjacent to atrioventricular conduction bundle.
* The defect allows left-right shunting of blood, this shunting depends upon the size of the defect. Small defects may close spontaneously, larger defects result in infant congestive heart failure.
* Clinically repaired by coils or tissue-adapted devices like muscular or perimembranous occluders.
|-
|}
(V.S.D.)

===Patent Ductus Arteriosus===

{| border='0px'

|-
| [[File:HeartILP_draft_patentda.jpg|Patent Ductus Arteriosus]]
|
* Patent Ductus Arteriosus (PDA) occurs commonly in preterm infants, can close spontaneously (by day three in 60% of normal term neonates) the remainder are ligated simply and with little risk.
* The operation is always recommended even in the absence of cardiac failure and can often be deferred until early childhood.

|-
|}

===Tetralogy of Fallot===
{| border='0px'
|-
| [[File:HeartILP_draft_tetralogyoffallot.jpg|Tetralogy of Fallot]]
|
* Named after Etienne-Louis Arthur Fallot (1888) who described it as "la maladie blue" and is a common developmental cardiac defect.
* The syndrome consists of a number of a number of cardiac defects possibly stemming from abnormal neural crest migration. The basic defect in a tetralogy of Fallot is an asymmetrical fusion of the truncoconal ridges and a malalignment of the aortic and pulmonary valves.
|-
|}

==Movies==

{| border='0px'

|-
| [[File:Heart1_looping icon.jpg|90px|link=Development_Animation_-_Heart Looping]]
| [[File:Heart1_realign icon.jpg|90px|link=Development_Animation_-_Heart Realign]]
| [[File:Heart1_atrium icon.jpg|90px|link=Development_Animation_-_Heart Atrial Septation]]
| [[File:heart1 ventricle icon.jpg|90px|link=Development_Animation_-_Heart Outflow Septation]]
|-
| [[Development_Animation_-_Heart Looping|Heart Looping]]
| [[Development_Animation_-_Heart Realign|Heart Realign]]
| [[Development_Animation_-_Heart Atrial Septation|Heart Atrial Septation]]
| [[Development_Animation_-_Heart Outflow Septation|Heart Outflow Septation]]
|-
|}

'''Link:''' [[Flash Movies]]

{{Template:2009ANAT2341}}

[[Category:2009ANAT2341]] [[Category:Science-Undergraduate]]

[[Category:Cardiovascular]] [[Category:Heart]]

2010 Lecture 21

2010-10-10T08:04:00Z

Z3267024:

<div style="background:#F5FFFA; border: 1px solid #CEF2E0; padding: 1em; margin: auto; width: 95%; float:left;"><div style="margin:0;background-color:#cef2e0;font-family:sans-serif;font-size:120%;font-weight:bold;border:1px solid #a3bfb1;text-align:left;color:#000;padding-left:0.4em;padding-top:0.2em;padding-bottom:0.2em;">Lecture Notice - Dr Nalini Pather</div>This online lecture page will contain the content required when attending the lecture. Currently this page is only a template and will be updated before the lecture (this notice removed when completed). Final lecture pages can also be printed out using the "printable version" lefthand menu.</div>

==Introduction==
[[File:Gray0473.gif|300px|right]]

In [[2010 Lecture 7|lecture 7 - Early Vascular Development]], the early development of the cardiovascular system was discussed. This second lecture will now focus on the extensive remodeling that occurs in both the heart and vascular system during later development. In addition, there will be discussion on the major cardiovascular abnormalities. The laboratory this week will also give you the opportunity to work through some of these concepts using a new online teaching module.

This material is also presented in an online [[Cardiac_Embryology|Cardiac Embryology tutorial]].

[[File:Basic_Heart_Development_Timeline.jpg|400px|Link=Cardiac_Embryology]]

{{Template:Heart Links}}

:'''Lecture Audio'''

==Lecture Objectives==
* Describe the development of primary and secondary atrial septa and the ventricular septum.
* Explain the changes occurring in the bulbis cordis and truncus arteriosus in its transformation from a single to a double tube.
* Describe the development of the aortic arches on the right and left sides from the fetus to the adult.
* Describe the development of arteries and veins.
* Describe the major cardiovascular developmental abnormalities.

==Textbook references==

* Human Embryology (3rd ed.) Larson Chapter 7 p151-188 Heart, Chapter 8 p189-228 Vasculature
* The Developing Human: Clinically Oriented Embryology (6th ed.) Chapter 14: p304-349

'''Other textbooks'''
* Before we Are Born (5th ed.) Moore and Persaud Chapter 12; p241-254
* Essentials of Human Embryology Larson Chapter 7 p97-122 Heart, Chapter 8 p123-146 Vasculature
* Human Embryology Fitzgerald and Fitzgerald Chapter 13-17: p77-111

'''Recent reviews'''
* Yutzey KE, Kirby ML. Wherefore heart thou? Embryonic origins of cardiogenic mesoderm. Dev Dyn. 2002 Mar;223(3):307-20. Review. [http://www.ncbi.nlm.nih.gov/pubmed/11891982?dopt=Abstract PMID: 11891982]
* Three-dimensional reconstruction of gene expression patterns during cardiac development. Soufan AT, Ruijter JM, van den Hoff MJ, de Boer PA, Hagoort J, Moorman AF. Physiol Genomics. 2003 May 13;13(3):187-95. Review. [http://www.ncbi.nlm.nih.gov/pubmed/12746463 PMID: 12746463]
* Moorman A, Webb S, Brown NA, Lamers W, Anderson RH. Development of the heart: (1) formation of the cardiac chambers and arterial trunks. Heart. 2003 Jul;89(7):806-14. [http://www.ncbi.nlm.nih.gov/pubmed/12807866?dopt=Abstract PMID: 12807866]
* Bruneau BG. Transcriptional regulation of vertebrate cardiac morphogenesis. Circ Res. 2002 Mar 22;90(5):509-19. Review. [http://www.ncbi.nlm.nih.gov/pubmed/11909814?dopt=Abstract PMID: 11909814]

----

==Heart Development==
[[File:Gray0462.gif|thumb|100px|Day 14 Heart tube]]
[[File:Heart_Tube_Fusion.jpg|400px|Early Human Heart Tube Development]]

* [[E#endocardial tube|endocardial tube]] in [[P#pericardial cavity|pericardial cavity]]
** dorsal mesentry (mesocardial) attachment lost
** attached at cranial (arterial) and caudal (venous) ends
* tube elongation - bending and series of expansions
[[File:Heart-cartoon-001.jpg|thumb|Adult Heart blood flow]]
Bulbus Cordis
* refers to the outflow tract in early embryo
* 3 parts
** distal - forms [[T#truncus arteriosus|truncus arteriosus]] (aorta and pulmonary artery)
** middle - [[C#conus arteriosus|conus arteriosus]] ventricular outflow tract
** proximal - right ventricle trabeculate part

{| border=1

|-
! Fetal Structure
! Adult Structure
|-
| Truncus arteriosus
| aorta
pulmonary trunk
|-
| Bulbus cordis
| right ventricle - smooth part (conus arteriosus)
left ventricle - smooth part (aortic vestibule
|-
| Primitive ventricle
| right ventricle - trabecular part
left ventricle - trabecular part
|-
| Primitive atrium
| right atrium - trabecular part
left atrium - trabecular part
|-
| Sinus venosus
| right atrium - smooth part (sinus venarum)
coronary sinus
oblique vein of left atrium
|}

===Heart Layers===
* '''pericardium''' - covers the heart, formed by 3 layers consisting of a fibrous pericardium and a double layered serous pericardium (parietal layer and visceral epicardium layer).
* '''myocardium''' - muscular wall of the heart, thickest layer formed by spirally arranged cardiac muscle cells.
* '''endocardium''' - lines the heart, epithelial (endothelial) tissue lining the inner surface of heart chambers and valves.

===Embryonic Heart Rate===

* Stage 9-10 2 mm embryo (gestational sac diameter of 20 mm) EHR at least 75 beats / minute
* Stage 11-12 5 mm embryo (gestational sac diameter of 30 mm) EHR at least 100 beats / minute
* Stage 16 10 mm embryo EHR at least 120 beats / minute
* Stage 18 15 mm embryo EHR at least 130 beats / minute

[http://embryology.med.unsw.edu.au/Movies/usound/Hum12wkFHR.htm Week 12 fetal heart rate doppler] [http://embryology.med.unsw.edu.au/Notes/heart8.htm Week 17 fetal heart rate audio]

==Separation of the Atria from the Venticles==

===Endocardial Cushions===
* form initial division of atria and ventricles
* form on dorsal and ventral wall of atrioventcular canals
* grow into canal - meet and fuse to separate atrioventricular canal into right and left channels.

==Atrial Septation==
[[File:Heart1_atrium icon.jpg|90px|link=Development_Animation_-_Heart Atrial Septation]]

[[File:Stage13 C7L.jpg|thumb|Heart (Carnegie stage 13)]]

Through all development blood shunts from right to left atrium (bypass lungs)

===Septum Primum===
[http://embryology.med.unsw.edu.au/wwwpig/pigc/c1l.htm Stage 13 Septum Primum] [http://embryology.med.unsw.edu.au/wwwhuman/lowpower/HumE/E2L.htm Stage 22 Septum Primum]

* dorso-cranial wall, crescentric-shaped membranous extension
* grows downward towards endocardial cushions
* opening is '''foramen primum''' (ostium primum)- serves at a shunt
* a series of perforations develop in cranial end - coalesce to form '''foramen secundum''' (ostium secundum)
* septum primum fuses with endocardial cushions - obliterates foramen primum

===Septum Secundum===
[[File:Gray0467.jpg|thumb|Septum Secundum]]
* crescentric septum secundum begins to form to the right of septum primum
* grows as septum primum downward, does not fuse with endocardial cushion, opening is '''foramen ovale'''
* arrangement of the two septa allows them to act as a one-way valve

===Right Atrium===
[[File:Gray0476.jpg|thumb|sinus venosus and tributaries]]
* with heart looping and formation of interatrial septa, the sinus venosus shifts completely to right atrium
* right sinus horn incorporates into dorsal wall of right atrium
* left sinus horn becomes the coronary sinus
* sinoatrial opening - has 2 flaps, left fuses with septum secundum, right forms valve to inferior vena cava and coronary sinus. [http://embryology.med.unsw.edu.au/wwwpig/pigc/c3l.htm Stage 13 - right venous valve] [http://embryology.med.unsw.edu.au/wwwhuman/lowpower/HumE/E2L.htm Stage 22 - right venous valve]

===Left Atrium===
* posterior wall - outgrowth forms single pulmonary vein, divided into 4 branches
* incorporation into the wall leads to 4 openings in posterior wall
* later moves to the right aligns with atrioventricular canal.

==Ventricular Septation==
[[File:Stage13 C7L.jpg|thumb|Heart (Carnegie stage 13)]]
[[File:Gray0498.jpg|thumb|Ventricular septum]]
[[File:Heart1_realign icon.jpg|90px|link=Development_Animation_-_Heart Realign]]

* 2 separate components - superior membranous, inferior muscular
===Muscular Septum===
[[File:Gray0470.jpg|thumb|muscular septum]]
* growth of inferior wall
* fusion of 3 components - right and left bulbar ridges and dorsal endocardial cushion

===Membranous Septum===
* above the muscular septum, fusion continuous with septation of the outflow tract

[[File:Heart-ventricular-septum-01.jpg‎]][[File:Heart-ventricular-septum-02.jpg‎]][[File:Heart-ventricular-septum-03.jpg‎]]

==Outflow Tract Septation==

[[File:heart1 ventricle icon.jpg|90px|link=Development_Animation_-_Heart Outflow Septation]]

* in early development, outflow tract is a single tube, bulbus cordis
* elongates to form proximal conus arteriosus and distal truncus arteriosus
* 2 growths from wall in spiral pattern, inferior upwards - separate tract into 2 channels [http://embryology.med.unsw.edu.au/wwwpig/pigb/b5l.htm Stage 13 truncus arteriousus]
* mesenchyme and neural crest contribute to this septation process
* fusion of outgrowths separate aortic and pulmonary outflow

{| border='0px'

|-
| [[File:Chick_Heart_001-icon.jpg|90px|link=Movie_-_Normal Chick Heart]]
| [[File:Chick_Heart_002-icon.jpg|90px|link=Movie_-_Abnormal Chick Heart]]
| [[File:Chick_Heart_002-icon.jpg|90px|link=Movie_-_Abnormal Chick Heart 2]]
|-
| [[Movie_-_Normal Chick Heart|Normal Heart]]
| [[Movie_-_Abnormal Chick Heart|Abnormal Heart]]
| [[Movie_-_Abnormal Chick Heart 2|Abnormal Heart 2]]
|-
|}

==Vascular Remodeling==
===Arterial System===
[[File:Gray0474.jpg|thumb|pharyngeal arch arteries]]
* Aortic sac - remodels forming 2 horns, R forms brachiocephalic artery, L forms common carotid artery

Pharyngeal arch arteries
* pharyngeal arch artery 1 and 2 regress
* pharyngeal arch artery 3 and the associated dorsal aorta form the paired internal carotid arteries, these in turn generate the external carotids
* Left pharyngeal arch artery 4 – forms the aortic arch

* paraxial mesoderm forms paired dorsal aorta
** head mesenchyme forms aortic arches
** connecting stalk contains unbilical (placental) arteries
** dorsal aortas give rise to
** vitelline arteries which connect to capillaries on yolk sac
** intersegmental arteries between somites

===Venous System===
Cardinal veins contribute nearly all systemic venous system.

<gallery>
File:Gray0477.jpg
File:Gray0478.jpg
File:Gray0479.jpg
File:Gray0480.jpg
</gallery>

common cardinal veins - ducts of Cuvier

hepatic veins - drain de-oxygenated blood from the liver into the inferior vena cava.

internal iliac vein - hypogastric vein

==Birth Changes==
[[File:Fetal_circulation1.jpg|thumb|Fetal circulation]]
At birth, cutting the umbilical cord and changes in the lungs after the first breaths trigger major functional adaptations in the fetal circulatory system.

* blood flow through ductus venosus is eliminated
* pulmonary circulation bed expands - reducing blood flow through ductus arteriosus
* physiological closure of interatrial shunt
* closure of ductus venosus in liver is prolonged

{| border=1

|-
! Fetal Structure
! Adult Structure
|-
| foramen ovale
| fossa ovalis
|-
| umbilical vein (intra-abdominal part)
| ligamentum teres
|-
| ductus venosus
| ligamentum venosum
|-
| umbilical arteries
| distal part -lateral umbilical ligaments; proximal part - superior vesical artery (supplies bladder)
|-
| ductus arteriosus
| ligamentum arteriosum
|}

==Abnormalities==
There are many different cardiac abnormalities, some more common than others, and only a few will be described in this lecture.

'''Major Abnormalities:''' Aortic Stenosis, Atrial Septal Defects, Coarctation of Aorta, Dextrocardia, Hypoplastic Left Heart, Long QT Syndrome, Patent Ductus Arteriosus, Pulmonary Atresia, Pulmonary Stenosis, Tetralogy of Fallot, Transposition of Great Vessels, Tricuspid Atresia, Total Anomalous Pulmonary Venous Connection, Ventricular Septal Defect, Abnormalities of Conducting System.

Links: [http://embryology.med.unsw.edu.au/Notes/heart2.htm Cardiovascular Development Abnormalities]

[[File:Abnormal81-92-heart.png|thumb]]

[[File:Statistics-Utah heart defects.jpg|thumb]]
===Atrial Septal Defects===

{| border='0px'
|-
| [[File:HeartILP_draft_asd.jpg|Atrial Septal Defect]]
|
* Atrial Septal Defects (ASD) are a group of common (1% of cardiac) congenital anomalies defects occurring in a number of different forms and more often in females.
* patent foramen ovale - allows a continuation of the atrial shunting of blood, in 25% of people a probe patent foramen ovale (allowing a probe to bypassed from one atria to the other) exists.
* ostium secundum defect
* endocardial cushion defect involving ostium primum
* sinus venosus defect - contributes about 10% of all ASDs and occurs mainly in a common and less common form. Common ("usual type") - in upper atrial septum which is contiguous with the superior vena cava. Less common - at junction of the right atrium and inferior vena cava.
* common atrium
|-
|}

===Ventricular Septal Defects===
{| border='0px'
|-
| [[File:HeartILP_draft_vsd.jpg|Ventricular Septal Defect]]
|
* The Ventricular Septal Defect (VSD) usually occurs in the membranous (perimembranous) (70%) rather than muscular interventricular septum, and is more frequent in males that females.
* Perimembranous defects are located close to the aortic and tricuspid valves and adjacent to atrioventricular conduction bundle.
* The defect allows left-right shunting of blood, this shunting depends upon the size of the defect. Small defects may close spontaneously, larger defects result in infant congestive heart failure.
* Clinically repaired by coils or tissue-adapted devices like muscular or perimembranous occluders.
|-
|}
(V.S.D.)

===Patent Ductus Arteriosus===

{| border='0px'

|-
| [[File:HeartILP_draft_patentda.jpg|Patent Ductus Arteriosus]]
|
* Patent Ductus Arteriosus (PDA) occurs commonly in preterm infants, can close spontaneously (by day three in 60% of normal term neonates) the remainder are ligated simply and with little risk.
* The operation is always recommended even in the absence of cardiac failure and can often be deferred until early childhood.

|-
|}

===Tetralogy of Fallot===
{| border='0px'
|-
| [[File:HeartILP_draft_tetralogyoffallot.jpg|Tetralogy of Fallot]]
|
* Named after Etienne-Louis Arthur Fallot (1888) who described it as "la maladie blue" and is a common developmental cardiac defect.
* The syndrome consists of a number of a number of cardiac defects possibly stemming from abnormal neural crest migration. The basic defect in a tetralogy of Fallot is an asymmetrical fusion of the truncoconal ridges and a malalignment of the aortic and pulmonary valves.
|-
|}

==Movies==

{| border='0px'

|-
| [[File:Heart1_looping icon.jpg|90px|link=Development_Animation_-_Heart Looping]]
| [[File:Heart1_realign icon.jpg|90px|link=Development_Animation_-_Heart Realign]]
| [[File:Heart1_atrium icon.jpg|90px|link=Development_Animation_-_Heart Atrial Septation]]
| [[File:heart1 ventricle icon.jpg|90px|link=Development_Animation_-_Heart Outflow Septation]]
|-
| [[Development_Animation_-_Heart Looping|Heart Looping]]
| [[Development_Animation_-_Heart Realign|Heart Realign]]
| [[Development_Animation_-_Heart Atrial Septation|Heart Atrial Septation]]
| [[Development_Animation_-_Heart Outflow Septation|Heart Outflow Septation]]
|-
|}

'''Link:''' [[Flash Movies]]

{{Template:2009ANAT2341}}

[[Category:2009ANAT2341]] [[Category:Science-Undergraduate]]

[[Category:Cardiovascular]] [[Category:Heart]]

2010 Lecture 21

2010-10-10T06:40:52Z

Z3267024:

<div style="background:#F5FFFA; border: 1px solid #CEF2E0; padding: 1em; margin: auto; width: 95%; float:left;"><div style="margin:0;background-color:#cef2e0;font-family:sans-serif;font-size:120%;font-weight:bold;border:1px solid #a3bfb1;text-align:left;color:#000;padding-left:0.4em;padding-top:0.2em;padding-bottom:0.2em;">Lecture Notice - Dr Nalini Pather</div>This online lecture page will contain the content required when attending the lecture. Currently this page is only a template and will be updated before the lecture (this notice removed when completed). Final lecture pages can also be printed out using the "printable version" lefthand menu.</div>

==Introduction==
[[File:Gray0473.gif|300px|right]]

In [[2010 Lecture 7|lecture 7 - Early Vascular Development]], the early development of the cardiovascular system was discussed. This second lecture will now focus on the extensive remodeling that occurs in both the heart and vascular system during later development. In addition, there will be discussion on the major cardiovascular abnormalities. The laboratory this week will also give you the opportunity to work through some of these concepts using a new online teaching module.

This material is also presented in an online [[Cardiac_Embryology|Cardiac Embryology tutorial]].

[[File:Basic_Heart_Development_Timeline.jpg|400px|Link=Cardiac_Embryology]]

{{Template:Heart Links}}

:'''Lecture Audio'''

==Lecture Objectives==
* Describe the development of primary and secondary atrial septa and the ventricular septum.
* Explain the changes occurring in the bulbis cordis and truncus arteriosus in its transformation from a single to a double tube.
* Describe the development of the aortic arches on the right and left sides from the fetus to the adult.
* Describe the development of arteries and veins.
* Describe the major cardiovascular developmental abnormalities.

==Textbook references==

* Human Embryology (3rd ed.) Larson Chapter 7 p151-188 Heart, Chapter 8 p189-228 Vasculature
* The Developing Human: Clinically Oriented Embryology (6th ed.) Chapter 14: p304-349

'''Other textbooks'''
* Before we Are Born (5th ed.) Moore and Persaud Chapter 12; p241-254
* Essentials of Human Embryology Larson Chapter 7 p97-122 Heart, Chapter 8 p123-146 Vasculature
* Human Embryology Fitzgerald and Fitzgerald Chapter 13-17: p77-111

'''Recent reviews'''
* Yutzey KE, Kirby ML. Wherefore heart thou? Embryonic origins of cardiogenic mesoderm. Dev Dyn. 2002 Mar;223(3):307-20. Review. [http://www.ncbi.nlm.nih.gov/pubmed/11891982?dopt=Abstract PMID: 11891982]
* Three-dimensional reconstruction of gene expression patterns during cardiac development. Soufan AT, Ruijter JM, van den Hoff MJ, de Boer PA, Hagoort J, Moorman AF. Physiol Genomics. 2003 May 13;13(3):187-95. Review. [http://www.ncbi.nlm.nih.gov/pubmed/12746463 PMID: 12746463]
* Moorman A, Webb S, Brown NA, Lamers W, Anderson RH. Development of the heart: (1) formation of the cardiac chambers and arterial trunks. Heart. 2003 Jul;89(7):806-14. [http://www.ncbi.nlm.nih.gov/pubmed/12807866?dopt=Abstract PMID: 12807866]
* Bruneau BG. Transcriptional regulation of vertebrate cardiac morphogenesis. Circ Res. 2002 Mar 22;90(5):509-19. Review. [http://www.ncbi.nlm.nih.gov/pubmed/11909814?dopt=Abstract PMID: 11909814]

----

==Heart Development==
[[File:Gray0462.gif|thumb|100px|Day 14 Heart tube]]
[[File:Heart_Tube_Fusion.jpg|400px|Early Human Heart Tube Development]]

* [[E#endocardial tube|endocardial tube]] in [[P#pericardial cavity|pericardial cavity]]
** dorsal mesentry (mesocardial) attachment lost
** attached at cranial (arterial) and caudal (venous) ends
* tube elongation - bending and series of expansions
[[File:Heart-cartoon-001.jpg|thumb|Adult Heart blood flow]]
Bulbus Cordis
* refers to the outflow tract in early embryo
* 3 parts
** distal - forms [[T#truncus arteriosus|truncus arteriosus]] (aorta and pulmonary artery)
** middle - [[C#conus arteriosus|conus arteriosus]] ventricular outflow tract
** proximal - right ventricle trabeculate part

{| border=1

|-
! Fetal Structure
! Adult Structure
|-
| Truncus arteriosus
| aorta
pulmonary trunk
|-
| Bulbus cordis
| right ventricle - smooth part (conus arteriosus)
left ventricle - smooth part (aortic vestibule
|-
| Primitive ventricle
| right ventricle - trabecular part
left ventricle - trabecular part
|-
| Primitive atrium
| right atrium - trabecular part
left atrium - trabecular part
|-
| Sinus venosus
| right atrium - smooth part (sinus venarum)
coronary sinus
oblique vein of left atrium
|}

===Heart Layers===
* '''pericardium''' - covers the heart, formed by 3 layers consisting of a fibrous pericardium and a double layered serous pericardium (parietal layer and visceral epicardium layer).
* '''myocardium''' - muscular wall of the heart, thickest layer formed by spirally arranged cardiac muscle cells.
* '''endocardium''' - lines the heart, epithelial (endothelial) tissue lining the inner surface of heart chambers and valves.

===Embryonic Heart Rate===

* Stage 9-10 2 mm embryo (gestational sac diameter of 20 mm) EHR at least 75 beats / minute
* Stage 11-12 5 mm embryo (gestational sac diameter of 30 mm) EHR at least 100 beats / minute
* Stage 16 10 mm embryo EHR at least 120 beats / minute
* Stage 18 15 mm embryo EHR at least 130 beats / minute

[http://embryology.med.unsw.edu.au/Movies/usound/Hum12wkFHR.htm Week 12 fetal heart rate doppler] [http://embryology.med.unsw.edu.au/Notes/heart8.htm Week 17 fetal heart rate audio]

==Separation of the Atria from the Venticles==

Endocardial Cushions
* form initial division of atria and ventricles
* form on dorsal and ventral wall of atrioventcular canals
* grow into canal - meet and fuse to separate atrioventricular canal into right and left channels.

==Atrial Septation==
[[File:Heart1_atrium icon.jpg|90px|link=Development_Animation_-_Heart Atrial Septation]]

[[File:Stage13 C7L.jpg|thumb|Heart (Carnegie stage 13)]]

Through all development blood shunts from right to left atrium (bypass lungs)

===Septum Primum===
[http://embryology.med.unsw.edu.au/wwwpig/pigc/c1l.htm Stage 13 Septum Primum] [http://embryology.med.unsw.edu.au/wwwhuman/lowpower/HumE/E2L.htm Stage 22 Septum Primum]

* dorso-cranial wall, membranous extension
* grows downward towards endocardial cushions
* opening is '''foramen primum''' (ostium primum)
* septum primum fuses with endocardial cushion, but cranially had begun to degenerate forming '''foramen secundum''' (ostium secundum)

===Septum Secundum===
[[File:Gray0467.jpg|thumb|Septum Secundum]]
* ventro-cranial wall
* grows as septum primum downward, does not fuse with endocardial cushion, opening is '''foramen ovale'''

===Right Atrium===
[[File:Gray0476.jpg|thumb|sinus venosus and tributaries]]
* right sinus horn incorporates into dorsal wall sinus venerum
* sinoatrial opening - has 2 flaps, left fuses with septum secundum, right forms valve to inferior vena cava and coronary sinus. [http://embryology.med.unsw.edu.au/wwwpig/pigc/c3l.htm Stage 13 - right venous valve] [http://embryology.med.unsw.edu.au/wwwhuman/lowpower/HumE/E2L.htm Stage 22 - right venous valve]

===Left Atrium===
* posterior wall - outgrowth forms single pulmonary vein, divided into 4 branches
* incorporation into the wall leads to 4 openings in posterior wall
* later moves to the right aligns with atrioventricular canal.

==Ventricular Septation==
[[File:Stage13 C7L.jpg|thumb|Heart (Carnegie stage 13)]]
[[File:Gray0498.jpg|thumb|Ventricular septum]]
[[File:Heart1_realign icon.jpg|90px|link=Development_Animation_-_Heart Realign]]

* 2 separate components - superior membranous, inferior muscular
===Muscular Septum===
[[File:Gray0470.jpg|thumb|muscular septum]]
* growth of inferior wall
* fusion of 3 components - right and left bulbar ridges and dorsal endocardial cushion

===Membranous Septum===
* above the muscular septum, fusion continuous with septation of the outflow tract

[[File:Heart-ventricular-septum-01.jpg‎]][[File:Heart-ventricular-septum-02.jpg‎]][[File:Heart-ventricular-septum-03.jpg‎]]

==Outflow Tract Septation==

[[File:heart1 ventricle icon.jpg|90px|link=Development_Animation_-_Heart Outflow Septation]]

* truncus arteriousus - 2 growths from wall in spiral pattern, inferior upwards [http://embryology.med.unsw.edu.au/wwwpig/pigb/b5l.htm Stage 13 truncus arteriousus]
* mesenchyme and neural crest contribute to this septation process
* fusion of outgrowths separate aortic and pulmonary outflow

{| border='0px'

|-
| [[File:Chick_Heart_001-icon.jpg|90px|link=Movie_-_Normal Chick Heart]]
| [[File:Chick_Heart_002-icon.jpg|90px|link=Movie_-_Abnormal Chick Heart]]
| [[File:Chick_Heart_002-icon.jpg|90px|link=Movie_-_Abnormal Chick Heart 2]]
|-
| [[Movie_-_Normal Chick Heart|Normal Heart]]
| [[Movie_-_Abnormal Chick Heart|Abnormal Heart]]
| [[Movie_-_Abnormal Chick Heart 2|Abnormal Heart 2]]
|-
|}

==Vascular Remodeling==
===Arterial System===
[[File:Gray0474.jpg|thumb|pharyngeal arch arteries]]
* Aortic sac - remodels forming 2 horns, R forms brachiocephalic artery, L forms common carotid artery

Pharyngeal arch arteries
* pharyngeal arch artery 1 and 2 regress
* pharyngeal arch artery 3 and the associated dorsal aorta form the paired internal carotid arteries, these in turn generate the external carotids
* Left pharyngeal arch artery 4 – forms the aortic arch

* paraxial mesoderm forms paired dorsal aorta
** head mesenchyme forms aortic arches
** connecting stalk contains unbilical (placental) arteries
** dorsal aortas give rise to
** vitelline arteries which connect to capillaries on yolk sac
** intersegmental arteries between somites

===Venous System===
Cardinal veins contribute nearly all systemic venous system.

<gallery>
File:Gray0477.jpg
File:Gray0478.jpg
File:Gray0479.jpg
File:Gray0480.jpg
</gallery>

common cardinal veins - ducts of Cuvier

hepatic veins - drain de-oxygenated blood from the liver into the inferior vena cava.

internal iliac vein - hypogastric vein

==Birth Changes==
[[File:Fetal_circulation1.jpg|thumb|Fetal circulation]]

{| border=1

|-
! Fetal Structure
! Adult Structure
|-
| foramen ovale
| fossa ovalis
|-
| umbilical vein (intra-abdominal part)
| ligamentum teres
|-
| ductus venosus
| ligamentum venosum
|-
| umbilical arteries and abdominal ligaments
| medial umbilical ligaments, superior vesicular artery (supplies bladder)
|-
| ductus arteriosum
| ligamentum arteriosum
|}

==Abnormalities==
There are many different cardiac abnormalities, some more common than others, and only a few will be described in this lecture.

'''Major Abnormalities:''' Aortic Stenosis, Atrial Septal Defects, Coarctation of Aorta, Dextrocardia, Hypoplastic Left Heart, Long QT Syndrome, Patent Ductus Arteriosus, Pulmonary Atresia, Pulmonary Stenosis, Tetralogy of Fallot, Transposition of Great Vessels, Tricuspid Atresia, Total Anomalous Pulmonary Venous Connection, Ventricular Septal Defect, Abnormalities of Conducting System.

Links: [http://embryology.med.unsw.edu.au/Notes/heart2.htm Cardiovascular Development Abnormalities]

[[File:Abnormal81-92-heart.png|thumb]]

[[File:Statistics-Utah heart defects.jpg|thumb]]
===Atrial Septal Defects===

{| border='0px'
|-
| [[File:HeartILP_draft_asd.jpg|Atrial Septal Defect]]
|
* Atrial Septal Defects (ASD) are a group of common (1% of cardiac) congenital anomalies defects occurring in a number of different forms and more often in females.
* patent foramen ovale - allows a continuation of the atrial shunting of blood, in 25% of people a probe patent foramen ovale (allowing a probe to bepassed from one atria to the other) exists.
* ostium secundum defect
* endocardial cushion defect involving ostium primum
* sinus venosus defect - contributes about 10% of all ASDs and occurs mainly in a common and less common form. Common ("usual type") - in upper atrial septum which is contiguous with the superior vena cava. Less common - at junction of the right atrium and inferior vena cava.
* common atrium
|-
|}

===Ventricular Septal Defects===
{| border='0px'
|-
| [[File:HeartILP_draft_vsd.jpg|Ventricular Septal Defect]]
|
* The Ventricular Septal Defect (VSD) usually occurs in the membranous (perimembranous) rather than muscular interventricular septum, and is more frequent in males that females.
* Perimembranous defects are located close to the aortic and tricuspid valves and adjacent to atrioventricular conduction bundle.
* The defect allows left-right shunting of blood, this shunting depends upon the size of the defect. Small defects may close spontaneously, larger defects result in infant congestive heart failure.
* Clinically repaired by coils or tissue-adapted devices like muscular or perimembranous occluders.
|-
|}
(V.S.D.)

===Patent Ductus Arteriosus===

{| border='0px'

|-
| [[File:HeartILP_draft_patentda.jpg|Patent Ductus Arteriosus]]
|
* Patent Ductus Arteriosus (P.D.A.) occurs commonly in preterm infants, can close spontaneously (by day three in 60% of normal term neonates) the remainder are ligated simply and with little risk.
* The operation is always recommended even in the absence of cardiac failure and can often be deferred until early childhood.

|-
|}

===Tetralogy of Fallot===
{| border='0px'
|-
| [[File:HeartILP_draft_tetralogyoffallot.jpg|Tetralogy of Fallot]]
|
* Named after Etienne-Louis Arthur Fallot (1888) who described it as "la maladie blue" and is a common developmental cardiac defect.
* The syndrome consists of a number of a number of cardiac defects possibly stemming from abnormal neural crest migration.
|-
|}

==Movies==

{| border='0px'

|-
| [[File:Heart1_looping icon.jpg|90px|link=Development_Animation_-_Heart Looping]]
| [[File:Heart1_realign icon.jpg|90px|link=Development_Animation_-_Heart Realign]]
| [[File:Heart1_atrium icon.jpg|90px|link=Development_Animation_-_Heart Atrial Septation]]
| [[File:heart1 ventricle icon.jpg|90px|link=Development_Animation_-_Heart Outflow Septation]]
|-
| [[Development_Animation_-_Heart Looping|Heart Looping]]
| [[Development_Animation_-_Heart Realign|Heart Realign]]
| [[Development_Animation_-_Heart Atrial Septation|Heart Atrial Septation]]
| [[Development_Animation_-_Heart Outflow Septation|Heart Outflow Septation]]
|-
|}

'''Link:''' [[Flash Movies]]

{{Template:2009ANAT2341}}

[[Category:2009ANAT2341]] [[Category:Science-Undergraduate]]

[[Category:Cardiovascular]] [[Category:Heart]]

2010 Lecture 21

2010-10-10T06:22:38Z

Z3267024: /* Introduction */

<div style="background:#F5FFFA; border: 1px solid #CEF2E0; padding: 1em; margin: auto; width: 95%; float:left;"><div style="margin:0;background-color:#cef2e0;font-family:sans-serif;font-size:120%;font-weight:bold;border:1px solid #a3bfb1;text-align:left;color:#000;padding-left:0.4em;padding-top:0.2em;padding-bottom:0.2em;">Lecture Notice - Dr Nalini Pather</div>This online lecture page will contain the content required when attending the lecture. Currently this page is only a template and will be updated before the lecture (this notice removed when completed). Final lecture pages can also be printed out using the "printable version" lefthand menu.</div>

==Introduction==
[[File:Gray0473.gif|300px|right]]

In [[2010 Lecture 7|lecture 7 - Early Vascular Development]], the early development of the cardiovascular system was discussed. This second lecture will now focus on the extensive remodeling that occurs in both the heart and vascular system during later development. In addition, there will be discussion on the major cardiovascular abnormalities. The laboratory this week will also give you the opportunity to work through some of these concepts using a new online teaching module.

This material is also presented in an online [[Cardiac_Embryology|Cardiac Embryology tutorial]].

[[File:Basic_Heart_Development_Timeline.jpg|400px|Link=Cardiac_Embryology]]

{{Template:Heart Links}}

:'''Lecture Audio'''

==Lecture Objectives==
* Describe the development of primary and secondary atrial septa and the ventricular septum.
* Explain the changes occurring in the bulbis cordis and truncus arteriosus in its transformation from a single to a double tube.
* Describe the development of the aortic arches on the right and left sides from the fetus to the adult.
* Describe the development of arteries and veins.
* Describe the major cardiovascular developmental abnormalities.

==Textbook references==

* Human Embryology (3rd ed.) Larson Chapter 7 p151-188 Heart, Chapter 8 p189-228 Vasculature
* The Developing Human: Clinically Oriented Embryology (6th ed.) Chapter 14: p304-349

'''Other textbooks'''
* Before we Are Born (5th ed.) Moore and Persaud Chapter 12; p241-254
* Essentials of Human Embryology Larson Chapter 7 p97-122 Heart, Chapter 8 p123-146 Vasculature
* Human Embryology Fitzgerald and Fitzgerald Chapter 13-17: p77-111

'''Recent reviews'''
* Yutzey KE, Kirby ML. Wherefore heart thou? Embryonic origins of cardiogenic mesoderm. Dev Dyn. 2002 Mar;223(3):307-20. Review. [http://www.ncbi.nlm.nih.gov/pubmed/11891982?dopt=Abstract PMID: 11891982]
* Three-dimensional reconstruction of gene expression patterns during cardiac development. Soufan AT, Ruijter JM, van den Hoff MJ, de Boer PA, Hagoort J, Moorman AF. Physiol Genomics. 2003 May 13;13(3):187-95. Review. [http://www.ncbi.nlm.nih.gov/pubmed/12746463 PMID: 12746463]
* Moorman A, Webb S, Brown NA, Lamers W, Anderson RH. Development of the heart: (1) formation of the cardiac chambers and arterial trunks. Heart. 2003 Jul;89(7):806-14. [http://www.ncbi.nlm.nih.gov/pubmed/12807866?dopt=Abstract PMID: 12807866]
* Bruneau BG. Transcriptional regulation of vertebrate cardiac morphogenesis. Circ Res. 2002 Mar 22;90(5):509-19. Review. [http://www.ncbi.nlm.nih.gov/pubmed/11909814?dopt=Abstract PMID: 11909814]

==Heart Development==
[[File:Gray0462.gif|thumb|100px|Day 14 Heart tube]]
[[File:Heart_Tube_Fusion.jpg|400px|Early Human Heart Tube Development]]

* [[E#endocardial tube|endocardial tube]] in [[P#pericardial cavity|pericardial cavity]]
** dorsal mesentry (mesocardial) attachment lost
** attached at cranial (arterial) and caudal (venous) ends
* tube elongation - bending and series of expansions
[[File:Heart-cartoon-001.jpg|thumb|Adult Heart blood flow]]
Bulbus Cordis
* refers to the outflow tract in early embryo
* 3 parts
** distal - forms [[T#truncus arteriosus|truncus arteriosus]] (aorta and pulmonary artery)
** middle - [[C#conus arteriosus|conus arteriosus]] ventricular outflow tract
** proximal - right ventricle trabeculate part

{| border=1

|-
! Fetal Structure
! Adult Structure
|-
| Truncus arteriosus
| aorta
pulmonary trunk
|-
| Bulbus cordis
| right ventricle - smooth part (conus arteriosus)
left ventricle - smooth part (aortic vestibule
|-
| Primitive ventricle
| right ventricle - trabecular part
left ventricle - trabecular part
|-
| Primitive atrium
| right atrium - trabecular part
left atrium - trabecular part
|-
| Sinus venosus
| right atrium - smooth part (sinus venarum)
coronary sinus
oblique vein of left atrium
|}

endocardial cushions
* form initial division of atria and ventricles
* fusion forms left and right atrioventricular canals

===Heart Layers===
* '''pericardium''' - covers the heart, formed by 3 layers consisting of a fibrous pericardium and a double layered serous pericardium (parietal layer and visceral epicardium layer).
* '''myocardium''' - muscular wall of the heart, thickest layer formed by spirally arranged cardiac muscle cells.
* '''endocardium''' - lines the heart, epithelial (endothelial) tissue lining the inner surface of heart chambers and valves.

===Embryonic Heart Rate===

* Stage 9-10 2 mm embryo (gestational sac diameter of 20 mm) EHR at least 75 beats / minute
* Stage 11-12 5 mm embryo (gestational sac diameter of 30 mm) EHR at least 100 beats / minute
* Stage 16 10 mm embryo EHR at least 120 beats / minute
* Stage 18 15 mm embryo EHR at least 130 beats / minute

[http://embryology.med.unsw.edu.au/Movies/usound/Hum12wkFHR.htm Week 12 fetal heart rate doppler] [http://embryology.med.unsw.edu.au/Notes/heart8.htm Week 17 fetal heart rate audio]

==Atrial Septation==
[[File:Heart1_atrium icon.jpg|90px|link=Development_Animation_-_Heart Atrial Septation]]

[[File:Stage13 C7L.jpg|thumb|Heart (Carnegie stage 13)]]

Through all development blood shunts from right to left atrium (bypass lungs)

===Septum Primum===
[http://embryology.med.unsw.edu.au/wwwpig/pigc/c1l.htm Stage 13 Septum Primum] [http://embryology.med.unsw.edu.au/wwwhuman/lowpower/HumE/E2L.htm Stage 22 Septum Primum]

* dorso-cranial wall, membranous extension
* grows downward towards endocardial cushions
* opening is '''foramen primum''' (ostium primum)
* septum primum fuses with endocardial cushion, but cranially had begun to degenerate forming '''foramen secundum''' (ostium secundum)

===Septum Secundum===
[[File:Gray0467.jpg|thumb|Septum Secundum]]
* ventro-cranial wall
* grows as septum primum downward, does not fuse with endocardial cushion, opening is '''foramen ovale'''

===Right Atrium===
[[File:Gray0476.jpg|thumb|sinus venosus and tributaries]]
* right sinus horn incorporates into dorsal wall sinus venerum
* sinoatrial opening - has 2 flaps, left fuses with septum secundum, right forms valve to inferior vena cava and coronary sinus. [http://embryology.med.unsw.edu.au/wwwpig/pigc/c3l.htm Stage 13 - right venous valve] [http://embryology.med.unsw.edu.au/wwwhuman/lowpower/HumE/E2L.htm Stage 22 - right venous valve]

===Left Atrium===
* posterior wall - outgrowth forms single pulmonary vein, divided into 4 branches
* incorporation into the wall leads to 4 openings in posterior wall
* later moves to the right aligns with atrioventricular canal.

==Ventricular Septation==
[[File:Stage13 C7L.jpg|thumb|Heart (Carnegie stage 13)]]
[[File:Gray0498.jpg|thumb|Ventricular septum]]
[[File:Heart1_realign icon.jpg|90px|link=Development_Animation_-_Heart Realign]]

* 2 separate components - superior membranous, inferior muscular
===Muscular Septum===
[[File:Gray0470.jpg|thumb|muscular septum]]
* growth of inferior wall
* fusion of 3 components - right and left bulbar ridges and dorsal endocardial cushion

===Membranous Septum===
* above the muscular septum, fusion continuous with septation of the outflow tract

[[File:Heart-ventricular-septum-01.jpg‎]][[File:Heart-ventricular-septum-02.jpg‎]][[File:Heart-ventricular-septum-03.jpg‎]]

==Outflow Tract Septation==

[[File:heart1 ventricle icon.jpg|90px|link=Development_Animation_-_Heart Outflow Septation]]

* truncus arteriousus - 2 growths from wall in spiral pattern, inferior upwards [http://embryology.med.unsw.edu.au/wwwpig/pigb/b5l.htm Stage 13 truncus arteriousus]
* mesenchyme and neural crest contribute to this septation process
* fusion of outgrowths separate aortic and pulmonary outflow

{| border='0px'

|-
| [[File:Chick_Heart_001-icon.jpg|90px|link=Movie_-_Normal Chick Heart]]
| [[File:Chick_Heart_002-icon.jpg|90px|link=Movie_-_Abnormal Chick Heart]]
| [[File:Chick_Heart_002-icon.jpg|90px|link=Movie_-_Abnormal Chick Heart 2]]
|-
| [[Movie_-_Normal Chick Heart|Normal Heart]]
| [[Movie_-_Abnormal Chick Heart|Abnormal Heart]]
| [[Movie_-_Abnormal Chick Heart 2|Abnormal Heart 2]]
|-
|}

==Vascular Remodeling==
===Arterial System===
[[File:Gray0474.jpg|thumb|pharyngeal arch arteries]]
* Aortic sac - remodels forming 2 horns, R forms brachiocephalic artery, L forms common carotid artery

Pharyngeal arch arteries
* pharyngeal arch artery 1 and 2 regress
* pharyngeal arch artery 3 and the associated dorsal aorta form the paired internal carotid arteries, these in turn generate the external carotids
* Left pharyngeal arch artery 4 – forms the aortic arch

* paraxial mesoderm forms paired dorsal aorta
** head mesenchyme forms aortic arches
** connecting stalk contains unbilical (placental) arteries
** dorsal aortas give rise to
** vitelline arteries which connect to capillaries on yolk sac
** intersegmental arteries between somites

===Venous System===
Cardinal veins contribute nearly all systemic venous system.

<gallery>
File:Gray0477.jpg
File:Gray0478.jpg
File:Gray0479.jpg
File:Gray0480.jpg
</gallery>

common cardinal veins - ducts of Cuvier

hepatic veins - drain de-oxygenated blood from the liver into the inferior vena cava.

internal iliac vein - hypogastric vein

==Birth Changes==
[[File:Fetal_circulation1.jpg|thumb|Fetal circulation]]

{| border=1

|-
! Fetal Structure
! Adult Structure
|-
| foramen ovale
| fossa ovalis
|-
| umbilical vein (intra-abdominal part)
| ligamentum teres
|-
| ductus venosus
| ligamentum venosum
|-
| umbilical arteries and abdominal ligaments
| medial umbilical ligaments, superior vesicular artery (supplies bladder)
|-
| ductus arteriosum
| ligamentum arteriosum
|}

==Abnormalities==
There are many different cardiac abnormalities, some more common than others, and only a few will be described in this lecture.

'''Major Abnormalities:''' Aortic Stenosis, Atrial Septal Defects, Coarctation of Aorta, Dextrocardia, Hypoplastic Left Heart, Long QT Syndrome, Patent Ductus Arteriosus, Pulmonary Atresia, Pulmonary Stenosis, Tetralogy of Fallot, Transposition of Great Vessels, Tricuspid Atresia, Total Anomalous Pulmonary Venous Connection, Ventricular Septal Defect, Abnormalities of Conducting System.

Links: [http://embryology.med.unsw.edu.au/Notes/heart2.htm Cardiovascular Development Abnormalities]

[[File:Abnormal81-92-heart.png|thumb]]

[[File:Statistics-Utah heart defects.jpg|thumb]]
===Atrial Septal Defects===

{| border='0px'
|-
| [[File:HeartILP_draft_asd.jpg|Atrial Septal Defect]]
|
* Atrial Septal Defects (ASD) are a group of common (1% of cardiac) congenital anomalies defects occurring in a number of different forms and more often in females.
* patent foramen ovale - allows a continuation of the atrial shunting of blood, in 25% of people a probe patent foramen ovale (allowing a probe to bepassed from one atria to the other) exists.
* ostium secundum defect
* endocardial cushion defect involving ostium primum
* sinus venosus defect - contributes about 10% of all ASDs and occurs mainly in a common and less common form. Common ("usual type") - in upper atrial septum which is contiguous with the superior vena cava. Less common - at junction of the right atrium and inferior vena cava.
* common atrium
|-
|}

===Ventricular Septal Defects===
{| border='0px'
|-
| [[File:HeartILP_draft_vsd.jpg|Ventricular Septal Defect]]
|
* The Ventricular Septal Defect (VSD) usually occurs in the membranous (perimembranous) rather than muscular interventricular septum, and is more frequent in males that females.
* Perimembranous defects are located close to the aortic and tricuspid valves and adjacent to atrioventricular conduction bundle.
* The defect allows left-right shunting of blood, this shunting depends upon the size of the defect. Small defects may close spontaneously, larger defects result in infant congestive heart failure.
* Clinically repaired by coils or tissue-adapted devices like muscular or perimembranous occluders.
|-
|}
(V.S.D.)

===Patent Ductus Arteriosus===

{| border='0px'

|-
| [[File:HeartILP_draft_patentda.jpg|Patent Ductus Arteriosus]]
|
* Patent Ductus Arteriosus (P.D.A.) occurs commonly in preterm infants, can close spontaneously (by day three in 60% of normal term neonates) the remainder are ligated simply and with little risk.
* The operation is always recommended even in the absence of cardiac failure and can often be deferred until early childhood.

|-
|}

===Tetralogy of Fallot===
{| border='0px'
|-
| [[File:HeartILP_draft_tetralogyoffallot.jpg|Tetralogy of Fallot]]
|
* Named after Etienne-Louis Arthur Fallot (1888) who described it as "la maladie blue" and is a common developmental cardiac defect.
* The syndrome consists of a number of a number of cardiac defects possibly stemming from abnormal neural crest migration.
|-
|}

==Movies==

{| border='0px'

|-
| [[File:Heart1_looping icon.jpg|90px|link=Development_Animation_-_Heart Looping]]
| [[File:Heart1_realign icon.jpg|90px|link=Development_Animation_-_Heart Realign]]
| [[File:Heart1_atrium icon.jpg|90px|link=Development_Animation_-_Heart Atrial Septation]]
| [[File:heart1 ventricle icon.jpg|90px|link=Development_Animation_-_Heart Outflow Septation]]
|-
| [[Development_Animation_-_Heart Looping|Heart Looping]]
| [[Development_Animation_-_Heart Realign|Heart Realign]]
| [[Development_Animation_-_Heart Atrial Septation|Heart Atrial Septation]]
| [[Development_Animation_-_Heart Outflow Septation|Heart Outflow Septation]]
|-
|}

'''Link:''' [[Flash Movies]]

{{Template:2009ANAT2341}}

[[Category:2009ANAT2341]] [[Category:Science-Undergraduate]]

[[Category:Cardiovascular]] [[Category:Heart]]

2010 Lecture 21

2010-10-10T02:37:34Z

Z3267024: /* Heart Development */

<div style="background:#F5FFFA; border: 1px solid #CEF2E0; padding: 1em; margin: auto; width: 95%; float:left;"><div style="margin:0;background-color:#cef2e0;font-family:sans-serif;font-size:120%;font-weight:bold;border:1px solid #a3bfb1;text-align:left;color:#000;padding-left:0.4em;padding-top:0.2em;padding-bottom:0.2em;">Lecture Notice - Dr Nalini Pather</div>This online lecture page will contain the content required when attending the lecture. Currently this page is only a template and will be updated before the lecture (this notice removed when completed). Final lecture pages can also be printed out using the "printable version" lefthand menu.</div>

==Introduction==
[[File:Gray0473.gif|300px|right]]

In [[2010 Lecture 7|lecture 7 - Early Vascular Development]], there was an introduction to the origins of the cardiovascular system. This second lecture will now focus on the extensive remodeling that occurs in both the heart and vascular system during later development. In addition, there will be discussion on the major cardiovascular abnormalities. The laboratory this week will also give you the opportunity to work through some of these concepts using a new online teaching module.

This material is also presented in an online [[Cardiac_Embryology|Cardiac Embryology tutorial]].

[[File:Basic_Heart_Development_Timeline.jpg|400px|Link=Cardiac_Embryology]]

{{Template:Heart Links}}

:'''Lecture Audio''' Lecture Date: 12-10-2009 Lecture Time: 12:00 Venue: CLB 5 Speaker: Mark Hill [http://lectopia.elearning.unsw.edu.au/ilectures/ilectures.lasso?ut=153&id=48833 Late Cardiovascular]

==Lecture Objectives==
* Describe the development of primary and secondary atrial septa and the ventricular septum.
* Explain the changes occurring in the bulbis cordis and truncus arteriosus in its transformation from a single to a double tube.
* Describe the development of the aortic arches on the right and left sides from the fetus to the adult.
* Describe the development of arteries and veins.
* Describe the major cardiovascular developmental abnormalities.

==Textbook references==

* Human Embryology (3rd ed.) Larson Chapter 7 p151-188 Heart, Chapter 8 p189-228 Vasculature
* The Developing Human: Clinically Oriented Embryology (6th ed.) Chapter 14: p304-349

'''Other textbooks'''
* Before we Are Born (5th ed.) Moore and Persaud Chapter 12; p241-254
* Essentials of Human Embryology Larson Chapter 7 p97-122 Heart, Chapter 8 p123-146 Vasculature
* Human Embryology Fitzgerald and Fitzgerald Chapter 13-17: p77-111

'''Recent reviews'''
* Yutzey KE, Kirby ML. Wherefore heart thou? Embryonic origins of cardiogenic mesoderm. Dev Dyn. 2002 Mar;223(3):307-20. Review. [http://www.ncbi.nlm.nih.gov/pubmed/11891982?dopt=Abstract PMID: 11891982]
* Three-dimensional reconstruction of gene expression patterns during cardiac development. Soufan AT, Ruijter JM, van den Hoff MJ, de Boer PA, Hagoort J, Moorman AF. Physiol Genomics. 2003 May 13;13(3):187-95. Review. [http://www.ncbi.nlm.nih.gov/pubmed/12746463 PMID: 12746463]
* Moorman A, Webb S, Brown NA, Lamers W, Anderson RH. Development of the heart: (1) formation of the cardiac chambers and arterial trunks. Heart. 2003 Jul;89(7):806-14. [http://www.ncbi.nlm.nih.gov/pubmed/12807866?dopt=Abstract PMID: 12807866]
* Bruneau BG. Transcriptional regulation of vertebrate cardiac morphogenesis. Circ Res. 2002 Mar 22;90(5):509-19. Review. [http://www.ncbi.nlm.nih.gov/pubmed/11909814?dopt=Abstract PMID: 11909814]

==Heart Development==
[[File:Gray0462.gif|thumb|100px|Day 14 Heart tube]]
[[File:Heart_Tube_Fusion.jpg|400px|Early Human Heart Tube Development]]

* [[E#endocardial tube|endocardial tube]] in [[P#pericardial cavity|pericardial cavity]]
** dorsal mesentry (mesocardial) attachment lost
** attached at cranial (arterial) and caudal (venous) ends
* tube elongation - bending and series of expansions
[[File:Heart-cartoon-001.jpg|thumb|Adult Heart blood flow]]
Bulbus Cordis
* refers to the outflow tract in early embryo
* 3 parts
** distal - forms [[T#truncus arteriosus|truncus arteriosus]] (aorta and pulmonary artery)
** middle - [[C#conus arteriosus|conus arteriosus]] ventricular outflow tract
** proximal - right ventricle trabeculate part

{| border=1

|-
! Fetal Structure
! Adult Structure
|-
| Truncus arteriosus
| aorta
pulmonary trunk
|-
| Bulbus cordis
| right ventricle - smooth part (conus arteriosus)
left ventricle - smooth part (aortic vestibule
|-
| Primitive ventricle
| right ventricle - trabecular part
left ventricle - trabecular part
|-
| Primitive atrium
| right atrium - trabecular part
left atrium - trabecular part
|-
| Sinus venosus
| right atrium - smooth part (sinus venarum)
coronary sinus
oblique vein of left atrium
|}

endocardial cushions
* form initial division of atria and ventricles
* fusion forms left and right atrioventricular canals

===Heart Layers===
* '''pericardium''' - covers the heart, formed by 3 layers consisting of a fibrous pericardium and a double layered serous pericardium (parietal layer and visceral epicardium layer).
* '''myocardium''' - muscular wall of the heart, thickest layer formed by spirally arranged cardiac muscle cells.
* '''endocardium''' - lines the heart, epithelial (endothelial) tissue lining the inner surface of heart chambers and valves.

===Embryonic Heart Rate===

* Stage 9-10 2 mm embryo (gestational sac diameter of 20 mm) EHR at least 75 beats / minute
* Stage 11-12 5 mm embryo (gestational sac diameter of 30 mm) EHR at least 100 beats / minute
* Stage 16 10 mm embryo EHR at least 120 beats / minute
* Stage 18 15 mm embryo EHR at least 130 beats / minute

[http://embryology.med.unsw.edu.au/Movies/usound/Hum12wkFHR.htm Week 12 fetal heart rate doppler] [http://embryology.med.unsw.edu.au/Notes/heart8.htm Week 17 fetal heart rate audio]

==Atrial Septation==
[[File:Heart1_atrium icon.jpg|90px|link=Development_Animation_-_Heart Atrial Septation]]

[[File:Stage13 C7L.jpg|thumb|Heart (Carnegie stage 13)]]

Through all development blood shunts from right to left atrium (bypass lungs)

===Septum Primum===
[http://embryology.med.unsw.edu.au/wwwpig/pigc/c1l.htm Stage 13 Septum Primum] [http://embryology.med.unsw.edu.au/wwwhuman/lowpower/HumE/E2L.htm Stage 22 Septum Primum]

* dorso-cranial wall, membranous extension
* grows downward towards endocardial cushions
* opening is '''foramen primum''' (ostium primum)
* septum primum fuses with endocardial cushion, but cranially had begun to degenerate forming '''foramen secundum''' (ostium secundum)

===Septum Secundum===
[[File:Gray0467.jpg|thumb|Septum Secundum]]
* ventro-cranial wall
* grows as septum primum downward, does not fuse with endocardial cushion, opening is '''foramen ovale'''

===Right Atrium===
[[File:Gray0476.jpg|thumb|sinus venosus and tributaries]]
* right sinus horn incorporates into dorsal wall sinus venerum
* sinoatrial opening - has 2 flaps, left fuses with septum secundum, right forms valve to inferior vena cava and coronary sinus. [http://embryology.med.unsw.edu.au/wwwpig/pigc/c3l.htm Stage 13 - right venous valve] [http://embryology.med.unsw.edu.au/wwwhuman/lowpower/HumE/E2L.htm Stage 22 - right venous valve]

===Left Atrium===
* posterior wall - outgrowth forms single pulmonary vein, divided into 4 branches
* incorporation into the wall leads to 4 openings in posterior wall
* later moves to the right aligns with atrioventricular canal.

==Ventricular Septation==
[[File:Stage13 C7L.jpg|thumb|Heart (Carnegie stage 13)]]
[[File:Gray0498.jpg|thumb|Ventricular septum]]
[[File:Heart1_realign icon.jpg|90px|link=Development_Animation_-_Heart Realign]]

* 2 separate components - superior membranous, inferior muscular
===Muscular Septum===
[[File:Gray0470.jpg|thumb|muscular septum]]
* growth of inferior wall
* fusion of 3 components - right and left bulbar ridges and dorsal endocardial cushion

===Membranous Septum===
* above the muscular septum, fusion continuous with septation of the outflow tract

[[File:Heart-ventricular-septum-01.jpg‎]][[File:Heart-ventricular-septum-02.jpg‎]][[File:Heart-ventricular-septum-03.jpg‎]]

==Outflow Tract Septation==

[[File:heart1 ventricle icon.jpg|90px|link=Development_Animation_-_Heart Outflow Septation]]

* truncus arteriousus - 2 growths from wall in spiral pattern, inferior upwards [http://embryology.med.unsw.edu.au/wwwpig/pigb/b5l.htm Stage 13 truncus arteriousus]
* mesenchyme and neural crest contribute to this septation process
* fusion of outgrowths separate aortic and pulmonary outflow

{| border='0px'

|-
| [[File:Chick_Heart_001-icon.jpg|90px|link=Movie_-_Normal Chick Heart]]
| [[File:Chick_Heart_002-icon.jpg|90px|link=Movie_-_Abnormal Chick Heart]]
| [[File:Chick_Heart_002-icon.jpg|90px|link=Movie_-_Abnormal Chick Heart 2]]
|-
| [[Movie_-_Normal Chick Heart|Normal Heart]]
| [[Movie_-_Abnormal Chick Heart|Abnormal Heart]]
| [[Movie_-_Abnormal Chick Heart 2|Abnormal Heart 2]]
|-
|}

==Vascular Remodeling==
===Arterial System===
[[File:Gray0474.jpg|thumb|pharyngeal arch arteries]]
* Aortic sac - remodels forming 2 horns, R forms brachiocephalic artery, L forms common carotid artery

Pharyngeal arch arteries
* pharyngeal arch artery 1 and 2 regress
* pharyngeal arch artery 3 and the associated dorsal aorta form the paired internal carotid arteries, these in turn generate the external carotids
* Left pharyngeal arch artery 4 – forms the aortic arch

* paraxial mesoderm forms paired dorsal aorta
** head mesenchyme forms aortic arches
** connecting stalk contains unbilical (placental) arteries
** dorsal aortas give rise to
** vitelline arteries which connect to capillaries on yolk sac
** intersegmental arteries between somites

===Venous System===
Cardinal veins contribute nearly all systemic venous system.

<gallery>
File:Gray0477.jpg
File:Gray0478.jpg
File:Gray0479.jpg
File:Gray0480.jpg
</gallery>

common cardinal veins - ducts of Cuvier

hepatic veins - drain de-oxygenated blood from the liver into the inferior vena cava.

internal iliac vein - hypogastric vein

==Birth Changes==
[[File:Fetal_circulation1.jpg|thumb|Fetal circulation]]

{| border=1

|-
! Fetal Structure
! Adult Structure
|-
| foramen ovale
| fossa ovalis
|-
| umbilical vein (intra-abdominal part)
| ligamentum teres
|-
| ductus venosus
| ligamentum venosum
|-
| umbilical arteries and abdominal ligaments
| medial umbilical ligaments, superior vesicular artery (supplies bladder)
|-
| ductus arteriosum
| ligamentum arteriosum
|}

==Abnormalities==
There are many different cardiac abnormalities, some more common than others, and only a few will be described in this lecture.

'''Major Abnormalities:''' Aortic Stenosis, Atrial Septal Defects, Coarctation of Aorta, Dextrocardia, Hypoplastic Left Heart, Long QT Syndrome, Patent Ductus Arteriosus, Pulmonary Atresia, Pulmonary Stenosis, Tetralogy of Fallot, Transposition of Great Vessels, Tricuspid Atresia, Total Anomalous Pulmonary Venous Connection, Ventricular Septal Defect, Abnormalities of Conducting System.

Links: [http://embryology.med.unsw.edu.au/Notes/heart2.htm Cardiovascular Development Abnormalities]

[[File:Abnormal81-92-heart.png|thumb]]

[[File:Statistics-Utah heart defects.jpg|thumb]]
===Atrial Septal Defects===

{| border='0px'
|-
| [[File:HeartILP_draft_asd.jpg|Atrial Septal Defect]]
|
* Atrial Septal Defects (ASD) are a group of common (1% of cardiac) congenital anomalies defects occurring in a number of different forms and more often in females.
* patent foramen ovale - allows a continuation of the atrial shunting of blood, in 25% of people a probe patent foramen ovale (allowing a probe to bepassed from one atria to the other) exists.
* ostium secundum defect
* endocardial cushion defect involving ostium primum
* sinus venosus defect - contributes about 10% of all ASDs and occurs mainly in a common and less common form. Common ("usual type") - in upper atrial septum which is contiguous with the superior vena cava. Less common - at junction of the right atrium and inferior vena cava.
* common atrium
|-
|}

===Ventricular Septal Defects===
{| border='0px'
|-
| [[File:HeartILP_draft_vsd.jpg|Ventricular Septal Defect]]
|
* The Ventricular Septal Defect (VSD) usually occurs in the membranous (perimembranous) rather than muscular interventricular septum, and is more frequent in males that females.
* Perimembranous defects are located close to the aortic and tricuspid valves and adjacent to atrioventricular conduction bundle.
* The defect allows left-right shunting of blood, this shunting depends upon the size of the defect. Small defects may close spontaneously, larger defects result in infant congestive heart failure.
* Clinically repaired by coils or tissue-adapted devices like muscular or perimembranous occluders.
|-
|}
(V.S.D.)

===Patent Ductus Arteriosus===

{| border='0px'

|-
| [[File:HeartILP_draft_patentda.jpg|Patent Ductus Arteriosus]]
|
* Patent Ductus Arteriosus (P.D.A.) occurs commonly in preterm infants, can close spontaneously (by day three in 60% of normal term neonates) the remainder are ligated simply and with little risk.
* The operation is always recommended even in the absence of cardiac failure and can often be deferred until early childhood.

|-
|}

===Tetralogy of Fallot===
{| border='0px'
|-
| [[File:HeartILP_draft_tetralogyoffallot.jpg|Tetralogy of Fallot]]
|
* Named after Etienne-Louis Arthur Fallot (1888) who described it as "la maladie blue" and is a common developmental cardiac defect.
* The syndrome consists of a number of a number of cardiac defects possibly stemming from abnormal neural crest migration.
|-
|}

==Movies==

{| border='0px'

|-
| [[File:Heart1_looping icon.jpg|90px|link=Development_Animation_-_Heart Looping]]
| [[File:Heart1_realign icon.jpg|90px|link=Development_Animation_-_Heart Realign]]
| [[File:Heart1_atrium icon.jpg|90px|link=Development_Animation_-_Heart Atrial Septation]]
| [[File:heart1 ventricle icon.jpg|90px|link=Development_Animation_-_Heart Outflow Septation]]
|-
| [[Development_Animation_-_Heart Looping|Heart Looping]]
| [[Development_Animation_-_Heart Realign|Heart Realign]]
| [[Development_Animation_-_Heart Atrial Septation|Heart Atrial Septation]]
| [[Development_Animation_-_Heart Outflow Septation|Heart Outflow Septation]]
|-
|}

'''Link:''' [[Flash Movies]]

{{Template:2009ANAT2341}}

[[Category:2009ANAT2341]] [[Category:Science-Undergraduate]]

[[Category:Cardiovascular]] [[Category:Heart]]

2010 Lecture 21

2010-10-10T02:27:11Z

Z3267024: /* Heart Development */

<div style="background:#F5FFFA; border: 1px solid #CEF2E0; padding: 1em; margin: auto; width: 95%; float:left;"><div style="margin:0;background-color:#cef2e0;font-family:sans-serif;font-size:120%;font-weight:bold;border:1px solid #a3bfb1;text-align:left;color:#000;padding-left:0.4em;padding-top:0.2em;padding-bottom:0.2em;">Lecture Notice - Dr Nalini Pather</div>This online lecture page will contain the content required when attending the lecture. Currently this page is only a template and will be updated before the lecture (this notice removed when completed). Final lecture pages can also be printed out using the "printable version" lefthand menu.</div>

==Introduction==
[[File:Gray0473.gif|300px|right]]

In [[2010 Lecture 7|lecture 7 - Early Vascular Development]], there was an introduction to the origins of the cardiovascular system. This second lecture will now focus on the extensive remodeling that occurs in both the heart and vascular system during later development. In addition, there will be discussion on the major cardiovascular abnormalities. The laboratory this week will also give you the opportunity to work through some of these concepts using a new online teaching module.

This material is also presented in an online [[Cardiac_Embryology|Cardiac Embryology tutorial]].

[[File:Basic_Heart_Development_Timeline.jpg|400px|Link=Cardiac_Embryology]]

{{Template:Heart Links}}

:'''Lecture Audio''' Lecture Date: 12-10-2009 Lecture Time: 12:00 Venue: CLB 5 Speaker: Mark Hill [http://lectopia.elearning.unsw.edu.au/ilectures/ilectures.lasso?ut=153&id=48833 Late Cardiovascular]

==Lecture Objectives==
* Describe the development of primary and secondary atrial septa and the ventricular septum.
* Explain the changes occurring in the bulbis cordis and truncus arteriosus in its transformation from a single to a double tube.
* Describe the development of the aortic arches on the right and left sides from the fetus to the adult.
* Describe the development of arteries and veins.
* Describe the major cardiovascular developmental abnormalities.

==Textbook references==

* Human Embryology (3rd ed.) Larson Chapter 7 p151-188 Heart, Chapter 8 p189-228 Vasculature
* The Developing Human: Clinically Oriented Embryology (6th ed.) Chapter 14: p304-349

'''Other textbooks'''
* Before we Are Born (5th ed.) Moore and Persaud Chapter 12; p241-254
* Essentials of Human Embryology Larson Chapter 7 p97-122 Heart, Chapter 8 p123-146 Vasculature
* Human Embryology Fitzgerald and Fitzgerald Chapter 13-17: p77-111

'''Recent reviews'''
* Yutzey KE, Kirby ML. Wherefore heart thou? Embryonic origins of cardiogenic mesoderm. Dev Dyn. 2002 Mar;223(3):307-20. Review. [http://www.ncbi.nlm.nih.gov/pubmed/11891982?dopt=Abstract PMID: 11891982]
* Three-dimensional reconstruction of gene expression patterns during cardiac development. Soufan AT, Ruijter JM, van den Hoff MJ, de Boer PA, Hagoort J, Moorman AF. Physiol Genomics. 2003 May 13;13(3):187-95. Review. [http://www.ncbi.nlm.nih.gov/pubmed/12746463 PMID: 12746463]
* Moorman A, Webb S, Brown NA, Lamers W, Anderson RH. Development of the heart: (1) formation of the cardiac chambers and arterial trunks. Heart. 2003 Jul;89(7):806-14. [http://www.ncbi.nlm.nih.gov/pubmed/12807866?dopt=Abstract PMID: 12807866]
* Bruneau BG. Transcriptional regulation of vertebrate cardiac morphogenesis. Circ Res. 2002 Mar 22;90(5):509-19. Review. [http://www.ncbi.nlm.nih.gov/pubmed/11909814?dopt=Abstract PMID: 11909814]

==Heart Development==
[[File:Gray0462.gif|thumb|100px|Day 14 Heart tube]]
[[File:Heart_Tube_Fusion.jpg|400px|Early Human Heart Tube Development]]

* [[E#endocardial tube|endocardial tube]] in [[P#pericardial cavity|pericardial cavity]]
** dorsal mesentry (mesocardial) attachment lost
** attached at cranial (arterial) and caudal (venous) ends
* tube elongation - bending and series of expansions
[[File:Heart-cartoon-001.jpg|thumb|Adult Heart blood flow]]
Bulbus Cordis - 3 parts
* distal - forms [[T#truncus arteriosus|truncus arteriosus]] (aorta and pulmonary artery)
* middle - [[C#conus cordis|conus cordis]] ventricular outflow tract
* proximal - right ventricle trabeculate part

{| border=1

|-
! Fetal Structure
! Adult Structure
|-
| Truncus arteriosus
| aorta
pulmonary trunk
|-
| Bulbus cordis
| right ventricle - smooth part (conus arteriosus)
left ventricle - smooth part (aortic vestibule
|-
| Primitive ventricle
| right ventricle - trabecular part
left ventricle - trabecular part
|-
| Primitive atrium
| right atrium - trabecular part
left atrium - trabecular part
|-
| Sinus venosus
| right atrium - smooth part (sinus venarum)
coronary sinus
oblique vein of left atrium
|}

endocardial cushions
* form initial division of atria and ventricles
* fusion forms left and right atrioventricular canals

===Heart Layers===
* '''pericardium''' - covers the heart, formed by 3 layers consisting of a fibrous pericardium and a double layered serous pericardium (parietal layer and visceral epicardium layer).
* '''myocardium''' - muscular wall of the heart, thickest layer formed by spirally arranged cardiac muscle cells.
* '''endocardium''' - lines the heart, epithelial (endothelial) tissue lining the inner surface of heart chambers and valves.

===Embryonic Heart Rate===

* Stage 9-10 2 mm embryo (gestational sac diameter of 20 mm) EHR at least 75 beats / minute
* Stage 11-12 5 mm embryo (gestational sac diameter of 30 mm) EHR at least 100 beats / minute
* Stage 16 10 mm embryo EHR at least 120 beats / minute
* Stage 18 15 mm embryo EHR at least 130 beats / minute

[http://embryology.med.unsw.edu.au/Movies/usound/Hum12wkFHR.htm Week 12 fetal heart rate doppler] [http://embryology.med.unsw.edu.au/Notes/heart8.htm Week 17 fetal heart rate audio]

==Atrial Septation==
[[File:Heart1_atrium icon.jpg|90px|link=Development_Animation_-_Heart Atrial Septation]]

[[File:Stage13 C7L.jpg|thumb|Heart (Carnegie stage 13)]]

Through all development blood shunts from right to left atrium (bypass lungs)

===Septum Primum===
[http://embryology.med.unsw.edu.au/wwwpig/pigc/c1l.htm Stage 13 Septum Primum] [http://embryology.med.unsw.edu.au/wwwhuman/lowpower/HumE/E2L.htm Stage 22 Septum Primum]

* dorso-cranial wall, membranous extension
* grows downward towards endocardial cushions
* opening is '''foramen primum''' (ostium primum)
* septum primum fuses with endocardial cushion, but cranially had begun to degenerate forming '''foramen secundum''' (ostium secundum)

===Septum Secundum===
[[File:Gray0467.jpg|thumb|Septum Secundum]]
* ventro-cranial wall
* grows as septum primum downward, does not fuse with endocardial cushion, opening is '''foramen ovale'''

===Right Atrium===
[[File:Gray0476.jpg|thumb|sinus venosus and tributaries]]
* right sinus horn incorporates into dorsal wall sinus venerum
* sinoatrial opening - has 2 flaps, left fuses with septum secundum, right forms valve to inferior vena cava and coronary sinus. [http://embryology.med.unsw.edu.au/wwwpig/pigc/c3l.htm Stage 13 - right venous valve] [http://embryology.med.unsw.edu.au/wwwhuman/lowpower/HumE/E2L.htm Stage 22 - right venous valve]

===Left Atrium===
* posterior wall - outgrowth forms single pulmonary vein, divided into 4 branches
* incorporation into the wall leads to 4 openings in posterior wall
* later moves to the right aligns with atrioventricular canal.

==Ventricular Septation==
[[File:Stage13 C7L.jpg|thumb|Heart (Carnegie stage 13)]]
[[File:Gray0498.jpg|thumb|Ventricular septum]]
[[File:Heart1_realign icon.jpg|90px|link=Development_Animation_-_Heart Realign]]

* 2 separate components - superior membranous, inferior muscular
===Muscular Septum===
[[File:Gray0470.jpg|thumb|muscular septum]]
* growth of inferior wall
* fusion of 3 components - right and left bulbar ridges and dorsal endocardial cushion

===Membranous Septum===
* above the muscular septum, fusion continuous with septation of the outflow tract

[[File:Heart-ventricular-septum-01.jpg‎]][[File:Heart-ventricular-septum-02.jpg‎]][[File:Heart-ventricular-septum-03.jpg‎]]

==Outflow Tract Septation==

[[File:heart1 ventricle icon.jpg|90px|link=Development_Animation_-_Heart Outflow Septation]]

* truncus arteriousus - 2 growths from wall in spiral pattern, inferior upwards [http://embryology.med.unsw.edu.au/wwwpig/pigb/b5l.htm Stage 13 truncus arteriousus]
* mesenchyme and neural crest contribute to this septation process
* fusion of outgrowths separate aortic and pulmonary outflow

{| border='0px'

|-
| [[File:Chick_Heart_001-icon.jpg|90px|link=Movie_-_Normal Chick Heart]]
| [[File:Chick_Heart_002-icon.jpg|90px|link=Movie_-_Abnormal Chick Heart]]
| [[File:Chick_Heart_002-icon.jpg|90px|link=Movie_-_Abnormal Chick Heart 2]]
|-
| [[Movie_-_Normal Chick Heart|Normal Heart]]
| [[Movie_-_Abnormal Chick Heart|Abnormal Heart]]
| [[Movie_-_Abnormal Chick Heart 2|Abnormal Heart 2]]
|-
|}

==Vascular Remodeling==
===Arterial System===
[[File:Gray0474.jpg|thumb|pharyngeal arch arteries]]
* Aortic sac - remodels forming 2 horns, R forms brachiocephalic artery, L forms common carotid artery

Pharyngeal arch arteries
* pharyngeal arch artery 1 and 2 regress
* pharyngeal arch artery 3 and the associated dorsal aorta form the paired internal carotid arteries, these in turn generate the external carotids
* Left pharyngeal arch artery 4 – forms the aortic arch

* paraxial mesoderm forms paired dorsal aorta
** head mesenchyme forms aortic arches
** connecting stalk contains unbilical (placental) arteries
** dorsal aortas give rise to
** vitelline arteries which connect to capillaries on yolk sac
** intersegmental arteries between somites

===Venous System===
Cardinal veins contribute nearly all systemic venous system.

<gallery>
File:Gray0477.jpg
File:Gray0478.jpg
File:Gray0479.jpg
File:Gray0480.jpg
</gallery>

common cardinal veins - ducts of Cuvier

hepatic veins - drain de-oxygenated blood from the liver into the inferior vena cava.

internal iliac vein - hypogastric vein

==Birth Changes==
[[File:Fetal_circulation1.jpg|thumb|Fetal circulation]]

{| border=1

|-
! Fetal Structure
! Adult Structure
|-
| foramen ovale
| fossa ovalis
|-
| umbilical vein (intra-abdominal part)
| ligamentum teres
|-
| ductus venosus
| ligamentum venosum
|-
| umbilical arteries and abdominal ligaments
| medial umbilical ligaments, superior vesicular artery (supplies bladder)
|-
| ductus arteriosum
| ligamentum arteriosum
|}

==Abnormalities==
There are many different cardiac abnormalities, some more common than others, and only a few will be described in this lecture.

'''Major Abnormalities:''' Aortic Stenosis, Atrial Septal Defects, Coarctation of Aorta, Dextrocardia, Hypoplastic Left Heart, Long QT Syndrome, Patent Ductus Arteriosus, Pulmonary Atresia, Pulmonary Stenosis, Tetralogy of Fallot, Transposition of Great Vessels, Tricuspid Atresia, Total Anomalous Pulmonary Venous Connection, Ventricular Septal Defect, Abnormalities of Conducting System.

Links: [http://embryology.med.unsw.edu.au/Notes/heart2.htm Cardiovascular Development Abnormalities]

[[File:Abnormal81-92-heart.png|thumb]]

[[File:Statistics-Utah heart defects.jpg|thumb]]
===Atrial Septal Defects===

{| border='0px'
|-
| [[File:HeartILP_draft_asd.jpg|Atrial Septal Defect]]
|
* Atrial Septal Defects (ASD) are a group of common (1% of cardiac) congenital anomalies defects occurring in a number of different forms and more often in females.
* patent foramen ovale - allows a continuation of the atrial shunting of blood, in 25% of people a probe patent foramen ovale (allowing a probe to bepassed from one atria to the other) exists.
* ostium secundum defect
* endocardial cushion defect involving ostium primum
* sinus venosus defect - contributes about 10% of all ASDs and occurs mainly in a common and less common form. Common ("usual type") - in upper atrial septum which is contiguous with the superior vena cava. Less common - at junction of the right atrium and inferior vena cava.
* common atrium
|-
|}

===Ventricular Septal Defects===
{| border='0px'
|-
| [[File:HeartILP_draft_vsd.jpg|Ventricular Septal Defect]]
|
* The Ventricular Septal Defect (VSD) usually occurs in the membranous (perimembranous) rather than muscular interventricular septum, and is more frequent in males that females.
* Perimembranous defects are located close to the aortic and tricuspid valves and adjacent to atrioventricular conduction bundle.
* The defect allows left-right shunting of blood, this shunting depends upon the size of the defect. Small defects may close spontaneously, larger defects result in infant congestive heart failure.
* Clinically repaired by coils or tissue-adapted devices like muscular or perimembranous occluders.
|-
|}
(V.S.D.)

===Patent Ductus Arteriosus===

{| border='0px'

|-
| [[File:HeartILP_draft_patentda.jpg|Patent Ductus Arteriosus]]
|
* Patent Ductus Arteriosus (P.D.A.) occurs commonly in preterm infants, can close spontaneously (by day three in 60% of normal term neonates) the remainder are ligated simply and with little risk.
* The operation is always recommended even in the absence of cardiac failure and can often be deferred until early childhood.

|-
|}

===Tetralogy of Fallot===
{| border='0px'
|-
| [[File:HeartILP_draft_tetralogyoffallot.jpg|Tetralogy of Fallot]]
|
* Named after Etienne-Louis Arthur Fallot (1888) who described it as "la maladie blue" and is a common developmental cardiac defect.
* The syndrome consists of a number of a number of cardiac defects possibly stemming from abnormal neural crest migration.
|-
|}

==Movies==

{| border='0px'

|-
| [[File:Heart1_looping icon.jpg|90px|link=Development_Animation_-_Heart Looping]]
| [[File:Heart1_realign icon.jpg|90px|link=Development_Animation_-_Heart Realign]]
| [[File:Heart1_atrium icon.jpg|90px|link=Development_Animation_-_Heart Atrial Septation]]
| [[File:heart1 ventricle icon.jpg|90px|link=Development_Animation_-_Heart Outflow Septation]]
|-
| [[Development_Animation_-_Heart Looping|Heart Looping]]
| [[Development_Animation_-_Heart Realign|Heart Realign]]
| [[Development_Animation_-_Heart Atrial Septation|Heart Atrial Septation]]
| [[Development_Animation_-_Heart Outflow Septation|Heart Outflow Septation]]
|-
|}

'''Link:''' [[Flash Movies]]

{{Template:2009ANAT2341}}

[[Category:2009ANAT2341]] [[Category:Science-Undergraduate]]

[[Category:Cardiovascular]] [[Category:Heart]]

2010 Lecture 21

2010-10-10T02:15:22Z

Z3267024: /* Heart Development */

<div style="background:#F5FFFA; border: 1px solid #CEF2E0; padding: 1em; margin: auto; width: 95%; float:left;"><div style="margin:0;background-color:#cef2e0;font-family:sans-serif;font-size:120%;font-weight:bold;border:1px solid #a3bfb1;text-align:left;color:#000;padding-left:0.4em;padding-top:0.2em;padding-bottom:0.2em;">Lecture Notice - Dr Nalini Pather</div>This online lecture page will contain the content required when attending the lecture. Currently this page is only a template and will be updated before the lecture (this notice removed when completed). Final lecture pages can also be printed out using the "printable version" lefthand menu.</div>

==Introduction==
[[File:Gray0473.gif|300px|right]]

In [[2010 Lecture 7|lecture 7 - Early Vascular Development]], there was an introduction to the origins of the cardiovascular system. This second lecture will now focus on the extensive remodeling that occurs in both the heart and vascular system during later development. In addition, there will be discussion on the major cardiovascular abnormalities. The laboratory this week will also give you the opportunity to work through some of these concepts using a new online teaching module.

This material is also presented in an online [[Cardiac_Embryology|Cardiac Embryology tutorial]].

[[File:Basic_Heart_Development_Timeline.jpg|400px|Link=Cardiac_Embryology]]

{{Template:Heart Links}}

:'''Lecture Audio''' Lecture Date: 12-10-2009 Lecture Time: 12:00 Venue: CLB 5 Speaker: Mark Hill [http://lectopia.elearning.unsw.edu.au/ilectures/ilectures.lasso?ut=153&id=48833 Late Cardiovascular]

==Lecture Objectives==
* Describe the development of primary and secondary atrial septa and the ventricular septum.
* Explain the changes occurring in the bulbis cordis and truncus arteriosus in its transformation from a single to a double tube.
* Describe the development of the aortic arches on the right and left sides from the fetus to the adult.
* Describe the development of arteries and veins.
* Describe the major cardiovascular developmental abnormalities.

==Textbook references==

* Human Embryology (3rd ed.) Larson Chapter 7 p151-188 Heart, Chapter 8 p189-228 Vasculature
* The Developing Human: Clinically Oriented Embryology (6th ed.) Chapter 14: p304-349

'''Other textbooks'''
* Before we Are Born (5th ed.) Moore and Persaud Chapter 12; p241-254
* Essentials of Human Embryology Larson Chapter 7 p97-122 Heart, Chapter 8 p123-146 Vasculature
* Human Embryology Fitzgerald and Fitzgerald Chapter 13-17: p77-111

'''Recent reviews'''
* Yutzey KE, Kirby ML. Wherefore heart thou? Embryonic origins of cardiogenic mesoderm. Dev Dyn. 2002 Mar;223(3):307-20. Review. [http://www.ncbi.nlm.nih.gov/pubmed/11891982?dopt=Abstract PMID: 11891982]
* Three-dimensional reconstruction of gene expression patterns during cardiac development. Soufan AT, Ruijter JM, van den Hoff MJ, de Boer PA, Hagoort J, Moorman AF. Physiol Genomics. 2003 May 13;13(3):187-95. Review. [http://www.ncbi.nlm.nih.gov/pubmed/12746463 PMID: 12746463]
* Moorman A, Webb S, Brown NA, Lamers W, Anderson RH. Development of the heart: (1) formation of the cardiac chambers and arterial trunks. Heart. 2003 Jul;89(7):806-14. [http://www.ncbi.nlm.nih.gov/pubmed/12807866?dopt=Abstract PMID: 12807866]
* Bruneau BG. Transcriptional regulation of vertebrate cardiac morphogenesis. Circ Res. 2002 Mar 22;90(5):509-19. Review. [http://www.ncbi.nlm.nih.gov/pubmed/11909814?dopt=Abstract PMID: 11909814]

==Heart Development==
[[File:Gray0462.gif|thumb|300px|Day 14 Heart tube]]
[[File:Heart_Tube_Fusion.jpg|500px|Early Human Heart Tube Development]]

* [[E#endocardial tube|endocardial tube]] in [[P#pericardial cavity|pericardial cavity]]
** dorsal mesentry (mesocardial) attachment lost
** attached at cranial (arterial) and caudal (venous) ends
* tube elongation - bending and series of expansions
[[File:Heart-cartoon-001.jpg|thumb|Adult Heart blood flow]]
Bulbus Cordis - 3 parts
* distal - forms [[T#truncus arteriosus|truncus arteriosus]] (aorta and pulmonary artery)
* middle - [[C#conus cordis|conus cordis]] ventricular outflow tract
* proximal - right ventricle trabeculate part

{| border=1

|-
! Fetal Structure
! Adult Structure
|-
| Truncus arteriosus
| aorta
pulmonary trunk
|-
| Bulbus cordis
| right ventricle - smooth part (conus arteriosus)
left ventricle - smooth part (aortic vestibule
|-
| Primitive ventricle
| right ventricle - trabecular part
left ventricle - trabecular part
|-
| Primitive atrium
| right atrium - trabecular part
left atrium - trabecular part
|-
| Sinus venosus
| right atrium - smooth part (sinus venarum)
coronary sinus
oblique vein of left atrium
|}

endocardial cushions
* form initial division of atria and ventricles
* fusion forms left and right atrioventricular canals

===Heart Layers===
* '''pericardium''' - covers the heart, formed by 3 layers consisting of a fibrous pericardium and a double layered serous pericardium (parietal layer and visceral epicardium layer).
* '''myocardium''' - muscular wall of the heart, thickest layer formed by spirally arranged cardiac muscle cells.
* '''endocardium''' - lines the heart, epithelial (endothelial) tissue lining the inner surface of heart chambers and valves.

===Embryonic Heart Rate===

* Stage 9-10 2 mm embryo (gestational sac diameter of 20 mm) EHR at least 75 beats / minute
* Stage 11-12 5 mm embryo (gestational sac diameter of 30 mm) EHR at least 100 beats / minute
* Stage 16 10 mm embryo EHR at least 120 beats / minute
* Stage 18 15 mm embryo EHR at least 130 beats / minute

[http://embryology.med.unsw.edu.au/Movies/usound/Hum12wkFHR.htm Week 12 fetal heart rate doppler] [http://embryology.med.unsw.edu.au/Notes/heart8.htm Week 17 fetal heart rate audio]

==Atrial Septation==
[[File:Heart1_atrium icon.jpg|90px|link=Development_Animation_-_Heart Atrial Septation]]

[[File:Stage13 C7L.jpg|thumb|Heart (Carnegie stage 13)]]

Through all development blood shunts from right to left atrium (bypass lungs)

===Septum Primum===
[http://embryology.med.unsw.edu.au/wwwpig/pigc/c1l.htm Stage 13 Septum Primum] [http://embryology.med.unsw.edu.au/wwwhuman/lowpower/HumE/E2L.htm Stage 22 Septum Primum]

* dorso-cranial wall, membranous extension
* grows downward towards endocardial cushions
* opening is '''foramen primum''' (ostium primum)
* septum primum fuses with endocardial cushion, but cranially had begun to degenerate forming '''foramen secundum''' (ostium secundum)

===Septum Secundum===
[[File:Gray0467.jpg|thumb|Septum Secundum]]
* ventro-cranial wall
* grows as septum primum downward, does not fuse with endocardial cushion, opening is '''foramen ovale'''

===Right Atrium===
[[File:Gray0476.jpg|thumb|sinus venosus and tributaries]]
* right sinus horn incorporates into dorsal wall sinus venerum
* sinoatrial opening - has 2 flaps, left fuses with septum secundum, right forms valve to inferior vena cava and coronary sinus. [http://embryology.med.unsw.edu.au/wwwpig/pigc/c3l.htm Stage 13 - right venous valve] [http://embryology.med.unsw.edu.au/wwwhuman/lowpower/HumE/E2L.htm Stage 22 - right venous valve]

===Left Atrium===
* posterior wall - outgrowth forms single pulmonary vein, divided into 4 branches
* incorporation into the wall leads to 4 openings in posterior wall
* later moves to the right aligns with atrioventricular canal.

==Ventricular Septation==
[[File:Stage13 C7L.jpg|thumb|Heart (Carnegie stage 13)]]
[[File:Gray0498.jpg|thumb|Ventricular septum]]
[[File:Heart1_realign icon.jpg|90px|link=Development_Animation_-_Heart Realign]]

* 2 separate components - superior membranous, inferior muscular
===Muscular Septum===
[[File:Gray0470.jpg|thumb|muscular septum]]
* growth of inferior wall
* fusion of 3 components - right and left bulbar ridges and dorsal endocardial cushion

===Membranous Septum===
* above the muscular septum, fusion continuous with septation of the outflow tract

[[File:Heart-ventricular-septum-01.jpg‎]][[File:Heart-ventricular-septum-02.jpg‎]][[File:Heart-ventricular-septum-03.jpg‎]]

==Outflow Tract Septation==

[[File:heart1 ventricle icon.jpg|90px|link=Development_Animation_-_Heart Outflow Septation]]

* truncus arteriousus - 2 growths from wall in spiral pattern, inferior upwards [http://embryology.med.unsw.edu.au/wwwpig/pigb/b5l.htm Stage 13 truncus arteriousus]
* mesenchyme and neural crest contribute to this septation process
* fusion of outgrowths separate aortic and pulmonary outflow

{| border='0px'

|-
| [[File:Chick_Heart_001-icon.jpg|90px|link=Movie_-_Normal Chick Heart]]
| [[File:Chick_Heart_002-icon.jpg|90px|link=Movie_-_Abnormal Chick Heart]]
| [[File:Chick_Heart_002-icon.jpg|90px|link=Movie_-_Abnormal Chick Heart 2]]
|-
| [[Movie_-_Normal Chick Heart|Normal Heart]]
| [[Movie_-_Abnormal Chick Heart|Abnormal Heart]]
| [[Movie_-_Abnormal Chick Heart 2|Abnormal Heart 2]]
|-
|}

==Vascular Remodeling==
===Arterial System===
[[File:Gray0474.jpg|thumb|pharyngeal arch arteries]]
* Aortic sac - remodels forming 2 horns, R forms brachiocephalic artery, L forms common carotid artery

Pharyngeal arch arteries
* pharyngeal arch artery 1 and 2 regress
* pharyngeal arch artery 3 and the associated dorsal aorta form the paired internal carotid arteries, these in turn generate the external carotids
* Left pharyngeal arch artery 4 – forms the aortic arch

* paraxial mesoderm forms paired dorsal aorta
** head mesenchyme forms aortic arches
** connecting stalk contains unbilical (placental) arteries
** dorsal aortas give rise to
** vitelline arteries which connect to capillaries on yolk sac
** intersegmental arteries between somites

===Venous System===
Cardinal veins contribute nearly all systemic venous system.

<gallery>
File:Gray0477.jpg
File:Gray0478.jpg
File:Gray0479.jpg
File:Gray0480.jpg
</gallery>

common cardinal veins - ducts of Cuvier

hepatic veins - drain de-oxygenated blood from the liver into the inferior vena cava.

internal iliac vein - hypogastric vein

==Birth Changes==
[[File:Fetal_circulation1.jpg|thumb|Fetal circulation]]

{| border=1

|-
! Fetal Structure
! Adult Structure
|-
| foramen ovale
| fossa ovalis
|-
| umbilical vein (intra-abdominal part)
| ligamentum teres
|-
| ductus venosus
| ligamentum venosum
|-
| umbilical arteries and abdominal ligaments
| medial umbilical ligaments, superior vesicular artery (supplies bladder)
|-
| ductus arteriosum
| ligamentum arteriosum
|}

==Abnormalities==
There are many different cardiac abnormalities, some more common than others, and only a few will be described in this lecture.

'''Major Abnormalities:''' Aortic Stenosis, Atrial Septal Defects, Coarctation of Aorta, Dextrocardia, Hypoplastic Left Heart, Long QT Syndrome, Patent Ductus Arteriosus, Pulmonary Atresia, Pulmonary Stenosis, Tetralogy of Fallot, Transposition of Great Vessels, Tricuspid Atresia, Total Anomalous Pulmonary Venous Connection, Ventricular Septal Defect, Abnormalities of Conducting System.

Links: [http://embryology.med.unsw.edu.au/Notes/heart2.htm Cardiovascular Development Abnormalities]

[[File:Abnormal81-92-heart.png|thumb]]

[[File:Statistics-Utah heart defects.jpg|thumb]]
===Atrial Septal Defects===

{| border='0px'
|-
| [[File:HeartILP_draft_asd.jpg|Atrial Septal Defect]]
|
* Atrial Septal Defects (ASD) are a group of common (1% of cardiac) congenital anomalies defects occurring in a number of different forms and more often in females.
* patent foramen ovale - allows a continuation of the atrial shunting of blood, in 25% of people a probe patent foramen ovale (allowing a probe to bepassed from one atria to the other) exists.
* ostium secundum defect
* endocardial cushion defect involving ostium primum
* sinus venosus defect - contributes about 10% of all ASDs and occurs mainly in a common and less common form. Common ("usual type") - in upper atrial septum which is contiguous with the superior vena cava. Less common - at junction of the right atrium and inferior vena cava.
* common atrium
|-
|}

===Ventricular Septal Defects===
{| border='0px'
|-
| [[File:HeartILP_draft_vsd.jpg|Ventricular Septal Defect]]
|
* The Ventricular Septal Defect (VSD) usually occurs in the membranous (perimembranous) rather than muscular interventricular septum, and is more frequent in males that females.
* Perimembranous defects are located close to the aortic and tricuspid valves and adjacent to atrioventricular conduction bundle.
* The defect allows left-right shunting of blood, this shunting depends upon the size of the defect. Small defects may close spontaneously, larger defects result in infant congestive heart failure.
* Clinically repaired by coils or tissue-adapted devices like muscular or perimembranous occluders.
|-
|}
(V.S.D.)

===Patent Ductus Arteriosus===

{| border='0px'

|-
| [[File:HeartILP_draft_patentda.jpg|Patent Ductus Arteriosus]]
|
* Patent Ductus Arteriosus (P.D.A.) occurs commonly in preterm infants, can close spontaneously (by day three in 60% of normal term neonates) the remainder are ligated simply and with little risk.
* The operation is always recommended even in the absence of cardiac failure and can often be deferred until early childhood.

|-
|}

===Tetralogy of Fallot===
{| border='0px'
|-
| [[File:HeartILP_draft_tetralogyoffallot.jpg|Tetralogy of Fallot]]
|
* Named after Etienne-Louis Arthur Fallot (1888) who described it as "la maladie blue" and is a common developmental cardiac defect.
* The syndrome consists of a number of a number of cardiac defects possibly stemming from abnormal neural crest migration.
|-
|}

==Movies==

{| border='0px'

|-
| [[File:Heart1_looping icon.jpg|90px|link=Development_Animation_-_Heart Looping]]
| [[File:Heart1_realign icon.jpg|90px|link=Development_Animation_-_Heart Realign]]
| [[File:Heart1_atrium icon.jpg|90px|link=Development_Animation_-_Heart Atrial Septation]]
| [[File:heart1 ventricle icon.jpg|90px|link=Development_Animation_-_Heart Outflow Septation]]
|-
| [[Development_Animation_-_Heart Looping|Heart Looping]]
| [[Development_Animation_-_Heart Realign|Heart Realign]]
| [[Development_Animation_-_Heart Atrial Septation|Heart Atrial Septation]]
| [[Development_Animation_-_Heart Outflow Septation|Heart Outflow Septation]]
|-
|}

'''Link:''' [[Flash Movies]]

{{Template:2009ANAT2341}}

[[Category:2009ANAT2341]] [[Category:Science-Undergraduate]]

[[Category:Cardiovascular]] [[Category:Heart]]

2010 Lecture 21

2010-10-09T12:19:45Z

Z3267024:

<div style="background:#F5FFFA; border: 1px solid #CEF2E0; padding: 1em; margin: auto; width: 95%; float:left;"><div style="margin:0;background-color:#cef2e0;font-family:sans-serif;font-size:120%;font-weight:bold;border:1px solid #a3bfb1;text-align:left;color:#000;padding-left:0.4em;padding-top:0.2em;padding-bottom:0.2em;">Lecture Notice - Dr Nalini Pather</div>This online lecture page will contain the content required when attending the lecture. Currently this page is only a template and will be updated before the lecture (this notice removed when completed). Final lecture pages can also be printed out using the "printable version" lefthand menu.</div>

{{Template:2010ANAT2341}}

==Introduction==
[[File:Gray0473.gif|300px|right]]

In [[2010 Lecture 7|lecture 7 - Early Vascular Development]], there was an introduction to the origins of the cardiovascular system. This second lecture will now focus on the extensive remodeling that occurs in both the heart and vascular system during later development. In addition, there will be discussion on the major cardiovascular abnormalities. The laboratory this week will also give you the opportunity to work through some of these concepts using a new online teaching module.

This material is also presented in an online [[Cardiac_Embryology|Cardiac Embryology tutorial]].

[[File:Basic_Heart_Development_Timeline.jpg|400px|Link=Cardiac_Embryology]]

{{Template:Heart Links}}

:'''Lecture Audio''' Lecture Date: 12-10-2009 Lecture Time: 12:00 Venue: CLB 5 Speaker: Mark Hill [http://lectopia.elearning.unsw.edu.au/ilectures/ilectures.lasso?ut=153&id=48833 Late Cardiovascular]

==Lecture Objectives==
* Describe the development of primary and secondary atrial septa and the ventricular septum.
* Explain the changes occurring in the bulbis cordis and truncus arteriosus in its transformation from a single to a double tube.
* Describe the development of the aortic arches on the right and left sides from the fetus to the adult.
* Describe the development of arteries and veins.
* Describe the major cardiovascular developmental abnormalities.

==Textbook references==

* Human Embryology (3rd ed.) Larson Chapter 7 p151-188 Heart, Chapter 8 p189-228 Vasculature
* The Developing Human: Clinically Oriented Embryology (6th ed.) Chapter 14: p304-349

'''Other textbooks'''
* Before we Are Born (5th ed.) Moore and Persaud Chapter 12; p241-254
* Essentials of Human Embryology Larson Chapter 7 p97-122 Heart, Chapter 8 p123-146 Vasculature
* Human Embryology Fitzgerald and Fitzgerald Chapter 13-17: p77-111

'''Recent reviews'''
* Yutzey KE, Kirby ML. Wherefore heart thou? Embryonic origins of cardiogenic mesoderm. Dev Dyn. 2002 Mar;223(3):307-20. Review. [http://www.ncbi.nlm.nih.gov/pubmed/11891982?dopt=Abstract PMID: 11891982]
* Three-dimensional reconstruction of gene expression patterns during cardiac development. Soufan AT, Ruijter JM, van den Hoff MJ, de Boer PA, Hagoort J, Moorman AF. Physiol Genomics. 2003 May 13;13(3):187-95. Review. [http://www.ncbi.nlm.nih.gov/pubmed/12746463 PMID: 12746463]
* Moorman A, Webb S, Brown NA, Lamers W, Anderson RH. Development of the heart: (1) formation of the cardiac chambers and arterial trunks. Heart. 2003 Jul;89(7):806-14. [http://www.ncbi.nlm.nih.gov/pubmed/12807866?dopt=Abstract PMID: 12807866]
* Bruneau BG. Transcriptional regulation of vertebrate cardiac morphogenesis. Circ Res. 2002 Mar 22;90(5):509-19. Review. [http://www.ncbi.nlm.nih.gov/pubmed/11909814?dopt=Abstract PMID: 11909814]

==Heart Development==
[[File:Gray0462.gif|thumb|Day 14 Heart tube]]
[[File:Heart_Tube_Fusion.jpg|500px|Early Human Heart Tube Development]]

* [[E#endocardial tube|endocardial tube]] in [[P#pericardial cavity|pericardial cavity]]
** dorsal mesentry (mesocardial) attachment lost
** attached at cranial (arterial) and caudal (venous) ends
* tube elongation - bending and series of expansions
[[File:Heart-cartoon-001.jpg|thumb|Adult Heart blood flow]]
Bulbus Cordis - 3 parts
* distal - forms [[T#truncus arteriosus|truncus arteriosus]] (aorta and pulmonary artery)
* middle - [[C#conus cordis|conus cordis]] ventricular outflow tract
* proximal - right ventricle trabeculate part

{| border=1

|-
! Fetal Structure
! Adult Structure
|-
| Truncus arteriosus
| aorta
pulmonary trunk
|-
| Bulbus cordis
| right ventricle - smooth part (conus arteriosus)
left ventricle - smooth part (aortic vestibule
|-
| Primitive ventricle
| right ventricle - trabecular part
left ventricle - trabecular part
|-
| Primitive atrium
| right atrium - trabecular part
left atrium - trabecular part
|-
| Sinus venosus
| right atrium - smooth part (sinus venarum)
coronary sinus
oblique vein of left atrium
|}

endocardial cushions
* form initial division of atria and ventricles
* fusion forms left and right atrioventricular canals

===Heart Layers===
* '''pericardium''' - covers the heart, formed by 3 layers consisting of a fibrous pericardium and a double layered serous pericardium (parietal layer and visceral epicardium layer).
* '''myocardium''' - muscular wall of the heart, thickest layer formed by spirally arranged cardiac muscle cells.
* '''endocardium''' - lines the heart, epithelial (endothelial) tissue lining the inner surface of heart chambers and valves.

===Embryonic Heart Rate===

* Stage 9-10 2 mm embryo (gestational sac diameter of 20 mm) EHR at least 75 beats / minute
* Stage 11-12 5 mm embryo (gestational sac diameter of 30 mm) EHR at least 100 beats / minute
* Stage 16 10 mm embryo EHR at least 120 beats / minute
* Stage 18 15 mm embryo EHR at least 130 beats / minute

[http://embryology.med.unsw.edu.au/Movies/usound/Hum12wkFHR.htm Week 12 fetal heart rate doppler] [http://embryology.med.unsw.edu.au/Notes/heart8.htm Week 17 fetal heart rate audio]

==Atrial Septation==
[[File:Heart1_atrium icon.jpg|90px|link=Development_Animation_-_Heart Atrial Septation]]

[[File:Stage13 C7L.jpg|thumb|Heart (Carnegie stage 13)]]

Through all development blood shunts from right to left atrium (bypass lungs)

===Septum Primum===
[http://embryology.med.unsw.edu.au/wwwpig/pigc/c1l.htm Stage 13 Septum Primum] [http://embryology.med.unsw.edu.au/wwwhuman/lowpower/HumE/E2L.htm Stage 22 Septum Primum]

* dorso-cranial wall, membranous extension
* grows downward towards endocardial cushions
* opening is '''foramen primum''' (ostium primum)
* septum primum fuses with endocardial cushion, but cranially had begun to degenerate forming '''foramen secundum''' (ostium secundum)

===Septum Secundum===
[[File:Gray0467.jpg|thumb|Septum Secundum]]
* ventro-cranial wall
* grows as septum primum downward, does not fuse with endocardial cushion, opening is '''foramen ovale'''

===Right Atrium===
[[File:Gray0476.jpg|thumb|sinus venosus and tributaries]]
* right sinus horn incorporates into dorsal wall sinus venerum
* sinoatrial opening - has 2 flaps, left fuses with septum secundum, right forms valve to inferior vena cava and coronary sinus. [http://embryology.med.unsw.edu.au/wwwpig/pigc/c3l.htm Stage 13 - right venous valve] [http://embryology.med.unsw.edu.au/wwwhuman/lowpower/HumE/E2L.htm Stage 22 - right venous valve]

===Left Atrium===
* posterior wall - outgrowth forms single pulmonary vein, divided into 4 branches
* incorporation into the wall leads to 4 openings in posterior wall
* later moves to the right aligns with atrioventricular canal.

==Ventricular Septation==
[[File:Stage13 C7L.jpg|thumb|Heart (Carnegie stage 13)]]
[[File:Gray0498.jpg|thumb|Ventricular septum]]
[[File:Heart1_realign icon.jpg|90px|link=Development_Animation_-_Heart Realign]]

* 2 separate components - superior membranous, inferior muscular
===Muscular Septum===
[[File:Gray0470.jpg|thumb|muscular septum]]
* growth of inferior wall
* fusion of 3 components - right and left bulbar ridges and dorsal endocardial cushion

===Membranous Septum===
* above the muscular septum, fusion continuous with septation of the outflow tract

[[File:Heart-ventricular-septum-01.jpg‎]][[File:Heart-ventricular-septum-02.jpg‎]][[File:Heart-ventricular-septum-03.jpg‎]]

==Outflow Tract Septation==

[[File:heart1 ventricle icon.jpg|90px|link=Development_Animation_-_Heart Outflow Septation]]

* truncus arteriousus - 2 growths from wall in spiral pattern, inferior upwards [http://embryology.med.unsw.edu.au/wwwpig/pigb/b5l.htm Stage 13 truncus arteriousus]
* mesenchyme and neural crest contribute to this septation process
* fusion of outgrowths separate aortic and pulmonary outflow

{| border='0px'

|-
| [[File:Chick_Heart_001-icon.jpg|90px|link=Movie_-_Normal Chick Heart]]
| [[File:Chick_Heart_002-icon.jpg|90px|link=Movie_-_Abnormal Chick Heart]]
| [[File:Chick_Heart_002-icon.jpg|90px|link=Movie_-_Abnormal Chick Heart 2]]
|-
| [[Movie_-_Normal Chick Heart|Normal Heart]]
| [[Movie_-_Abnormal Chick Heart|Abnormal Heart]]
| [[Movie_-_Abnormal Chick Heart 2|Abnormal Heart 2]]
|-
|}

==Vascular Remodeling==
===Arterial System===
[[File:Gray0474.jpg|thumb|pharyngeal arch arteries]]
* Aortic sac - remodels forming 2 horns, R forms brachiocephalic artery, L forms common carotid artery

Pharyngeal arch arteries
* pharyngeal arch artery 1 and 2 regress
* pharyngeal arch artery 3 and the associated dorsal aorta form the paired internal carotid arteries, these in turn generate the external carotids
* Left pharyngeal arch artery 4 – forms the aortic arch

* paraxial mesoderm forms paired dorsal aorta
** head mesenchyme forms aortic arches
** connecting stalk contains unbilical (placental) arteries
** dorsal aortas give rise to
** vitelline arteries which connect to capillaries on yolk sac
** intersegmental arteries between somites

===Venous System===
Cardinal veins contribute nearly all systemic venous system.

<gallery>
File:Gray0477.jpg
File:Gray0478.jpg
File:Gray0479.jpg
File:Gray0480.jpg
</gallery>

common cardinal veins - ducts of Cuvier

hepatic veins - drain de-oxygenated blood from the liver into the inferior vena cava.

internal iliac vein - hypogastric vein

==Birth Changes==
[[File:Fetal_circulation1.jpg|thumb|Fetal circulation]]

{| border=1

|-
! Fetal Structure
! Adult Structure
|-
| foramen ovale
| fossa ovalis
|-
| umbilical vein (intra-abdominal part)
| ligamentum teres
|-
| ductus venosus
| ligamentum venosum
|-
| umbilical arteries and abdominal ligaments
| medial umbilical ligaments, superior vesicular artery (supplies bladder)
|-
| ductus arteriosum
| ligamentum arteriosum
|}

==Abnormalities==
There are many different cardiac abnormalities, some more common than others, and only a few will be described in this lecture.

'''Major Abnormalities:''' Aortic Stenosis, Atrial Septal Defects, Coarctation of Aorta, Dextrocardia, Hypoplastic Left Heart, Long QT Syndrome, Patent Ductus Arteriosus, Pulmonary Atresia, Pulmonary Stenosis, Tetralogy of Fallot, Transposition of Great Vessels, Tricuspid Atresia, Total Anomalous Pulmonary Venous Connection, Ventricular Septal Defect, Abnormalities of Conducting System.

Links: [http://embryology.med.unsw.edu.au/Notes/heart2.htm Cardiovascular Development Abnormalities]

[[File:Abnormal81-92-heart.png|thumb]]

[[File:Statistics-Utah heart defects.jpg|thumb]]
===Atrial Septal Defects===

{| border='0px'
|-
| [[File:HeartILP_draft_asd.jpg|Atrial Septal Defect]]
|
* Atrial Septal Defects (ASD) are a group of common (1% of cardiac) congenital anomalies defects occurring in a number of different forms and more often in females.
* patent foramen ovale - allows a continuation of the atrial shunting of blood, in 25% of people a probe patent foramen ovale (allowing a probe to bepassed from one atria to the other) exists.
* ostium secundum defect
* endocardial cushion defect involving ostium primum
* sinus venosus defect - contributes about 10% of all ASDs and occurs mainly in a common and less common form. Common ("usual type") - in upper atrial septum which is contiguous with the superior vena cava. Less common - at junction of the right atrium and inferior vena cava.
* common atrium
|-
|}

===Ventricular Septal Defects===
{| border='0px'
|-
| [[File:HeartILP_draft_vsd.jpg|Ventricular Septal Defect]]
|
* The Ventricular Septal Defect (VSD) usually occurs in the membranous (perimembranous) rather than muscular interventricular septum, and is more frequent in males that females.
* Perimembranous defects are located close to the aortic and tricuspid valves and adjacent to atrioventricular conduction bundle.
* The defect allows left-right shunting of blood, this shunting depends upon the size of the defect. Small defects may close spontaneously, larger defects result in infant congestive heart failure.
* Clinically repaired by coils or tissue-adapted devices like muscular or perimembranous occluders.
|-
|}
(V.S.D.)

===Patent Ductus Arteriosus===

{| border='0px'

|-
| [[File:HeartILP_draft_patentda.jpg|Patent Ductus Arteriosus]]
|
* Patent Ductus Arteriosus (P.D.A.) occurs commonly in preterm infants, can close spontaneously (by day three in 60% of normal term neonates) the remainder are ligated simply and with little risk.
* The operation is always recommended even in the absence of cardiac failure and can often be deferred until early childhood.

|-
|}

===Tetralogy of Fallot===
{| border='0px'
|-
| [[File:HeartILP_draft_tetralogyoffallot.jpg|Tetralogy of Fallot]]
|
* Named after Etienne-Louis Arthur Fallot (1888) who described it as "la maladie blue" and is a common developmental cardiac defect.
* The syndrome consists of a number of a number of cardiac defects possibly stemming from abnormal neural crest migration.
|-
|}

==Movies==

{| border='0px'

|-
| [[File:Heart1_looping icon.jpg|90px|link=Development_Animation_-_Heart Looping]]
| [[File:Heart1_realign icon.jpg|90px|link=Development_Animation_-_Heart Realign]]
| [[File:Heart1_atrium icon.jpg|90px|link=Development_Animation_-_Heart Atrial Septation]]
| [[File:heart1 ventricle icon.jpg|90px|link=Development_Animation_-_Heart Outflow Septation]]
|-
| [[Development_Animation_-_Heart Looping|Heart Looping]]
| [[Development_Animation_-_Heart Realign|Heart Realign]]
| [[Development_Animation_-_Heart Atrial Septation|Heart Atrial Septation]]
| [[Development_Animation_-_Heart Outflow Septation|Heart Outflow Septation]]
|-
|}

'''Link:''' [[Flash Movies]]

{{Template:2009ANAT2341}}

[[Category:2009ANAT2341]] [[Category:Science-Undergraduate]]

[[Category:Cardiovascular]] [[Category:Heart]]

2010 Lecture 21

2010-10-09T12:09:35Z

Z3267024:

<div style="background:#F5FFFA; border: 1px solid #CEF2E0; padding: 1em; margin: auto; width: 95%; float:left;"><div style="margin:0;background-color:#cef2e0;font-family:sans-serif;font-size:120%;font-weight:bold;border:1px solid #a3bfb1;text-align:left;color:#000;padding-left:0.4em;padding-top:0.2em;padding-bottom:0.2em;">Lecture Notice - Dr Nalini Pather</div>This online lecture page will contain the content required when attending the lecture. Currently this page is only a template and will be updated before the lecture (this notice removed when completed). Final lecture pages can also be printed out using the "printable version" lefthand menu.</div>

{{Template:2010ANAT2341}}

==Introduction==
[[File:Gray0473.gif|300px|right]]

In [[2010 Lecture 7|lecture 7 - Early Vascular Development]], there was an introduction to the origins of the cardiovascular system. This second lecture will now focus on the extensive remodeling that occurs in both the heart and vascular system during later development. In addition, there will be discussion on the major cardiovascular abnormalities. The laboratory this week will also give you the opportunity to work through some of these concepts using a new online teaching module.

This material is also presented in an online [[Cardiac_Embryology|Cardiac Embryology tutorial]].

[[File:Basic_Heart_Development_Timeline.jpg|400px|Link=Cardiac_Embryology]]

{{Template:Heart Links}}

:'''Lecture Audio''' Lecture Date: 12-10-2009 Lecture Time: 12:00 Venue: CLB 5 Speaker: Mark Hill [http://lectopia.elearning.unsw.edu.au/ilectures/ilectures.lasso?ut=153&id=48833 Late Cardiovascular]

==Lecture Objectives==
* Describe the development of primary and secondary atrial septa and the ventricular septum.
* Explain the changes occurring in the bulbis cordis and truncus arteriosus in its transformation from a single to a double tube.
* Describe the development of the aortic arches on the right and left sides from the fetus to the adult.
* Describe the development of arteries and veins.
* Describe the major cardiovascular developmental abnormalities.

==Textbook references==

* Human Embryology (3rd ed.) Larson Chapter 7 p151-188 Heart, Chapter 8 p189-228 Vasculature
* The Developing Human: Clinically Oriented Embryology (6th ed.) Chapter 14: p304-349

'''Other textbooks'''
* Before we Are Born (5th ed.) Moore and Persaud Chapter 12; p241-254
* Essentials of Human Embryology Larson Chapter 7 p97-122 Heart, Chapter 8 p123-146 Vasculature
* Human Embryology Fitzgerald and Fitzgerald Chapter 13-17: p77-111

'''Recent reviews'''
* Yutzey KE, Kirby ML. Wherefore heart thou? Embryonic origins of cardiogenic mesoderm. Dev Dyn. 2002 Mar;223(3):307-20. Review. [http://www.ncbi.nlm.nih.gov/pubmed/11891982?dopt=Abstract PMID: 11891982]
* Three-dimensional reconstruction of gene expression patterns during cardiac development. Soufan AT, Ruijter JM, van den Hoff MJ, de Boer PA, Hagoort J, Moorman AF. Physiol Genomics. 2003 May 13;13(3):187-95. Review. [http://www.ncbi.nlm.nih.gov/pubmed/12746463 PMID: 12746463]
* Moorman A, Webb S, Brown NA, Lamers W, Anderson RH. Development of the heart: (1) formation of the cardiac chambers and arterial trunks. Heart. 2003 Jul;89(7):806-14. [http://www.ncbi.nlm.nih.gov/pubmed/12807866?dopt=Abstract PMID: 12807866]
* Bruneau BG. Transcriptional regulation of vertebrate cardiac morphogenesis. Circ Res. 2002 Mar 22;90(5):509-19. Review. [http://www.ncbi.nlm.nih.gov/pubmed/11909814?dopt=Abstract PMID: 11909814]

==Heart Development==
[[File:Gray0462.gif|thumb|Day 14 Heart tube]]
[[File:Heart_Tube_Fusion.jpg|500px|Early Human Heart Tube Development]]

* [[E#endocardial tube|endocardial tube]] in [[P#pericardial cavity|pericardial cavity]]
** dorsal mesentry (mesocardial) attachment lost
** attached at cranial (arterial) and caudal (venous) ends
* tube elongation - bending and series of expansions
[[File:Heart-cartoon-001.jpg|thumb|Adult Heart blood flow]]
Bulbus Cordis - 3 parts
* distal - forms [[T#truncus arteriosus|truncus arteriosus]] (aorta and pulmonary artery)
* middle - [[C#conus cordis|conus cordis]] ventricular outflow tract
* proximal - right ventricle trabeculate part

{| border=1

|-
! Fetal Structure
! Adult Structure
|-
| Truncus arteriosus
| aorta; pulmonary trunk
|-
| Bulbus cordis
| right ventricle - smooth part (conus arteriosus)
| left ventricle - smooth part (aortic vestibule
|-
| Primitive ventricle
| right ventricle - trabecular part; left ventricle - trabecular part
|-
| Primitive atrium
| right atrium - trabecular part; left atrium - trabecular part
|-
| Sinus venosus
| right atrium - smooth part (sinus venarum)
coronary sinus
oblique vein of left atrium

|}

endocardial cushions
* form initial division of atria and ventricles
* fusion forms left and right atrioventricular canals

===Heart Layers===
* '''pericardium''' - covers the heart, formed by 3 layers consisting of a fibrous pericardium and a double layered serous pericardium (parietal layer and visceral epicardium layer).
* '''myocardium''' - muscular wall of the heart, thickest layer formed by spirally arranged cardiac muscle cells.
* '''endocardium''' - lines the heart, epithelial (endothelial) tissue lining the inner surface of heart chambers and valves.

===Embryonic Heart Rate===

* Stage 9-10 2 mm embryo (gestational sac diameter of 20 mm) EHR at least 75 beats / minute
* Stage 11-12 5 mm embryo (gestational sac diameter of 30 mm) EHR at least 100 beats / minute
* Stage 16 10 mm embryo EHR at least 120 beats / minute
* Stage 18 15 mm embryo EHR at least 130 beats / minute

[http://embryology.med.unsw.edu.au/Movies/usound/Hum12wkFHR.htm Week 12 fetal heart rate doppler] [http://embryology.med.unsw.edu.au/Notes/heart8.htm Week 17 fetal heart rate audio]

==Atrial Septation==
[[File:Heart1_atrium icon.jpg|90px|link=Development_Animation_-_Heart Atrial Septation]]

[[File:Stage13 C7L.jpg|thumb|Heart (Carnegie stage 13)]]

Through all development blood shunts from right to left atrium (bypass lungs)

===Septum Primum===
[http://embryology.med.unsw.edu.au/wwwpig/pigc/c1l.htm Stage 13 Septum Primum] [http://embryology.med.unsw.edu.au/wwwhuman/lowpower/HumE/E2L.htm Stage 22 Septum Primum]

* dorso-cranial wall, membranous extension
* grows downward towards endocardial cushions
* opening is '''foramen primum''' (ostium primum)
* septum primum fuses with endocardial cushion, but cranially had begun to degenerate forming '''foramen secundum''' (ostium secundum)

===Septum Secundum===
[[File:Gray0467.jpg|thumb|Septum Secundum]]
* ventro-cranial wall
* grows as septum primum downward, does not fuse with endocardial cushion, opening is '''foramen ovale'''

===Right Atrium===
[[File:Gray0476.jpg|thumb|sinus venosus and tributaries]]
* right sinus horn incorporates into dorsal wall sinus venerum
* sinoatrial opening - has 2 flaps, left fuses with septum secundum, right forms valve to inferior vena cava and coronary sinus. [http://embryology.med.unsw.edu.au/wwwpig/pigc/c3l.htm Stage 13 - right venous valve] [http://embryology.med.unsw.edu.au/wwwhuman/lowpower/HumE/E2L.htm Stage 22 - right venous valve]

===Left Atrium===
* posterior wall - outgrowth forms single pulmonary vein, divided into 4 branches
* incorporation into the wall leads to 4 openings in posterior wall
* later moves to the right aligns with atrioventricular canal.

==Ventricular Septation==
[[File:Stage13 C7L.jpg|thumb|Heart (Carnegie stage 13)]]
[[File:Gray0498.jpg|thumb|Ventricular septum]]
[[File:Heart1_realign icon.jpg|90px|link=Development_Animation_-_Heart Realign]]

* 2 separate components - superior membranous, inferior muscular
===Muscular Septum===
[[File:Gray0470.jpg|thumb|muscular septum]]
* growth of inferior wall
* fusion of 3 components - right and left bulbar ridges and dorsal endocardial cushion

===Membranous Septum===
* above the muscular septum, fusion continuous with septation of the outflow tract

[[File:Heart-ventricular-septum-01.jpg‎]][[File:Heart-ventricular-septum-02.jpg‎]][[File:Heart-ventricular-septum-03.jpg‎]]

==Outflow Tract Septation==

[[File:heart1 ventricle icon.jpg|90px|link=Development_Animation_-_Heart Outflow Septation]]

* truncus arteriousus - 2 growths from wall in spiral pattern, inferior upwards [http://embryology.med.unsw.edu.au/wwwpig/pigb/b5l.htm Stage 13 truncus arteriousus]
* mesenchyme and neural crest contribute to this septation process
* fusion of outgrowths separate aortic and pulmonary outflow

{| border='0px'

|-
| [[File:Chick_Heart_001-icon.jpg|90px|link=Movie_-_Normal Chick Heart]]
| [[File:Chick_Heart_002-icon.jpg|90px|link=Movie_-_Abnormal Chick Heart]]
| [[File:Chick_Heart_002-icon.jpg|90px|link=Movie_-_Abnormal Chick Heart 2]]
|-
| [[Movie_-_Normal Chick Heart|Normal Heart]]
| [[Movie_-_Abnormal Chick Heart|Abnormal Heart]]
| [[Movie_-_Abnormal Chick Heart 2|Abnormal Heart 2]]
|-
|}

==Vascular Remodeling==
===Arterial System===
[[File:Gray0474.jpg|thumb|pharyngeal arch arteries]]
* Aortic sac - remodels forming 2 horns, R forms brachiocephalic artery, L forms common carotid artery

Pharyngeal arch arteries
* pharyngeal arch artery 1 and 2 regress
* pharyngeal arch artery 3 and the associated dorsal aorta form the paired internal carotid arteries, these in turn generate the external carotids
* Left pharyngeal arch artery 4 – forms the aortic arch

* paraxial mesoderm forms paired dorsal aorta
** head mesenchyme forms aortic arches
** connecting stalk contains unbilical (placental) arteries
** dorsal aortas give rise to
** vitelline arteries which connect to capillaries on yolk sac
** intersegmental arteries between somites

===Venous System===
Cardinal veins contribute nearly all systemic venous system.

<gallery>
File:Gray0477.jpg
File:Gray0478.jpg
File:Gray0479.jpg
File:Gray0480.jpg
</gallery>

common cardinal veins - ducts of Cuvier

hepatic veins - drain de-oxygenated blood from the liver into the inferior vena cava.

internal iliac vein - hypogastric vein

==Birth Changes==
[[File:Fetal_circulation1.jpg|thumb|Fetal circulation]]

{| border=1

|-
! Fetal Structure
! Adult Structure
|-
| foramen ovale
| fossa ovalis
|-
| umbilical vein (intra-abdominal part)
| ligamentum teres
|-
| ductus venosus
| ligamentum venosum
|-
| umbilical arteries and abdominal ligaments
| medial umbilical ligaments, superior vesicular artery (supplies bladder)
|-
| ductus arteriosum
| ligamentum arteriosum
|}

==Abnormalities==
There are many different cardiac abnormalities, some more common than others, and only a few will be described in this lecture.

'''Major Abnormalities:''' Aortic Stenosis, Atrial Septal Defects, Coarctation of Aorta, Dextrocardia, Hypoplastic Left Heart, Long QT Syndrome, Patent Ductus Arteriosus, Pulmonary Atresia, Pulmonary Stenosis, Tetralogy of Fallot, Transposition of Great Vessels, Tricuspid Atresia, Total Anomalous Pulmonary Venous Connection, Ventricular Septal Defect, Abnormalities of Conducting System.

Links: [http://embryology.med.unsw.edu.au/Notes/heart2.htm Cardiovascular Development Abnormalities]

[[File:Abnormal81-92-heart.png|thumb]]

[[File:Statistics-Utah heart defects.jpg|thumb]]
===Atrial Septal Defects===

{| border='0px'
|-
| [[File:HeartILP_draft_asd.jpg|Atrial Septal Defect]]
|
* Atrial Septal Defects (ASD) are a group of common (1% of cardiac) congenital anomalies defects occurring in a number of different forms and more often in females.
* patent foramen ovale - allows a continuation of the atrial shunting of blood, in 25% of people a probe patent foramen ovale (allowing a probe to bepassed from one atria to the other) exists.
* ostium secundum defect
* endocardial cushion defect involving ostium primum
* sinus venosus defect - contributes about 10% of all ASDs and occurs mainly in a common and less common form. Common ("usual type") - in upper atrial septum which is contiguous with the superior vena cava. Less common - at junction of the right atrium and inferior vena cava.
* common atrium
|-
|}

===Ventricular Septal Defects===
{| border='0px'
|-
| [[File:HeartILP_draft_vsd.jpg|Ventricular Septal Defect]]
|
* The Ventricular Septal Defect (VSD) usually occurs in the membranous (perimembranous) rather than muscular interventricular septum, and is more frequent in males that females.
* Perimembranous defects are located close to the aortic and tricuspid valves and adjacent to atrioventricular conduction bundle.
* The defect allows left-right shunting of blood, this shunting depends upon the size of the defect. Small defects may close spontaneously, larger defects result in infant congestive heart failure.
* Clinically repaired by coils or tissue-adapted devices like muscular or perimembranous occluders.
|-
|}
(V.S.D.)

===Patent Ductus Arteriosus===

{| border='0px'

|-
| [[File:HeartILP_draft_patentda.jpg|Patent Ductus Arteriosus]]
|
* Patent Ductus Arteriosus (P.D.A.) occurs commonly in preterm infants, can close spontaneously (by day three in 60% of normal term neonates) the remainder are ligated simply and with little risk.
* The operation is always recommended even in the absence of cardiac failure and can often be deferred until early childhood.

|-
|}

===Tetralogy of Fallot===
{| border='0px'
|-
| [[File:HeartILP_draft_tetralogyoffallot.jpg|Tetralogy of Fallot]]
|
* Named after Etienne-Louis Arthur Fallot (1888) who described it as "la maladie blue" and is a common developmental cardiac defect.
* The syndrome consists of a number of a number of cardiac defects possibly stemming from abnormal neural crest migration.
|-
|}

==Movies==

{| border='0px'

|-
| [[File:Heart1_looping icon.jpg|90px|link=Development_Animation_-_Heart Looping]]
| [[File:Heart1_realign icon.jpg|90px|link=Development_Animation_-_Heart Realign]]
| [[File:Heart1_atrium icon.jpg|90px|link=Development_Animation_-_Heart Atrial Septation]]
| [[File:heart1 ventricle icon.jpg|90px|link=Development_Animation_-_Heart Outflow Septation]]
|-
| [[Development_Animation_-_Heart Looping|Heart Looping]]
| [[Development_Animation_-_Heart Realign|Heart Realign]]
| [[Development_Animation_-_Heart Atrial Septation|Heart Atrial Septation]]
| [[Development_Animation_-_Heart Outflow Septation|Heart Outflow Septation]]
|-
|}

'''Link:''' [[Flash Movies]]

{{Template:2009ANAT2341}}

[[Category:2009ANAT2341]] [[Category:Science-Undergraduate]]

[[Category:Cardiovascular]] [[Category:Heart]]

2010 Lecture 21

2010-10-09T11:58:19Z

Z3267024:

<div style="background:#F5FFFA; border: 1px solid #CEF2E0; padding: 1em; margin: auto; width: 95%; float:left;"><div style="margin:0;background-color:#cef2e0;font-family:sans-serif;font-size:120%;font-weight:bold;border:1px solid #a3bfb1;text-align:left;color:#000;padding-left:0.4em;padding-top:0.2em;padding-bottom:0.2em;">Lecture Notice - Dr Nalini Pather</div>This online lecture page will contain the content required when attending the lecture. Currently this page is only a template and will be updated before the lecture (this notice removed when completed). Final lecture pages can also be printed out using the "printable version" lefthand menu.</div>

{{Template:2010ANAT2341}}

==Introduction==
[[File:Gray0473.gif|300px|right]]

In [[2010 Lecture 7|lecture 7 - Early Vascular Development]], there was an introduction to the origins of the cardiovascular system. This second lecture will now focus on the extensive remodeling that occurs in both the heart and vascular system during later development. In addition, there will be discussion on the major cardiovascular abnormalities. The laboratory this week will also give you the opportunity to work through some of these concepts using a new online teaching module.

This material is also presented in an online [[Cardiac_Embryology|Cardiac Embryology tutorial]].

[[File:Basic_Heart_Development_Timeline.jpg|400px|Link=Cardiac_Embryology]]

{{Template:Heart Links}}

:'''Lecture Audio''' Lecture Date: 12-10-2009 Lecture Time: 12:00 Venue: CLB 5 Speaker: Mark Hill [http://lectopia.elearning.unsw.edu.au/ilectures/ilectures.lasso?ut=153&id=48833 Late Cardiovascular]

==Lecture Objectives==
* Describe the development of primary and secondary atrial septa and the ventricular septum.
* Explain the changes occurring in the bulbis cordis and truncus arteriosus in its transformation from a single to a double tube.
* Describe the development of the aortic arches on the right and left sides from the fetus to the adult.
* Describe the development of arteries and veins.
* Describe the major cardiovascular developmental abnormalities.

==Textbook references==

* Human Embryology (3rd ed.) Larson Chapter 7 p151-188 Heart, Chapter 8 p189-228 Vasculature
* The Developing Human: Clinically Oriented Embryology (6th ed.) Chapter 14: p304-349

'''Other textbooks'''
* Before we Are Born (5th ed.) Moore and Persaud Chapter 12; p241-254
* Essentials of Human Embryology Larson Chapter 7 p97-122 Heart, Chapter 8 p123-146 Vasculature
* Human Embryology Fitzgerald and Fitzgerald Chapter 13-17: p77-111

'''Recent reviews'''
* Yutzey KE, Kirby ML. Wherefore heart thou? Embryonic origins of cardiogenic mesoderm. Dev Dyn. 2002 Mar;223(3):307-20. Review. [http://www.ncbi.nlm.nih.gov/pubmed/11891982?dopt=Abstract PMID: 11891982]
* Three-dimensional reconstruction of gene expression patterns during cardiac development. Soufan AT, Ruijter JM, van den Hoff MJ, de Boer PA, Hagoort J, Moorman AF. Physiol Genomics. 2003 May 13;13(3):187-95. Review. [http://www.ncbi.nlm.nih.gov/pubmed/12746463 PMID: 12746463]
* Moorman A, Webb S, Brown NA, Lamers W, Anderson RH. Development of the heart: (1) formation of the cardiac chambers and arterial trunks. Heart. 2003 Jul;89(7):806-14. [http://www.ncbi.nlm.nih.gov/pubmed/12807866?dopt=Abstract PMID: 12807866]
* Bruneau BG. Transcriptional regulation of vertebrate cardiac morphogenesis. Circ Res. 2002 Mar 22;90(5):509-19. Review. [http://www.ncbi.nlm.nih.gov/pubmed/11909814?dopt=Abstract PMID: 11909814]

==Heart Development==
[[File:Gray0462.gif|thumb|Day 14 Heart tube]]
[[File:Heart_Tube_Fusion.jpg|500px|Early Human Heart Tube Development]]

* [[E#endocardial tube|endocardial tube]] in [[P#pericardial cavity|pericardial cavity]]
** dorsal mesentry (mesocardial) attachment lost
** attached at cranial (arterial) and caudal (venous) ends
* tube elongation - bending and series of expansions
[[File:Heart-cartoon-001.jpg|thumb|Adult Heart blood flow]]
Bulbus Cordis - 3 parts
* distal - forms [[T#truncus arteriosus|truncus arteriosus]] (aorta and pulmonary artery)
* middle - [[C#conus cordis|conus cordis]] ventricular outflow tract
* proximal - right ventricle trabeculate part

endocardial cushions
* form initial division of atria and ventricles
* fusion forms left and right atrioventricular canals

===Heart Layers===
* '''pericardium''' - covers the heart, formed by 3 layers consisting of a fibrous pericardium and a double layered serous pericardium (parietal layer and visceral epicardium layer).
* '''myocardium''' - muscular wall of the heart, thickest layer formed by spirally arranged cardiac muscle cells.
* '''endocardium''' - lines the heart, epithelial (endothelial) tissue lining the inner surface of heart chambers and valves.

===Embryonic Heart Rate===

* Stage 9-10 2 mm embryo (gestational sac diameter of 20 mm) EHR at least 75 beats / minute
* Stage 11-12 5 mm embryo (gestational sac diameter of 30 mm) EHR at least 100 beats / minute
* Stage 16 10 mm embryo EHR at least 120 beats / minute
* Stage 18 15 mm embryo EHR at least 130 beats / minute

[http://embryology.med.unsw.edu.au/Movies/usound/Hum12wkFHR.htm Week 12 fetal heart rate doppler] [http://embryology.med.unsw.edu.au/Notes/heart8.htm Week 17 fetal heart rate audio]

==Atrial Septation==
[[File:Heart1_atrium icon.jpg|90px|link=Development_Animation_-_Heart Atrial Septation]]

[[File:Stage13 C7L.jpg|thumb|Heart (Carnegie stage 13)]]

Through all development blood shunts from right to left atrium (bypass lungs)

===Septum Primum===
[http://embryology.med.unsw.edu.au/wwwpig/pigc/c1l.htm Stage 13 Septum Primum] [http://embryology.med.unsw.edu.au/wwwhuman/lowpower/HumE/E2L.htm Stage 22 Septum Primum]

* dorso-cranial wall, membranous extension
* grows downward towards endocardial cushions
* opening is '''foramen primum''' (ostium primum)
* septum primum fuses with endocardial cushion, but cranially had begun to degenerate forming '''foramen secundum''' (ostium secundum)

===Septum Secundum===
[[File:Gray0467.jpg|thumb|Septum Secundum]]
* ventro-cranial wall
* grows as septum primum downward, does not fuse with endocardial cushion, opening is '''foramen ovale'''

===Right Atrium===
[[File:Gray0476.jpg|thumb|sinus venosus and tributaries]]
* right sinus horn incorporates into dorsal wall sinus venerum
* sinoatrial opening - has 2 flaps, left fuses with septum secundum, right forms valve to inferior vena cava and coronary sinus. [http://embryology.med.unsw.edu.au/wwwpig/pigc/c3l.htm Stage 13 - right venous valve] [http://embryology.med.unsw.edu.au/wwwhuman/lowpower/HumE/E2L.htm Stage 22 - right venous valve]

===Left Atrium===
* posterior wall - outgrowth forms single pulmonary vein, divided into 4 branches
* incorporation into the wall leads to 4 openings in posterior wall
* later moves to the right aligns with atrioventricular canal.

==Ventricular Septation==
[[File:Stage13 C7L.jpg|thumb|Heart (Carnegie stage 13)]]
[[File:Gray0498.jpg|thumb|Ventricular septum]]
[[File:Heart1_realign icon.jpg|90px|link=Development_Animation_-_Heart Realign]]

* 2 separate components - superior membranous, inferior muscular
===Muscular Septum===
[[File:Gray0470.jpg|thumb|muscular septum]]
* growth of inferior wall
* fusion of 3 components - right and left bulbar ridges and dorsal endocardial cushion

===Membranous Septum===
* above the muscular septum, fusion continuous with septation of the outflow tract

[[File:Heart-ventricular-septum-01.jpg‎]][[File:Heart-ventricular-septum-02.jpg‎]][[File:Heart-ventricular-septum-03.jpg‎]]

==Outflow Tract Septation==

[[File:heart1 ventricle icon.jpg|90px|link=Development_Animation_-_Heart Outflow Septation]]

* truncus arteriousus - 2 growths from wall in spiral pattern, inferior upwards [http://embryology.med.unsw.edu.au/wwwpig/pigb/b5l.htm Stage 13 truncus arteriousus]
* mesenchyme and neural crest contribute to this septation process
* fusion of outgrowths separate aortic and pulmonary outflow

{| border='0px'

|-
| [[File:Chick_Heart_001-icon.jpg|90px|link=Movie_-_Normal Chick Heart]]
| [[File:Chick_Heart_002-icon.jpg|90px|link=Movie_-_Abnormal Chick Heart]]
| [[File:Chick_Heart_002-icon.jpg|90px|link=Movie_-_Abnormal Chick Heart 2]]
|-
| [[Movie_-_Normal Chick Heart|Normal Heart]]
| [[Movie_-_Abnormal Chick Heart|Abnormal Heart]]
| [[Movie_-_Abnormal Chick Heart 2|Abnormal Heart 2]]
|-
|}

==Vascular Remodeling==
===Arterial System===
[[File:Gray0474.jpg|thumb|pharyngeal arch arteries]]
* Aortic sac - remodels forming 2 horns, R forms brachiocephalic artery, L forms common carotid artery

Pharyngeal arch arteries
* pharyngeal arch artery 1 and 2 regress
* pharyngeal arch artery 3 and the associated dorsal aorta form the paired internal carotid arteries, these in turn generate the external carotids
* Left pharyngeal arch artery 4 – forms the aortic arch

* paraxial mesoderm forms paired dorsal aorta
** head mesenchyme forms aortic arches
** connecting stalk contains unbilical (placental) arteries
** dorsal aortas give rise to
** vitelline arteries which connect to capillaries on yolk sac
** intersegmental arteries between somites

===Venous System===
Cardinal veins contribute nearly all systemic venous system.

<gallery>
File:Gray0477.jpg
File:Gray0478.jpg
File:Gray0479.jpg
File:Gray0480.jpg
</gallery>

common cardinal veins - ducts of Cuvier

hepatic veins - drain de-oxygenated blood from the liver into the inferior vena cava.

internal iliac vein - hypogastric vein

==Birth Changes==
[[File:Fetal_circulation1.jpg|thumb|Fetal circulation]]

{| border=1

|-
! Fetal Structure
! Adult Structure
|-
| foramen ovale
| fossa ovalis
|-
| umbilical vein (intra-abdominal part)
| ligamentum teres
|-
| ductus venosus
| ligamentum venosum
|-
| umbilical arteries and abdominal ligaments
| medial umbilical ligaments, superior vesicular artery (supplies bladder)
|-
| ductus arteriosum
| ligamentum arteriosum
|}

==Abnormalities==
There are many different cardiac abnormalities, some more common than others, and only a few will be described in this lecture.

'''Major Abnormalities:''' Aortic Stenosis, Atrial Septal Defects, Coarctation of Aorta, Dextrocardia, Hypoplastic Left Heart, Long QT Syndrome, Patent Ductus Arteriosus, Pulmonary Atresia, Pulmonary Stenosis, Tetralogy of Fallot, Transposition of Great Vessels, Tricuspid Atresia, Total Anomalous Pulmonary Venous Connection, Ventricular Septal Defect, Abnormalities of Conducting System.

Links: [http://embryology.med.unsw.edu.au/Notes/heart2.htm Cardiovascular Development Abnormalities]

[[File:Abnormal81-92-heart.png|thumb]]

[[File:Statistics-Utah heart defects.jpg|thumb]]
===Atrial Septal Defects===

{| border='0px'
|-
| [[File:HeartILP_draft_asd.jpg|Atrial Septal Defect]]
|
* Atrial Septal Defects (ASD) are a group of common (1% of cardiac) congenital anomalies defects occurring in a number of different forms and more often in females.
* patent foramen ovale - allows a continuation of the atrial shunting of blood, in 25% of people a probe patent foramen ovale (allowing a probe to bepassed from one atria to the other) exists.
* ostium secundum defect
* endocardial cushion defect involving ostium primum
* sinus venosus defect - contributes about 10% of all ASDs and occurs mainly in a common and less common form. Common ("usual type") - in upper atrial septum which is contiguous with the superior vena cava. Less common - at junction of the right atrium and inferior vena cava.
* common atrium
|-
|}

===Ventricular Septal Defects===
{| border='0px'
|-
| [[File:HeartILP_draft_vsd.jpg|Ventricular Septal Defect]]
|
* The Ventricular Septal Defect (VSD) usually occurs in the membranous (perimembranous) rather than muscular interventricular septum, and is more frequent in males that females.
* Perimembranous defects are located close to the aortic and tricuspid valves and adjacent to atrioventricular conduction bundle.
* The defect allows left-right shunting of blood, this shunting depends upon the size of the defect. Small defects may close spontaneously, larger defects result in infant congestive heart failure.
* Clinically repaired by coils or tissue-adapted devices like muscular or perimembranous occluders.
|-
|}
(V.S.D.)

===Patent Ductus Arteriosus===

{| border='0px'

|-
| [[File:HeartILP_draft_patentda.jpg|Patent Ductus Arteriosus]]
|
* Patent Ductus Arteriosus (P.D.A.) occurs commonly in preterm infants, can close spontaneously (by day three in 60% of normal term neonates) the remainder are ligated simply and with little risk.
* The operation is always recommended even in the absence of cardiac failure and can often be deferred until early childhood.

|-
|}

===Tetralogy of Fallot===
{| border='0px'
|-
| [[File:HeartILP_draft_tetralogyoffallot.jpg|Tetralogy of Fallot]]
|
* Named after Etienne-Louis Arthur Fallot (1888) who described it as "la maladie blue" and is a common developmental cardiac defect.
* The syndrome consists of a number of a number of cardiac defects possibly stemming from abnormal neural crest migration.
|-
|}

==Movies==

{| border='0px'

|-
| [[File:Heart1_looping icon.jpg|90px|link=Development_Animation_-_Heart Looping]]
| [[File:Heart1_realign icon.jpg|90px|link=Development_Animation_-_Heart Realign]]
| [[File:Heart1_atrium icon.jpg|90px|link=Development_Animation_-_Heart Atrial Septation]]
| [[File:heart1 ventricle icon.jpg|90px|link=Development_Animation_-_Heart Outflow Septation]]
|-
| [[Development_Animation_-_Heart Looping|Heart Looping]]
| [[Development_Animation_-_Heart Realign|Heart Realign]]
| [[Development_Animation_-_Heart Atrial Septation|Heart Atrial Septation]]
| [[Development_Animation_-_Heart Outflow Septation|Heart Outflow Septation]]
|-
|}

'''Link:''' [[Flash Movies]]

{{Template:2009ANAT2341}}

[[Category:2009ANAT2341]] [[Category:Science-Undergraduate]]

[[Category:Cardiovascular]] [[Category:Heart]]

ANAT2341 2010 Students

2010-08-19T03:21:17Z

Z3267024: /* Lab 4 Questions */

== Introduction ==

This page allows 2010 Students to access their own specific wiki page.

* Please note that all changes including additions, deletions and edits are logged by the wiki.
* For individual assessment, specific comments about the course and for your own use, each student has their own wiki page using their student number as a title for the page.
* Hint - you can quickly get directly to your own page on your own home computer by adding your student number to the link below and then bookmarking.
<nowiki>http://php.med.unsw.edu.au/embryology/index.php?title=User: </nowiki>

==Progressive Assessment==

The individual student assessment (20% of final mark) consists of a series of tasks allocated in lectures and practical classes that must be completed on time and correctly.

===Lab 1 Questions===

Complete tasks associated with the online individual and group assessments including:
# Demonstrate the ability to create an attendance signature.
# Create a subheading, link and add an image to student page.
# [[Test_Student_2010#Topic_Vote|Vote here]] (with student signature) for the major topic for the group project before Lab 2.

===Lab 2 Questions===

# What factor do the synctiotrophoblast cells secrete to support the ongoing pregnancy?
# What does the corpus luteum secrete to prevent continuation of the menstrual cycle?

===Lab 3 Questions===

# What Carnegie stages occur during week 3 and week 4?
# What is the change in overall embryo size form the beginning of week 3 to the end of week 4?
# Approximately when do the cranial (anterior) and caudal (posterior) neuropores close in the human embryo?

===Lab 4 Questions===

# Name the vessels that drain into the sinus venosus?
# What is the fate of the vitelline artery and vitelline vein?
# Name the 4 layers that constitute the placental barrier?
# What stem cells are found in abundance, and may be harvested from the placenta for therapeutic uses?

==Current Students==

Links will be added to student page before the first Laboratory. [[User:S8600021|Dr Mark Hill]]

[[Test Student 2010]]
===Group 1 - Ultrasound===

[[2010_Group_Project_1|Group 1 - Ultrasound]]

[[User:z3305561|z3305561]]

[[User:z3288088|z3288088]]

[[User:z3252833|z3252833]]

===Group 2 - Chorionic villus sampling===

[[2010_Group_Project_2|Group 2 - Chorionic villus sampling]]

[[User:z3224500|z3224500]]

[[User:z3292955|z3292955]]

[[User:z3265772|z3265772]]

===Group 3 - Amniocentesis===

[[2010_Group_Project_3|Group 3 - Amniocentesis]]

[[User:z3254753|z3254753]]

[[User:z3292208|z3292208]]

[[User:z3129413|z3129413]]

===Group 4 - Percutaneous Umbilical Cord Blood Sampling (PUBS)===

[[2010_Group_Project_4|Group 4 - Percutaneous Umbilical Cord Blood Sampling]]

[[User:z3252635|z3252635]]

[[User:z3293029|z3293029]]

[[User:z3241780|z3241780]]

===Group 5 - Fetal Fibronectin===

[[2010_Group_Project_5|Group 5 - Fetal Fibronectin]]

[[User:z3252083|z3252083]]

[[User:z3291079|z3291079]]

[[User:z3318446|z3318446]]

===Group 6 - Maternal serum alpha-fetoprotein (MSAFP)===

[[2010_Group_Project_6|Group 6 - Maternal serum alpha-fetoprotein]]

--[[User:S8600021|Mark Hill]] 02:02, 5 August 2010 (UTC) Note - This group may need to be split or reorganised again if student enrolment changes.

[[User:z3290040|z3290040]]

[[User:z3254433|z3254433]]

[[User:z3186755|z3186755]]

[[User:z3245851|z3245851]]

[[User:z3216889|z3216889]]

== Student Wiki Page Help ==

* [[Editing Basics]] a page designed to help beginners edit their project page.
* [[media:Wiki-refcard.pdf‎ | One page Wiki Reference Card]] print this out and use it to help you with editing your project.
* [http://meta.wikimedia.org/wiki/Help:Contents#For_editors WikiHelp For editors] external link to more detailed information o page editing.
* [http://www.openoffice.org/ Open Office] is a free office suite that includes a word processor that can save documents in Wiki format. These can then be opened and pasted into your project page.
* sources for your project.
* [[References|ANAT2341 Project Referencing]] how to add references to your project page.

{{Template:2010ANAT2341}}

ANAT2341 2010 Students

2010-08-19T03:20:44Z

Z3267024: /* Lab 4 Questions */

== Introduction ==

This page allows 2010 Students to access their own specific wiki page.

* Please note that all changes including additions, deletions and edits are logged by the wiki.
* For individual assessment, specific comments about the course and for your own use, each student has their own wiki page using their student number as a title for the page.
* Hint - you can quickly get directly to your own page on your own home computer by adding your student number to the link below and then bookmarking.
<nowiki>http://php.med.unsw.edu.au/embryology/index.php?title=User: </nowiki>

==Progressive Assessment==

The individual student assessment (20% of final mark) consists of a series of tasks allocated in lectures and practical classes that must be completed on time and correctly.

===Lab 1 Questions===

Complete tasks associated with the online individual and group assessments including:
# Demonstrate the ability to create an attendance signature.
# Create a subheading, link and add an image to student page.
# [[Test_Student_2010#Topic_Vote|Vote here]] (with student signature) for the major topic for the group project before Lab 2.

===Lab 2 Questions===

# What factor do the synctiotrophoblast cells secrete to support the ongoing pregnancy?
# What does the corpus luteum secrete to prevent continuation of the menstrual cycle?

===Lab 3 Questions===

# What Carnegie stages occur during week 3 and week 4?
# What is the change in overall embryo size form the beginning of week 3 to the end of week 4?
# Approximately when do the cranial (anterior) and caudal (posterior) neuropores close in the human embryo?

===Lab 4 Questions===

# Name the vessels that drain into the sinus venosus?
# What is the fate of the vitelline artery and vitelline vein?
# Name the 4 layers that constitute the placental barrier?
# What stem cells are found in abundance and may be havested from the placenta?

==Current Students==

Links will be added to student page before the first Laboratory. [[User:S8600021|Dr Mark Hill]]

[[Test Student 2010]]
===Group 1 - Ultrasound===

[[2010_Group_Project_1|Group 1 - Ultrasound]]

[[User:z3305561|z3305561]]

[[User:z3288088|z3288088]]

[[User:z3252833|z3252833]]

===Group 2 - Chorionic villus sampling===

[[2010_Group_Project_2|Group 2 - Chorionic villus sampling]]

[[User:z3224500|z3224500]]

[[User:z3292955|z3292955]]

[[User:z3265772|z3265772]]

===Group 3 - Amniocentesis===

[[2010_Group_Project_3|Group 3 - Amniocentesis]]

[[User:z3254753|z3254753]]

[[User:z3292208|z3292208]]

[[User:z3129413|z3129413]]

===Group 4 - Percutaneous Umbilical Cord Blood Sampling (PUBS)===

[[2010_Group_Project_4|Group 4 - Percutaneous Umbilical Cord Blood Sampling]]

[[User:z3252635|z3252635]]

[[User:z3293029|z3293029]]

[[User:z3241780|z3241780]]

===Group 5 - Fetal Fibronectin===

[[2010_Group_Project_5|Group 5 - Fetal Fibronectin]]

[[User:z3252083|z3252083]]

[[User:z3291079|z3291079]]

[[User:z3318446|z3318446]]

===Group 6 - Maternal serum alpha-fetoprotein (MSAFP)===

[[2010_Group_Project_6|Group 6 - Maternal serum alpha-fetoprotein]]

--[[User:S8600021|Mark Hill]] 02:02, 5 August 2010 (UTC) Note - This group may need to be split or reorganised again if student enrolment changes.

[[User:z3290040|z3290040]]

[[User:z3254433|z3254433]]

[[User:z3186755|z3186755]]

[[User:z3245851|z3245851]]

[[User:z3216889|z3216889]]

== Student Wiki Page Help ==

* [[Editing Basics]] a page designed to help beginners edit their project page.
* [[media:Wiki-refcard.pdf‎ | One page Wiki Reference Card]] print this out and use it to help you with editing your project.
* [http://meta.wikimedia.org/wiki/Help:Contents#For_editors WikiHelp For editors] external link to more detailed information o page editing.
* [http://www.openoffice.org/ Open Office] is a free office suite that includes a word processor that can save documents in Wiki format. These can then be opened and pasted into your project page.
* sources for your project.
* [[References|ANAT2341 Project Referencing]] how to add references to your project page.

{{Template:2010ANAT2341}}

ANAT2341 2010 Students

2010-08-19T03:19:35Z

Z3267024: /* Lab 4 Questions */

== Introduction ==

This page allows 2010 Students to access their own specific wiki page.

* Please note that all changes including additions, deletions and edits are logged by the wiki.
* For individual assessment, specific comments about the course and for your own use, each student has their own wiki page using their student number as a title for the page.
* Hint - you can quickly get directly to your own page on your own home computer by adding your student number to the link below and then bookmarking.
<nowiki>http://php.med.unsw.edu.au/embryology/index.php?title=User: </nowiki>

==Progressive Assessment==

The individual student assessment (20% of final mark) consists of a series of tasks allocated in lectures and practical classes that must be completed on time and correctly.

===Lab 1 Questions===

Complete tasks associated with the online individual and group assessments including:
# Demonstrate the ability to create an attendance signature.
# Create a subheading, link and add an image to student page.
# [[Test_Student_2010#Topic_Vote|Vote here]] (with student signature) for the major topic for the group project before Lab 2.

===Lab 2 Questions===

# What factor do the synctiotrophoblast cells secrete to support the ongoing pregnancy?
# What does the corpus luteum secrete to prevent continuation of the menstrual cycle?

===Lab 3 Questions===

# What Carnegie stages occur during week 3 and week 4?
# What is the change in overall embryo size form the beginning of week 3 to the end of week 4?
# Approximately when do the cranial (anterior) and caudal (posterior) neuropores close in the human embryo?

===Lab 4 Questions===

# Name the vessels that drain into the sinus venosus?
# What is the fate of the vitelline artery and vitelline vein?
# Name the 4 layers that constitute the placental barrier?

==Current Students==

Links will be added to student page before the first Laboratory. [[User:S8600021|Dr Mark Hill]]

[[Test Student 2010]]
===Group 1 - Ultrasound===

[[2010_Group_Project_1|Group 1 - Ultrasound]]

[[User:z3305561|z3305561]]

[[User:z3288088|z3288088]]

[[User:z3252833|z3252833]]

===Group 2 - Chorionic villus sampling===

[[2010_Group_Project_2|Group 2 - Chorionic villus sampling]]

[[User:z3224500|z3224500]]

[[User:z3292955|z3292955]]

[[User:z3265772|z3265772]]

===Group 3 - Amniocentesis===

[[2010_Group_Project_3|Group 3 - Amniocentesis]]

[[User:z3254753|z3254753]]

[[User:z3292208|z3292208]]

[[User:z3129413|z3129413]]

===Group 4 - Percutaneous Umbilical Cord Blood Sampling (PUBS)===

[[2010_Group_Project_4|Group 4 - Percutaneous Umbilical Cord Blood Sampling]]

[[User:z3252635|z3252635]]

[[User:z3293029|z3293029]]

[[User:z3241780|z3241780]]

===Group 5 - Fetal Fibronectin===

[[2010_Group_Project_5|Group 5 - Fetal Fibronectin]]

[[User:z3252083|z3252083]]

[[User:z3291079|z3291079]]

[[User:z3318446|z3318446]]

===Group 6 - Maternal serum alpha-fetoprotein (MSAFP)===

[[2010_Group_Project_6|Group 6 - Maternal serum alpha-fetoprotein]]

--[[User:S8600021|Mark Hill]] 02:02, 5 August 2010 (UTC) Note - This group may need to be split or reorganised again if student enrolment changes.

[[User:z3290040|z3290040]]

[[User:z3254433|z3254433]]

[[User:z3186755|z3186755]]

[[User:z3245851|z3245851]]

[[User:z3216889|z3216889]]

== Student Wiki Page Help ==

* [[Editing Basics]] a page designed to help beginners edit their project page.
* [[media:Wiki-refcard.pdf‎ | One page Wiki Reference Card]] print this out and use it to help you with editing your project.
* [http://meta.wikimedia.org/wiki/Help:Contents#For_editors WikiHelp For editors] external link to more detailed information o page editing.
* [http://www.openoffice.org/ Open Office] is a free office suite that includes a word processor that can save documents in Wiki format. These can then be opened and pasted into your project page.
* sources for your project.
* [[References|ANAT2341 Project Referencing]] how to add references to your project page.

{{Template:2010ANAT2341}}

ANAT2341 2010 Students

2010-08-19T03:19:17Z

Z3267024: /* Progressive Assessment */

== Introduction ==

This page allows 2010 Students to access their own specific wiki page.

* Please note that all changes including additions, deletions and edits are logged by the wiki.
* For individual assessment, specific comments about the course and for your own use, each student has their own wiki page using their student number as a title for the page.
* Hint - you can quickly get directly to your own page on your own home computer by adding your student number to the link below and then bookmarking.
<nowiki>http://php.med.unsw.edu.au/embryology/index.php?title=User: </nowiki>

==Progressive Assessment==

The individual student assessment (20% of final mark) consists of a series of tasks allocated in lectures and practical classes that must be completed on time and correctly.

===Lab 1 Questions===

Complete tasks associated with the online individual and group assessments including:
# Demonstrate the ability to create an attendance signature.
# Create a subheading, link and add an image to student page.
# [[Test_Student_2010#Topic_Vote|Vote here]] (with student signature) for the major topic for the group project before Lab 2.

===Lab 2 Questions===

# What factor do the synctiotrophoblast cells secrete to support the ongoing pregnancy?
# What does the corpus luteum secrete to prevent continuation of the menstrual cycle?

===Lab 3 Questions===

# What Carnegie stages occur during week 3 and week 4?
# What is the change in overall embryo size form the beginning of week 3 to the end of week 4?
# Approximately when do the cranial (anterior) and caudal (posterior) neuropores close in the human embryo?

===Lab 4 Questions===

# Name the vessels that drain into the sinus venosus?
# What is the fate of the vitelline artery and vitelline vein?
# What are the 4 layers that constitute the placental barrier?

==Current Students==

Links will be added to student page before the first Laboratory. [[User:S8600021|Dr Mark Hill]]

[[Test Student 2010]]
===Group 1 - Ultrasound===

[[2010_Group_Project_1|Group 1 - Ultrasound]]

[[User:z3305561|z3305561]]

[[User:z3288088|z3288088]]

[[User:z3252833|z3252833]]

===Group 2 - Chorionic villus sampling===

[[2010_Group_Project_2|Group 2 - Chorionic villus sampling]]

[[User:z3224500|z3224500]]

[[User:z3292955|z3292955]]

[[User:z3265772|z3265772]]

===Group 3 - Amniocentesis===

[[2010_Group_Project_3|Group 3 - Amniocentesis]]

[[User:z3254753|z3254753]]

[[User:z3292208|z3292208]]

[[User:z3129413|z3129413]]

===Group 4 - Percutaneous Umbilical Cord Blood Sampling (PUBS)===

[[2010_Group_Project_4|Group 4 - Percutaneous Umbilical Cord Blood Sampling]]

[[User:z3252635|z3252635]]

[[User:z3293029|z3293029]]

[[User:z3241780|z3241780]]

===Group 5 - Fetal Fibronectin===

[[2010_Group_Project_5|Group 5 - Fetal Fibronectin]]

[[User:z3252083|z3252083]]

[[User:z3291079|z3291079]]

[[User:z3318446|z3318446]]

===Group 6 - Maternal serum alpha-fetoprotein (MSAFP)===

[[2010_Group_Project_6|Group 6 - Maternal serum alpha-fetoprotein]]

--[[User:S8600021|Mark Hill]] 02:02, 5 August 2010 (UTC) Note - This group may need to be split or reorganised again if student enrolment changes.

[[User:z3290040|z3290040]]

[[User:z3254433|z3254433]]

[[User:z3186755|z3186755]]

[[User:z3245851|z3245851]]

[[User:z3216889|z3216889]]

== Student Wiki Page Help ==

* [[Editing Basics]] a page designed to help beginners edit their project page.
* [[media:Wiki-refcard.pdf‎ | One page Wiki Reference Card]] print this out and use it to help you with editing your project.
* [http://meta.wikimedia.org/wiki/Help:Contents#For_editors WikiHelp For editors] external link to more detailed information o page editing.
* [http://www.openoffice.org/ Open Office] is a free office suite that includes a word processor that can save documents in Wiki format. These can then be opened and pasted into your project page.
* sources for your project.
* [[References|ANAT2341 Project Referencing]] how to add references to your project page.

{{Template:2010ANAT2341}}

2010 Lab 4

2010-08-18T20:40:27Z

Z3267024: /* Early circulation */

=Cardiovascular and Placenta=

== Introduction ==
This laboratory will explore the development of the embryonic cardiovascular system, which includes the placental vascular system. We will look through cross-sections of the Carnegie stage 14 embryo and follow the flow of blood through the embryonic vasculature.
In this lab, we will also examine placentation.

==Objectives==

# Understand development of early embryo heart and vascular system.
# Understand the early placentation events and the development of placental blood vessels.

== Early circulation ==
[[Image:Embryonic Circulations.jpg|thumb|right|Three components of early circulation]]

The vascular system of the embryo is formed from blood islands that appear in the extraembryonic mesoderm of the yolk sac and the embryonic mesoderm (primarily splanchnic mesoderm). Both of these clusters fuse together and extend, forming a vast network.

The early circulation has 3 components: Vitelline, Embryonic, Placental Each of these has its own system of arteries and veins.

* '''Vitelline''' - (not shown) the vitelline arteries branch off the dorsal aortas and enter the yolk sac, covering its entire surface. The vitelline veins return red blood cells from the capillary beds to the sinus venosus, posterior to the heart. The vitelline vessels eventually contribute to the portal system of the liver in the adult.

* '''Embryonic''' - blood from the dorsal aorta enters intersegmental arteries, including the arteries of the pharyngeal arches. The blood returns to the heart via the anterior and posterior cardinal veins.

* '''Placental''' - the umbilical arteries receive blood from the aorta. This is carried to the chorionic villi, where exchange occurs with the mother. Waste products are disposed of, nutrients and oxygen are collected, and then the umbilical veins convey the blood to the sinus venosus.

'''Heart''' - The heart develops from cardiogenic mesoderm, a region of splanchnic mesoderm lying above the buccopharyngeal membrane. Development begins in week 3 with the formation of a pair of heart tubes. These fuse and form a single tube in week 4, as a result of the embryonic folding processes that occur. As the heart grows, septation events occur, transforming it into a 4-chambered pump. Initially, the ventricles develop above the atria; however simultaneous growth and bending of the tube bring the structures into correct position. In humans, the heart begins to beat on day 22-23.

[[Image:Heart Tube Segments.jpg|thumb|right|Three components of early circulation]]

[[File:Stage13_bloodflow.jpg]]

====Cardiovascular Movies====

{| border='0px'

|-
| [[File:Heart1_looping icon.jpg|90px|link=Development_Animation_-_Heart Looping]]
|-
| [[Development_Animation_-_Heart Looping|Heart Looping]]
|-
|}

== Stage 14 Embryo ==
'''Stage 14 3D CVS reconstruction''' [http://embryology.med.unsw.edu.au/Movies/CVS3dmodel.htm Small movie page] | [http://embryology.med.unsw.edu.au/Movies/CVS3dmodelonly.htm large movie page] | [[Media:CVS3d.mov|Stage 14 3D small movie]] | [[Media:Stage_14_CVS3d_large.mov|Stage 14 3D large movie]]

[[File:Stage14 planesm.gif|left]]
{| class="prettytable"
|-
| [http://embryology.med.unsw.edu.au/wwwpig/piga/a1l.htm A1]
| [http://embryology.med.unsw.edu.au/wwwpig/piga/a2l.htm A2]
| [http://embryology.med.unsw.edu.au/wwwpig/piga/a3l.htm A3]
| [http://embryology.med.unsw.edu.au/wwwpig/piga/a4l.htm A4]
| [http://embryology.med.unsw.edu.au/wwwpig/piga/a5l.htm A5]
| [http://embryology.med.unsw.edu.au/wwwpig/piga/a6l.htm A6]
| [http://embryology.med.unsw.edu.au/wwwpig/piga/a7l.htm A7]

|-
| [http://embryology.med.unsw.edu.au/wwwpig/pigb/b1l.htm B1]
| [http://embryology.med.unsw.edu.au/wwwpig/pigb/b2l.htm B2]
| [http://embryology.med.unsw.edu.au/wwwpig/pigb/b3l.htm B3]
| [http://embryology.med.unsw.edu.au/wwwpig/pigb/b4l.htm B4]
| [http://embryology.med.unsw.edu.au/wwwpig/pigb/b5l.htm B5]
| [http://embryology.med.unsw.edu.au/wwwpig/pigb/b6l.htm B6]
| [http://embryology.med.unsw.edu.au/wwwpig/pigb/b7l.htm B7]

|-
| [http://embryology.med.unsw.edu.au/wwwpig/pigc/c1l.htm C1]
| [http://embryology.med.unsw.edu.au/wwwpig/pigc/c2l.htm C2]
| [http://embryology.med.unsw.edu.au/wwwpig/pigc/c3l.htm C3]
| [http://embryology.med.unsw.edu.au/wwwpig/pigc/c4l.htm C4]
| [http://embryology.med.unsw.edu.au/wwwpig/pigc/c5l.htm C5]
| [http://embryology.med.unsw.edu.au/wwwpig/pigc/c6l.htm C6]
| [http://embryology.med.unsw.edu.au/wwwpig/pigc/c7l.htm C7]

|-
| [http://embryology.med.unsw.edu.au/wwwpig/pigd/d1l.htm D1]
| [http://embryology.med.unsw.edu.au/wwwpig/pigd/d2l.htm D2]
| [http://embryology.med.unsw.edu.au/wwwpig/pigd/d3l.htm D3]
| [http://embryology.med.unsw.edu.au/wwwpig/pigd/d4l.htm D4]
| [http://embryology.med.unsw.edu.au/wwwpig/pigd/d5l.htm D5]
| [http://embryology.med.unsw.edu.au/wwwpig/pigd/d6l.htm D6]
| [http://embryology.med.unsw.edu.au/wwwpig/pigd/d7l.htm D7]

|-
| [http://embryology.med.unsw.edu.au/wwwpig/pige/e1l.htm E1]
| [http://embryology.med.unsw.edu.au/wwwpig/pige/e2l.htm E2]
| [http://embryology.med.unsw.edu.au/wwwpig/pige/e3l.htm E3]
| [http://embryology.med.unsw.edu.au/wwwpig/pige/e4l.htm E4]
| [http://embryology.med.unsw.edu.au/wwwpig/pige/e5l.htm E5]
| [http://embryology.med.unsw.edu.au/wwwpig/pige/e6l.htm E6]
| [http://embryology.med.unsw.edu.au/wwwpig/pige/e7l.htm E7]

|-
| [http://embryology.med.unsw.edu.au/wwwpig/pigf/f1l.htm F1]
| [http://embryology.med.unsw.edu.au/wwwpig/pigf/f2l.htm F2]
| [http://embryology.med.unsw.edu.au/wwwpig/pigf/f3l.htm F3]
| [http://embryology.med.unsw.edu.au/wwwpig/pigf/f4l.htm F4]
| [http://embryology.med.unsw.edu.au/wwwpig/pigf/f5l.htm F5]
| [http://embryology.med.unsw.edu.au/wwwpig/pigf/f6l.htm F6]
| [http://embryology.med.unsw.edu.au/wwwpig/pigf/f7l.htm F7]

|-
| [http://embryology.med.unsw.edu.au/wwwpig/pigg/g1l.htm G1]
| [http://embryology.med.unsw.edu.au/wwwpig/pigg/g2l.htm G2]
| [http://embryology.med.unsw.edu.au/wwwpig/pigg/g3l.htm G3]
| [http://embryology.med.unsw.edu.au/wwwpig/pigg/g4l.htm G4]
| [http://embryology.med.unsw.edu.au/wwwpig/pigg/g5l.htm G5]
| [http://embryology.med.unsw.edu.au/wwwpig/pigg/g6l.htm G6]
| [http://embryology.med.unsw.edu.au/wwwpig/pigg/g7l.htm G7]

|}

Compare this mid-embryonic cardiovascular system with that existing at the end of embryonic development [http://embryology.med.unsw.edu.au/Movies/CVS3dmodelst22.htm Stage 22 3D CVS reconstruction]

== Placentation ==

Compare the features of a normal and gravid uterus.

[[Image:Uterine and placental vasculature.jpg|thumb|right|Changes in the uterine vasculature with pregnancy]]

[[Image:Cvs.jpg|thumb|right|Chorionic villi sampling]]

==Chorionic Villi==
* Compare the features of primary, secondary, tertiary and stemmed villi
<gallery>
File:Gray0036.gif|Primary chorionic villi
File:Gray0037.gif|Secondary chorionic villi
File:Placenta anchoring villi.jpg|Placenta anchoring villi
</gallery>

[[Image:Gray0039.gif|thumb|Section through the placenta]]

[http://share.eldoc.ub.rug.nl/FILES/root2/2010/Mesestcei/Castrechini_2010_Placenta.pdf Mesenchymal stem cells in chorionic villi]

== Group projects ==

The laboratory will also allow time for work on the group online project. What have your other group members and other groups done so far?

==UNSW Embryology Links==

* '''Cardiovascular Slides''' [http://embryology.med.unsw.edu.au/Science/ANAT2341lecture07.htm Cardiovasular Lecture 7 2008] | [http://embryology.med.unsw.edu.au/pdf/ANAT2341L07Hearts1.pdf Heart Lecture 2008 - 1 slide/page ] | [http://embryology.med.unsw.edu.au/pdf/ANAT2341L07Hearts4.pdf Heart Lecture 2008 Slides - 4 slides/page] | [http://embryology.med.unsw.edu.au/pdf/ANAT2341L07Hearts6.pdf Heart Lecture 2008 Slides - 6 slides/page]
* '''Cardiovascular Movies''' [http://embryology.med.unsw.edu.au/Movies/heart.htm Heart Movies] | [http://embryology.med.unsw.edu.au//Movies/larsen/looping.mov Heart Looping] | [http://embryology.med.unsw.edu.au//Movies/larsen/atrium.mov Atrial Septation] | [http://embryology.med.unsw.edu.au//Movies/larsen/avc.mov Realignment] | [http://embryology.med.unsw.edu.au//Movies/larsen/ventricl.mov Ventricular Septation] | [http://embryology.med.unsw.edu.au/Movies/heart.htm#HeartSeptation Heart Septation Models] | [http://embryology.med.unsw.edu.au/Movies/heart.htm#HistoricHeart Historic Heart Movie] |

* '''Cardiovascular Notes''' [http://embryology.med.unsw.edu.au/Notes/heart.htm Introduction] | [http://embryology.med.unsw.edu.au/Notes/heart2.htm Abnormalities] | [http://embryology.med.unsw.edu.au/Notes/heart3.htm Stage 13/14] | [http://embryology.med.unsw.edu.au/Notes/heart4.htm Stage 22] | [http://embryology.med.unsw.edu.au/Notes/heart5.htm Stage 22 Selected Highpower] | [http://embryology.med.unsw.edu.au/Notes/heart6.htm Heart] | [http://embryology.med.unsw.edu.au/Notes/heart8.htm Heart Rate] | [http://embryology.med.unsw.edu.au/Notes/heart20.htm Blood][http://embryology.med.unsw.edu.au/Notes/heart19.htm Blood Vessels] | [http://embryology.med.unsw.edu.au/Notes/heart11.htm Molecular] | [http://embryology.med.unsw.edu.au/Notes/heart31.htm Lymphatic] | [http://embryology.med.unsw.edu.au/Notes/hearttxt.htm Text only page] | [http://embryology.med.unsw.edu.au/Notes/heartlink.htm WWW Links] | [http://embryology.med.unsw.edu.au/Child/heart.htm Postnatal] | [http://embryology.med.unsw.edu.au/history/page2b.htm#Harvey History - Harvey]

* '''Placenta Slides''' [http://embryology.med.unsw.edu.au/Science/ANAT2341lecture08.htm Placenta Lecture 8 2008] | [http://embryology.med.unsw.edu.au/pdf/ANAT2341L8Placentas1.pdf Placenta Lecture 2008 - 1 slide/page ] | [http://embryology.med.unsw.edu.au/pdf/ANAT2341L8Placentas4.pdf Placenta Lecture 2008 Slides - 4 slides/page] | [http://embryology.med.unsw.edu.au/pdf/ANAT2341L8Placentas6.pdf Placenta Lecture 2008 Slides - 6 slides/page]
* '''Placenta Movies''' [http://embryology.med.unsw.edu.au/Movies/heart.htm Heart Movies] | [http://embryology.med.unsw.edu.au//Movies/larsen/looping.mov Heart Looping] | [http://embryology.med.unsw.edu.au//Movies/larsen/atrium.mov Atrial Septation] | [http://embryology.med.unsw.edu.au//Movies/larsen/avc.mov Realignment] | [http://embryology.med.unsw.edu.au//Movies/larsen/ventricl.mov Ventricular Septation] | [http://embryology.med.unsw.edu.au/Movies/heart.htm#HeartSeptation Heart Septation Models] | [http://embryology.med.unsw.edu.au/Movies/heart.htm#HistoricHeart Historic Heart Movie] |

* '''Placenta Notes''' [http://embryology.med.unsw.edu.au/Notes/placenta.htm Introduction] | [http://embryology.med.unsw.edu.au/Notes/placenta2.htm Abnormalities] | [http://embryology.med.unsw.edu.au/Notes/placenta3.htm Stage 13/14] | [http://embryology.med.unsw.edu.au/Notes/placenta4.htm Human (Stage22)] | [http://embryology.med.unsw.edu.au/Notes/placenta5.htm Histology] | [http://embryology.med.unsw.edu.au/Notes/placenta7.htm Villi Development] | [http://embryology.med.unsw.edu.au/Notes/placenta8.htm Maternal Decidua] | [http://embryology.med.unsw.edu.au/Notes/placenta6.htm Vascular Beds] | [http://embryology.med.unsw.edu.au/Notes/placenta11.htm Molecular] | [http://embryology.med.unsw.edu.au/Child/heart.htm Postnatal] | [http://embryology.med.unsw.edu.au/Notes/endocrine14.htm Endocrine Placenta]

* '''General Links''' [http://embryology.med.unsw.edu.au/sysnote.htm System Notes] | [http://embryology.med.unsw.edu.au/week/weekbyweek.htm Development Timeline]

==Internet links==

'''Embryo Images Unit:''' [http://www.med.unc.edu/embryo_images/ Embryo Images Online] Early Cell Populations (cardiogenic section) | [http://www.med.unc.edu/embryo_images/unit-cardev/cardev_htms/cardevtoc.htm Cardiovascular Development] | [http://www.med.unc.edu/embryo_images/unit-cardev/cardev_htms/cardev001.htm Week 3 Development] | [http://www.med.unc.edu/embryo_images/unit-cardev/cardev_htms/cardev007.htmhttp://www.med.unc.edu/embryo_images/unit-cardev/cardev_htms/cardev007.htm Week 4 Development] | [http://www.med.unc.edu/embryo_images/unit-cardev/cardev_htms/cardev018.htm Heart Chambers and Outflow Tract] | [http://www.med.unc.edu/embryo_images/unit-cardev/cardev_htms/cardev022.htm Atrioventricular Septation] | [http://www.med.unc.edu/embryo_images/unit-cardev/cardev_htms/cardev028.htm Outflow Tract Septation] | [http://www.med.unc.edu/embryo_images/unit-cardev/cardev_htms/cardev035.htm Ventricular Septation] | [http://www.med.unc.edu/embryo_images/unit-cardev/cardev_htms/cardev036.htm Atrial Septation] | [http://www.med.unc.edu/embryo_images/unit-cardev/cardev_htms/cardev040.htm Atrial Walls] [http://www.med.unc.edu/embryo_images/unit-cardev/cardev_htms/cardev041.htm Aortic Arch Vessels] | [http://www.med.unc.edu/embryo_images/unit-cardev/cardev_htms/cardev042.htm Changes at Birth]

{{Template:2009ANAT2341}}

[[Category:2009ANAT2341]]
[[Category:Science-Undergraduate]]
[[Category:Heart]]
[[Category:Cardiovascular]]

2010 Lab 4

2010-08-18T20:34:17Z

Z3267024: /* Cardiovascular Movies */

=Cardiovascular and Placenta=

== Introduction ==
This laboratory will explore the development of the embryonic cardiovascular system, which includes the placental vascular system. We will look through cross-sections of the Carnegie stage 14 embryo and follow the flow of blood through the embryonic vasculature.
In this lab, we will also examine placentation.

==Objectives==

# Understand development of early embryo heart and vascular system.
# Understand the early placentation events and the development of placental blood vessels.

== Early circulation ==
[[Image:Embryonic Circulations.jpg|thumb|right|Three components of early circulation]]

The vascular system of the embryo is formed from blood islands that appear in the extraembryonic mesoderm of the yolk sac and the embryonic mesoderm (primarily splanchnic mesoderm). Both of these clusters fuse together and extend, forming a vast network.

The early circulation has 3 components: Vitelline, Embryonic, Placental Each of these has its own system of arteries and veins.

* '''Vitelline''' - (not shown) the vitelline arteries branch off the dorsal aortas and enter the yolk sac, covering its entire surface. The vitelline veins return red blood cells from the capillary beds to the sinus venosus, posterior to the heart. The vitelline vessels eventually contribute to the portal system of the liver in the adult.

* '''Embryonic''' - blood from the dorsal aorta enters intersegmental arteries, including the arteries of the pharyngeal arches. The blood returns to the heart via the anterior and posterior cardinal veins.

* '''Placental''' - the umbilical arteries receive blood from the aorta. This is carried to the chorionic villi, where exchange occurs with the mother. Waste products are disposed of, nutrients and oxygen are collected, and then the umbilical veins convey the blood to the sinus venosus.

'''Heart''' - The heart develops from cardiogenic mesoderm, a region of splanchnic mesoderm lying above the buccopharyngeal membrane. Development begins in week 3 with the formation of a pair of heart tubes. These fuse and form a single tube in week 4, as a result of the embryonic folding processes that occur. As the heart grows, septation events occur, transforming it into a 4-chambered pump. Initially, the ventricles develop above the atria; however simultaneous growth and bending of the tube bring the structures into correct position. In humans, the heart begins to beat on day 22-23.

[[File:Stage13_bloodflow.jpg]]

====Cardiovascular Movies====

{| border='0px'

|-
| [[File:Heart1_looping icon.jpg|90px|link=Development_Animation_-_Heart Looping]]
|-
| [[Development_Animation_-_Heart Looping|Heart Looping]]
|-
|}

== Stage 14 Embryo ==
'''Stage 14 3D CVS reconstruction''' [http://embryology.med.unsw.edu.au/Movies/CVS3dmodel.htm Small movie page] | [http://embryology.med.unsw.edu.au/Movies/CVS3dmodelonly.htm large movie page] | [[Media:CVS3d.mov|Stage 14 3D small movie]] | [[Media:Stage_14_CVS3d_large.mov|Stage 14 3D large movie]]

[[File:Stage14 planesm.gif|left]]
{| class="prettytable"
|-
| [http://embryology.med.unsw.edu.au/wwwpig/piga/a1l.htm A1]
| [http://embryology.med.unsw.edu.au/wwwpig/piga/a2l.htm A2]
| [http://embryology.med.unsw.edu.au/wwwpig/piga/a3l.htm A3]
| [http://embryology.med.unsw.edu.au/wwwpig/piga/a4l.htm A4]
| [http://embryology.med.unsw.edu.au/wwwpig/piga/a5l.htm A5]
| [http://embryology.med.unsw.edu.au/wwwpig/piga/a6l.htm A6]
| [http://embryology.med.unsw.edu.au/wwwpig/piga/a7l.htm A7]

|-
| [http://embryology.med.unsw.edu.au/wwwpig/pigb/b1l.htm B1]
| [http://embryology.med.unsw.edu.au/wwwpig/pigb/b2l.htm B2]
| [http://embryology.med.unsw.edu.au/wwwpig/pigb/b3l.htm B3]
| [http://embryology.med.unsw.edu.au/wwwpig/pigb/b4l.htm B4]
| [http://embryology.med.unsw.edu.au/wwwpig/pigb/b5l.htm B5]
| [http://embryology.med.unsw.edu.au/wwwpig/pigb/b6l.htm B6]
| [http://embryology.med.unsw.edu.au/wwwpig/pigb/b7l.htm B7]

|-
| [http://embryology.med.unsw.edu.au/wwwpig/pigc/c1l.htm C1]
| [http://embryology.med.unsw.edu.au/wwwpig/pigc/c2l.htm C2]
| [http://embryology.med.unsw.edu.au/wwwpig/pigc/c3l.htm C3]
| [http://embryology.med.unsw.edu.au/wwwpig/pigc/c4l.htm C4]
| [http://embryology.med.unsw.edu.au/wwwpig/pigc/c5l.htm C5]
| [http://embryology.med.unsw.edu.au/wwwpig/pigc/c6l.htm C6]
| [http://embryology.med.unsw.edu.au/wwwpig/pigc/c7l.htm C7]

|-
| [http://embryology.med.unsw.edu.au/wwwpig/pigd/d1l.htm D1]
| [http://embryology.med.unsw.edu.au/wwwpig/pigd/d2l.htm D2]
| [http://embryology.med.unsw.edu.au/wwwpig/pigd/d3l.htm D3]
| [http://embryology.med.unsw.edu.au/wwwpig/pigd/d4l.htm D4]
| [http://embryology.med.unsw.edu.au/wwwpig/pigd/d5l.htm D5]
| [http://embryology.med.unsw.edu.au/wwwpig/pigd/d6l.htm D6]
| [http://embryology.med.unsw.edu.au/wwwpig/pigd/d7l.htm D7]

|-
| [http://embryology.med.unsw.edu.au/wwwpig/pige/e1l.htm E1]
| [http://embryology.med.unsw.edu.au/wwwpig/pige/e2l.htm E2]
| [http://embryology.med.unsw.edu.au/wwwpig/pige/e3l.htm E3]
| [http://embryology.med.unsw.edu.au/wwwpig/pige/e4l.htm E4]
| [http://embryology.med.unsw.edu.au/wwwpig/pige/e5l.htm E5]
| [http://embryology.med.unsw.edu.au/wwwpig/pige/e6l.htm E6]
| [http://embryology.med.unsw.edu.au/wwwpig/pige/e7l.htm E7]

|-
| [http://embryology.med.unsw.edu.au/wwwpig/pigf/f1l.htm F1]
| [http://embryology.med.unsw.edu.au/wwwpig/pigf/f2l.htm F2]
| [http://embryology.med.unsw.edu.au/wwwpig/pigf/f3l.htm F3]
| [http://embryology.med.unsw.edu.au/wwwpig/pigf/f4l.htm F4]
| [http://embryology.med.unsw.edu.au/wwwpig/pigf/f5l.htm F5]
| [http://embryology.med.unsw.edu.au/wwwpig/pigf/f6l.htm F6]
| [http://embryology.med.unsw.edu.au/wwwpig/pigf/f7l.htm F7]

|-
| [http://embryology.med.unsw.edu.au/wwwpig/pigg/g1l.htm G1]
| [http://embryology.med.unsw.edu.au/wwwpig/pigg/g2l.htm G2]
| [http://embryology.med.unsw.edu.au/wwwpig/pigg/g3l.htm G3]
| [http://embryology.med.unsw.edu.au/wwwpig/pigg/g4l.htm G4]
| [http://embryology.med.unsw.edu.au/wwwpig/pigg/g5l.htm G5]
| [http://embryology.med.unsw.edu.au/wwwpig/pigg/g6l.htm G6]
| [http://embryology.med.unsw.edu.au/wwwpig/pigg/g7l.htm G7]

|}

Compare this mid-embryonic cardiovascular system with that existing at the end of embryonic development [http://embryology.med.unsw.edu.au/Movies/CVS3dmodelst22.htm Stage 22 3D CVS reconstruction]

== Placentation ==

Compare the features of a normal and gravid uterus.

[[Image:Uterine and placental vasculature.jpg|thumb|right|Changes in the uterine vasculature with pregnancy]]

[[Image:Cvs.jpg|thumb|right|Chorionic villi sampling]]

==Chorionic Villi==
* Compare the features of primary, secondary, tertiary and stemmed villi
<gallery>
File:Gray0036.gif|Primary chorionic villi
File:Gray0037.gif|Secondary chorionic villi
File:Placenta anchoring villi.jpg|Placenta anchoring villi
</gallery>

[[Image:Gray0039.gif|thumb|Section through the placenta]]

[http://share.eldoc.ub.rug.nl/FILES/root2/2010/Mesestcei/Castrechini_2010_Placenta.pdf Mesenchymal stem cells in chorionic villi]

== Group projects ==

The laboratory will also allow time for work on the group online project. What have your other group members and other groups done so far?

==UNSW Embryology Links==

* '''Cardiovascular Slides''' [http://embryology.med.unsw.edu.au/Science/ANAT2341lecture07.htm Cardiovasular Lecture 7 2008] | [http://embryology.med.unsw.edu.au/pdf/ANAT2341L07Hearts1.pdf Heart Lecture 2008 - 1 slide/page ] | [http://embryology.med.unsw.edu.au/pdf/ANAT2341L07Hearts4.pdf Heart Lecture 2008 Slides - 4 slides/page] | [http://embryology.med.unsw.edu.au/pdf/ANAT2341L07Hearts6.pdf Heart Lecture 2008 Slides - 6 slides/page]
* '''Cardiovascular Movies''' [http://embryology.med.unsw.edu.au/Movies/heart.htm Heart Movies] | [http://embryology.med.unsw.edu.au//Movies/larsen/looping.mov Heart Looping] | [http://embryology.med.unsw.edu.au//Movies/larsen/atrium.mov Atrial Septation] | [http://embryology.med.unsw.edu.au//Movies/larsen/avc.mov Realignment] | [http://embryology.med.unsw.edu.au//Movies/larsen/ventricl.mov Ventricular Septation] | [http://embryology.med.unsw.edu.au/Movies/heart.htm#HeartSeptation Heart Septation Models] | [http://embryology.med.unsw.edu.au/Movies/heart.htm#HistoricHeart Historic Heart Movie] |

* '''Cardiovascular Notes''' [http://embryology.med.unsw.edu.au/Notes/heart.htm Introduction] | [http://embryology.med.unsw.edu.au/Notes/heart2.htm Abnormalities] | [http://embryology.med.unsw.edu.au/Notes/heart3.htm Stage 13/14] | [http://embryology.med.unsw.edu.au/Notes/heart4.htm Stage 22] | [http://embryology.med.unsw.edu.au/Notes/heart5.htm Stage 22 Selected Highpower] | [http://embryology.med.unsw.edu.au/Notes/heart6.htm Heart] | [http://embryology.med.unsw.edu.au/Notes/heart8.htm Heart Rate] | [http://embryology.med.unsw.edu.au/Notes/heart20.htm Blood][http://embryology.med.unsw.edu.au/Notes/heart19.htm Blood Vessels] | [http://embryology.med.unsw.edu.au/Notes/heart11.htm Molecular] | [http://embryology.med.unsw.edu.au/Notes/heart31.htm Lymphatic] | [http://embryology.med.unsw.edu.au/Notes/hearttxt.htm Text only page] | [http://embryology.med.unsw.edu.au/Notes/heartlink.htm WWW Links] | [http://embryology.med.unsw.edu.au/Child/heart.htm Postnatal] | [http://embryology.med.unsw.edu.au/history/page2b.htm#Harvey History - Harvey]

* '''Placenta Slides''' [http://embryology.med.unsw.edu.au/Science/ANAT2341lecture08.htm Placenta Lecture 8 2008] | [http://embryology.med.unsw.edu.au/pdf/ANAT2341L8Placentas1.pdf Placenta Lecture 2008 - 1 slide/page ] | [http://embryology.med.unsw.edu.au/pdf/ANAT2341L8Placentas4.pdf Placenta Lecture 2008 Slides - 4 slides/page] | [http://embryology.med.unsw.edu.au/pdf/ANAT2341L8Placentas6.pdf Placenta Lecture 2008 Slides - 6 slides/page]
* '''Placenta Movies''' [http://embryology.med.unsw.edu.au/Movies/heart.htm Heart Movies] | [http://embryology.med.unsw.edu.au//Movies/larsen/looping.mov Heart Looping] | [http://embryology.med.unsw.edu.au//Movies/larsen/atrium.mov Atrial Septation] | [http://embryology.med.unsw.edu.au//Movies/larsen/avc.mov Realignment] | [http://embryology.med.unsw.edu.au//Movies/larsen/ventricl.mov Ventricular Septation] | [http://embryology.med.unsw.edu.au/Movies/heart.htm#HeartSeptation Heart Septation Models] | [http://embryology.med.unsw.edu.au/Movies/heart.htm#HistoricHeart Historic Heart Movie] |

* '''Placenta Notes''' [http://embryology.med.unsw.edu.au/Notes/placenta.htm Introduction] | [http://embryology.med.unsw.edu.au/Notes/placenta2.htm Abnormalities] | [http://embryology.med.unsw.edu.au/Notes/placenta3.htm Stage 13/14] | [http://embryology.med.unsw.edu.au/Notes/placenta4.htm Human (Stage22)] | [http://embryology.med.unsw.edu.au/Notes/placenta5.htm Histology] | [http://embryology.med.unsw.edu.au/Notes/placenta7.htm Villi Development] | [http://embryology.med.unsw.edu.au/Notes/placenta8.htm Maternal Decidua] | [http://embryology.med.unsw.edu.au/Notes/placenta6.htm Vascular Beds] | [http://embryology.med.unsw.edu.au/Notes/placenta11.htm Molecular] | [http://embryology.med.unsw.edu.au/Child/heart.htm Postnatal] | [http://embryology.med.unsw.edu.au/Notes/endocrine14.htm Endocrine Placenta]

* '''General Links''' [http://embryology.med.unsw.edu.au/sysnote.htm System Notes] | [http://embryology.med.unsw.edu.au/week/weekbyweek.htm Development Timeline]

==Internet links==

'''Embryo Images Unit:''' [http://www.med.unc.edu/embryo_images/ Embryo Images Online] Early Cell Populations (cardiogenic section) | [http://www.med.unc.edu/embryo_images/unit-cardev/cardev_htms/cardevtoc.htm Cardiovascular Development] | [http://www.med.unc.edu/embryo_images/unit-cardev/cardev_htms/cardev001.htm Week 3 Development] | [http://www.med.unc.edu/embryo_images/unit-cardev/cardev_htms/cardev007.htmhttp://www.med.unc.edu/embryo_images/unit-cardev/cardev_htms/cardev007.htm Week 4 Development] | [http://www.med.unc.edu/embryo_images/unit-cardev/cardev_htms/cardev018.htm Heart Chambers and Outflow Tract] | [http://www.med.unc.edu/embryo_images/unit-cardev/cardev_htms/cardev022.htm Atrioventricular Septation] | [http://www.med.unc.edu/embryo_images/unit-cardev/cardev_htms/cardev028.htm Outflow Tract Septation] | [http://www.med.unc.edu/embryo_images/unit-cardev/cardev_htms/cardev035.htm Ventricular Septation] | [http://www.med.unc.edu/embryo_images/unit-cardev/cardev_htms/cardev036.htm Atrial Septation] | [http://www.med.unc.edu/embryo_images/unit-cardev/cardev_htms/cardev040.htm Atrial Walls] [http://www.med.unc.edu/embryo_images/unit-cardev/cardev_htms/cardev041.htm Aortic Arch Vessels] | [http://www.med.unc.edu/embryo_images/unit-cardev/cardev_htms/cardev042.htm Changes at Birth]

{{Template:2009ANAT2341}}

[[Category:2009ANAT2341]]
[[Category:Science-Undergraduate]]
[[Category:Heart]]
[[Category:Cardiovascular]]

2010 Lab 4

2010-08-18T20:31:47Z

Z3267024: /* Cardiovascular and Placenta */

=Cardiovascular and Placenta=

== Introduction ==
This laboratory will explore the development of the embryonic cardiovascular system, which includes the placental vascular system. We will look through cross-sections of the Carnegie stage 14 embryo and follow the flow of blood through the embryonic vasculature.
In this lab, we will also examine placentation.

==Objectives==

# Understand development of early embryo heart and vascular system.
# Understand the early placentation events and the development of placental blood vessels.

== Early circulation ==
[[Image:Embryonic Circulations.jpg|thumb|right|Three components of early circulation]]

The vascular system of the embryo is formed from blood islands that appear in the extraembryonic mesoderm of the yolk sac and the embryonic mesoderm (primarily splanchnic mesoderm). Both of these clusters fuse together and extend, forming a vast network.

The early circulation has 3 components: Vitelline, Embryonic, Placental Each of these has its own system of arteries and veins.

* '''Vitelline''' - (not shown) the vitelline arteries branch off the dorsal aortas and enter the yolk sac, covering its entire surface. The vitelline veins return red blood cells from the capillary beds to the sinus venosus, posterior to the heart. The vitelline vessels eventually contribute to the portal system of the liver in the adult.

* '''Embryonic''' - blood from the dorsal aorta enters intersegmental arteries, including the arteries of the pharyngeal arches. The blood returns to the heart via the anterior and posterior cardinal veins.

* '''Placental''' - the umbilical arteries receive blood from the aorta. This is carried to the chorionic villi, where exchange occurs with the mother. Waste products are disposed of, nutrients and oxygen are collected, and then the umbilical veins convey the blood to the sinus venosus.

'''Heart''' - The heart develops from cardiogenic mesoderm, a region of splanchnic mesoderm lying above the buccopharyngeal membrane. Development begins in week 3 with the formation of a pair of heart tubes. These fuse and form a single tube in week 4, as a result of the embryonic folding processes that occur. As the heart grows, septation events occur, transforming it into a 4-chambered pump. Initially, the ventricles develop above the atria; however simultaneous growth and bending of the tube bring the structures into correct position. In humans, the heart begins to beat on day 22-23.

[[File:Stage13_bloodflow.jpg]]

====Cardiovascular Movies====

{| border='0px'

|-
| [[File:Heart1_looping icon.jpg|90px|link=Development_Animation_-_Heart Looping]]
| [[File:Heart1_realign icon.jpg|90px|link=Development_Animation_-_Heart Realign]]
| [[File:Heart1_atrium icon.jpg|90px|link=Development_Animation_-_Heart Atrial Septation]]
| [[File:heart1 ventricle icon.jpg|90px|link=Development_Animation_-_Heart Outflow Septation]]
|-
| [[Development_Animation_-_Heart Looping|Heart Looping]]
| [[Development_Animation_-_Heart Realign|Heart Realign]]
| [[Development_Animation_-_Heart Atrial Septation|Heart Atrial Septation]]
| [[Development_Animation_-_Heart Outflow Septation|Heart Outflow Septation]]
|-
|}

== Stage 14 Embryo ==
'''Stage 14 3D CVS reconstruction''' [http://embryology.med.unsw.edu.au/Movies/CVS3dmodel.htm Small movie page] | [http://embryology.med.unsw.edu.au/Movies/CVS3dmodelonly.htm large movie page] | [[Media:CVS3d.mov|Stage 14 3D small movie]] | [[Media:Stage_14_CVS3d_large.mov|Stage 14 3D large movie]]

[[File:Stage14 planesm.gif|left]]
{| class="prettytable"
|-
| [http://embryology.med.unsw.edu.au/wwwpig/piga/a1l.htm A1]
| [http://embryology.med.unsw.edu.au/wwwpig/piga/a2l.htm A2]
| [http://embryology.med.unsw.edu.au/wwwpig/piga/a3l.htm A3]
| [http://embryology.med.unsw.edu.au/wwwpig/piga/a4l.htm A4]
| [http://embryology.med.unsw.edu.au/wwwpig/piga/a5l.htm A5]
| [http://embryology.med.unsw.edu.au/wwwpig/piga/a6l.htm A6]
| [http://embryology.med.unsw.edu.au/wwwpig/piga/a7l.htm A7]

|-
| [http://embryology.med.unsw.edu.au/wwwpig/pigb/b1l.htm B1]
| [http://embryology.med.unsw.edu.au/wwwpig/pigb/b2l.htm B2]
| [http://embryology.med.unsw.edu.au/wwwpig/pigb/b3l.htm B3]
| [http://embryology.med.unsw.edu.au/wwwpig/pigb/b4l.htm B4]
| [http://embryology.med.unsw.edu.au/wwwpig/pigb/b5l.htm B5]
| [http://embryology.med.unsw.edu.au/wwwpig/pigb/b6l.htm B6]
| [http://embryology.med.unsw.edu.au/wwwpig/pigb/b7l.htm B7]

|-
| [http://embryology.med.unsw.edu.au/wwwpig/pigc/c1l.htm C1]
| [http://embryology.med.unsw.edu.au/wwwpig/pigc/c2l.htm C2]
| [http://embryology.med.unsw.edu.au/wwwpig/pigc/c3l.htm C3]
| [http://embryology.med.unsw.edu.au/wwwpig/pigc/c4l.htm C4]
| [http://embryology.med.unsw.edu.au/wwwpig/pigc/c5l.htm C5]
| [http://embryology.med.unsw.edu.au/wwwpig/pigc/c6l.htm C6]
| [http://embryology.med.unsw.edu.au/wwwpig/pigc/c7l.htm C7]

|-
| [http://embryology.med.unsw.edu.au/wwwpig/pigd/d1l.htm D1]
| [http://embryology.med.unsw.edu.au/wwwpig/pigd/d2l.htm D2]
| [http://embryology.med.unsw.edu.au/wwwpig/pigd/d3l.htm D3]
| [http://embryology.med.unsw.edu.au/wwwpig/pigd/d4l.htm D4]
| [http://embryology.med.unsw.edu.au/wwwpig/pigd/d5l.htm D5]
| [http://embryology.med.unsw.edu.au/wwwpig/pigd/d6l.htm D6]
| [http://embryology.med.unsw.edu.au/wwwpig/pigd/d7l.htm D7]

|-
| [http://embryology.med.unsw.edu.au/wwwpig/pige/e1l.htm E1]
| [http://embryology.med.unsw.edu.au/wwwpig/pige/e2l.htm E2]
| [http://embryology.med.unsw.edu.au/wwwpig/pige/e3l.htm E3]
| [http://embryology.med.unsw.edu.au/wwwpig/pige/e4l.htm E4]
| [http://embryology.med.unsw.edu.au/wwwpig/pige/e5l.htm E5]
| [http://embryology.med.unsw.edu.au/wwwpig/pige/e6l.htm E6]
| [http://embryology.med.unsw.edu.au/wwwpig/pige/e7l.htm E7]

|-
| [http://embryology.med.unsw.edu.au/wwwpig/pigf/f1l.htm F1]
| [http://embryology.med.unsw.edu.au/wwwpig/pigf/f2l.htm F2]
| [http://embryology.med.unsw.edu.au/wwwpig/pigf/f3l.htm F3]
| [http://embryology.med.unsw.edu.au/wwwpig/pigf/f4l.htm F4]
| [http://embryology.med.unsw.edu.au/wwwpig/pigf/f5l.htm F5]
| [http://embryology.med.unsw.edu.au/wwwpig/pigf/f6l.htm F6]
| [http://embryology.med.unsw.edu.au/wwwpig/pigf/f7l.htm F7]

|-
| [http://embryology.med.unsw.edu.au/wwwpig/pigg/g1l.htm G1]
| [http://embryology.med.unsw.edu.au/wwwpig/pigg/g2l.htm G2]
| [http://embryology.med.unsw.edu.au/wwwpig/pigg/g3l.htm G3]
| [http://embryology.med.unsw.edu.au/wwwpig/pigg/g4l.htm G4]
| [http://embryology.med.unsw.edu.au/wwwpig/pigg/g5l.htm G5]
| [http://embryology.med.unsw.edu.au/wwwpig/pigg/g6l.htm G6]
| [http://embryology.med.unsw.edu.au/wwwpig/pigg/g7l.htm G7]

|}

Compare this mid-embryonic cardiovascular system with that existing at the end of embryonic development [http://embryology.med.unsw.edu.au/Movies/CVS3dmodelst22.htm Stage 22 3D CVS reconstruction]

== Placentation ==

Compare the features of a normal and gravid uterus.

[[Image:Uterine and placental vasculature.jpg|thumb|right|Changes in the uterine vasculature with pregnancy]]

[[Image:Cvs.jpg|thumb|right|Chorionic villi sampling]]

==Chorionic Villi==
* Compare the features of primary, secondary, tertiary and stemmed villi
<gallery>
File:Gray0036.gif|Primary chorionic villi
File:Gray0037.gif|Secondary chorionic villi
File:Placenta anchoring villi.jpg|Placenta anchoring villi
</gallery>

[[Image:Gray0039.gif|thumb|Section through the placenta]]

[http://share.eldoc.ub.rug.nl/FILES/root2/2010/Mesestcei/Castrechini_2010_Placenta.pdf Mesenchymal stem cells in chorionic villi]

== Group projects ==

The laboratory will also allow time for work on the group online project. What have your other group members and other groups done so far?

==UNSW Embryology Links==

* '''Cardiovascular Slides''' [http://embryology.med.unsw.edu.au/Science/ANAT2341lecture07.htm Cardiovasular Lecture 7 2008] | [http://embryology.med.unsw.edu.au/pdf/ANAT2341L07Hearts1.pdf Heart Lecture 2008 - 1 slide/page ] | [http://embryology.med.unsw.edu.au/pdf/ANAT2341L07Hearts4.pdf Heart Lecture 2008 Slides - 4 slides/page] | [http://embryology.med.unsw.edu.au/pdf/ANAT2341L07Hearts6.pdf Heart Lecture 2008 Slides - 6 slides/page]
* '''Cardiovascular Movies''' [http://embryology.med.unsw.edu.au/Movies/heart.htm Heart Movies] | [http://embryology.med.unsw.edu.au//Movies/larsen/looping.mov Heart Looping] | [http://embryology.med.unsw.edu.au//Movies/larsen/atrium.mov Atrial Septation] | [http://embryology.med.unsw.edu.au//Movies/larsen/avc.mov Realignment] | [http://embryology.med.unsw.edu.au//Movies/larsen/ventricl.mov Ventricular Septation] | [http://embryology.med.unsw.edu.au/Movies/heart.htm#HeartSeptation Heart Septation Models] | [http://embryology.med.unsw.edu.au/Movies/heart.htm#HistoricHeart Historic Heart Movie] |

* '''Cardiovascular Notes''' [http://embryology.med.unsw.edu.au/Notes/heart.htm Introduction] | [http://embryology.med.unsw.edu.au/Notes/heart2.htm Abnormalities] | [http://embryology.med.unsw.edu.au/Notes/heart3.htm Stage 13/14] | [http://embryology.med.unsw.edu.au/Notes/heart4.htm Stage 22] | [http://embryology.med.unsw.edu.au/Notes/heart5.htm Stage 22 Selected Highpower] | [http://embryology.med.unsw.edu.au/Notes/heart6.htm Heart] | [http://embryology.med.unsw.edu.au/Notes/heart8.htm Heart Rate] | [http://embryology.med.unsw.edu.au/Notes/heart20.htm Blood][http://embryology.med.unsw.edu.au/Notes/heart19.htm Blood Vessels] | [http://embryology.med.unsw.edu.au/Notes/heart11.htm Molecular] | [http://embryology.med.unsw.edu.au/Notes/heart31.htm Lymphatic] | [http://embryology.med.unsw.edu.au/Notes/hearttxt.htm Text only page] | [http://embryology.med.unsw.edu.au/Notes/heartlink.htm WWW Links] | [http://embryology.med.unsw.edu.au/Child/heart.htm Postnatal] | [http://embryology.med.unsw.edu.au/history/page2b.htm#Harvey History - Harvey]

* '''Placenta Slides''' [http://embryology.med.unsw.edu.au/Science/ANAT2341lecture08.htm Placenta Lecture 8 2008] | [http://embryology.med.unsw.edu.au/pdf/ANAT2341L8Placentas1.pdf Placenta Lecture 2008 - 1 slide/page ] | [http://embryology.med.unsw.edu.au/pdf/ANAT2341L8Placentas4.pdf Placenta Lecture 2008 Slides - 4 slides/page] | [http://embryology.med.unsw.edu.au/pdf/ANAT2341L8Placentas6.pdf Placenta Lecture 2008 Slides - 6 slides/page]
* '''Placenta Movies''' [http://embryology.med.unsw.edu.au/Movies/heart.htm Heart Movies] | [http://embryology.med.unsw.edu.au//Movies/larsen/looping.mov Heart Looping] | [http://embryology.med.unsw.edu.au//Movies/larsen/atrium.mov Atrial Septation] | [http://embryology.med.unsw.edu.au//Movies/larsen/avc.mov Realignment] | [http://embryology.med.unsw.edu.au//Movies/larsen/ventricl.mov Ventricular Septation] | [http://embryology.med.unsw.edu.au/Movies/heart.htm#HeartSeptation Heart Septation Models] | [http://embryology.med.unsw.edu.au/Movies/heart.htm#HistoricHeart Historic Heart Movie] |

* '''Placenta Notes''' [http://embryology.med.unsw.edu.au/Notes/placenta.htm Introduction] | [http://embryology.med.unsw.edu.au/Notes/placenta2.htm Abnormalities] | [http://embryology.med.unsw.edu.au/Notes/placenta3.htm Stage 13/14] | [http://embryology.med.unsw.edu.au/Notes/placenta4.htm Human (Stage22)] | [http://embryology.med.unsw.edu.au/Notes/placenta5.htm Histology] | [http://embryology.med.unsw.edu.au/Notes/placenta7.htm Villi Development] | [http://embryology.med.unsw.edu.au/Notes/placenta8.htm Maternal Decidua] | [http://embryology.med.unsw.edu.au/Notes/placenta6.htm Vascular Beds] | [http://embryology.med.unsw.edu.au/Notes/placenta11.htm Molecular] | [http://embryology.med.unsw.edu.au/Child/heart.htm Postnatal] | [http://embryology.med.unsw.edu.au/Notes/endocrine14.htm Endocrine Placenta]

* '''General Links''' [http://embryology.med.unsw.edu.au/sysnote.htm System Notes] | [http://embryology.med.unsw.edu.au/week/weekbyweek.htm Development Timeline]

==Internet links==

'''Embryo Images Unit:''' [http://www.med.unc.edu/embryo_images/ Embryo Images Online] Early Cell Populations (cardiogenic section) | [http://www.med.unc.edu/embryo_images/unit-cardev/cardev_htms/cardevtoc.htm Cardiovascular Development] | [http://www.med.unc.edu/embryo_images/unit-cardev/cardev_htms/cardev001.htm Week 3 Development] | [http://www.med.unc.edu/embryo_images/unit-cardev/cardev_htms/cardev007.htmhttp://www.med.unc.edu/embryo_images/unit-cardev/cardev_htms/cardev007.htm Week 4 Development] | [http://www.med.unc.edu/embryo_images/unit-cardev/cardev_htms/cardev018.htm Heart Chambers and Outflow Tract] | [http://www.med.unc.edu/embryo_images/unit-cardev/cardev_htms/cardev022.htm Atrioventricular Septation] | [http://www.med.unc.edu/embryo_images/unit-cardev/cardev_htms/cardev028.htm Outflow Tract Septation] | [http://www.med.unc.edu/embryo_images/unit-cardev/cardev_htms/cardev035.htm Ventricular Septation] | [http://www.med.unc.edu/embryo_images/unit-cardev/cardev_htms/cardev036.htm Atrial Septation] | [http://www.med.unc.edu/embryo_images/unit-cardev/cardev_htms/cardev040.htm Atrial Walls] [http://www.med.unc.edu/embryo_images/unit-cardev/cardev_htms/cardev041.htm Aortic Arch Vessels] | [http://www.med.unc.edu/embryo_images/unit-cardev/cardev_htms/cardev042.htm Changes at Birth]

{{Template:2009ANAT2341}}

[[Category:2009ANAT2341]]
[[Category:Science-Undergraduate]]
[[Category:Heart]]
[[Category:Cardiovascular]]

2010 Lab 4

2010-08-18T20:27:48Z

Z3267024: /* Cardiovascular and Placenta */

=Cardiovascular and Placenta=

== Introduction ==
This laboratory will explore the development of the embryonic cardiovascular system, which includes the placental vascular system. We will look through cross-sections of the Carnegie stage 14 embryo and follow the flow of blood through the embryonic vasculature.
In this lab, we will also examine placentation.

==Objectives==

# Understand development of early embryo heart and vascular system.
# Understand the early placentation events and the development of placental blood vessels.

== Early circulation ==
[[Image:Embryonic Circulations.jpg|thumb|right|Three components of early circulation]]

The vascular system of the embryo is formed from blood islands that appear in the extraembryonic mesoderm of the yolk sac and the embryonic mesoderm (primarily splanchnic mesoderm). Both of these clusters fuse together and extend, forming a vast network.

The early circulation has 3 components: Vitelline, Embryonic, Placental Each of these has its own system of arteries and veins.

* '''Vitelline''' - (not shown) the vitelline arteries branch off the dorsal aortas and enter the yolk sac, covering its entire surface. The vitelline veins return red blood cells from the capillary beds to the sinus venosus, posterior to the heart. The vitelline vessels eventually contribute to the portal system of the liver in the adult.

* '''Embryonic''' - blood from the dorsal aorta enters intersegmental arteries, including the arteries of the pharyngeal arches. The blood returns to the heart via the anterior and posterior cardinal veins.

* '''Placental''' - the umbilical arteries receive blood from the aorta. This is carried to the chorionic villi, where exchange occurs with the mother. Waste products are disposed of, nutrients and oxygen are collected, and then the umbilical veins convey the blood to the sinus venosus.

'''Heart''' - The heart develops from cardiogenic mesoderm, a region of splanchnic mesoderm lying above the buccopharyngeal membrane. Development begins in week 3 with the formation of a pair of heart tubes. These fuse and form a single tube in week 4, as a result of the embryonic folding processes that occur. As the heart grows, septation events occur, transforming it into a 4-chambered pump. Initially, the ventricles develop above the atria; however simultaneous growth and bending of the tube bring the structures into correct position. In humans, the heart begins to beat on day 22-23.

[[File:Stage13_bloodflow.jpg]]

====Cardiovascular Movies====

{| border='0px'

|-
| [[File:Heart1_looping icon.jpg|90px|link=Development_Animation_-_Heart Looping]]
| [[File:Heart1_realign icon.jpg|90px|link=Development_Animation_-_Heart Realign]]
| [[File:Heart1_atrium icon.jpg|90px|link=Development_Animation_-_Heart Atrial Septation]]
| [[File:heart1 ventricle icon.jpg|90px|link=Development_Animation_-_Heart Outflow Septation]]
|-
| [[Development_Animation_-_Heart Looping|Heart Looping]]
| [[Development_Animation_-_Heart Realign|Heart Realign]]
| [[Development_Animation_-_Heart Atrial Septation|Heart Atrial Septation]]
| [[Development_Animation_-_Heart Outflow Septation|Heart Outflow Septation]]

== Stage 14 Embryo ==
'''Stage 14 3D CVS reconstruction''' [http://embryology.med.unsw.edu.au/Movies/CVS3dmodel.htm Small movie page] | [http://embryology.med.unsw.edu.au/Movies/CVS3dmodelonly.htm large movie page] | [[Media:CVS3d.mov|Stage 14 3D small movie]] | [[Media:Stage_14_CVS3d_large.mov|Stage 14 3D large movie]]

[[File:Stage14 planesm.gif|left]]
{| class="prettytable"
|-
| [http://embryology.med.unsw.edu.au/wwwpig/piga/a1l.htm A1]
| [http://embryology.med.unsw.edu.au/wwwpig/piga/a2l.htm A2]
| [http://embryology.med.unsw.edu.au/wwwpig/piga/a3l.htm A3]
| [http://embryology.med.unsw.edu.au/wwwpig/piga/a4l.htm A4]
| [http://embryology.med.unsw.edu.au/wwwpig/piga/a5l.htm A5]
| [http://embryology.med.unsw.edu.au/wwwpig/piga/a6l.htm A6]
| [http://embryology.med.unsw.edu.au/wwwpig/piga/a7l.htm A7]

|-
| [http://embryology.med.unsw.edu.au/wwwpig/pigb/b1l.htm B1]
| [http://embryology.med.unsw.edu.au/wwwpig/pigb/b2l.htm B2]
| [http://embryology.med.unsw.edu.au/wwwpig/pigb/b3l.htm B3]
| [http://embryology.med.unsw.edu.au/wwwpig/pigb/b4l.htm B4]
| [http://embryology.med.unsw.edu.au/wwwpig/pigb/b5l.htm B5]
| [http://embryology.med.unsw.edu.au/wwwpig/pigb/b6l.htm B6]
| [http://embryology.med.unsw.edu.au/wwwpig/pigb/b7l.htm B7]

|-
| [http://embryology.med.unsw.edu.au/wwwpig/pigc/c1l.htm C1]
| [http://embryology.med.unsw.edu.au/wwwpig/pigc/c2l.htm C2]
| [http://embryology.med.unsw.edu.au/wwwpig/pigc/c3l.htm C3]
| [http://embryology.med.unsw.edu.au/wwwpig/pigc/c4l.htm C4]
| [http://embryology.med.unsw.edu.au/wwwpig/pigc/c5l.htm C5]
| [http://embryology.med.unsw.edu.au/wwwpig/pigc/c6l.htm C6]
| [http://embryology.med.unsw.edu.au/wwwpig/pigc/c7l.htm C7]

|-
| [http://embryology.med.unsw.edu.au/wwwpig/pigd/d1l.htm D1]
| [http://embryology.med.unsw.edu.au/wwwpig/pigd/d2l.htm D2]
| [http://embryology.med.unsw.edu.au/wwwpig/pigd/d3l.htm D3]
| [http://embryology.med.unsw.edu.au/wwwpig/pigd/d4l.htm D4]
| [http://embryology.med.unsw.edu.au/wwwpig/pigd/d5l.htm D5]
| [http://embryology.med.unsw.edu.au/wwwpig/pigd/d6l.htm D6]
| [http://embryology.med.unsw.edu.au/wwwpig/pigd/d7l.htm D7]

|-
| [http://embryology.med.unsw.edu.au/wwwpig/pige/e1l.htm E1]
| [http://embryology.med.unsw.edu.au/wwwpig/pige/e2l.htm E2]
| [http://embryology.med.unsw.edu.au/wwwpig/pige/e3l.htm E3]
| [http://embryology.med.unsw.edu.au/wwwpig/pige/e4l.htm E4]
| [http://embryology.med.unsw.edu.au/wwwpig/pige/e5l.htm E5]
| [http://embryology.med.unsw.edu.au/wwwpig/pige/e6l.htm E6]
| [http://embryology.med.unsw.edu.au/wwwpig/pige/e7l.htm E7]

|-
| [http://embryology.med.unsw.edu.au/wwwpig/pigf/f1l.htm F1]
| [http://embryology.med.unsw.edu.au/wwwpig/pigf/f2l.htm F2]
| [http://embryology.med.unsw.edu.au/wwwpig/pigf/f3l.htm F3]
| [http://embryology.med.unsw.edu.au/wwwpig/pigf/f4l.htm F4]
| [http://embryology.med.unsw.edu.au/wwwpig/pigf/f5l.htm F5]
| [http://embryology.med.unsw.edu.au/wwwpig/pigf/f6l.htm F6]
| [http://embryology.med.unsw.edu.au/wwwpig/pigf/f7l.htm F7]

|-
| [http://embryology.med.unsw.edu.au/wwwpig/pigg/g1l.htm G1]
| [http://embryology.med.unsw.edu.au/wwwpig/pigg/g2l.htm G2]
| [http://embryology.med.unsw.edu.au/wwwpig/pigg/g3l.htm G3]
| [http://embryology.med.unsw.edu.au/wwwpig/pigg/g4l.htm G4]
| [http://embryology.med.unsw.edu.au/wwwpig/pigg/g5l.htm G5]
| [http://embryology.med.unsw.edu.au/wwwpig/pigg/g6l.htm G6]
| [http://embryology.med.unsw.edu.au/wwwpig/pigg/g7l.htm G7]

|}

Compare this mid-embryonic cardiovascular system with that existing at the end of embryonic development [http://embryology.med.unsw.edu.au/Movies/CVS3dmodelst22.htm Stage 22 3D CVS reconstruction]

== Placentation ==

Compare the features of a normal and gravid uterus.

[[Image:Uterine and placental vasculature.jpg|thumb|right|Changes in the uterine vasculature with pregnancy]]

[[Image:Cvs.jpg|thumb|right|Chorionic villi sampling]]

==Chorionic Villi==
* Compare the features of primary, secondary, tertiary and stemmed villi
<gallery>
File:Gray0036.gif|Primary chorionic villi
File:Gray0037.gif|Secondary chorionic villi
File:Placenta anchoring villi.jpg|Placenta anchoring villi
</gallery>

[[Image:Gray0039.gif|thumb|Section through the placenta]]

[http://share.eldoc.ub.rug.nl/FILES/root2/2010/Mesestcei/Castrechini_2010_Placenta.pdf Mesenchymal stem cells in chorionic villi]

== Group projects ==

The laboratory will also allow time for work on the group online project. What have your other group members and other groups done so far?

==UNSW Embryology Links==

* '''Cardiovascular Slides''' [http://embryology.med.unsw.edu.au/Science/ANAT2341lecture07.htm Cardiovasular Lecture 7 2008] | [http://embryology.med.unsw.edu.au/pdf/ANAT2341L07Hearts1.pdf Heart Lecture 2008 - 1 slide/page ] | [http://embryology.med.unsw.edu.au/pdf/ANAT2341L07Hearts4.pdf Heart Lecture 2008 Slides - 4 slides/page] | [http://embryology.med.unsw.edu.au/pdf/ANAT2341L07Hearts6.pdf Heart Lecture 2008 Slides - 6 slides/page]
* '''Cardiovascular Movies''' [http://embryology.med.unsw.edu.au/Movies/heart.htm Heart Movies] | [http://embryology.med.unsw.edu.au//Movies/larsen/looping.mov Heart Looping] | [http://embryology.med.unsw.edu.au//Movies/larsen/atrium.mov Atrial Septation] | [http://embryology.med.unsw.edu.au//Movies/larsen/avc.mov Realignment] | [http://embryology.med.unsw.edu.au//Movies/larsen/ventricl.mov Ventricular Septation] | [http://embryology.med.unsw.edu.au/Movies/heart.htm#HeartSeptation Heart Septation Models] | [http://embryology.med.unsw.edu.au/Movies/heart.htm#HistoricHeart Historic Heart Movie] |

* '''Cardiovascular Notes''' [http://embryology.med.unsw.edu.au/Notes/heart.htm Introduction] | [http://embryology.med.unsw.edu.au/Notes/heart2.htm Abnormalities] | [http://embryology.med.unsw.edu.au/Notes/heart3.htm Stage 13/14] | [http://embryology.med.unsw.edu.au/Notes/heart4.htm Stage 22] | [http://embryology.med.unsw.edu.au/Notes/heart5.htm Stage 22 Selected Highpower] | [http://embryology.med.unsw.edu.au/Notes/heart6.htm Heart] | [http://embryology.med.unsw.edu.au/Notes/heart8.htm Heart Rate] | [http://embryology.med.unsw.edu.au/Notes/heart20.htm Blood][http://embryology.med.unsw.edu.au/Notes/heart19.htm Blood Vessels] | [http://embryology.med.unsw.edu.au/Notes/heart11.htm Molecular] | [http://embryology.med.unsw.edu.au/Notes/heart31.htm Lymphatic] | [http://embryology.med.unsw.edu.au/Notes/hearttxt.htm Text only page] | [http://embryology.med.unsw.edu.au/Notes/heartlink.htm WWW Links] | [http://embryology.med.unsw.edu.au/Child/heart.htm Postnatal] | [http://embryology.med.unsw.edu.au/history/page2b.htm#Harvey History - Harvey]

* '''Placenta Slides''' [http://embryology.med.unsw.edu.au/Science/ANAT2341lecture08.htm Placenta Lecture 8 2008] | [http://embryology.med.unsw.edu.au/pdf/ANAT2341L8Placentas1.pdf Placenta Lecture 2008 - 1 slide/page ] | [http://embryology.med.unsw.edu.au/pdf/ANAT2341L8Placentas4.pdf Placenta Lecture 2008 Slides - 4 slides/page] | [http://embryology.med.unsw.edu.au/pdf/ANAT2341L8Placentas6.pdf Placenta Lecture 2008 Slides - 6 slides/page]
* '''Placenta Movies''' [http://embryology.med.unsw.edu.au/Movies/heart.htm Heart Movies] | [http://embryology.med.unsw.edu.au//Movies/larsen/looping.mov Heart Looping] | [http://embryology.med.unsw.edu.au//Movies/larsen/atrium.mov Atrial Septation] | [http://embryology.med.unsw.edu.au//Movies/larsen/avc.mov Realignment] | [http://embryology.med.unsw.edu.au//Movies/larsen/ventricl.mov Ventricular Septation] | [http://embryology.med.unsw.edu.au/Movies/heart.htm#HeartSeptation Heart Septation Models] | [http://embryology.med.unsw.edu.au/Movies/heart.htm#HistoricHeart Historic Heart Movie] |

* '''Placenta Notes''' [http://embryology.med.unsw.edu.au/Notes/placenta.htm Introduction] | [http://embryology.med.unsw.edu.au/Notes/placenta2.htm Abnormalities] | [http://embryology.med.unsw.edu.au/Notes/placenta3.htm Stage 13/14] | [http://embryology.med.unsw.edu.au/Notes/placenta4.htm Human (Stage22)] | [http://embryology.med.unsw.edu.au/Notes/placenta5.htm Histology] | [http://embryology.med.unsw.edu.au/Notes/placenta7.htm Villi Development] | [http://embryology.med.unsw.edu.au/Notes/placenta8.htm Maternal Decidua] | [http://embryology.med.unsw.edu.au/Notes/placenta6.htm Vascular Beds] | [http://embryology.med.unsw.edu.au/Notes/placenta11.htm Molecular] | [http://embryology.med.unsw.edu.au/Child/heart.htm Postnatal] | [http://embryology.med.unsw.edu.au/Notes/endocrine14.htm Endocrine Placenta]

* '''General Links''' [http://embryology.med.unsw.edu.au/sysnote.htm System Notes] | [http://embryology.med.unsw.edu.au/week/weekbyweek.htm Development Timeline]

==Internet links==

'''Embryo Images Unit:''' [http://www.med.unc.edu/embryo_images/ Embryo Images Online] Early Cell Populations (cardiogenic section) | [http://www.med.unc.edu/embryo_images/unit-cardev/cardev_htms/cardevtoc.htm Cardiovascular Development] | [http://www.med.unc.edu/embryo_images/unit-cardev/cardev_htms/cardev001.htm Week 3 Development] | [http://www.med.unc.edu/embryo_images/unit-cardev/cardev_htms/cardev007.htmhttp://www.med.unc.edu/embryo_images/unit-cardev/cardev_htms/cardev007.htm Week 4 Development] | [http://www.med.unc.edu/embryo_images/unit-cardev/cardev_htms/cardev018.htm Heart Chambers and Outflow Tract] | [http://www.med.unc.edu/embryo_images/unit-cardev/cardev_htms/cardev022.htm Atrioventricular Septation] | [http://www.med.unc.edu/embryo_images/unit-cardev/cardev_htms/cardev028.htm Outflow Tract Septation] | [http://www.med.unc.edu/embryo_images/unit-cardev/cardev_htms/cardev035.htm Ventricular Septation] | [http://www.med.unc.edu/embryo_images/unit-cardev/cardev_htms/cardev036.htm Atrial Septation] | [http://www.med.unc.edu/embryo_images/unit-cardev/cardev_htms/cardev040.htm Atrial Walls] [http://www.med.unc.edu/embryo_images/unit-cardev/cardev_htms/cardev041.htm Aortic Arch Vessels] | [http://www.med.unc.edu/embryo_images/unit-cardev/cardev_htms/cardev042.htm Changes at Birth]

{{Template:2009ANAT2341}}

[[Category:2009ANAT2341]]
[[Category:Science-Undergraduate]]
[[Category:Heart]]
[[Category:Cardiovascular]]

2010 Lab 4

2010-08-18T20:22:25Z

Z3267024: /* Cardiovascular and Placenta */

=Cardiovascular and Placenta=

== Introduction ==
This laboratory will explore the development of the embryonic cardiovascular system, which includes the placental vascular system. We will look through cross-sections of the Carnegie stage 14 embryo and follow the flow of blood through the embryonic vasculature.
In this lab, we will also examine placentation.

==Objectives==

# Understand development of early embryo heart and vascular system.
# Understand the early placentation events and the development of placental blood vessels.

== Early circulation ==
[[Image:Embryonic Circulations.jpg|thumb|right|Three components of early circulation]]

The vascular system of the embryo is formed from blood islands that appear in the extraembryonic mesoderm of the yolk sac and the embryonic mesoderm (primarily splanchnic mesoderm). Both of these clusters fuse together and extend, forming a vast network.

The early circulation has 3 components: Vitelline, Embryonic, Placental Each of these has its own system of arteries and veins.

* '''Vitelline''' - (not shown) the vitelline arteries branch off the dorsal aortas and enter the yolk sac, covering its entire surface. The vitelline veins return red blood cells from the capillary beds to the sinus venosus, posterior to the heart. The vitelline vessels eventually contribute to the portal system of the liver in the adult.

* '''Embryonic''' - blood from the dorsal aorta enters intersegmental arteries, including the arteries of the pharyngeal arches. The blood returns to the heart via the anterior and posterior cardinal veins.

* '''Placental''' - the umbilical arteries receive blood from the aorta. This is carried to the chorionic villi, where exchange occurs with the mother. Waste products are disposed of, nutrients and oxygen are collected, and then the umbilical veins convey the blood to the sinus venosus.

'''Heart''' - The heart develops from cardiogenic mesoderm, a region of splanchnic mesoderm lying above the buccopharyngeal membrane. Development begins in week 3 with the formation of a pair of heart tubes. These fuse and form a single tube in week 4, as a result of the embryonic folding processes that occur. As the heart grows, septation events occur, transforming it into a 4-chambered pump. Initially, the ventricles develop above the atria; however simultaneous growth and bending of the tube bring the structures into correct position. In humans, the heart begins to beat on day 22-23.

[[File:Stage13_bloodflow.jpg]]

== Stage 14 Embryo ==
'''Stage 14 3D CVS reconstruction''' [http://embryology.med.unsw.edu.au/Movies/CVS3dmodel.htm Small movie page] | [http://embryology.med.unsw.edu.au/Movies/CVS3dmodelonly.htm large movie page] | [[Media:CVS3d.mov|Stage 14 3D small movie]] | [[Media:Stage_14_CVS3d_large.mov|Stage 14 3D large movie]]

[[File:Stage14 planesm.gif|left]]
{| class="prettytable"
|-
| [http://embryology.med.unsw.edu.au/wwwpig/piga/a1l.htm A1]
| [http://embryology.med.unsw.edu.au/wwwpig/piga/a2l.htm A2]
| [http://embryology.med.unsw.edu.au/wwwpig/piga/a3l.htm A3]
| [http://embryology.med.unsw.edu.au/wwwpig/piga/a4l.htm A4]
| [http://embryology.med.unsw.edu.au/wwwpig/piga/a5l.htm A5]
| [http://embryology.med.unsw.edu.au/wwwpig/piga/a6l.htm A6]
| [http://embryology.med.unsw.edu.au/wwwpig/piga/a7l.htm A7]

|-
| [http://embryology.med.unsw.edu.au/wwwpig/pigb/b1l.htm B1]
| [http://embryology.med.unsw.edu.au/wwwpig/pigb/b2l.htm B2]
| [http://embryology.med.unsw.edu.au/wwwpig/pigb/b3l.htm B3]
| [http://embryology.med.unsw.edu.au/wwwpig/pigb/b4l.htm B4]
| [http://embryology.med.unsw.edu.au/wwwpig/pigb/b5l.htm B5]
| [http://embryology.med.unsw.edu.au/wwwpig/pigb/b6l.htm B6]
| [http://embryology.med.unsw.edu.au/wwwpig/pigb/b7l.htm B7]

|-
| [http://embryology.med.unsw.edu.au/wwwpig/pigc/c1l.htm C1]
| [http://embryology.med.unsw.edu.au/wwwpig/pigc/c2l.htm C2]
| [http://embryology.med.unsw.edu.au/wwwpig/pigc/c3l.htm C3]
| [http://embryology.med.unsw.edu.au/wwwpig/pigc/c4l.htm C4]
| [http://embryology.med.unsw.edu.au/wwwpig/pigc/c5l.htm C5]
| [http://embryology.med.unsw.edu.au/wwwpig/pigc/c6l.htm C6]
| [http://embryology.med.unsw.edu.au/wwwpig/pigc/c7l.htm C7]

|-
| [http://embryology.med.unsw.edu.au/wwwpig/pigd/d1l.htm D1]
| [http://embryology.med.unsw.edu.au/wwwpig/pigd/d2l.htm D2]
| [http://embryology.med.unsw.edu.au/wwwpig/pigd/d3l.htm D3]
| [http://embryology.med.unsw.edu.au/wwwpig/pigd/d4l.htm D4]
| [http://embryology.med.unsw.edu.au/wwwpig/pigd/d5l.htm D5]
| [http://embryology.med.unsw.edu.au/wwwpig/pigd/d6l.htm D6]
| [http://embryology.med.unsw.edu.au/wwwpig/pigd/d7l.htm D7]

|-
| [http://embryology.med.unsw.edu.au/wwwpig/pige/e1l.htm E1]
| [http://embryology.med.unsw.edu.au/wwwpig/pige/e2l.htm E2]
| [http://embryology.med.unsw.edu.au/wwwpig/pige/e3l.htm E3]
| [http://embryology.med.unsw.edu.au/wwwpig/pige/e4l.htm E4]
| [http://embryology.med.unsw.edu.au/wwwpig/pige/e5l.htm E5]
| [http://embryology.med.unsw.edu.au/wwwpig/pige/e6l.htm E6]
| [http://embryology.med.unsw.edu.au/wwwpig/pige/e7l.htm E7]

|-
| [http://embryology.med.unsw.edu.au/wwwpig/pigf/f1l.htm F1]
| [http://embryology.med.unsw.edu.au/wwwpig/pigf/f2l.htm F2]
| [http://embryology.med.unsw.edu.au/wwwpig/pigf/f3l.htm F3]
| [http://embryology.med.unsw.edu.au/wwwpig/pigf/f4l.htm F4]
| [http://embryology.med.unsw.edu.au/wwwpig/pigf/f5l.htm F5]
| [http://embryology.med.unsw.edu.au/wwwpig/pigf/f6l.htm F6]
| [http://embryology.med.unsw.edu.au/wwwpig/pigf/f7l.htm F7]

|-
| [http://embryology.med.unsw.edu.au/wwwpig/pigg/g1l.htm G1]
| [http://embryology.med.unsw.edu.au/wwwpig/pigg/g2l.htm G2]
| [http://embryology.med.unsw.edu.au/wwwpig/pigg/g3l.htm G3]
| [http://embryology.med.unsw.edu.au/wwwpig/pigg/g4l.htm G4]
| [http://embryology.med.unsw.edu.au/wwwpig/pigg/g5l.htm G5]
| [http://embryology.med.unsw.edu.au/wwwpig/pigg/g6l.htm G6]
| [http://embryology.med.unsw.edu.au/wwwpig/pigg/g7l.htm G7]

|}

Compare this mid-embryonic cardiovascular system with that existing at the end of embryonic development [http://embryology.med.unsw.edu.au/Movies/CVS3dmodelst22.htm Stage 22 3D CVS reconstruction]

== Placentation ==

Compare the features of a normal and gravid uterus.

[[Image:Uterine and placental vasculature.jpg|thumb|right|Changes in the uterine vasculature with pregnancy]]

[[Image:Cvs.jpg|thumb|right|Chorionic villi sampling]]

==Chorionic Villi==
* Compare the features of primary, secondary, tertiary and stemmed villi
<gallery>
File:Gray0036.gif|Primary chorionic villi
File:Gray0037.gif|Secondary chorionic villi
File:Placenta anchoring villi.jpg|Placenta anchoring villi
</gallery>

[[Image:Gray0039.gif|thumb|Section through the placenta]]

[http://share.eldoc.ub.rug.nl/FILES/root2/2010/Mesestcei/Castrechini_2010_Placenta.pdf Mesenchymal stem cells in chorionic villi]

== Group projects ==

The laboratory will also allow time for work on the group online project. What have your other group members and other groups done so far?

==UNSW Embryology Links==

* '''Cardiovascular Slides''' [http://embryology.med.unsw.edu.au/Science/ANAT2341lecture07.htm Cardiovasular Lecture 7 2008] | [http://embryology.med.unsw.edu.au/pdf/ANAT2341L07Hearts1.pdf Heart Lecture 2008 - 1 slide/page ] | [http://embryology.med.unsw.edu.au/pdf/ANAT2341L07Hearts4.pdf Heart Lecture 2008 Slides - 4 slides/page] | [http://embryology.med.unsw.edu.au/pdf/ANAT2341L07Hearts6.pdf Heart Lecture 2008 Slides - 6 slides/page]
* '''Cardiovascular Movies''' [http://embryology.med.unsw.edu.au/Movies/heart.htm Heart Movies] | [http://embryology.med.unsw.edu.au//Movies/larsen/looping.mov Heart Looping] | [http://embryology.med.unsw.edu.au//Movies/larsen/atrium.mov Atrial Septation] | [http://embryology.med.unsw.edu.au//Movies/larsen/avc.mov Realignment] | [http://embryology.med.unsw.edu.au//Movies/larsen/ventricl.mov Ventricular Septation] | [http://embryology.med.unsw.edu.au/Movies/heart.htm#HeartSeptation Heart Septation Models] | [http://embryology.med.unsw.edu.au/Movies/heart.htm#HistoricHeart Historic Heart Movie] |

* '''Cardiovascular Notes''' [http://embryology.med.unsw.edu.au/Notes/heart.htm Introduction] | [http://embryology.med.unsw.edu.au/Notes/heart2.htm Abnormalities] | [http://embryology.med.unsw.edu.au/Notes/heart3.htm Stage 13/14] | [http://embryology.med.unsw.edu.au/Notes/heart4.htm Stage 22] | [http://embryology.med.unsw.edu.au/Notes/heart5.htm Stage 22 Selected Highpower] | [http://embryology.med.unsw.edu.au/Notes/heart6.htm Heart] | [http://embryology.med.unsw.edu.au/Notes/heart8.htm Heart Rate] | [http://embryology.med.unsw.edu.au/Notes/heart20.htm Blood][http://embryology.med.unsw.edu.au/Notes/heart19.htm Blood Vessels] | [http://embryology.med.unsw.edu.au/Notes/heart11.htm Molecular] | [http://embryology.med.unsw.edu.au/Notes/heart31.htm Lymphatic] | [http://embryology.med.unsw.edu.au/Notes/hearttxt.htm Text only page] | [http://embryology.med.unsw.edu.au/Notes/heartlink.htm WWW Links] | [http://embryology.med.unsw.edu.au/Child/heart.htm Postnatal] | [http://embryology.med.unsw.edu.au/history/page2b.htm#Harvey History - Harvey]

* '''Placenta Slides''' [http://embryology.med.unsw.edu.au/Science/ANAT2341lecture08.htm Placenta Lecture 8 2008] | [http://embryology.med.unsw.edu.au/pdf/ANAT2341L8Placentas1.pdf Placenta Lecture 2008 - 1 slide/page ] | [http://embryology.med.unsw.edu.au/pdf/ANAT2341L8Placentas4.pdf Placenta Lecture 2008 Slides - 4 slides/page] | [http://embryology.med.unsw.edu.au/pdf/ANAT2341L8Placentas6.pdf Placenta Lecture 2008 Slides - 6 slides/page]
* '''Placenta Movies''' [http://embryology.med.unsw.edu.au/Movies/heart.htm Heart Movies] | [http://embryology.med.unsw.edu.au//Movies/larsen/looping.mov Heart Looping] | [http://embryology.med.unsw.edu.au//Movies/larsen/atrium.mov Atrial Septation] | [http://embryology.med.unsw.edu.au//Movies/larsen/avc.mov Realignment] | [http://embryology.med.unsw.edu.au//Movies/larsen/ventricl.mov Ventricular Septation] | [http://embryology.med.unsw.edu.au/Movies/heart.htm#HeartSeptation Heart Septation Models] | [http://embryology.med.unsw.edu.au/Movies/heart.htm#HistoricHeart Historic Heart Movie] |

* '''Placenta Notes''' [http://embryology.med.unsw.edu.au/Notes/placenta.htm Introduction] | [http://embryology.med.unsw.edu.au/Notes/placenta2.htm Abnormalities] | [http://embryology.med.unsw.edu.au/Notes/placenta3.htm Stage 13/14] | [http://embryology.med.unsw.edu.au/Notes/placenta4.htm Human (Stage22)] | [http://embryology.med.unsw.edu.au/Notes/placenta5.htm Histology] | [http://embryology.med.unsw.edu.au/Notes/placenta7.htm Villi Development] | [http://embryology.med.unsw.edu.au/Notes/placenta8.htm Maternal Decidua] | [http://embryology.med.unsw.edu.au/Notes/placenta6.htm Vascular Beds] | [http://embryology.med.unsw.edu.au/Notes/placenta11.htm Molecular] | [http://embryology.med.unsw.edu.au/Child/heart.htm Postnatal] | [http://embryology.med.unsw.edu.au/Notes/endocrine14.htm Endocrine Placenta]

* '''General Links''' [http://embryology.med.unsw.edu.au/sysnote.htm System Notes] | [http://embryology.med.unsw.edu.au/week/weekbyweek.htm Development Timeline]

==Internet links==

'''Embryo Images Unit:''' [http://www.med.unc.edu/embryo_images/ Embryo Images Online] Early Cell Populations (cardiogenic section) | [http://www.med.unc.edu/embryo_images/unit-cardev/cardev_htms/cardevtoc.htm Cardiovascular Development] | [http://www.med.unc.edu/embryo_images/unit-cardev/cardev_htms/cardev001.htm Week 3 Development] | [http://www.med.unc.edu/embryo_images/unit-cardev/cardev_htms/cardev007.htmhttp://www.med.unc.edu/embryo_images/unit-cardev/cardev_htms/cardev007.htm Week 4 Development] | [http://www.med.unc.edu/embryo_images/unit-cardev/cardev_htms/cardev018.htm Heart Chambers and Outflow Tract] | [http://www.med.unc.edu/embryo_images/unit-cardev/cardev_htms/cardev022.htm Atrioventricular Septation] | [http://www.med.unc.edu/embryo_images/unit-cardev/cardev_htms/cardev028.htm Outflow Tract Septation] | [http://www.med.unc.edu/embryo_images/unit-cardev/cardev_htms/cardev035.htm Ventricular Septation] | [http://www.med.unc.edu/embryo_images/unit-cardev/cardev_htms/cardev036.htm Atrial Septation] | [http://www.med.unc.edu/embryo_images/unit-cardev/cardev_htms/cardev040.htm Atrial Walls] [http://www.med.unc.edu/embryo_images/unit-cardev/cardev_htms/cardev041.htm Aortic Arch Vessels] | [http://www.med.unc.edu/embryo_images/unit-cardev/cardev_htms/cardev042.htm Changes at Birth]

{{Template:2009ANAT2341}}

[[Category:2009ANAT2341]]
[[Category:Science-Undergraduate]]
[[Category:Heart]]
[[Category:Cardiovascular]]

2010 Lab 4

2010-08-18T11:09:54Z

Z3267024: /* Cardiovascular and Placenta */

=Cardiovascular and Placenta=

==Objectives==

# Understand development of early embryo heart and vascular system.
# Understand the early placentation events and the development of placental blood vessels.

== Introduction ==
This laboratory will explore the development of the embryonic cardiovascular system, which includes the placental vascular system. We will look through cross-sections of the Carnegie stage 14 embryo and follow the flow of blood through the embryonic vasculature.
In this lab, we will also examine placentation.

== Introduction ==
[[Image:Embryonic Circulations.jpg|thumb|right|Three components of early circulation]]

The vascular system of the embryo is formed from blood islands that appear in the extraembryonic mesoderm of the yolk sac and the embryonic mesoderm (primarily splanchnic mesoderm). Both of these clusters fuse together and extend, forming a vast network.

The early circulation has 3 components: Vitelline, Embryonic, Placental Each of these has its own system of arteries and veins.

* '''Vitelline''' - (not shown) the vitelline arteries branch off the dorsal aortas and enter the yolk sac, covering its entire surface. The vitelline veins return red blood cells from the capillary beds to the sinus venosus, posterior to the heart. The vitelline vessels eventually contribute to the portal system of the liver in the adult.

* '''Embryonic''' - blood from the dorsal aorta enters intersegmental arteries, including the arteries of the pharyngeal arches. The blood returns to the heart via the anterior and posterior cardinal veins.

* '''Placental''' - the umbilical arteries receive blood from the aorta. This is carried to the chorionic villi, where exchange occurs with the mother. Waste products are disposed of, nutrients and oxygen are collected, and then the umbilical veins convey the blood to the sinus venosus.

'''Heart''' - The heart develops from cardiogenic mesoderm, a region of splanchnic mesoderm lying above the buccopharyngeal membrane. Development begins in week 3 with the formation of a pair of heart tubes. These fuse and form a single tube in week 4, as a result of the embryonic folding processes that occur. As the heart grows, septation events occur, transforming it into a 4-chambered pump. Initially, the ventricles develop above the atria; however simultaneous growth and bending of the tube bring the structures into correct position. In humans, the heart begins to beat on day 22-23.

[[File:Stage13_bloodflow.jpg]]

== Stage 14 Embryo ==
'''Stage 14 3D CVS reconstruction''' [http://embryology.med.unsw.edu.au/Movies/CVS3dmodel.htm Small movie page] | [http://embryology.med.unsw.edu.au/Movies/CVS3dmodelonly.htm large movie page] | [[Media:CVS3d.mov|Stage 14 3D small movie]] | [[Media:Stage_14_CVS3d_large.mov|Stage 14 3D large movie]]

[[File:Stage14 planesm.gif|left]]
{| class="prettytable"
|-
| [http://embryology.med.unsw.edu.au/wwwpig/piga/a1l.htm A1]
| [http://embryology.med.unsw.edu.au/wwwpig/piga/a2l.htm A2]
| [http://embryology.med.unsw.edu.au/wwwpig/piga/a3l.htm A3]
| [http://embryology.med.unsw.edu.au/wwwpig/piga/a4l.htm A4]
| [http://embryology.med.unsw.edu.au/wwwpig/piga/a5l.htm A5]
| [http://embryology.med.unsw.edu.au/wwwpig/piga/a6l.htm A6]
| [http://embryology.med.unsw.edu.au/wwwpig/piga/a7l.htm A7]

|-
| [http://embryology.med.unsw.edu.au/wwwpig/pigb/b1l.htm B1]
| [http://embryology.med.unsw.edu.au/wwwpig/pigb/b2l.htm B2]
| [http://embryology.med.unsw.edu.au/wwwpig/pigb/b3l.htm B3]
| [http://embryology.med.unsw.edu.au/wwwpig/pigb/b4l.htm B4]
| [http://embryology.med.unsw.edu.au/wwwpig/pigb/b5l.htm B5]
| [http://embryology.med.unsw.edu.au/wwwpig/pigb/b6l.htm B6]
| [http://embryology.med.unsw.edu.au/wwwpig/pigb/b7l.htm B7]

|-
| [http://embryology.med.unsw.edu.au/wwwpig/pigc/c1l.htm C1]
| [http://embryology.med.unsw.edu.au/wwwpig/pigc/c2l.htm C2]
| [http://embryology.med.unsw.edu.au/wwwpig/pigc/c3l.htm C3]
| [http://embryology.med.unsw.edu.au/wwwpig/pigc/c4l.htm C4]
| [http://embryology.med.unsw.edu.au/wwwpig/pigc/c5l.htm C5]
| [http://embryology.med.unsw.edu.au/wwwpig/pigc/c6l.htm C6]
| [http://embryology.med.unsw.edu.au/wwwpig/pigc/c7l.htm C7]

|-
| [http://embryology.med.unsw.edu.au/wwwpig/pigd/d1l.htm D1]
| [http://embryology.med.unsw.edu.au/wwwpig/pigd/d2l.htm D2]
| [http://embryology.med.unsw.edu.au/wwwpig/pigd/d3l.htm D3]
| [http://embryology.med.unsw.edu.au/wwwpig/pigd/d4l.htm D4]
| [http://embryology.med.unsw.edu.au/wwwpig/pigd/d5l.htm D5]
| [http://embryology.med.unsw.edu.au/wwwpig/pigd/d6l.htm D6]
| [http://embryology.med.unsw.edu.au/wwwpig/pigd/d7l.htm D7]

|-
| [http://embryology.med.unsw.edu.au/wwwpig/pige/e1l.htm E1]
| [http://embryology.med.unsw.edu.au/wwwpig/pige/e2l.htm E2]
| [http://embryology.med.unsw.edu.au/wwwpig/pige/e3l.htm E3]
| [http://embryology.med.unsw.edu.au/wwwpig/pige/e4l.htm E4]
| [http://embryology.med.unsw.edu.au/wwwpig/pige/e5l.htm E5]
| [http://embryology.med.unsw.edu.au/wwwpig/pige/e6l.htm E6]
| [http://embryology.med.unsw.edu.au/wwwpig/pige/e7l.htm E7]

|-
| [http://embryology.med.unsw.edu.au/wwwpig/pigf/f1l.htm F1]
| [http://embryology.med.unsw.edu.au/wwwpig/pigf/f2l.htm F2]
| [http://embryology.med.unsw.edu.au/wwwpig/pigf/f3l.htm F3]
| [http://embryology.med.unsw.edu.au/wwwpig/pigf/f4l.htm F4]
| [http://embryology.med.unsw.edu.au/wwwpig/pigf/f5l.htm F5]
| [http://embryology.med.unsw.edu.au/wwwpig/pigf/f6l.htm F6]
| [http://embryology.med.unsw.edu.au/wwwpig/pigf/f7l.htm F7]

|-
| [http://embryology.med.unsw.edu.au/wwwpig/pigg/g1l.htm G1]
| [http://embryology.med.unsw.edu.au/wwwpig/pigg/g2l.htm G2]
| [http://embryology.med.unsw.edu.au/wwwpig/pigg/g3l.htm G3]
| [http://embryology.med.unsw.edu.au/wwwpig/pigg/g4l.htm G4]
| [http://embryology.med.unsw.edu.au/wwwpig/pigg/g5l.htm G5]
| [http://embryology.med.unsw.edu.au/wwwpig/pigg/g6l.htm G6]
| [http://embryology.med.unsw.edu.au/wwwpig/pigg/g7l.htm G7]

|}

Compare this mid-embryonic cardiovascular system with that existing at the end of embryonic development [http://embryology.med.unsw.edu.au/Movies/CVS3dmodelst22.htm Stage 22 3D CVS reconstruction]

== Placentation ==

Compare the features of a normal and gravid uterus.

[[Image:Uterine and placental vasculature.jpg|thumb|right|Changes in the uterine vasculature with pregnancy]]

[[Image:Cvs.jpg|thumb|right|Chorionic villi sampling]]

==Chorionic Villi==
* Compare the features of primary, secondary, tertiary and stemmed villi
<gallery>
File:Gray0036.gif|Primary chorionic villi
File:Gray0037.gif|Secondary chorionic villi
File:Placenta anchoring villi.jpg|Placenta anchoring villi
</gallery>

[[Image:Gray0039.gif|thumb|Section through the placenta]]

[http://share.eldoc.ub.rug.nl/FILES/root2/2010/Mesestcei/Castrechini_2010_Placenta.pdf Mesenchymal stem cells in chorionic villi]

== Group projects ==

The laboratory will also allow time for work on the group online project. What have your other group members and other groups done so far?

==UNSW Embryology Links==

* '''Cardiovascular Slides''' [http://embryology.med.unsw.edu.au/Science/ANAT2341lecture07.htm Cardiovasular Lecture 7 2008] | [http://embryology.med.unsw.edu.au/pdf/ANAT2341L07Hearts1.pdf Heart Lecture 2008 - 1 slide/page ] | [http://embryology.med.unsw.edu.au/pdf/ANAT2341L07Hearts4.pdf Heart Lecture 2008 Slides - 4 slides/page] | [http://embryology.med.unsw.edu.au/pdf/ANAT2341L07Hearts6.pdf Heart Lecture 2008 Slides - 6 slides/page]
* '''Cardiovascular Movies''' [http://embryology.med.unsw.edu.au/Movies/heart.htm Heart Movies] | [http://embryology.med.unsw.edu.au//Movies/larsen/looping.mov Heart Looping] | [http://embryology.med.unsw.edu.au//Movies/larsen/atrium.mov Atrial Septation] | [http://embryology.med.unsw.edu.au//Movies/larsen/avc.mov Realignment] | [http://embryology.med.unsw.edu.au//Movies/larsen/ventricl.mov Ventricular Septation] | [http://embryology.med.unsw.edu.au/Movies/heart.htm#HeartSeptation Heart Septation Models] | [http://embryology.med.unsw.edu.au/Movies/heart.htm#HistoricHeart Historic Heart Movie] |

* '''Cardiovascular Notes''' [http://embryology.med.unsw.edu.au/Notes/heart.htm Introduction] | [http://embryology.med.unsw.edu.au/Notes/heart2.htm Abnormalities] | [http://embryology.med.unsw.edu.au/Notes/heart3.htm Stage 13/14] | [http://embryology.med.unsw.edu.au/Notes/heart4.htm Stage 22] | [http://embryology.med.unsw.edu.au/Notes/heart5.htm Stage 22 Selected Highpower] | [http://embryology.med.unsw.edu.au/Notes/heart6.htm Heart] | [http://embryology.med.unsw.edu.au/Notes/heart8.htm Heart Rate] | [http://embryology.med.unsw.edu.au/Notes/heart20.htm Blood][http://embryology.med.unsw.edu.au/Notes/heart19.htm Blood Vessels] | [http://embryology.med.unsw.edu.au/Notes/heart11.htm Molecular] | [http://embryology.med.unsw.edu.au/Notes/heart31.htm Lymphatic] | [http://embryology.med.unsw.edu.au/Notes/hearttxt.htm Text only page] | [http://embryology.med.unsw.edu.au/Notes/heartlink.htm WWW Links] | [http://embryology.med.unsw.edu.au/Child/heart.htm Postnatal] | [http://embryology.med.unsw.edu.au/history/page2b.htm#Harvey History - Harvey]

* '''Placenta Slides''' [http://embryology.med.unsw.edu.au/Science/ANAT2341lecture08.htm Placenta Lecture 8 2008] | [http://embryology.med.unsw.edu.au/pdf/ANAT2341L8Placentas1.pdf Placenta Lecture 2008 - 1 slide/page ] | [http://embryology.med.unsw.edu.au/pdf/ANAT2341L8Placentas4.pdf Placenta Lecture 2008 Slides - 4 slides/page] | [http://embryology.med.unsw.edu.au/pdf/ANAT2341L8Placentas6.pdf Placenta Lecture 2008 Slides - 6 slides/page]
* '''Placenta Movies''' [http://embryology.med.unsw.edu.au/Movies/heart.htm Heart Movies] | [http://embryology.med.unsw.edu.au//Movies/larsen/looping.mov Heart Looping] | [http://embryology.med.unsw.edu.au//Movies/larsen/atrium.mov Atrial Septation] | [http://embryology.med.unsw.edu.au//Movies/larsen/avc.mov Realignment] | [http://embryology.med.unsw.edu.au//Movies/larsen/ventricl.mov Ventricular Septation] | [http://embryology.med.unsw.edu.au/Movies/heart.htm#HeartSeptation Heart Septation Models] | [http://embryology.med.unsw.edu.au/Movies/heart.htm#HistoricHeart Historic Heart Movie] |

* '''Placenta Notes''' [http://embryology.med.unsw.edu.au/Notes/placenta.htm Introduction] | [http://embryology.med.unsw.edu.au/Notes/placenta2.htm Abnormalities] | [http://embryology.med.unsw.edu.au/Notes/placenta3.htm Stage 13/14] | [http://embryology.med.unsw.edu.au/Notes/placenta4.htm Human (Stage22)] | [http://embryology.med.unsw.edu.au/Notes/placenta5.htm Histology] | [http://embryology.med.unsw.edu.au/Notes/placenta7.htm Villi Development] | [http://embryology.med.unsw.edu.au/Notes/placenta8.htm Maternal Decidua] | [http://embryology.med.unsw.edu.au/Notes/placenta6.htm Vascular Beds] | [http://embryology.med.unsw.edu.au/Notes/placenta11.htm Molecular] | [http://embryology.med.unsw.edu.au/Child/heart.htm Postnatal] | [http://embryology.med.unsw.edu.au/Notes/endocrine14.htm Endocrine Placenta]

* '''General Links''' [http://embryology.med.unsw.edu.au/sysnote.htm System Notes] | [http://embryology.med.unsw.edu.au/week/weekbyweek.htm Development Timeline]

==Internet links==

'''Embryo Images Unit:''' [http://www.med.unc.edu/embryo_images/ Embryo Images Online] Early Cell Populations (cardiogenic section) | [http://www.med.unc.edu/embryo_images/unit-cardev/cardev_htms/cardevtoc.htm Cardiovascular Development] | [http://www.med.unc.edu/embryo_images/unit-cardev/cardev_htms/cardev001.htm Week 3 Development] | [http://www.med.unc.edu/embryo_images/unit-cardev/cardev_htms/cardev007.htmhttp://www.med.unc.edu/embryo_images/unit-cardev/cardev_htms/cardev007.htm Week 4 Development] | [http://www.med.unc.edu/embryo_images/unit-cardev/cardev_htms/cardev018.htm Heart Chambers and Outflow Tract] | [http://www.med.unc.edu/embryo_images/unit-cardev/cardev_htms/cardev022.htm Atrioventricular Septation] | [http://www.med.unc.edu/embryo_images/unit-cardev/cardev_htms/cardev028.htm Outflow Tract Septation] | [http://www.med.unc.edu/embryo_images/unit-cardev/cardev_htms/cardev035.htm Ventricular Septation] | [http://www.med.unc.edu/embryo_images/unit-cardev/cardev_htms/cardev036.htm Atrial Septation] | [http://www.med.unc.edu/embryo_images/unit-cardev/cardev_htms/cardev040.htm Atrial Walls] [http://www.med.unc.edu/embryo_images/unit-cardev/cardev_htms/cardev041.htm Aortic Arch Vessels] | [http://www.med.unc.edu/embryo_images/unit-cardev/cardev_htms/cardev042.htm Changes at Birth]

{{Template:2009ANAT2341}}

[[Category:2009ANAT2341]]
[[Category:Science-Undergraduate]]
[[Category:Heart]]
[[Category:Cardiovascular]]

2010 Lab 4

2010-08-18T10:37:35Z

Z3267024: /* Cardiovascular and Placenta */

=Cardiovascular and Placenta=

==Objectives==

# Understand development of early embryo heart and vascular system.
# Understand the early placentation events and the development of placental blood vessels.

== Introduction ==
This laboratory will explore the development of the embryonic cardiovascular system, which includes the placental vascular system. We will look through cross-sections of the Carnegie stage 14 embryo and follow the flow of blood through the embryonic vasculature.
In this lab, we will also examine placentation.

== Introduction ==
[[Image:Embryonic Circulations.jpg|thumb|right|Three components of early circulation]]

The vascular system of the embryo is formed from blood islands that appear in the extraembryonic mesoderm of the yolk sac and the embryonic mesoderm (primarily splanchnic mesoderm). Both of these clusters fuse together and extend, forming a vast network.

The early circulation has 3 components: Vitelline, Embryonic, Placental Each of these has its own system of arteries and veins.

* '''Vitelline''' - (not shown) the vitelline arteries branch off the dorsal aortas and enter the yolk sac, covering its entire surface. The vitelline veins return red blood cells from the capillary beds to the sinus venosus, posterior to the heart. The vitelline vessels eventually contribute to the portal system of the liver in the adult.

* '''Embryonic''' - blood from the dorsal aorta enters intersegmental arteries, including the arteries of the pharyngeal arches. The blood returns to the heart via the anterior and posterior cardinal veins.

* '''Placental''' - the umbilical arteries receive blood from the aorta. This is carried to the chorionic villi, where exchange occurs with the mother. Waste products are disposed of, nutrients and oxygen are collected, and then the umbilical veins convey the blood to the sinus venosus.

'''Heart''' - The heart develops from cardiogenic mesoderm, a region of splanchnic mesoderm lying above the buccopharyngeal membrane. Development begins in week 3 with the formation of a pair of heart tubes. These fuse and form a single tube in week 4, as a result of the embryonic folding processes that occur. As the heart grows, septation events occur, transforming it into a 4-chambered pump. Initially, the ventricles develop above the atria; however simultaneous growth and bending of the tube bring the structures into correct position. In humans, the heart begins to beat on day 22-23.

[[File:Stage13_bloodflow.jpg]]

== Stage 14 Embryo ==
'''Stage 14 3D CVS reconstruction''' [http://embryology.med.unsw.edu.au/Movies/CVS3dmodel.htm Small movie page] | [http://embryology.med.unsw.edu.au/Movies/CVS3dmodelonly.htm large movie page] | [[Media:CVS3d.mov|Stage 14 3D small movie]] | [[Media:Stage_14_CVS3d_large.mov|Stage 14 3D large movie]]

[[File:Stage14 planesm.gif|left]]
{| class="prettytable"
|-
| [http://embryology.med.unsw.edu.au/wwwpig/piga/a1l.htm A1]
| [http://embryology.med.unsw.edu.au/wwwpig/piga/a2l.htm A2]
| [http://embryology.med.unsw.edu.au/wwwpig/piga/a3l.htm A3]
| [http://embryology.med.unsw.edu.au/wwwpig/piga/a4l.htm A4]
| [http://embryology.med.unsw.edu.au/wwwpig/piga/a5l.htm A5]
| [http://embryology.med.unsw.edu.au/wwwpig/piga/a6l.htm A6]
| [http://embryology.med.unsw.edu.au/wwwpig/piga/a7l.htm A7]

|-
| [http://embryology.med.unsw.edu.au/wwwpig/pigb/b1l.htm B1]
| [http://embryology.med.unsw.edu.au/wwwpig/pigb/b2l.htm B2]
| [http://embryology.med.unsw.edu.au/wwwpig/pigb/b3l.htm B3]
| [http://embryology.med.unsw.edu.au/wwwpig/pigb/b4l.htm B4]
| [http://embryology.med.unsw.edu.au/wwwpig/pigb/b5l.htm B5]
| [http://embryology.med.unsw.edu.au/wwwpig/pigb/b6l.htm B6]
| [http://embryology.med.unsw.edu.au/wwwpig/pigb/b7l.htm B7]

|-
| [http://embryology.med.unsw.edu.au/wwwpig/pigc/c1l.htm C1]
| [http://embryology.med.unsw.edu.au/wwwpig/pigc/c2l.htm C2]
| [http://embryology.med.unsw.edu.au/wwwpig/pigc/c3l.htm C3]
| [http://embryology.med.unsw.edu.au/wwwpig/pigc/c4l.htm C4]
| [http://embryology.med.unsw.edu.au/wwwpig/pigc/c5l.htm C5]
| [http://embryology.med.unsw.edu.au/wwwpig/pigc/c6l.htm C6]
| [http://embryology.med.unsw.edu.au/wwwpig/pigc/c7l.htm C7]

|-
| [http://embryology.med.unsw.edu.au/wwwpig/pigd/d1l.htm D1]
| [http://embryology.med.unsw.edu.au/wwwpig/pigd/d2l.htm D2]
| [http://embryology.med.unsw.edu.au/wwwpig/pigd/d3l.htm D3]
| [http://embryology.med.unsw.edu.au/wwwpig/pigd/d4l.htm D4]
| [http://embryology.med.unsw.edu.au/wwwpig/pigd/d5l.htm D5]
| [http://embryology.med.unsw.edu.au/wwwpig/pigd/d6l.htm D6]
| [http://embryology.med.unsw.edu.au/wwwpig/pigd/d7l.htm D7]

|-
| [http://embryology.med.unsw.edu.au/wwwpig/pige/e1l.htm E1]
| [http://embryology.med.unsw.edu.au/wwwpig/pige/e2l.htm E2]
| [http://embryology.med.unsw.edu.au/wwwpig/pige/e3l.htm E3]
| [http://embryology.med.unsw.edu.au/wwwpig/pige/e4l.htm E4]
| [http://embryology.med.unsw.edu.au/wwwpig/pige/e5l.htm E5]
| [http://embryology.med.unsw.edu.au/wwwpig/pige/e6l.htm E6]
| [http://embryology.med.unsw.edu.au/wwwpig/pige/e7l.htm E7]

|-
| [http://embryology.med.unsw.edu.au/wwwpig/pigf/f1l.htm F1]
| [http://embryology.med.unsw.edu.au/wwwpig/pigf/f2l.htm F2]
| [http://embryology.med.unsw.edu.au/wwwpig/pigf/f3l.htm F3]
| [http://embryology.med.unsw.edu.au/wwwpig/pigf/f4l.htm F4]
| [http://embryology.med.unsw.edu.au/wwwpig/pigf/f5l.htm F5]
| [http://embryology.med.unsw.edu.au/wwwpig/pigf/f6l.htm F6]
| [http://embryology.med.unsw.edu.au/wwwpig/pigf/f7l.htm F7]

|-
| [http://embryology.med.unsw.edu.au/wwwpig/pigg/g1l.htm G1]
| [http://embryology.med.unsw.edu.au/wwwpig/pigg/g2l.htm G2]
| [http://embryology.med.unsw.edu.au/wwwpig/pigg/g3l.htm G3]
| [http://embryology.med.unsw.edu.au/wwwpig/pigg/g4l.htm G4]
| [http://embryology.med.unsw.edu.au/wwwpig/pigg/g5l.htm G5]
| [http://embryology.med.unsw.edu.au/wwwpig/pigg/g6l.htm G6]
| [http://embryology.med.unsw.edu.au/wwwpig/pigg/g7l.htm G7]

|}

Compare this mid-embryonic cardiovascular system with that existing at the end of embryonic development [http://embryology.med.unsw.edu.au/Movies/CVS3dmodelst22.htm Stage 22 3D CVS reconstruction]

== Placentation ==

Compare the features of a normal and gravid uterus.

[[Image:Uterine and placental vasculature.jpg|thumb|right|Changes in the uterine vasculature with pregnancy]]

[[Image:Cvs.jpg|thumb|right|Chorionic villi sampling]]

==Chorionic Villi==
* Compare the features of primary, secondary, tertiary and stemmed villi
<gallery>
File:Gray0036.gif|Primary chorionic villi
File:Gray0037.gif|Secondary chorionic villi
File:Placenta anchoring villi.jpg|Placenta anchoring villi
</gallery>

[[Image:Gray0039.gif|thumb|Section through the placenta]]

== Group projects ==

The laboratory will also allow time for work on the group online project. What have your other group members and other groups done so far?

==UNSW Embryology Links==

* '''Cardiovascular Slides''' [http://embryology.med.unsw.edu.au/Science/ANAT2341lecture07.htm Cardiovasular Lecture 7 2008] | [http://embryology.med.unsw.edu.au/pdf/ANAT2341L07Hearts1.pdf Heart Lecture 2008 - 1 slide/page ] | [http://embryology.med.unsw.edu.au/pdf/ANAT2341L07Hearts4.pdf Heart Lecture 2008 Slides - 4 slides/page] | [http://embryology.med.unsw.edu.au/pdf/ANAT2341L07Hearts6.pdf Heart Lecture 2008 Slides - 6 slides/page]
* '''Cardiovascular Movies''' [http://embryology.med.unsw.edu.au/Movies/heart.htm Heart Movies] | [http://embryology.med.unsw.edu.au//Movies/larsen/looping.mov Heart Looping] | [http://embryology.med.unsw.edu.au//Movies/larsen/atrium.mov Atrial Septation] | [http://embryology.med.unsw.edu.au//Movies/larsen/avc.mov Realignment] | [http://embryology.med.unsw.edu.au//Movies/larsen/ventricl.mov Ventricular Septation] | [http://embryology.med.unsw.edu.au/Movies/heart.htm#HeartSeptation Heart Septation Models] | [http://embryology.med.unsw.edu.au/Movies/heart.htm#HistoricHeart Historic Heart Movie] |

* '''Cardiovascular Notes''' [http://embryology.med.unsw.edu.au/Notes/heart.htm Introduction] | [http://embryology.med.unsw.edu.au/Notes/heart2.htm Abnormalities] | [http://embryology.med.unsw.edu.au/Notes/heart3.htm Stage 13/14] | [http://embryology.med.unsw.edu.au/Notes/heart4.htm Stage 22] | [http://embryology.med.unsw.edu.au/Notes/heart5.htm Stage 22 Selected Highpower] | [http://embryology.med.unsw.edu.au/Notes/heart6.htm Heart] | [http://embryology.med.unsw.edu.au/Notes/heart8.htm Heart Rate] | [http://embryology.med.unsw.edu.au/Notes/heart20.htm Blood][http://embryology.med.unsw.edu.au/Notes/heart19.htm Blood Vessels] | [http://embryology.med.unsw.edu.au/Notes/heart11.htm Molecular] | [http://embryology.med.unsw.edu.au/Notes/heart31.htm Lymphatic] | [http://embryology.med.unsw.edu.au/Notes/hearttxt.htm Text only page] | [http://embryology.med.unsw.edu.au/Notes/heartlink.htm WWW Links] | [http://embryology.med.unsw.edu.au/Child/heart.htm Postnatal] | [http://embryology.med.unsw.edu.au/history/page2b.htm#Harvey History - Harvey]

* '''Placenta Slides''' [http://embryology.med.unsw.edu.au/Science/ANAT2341lecture08.htm Placenta Lecture 8 2008] | [http://embryology.med.unsw.edu.au/pdf/ANAT2341L8Placentas1.pdf Placenta Lecture 2008 - 1 slide/page ] | [http://embryology.med.unsw.edu.au/pdf/ANAT2341L8Placentas4.pdf Placenta Lecture 2008 Slides - 4 slides/page] | [http://embryology.med.unsw.edu.au/pdf/ANAT2341L8Placentas6.pdf Placenta Lecture 2008 Slides - 6 slides/page]
* '''Placenta Movies''' [http://embryology.med.unsw.edu.au/Movies/heart.htm Heart Movies] | [http://embryology.med.unsw.edu.au//Movies/larsen/looping.mov Heart Looping] | [http://embryology.med.unsw.edu.au//Movies/larsen/atrium.mov Atrial Septation] | [http://embryology.med.unsw.edu.au//Movies/larsen/avc.mov Realignment] | [http://embryology.med.unsw.edu.au//Movies/larsen/ventricl.mov Ventricular Septation] | [http://embryology.med.unsw.edu.au/Movies/heart.htm#HeartSeptation Heart Septation Models] | [http://embryology.med.unsw.edu.au/Movies/heart.htm#HistoricHeart Historic Heart Movie] |

* '''Placenta Notes''' [http://embryology.med.unsw.edu.au/Notes/placenta.htm Introduction] | [http://embryology.med.unsw.edu.au/Notes/placenta2.htm Abnormalities] | [http://embryology.med.unsw.edu.au/Notes/placenta3.htm Stage 13/14] | [http://embryology.med.unsw.edu.au/Notes/placenta4.htm Human (Stage22)] | [http://embryology.med.unsw.edu.au/Notes/placenta5.htm Histology] | [http://embryology.med.unsw.edu.au/Notes/placenta7.htm Villi Development] | [http://embryology.med.unsw.edu.au/Notes/placenta8.htm Maternal Decidua] | [http://embryology.med.unsw.edu.au/Notes/placenta6.htm Vascular Beds] | [http://embryology.med.unsw.edu.au/Notes/placenta11.htm Molecular] | [http://embryology.med.unsw.edu.au/Child/heart.htm Postnatal] | [http://embryology.med.unsw.edu.au/Notes/endocrine14.htm Endocrine Placenta]

* '''General Links''' [http://embryology.med.unsw.edu.au/sysnote.htm System Notes] | [http://embryology.med.unsw.edu.au/week/weekbyweek.htm Development Timeline]

==Internet links==

'''Embryo Images Unit:''' [http://www.med.unc.edu/embryo_images/ Embryo Images Online] Early Cell Populations (cardiogenic section) | [http://www.med.unc.edu/embryo_images/unit-cardev/cardev_htms/cardevtoc.htm Cardiovascular Development] | [http://www.med.unc.edu/embryo_images/unit-cardev/cardev_htms/cardev001.htm Week 3 Development] | [http://www.med.unc.edu/embryo_images/unit-cardev/cardev_htms/cardev007.htmhttp://www.med.unc.edu/embryo_images/unit-cardev/cardev_htms/cardev007.htm Week 4 Development] | [http://www.med.unc.edu/embryo_images/unit-cardev/cardev_htms/cardev018.htm Heart Chambers and Outflow Tract] | [http://www.med.unc.edu/embryo_images/unit-cardev/cardev_htms/cardev022.htm Atrioventricular Septation] | [http://www.med.unc.edu/embryo_images/unit-cardev/cardev_htms/cardev028.htm Outflow Tract Septation] | [http://www.med.unc.edu/embryo_images/unit-cardev/cardev_htms/cardev035.htm Ventricular Septation] | [http://www.med.unc.edu/embryo_images/unit-cardev/cardev_htms/cardev036.htm Atrial Septation] | [http://www.med.unc.edu/embryo_images/unit-cardev/cardev_htms/cardev040.htm Atrial Walls] [http://www.med.unc.edu/embryo_images/unit-cardev/cardev_htms/cardev041.htm Aortic Arch Vessels] | [http://www.med.unc.edu/embryo_images/unit-cardev/cardev_htms/cardev042.htm Changes at Birth]

{{Template:2009ANAT2341}}

[[Category:2009ANAT2341]]
[[Category:Science-Undergraduate]]
[[Category:Heart]]
[[Category:Cardiovascular]]

2010 Lab 4

2010-08-18T09:46:01Z

Z3267024: /* Cardiovascular and Placenta */

=Cardiovascular and Placenta=

==Objectives==

# Understand development of early embryo heart and vascular system.
# Understand the early placentation events and the development of placental blood vessels.

== Introduction ==
This laboratory will explore the development of the embryonic cardiovascular system, which includes the placental vascular system. We will look through cross-sections of the Carnegie stage 14 embryo and follow the flow of blood through the embryonic vasculature.
In this lab, we will also examine placentation.

[[File:Stage13_bloodflow.jpg]]

== Introduction ==
[[Image:Embryonic Circulations.jpg|thumb|right|Three components of early circulation]]

The vascular system of the embryo is formed from blood islands that appear in the extraembryonic mesoderm of the yolk sac and the embryonic mesoderm (primarily splanchnic mesoderm). Both of these clusters fuse together and extend, forming a vast network.

The early circulation has 3 components: Vitelline, Embryonic, Placental Each of these has its own system of arteries and veins.

* '''Vitelline''' - (not shown) the vitelline arteries branch off the dorsal aortas and enter the yolk sac, covering its entire surface. The vitelline veins return red blood cells from the capillary beds to the sinus venosus, posterior to the heart. The vitelline vessels eventually contribute to the portal system of the liver in the adult.

* '''Embryonic''' - blood from the dorsal aorta enters intersegmental arteries, including the arteries of the pharyngeal arches. The blood returns to the heart via the anterior and posterior cardinal veins.

* '''Placental''' - the umbilical arteries receive blood from the aorta. This is carried to the chorionic villi, where exchange occurs with the mother. Waste products are disposed of, nutrients and oxygen are collected, and then the umbilical veins convey the blood to the sinus venosus.

'''Heart''' - The heart develops from cardiogenic mesoderm, a region of splanchnic mesoderm lying above the buccopharyngeal membrane. Development begins in week 3 with the formation of a pair of heart tubes. These fuse and form a single tube in week 4, as a result of the embryonic folding processes that occur. As the heart grows, septation events occur, transforming it into a 4-chambered pump. Initially, the ventricles develop above the atria; however simultaneous growth and bending of the tube bring the structures into correct position. In humans, the heart begins to beat on day 22-23.

== Stage 14 Embryo ==
'''Stage 14 3D CVS reconstruction''' [http://embryology.med.unsw.edu.au/Movies/CVS3dmodel.htm Small movie page] | [http://embryology.med.unsw.edu.au/Movies/CVS3dmodelonly.htm large movie page] | [[Media:CVS3d.mov|Stage 14 3D small movie]] | [[Media:Stage_14_CVS3d_large.mov|Stage 14 3D large movie]]

[[File:Stage14 planesm.gif|left]]
{| class="prettytable"
|-
| [http://embryology.med.unsw.edu.au/wwwpig/piga/a1l.htm A1]
| [http://embryology.med.unsw.edu.au/wwwpig/piga/a2l.htm A2]
| [http://embryology.med.unsw.edu.au/wwwpig/piga/a3l.htm A3]
| [http://embryology.med.unsw.edu.au/wwwpig/piga/a4l.htm A4]
| [http://embryology.med.unsw.edu.au/wwwpig/piga/a5l.htm A5]
| [http://embryology.med.unsw.edu.au/wwwpig/piga/a6l.htm A6]
| [http://embryology.med.unsw.edu.au/wwwpig/piga/a7l.htm A7]

|-
| [http://embryology.med.unsw.edu.au/wwwpig/pigb/b1l.htm B1]
| [http://embryology.med.unsw.edu.au/wwwpig/pigb/b2l.htm B2]
| [http://embryology.med.unsw.edu.au/wwwpig/pigb/b3l.htm B3]
| [http://embryology.med.unsw.edu.au/wwwpig/pigb/b4l.htm B4]
| [http://embryology.med.unsw.edu.au/wwwpig/pigb/b5l.htm B5]
| [http://embryology.med.unsw.edu.au/wwwpig/pigb/b6l.htm B6]
| [http://embryology.med.unsw.edu.au/wwwpig/pigb/b7l.htm B7]

|-
| [http://embryology.med.unsw.edu.au/wwwpig/pigc/c1l.htm C1]
| [http://embryology.med.unsw.edu.au/wwwpig/pigc/c2l.htm C2]
| [http://embryology.med.unsw.edu.au/wwwpig/pigc/c3l.htm C3]
| [http://embryology.med.unsw.edu.au/wwwpig/pigc/c4l.htm C4]
| [http://embryology.med.unsw.edu.au/wwwpig/pigc/c5l.htm C5]
| [http://embryology.med.unsw.edu.au/wwwpig/pigc/c6l.htm C6]
| [http://embryology.med.unsw.edu.au/wwwpig/pigc/c7l.htm C7]

|-
| [http://embryology.med.unsw.edu.au/wwwpig/pigd/d1l.htm D1]
| [http://embryology.med.unsw.edu.au/wwwpig/pigd/d2l.htm D2]
| [http://embryology.med.unsw.edu.au/wwwpig/pigd/d3l.htm D3]
| [http://embryology.med.unsw.edu.au/wwwpig/pigd/d4l.htm D4]
| [http://embryology.med.unsw.edu.au/wwwpig/pigd/d5l.htm D5]
| [http://embryology.med.unsw.edu.au/wwwpig/pigd/d6l.htm D6]
| [http://embryology.med.unsw.edu.au/wwwpig/pigd/d7l.htm D7]

|-
| [http://embryology.med.unsw.edu.au/wwwpig/pige/e1l.htm E1]
| [http://embryology.med.unsw.edu.au/wwwpig/pige/e2l.htm E2]
| [http://embryology.med.unsw.edu.au/wwwpig/pige/e3l.htm E3]
| [http://embryology.med.unsw.edu.au/wwwpig/pige/e4l.htm E4]
| [http://embryology.med.unsw.edu.au/wwwpig/pige/e5l.htm E5]
| [http://embryology.med.unsw.edu.au/wwwpig/pige/e6l.htm E6]
| [http://embryology.med.unsw.edu.au/wwwpig/pige/e7l.htm E7]

|-
| [http://embryology.med.unsw.edu.au/wwwpig/pigf/f1l.htm F1]
| [http://embryology.med.unsw.edu.au/wwwpig/pigf/f2l.htm F2]
| [http://embryology.med.unsw.edu.au/wwwpig/pigf/f3l.htm F3]
| [http://embryology.med.unsw.edu.au/wwwpig/pigf/f4l.htm F4]
| [http://embryology.med.unsw.edu.au/wwwpig/pigf/f5l.htm F5]
| [http://embryology.med.unsw.edu.au/wwwpig/pigf/f6l.htm F6]
| [http://embryology.med.unsw.edu.au/wwwpig/pigf/f7l.htm F7]

|-
| [http://embryology.med.unsw.edu.au/wwwpig/pigg/g1l.htm G1]
| [http://embryology.med.unsw.edu.au/wwwpig/pigg/g2l.htm G2]
| [http://embryology.med.unsw.edu.au/wwwpig/pigg/g3l.htm G3]
| [http://embryology.med.unsw.edu.au/wwwpig/pigg/g4l.htm G4]
| [http://embryology.med.unsw.edu.au/wwwpig/pigg/g5l.htm G5]
| [http://embryology.med.unsw.edu.au/wwwpig/pigg/g6l.htm G6]
| [http://embryology.med.unsw.edu.au/wwwpig/pigg/g7l.htm G7]

|}

Compare this mid-embryonic cardiovascular system with that existing at the end of embryonic development [http://embryology.med.unsw.edu.au/Movies/CVS3dmodelst22.htm Stage 22 3D CVS reconstruction]

== Placentation ==

Compare the features of a normal and gravid uterus.

[[Image:Uterine and placental vasculature.jpg|thumb|right|Changes in the uterine vasculature with pregnancy]]

[[Image:Cvs.jpg|thumb|right|Chorionic villi sampling]]

==Chorionic Villi==
* Compare the features of primary, secondary, tertiary and stemmed villi
<gallery>
File:Gray0036.gif|Primary chorionic villi
File:Gray0037.gif|Secondary chorionic villi
File:Placenta anchoring villi.jpg|Placenta anchoring villi
</gallery>

[[Image:Gray0039.gif|thumb|Section through the placenta]]

== Group projects ==

The laboratory will also allow time for work on the group online project. What have your other group members and other groups done so far?

==UNSW Embryology Links==

* '''Cardiovascular Slides''' [http://embryology.med.unsw.edu.au/Science/ANAT2341lecture07.htm Cardiovasular Lecture 7 2008] | [http://embryology.med.unsw.edu.au/pdf/ANAT2341L07Hearts1.pdf Heart Lecture 2008 - 1 slide/page ] | [http://embryology.med.unsw.edu.au/pdf/ANAT2341L07Hearts4.pdf Heart Lecture 2008 Slides - 4 slides/page] | [http://embryology.med.unsw.edu.au/pdf/ANAT2341L07Hearts6.pdf Heart Lecture 2008 Slides - 6 slides/page]
* '''Cardiovascular Movies''' [http://embryology.med.unsw.edu.au/Movies/heart.htm Heart Movies] | [http://embryology.med.unsw.edu.au//Movies/larsen/looping.mov Heart Looping] | [http://embryology.med.unsw.edu.au//Movies/larsen/atrium.mov Atrial Septation] | [http://embryology.med.unsw.edu.au//Movies/larsen/avc.mov Realignment] | [http://embryology.med.unsw.edu.au//Movies/larsen/ventricl.mov Ventricular Septation] | [http://embryology.med.unsw.edu.au/Movies/heart.htm#HeartSeptation Heart Septation Models] | [http://embryology.med.unsw.edu.au/Movies/heart.htm#HistoricHeart Historic Heart Movie] |

* '''Cardiovascular Notes''' [http://embryology.med.unsw.edu.au/Notes/heart.htm Introduction] | [http://embryology.med.unsw.edu.au/Notes/heart2.htm Abnormalities] | [http://embryology.med.unsw.edu.au/Notes/heart3.htm Stage 13/14] | [http://embryology.med.unsw.edu.au/Notes/heart4.htm Stage 22] | [http://embryology.med.unsw.edu.au/Notes/heart5.htm Stage 22 Selected Highpower] | [http://embryology.med.unsw.edu.au/Notes/heart6.htm Heart] | [http://embryology.med.unsw.edu.au/Notes/heart8.htm Heart Rate] | [http://embryology.med.unsw.edu.au/Notes/heart20.htm Blood][http://embryology.med.unsw.edu.au/Notes/heart19.htm Blood Vessels] | [http://embryology.med.unsw.edu.au/Notes/heart11.htm Molecular] | [http://embryology.med.unsw.edu.au/Notes/heart31.htm Lymphatic] | [http://embryology.med.unsw.edu.au/Notes/hearttxt.htm Text only page] | [http://embryology.med.unsw.edu.au/Notes/heartlink.htm WWW Links] | [http://embryology.med.unsw.edu.au/Child/heart.htm Postnatal] | [http://embryology.med.unsw.edu.au/history/page2b.htm#Harvey History - Harvey]

* '''Placenta Slides''' [http://embryology.med.unsw.edu.au/Science/ANAT2341lecture08.htm Placenta Lecture 8 2008] | [http://embryology.med.unsw.edu.au/pdf/ANAT2341L8Placentas1.pdf Placenta Lecture 2008 - 1 slide/page ] | [http://embryology.med.unsw.edu.au/pdf/ANAT2341L8Placentas4.pdf Placenta Lecture 2008 Slides - 4 slides/page] | [http://embryology.med.unsw.edu.au/pdf/ANAT2341L8Placentas6.pdf Placenta Lecture 2008 Slides - 6 slides/page]
* '''Placenta Movies''' [http://embryology.med.unsw.edu.au/Movies/heart.htm Heart Movies] | [http://embryology.med.unsw.edu.au//Movies/larsen/looping.mov Heart Looping] | [http://embryology.med.unsw.edu.au//Movies/larsen/atrium.mov Atrial Septation] | [http://embryology.med.unsw.edu.au//Movies/larsen/avc.mov Realignment] | [http://embryology.med.unsw.edu.au//Movies/larsen/ventricl.mov Ventricular Septation] | [http://embryology.med.unsw.edu.au/Movies/heart.htm#HeartSeptation Heart Septation Models] | [http://embryology.med.unsw.edu.au/Movies/heart.htm#HistoricHeart Historic Heart Movie] |

* '''Placenta Notes''' [http://embryology.med.unsw.edu.au/Notes/placenta.htm Introduction] | [http://embryology.med.unsw.edu.au/Notes/placenta2.htm Abnormalities] | [http://embryology.med.unsw.edu.au/Notes/placenta3.htm Stage 13/14] | [http://embryology.med.unsw.edu.au/Notes/placenta4.htm Human (Stage22)] | [http://embryology.med.unsw.edu.au/Notes/placenta5.htm Histology] | [http://embryology.med.unsw.edu.au/Notes/placenta7.htm Villi Development] | [http://embryology.med.unsw.edu.au/Notes/placenta8.htm Maternal Decidua] | [http://embryology.med.unsw.edu.au/Notes/placenta6.htm Vascular Beds] | [http://embryology.med.unsw.edu.au/Notes/placenta11.htm Molecular] | [http://embryology.med.unsw.edu.au/Child/heart.htm Postnatal] | [http://embryology.med.unsw.edu.au/Notes/endocrine14.htm Endocrine Placenta]

* '''General Links''' [http://embryology.med.unsw.edu.au/sysnote.htm System Notes] | [http://embryology.med.unsw.edu.au/week/weekbyweek.htm Development Timeline]

==Internet links==

'''Embryo Images Unit:''' [http://www.med.unc.edu/embryo_images/ Embryo Images Online] Early Cell Populations (cardiogenic section) | [http://www.med.unc.edu/embryo_images/unit-cardev/cardev_htms/cardevtoc.htm Cardiovascular Development] | [http://www.med.unc.edu/embryo_images/unit-cardev/cardev_htms/cardev001.htm Week 3 Development] | [http://www.med.unc.edu/embryo_images/unit-cardev/cardev_htms/cardev007.htmhttp://www.med.unc.edu/embryo_images/unit-cardev/cardev_htms/cardev007.htm Week 4 Development] | [http://www.med.unc.edu/embryo_images/unit-cardev/cardev_htms/cardev018.htm Heart Chambers and Outflow Tract] | [http://www.med.unc.edu/embryo_images/unit-cardev/cardev_htms/cardev022.htm Atrioventricular Septation] | [http://www.med.unc.edu/embryo_images/unit-cardev/cardev_htms/cardev028.htm Outflow Tract Septation] | [http://www.med.unc.edu/embryo_images/unit-cardev/cardev_htms/cardev035.htm Ventricular Septation] | [http://www.med.unc.edu/embryo_images/unit-cardev/cardev_htms/cardev036.htm Atrial Septation] | [http://www.med.unc.edu/embryo_images/unit-cardev/cardev_htms/cardev040.htm Atrial Walls] [http://www.med.unc.edu/embryo_images/unit-cardev/cardev_htms/cardev041.htm Aortic Arch Vessels] | [http://www.med.unc.edu/embryo_images/unit-cardev/cardev_htms/cardev042.htm Changes at Birth]

{{Template:2009ANAT2341}}

[[Category:2009ANAT2341]]
[[Category:Science-Undergraduate]]
[[Category:Heart]]
[[Category:Cardiovascular]]

2010 Lab 4

2010-08-18T09:44:46Z

Z3267024: /* Cardiovascular and Placenta */

=Cardiovascular and Placenta=

==Objectives==

# Understand development of early embryo heart and vascular system.
# Understand the early placentation events and the development of placental blood vessels.

== Introduction ==
This laboratory will explore the development of the embryonic cardiovascular system, which includes the placental vascular system. We will look through cross-sections of the Carnegie stage 14 embryo and follow the flow of blood through the embryonic vasculature.
In this lab, we will also examine placentation.

[[File:Stage13_bloodflow.jpg]]

== Introduction ==
[[Image:Embryonic Circulations.jpg|thumb|right|Three components of early circulation]]

The vascular system of the embryo is formed from blood islands that appear in the extraembryonic mesoderm of the yolk sac and the embryonic mesoderm (primarily splanchnic mesoderm). Both of these clusters fuse together and extend, forming a vast network.

The early circulation has 3 components: Vitelline, Embryonic, Placental Each of these has its own system of arteries and veins.

* '''Vitelline''' - (not shown) the vitelline arteries branch off the dorsal aortas and enter the yolk sac, covering its entire surface. The vitelline veins return red blood cells from the capillary beds to the sinus venosus, posterior to the heart. The vitelline vessels eventually contribute to the portal system of the liver in the adult.

* '''Embryonic''' - blood from the dorsal aorta enters intersegmental arteries, including the arteries of the pharyngeal arches. The blood returns to the heart via the anterior and posterior cardinal veins.

* '''Placental''' - the umbilical arteries receive blood from the aorta. This is carried to the chorionic villi, where exchange occurs with the mother. Waste products are disposed of, nutrients and oxygen are collected, and then the umbilical veins convey the blood to the sinus venosus.

'''Heart''' - The heart develops from cardiogenic mesoderm, a region of splanchnic mesoderm lying above the buccopharyngeal membrane. Development begins in week 3 with the formation of a pair of heart tubes. These fuse and form a single tube in week 4, as a result of the embryonic folding processes that occur. As the heart grows, septation events occur, transforming it into a 4-chambered pump. Initially, the ventricles develop above the atria; however simultaneous growth and bending of the tube bring the structures into correct position. In humans, the heart begins to beat on day 22-23.

== Stage 14 Embryo ==
'''Stage 14 3D CVS reconstruction''' [http://embryology.med.unsw.edu.au/Movies/CVS3dmodel.htm Small movie page] | [http://embryology.med.unsw.edu.au/Movies/CVS3dmodelonly.htm large movie page] | [[Media:CVS3d.mov|Stage 14 3D small movie]] | [[Media:Stage_14_CVS3d_large.mov|Stage 14 3D large movie]]

[[File:Stage14 planesm.gif|left]]
{| class="prettytable"
|-
| [http://embryology.med.unsw.edu.au/wwwpig/piga/a1l.htm A1]
| [http://embryology.med.unsw.edu.au/wwwpig/piga/a2l.htm A2]
| [http://embryology.med.unsw.edu.au/wwwpig/piga/a3l.htm A3]
| [http://embryology.med.unsw.edu.au/wwwpig/piga/a4l.htm A4]
| [http://embryology.med.unsw.edu.au/wwwpig/piga/a5l.htm A5]
| [http://embryology.med.unsw.edu.au/wwwpig/piga/a6l.htm A6]
| [http://embryology.med.unsw.edu.au/wwwpig/piga/a7l.htm A7]

|-
| [http://embryology.med.unsw.edu.au/wwwpig/pigb/b1l.htm B1]
| [http://embryology.med.unsw.edu.au/wwwpig/pigb/b2l.htm B2]
| [http://embryology.med.unsw.edu.au/wwwpig/pigb/b3l.htm B3]
| [http://embryology.med.unsw.edu.au/wwwpig/pigb/b4l.htm B4]
| [http://embryology.med.unsw.edu.au/wwwpig/pigb/b5l.htm B5]
| [http://embryology.med.unsw.edu.au/wwwpig/pigb/b6l.htm B6]
| [http://embryology.med.unsw.edu.au/wwwpig/pigb/b7l.htm B7]

|-
| [http://embryology.med.unsw.edu.au/wwwpig/pigc/c1l.htm C1]
| [http://embryology.med.unsw.edu.au/wwwpig/pigc/c2l.htm C2]
| [http://embryology.med.unsw.edu.au/wwwpig/pigc/c3l.htm C3]
| [http://embryology.med.unsw.edu.au/wwwpig/pigc/c4l.htm C4]
| [http://embryology.med.unsw.edu.au/wwwpig/pigc/c5l.htm C5]
| [http://embryology.med.unsw.edu.au/wwwpig/pigc/c6l.htm C6]
| [http://embryology.med.unsw.edu.au/wwwpig/pigc/c7l.htm C7]

|-
| [http://embryology.med.unsw.edu.au/wwwpig/pigd/d1l.htm D1]
| [http://embryology.med.unsw.edu.au/wwwpig/pigd/d2l.htm D2]
| [http://embryology.med.unsw.edu.au/wwwpig/pigd/d3l.htm D3]
| [http://embryology.med.unsw.edu.au/wwwpig/pigd/d4l.htm D4]
| [http://embryology.med.unsw.edu.au/wwwpig/pigd/d5l.htm D5]
| [http://embryology.med.unsw.edu.au/wwwpig/pigd/d6l.htm D6]
| [http://embryology.med.unsw.edu.au/wwwpig/pigd/d7l.htm D7]

|-
| [http://embryology.med.unsw.edu.au/wwwpig/pige/e1l.htm E1]
| [http://embryology.med.unsw.edu.au/wwwpig/pige/e2l.htm E2]
| [http://embryology.med.unsw.edu.au/wwwpig/pige/e3l.htm E3]
| [http://embryology.med.unsw.edu.au/wwwpig/pige/e4l.htm E4]
| [http://embryology.med.unsw.edu.au/wwwpig/pige/e5l.htm E5]
| [http://embryology.med.unsw.edu.au/wwwpig/pige/e6l.htm E6]
| [http://embryology.med.unsw.edu.au/wwwpig/pige/e7l.htm E7]

|-
| [http://embryology.med.unsw.edu.au/wwwpig/pigf/f1l.htm F1]
| [http://embryology.med.unsw.edu.au/wwwpig/pigf/f2l.htm F2]
| [http://embryology.med.unsw.edu.au/wwwpig/pigf/f3l.htm F3]
| [http://embryology.med.unsw.edu.au/wwwpig/pigf/f4l.htm F4]
| [http://embryology.med.unsw.edu.au/wwwpig/pigf/f5l.htm F5]
| [http://embryology.med.unsw.edu.au/wwwpig/pigf/f6l.htm F6]
| [http://embryology.med.unsw.edu.au/wwwpig/pigf/f7l.htm F7]

|-
| [http://embryology.med.unsw.edu.au/wwwpig/pigg/g1l.htm G1]
| [http://embryology.med.unsw.edu.au/wwwpig/pigg/g2l.htm G2]
| [http://embryology.med.unsw.edu.au/wwwpig/pigg/g3l.htm G3]
| [http://embryology.med.unsw.edu.au/wwwpig/pigg/g4l.htm G4]
| [http://embryology.med.unsw.edu.au/wwwpig/pigg/g5l.htm G5]
| [http://embryology.med.unsw.edu.au/wwwpig/pigg/g6l.htm G6]
| [http://embryology.med.unsw.edu.au/wwwpig/pigg/g7l.htm G7]

|}

Compare this mid-embryonic cardiovascular system with that existing at the end of embryonic development [http://embryology.med.unsw.edu.au/Movies/CVS3dmodelst22.htm Stage 22 3D CVS reconstruction]

== Placentation ==

Compare the features of a normal and gravid uterus.

[[Image:Uterine and placental vasculature.jpg|thumb|right|Changes in the uterine vasculature with pregnancy]]

[[Image:Cvs.jpg|thumb|right|Chorionic villi sampling]]

==Chorionic Villi==
* Compare the features of primary, secondary, tertiary and stemmed villi

<gallery>
File:Gray0036.gif|Primary chorionic villi
File:Gray0037.gif|Secondary chorionic villi
File:Placenta anchoring villi.jpg|Placenta anchoring villi
</gallery>

[[Image:Gray0039.gif|Section through the placenta]]

== Group projects ==

The laboratory will also allow time for work on the group online project. What have your other group members and other groups done so far?

==UNSW Embryology Links==

* '''Cardiovascular Slides''' [http://embryology.med.unsw.edu.au/Science/ANAT2341lecture07.htm Cardiovasular Lecture 7 2008] | [http://embryology.med.unsw.edu.au/pdf/ANAT2341L07Hearts1.pdf Heart Lecture 2008 - 1 slide/page ] | [http://embryology.med.unsw.edu.au/pdf/ANAT2341L07Hearts4.pdf Heart Lecture 2008 Slides - 4 slides/page] | [http://embryology.med.unsw.edu.au/pdf/ANAT2341L07Hearts6.pdf Heart Lecture 2008 Slides - 6 slides/page]
* '''Cardiovascular Movies''' [http://embryology.med.unsw.edu.au/Movies/heart.htm Heart Movies] | [http://embryology.med.unsw.edu.au//Movies/larsen/looping.mov Heart Looping] | [http://embryology.med.unsw.edu.au//Movies/larsen/atrium.mov Atrial Septation] | [http://embryology.med.unsw.edu.au//Movies/larsen/avc.mov Realignment] | [http://embryology.med.unsw.edu.au//Movies/larsen/ventricl.mov Ventricular Septation] | [http://embryology.med.unsw.edu.au/Movies/heart.htm#HeartSeptation Heart Septation Models] | [http://embryology.med.unsw.edu.au/Movies/heart.htm#HistoricHeart Historic Heart Movie] |

* '''Cardiovascular Notes''' [http://embryology.med.unsw.edu.au/Notes/heart.htm Introduction] | [http://embryology.med.unsw.edu.au/Notes/heart2.htm Abnormalities] | [http://embryology.med.unsw.edu.au/Notes/heart3.htm Stage 13/14] | [http://embryology.med.unsw.edu.au/Notes/heart4.htm Stage 22] | [http://embryology.med.unsw.edu.au/Notes/heart5.htm Stage 22 Selected Highpower] | [http://embryology.med.unsw.edu.au/Notes/heart6.htm Heart] | [http://embryology.med.unsw.edu.au/Notes/heart8.htm Heart Rate] | [http://embryology.med.unsw.edu.au/Notes/heart20.htm Blood][http://embryology.med.unsw.edu.au/Notes/heart19.htm Blood Vessels] | [http://embryology.med.unsw.edu.au/Notes/heart11.htm Molecular] | [http://embryology.med.unsw.edu.au/Notes/heart31.htm Lymphatic] | [http://embryology.med.unsw.edu.au/Notes/hearttxt.htm Text only page] | [http://embryology.med.unsw.edu.au/Notes/heartlink.htm WWW Links] | [http://embryology.med.unsw.edu.au/Child/heart.htm Postnatal] | [http://embryology.med.unsw.edu.au/history/page2b.htm#Harvey History - Harvey]

* '''Placenta Slides''' [http://embryology.med.unsw.edu.au/Science/ANAT2341lecture08.htm Placenta Lecture 8 2008] | [http://embryology.med.unsw.edu.au/pdf/ANAT2341L8Placentas1.pdf Placenta Lecture 2008 - 1 slide/page ] | [http://embryology.med.unsw.edu.au/pdf/ANAT2341L8Placentas4.pdf Placenta Lecture 2008 Slides - 4 slides/page] | [http://embryology.med.unsw.edu.au/pdf/ANAT2341L8Placentas6.pdf Placenta Lecture 2008 Slides - 6 slides/page]
* '''Placenta Movies''' [http://embryology.med.unsw.edu.au/Movies/heart.htm Heart Movies] | [http://embryology.med.unsw.edu.au//Movies/larsen/looping.mov Heart Looping] | [http://embryology.med.unsw.edu.au//Movies/larsen/atrium.mov Atrial Septation] | [http://embryology.med.unsw.edu.au//Movies/larsen/avc.mov Realignment] | [http://embryology.med.unsw.edu.au//Movies/larsen/ventricl.mov Ventricular Septation] | [http://embryology.med.unsw.edu.au/Movies/heart.htm#HeartSeptation Heart Septation Models] | [http://embryology.med.unsw.edu.au/Movies/heart.htm#HistoricHeart Historic Heart Movie] |

* '''Placenta Notes''' [http://embryology.med.unsw.edu.au/Notes/placenta.htm Introduction] | [http://embryology.med.unsw.edu.au/Notes/placenta2.htm Abnormalities] | [http://embryology.med.unsw.edu.au/Notes/placenta3.htm Stage 13/14] | [http://embryology.med.unsw.edu.au/Notes/placenta4.htm Human (Stage22)] | [http://embryology.med.unsw.edu.au/Notes/placenta5.htm Histology] | [http://embryology.med.unsw.edu.au/Notes/placenta7.htm Villi Development] | [http://embryology.med.unsw.edu.au/Notes/placenta8.htm Maternal Decidua] | [http://embryology.med.unsw.edu.au/Notes/placenta6.htm Vascular Beds] | [http://embryology.med.unsw.edu.au/Notes/placenta11.htm Molecular] | [http://embryology.med.unsw.edu.au/Child/heart.htm Postnatal] | [http://embryology.med.unsw.edu.au/Notes/endocrine14.htm Endocrine Placenta]

* '''General Links''' [http://embryology.med.unsw.edu.au/sysnote.htm System Notes] | [http://embryology.med.unsw.edu.au/week/weekbyweek.htm Development Timeline]

==Internet links==

'''Embryo Images Unit:''' [http://www.med.unc.edu/embryo_images/ Embryo Images Online] Early Cell Populations (cardiogenic section) | [http://www.med.unc.edu/embryo_images/unit-cardev/cardev_htms/cardevtoc.htm Cardiovascular Development] | [http://www.med.unc.edu/embryo_images/unit-cardev/cardev_htms/cardev001.htm Week 3 Development] | [http://www.med.unc.edu/embryo_images/unit-cardev/cardev_htms/cardev007.htmhttp://www.med.unc.edu/embryo_images/unit-cardev/cardev_htms/cardev007.htm Week 4 Development] | [http://www.med.unc.edu/embryo_images/unit-cardev/cardev_htms/cardev018.htm Heart Chambers and Outflow Tract] | [http://www.med.unc.edu/embryo_images/unit-cardev/cardev_htms/cardev022.htm Atrioventricular Septation] | [http://www.med.unc.edu/embryo_images/unit-cardev/cardev_htms/cardev028.htm Outflow Tract Septation] | [http://www.med.unc.edu/embryo_images/unit-cardev/cardev_htms/cardev035.htm Ventricular Septation] | [http://www.med.unc.edu/embryo_images/unit-cardev/cardev_htms/cardev036.htm Atrial Septation] | [http://www.med.unc.edu/embryo_images/unit-cardev/cardev_htms/cardev040.htm Atrial Walls] [http://www.med.unc.edu/embryo_images/unit-cardev/cardev_htms/cardev041.htm Aortic Arch Vessels] | [http://www.med.unc.edu/embryo_images/unit-cardev/cardev_htms/cardev042.htm Changes at Birth]

{{Template:2009ANAT2341}}

[[Category:2009ANAT2341]]
[[Category:Science-Undergraduate]]
[[Category:Heart]]
[[Category:Cardiovascular]]

2010 Lab 4

2010-08-18T09:43:09Z

Z3267024: /* Placentation */

=Cardiovascular and Placenta=

==Objectives==

# Understand development of early embryo heart and vascular system.
# Understand the early placentation events and the development of placental blood vessels.

== Introduction ==
This laboratory will explore the development of the embryonic cardiovascular system, which includes the placental vascular system. We will look through cross-sections of the Carnegie stage 14 embryo and follow the flow of blood through the embryonic vasculature.
In this lab, we will also examine placentation.

[[File:Stage13_bloodflow.jpg]]

== Introduction ==
[[Image:Embryonic Circulations.jpg|thumb|right|Three components of early circulation]]

The vascular system of the embryo is formed from blood islands that appear in the extraembryonic mesoderm of the yolk sac and the embryonic mesoderm (primarily splanchnic mesoderm). Both of these clusters fuse together and extend, forming a vast network.

The early circulation has 3 components: Vitelline, Embryonic, Placental Each of these has its own system of arteries and veins.

* '''Vitelline''' - (not shown) the vitelline arteries branch off the dorsal aortas and enter the yolk sac, covering its entire surface. The vitelline veins return red blood cells from the capillary beds to the sinus venosus, posterior to the heart. The vitelline vessels eventually contribute to the portal system of the liver in the adult.

* '''Embryonic''' - blood from the dorsal aorta enters intersegmental arteries, including the arteries of the pharyngeal arches. The blood returns to the heart via the anterior and posterior cardinal veins.

* '''Placental''' - the umbilical arteries receive blood from the aorta. This is carried to the chorionic villi, where exchange occurs with the mother. Waste products are disposed of, nutrients and oxygen are collected, and then the umbilical veins convey the blood to the sinus venosus.

'''Heart''' - The heart develops from cardiogenic mesoderm, a region of splanchnic mesoderm lying above the buccopharyngeal membrane. Development begins in week 3 with the formation of a pair of heart tubes. These fuse and form a single tube in week 4, as a result of the embryonic folding processes that occur. As the heart grows, septation events occur, transforming it into a 4-chambered pump. Initially, the ventricles develop above the atria; however simultaneous growth and bending of the tube bring the structures into correct position. In humans, the heart begins to beat on day 22-23.

== Stage 14 Embryo ==
'''Stage 14 3D CVS reconstruction''' [http://embryology.med.unsw.edu.au/Movies/CVS3dmodel.htm Small movie page] | [http://embryology.med.unsw.edu.au/Movies/CVS3dmodelonly.htm large movie page] | [[Media:CVS3d.mov|Stage 14 3D small movie]] | [[Media:Stage_14_CVS3d_large.mov|Stage 14 3D large movie]]

[[File:Stage14 planesm.gif|left]]
{| class="prettytable"
|-
| [http://embryology.med.unsw.edu.au/wwwpig/piga/a1l.htm A1]
| [http://embryology.med.unsw.edu.au/wwwpig/piga/a2l.htm A2]
| [http://embryology.med.unsw.edu.au/wwwpig/piga/a3l.htm A3]
| [http://embryology.med.unsw.edu.au/wwwpig/piga/a4l.htm A4]
| [http://embryology.med.unsw.edu.au/wwwpig/piga/a5l.htm A5]
| [http://embryology.med.unsw.edu.au/wwwpig/piga/a6l.htm A6]
| [http://embryology.med.unsw.edu.au/wwwpig/piga/a7l.htm A7]

|-
| [http://embryology.med.unsw.edu.au/wwwpig/pigb/b1l.htm B1]
| [http://embryology.med.unsw.edu.au/wwwpig/pigb/b2l.htm B2]
| [http://embryology.med.unsw.edu.au/wwwpig/pigb/b3l.htm B3]
| [http://embryology.med.unsw.edu.au/wwwpig/pigb/b4l.htm B4]
| [http://embryology.med.unsw.edu.au/wwwpig/pigb/b5l.htm B5]
| [http://embryology.med.unsw.edu.au/wwwpig/pigb/b6l.htm B6]
| [http://embryology.med.unsw.edu.au/wwwpig/pigb/b7l.htm B7]

|-
| [http://embryology.med.unsw.edu.au/wwwpig/pigc/c1l.htm C1]
| [http://embryology.med.unsw.edu.au/wwwpig/pigc/c2l.htm C2]
| [http://embryology.med.unsw.edu.au/wwwpig/pigc/c3l.htm C3]
| [http://embryology.med.unsw.edu.au/wwwpig/pigc/c4l.htm C4]
| [http://embryology.med.unsw.edu.au/wwwpig/pigc/c5l.htm C5]
| [http://embryology.med.unsw.edu.au/wwwpig/pigc/c6l.htm C6]
| [http://embryology.med.unsw.edu.au/wwwpig/pigc/c7l.htm C7]

|-
| [http://embryology.med.unsw.edu.au/wwwpig/pigd/d1l.htm D1]
| [http://embryology.med.unsw.edu.au/wwwpig/pigd/d2l.htm D2]
| [http://embryology.med.unsw.edu.au/wwwpig/pigd/d3l.htm D3]
| [http://embryology.med.unsw.edu.au/wwwpig/pigd/d4l.htm D4]
| [http://embryology.med.unsw.edu.au/wwwpig/pigd/d5l.htm D5]
| [http://embryology.med.unsw.edu.au/wwwpig/pigd/d6l.htm D6]
| [http://embryology.med.unsw.edu.au/wwwpig/pigd/d7l.htm D7]

|-
| [http://embryology.med.unsw.edu.au/wwwpig/pige/e1l.htm E1]
| [http://embryology.med.unsw.edu.au/wwwpig/pige/e2l.htm E2]
| [http://embryology.med.unsw.edu.au/wwwpig/pige/e3l.htm E3]
| [http://embryology.med.unsw.edu.au/wwwpig/pige/e4l.htm E4]
| [http://embryology.med.unsw.edu.au/wwwpig/pige/e5l.htm E5]
| [http://embryology.med.unsw.edu.au/wwwpig/pige/e6l.htm E6]
| [http://embryology.med.unsw.edu.au/wwwpig/pige/e7l.htm E7]

|-
| [http://embryology.med.unsw.edu.au/wwwpig/pigf/f1l.htm F1]
| [http://embryology.med.unsw.edu.au/wwwpig/pigf/f2l.htm F2]
| [http://embryology.med.unsw.edu.au/wwwpig/pigf/f3l.htm F3]
| [http://embryology.med.unsw.edu.au/wwwpig/pigf/f4l.htm F4]
| [http://embryology.med.unsw.edu.au/wwwpig/pigf/f5l.htm F5]
| [http://embryology.med.unsw.edu.au/wwwpig/pigf/f6l.htm F6]
| [http://embryology.med.unsw.edu.au/wwwpig/pigf/f7l.htm F7]

|-
| [http://embryology.med.unsw.edu.au/wwwpig/pigg/g1l.htm G1]
| [http://embryology.med.unsw.edu.au/wwwpig/pigg/g2l.htm G2]
| [http://embryology.med.unsw.edu.au/wwwpig/pigg/g3l.htm G3]
| [http://embryology.med.unsw.edu.au/wwwpig/pigg/g4l.htm G4]
| [http://embryology.med.unsw.edu.au/wwwpig/pigg/g5l.htm G5]
| [http://embryology.med.unsw.edu.au/wwwpig/pigg/g6l.htm G6]
| [http://embryology.med.unsw.edu.au/wwwpig/pigg/g7l.htm G7]

|}

Compare this mid-embryonic cardiovascular system with that existing at the end of embryonic development [http://embryology.med.unsw.edu.au/Movies/CVS3dmodelst22.htm Stage 22 3D CVS reconstruction]

== Placentation ==

Compare the features of a normal and gravid uterus.

[[Image:Uterine and placental vasculature.jpg|thumb|right|Changes in the uterine vasculature with pregnancy]]

[[Image:Cvs.jpg|thumb|right|Chorionic villi sampling]]

==Chorionic Villi==
<gallery>
File:Gray0036.gif|Primary chorionic villi
File:Gray0037.gif|Secondary chorionic villi
File:Placenta anchoring villi.jpg|Placenta anchoring villi
</gallery>

* Compare the features of primary, secondary, tertiary and stemmed villi

[[Image:Gray0039.gif|Section through the placenta]]

== Group projects ==

The laboratory will also allow time for work on the group online project. What have your other group members and other groups done so far?

==UNSW Embryology Links==

* '''Cardiovascular Slides''' [http://embryology.med.unsw.edu.au/Science/ANAT2341lecture07.htm Cardiovasular Lecture 7 2008] | [http://embryology.med.unsw.edu.au/pdf/ANAT2341L07Hearts1.pdf Heart Lecture 2008 - 1 slide/page ] | [http://embryology.med.unsw.edu.au/pdf/ANAT2341L07Hearts4.pdf Heart Lecture 2008 Slides - 4 slides/page] | [http://embryology.med.unsw.edu.au/pdf/ANAT2341L07Hearts6.pdf Heart Lecture 2008 Slides - 6 slides/page]
* '''Cardiovascular Movies''' [http://embryology.med.unsw.edu.au/Movies/heart.htm Heart Movies] | [http://embryology.med.unsw.edu.au//Movies/larsen/looping.mov Heart Looping] | [http://embryology.med.unsw.edu.au//Movies/larsen/atrium.mov Atrial Septation] | [http://embryology.med.unsw.edu.au//Movies/larsen/avc.mov Realignment] | [http://embryology.med.unsw.edu.au//Movies/larsen/ventricl.mov Ventricular Septation] | [http://embryology.med.unsw.edu.au/Movies/heart.htm#HeartSeptation Heart Septation Models] | [http://embryology.med.unsw.edu.au/Movies/heart.htm#HistoricHeart Historic Heart Movie] |

* '''Cardiovascular Notes''' [http://embryology.med.unsw.edu.au/Notes/heart.htm Introduction] | [http://embryology.med.unsw.edu.au/Notes/heart2.htm Abnormalities] | [http://embryology.med.unsw.edu.au/Notes/heart3.htm Stage 13/14] | [http://embryology.med.unsw.edu.au/Notes/heart4.htm Stage 22] | [http://embryology.med.unsw.edu.au/Notes/heart5.htm Stage 22 Selected Highpower] | [http://embryology.med.unsw.edu.au/Notes/heart6.htm Heart] | [http://embryology.med.unsw.edu.au/Notes/heart8.htm Heart Rate] | [http://embryology.med.unsw.edu.au/Notes/heart20.htm Blood][http://embryology.med.unsw.edu.au/Notes/heart19.htm Blood Vessels] | [http://embryology.med.unsw.edu.au/Notes/heart11.htm Molecular] | [http://embryology.med.unsw.edu.au/Notes/heart31.htm Lymphatic] | [http://embryology.med.unsw.edu.au/Notes/hearttxt.htm Text only page] | [http://embryology.med.unsw.edu.au/Notes/heartlink.htm WWW Links] | [http://embryology.med.unsw.edu.au/Child/heart.htm Postnatal] | [http://embryology.med.unsw.edu.au/history/page2b.htm#Harvey History - Harvey]

* '''Placenta Slides''' [http://embryology.med.unsw.edu.au/Science/ANAT2341lecture08.htm Placenta Lecture 8 2008] | [http://embryology.med.unsw.edu.au/pdf/ANAT2341L8Placentas1.pdf Placenta Lecture 2008 - 1 slide/page ] | [http://embryology.med.unsw.edu.au/pdf/ANAT2341L8Placentas4.pdf Placenta Lecture 2008 Slides - 4 slides/page] | [http://embryology.med.unsw.edu.au/pdf/ANAT2341L8Placentas6.pdf Placenta Lecture 2008 Slides - 6 slides/page]
* '''Placenta Movies''' [http://embryology.med.unsw.edu.au/Movies/heart.htm Heart Movies] | [http://embryology.med.unsw.edu.au//Movies/larsen/looping.mov Heart Looping] | [http://embryology.med.unsw.edu.au//Movies/larsen/atrium.mov Atrial Septation] | [http://embryology.med.unsw.edu.au//Movies/larsen/avc.mov Realignment] | [http://embryology.med.unsw.edu.au//Movies/larsen/ventricl.mov Ventricular Septation] | [http://embryology.med.unsw.edu.au/Movies/heart.htm#HeartSeptation Heart Septation Models] | [http://embryology.med.unsw.edu.au/Movies/heart.htm#HistoricHeart Historic Heart Movie] |

* '''Placenta Notes''' [http://embryology.med.unsw.edu.au/Notes/placenta.htm Introduction] | [http://embryology.med.unsw.edu.au/Notes/placenta2.htm Abnormalities] | [http://embryology.med.unsw.edu.au/Notes/placenta3.htm Stage 13/14] | [http://embryology.med.unsw.edu.au/Notes/placenta4.htm Human (Stage22)] | [http://embryology.med.unsw.edu.au/Notes/placenta5.htm Histology] | [http://embryology.med.unsw.edu.au/Notes/placenta7.htm Villi Development] | [http://embryology.med.unsw.edu.au/Notes/placenta8.htm Maternal Decidua] | [http://embryology.med.unsw.edu.au/Notes/placenta6.htm Vascular Beds] | [http://embryology.med.unsw.edu.au/Notes/placenta11.htm Molecular] | [http://embryology.med.unsw.edu.au/Child/heart.htm Postnatal] | [http://embryology.med.unsw.edu.au/Notes/endocrine14.htm Endocrine Placenta]

* '''General Links''' [http://embryology.med.unsw.edu.au/sysnote.htm System Notes] | [http://embryology.med.unsw.edu.au/week/weekbyweek.htm Development Timeline]

==Internet links==

'''Embryo Images Unit:''' [http://www.med.unc.edu/embryo_images/ Embryo Images Online] Early Cell Populations (cardiogenic section) | [http://www.med.unc.edu/embryo_images/unit-cardev/cardev_htms/cardevtoc.htm Cardiovascular Development] | [http://www.med.unc.edu/embryo_images/unit-cardev/cardev_htms/cardev001.htm Week 3 Development] | [http://www.med.unc.edu/embryo_images/unit-cardev/cardev_htms/cardev007.htmhttp://www.med.unc.edu/embryo_images/unit-cardev/cardev_htms/cardev007.htm Week 4 Development] | [http://www.med.unc.edu/embryo_images/unit-cardev/cardev_htms/cardev018.htm Heart Chambers and Outflow Tract] | [http://www.med.unc.edu/embryo_images/unit-cardev/cardev_htms/cardev022.htm Atrioventricular Septation] | [http://www.med.unc.edu/embryo_images/unit-cardev/cardev_htms/cardev028.htm Outflow Tract Septation] | [http://www.med.unc.edu/embryo_images/unit-cardev/cardev_htms/cardev035.htm Ventricular Septation] | [http://www.med.unc.edu/embryo_images/unit-cardev/cardev_htms/cardev036.htm Atrial Septation] | [http://www.med.unc.edu/embryo_images/unit-cardev/cardev_htms/cardev040.htm Atrial Walls] [http://www.med.unc.edu/embryo_images/unit-cardev/cardev_htms/cardev041.htm Aortic Arch Vessels] | [http://www.med.unc.edu/embryo_images/unit-cardev/cardev_htms/cardev042.htm Changes at Birth]

{{Template:2009ANAT2341}}

[[Category:2009ANAT2341]]
[[Category:Science-Undergraduate]]
[[Category:Heart]]
[[Category:Cardiovascular]]

2010 Lab 4

2010-08-18T09:40:36Z

Z3267024: /* Cardiovascular and Placenta */

=Cardiovascular and Placenta=

==Objectives==

# Understand development of early embryo heart and vascular system.
# Understand the early placentation events and the development of placental blood vessels.

== Introduction ==
This laboratory will explore the development of the embryonic cardiovascular system, which includes the placental vascular system. We will look through cross-sections of the Carnegie stage 14 embryo and follow the flow of blood through the embryonic vasculature.
In this lab, we will also examine placentation.

[[File:Stage13_bloodflow.jpg]]

== Introduction ==
[[Image:Embryonic Circulations.jpg|thumb|right|Three components of early circulation]]

The vascular system of the embryo is formed from blood islands that appear in the extraembryonic mesoderm of the yolk sac and the embryonic mesoderm (primarily splanchnic mesoderm). Both of these clusters fuse together and extend, forming a vast network.

The early circulation has 3 components: Vitelline, Embryonic, Placental Each of these has its own system of arteries and veins.

* '''Vitelline''' - (not shown) the vitelline arteries branch off the dorsal aortas and enter the yolk sac, covering its entire surface. The vitelline veins return red blood cells from the capillary beds to the sinus venosus, posterior to the heart. The vitelline vessels eventually contribute to the portal system of the liver in the adult.

* '''Embryonic''' - blood from the dorsal aorta enters intersegmental arteries, including the arteries of the pharyngeal arches. The blood returns to the heart via the anterior and posterior cardinal veins.

* '''Placental''' - the umbilical arteries receive blood from the aorta. This is carried to the chorionic villi, where exchange occurs with the mother. Waste products are disposed of, nutrients and oxygen are collected, and then the umbilical veins convey the blood to the sinus venosus.

'''Heart''' - The heart develops from cardiogenic mesoderm, a region of splanchnic mesoderm lying above the buccopharyngeal membrane. Development begins in week 3 with the formation of a pair of heart tubes. These fuse and form a single tube in week 4, as a result of the embryonic folding processes that occur. As the heart grows, septation events occur, transforming it into a 4-chambered pump. Initially, the ventricles develop above the atria; however simultaneous growth and bending of the tube bring the structures into correct position. In humans, the heart begins to beat on day 22-23.

== Stage 14 Embryo ==
'''Stage 14 3D CVS reconstruction''' [http://embryology.med.unsw.edu.au/Movies/CVS3dmodel.htm Small movie page] | [http://embryology.med.unsw.edu.au/Movies/CVS3dmodelonly.htm large movie page] | [[Media:CVS3d.mov|Stage 14 3D small movie]] | [[Media:Stage_14_CVS3d_large.mov|Stage 14 3D large movie]]

[[File:Stage14 planesm.gif|left]]
{| class="prettytable"
|-
| [http://embryology.med.unsw.edu.au/wwwpig/piga/a1l.htm A1]
| [http://embryology.med.unsw.edu.au/wwwpig/piga/a2l.htm A2]
| [http://embryology.med.unsw.edu.au/wwwpig/piga/a3l.htm A3]
| [http://embryology.med.unsw.edu.au/wwwpig/piga/a4l.htm A4]
| [http://embryology.med.unsw.edu.au/wwwpig/piga/a5l.htm A5]
| [http://embryology.med.unsw.edu.au/wwwpig/piga/a6l.htm A6]
| [http://embryology.med.unsw.edu.au/wwwpig/piga/a7l.htm A7]

|-
| [http://embryology.med.unsw.edu.au/wwwpig/pigb/b1l.htm B1]
| [http://embryology.med.unsw.edu.au/wwwpig/pigb/b2l.htm B2]
| [http://embryology.med.unsw.edu.au/wwwpig/pigb/b3l.htm B3]
| [http://embryology.med.unsw.edu.au/wwwpig/pigb/b4l.htm B4]
| [http://embryology.med.unsw.edu.au/wwwpig/pigb/b5l.htm B5]
| [http://embryology.med.unsw.edu.au/wwwpig/pigb/b6l.htm B6]
| [http://embryology.med.unsw.edu.au/wwwpig/pigb/b7l.htm B7]

|-
| [http://embryology.med.unsw.edu.au/wwwpig/pigc/c1l.htm C1]
| [http://embryology.med.unsw.edu.au/wwwpig/pigc/c2l.htm C2]
| [http://embryology.med.unsw.edu.au/wwwpig/pigc/c3l.htm C3]
| [http://embryology.med.unsw.edu.au/wwwpig/pigc/c4l.htm C4]
| [http://embryology.med.unsw.edu.au/wwwpig/pigc/c5l.htm C5]
| [http://embryology.med.unsw.edu.au/wwwpig/pigc/c6l.htm C6]
| [http://embryology.med.unsw.edu.au/wwwpig/pigc/c7l.htm C7]

|-
| [http://embryology.med.unsw.edu.au/wwwpig/pigd/d1l.htm D1]
| [http://embryology.med.unsw.edu.au/wwwpig/pigd/d2l.htm D2]
| [http://embryology.med.unsw.edu.au/wwwpig/pigd/d3l.htm D3]
| [http://embryology.med.unsw.edu.au/wwwpig/pigd/d4l.htm D4]
| [http://embryology.med.unsw.edu.au/wwwpig/pigd/d5l.htm D5]
| [http://embryology.med.unsw.edu.au/wwwpig/pigd/d6l.htm D6]
| [http://embryology.med.unsw.edu.au/wwwpig/pigd/d7l.htm D7]

|-
| [http://embryology.med.unsw.edu.au/wwwpig/pige/e1l.htm E1]
| [http://embryology.med.unsw.edu.au/wwwpig/pige/e2l.htm E2]
| [http://embryology.med.unsw.edu.au/wwwpig/pige/e3l.htm E3]
| [http://embryology.med.unsw.edu.au/wwwpig/pige/e4l.htm E4]
| [http://embryology.med.unsw.edu.au/wwwpig/pige/e5l.htm E5]
| [http://embryology.med.unsw.edu.au/wwwpig/pige/e6l.htm E6]
| [http://embryology.med.unsw.edu.au/wwwpig/pige/e7l.htm E7]

|-
| [http://embryology.med.unsw.edu.au/wwwpig/pigf/f1l.htm F1]
| [http://embryology.med.unsw.edu.au/wwwpig/pigf/f2l.htm F2]
| [http://embryology.med.unsw.edu.au/wwwpig/pigf/f3l.htm F3]
| [http://embryology.med.unsw.edu.au/wwwpig/pigf/f4l.htm F4]
| [http://embryology.med.unsw.edu.au/wwwpig/pigf/f5l.htm F5]
| [http://embryology.med.unsw.edu.au/wwwpig/pigf/f6l.htm F6]
| [http://embryology.med.unsw.edu.au/wwwpig/pigf/f7l.htm F7]

|-
| [http://embryology.med.unsw.edu.au/wwwpig/pigg/g1l.htm G1]
| [http://embryology.med.unsw.edu.au/wwwpig/pigg/g2l.htm G2]
| [http://embryology.med.unsw.edu.au/wwwpig/pigg/g3l.htm G3]
| [http://embryology.med.unsw.edu.au/wwwpig/pigg/g4l.htm G4]
| [http://embryology.med.unsw.edu.au/wwwpig/pigg/g5l.htm G5]
| [http://embryology.med.unsw.edu.au/wwwpig/pigg/g6l.htm G6]
| [http://embryology.med.unsw.edu.au/wwwpig/pigg/g7l.htm G7]

|}

Compare this mid-embryonic cardiovascular system with that existing at the end of embryonic development [http://embryology.med.unsw.edu.au/Movies/CVS3dmodelst22.htm Stage 22 3D CVS reconstruction]

== Placentation ==

[[Image:Uterine and placental vasculature.jpg|thumb|right|Changes in the uterine vasculature with pregnancy]]

[[Image:Cvs.jpg|thumb|right|Chorionic villi sampling]]

==Chorionic Villi==
<gallery>
File:Gray0036.gif|Primary chorionic villi
File:Gray0037.gif|Secondary chorionic villi
File:Placenta anchoring villi.jpg|Placenta anchoring villi
</gallery>

* Compare the features of primary, secondary, tertiary and stemmed villi

[[Image:Gray0039.gif|Section through the placenta]]

== Group projects ==

The laboratory will also allow time for work on the group online project. What have your other group members and other groups done so far?

==UNSW Embryology Links==

* '''Cardiovascular Slides''' [http://embryology.med.unsw.edu.au/Science/ANAT2341lecture07.htm Cardiovasular Lecture 7 2008] | [http://embryology.med.unsw.edu.au/pdf/ANAT2341L07Hearts1.pdf Heart Lecture 2008 - 1 slide/page ] | [http://embryology.med.unsw.edu.au/pdf/ANAT2341L07Hearts4.pdf Heart Lecture 2008 Slides - 4 slides/page] | [http://embryology.med.unsw.edu.au/pdf/ANAT2341L07Hearts6.pdf Heart Lecture 2008 Slides - 6 slides/page]
* '''Cardiovascular Movies''' [http://embryology.med.unsw.edu.au/Movies/heart.htm Heart Movies] | [http://embryology.med.unsw.edu.au//Movies/larsen/looping.mov Heart Looping] | [http://embryology.med.unsw.edu.au//Movies/larsen/atrium.mov Atrial Septation] | [http://embryology.med.unsw.edu.au//Movies/larsen/avc.mov Realignment] | [http://embryology.med.unsw.edu.au//Movies/larsen/ventricl.mov Ventricular Septation] | [http://embryology.med.unsw.edu.au/Movies/heart.htm#HeartSeptation Heart Septation Models] | [http://embryology.med.unsw.edu.au/Movies/heart.htm#HistoricHeart Historic Heart Movie] |

* '''Cardiovascular Notes''' [http://embryology.med.unsw.edu.au/Notes/heart.htm Introduction] | [http://embryology.med.unsw.edu.au/Notes/heart2.htm Abnormalities] | [http://embryology.med.unsw.edu.au/Notes/heart3.htm Stage 13/14] | [http://embryology.med.unsw.edu.au/Notes/heart4.htm Stage 22] | [http://embryology.med.unsw.edu.au/Notes/heart5.htm Stage 22 Selected Highpower] | [http://embryology.med.unsw.edu.au/Notes/heart6.htm Heart] | [http://embryology.med.unsw.edu.au/Notes/heart8.htm Heart Rate] | [http://embryology.med.unsw.edu.au/Notes/heart20.htm Blood][http://embryology.med.unsw.edu.au/Notes/heart19.htm Blood Vessels] | [http://embryology.med.unsw.edu.au/Notes/heart11.htm Molecular] | [http://embryology.med.unsw.edu.au/Notes/heart31.htm Lymphatic] | [http://embryology.med.unsw.edu.au/Notes/hearttxt.htm Text only page] | [http://embryology.med.unsw.edu.au/Notes/heartlink.htm WWW Links] | [http://embryology.med.unsw.edu.au/Child/heart.htm Postnatal] | [http://embryology.med.unsw.edu.au/history/page2b.htm#Harvey History - Harvey]

* '''Placenta Slides''' [http://embryology.med.unsw.edu.au/Science/ANAT2341lecture08.htm Placenta Lecture 8 2008] | [http://embryology.med.unsw.edu.au/pdf/ANAT2341L8Placentas1.pdf Placenta Lecture 2008 - 1 slide/page ] | [http://embryology.med.unsw.edu.au/pdf/ANAT2341L8Placentas4.pdf Placenta Lecture 2008 Slides - 4 slides/page] | [http://embryology.med.unsw.edu.au/pdf/ANAT2341L8Placentas6.pdf Placenta Lecture 2008 Slides - 6 slides/page]
* '''Placenta Movies''' [http://embryology.med.unsw.edu.au/Movies/heart.htm Heart Movies] | [http://embryology.med.unsw.edu.au//Movies/larsen/looping.mov Heart Looping] | [http://embryology.med.unsw.edu.au//Movies/larsen/atrium.mov Atrial Septation] | [http://embryology.med.unsw.edu.au//Movies/larsen/avc.mov Realignment] | [http://embryology.med.unsw.edu.au//Movies/larsen/ventricl.mov Ventricular Septation] | [http://embryology.med.unsw.edu.au/Movies/heart.htm#HeartSeptation Heart Septation Models] | [http://embryology.med.unsw.edu.au/Movies/heart.htm#HistoricHeart Historic Heart Movie] |

* '''Placenta Notes''' [http://embryology.med.unsw.edu.au/Notes/placenta.htm Introduction] | [http://embryology.med.unsw.edu.au/Notes/placenta2.htm Abnormalities] | [http://embryology.med.unsw.edu.au/Notes/placenta3.htm Stage 13/14] | [http://embryology.med.unsw.edu.au/Notes/placenta4.htm Human (Stage22)] | [http://embryology.med.unsw.edu.au/Notes/placenta5.htm Histology] | [http://embryology.med.unsw.edu.au/Notes/placenta7.htm Villi Development] | [http://embryology.med.unsw.edu.au/Notes/placenta8.htm Maternal Decidua] | [http://embryology.med.unsw.edu.au/Notes/placenta6.htm Vascular Beds] | [http://embryology.med.unsw.edu.au/Notes/placenta11.htm Molecular] | [http://embryology.med.unsw.edu.au/Child/heart.htm Postnatal] | [http://embryology.med.unsw.edu.au/Notes/endocrine14.htm Endocrine Placenta]

* '''General Links''' [http://embryology.med.unsw.edu.au/sysnote.htm System Notes] | [http://embryology.med.unsw.edu.au/week/weekbyweek.htm Development Timeline]

==Internet links==

'''Embryo Images Unit:''' [http://www.med.unc.edu/embryo_images/ Embryo Images Online] Early Cell Populations (cardiogenic section) | [http://www.med.unc.edu/embryo_images/unit-cardev/cardev_htms/cardevtoc.htm Cardiovascular Development] | [http://www.med.unc.edu/embryo_images/unit-cardev/cardev_htms/cardev001.htm Week 3 Development] | [http://www.med.unc.edu/embryo_images/unit-cardev/cardev_htms/cardev007.htmhttp://www.med.unc.edu/embryo_images/unit-cardev/cardev_htms/cardev007.htm Week 4 Development] | [http://www.med.unc.edu/embryo_images/unit-cardev/cardev_htms/cardev018.htm Heart Chambers and Outflow Tract] | [http://www.med.unc.edu/embryo_images/unit-cardev/cardev_htms/cardev022.htm Atrioventricular Septation] | [http://www.med.unc.edu/embryo_images/unit-cardev/cardev_htms/cardev028.htm Outflow Tract Septation] | [http://www.med.unc.edu/embryo_images/unit-cardev/cardev_htms/cardev035.htm Ventricular Septation] | [http://www.med.unc.edu/embryo_images/unit-cardev/cardev_htms/cardev036.htm Atrial Septation] | [http://www.med.unc.edu/embryo_images/unit-cardev/cardev_htms/cardev040.htm Atrial Walls] [http://www.med.unc.edu/embryo_images/unit-cardev/cardev_htms/cardev041.htm Aortic Arch Vessels] | [http://www.med.unc.edu/embryo_images/unit-cardev/cardev_htms/cardev042.htm Changes at Birth]

{{Template:2009ANAT2341}}

[[Category:2009ANAT2341]]
[[Category:Science-Undergraduate]]
[[Category:Heart]]
[[Category:Cardiovascular]]

2010 Lab 4

2010-08-18T09:35:58Z

Z3267024: /* Placentation */

=Cardiovascular and Placenta=

== Introduction ==
[[Image:Embryonic Circulations.jpg|thumb|right|Three components of early circulation]]

The vascular system of the embryo is formed from blood islands that appear in the extraembryonic mesoderm of the yolk sac and the embryonic mesoderm (primarily splanchnic mesoderm). Both of these clusters fuse together and extend, forming a vast network.

The early circulation has 3 components: Vitelline, Embryonic, Placental Each of these has its own system of arteries and veins.

* '''Vitelline''' - (not shown) the vitelline arteries branch off the dorsal aortas and enter the yolk sac, covering its entire surface. The vitelline veins return red blood cells from the capillary beds to the sinus venosus, posterior to the heart. The vitelline vessels eventually contribute to the portal system of the liver in the adult.

* '''Embryonic''' - blood from the dorsal aorta enters intersegmental arteries, including the arteries of the pharyngeal arches. The blood returns to the heart via the anterior and posterior cardinal veins.

* '''Placental''' - the umbilical arteries receive blood from the aorta. This is carried to the chorionic villi, where exchange occurs with the mother. Waste products are disposed of, nutrients and oxygen are collected, and then the umbilical veins convey the blood to the sinus venosus.

'''Heart''' - The heart develops from cardiogenic mesoderm, a region of splanchnic mesoderm lying above the buccopharyngeal membrane. Development begins in week 3 with the formation of a pair of heart tubes. These fuse and form a single tube in week 4, as a result of the embryonic folding processes that occur. As the heart grows, septation events occur, transforming it into a 4-chambered pump. Initially, the ventricles develop above the atria; however simultaneous growth and bending of the tube bring the structures into correct position. In humans, the heart begins to beat on day 22-23.

==Objectives==

# Understand development of early embryo heart and vascular system.
# Understand the early placentation events and the development of placental blood vessels.

== Introduction ==
This laboratory will explore the development of the embryonic cardiovascular system, which includes the placental vascular system. We will look through cross-sections of the Carnegie stage 13 embryo and follow the flow of blood through the embryonic vasculature.

[[File:Stage13_bloodflow.jpg]]

== Stage 14 Embryo ==
'''Stage 14 3D CVS reconstruction''' [http://embryology.med.unsw.edu.au/Movies/CVS3dmodel.htm Small movie page] | [http://embryology.med.unsw.edu.au/Movies/CVS3dmodelonly.htm large movie page] | [[Media:CVS3d.mov|Stage 14 3D small movie]] | [[Media:Stage_14_CVS3d_large.mov|Stage 14 3D large movie]]

[[File:Stage14 planesm.gif|left]]
{| class="prettytable"
|-
| [http://embryology.med.unsw.edu.au/wwwpig/piga/a1l.htm A1]
| [http://embryology.med.unsw.edu.au/wwwpig/piga/a2l.htm A2]
| [http://embryology.med.unsw.edu.au/wwwpig/piga/a3l.htm A3]
| [http://embryology.med.unsw.edu.au/wwwpig/piga/a4l.htm A4]
| [http://embryology.med.unsw.edu.au/wwwpig/piga/a5l.htm A5]
| [http://embryology.med.unsw.edu.au/wwwpig/piga/a6l.htm A6]
| [http://embryology.med.unsw.edu.au/wwwpig/piga/a7l.htm A7]

|-
| [http://embryology.med.unsw.edu.au/wwwpig/pigb/b1l.htm B1]
| [http://embryology.med.unsw.edu.au/wwwpig/pigb/b2l.htm B2]
| [http://embryology.med.unsw.edu.au/wwwpig/pigb/b3l.htm B3]
| [http://embryology.med.unsw.edu.au/wwwpig/pigb/b4l.htm B4]
| [http://embryology.med.unsw.edu.au/wwwpig/pigb/b5l.htm B5]
| [http://embryology.med.unsw.edu.au/wwwpig/pigb/b6l.htm B6]
| [http://embryology.med.unsw.edu.au/wwwpig/pigb/b7l.htm B7]

|-
| [http://embryology.med.unsw.edu.au/wwwpig/pigc/c1l.htm C1]
| [http://embryology.med.unsw.edu.au/wwwpig/pigc/c2l.htm C2]
| [http://embryology.med.unsw.edu.au/wwwpig/pigc/c3l.htm C3]
| [http://embryology.med.unsw.edu.au/wwwpig/pigc/c4l.htm C4]
| [http://embryology.med.unsw.edu.au/wwwpig/pigc/c5l.htm C5]
| [http://embryology.med.unsw.edu.au/wwwpig/pigc/c6l.htm C6]
| [http://embryology.med.unsw.edu.au/wwwpig/pigc/c7l.htm C7]

|-
| [http://embryology.med.unsw.edu.au/wwwpig/pigd/d1l.htm D1]
| [http://embryology.med.unsw.edu.au/wwwpig/pigd/d2l.htm D2]
| [http://embryology.med.unsw.edu.au/wwwpig/pigd/d3l.htm D3]
| [http://embryology.med.unsw.edu.au/wwwpig/pigd/d4l.htm D4]
| [http://embryology.med.unsw.edu.au/wwwpig/pigd/d5l.htm D5]
| [http://embryology.med.unsw.edu.au/wwwpig/pigd/d6l.htm D6]
| [http://embryology.med.unsw.edu.au/wwwpig/pigd/d7l.htm D7]

|-
| [http://embryology.med.unsw.edu.au/wwwpig/pige/e1l.htm E1]
| [http://embryology.med.unsw.edu.au/wwwpig/pige/e2l.htm E2]
| [http://embryology.med.unsw.edu.au/wwwpig/pige/e3l.htm E3]
| [http://embryology.med.unsw.edu.au/wwwpig/pige/e4l.htm E4]
| [http://embryology.med.unsw.edu.au/wwwpig/pige/e5l.htm E5]
| [http://embryology.med.unsw.edu.au/wwwpig/pige/e6l.htm E6]
| [http://embryology.med.unsw.edu.au/wwwpig/pige/e7l.htm E7]

|-
| [http://embryology.med.unsw.edu.au/wwwpig/pigf/f1l.htm F1]
| [http://embryology.med.unsw.edu.au/wwwpig/pigf/f2l.htm F2]
| [http://embryology.med.unsw.edu.au/wwwpig/pigf/f3l.htm F3]
| [http://embryology.med.unsw.edu.au/wwwpig/pigf/f4l.htm F4]
| [http://embryology.med.unsw.edu.au/wwwpig/pigf/f5l.htm F5]
| [http://embryology.med.unsw.edu.au/wwwpig/pigf/f6l.htm F6]
| [http://embryology.med.unsw.edu.au/wwwpig/pigf/f7l.htm F7]

|-
| [http://embryology.med.unsw.edu.au/wwwpig/pigg/g1l.htm G1]
| [http://embryology.med.unsw.edu.au/wwwpig/pigg/g2l.htm G2]
| [http://embryology.med.unsw.edu.au/wwwpig/pigg/g3l.htm G3]
| [http://embryology.med.unsw.edu.au/wwwpig/pigg/g4l.htm G4]
| [http://embryology.med.unsw.edu.au/wwwpig/pigg/g5l.htm G5]
| [http://embryology.med.unsw.edu.au/wwwpig/pigg/g6l.htm G6]
| [http://embryology.med.unsw.edu.au/wwwpig/pigg/g7l.htm G7]

|}

Compare this mid-embryonic cardiovascular system with that existing at the end of embryonic development [http://embryology.med.unsw.edu.au/Movies/CVS3dmodelst22.htm Stage 22 3D CVS reconstruction]

== Placentation ==

[[Image:Uterine and placental vasculature.jpg|thumb|right|Changes in the uterine vasculature with pregnancy]]

[[Image:Cvs.jpg|thumb|right|Chorionic villi sampling]]

==Chorionic Villi==
<gallery>
File:Gray0036.gif|Primary chorionic villi
File:Gray0037.gif|Secondary chorionic villi
File:Placenta anchoring villi.jpg|Placenta anchoring villi
</gallery>
* '''primary villi''' - week 2, first stage of chorionic villi development, trophoblastic shell cells (syncitiotrophoblasts and cytotrophoblasts) form finger-like extensions into maternal decidua.

* '''secondary villi''' - week 3, second stage of chorionic villi development, extraembryonic mesoderm grows into villi, covers entire surface of chorionic sac.

* '''tertiary villi''' third stage of chorionic villi development, mesenchyme differentiates into blood vessels and cells, forms arteriocapillary network, fuse with placental vessels, developing in connecting stalk

* '''stem villi''' - or anchoring villi, cytotrophoblast cells attached to maternal tissue.

* '''branched villi''' - or terminal villi, grow from sides of stem villi, region of main exchange, surrounded by maternal blood in intervillous spaces.

[[Image:Gray0039.gif|Section through the placenta]]

== Group projects ==

The laboratory will also allow time for work on the group online project. What have your other group members and other groups done so far?

==UNSW Embryology Links==

* '''Cardiovascular Slides''' [http://embryology.med.unsw.edu.au/Science/ANAT2341lecture07.htm Cardiovasular Lecture 7 2008] | [http://embryology.med.unsw.edu.au/pdf/ANAT2341L07Hearts1.pdf Heart Lecture 2008 - 1 slide/page ] | [http://embryology.med.unsw.edu.au/pdf/ANAT2341L07Hearts4.pdf Heart Lecture 2008 Slides - 4 slides/page] | [http://embryology.med.unsw.edu.au/pdf/ANAT2341L07Hearts6.pdf Heart Lecture 2008 Slides - 6 slides/page]
* '''Cardiovascular Movies''' [http://embryology.med.unsw.edu.au/Movies/heart.htm Heart Movies] | [http://embryology.med.unsw.edu.au//Movies/larsen/looping.mov Heart Looping] | [http://embryology.med.unsw.edu.au//Movies/larsen/atrium.mov Atrial Septation] | [http://embryology.med.unsw.edu.au//Movies/larsen/avc.mov Realignment] | [http://embryology.med.unsw.edu.au//Movies/larsen/ventricl.mov Ventricular Septation] | [http://embryology.med.unsw.edu.au/Movies/heart.htm#HeartSeptation Heart Septation Models] | [http://embryology.med.unsw.edu.au/Movies/heart.htm#HistoricHeart Historic Heart Movie] |

* '''Cardiovascular Notes''' [http://embryology.med.unsw.edu.au/Notes/heart.htm Introduction] | [http://embryology.med.unsw.edu.au/Notes/heart2.htm Abnormalities] | [http://embryology.med.unsw.edu.au/Notes/heart3.htm Stage 13/14] | [http://embryology.med.unsw.edu.au/Notes/heart4.htm Stage 22] | [http://embryology.med.unsw.edu.au/Notes/heart5.htm Stage 22 Selected Highpower] | [http://embryology.med.unsw.edu.au/Notes/heart6.htm Heart] | [http://embryology.med.unsw.edu.au/Notes/heart8.htm Heart Rate] | [http://embryology.med.unsw.edu.au/Notes/heart20.htm Blood][http://embryology.med.unsw.edu.au/Notes/heart19.htm Blood Vessels] | [http://embryology.med.unsw.edu.au/Notes/heart11.htm Molecular] | [http://embryology.med.unsw.edu.au/Notes/heart31.htm Lymphatic] | [http://embryology.med.unsw.edu.au/Notes/hearttxt.htm Text only page] | [http://embryology.med.unsw.edu.au/Notes/heartlink.htm WWW Links] | [http://embryology.med.unsw.edu.au/Child/heart.htm Postnatal] | [http://embryology.med.unsw.edu.au/history/page2b.htm#Harvey History - Harvey]

* '''Placenta Slides''' [http://embryology.med.unsw.edu.au/Science/ANAT2341lecture08.htm Placenta Lecture 8 2008] | [http://embryology.med.unsw.edu.au/pdf/ANAT2341L8Placentas1.pdf Placenta Lecture 2008 - 1 slide/page ] | [http://embryology.med.unsw.edu.au/pdf/ANAT2341L8Placentas4.pdf Placenta Lecture 2008 Slides - 4 slides/page] | [http://embryology.med.unsw.edu.au/pdf/ANAT2341L8Placentas6.pdf Placenta Lecture 2008 Slides - 6 slides/page]
* '''Placenta Movies''' [http://embryology.med.unsw.edu.au/Movies/heart.htm Heart Movies] | [http://embryology.med.unsw.edu.au//Movies/larsen/looping.mov Heart Looping] | [http://embryology.med.unsw.edu.au//Movies/larsen/atrium.mov Atrial Septation] | [http://embryology.med.unsw.edu.au//Movies/larsen/avc.mov Realignment] | [http://embryology.med.unsw.edu.au//Movies/larsen/ventricl.mov Ventricular Septation] | [http://embryology.med.unsw.edu.au/Movies/heart.htm#HeartSeptation Heart Septation Models] | [http://embryology.med.unsw.edu.au/Movies/heart.htm#HistoricHeart Historic Heart Movie] |

* '''Placenta Notes''' [http://embryology.med.unsw.edu.au/Notes/placenta.htm Introduction] | [http://embryology.med.unsw.edu.au/Notes/placenta2.htm Abnormalities] | [http://embryology.med.unsw.edu.au/Notes/placenta3.htm Stage 13/14] | [http://embryology.med.unsw.edu.au/Notes/placenta4.htm Human (Stage22)] | [http://embryology.med.unsw.edu.au/Notes/placenta5.htm Histology] | [http://embryology.med.unsw.edu.au/Notes/placenta7.htm Villi Development] | [http://embryology.med.unsw.edu.au/Notes/placenta8.htm Maternal Decidua] | [http://embryology.med.unsw.edu.au/Notes/placenta6.htm Vascular Beds] | [http://embryology.med.unsw.edu.au/Notes/placenta11.htm Molecular] | [http://embryology.med.unsw.edu.au/Child/heart.htm Postnatal] | [http://embryology.med.unsw.edu.au/Notes/endocrine14.htm Endocrine Placenta]

* '''General Links''' [http://embryology.med.unsw.edu.au/sysnote.htm System Notes] | [http://embryology.med.unsw.edu.au/week/weekbyweek.htm Development Timeline]

==Internet links==

'''Embryo Images Unit:''' [http://www.med.unc.edu/embryo_images/ Embryo Images Online] Early Cell Populations (cardiogenic section) | [http://www.med.unc.edu/embryo_images/unit-cardev/cardev_htms/cardevtoc.htm Cardiovascular Development] | [http://www.med.unc.edu/embryo_images/unit-cardev/cardev_htms/cardev001.htm Week 3 Development] | [http://www.med.unc.edu/embryo_images/unit-cardev/cardev_htms/cardev007.htmhttp://www.med.unc.edu/embryo_images/unit-cardev/cardev_htms/cardev007.htm Week 4 Development] | [http://www.med.unc.edu/embryo_images/unit-cardev/cardev_htms/cardev018.htm Heart Chambers and Outflow Tract] | [http://www.med.unc.edu/embryo_images/unit-cardev/cardev_htms/cardev022.htm Atrioventricular Septation] | [http://www.med.unc.edu/embryo_images/unit-cardev/cardev_htms/cardev028.htm Outflow Tract Septation] | [http://www.med.unc.edu/embryo_images/unit-cardev/cardev_htms/cardev035.htm Ventricular Septation] | [http://www.med.unc.edu/embryo_images/unit-cardev/cardev_htms/cardev036.htm Atrial Septation] | [http://www.med.unc.edu/embryo_images/unit-cardev/cardev_htms/cardev040.htm Atrial Walls] [http://www.med.unc.edu/embryo_images/unit-cardev/cardev_htms/cardev041.htm Aortic Arch Vessels] | [http://www.med.unc.edu/embryo_images/unit-cardev/cardev_htms/cardev042.htm Changes at Birth]

{{Template:2009ANAT2341}}

[[Category:2009ANAT2341]]
[[Category:Science-Undergraduate]]
[[Category:Heart]]
[[Category:Cardiovascular]]

2010 Lab 4

2010-08-18T04:23:16Z

Z3267024: /* Placentation */

=Cardiovascular and Placenta=

== Introduction ==
[[Image:Embryonic Circulations.jpg|thumb|right|Three components of early circulation]]

The vascular system of the embryo is formed from blood islands that appear in the extraembryonic mesoderm of the yolk sac and the embryonic mesoderm (primarily splanchnic mesoderm). Both of these clusters fuse together and extend, forming a vast network.

The early circulation has 3 components: Vitelline, Embryonic, Placental Each of these has its own system of arteries and veins.

* '''Vitelline''' - (not shown) the vitelline arteries branch off the dorsal aortas and enter the yolk sac, covering its entire surface. The vitelline veins return red blood cells from the capillary beds to the sinus venosus, posterior to the heart. The vitelline vessels eventually contribute to the portal system of the liver in the adult.

* '''Embryonic''' - blood from the dorsal aorta enters intersegmental arteries, including the arteries of the pharyngeal arches. The blood returns to the heart via the anterior and posterior cardinal veins.

* '''Placental''' - the umbilical arteries receive blood from the aorta. This is carried to the chorionic villi, where exchange occurs with the mother. Waste products are disposed of, nutrients and oxygen are collected, and then the umbilical veins convey the blood to the sinus venosus.

'''Heart''' - The heart develops from cardiogenic mesoderm, a region of splanchnic mesoderm lying above the buccopharyngeal membrane. Development begins in week 3 with the formation of a pair of heart tubes. These fuse and form a single tube in week 4, as a result of the embryonic folding processes that occur. As the heart grows, septation events occur, transforming it into a 4-chambered pump. Initially, the ventricles develop above the atria; however simultaneous growth and bending of the tube bring the structures into correct position. In humans, the heart begins to beat on day 22-23.

==Objectives==

# Understand development of early embryo heart and vascular system.
# Understand the early placentation events and the development of placental blood vessels.

== Introduction ==
This laboratory will explore the development of the embryonic cardiovascular system, which includes the placental vascular system. We will look through cross-sections of the Carnegie stage 13 embryo and follow the flow of blood through the embryonic vasculature.

[[File:Stage13_bloodflow.jpg]]

== Stage 14 Embryo ==
'''Stage 14 3D CVS reconstruction''' [http://embryology.med.unsw.edu.au/Movies/CVS3dmodel.htm Small movie page] | [http://embryology.med.unsw.edu.au/Movies/CVS3dmodelonly.htm large movie page] | [[Media:CVS3d.mov|Stage 14 3D small movie]] | [[Media:Stage_14_CVS3d_large.mov|Stage 14 3D large movie]]

[[File:Stage14 planesm.gif|left]]
{| class="prettytable"
|-
| [http://embryology.med.unsw.edu.au/wwwpig/piga/a1l.htm A1]
| [http://embryology.med.unsw.edu.au/wwwpig/piga/a2l.htm A2]
| [http://embryology.med.unsw.edu.au/wwwpig/piga/a3l.htm A3]
| [http://embryology.med.unsw.edu.au/wwwpig/piga/a4l.htm A4]
| [http://embryology.med.unsw.edu.au/wwwpig/piga/a5l.htm A5]
| [http://embryology.med.unsw.edu.au/wwwpig/piga/a6l.htm A6]
| [http://embryology.med.unsw.edu.au/wwwpig/piga/a7l.htm A7]

|-
| [http://embryology.med.unsw.edu.au/wwwpig/pigb/b1l.htm B1]
| [http://embryology.med.unsw.edu.au/wwwpig/pigb/b2l.htm B2]
| [http://embryology.med.unsw.edu.au/wwwpig/pigb/b3l.htm B3]
| [http://embryology.med.unsw.edu.au/wwwpig/pigb/b4l.htm B4]
| [http://embryology.med.unsw.edu.au/wwwpig/pigb/b5l.htm B5]
| [http://embryology.med.unsw.edu.au/wwwpig/pigb/b6l.htm B6]
| [http://embryology.med.unsw.edu.au/wwwpig/pigb/b7l.htm B7]

|-
| [http://embryology.med.unsw.edu.au/wwwpig/pigc/c1l.htm C1]
| [http://embryology.med.unsw.edu.au/wwwpig/pigc/c2l.htm C2]
| [http://embryology.med.unsw.edu.au/wwwpig/pigc/c3l.htm C3]
| [http://embryology.med.unsw.edu.au/wwwpig/pigc/c4l.htm C4]
| [http://embryology.med.unsw.edu.au/wwwpig/pigc/c5l.htm C5]
| [http://embryology.med.unsw.edu.au/wwwpig/pigc/c6l.htm C6]
| [http://embryology.med.unsw.edu.au/wwwpig/pigc/c7l.htm C7]

|-
| [http://embryology.med.unsw.edu.au/wwwpig/pigd/d1l.htm D1]
| [http://embryology.med.unsw.edu.au/wwwpig/pigd/d2l.htm D2]
| [http://embryology.med.unsw.edu.au/wwwpig/pigd/d3l.htm D3]
| [http://embryology.med.unsw.edu.au/wwwpig/pigd/d4l.htm D4]
| [http://embryology.med.unsw.edu.au/wwwpig/pigd/d5l.htm D5]
| [http://embryology.med.unsw.edu.au/wwwpig/pigd/d6l.htm D6]
| [http://embryology.med.unsw.edu.au/wwwpig/pigd/d7l.htm D7]

|-
| [http://embryology.med.unsw.edu.au/wwwpig/pige/e1l.htm E1]
| [http://embryology.med.unsw.edu.au/wwwpig/pige/e2l.htm E2]
| [http://embryology.med.unsw.edu.au/wwwpig/pige/e3l.htm E3]
| [http://embryology.med.unsw.edu.au/wwwpig/pige/e4l.htm E4]
| [http://embryology.med.unsw.edu.au/wwwpig/pige/e5l.htm E5]
| [http://embryology.med.unsw.edu.au/wwwpig/pige/e6l.htm E6]
| [http://embryology.med.unsw.edu.au/wwwpig/pige/e7l.htm E7]

|-
| [http://embryology.med.unsw.edu.au/wwwpig/pigf/f1l.htm F1]
| [http://embryology.med.unsw.edu.au/wwwpig/pigf/f2l.htm F2]
| [http://embryology.med.unsw.edu.au/wwwpig/pigf/f3l.htm F3]
| [http://embryology.med.unsw.edu.au/wwwpig/pigf/f4l.htm F4]
| [http://embryology.med.unsw.edu.au/wwwpig/pigf/f5l.htm F5]
| [http://embryology.med.unsw.edu.au/wwwpig/pigf/f6l.htm F6]
| [http://embryology.med.unsw.edu.au/wwwpig/pigf/f7l.htm F7]

|-
| [http://embryology.med.unsw.edu.au/wwwpig/pigg/g1l.htm G1]
| [http://embryology.med.unsw.edu.au/wwwpig/pigg/g2l.htm G2]
| [http://embryology.med.unsw.edu.au/wwwpig/pigg/g3l.htm G3]
| [http://embryology.med.unsw.edu.au/wwwpig/pigg/g4l.htm G4]
| [http://embryology.med.unsw.edu.au/wwwpig/pigg/g5l.htm G5]
| [http://embryology.med.unsw.edu.au/wwwpig/pigg/g6l.htm G6]
| [http://embryology.med.unsw.edu.au/wwwpig/pigg/g7l.htm G7]

|}

Compare this mid-embryonic cardiovascular system with that existing at the end of embryonic development [http://embryology.med.unsw.edu.au/Movies/CVS3dmodelst22.htm Stage 22 3D CVS reconstruction]

== Placentation ==

[[Image:Uterine and placental vasculature.jpg|thumb|right|Changes in the uterine vasculature with pregnancy]]

==Chorionic Villi==
<gallery>
File:Gray0036.gif|Primary chorionic villi
File:Gray0037.gif|Secondary chorionic villi
File:Placenta anchoring villi.jpg|Placenta anchoring villi
</gallery>
* '''primary villi''' - week 2, first stage of chorionic villi development, trophoblastic shell cells (syncitiotrophoblasts and cytotrophoblasts) form finger-like extensions into maternal decidua.

* '''secondary villi''' - week 3, second stage of chorionic villi development, extraembryonic mesoderm grows into villi, covers entire surface of chorionic sac.

* '''tertiary villi''' third stage of chorionic villi development, mesenchyme differentiates into blood vessels and cells, forms arteriocapillary network, fuse with placental vessels, developing in connecting stalk

* '''stem villi''' - or anchoring villi, cytotrophoblast cells attached to maternal tissue.

* '''branched villi''' - or terminal villi, grow from sides of stem villi, region of main exchange, surrounded by maternal blood in intervillous spaces.

[[Image:Gray0039.gif|Section through the placenta]]

== Group projects ==

The laboratory will also allow time for work on the group online project. What have your other group members and other groups done so far?

==UNSW Embryology Links==

* '''Cardiovascular Slides''' [http://embryology.med.unsw.edu.au/Science/ANAT2341lecture07.htm Cardiovasular Lecture 7 2008] | [http://embryology.med.unsw.edu.au/pdf/ANAT2341L07Hearts1.pdf Heart Lecture 2008 - 1 slide/page ] | [http://embryology.med.unsw.edu.au/pdf/ANAT2341L07Hearts4.pdf Heart Lecture 2008 Slides - 4 slides/page] | [http://embryology.med.unsw.edu.au/pdf/ANAT2341L07Hearts6.pdf Heart Lecture 2008 Slides - 6 slides/page]
* '''Cardiovascular Movies''' [http://embryology.med.unsw.edu.au/Movies/heart.htm Heart Movies] | [http://embryology.med.unsw.edu.au//Movies/larsen/looping.mov Heart Looping] | [http://embryology.med.unsw.edu.au//Movies/larsen/atrium.mov Atrial Septation] | [http://embryology.med.unsw.edu.au//Movies/larsen/avc.mov Realignment] | [http://embryology.med.unsw.edu.au//Movies/larsen/ventricl.mov Ventricular Septation] | [http://embryology.med.unsw.edu.au/Movies/heart.htm#HeartSeptation Heart Septation Models] | [http://embryology.med.unsw.edu.au/Movies/heart.htm#HistoricHeart Historic Heart Movie] |

* '''Cardiovascular Notes''' [http://embryology.med.unsw.edu.au/Notes/heart.htm Introduction] | [http://embryology.med.unsw.edu.au/Notes/heart2.htm Abnormalities] | [http://embryology.med.unsw.edu.au/Notes/heart3.htm Stage 13/14] | [http://embryology.med.unsw.edu.au/Notes/heart4.htm Stage 22] | [http://embryology.med.unsw.edu.au/Notes/heart5.htm Stage 22 Selected Highpower] | [http://embryology.med.unsw.edu.au/Notes/heart6.htm Heart] | [http://embryology.med.unsw.edu.au/Notes/heart8.htm Heart Rate] | [http://embryology.med.unsw.edu.au/Notes/heart20.htm Blood][http://embryology.med.unsw.edu.au/Notes/heart19.htm Blood Vessels] | [http://embryology.med.unsw.edu.au/Notes/heart11.htm Molecular] | [http://embryology.med.unsw.edu.au/Notes/heart31.htm Lymphatic] | [http://embryology.med.unsw.edu.au/Notes/hearttxt.htm Text only page] | [http://embryology.med.unsw.edu.au/Notes/heartlink.htm WWW Links] | [http://embryology.med.unsw.edu.au/Child/heart.htm Postnatal] | [http://embryology.med.unsw.edu.au/history/page2b.htm#Harvey History - Harvey]

* '''Placenta Slides''' [http://embryology.med.unsw.edu.au/Science/ANAT2341lecture08.htm Placenta Lecture 8 2008] | [http://embryology.med.unsw.edu.au/pdf/ANAT2341L8Placentas1.pdf Placenta Lecture 2008 - 1 slide/page ] | [http://embryology.med.unsw.edu.au/pdf/ANAT2341L8Placentas4.pdf Placenta Lecture 2008 Slides - 4 slides/page] | [http://embryology.med.unsw.edu.au/pdf/ANAT2341L8Placentas6.pdf Placenta Lecture 2008 Slides - 6 slides/page]
* '''Placenta Movies''' [http://embryology.med.unsw.edu.au/Movies/heart.htm Heart Movies] | [http://embryology.med.unsw.edu.au//Movies/larsen/looping.mov Heart Looping] | [http://embryology.med.unsw.edu.au//Movies/larsen/atrium.mov Atrial Septation] | [http://embryology.med.unsw.edu.au//Movies/larsen/avc.mov Realignment] | [http://embryology.med.unsw.edu.au//Movies/larsen/ventricl.mov Ventricular Septation] | [http://embryology.med.unsw.edu.au/Movies/heart.htm#HeartSeptation Heart Septation Models] | [http://embryology.med.unsw.edu.au/Movies/heart.htm#HistoricHeart Historic Heart Movie] |

* '''Placenta Notes''' [http://embryology.med.unsw.edu.au/Notes/placenta.htm Introduction] | [http://embryology.med.unsw.edu.au/Notes/placenta2.htm Abnormalities] | [http://embryology.med.unsw.edu.au/Notes/placenta3.htm Stage 13/14] | [http://embryology.med.unsw.edu.au/Notes/placenta4.htm Human (Stage22)] | [http://embryology.med.unsw.edu.au/Notes/placenta5.htm Histology] | [http://embryology.med.unsw.edu.au/Notes/placenta7.htm Villi Development] | [http://embryology.med.unsw.edu.au/Notes/placenta8.htm Maternal Decidua] | [http://embryology.med.unsw.edu.au/Notes/placenta6.htm Vascular Beds] | [http://embryology.med.unsw.edu.au/Notes/placenta11.htm Molecular] | [http://embryology.med.unsw.edu.au/Child/heart.htm Postnatal] | [http://embryology.med.unsw.edu.au/Notes/endocrine14.htm Endocrine Placenta]

* '''General Links''' [http://embryology.med.unsw.edu.au/sysnote.htm System Notes] | [http://embryology.med.unsw.edu.au/week/weekbyweek.htm Development Timeline]

==Internet links==

'''Embryo Images Unit:''' [http://www.med.unc.edu/embryo_images/ Embryo Images Online] Early Cell Populations (cardiogenic section) | [http://www.med.unc.edu/embryo_images/unit-cardev/cardev_htms/cardevtoc.htm Cardiovascular Development] | [http://www.med.unc.edu/embryo_images/unit-cardev/cardev_htms/cardev001.htm Week 3 Development] | [http://www.med.unc.edu/embryo_images/unit-cardev/cardev_htms/cardev007.htmhttp://www.med.unc.edu/embryo_images/unit-cardev/cardev_htms/cardev007.htm Week 4 Development] | [http://www.med.unc.edu/embryo_images/unit-cardev/cardev_htms/cardev018.htm Heart Chambers and Outflow Tract] | [http://www.med.unc.edu/embryo_images/unit-cardev/cardev_htms/cardev022.htm Atrioventricular Septation] | [http://www.med.unc.edu/embryo_images/unit-cardev/cardev_htms/cardev028.htm Outflow Tract Septation] | [http://www.med.unc.edu/embryo_images/unit-cardev/cardev_htms/cardev035.htm Ventricular Septation] | [http://www.med.unc.edu/embryo_images/unit-cardev/cardev_htms/cardev036.htm Atrial Septation] | [http://www.med.unc.edu/embryo_images/unit-cardev/cardev_htms/cardev040.htm Atrial Walls] [http://www.med.unc.edu/embryo_images/unit-cardev/cardev_htms/cardev041.htm Aortic Arch Vessels] | [http://www.med.unc.edu/embryo_images/unit-cardev/cardev_htms/cardev042.htm Changes at Birth]

{{Template:2009ANAT2341}}

[[Category:2009ANAT2341]]
[[Category:Science-Undergraduate]]
[[Category:Heart]]
[[Category:Cardiovascular]]

2010 Lab 4

2010-08-18T04:22:40Z

Z3267024: /* Cardiovascular and Placenta */

=Cardiovascular and Placenta=

== Introduction ==
[[Image:Embryonic Circulations.jpg|thumb|right|Three components of early circulation]]

The vascular system of the embryo is formed from blood islands that appear in the extraembryonic mesoderm of the yolk sac and the embryonic mesoderm (primarily splanchnic mesoderm). Both of these clusters fuse together and extend, forming a vast network.

The early circulation has 3 components: Vitelline, Embryonic, Placental Each of these has its own system of arteries and veins.

* '''Vitelline''' - (not shown) the vitelline arteries branch off the dorsal aortas and enter the yolk sac, covering its entire surface. The vitelline veins return red blood cells from the capillary beds to the sinus venosus, posterior to the heart. The vitelline vessels eventually contribute to the portal system of the liver in the adult.

* '''Embryonic''' - blood from the dorsal aorta enters intersegmental arteries, including the arteries of the pharyngeal arches. The blood returns to the heart via the anterior and posterior cardinal veins.

* '''Placental''' - the umbilical arteries receive blood from the aorta. This is carried to the chorionic villi, where exchange occurs with the mother. Waste products are disposed of, nutrients and oxygen are collected, and then the umbilical veins convey the blood to the sinus venosus.

'''Heart''' - The heart develops from cardiogenic mesoderm, a region of splanchnic mesoderm lying above the buccopharyngeal membrane. Development begins in week 3 with the formation of a pair of heart tubes. These fuse and form a single tube in week 4, as a result of the embryonic folding processes that occur. As the heart grows, septation events occur, transforming it into a 4-chambered pump. Initially, the ventricles develop above the atria; however simultaneous growth and bending of the tube bring the structures into correct position. In humans, the heart begins to beat on day 22-23.

==Objectives==

# Understand development of early embryo heart and vascular system.
# Understand the early placentation events and the development of placental blood vessels.

== Introduction ==
This laboratory will explore the development of the embryonic cardiovascular system, which includes the placental vascular system. We will look through cross-sections of the Carnegie stage 13 embryo and follow the flow of blood through the embryonic vasculature.

[[File:Stage13_bloodflow.jpg]]

== Stage 14 Embryo ==
'''Stage 14 3D CVS reconstruction''' [http://embryology.med.unsw.edu.au/Movies/CVS3dmodel.htm Small movie page] | [http://embryology.med.unsw.edu.au/Movies/CVS3dmodelonly.htm large movie page] | [[Media:CVS3d.mov|Stage 14 3D small movie]] | [[Media:Stage_14_CVS3d_large.mov|Stage 14 3D large movie]]

[[File:Stage14 planesm.gif|left]]
{| class="prettytable"
|-
| [http://embryology.med.unsw.edu.au/wwwpig/piga/a1l.htm A1]
| [http://embryology.med.unsw.edu.au/wwwpig/piga/a2l.htm A2]
| [http://embryology.med.unsw.edu.au/wwwpig/piga/a3l.htm A3]
| [http://embryology.med.unsw.edu.au/wwwpig/piga/a4l.htm A4]
| [http://embryology.med.unsw.edu.au/wwwpig/piga/a5l.htm A5]
| [http://embryology.med.unsw.edu.au/wwwpig/piga/a6l.htm A6]
| [http://embryology.med.unsw.edu.au/wwwpig/piga/a7l.htm A7]

|-
| [http://embryology.med.unsw.edu.au/wwwpig/pigb/b1l.htm B1]
| [http://embryology.med.unsw.edu.au/wwwpig/pigb/b2l.htm B2]
| [http://embryology.med.unsw.edu.au/wwwpig/pigb/b3l.htm B3]
| [http://embryology.med.unsw.edu.au/wwwpig/pigb/b4l.htm B4]
| [http://embryology.med.unsw.edu.au/wwwpig/pigb/b5l.htm B5]
| [http://embryology.med.unsw.edu.au/wwwpig/pigb/b6l.htm B6]
| [http://embryology.med.unsw.edu.au/wwwpig/pigb/b7l.htm B7]

|-
| [http://embryology.med.unsw.edu.au/wwwpig/pigc/c1l.htm C1]
| [http://embryology.med.unsw.edu.au/wwwpig/pigc/c2l.htm C2]
| [http://embryology.med.unsw.edu.au/wwwpig/pigc/c3l.htm C3]
| [http://embryology.med.unsw.edu.au/wwwpig/pigc/c4l.htm C4]
| [http://embryology.med.unsw.edu.au/wwwpig/pigc/c5l.htm C5]
| [http://embryology.med.unsw.edu.au/wwwpig/pigc/c6l.htm C6]
| [http://embryology.med.unsw.edu.au/wwwpig/pigc/c7l.htm C7]

|-
| [http://embryology.med.unsw.edu.au/wwwpig/pigd/d1l.htm D1]
| [http://embryology.med.unsw.edu.au/wwwpig/pigd/d2l.htm D2]
| [http://embryology.med.unsw.edu.au/wwwpig/pigd/d3l.htm D3]
| [http://embryology.med.unsw.edu.au/wwwpig/pigd/d4l.htm D4]
| [http://embryology.med.unsw.edu.au/wwwpig/pigd/d5l.htm D5]
| [http://embryology.med.unsw.edu.au/wwwpig/pigd/d6l.htm D6]
| [http://embryology.med.unsw.edu.au/wwwpig/pigd/d7l.htm D7]

|-
| [http://embryology.med.unsw.edu.au/wwwpig/pige/e1l.htm E1]
| [http://embryology.med.unsw.edu.au/wwwpig/pige/e2l.htm E2]
| [http://embryology.med.unsw.edu.au/wwwpig/pige/e3l.htm E3]
| [http://embryology.med.unsw.edu.au/wwwpig/pige/e4l.htm E4]
| [http://embryology.med.unsw.edu.au/wwwpig/pige/e5l.htm E5]
| [http://embryology.med.unsw.edu.au/wwwpig/pige/e6l.htm E6]
| [http://embryology.med.unsw.edu.au/wwwpig/pige/e7l.htm E7]

|-
| [http://embryology.med.unsw.edu.au/wwwpig/pigf/f1l.htm F1]
| [http://embryology.med.unsw.edu.au/wwwpig/pigf/f2l.htm F2]
| [http://embryology.med.unsw.edu.au/wwwpig/pigf/f3l.htm F3]
| [http://embryology.med.unsw.edu.au/wwwpig/pigf/f4l.htm F4]
| [http://embryology.med.unsw.edu.au/wwwpig/pigf/f5l.htm F5]
| [http://embryology.med.unsw.edu.au/wwwpig/pigf/f6l.htm F6]
| [http://embryology.med.unsw.edu.au/wwwpig/pigf/f7l.htm F7]

|-
| [http://embryology.med.unsw.edu.au/wwwpig/pigg/g1l.htm G1]
| [http://embryology.med.unsw.edu.au/wwwpig/pigg/g2l.htm G2]
| [http://embryology.med.unsw.edu.au/wwwpig/pigg/g3l.htm G3]
| [http://embryology.med.unsw.edu.au/wwwpig/pigg/g4l.htm G4]
| [http://embryology.med.unsw.edu.au/wwwpig/pigg/g5l.htm G5]
| [http://embryology.med.unsw.edu.au/wwwpig/pigg/g6l.htm G6]
| [http://embryology.med.unsw.edu.au/wwwpig/pigg/g7l.htm G7]

|}

Compare this mid-embryonic cardiovascular system with that existing at the end of embryonic development [http://embryology.med.unsw.edu.au/Movies/CVS3dmodelst22.htm Stage 22 3D CVS reconstruction]

== Placentation ==

[[Image:Uterine and placental vasculature.jpg|thumb|right|Changes in the uterine vasculture with pregnancy]]

==Chorionic Villi==
<gallery>
File:Gray0036.gif|Primary chorionic villi
File:Gray0037.gif|Secondary chorionic villi
File:Placenta anchoring villi.jpg|Placenta anchoring villi
</gallery>
* '''primary villi''' - week 2, first stage of chorionic villi development, trophoblastic shell cells (syncitiotrophoblasts and cytotrophoblasts) form finger-like extensions into maternal decidua.

* '''secondary villi''' - week 3, second stage of chorionic villi development, extraembryonic mesoderm grows into villi, covers entire surface of chorionic sac.

* '''tertiary villi''' third stage of chorionic villi development, mesenchyme differentiates into blood vessels and cells, forms arteriocapillary network, fuse with placental vessels, developing in connecting stalk

* '''stem villi''' - or anchoring villi, cytotrophoblast cells attached to maternal tissue.

* '''branched villi''' - or terminal villi, grow from sides of stem villi, region of main exchange, surrounded by maternal blood in intervillous spaces.

[[Image:Gray0039.gif|Section through the placenta]]

== Group projects ==

The laboratory will also allow time for work on the group online project. What have your other group members and other groups done so far?

==UNSW Embryology Links==

* '''Cardiovascular Slides''' [http://embryology.med.unsw.edu.au/Science/ANAT2341lecture07.htm Cardiovasular Lecture 7 2008] | [http://embryology.med.unsw.edu.au/pdf/ANAT2341L07Hearts1.pdf Heart Lecture 2008 - 1 slide/page ] | [http://embryology.med.unsw.edu.au/pdf/ANAT2341L07Hearts4.pdf Heart Lecture 2008 Slides - 4 slides/page] | [http://embryology.med.unsw.edu.au/pdf/ANAT2341L07Hearts6.pdf Heart Lecture 2008 Slides - 6 slides/page]
* '''Cardiovascular Movies''' [http://embryology.med.unsw.edu.au/Movies/heart.htm Heart Movies] | [http://embryology.med.unsw.edu.au//Movies/larsen/looping.mov Heart Looping] | [http://embryology.med.unsw.edu.au//Movies/larsen/atrium.mov Atrial Septation] | [http://embryology.med.unsw.edu.au//Movies/larsen/avc.mov Realignment] | [http://embryology.med.unsw.edu.au//Movies/larsen/ventricl.mov Ventricular Septation] | [http://embryology.med.unsw.edu.au/Movies/heart.htm#HeartSeptation Heart Septation Models] | [http://embryology.med.unsw.edu.au/Movies/heart.htm#HistoricHeart Historic Heart Movie] |

* '''Cardiovascular Notes''' [http://embryology.med.unsw.edu.au/Notes/heart.htm Introduction] | [http://embryology.med.unsw.edu.au/Notes/heart2.htm Abnormalities] | [http://embryology.med.unsw.edu.au/Notes/heart3.htm Stage 13/14] | [http://embryology.med.unsw.edu.au/Notes/heart4.htm Stage 22] | [http://embryology.med.unsw.edu.au/Notes/heart5.htm Stage 22 Selected Highpower] | [http://embryology.med.unsw.edu.au/Notes/heart6.htm Heart] | [http://embryology.med.unsw.edu.au/Notes/heart8.htm Heart Rate] | [http://embryology.med.unsw.edu.au/Notes/heart20.htm Blood][http://embryology.med.unsw.edu.au/Notes/heart19.htm Blood Vessels] | [http://embryology.med.unsw.edu.au/Notes/heart11.htm Molecular] | [http://embryology.med.unsw.edu.au/Notes/heart31.htm Lymphatic] | [http://embryology.med.unsw.edu.au/Notes/hearttxt.htm Text only page] | [http://embryology.med.unsw.edu.au/Notes/heartlink.htm WWW Links] | [http://embryology.med.unsw.edu.au/Child/heart.htm Postnatal] | [http://embryology.med.unsw.edu.au/history/page2b.htm#Harvey History - Harvey]

* '''Placenta Slides''' [http://embryology.med.unsw.edu.au/Science/ANAT2341lecture08.htm Placenta Lecture 8 2008] | [http://embryology.med.unsw.edu.au/pdf/ANAT2341L8Placentas1.pdf Placenta Lecture 2008 - 1 slide/page ] | [http://embryology.med.unsw.edu.au/pdf/ANAT2341L8Placentas4.pdf Placenta Lecture 2008 Slides - 4 slides/page] | [http://embryology.med.unsw.edu.au/pdf/ANAT2341L8Placentas6.pdf Placenta Lecture 2008 Slides - 6 slides/page]
* '''Placenta Movies''' [http://embryology.med.unsw.edu.au/Movies/heart.htm Heart Movies] | [http://embryology.med.unsw.edu.au//Movies/larsen/looping.mov Heart Looping] | [http://embryology.med.unsw.edu.au//Movies/larsen/atrium.mov Atrial Septation] | [http://embryology.med.unsw.edu.au//Movies/larsen/avc.mov Realignment] | [http://embryology.med.unsw.edu.au//Movies/larsen/ventricl.mov Ventricular Septation] | [http://embryology.med.unsw.edu.au/Movies/heart.htm#HeartSeptation Heart Septation Models] | [http://embryology.med.unsw.edu.au/Movies/heart.htm#HistoricHeart Historic Heart Movie] |

* '''Placenta Notes''' [http://embryology.med.unsw.edu.au/Notes/placenta.htm Introduction] | [http://embryology.med.unsw.edu.au/Notes/placenta2.htm Abnormalities] | [http://embryology.med.unsw.edu.au/Notes/placenta3.htm Stage 13/14] | [http://embryology.med.unsw.edu.au/Notes/placenta4.htm Human (Stage22)] | [http://embryology.med.unsw.edu.au/Notes/placenta5.htm Histology] | [http://embryology.med.unsw.edu.au/Notes/placenta7.htm Villi Development] | [http://embryology.med.unsw.edu.au/Notes/placenta8.htm Maternal Decidua] | [http://embryology.med.unsw.edu.au/Notes/placenta6.htm Vascular Beds] | [http://embryology.med.unsw.edu.au/Notes/placenta11.htm Molecular] | [http://embryology.med.unsw.edu.au/Child/heart.htm Postnatal] | [http://embryology.med.unsw.edu.au/Notes/endocrine14.htm Endocrine Placenta]

* '''General Links''' [http://embryology.med.unsw.edu.au/sysnote.htm System Notes] | [http://embryology.med.unsw.edu.au/week/weekbyweek.htm Development Timeline]

==Internet links==

'''Embryo Images Unit:''' [http://www.med.unc.edu/embryo_images/ Embryo Images Online] Early Cell Populations (cardiogenic section) | [http://www.med.unc.edu/embryo_images/unit-cardev/cardev_htms/cardevtoc.htm Cardiovascular Development] | [http://www.med.unc.edu/embryo_images/unit-cardev/cardev_htms/cardev001.htm Week 3 Development] | [http://www.med.unc.edu/embryo_images/unit-cardev/cardev_htms/cardev007.htmhttp://www.med.unc.edu/embryo_images/unit-cardev/cardev_htms/cardev007.htm Week 4 Development] | [http://www.med.unc.edu/embryo_images/unit-cardev/cardev_htms/cardev018.htm Heart Chambers and Outflow Tract] | [http://www.med.unc.edu/embryo_images/unit-cardev/cardev_htms/cardev022.htm Atrioventricular Septation] | [http://www.med.unc.edu/embryo_images/unit-cardev/cardev_htms/cardev028.htm Outflow Tract Septation] | [http://www.med.unc.edu/embryo_images/unit-cardev/cardev_htms/cardev035.htm Ventricular Septation] | [http://www.med.unc.edu/embryo_images/unit-cardev/cardev_htms/cardev036.htm Atrial Septation] | [http://www.med.unc.edu/embryo_images/unit-cardev/cardev_htms/cardev040.htm Atrial Walls] [http://www.med.unc.edu/embryo_images/unit-cardev/cardev_htms/cardev041.htm Aortic Arch Vessels] | [http://www.med.unc.edu/embryo_images/unit-cardev/cardev_htms/cardev042.htm Changes at Birth]

{{Template:2009ANAT2341}}

[[Category:2009ANAT2341]]
[[Category:Science-Undergraduate]]
[[Category:Heart]]
[[Category:Cardiovascular]]

2010 Lecture 8

2010-08-18T04:19:09Z

Z3267024: /* Placental Blood vessels */

== Introduction ==
<div style="background:#F5FFFA; border: 1px solid #CEF2E0; padding: 1em; margin: auto; width: 90%; float:left;"><div style="margin:0;background-color:#cef2e0;font-family:sans-serif;font-size:120%;font-weight:bold;border:1px solid #a3bfb1;text-align:left;color:#000;padding-left:0.4em;padding-top:0.2em;padding-bottom:0.2em;"> Lecturer : Dr Nalini Pather </div></div>

[[File:Placental membranes.jpg|350px|left|fetal membranes and placenta]]

This lecture is an introduction to the development and functions of the placenta.

[[File:Week2_001 icon.jpg|90px|link=Development_Animation_-_Implantation]]

The placenta (Greek, ''plakuos'' = flat cake) named on the basis of this organs appearance. The placenta a mateno-fetal organ which begins developing at implantation of the blastocyst and is delivered with the fetus at birth. Only recently have we begun to understand the many different functions this organ carries out in addition to its role in embryonic nutrition. This lecture follows on the concepts of cardiovascular development covered in the previous lecture.

The placenta and placental blood at birth has recently been seen as a new source for stem cells in bone marrow replacement therapy in many diseases. (More? [http://embryology.med.unsw.edu.au/Notes/stemcell4.htm Stem Cells - Cord Blood])

* '''Lectopia Lecture Audio'''

== Lecture Objectives ==
[[File:Uterine and placental vasculature.jpg|thumb|Uterine and placental vasculature]]
* Understanding of placental villi development
* Understanding of placental structure
* Understanding of placental functions
* Brief understanding of placental abnormalities

==Textbook References==
* '''Human Embryology''' Larson Ch7 p151-188 Heart, Ch8 p189-228 Vasculature
* The Developing Human: Clinically Oriented Embryology (6th ed.) Moore and Persaud Ch14: p304-349

'''Other textbooks'''
* Before we Are Born (5th ed.) Moore and Persaud Ch12; p241-254
* Essentials of Human Embryology Larson Ch7 p97-122 Heart, Ch8 p123-146 Vasculature
* Human Embryology Fitzgerald and Fitzgerald Ch13-17: p77-111

==UNSW Embryology Links==

* '''Placenta Slides''' [http://embryology.med.unsw.edu.au/Science/ANAT2341lecture08.htm Placenta Lecture 8 2008] | [http://embryology.med.unsw.edu.au/pdf/ANAT2341L8Placentas1.pdf Placenta Lecture 2008 - 1 slide/page ] | [http://embryology.med.unsw.edu.au/pdf/ANAT2341L8Placentas4.pdf Placenta Lecture 2008 Slides - 4 slides/page] | [http://embryology.med.unsw.edu.au/pdf/ANAT2341L8Placentas6.pdf Placenta Lecture 2008 Slides - 6 slides/page]
* '''Placenta Movies''' [http://embryology.med.unsw.edu.au/Movies/heart.htm Heart Movies] | [http://embryology.med.unsw.edu.au//Movies/larsen/looping.mov Heart Looping] | [http://embryology.med.unsw.edu.au//Movies/larsen/atrium.mov Atrial Septation] | [http://embryology.med.unsw.edu.au//Movies/larsen/avc.mov Realignment] | [http://embryology.med.unsw.edu.au//Movies/larsen/ventricl.mov Ventricular Septation] | [http://embryology.med.unsw.edu.au/Movies/heart.htm#HeartSeptation Heart Septation Models] | [http://embryology.med.unsw.edu.au/Movies/heart.htm#HistoricHeart Historic Heart Movie] |

* '''Placenta Notes''' [http://embryology.med.unsw.edu.au/Notes/placenta.htm Introduction] | [http://embryology.med.unsw.edu.au/Notes/placenta2.htm Abnormalities] | [http://embryology.med.unsw.edu.au/Notes/placenta3.htm Stage 13/14] | [http://embryology.med.unsw.edu.au/Notes/placenta4.htm Human (Stage22)] | [http://embryology.med.unsw.edu.au/Notes/placenta5.htm Histology] | [http://embryology.med.unsw.edu.au/Notes/placenta7.htm Villi Development] | [http://embryology.med.unsw.edu.au/Notes/placenta8.htm Maternal Decidua] | [http://embryology.med.unsw.edu.au/Notes/placenta6.htm Vascular Beds] | [http://embryology.med.unsw.edu.au/Notes/placenta11.htm Molecular] | [http://embryology.med.unsw.edu.au/Child/heart.htm Postnatal] | [http://embryology.med.unsw.edu.au/Notes/endocrine14.htm Endocrine Placenta]

* [http://embryology.med.unsw.edu.au/sysnote.htm System Notes] | [http://embryology.med.unsw.edu.au/week/weekbyweek.htm Development Timeline]
* [http://vslide2.med.unsw.edu.au/fetal-membranes.html Virtual Microscopy fetal-membranes]

== Nutrition ==
[[File:Gray0032.gif|thumb|Early implantation]]
* [[H#histiotrophic nutrition|Histiotrophic nutrition]] describes early placental development and the form of intital transfer of nutrition from maternal to embryo.
* [[H#hemotrophic nutrition|Hemotrophic nutrition]] describes the later blood-borne nutrition.

==Fetal Membranes==
<gallery>
File:Gray0024.gif
File:Gray0025.gif
File:Gray0026.gif
File:Gray0027.gif
</gallery>

== Placenta at Birth ==
[[File:Gray0038.gif|thumb|Fetus in utero, between fifth and sixth months]]
[[File:Early placental structure.jpg|thumb|Early placental structure]]
* '''Placenta '''(Greek, ''plakuos'' = flat cake)
* embryonic/maternal organ
* villous chorion/decidua basalis
* continuous with amniotic and chorionic sacks
===Dimensions===
* at birth - discoid up to 20cm diameter and 3 cm thick (term) and weighs 500-600 gm
* Shapes - accessory placenta, bidiscoid, diffuse, horseshoe
* maternal and embryonic surface, both delivered at parturition
** retention may cause uterine hemorrhage

===Maternal Surface===
* Cotyledons - form cobblestone appearance, originally placental septa formed grooves
* covered with maternal decidua basalis
===Fetal Surface===
* umbilical cord attachment - cord 1-2 cm diameter, 30-90cm long
* covered with amniotic membrane and attached to chorionic plate
* umbilical vessels branch into chorionic vessels which anastomose
[http://www.embryology.ch/anglais/fplacenta/villosite01.html Placenta:fetal and maternal surfaces]

==Placental Classification==
Classification of placenta is on the basis of histological (microscopic) structural organization and layers between fetal and maternal circulation, giving 3 main groups:
* '''Haemochorial''' - placenta where the chorion comes in direct contact with maternal blood (human)
* '''Endotheliochorial''' - maternal endometrial blood vessels are bare to their endothelium and these comes in contact with the chorion. (dogs, cats)
* '''Epitheliochorial''' - maternal epithelium of the uterus comes in contact with the chorion.considered as primitive (pigs, cows)

The presence of these three differing types of placenta have also been used to describe the pattern mammalian evolution. See also Placental Layers

==Placental Types==
* Discoid in humans, mice, insectivores, rabbits, rats, and monkeys.
* Zonary in dogs, cats, bears and seals.
* Cotyledenary in cows, deer, goat, and giraffe.
* Diffuse in horses, pigs, camels, lemurs, opossums, kangaroos, and whales

==Chorionic Villi==
<gallery>
File:Gray0036.gif|Primary chorionic villi
File:Gray0037.gif|Secondary chorionic villi
File:Placenta anchoring villi.jpg|Placenta anchoring villi
</gallery>
* '''primary villi''' - week 2, first stage of chorionic villi development, trophoblastic shell cells (syncitiotrophoblasts and cytotrophoblasts) form finger-like extensions into maternal decidua.

* '''secondary villi''' - week 3, second stage of chorionic villi development, extraembryonic mesoderm grows into villi, covers entire surface of chorionic sac.

* '''tertiary villi''' third stage of chorionic villi development, mesenchyme differentiates into blood vessels and cells, forms arteriocapillary network, fuse with placental vessels, developing in connecting stalk

* '''stem villi''' - or anchoring villi, cytotrophoblast cells attached to maternal tissue.

* '''branched villi''' - or terminal villi, grow from sides of stem villi, region of main exchange, surrounded by maternal blood in intervillous spaces.

===Chorionoic Villi Location===
[[File:Gray0034.gif|thumb]]
* originally cover entire chorionic surface and become restricted to decidua basalis region forming 2 regions
* Frondosum - "leafy" where villi are mainly located
* Capsularis - smooth chorion, where villi are absent or not abundant

===Chorionoic Villi Trimester Development===
'''Trimester 1 and 2'''
* In the first two trimesters immature intermediate villi, developmental steps towards the stem villi.
'''Trimester 3'''
* Mature intermediate villi develop during the last trimester, produce numerous terminal villi.
* Terminal villi are not active outgrowths caused by proliferation of the trophoblast, but rather passive protrusions induced by capillary coiling due to excessive longitudinal growth of the fetal capillaries within the mature intermediate villi.
* The arrangement of the capillary bed in the terminal villi can vary from simple U-like loops to a richly branched network due to capillary elongation and sprouting.

(Data from [http://www.ncbi.nlm.nih.gov/pubmed/11045879 PMID: 2327595])

==Placental Function==
* 4 layers separate maternal and fetal blood: syncitiotrophoblast, cytotrophoblast, villi connective tissue and fetal capillary endothelium
* 3 main functions: metabolism, transport and endocrine

===Placental Metabolism===

Synthesizes: glycogen, cholesterol, fatty acids
* provides nutrient and energy

===Placental Transport===
[[File:Placenta oxygen exchange levels.jpg|right|200px]]
gases and nutrition
* oxygen, carbon dioxide, carbon monoxide
* water, glucose, vitamins
* hormones, mainly steroid not protein
* electrolytes
* maternal antibodies
* waste products - urea, uric acid, bilirubin
* drugs and their metabolites (fetal drug addiction)
* infectious agents (cytomegalovirus, rubella, measles, microorganisms)

===Placental Endocrine===
* Human chorionic gonadotrophin (hCG) - like leutenizing hormone, supports corpus luteum
* Human chorionic somatommotropin (hCS) (or placental lactogen) - hormone level increases in maternal blood through pregnancy, decreases maternal insulin sensitivity (raising maternal blood glucose levels and decreasing maternal glucose utilization) aiding fetal nutrition ("anti-insulin" function)
* Human chorionic thyrotropin (hCT) - Peptide placental hormone, similar to anterior pituitary released thyroid stimulating hormone (TSH), which along with human chorionic gonadotrophin (hCG) is thought to act on maternal thyroid. There is little recent research published on this hormone, its level and activities.
* Human chorionic corticotropin (hCACTH) - placental hormone thought to have corticotropin (ACTH)-like activity, increasing maternal cortisol levels.
* Steroid Hormones
** progestins - progesterone, support of the endometrium and suppress uterine smooth muscle contractility.
** estrogens - estriol, stimulate growth of the myometrium and mammary gland development.
** both hormones support maternal endometrium
* Relaxin - Humans high levels early in pregnancy than at birth promotes angiogenesis probably plays a role in development of the uterus/ placenta than in the birth process

==Placental Blood vessels==
[[File:Gray0039.gif|thumb|Scheme of placental circulation]]

* form initially in the connecting stalk (then umbilical cord) anastomose in chorioni
** extend maternally toward chorionic villi
** extend embryonically to the sinus venosus and dorsal aorta

Arteries - paired, carry deoxygenated blood (from dorsal aorta) and waste products to the placental villi

Veins - paired initially then only left at end of embryonic period, carry oxygenated blood to the embryo (sinus venosus) '''Parturition (Childbirth) Overview'''

== Fetal Placenta ==

Trophoblast cells are the major source of placental hormones.

'''Placental growth hormone''' (PGH) is mainly expressed in the syncytiotrophoblast cells (PGH differs from pituitary derived growth hormone by 13 amino acids). extravillous cytotrophoblast - arise from anchoring villi invade the uterine spiral arteries, generating fibrinoid material and endovascular trophoblastic cells. syncytiotrophoblast

'''Fetal Blood Vessels''' At least 2 phases of development during pregnancy driven by vascular endothelial growth factor (VEGF):

# Initially cytotrophoblasts are the cellular stimulus to vasculogenesis and angiogenesis.
# Later Hofbauer (lacental villi macrophages of mesenchymal origin) and stromal cells take over the stimulation of blood vessel development.

'''Placenta Human chorionic gonadotrophin''' (hCG) After implantation cells within the developing placenta (syncitiotrophoblasts) synthesize and secrete Human chorionic gonadotrophin (hCG) into the maternal bloodstream. The main function of serum hCG is to maintain the corpus luteum in the maternal ovary and therefore maintain the early pregnancy, that is block the menstrual cycle. Later the placenta itself supports the pregnancy.

== Maternal Placenta ==
[[File:Uterine and placental vasculature.jpg|thumb|Uterine and placental vasculature]]
[[File:Placenta spiral artery conversion.jpg|thumb|Placenta spiral artery conversion]]

'''Fibrinoid''' - said to exist as 2 forms of extracellular matrix:
# Fibrin-type fibrinoid is a maternal blood-clot product which replaces degenerative syncytiotrophoblast
# Matrix-type fibrinoid is secreted by invasive extravillous trophoblast cells.

Fibrinoid layer (Nitabuch's layer) is thought to act to prevent excessively deep implantation.

'''Decidualization''' - process of endometrial stromal cells (fibroblast-like) change in morphology (polygonal cells) and protein expression and secretion (specific decidual proteins: prolactin, insulin-like growth factor binding protein-1, tissue factor, interleukin-15, and VEGF).
# Estrogen and progesterone - receptive phase, luminal and glandular epithelial cells change in preparation for blastocyst adplantation.
# Human Chorionic gonadotropin - luminal epithelium endoreplication leading to epithelial plaque formation.
# Human Chorionic gonadotropin - trophoblast invasion and decidualization of human stromal fibroblasts.

'''Artery Dilatation''' - due to extravillous trophoblast cells invading uterine wall and maternal spiral arteries replacing both smooth muscle with fibrinoid material and part of vessel endothelium. There is also a proliferation of maternal blood vessels.

'''Other changes'''
* Endoreplication - rounds of nuclear DNA replication without intervening cell or nuclear division (mitosis).
* Cytokines - of maternal origin also act on placental development.
* Natural Killer (NK) cells - 30% of all the decidual cells towards the end of the first trimester of pregnancy. These lymphocytes are present in the maternal decidua in large numbers (70%, normal circulating blood lymphocytes 15%) close to the extravillous trophoblast cells. Have a cytolytic potential against virus-infected and tumor-transformed cells.

==Placental Abnormalities==
[[File:Placenta abnormalities.jpg|thumb|Placental abnormalities]]
[[File:Galletti1770_placenta previa.jpg|thumb|Historic model of placenta previa]]
[[File:Hydatidiform_mole.jpg|thumb|Hydatidiform mole pathology]]
* '''Placenta Accreta''' - abnormal adherence, with absence of decidua basalis. The incidence of placenta accreta also significantly increases in women with previous cesarean section compared to those without a prior surgical delivery.
* '''Placenta Increta''' - occurs when the placenta attaches deep into the uterine wall and penetrates into the uterine muscle, but does not penetrate the uterine serosa. Placenta increta accounts for approximately 15-17% of all cases.
* '''Placenta Percreta''' - placental villi penetrate myometrium and through to uterine serosa.
* '''Placenta Previa''' - In this placenatal abnormality, the placenta overlies internal os of uterus, essentially covering the birth canal. This condition occurs in approximately 1 in 200 to 250 pregnancies. In the third trimester and at term, abnormal bleeding can require cesarian delivery and can also lead to Abruptio Placenta. Ultrasound screening programs during 1st and early 2nd trimester pregnancies now include placental localization. Diagnosis can also be made by transvaginal ultrasound.
* '''Vasa Previa''' - (vasa praevia) placental abnormality where the fetal vessels lie within the membranes close too or crossing the inner cervical os (opening). This occurs normally in 1:2500-5000 pregnancies and leads to complications similar too those for Placenta Previa.Type II is defined as the condition where the fetal vessels are found crossing over the internal os connecting either a bilobed placenta or a succenturiate lobe with the main placental mass. Some recent evidence of successful in utero laser ablation of type II vasa previa at 22.5 weeks of gestation.
* '''Abruptio Placenta''' - a retroplacental blood clot formation, abnormal hemorrhage prior to delivery.
* '''Chronic Intervillositis''' - (massive chronicintervillositis, chronic histiocytic intervillositis) Rare placental abnormality and pathology defined by inflammatory placental lesions, mainly in the intervillous space (IVS), with a maternal infiltrate of mononuclear cells (monocytes, lymphocytes, histiocytes) and intervillous fibrinoid deposition.

* '''Hydatidiform mole''' - placental tumor with no embryo development. Several forms of hydatidiform mole: partial mole, complete mole and persistent gestational trophoblastic tumor. Many of these tumours arise from a haploid sperm fertilizing an egg without a female pronucleus (the alternative form, an embryo without sperm contribution, is called parthenogenesis). The tumour has a "grape-like" placental appearance without enclosed embryo formation. Following a first molar pregnancy, there is approximately a 1% risk of a second molar pregnancy.
'''Links:''' [http://embryology.med.unsw.edu.au/Notes/placenta2.htm Placental Abnormalities]

===Placental Cord Abnormalities===
[[File:Placental cord cross-section.jpg|thumb|Placental cord cross-section]]
There are few abnormalities associated with umbilical cord development, other that abnormally short or long cords, which in most cases do not cause difficulties. In some cases though, long cords can wrap around limbs or the fetus neck, which can then restrict blood flow or lead to tissue or nerve damage, and therefore effect develoment.

* '''Cord knotting''' - can also occur (1%) in most cases these knots have no effect, in some cases of severe knotting this can prevents the passage of placental blood.
* '''Cord torsion''' - Rare event where even without knot formation can also affect placental blood flow, even leading to fetal demise.

'''Links:''' [http://embryology.med.unsw.edu.au/Notes/placenta2.htm Placental Abnormalities] | [http://www-medlib.med.utah.edu/WebPath/PLACHTML/PLAC010.html WebPath - umbilical cord knot 1] | [http://www-medlib.med.utah.edu/WebPath/PLACHTML/PLAC028.html WebPath - umbilical cord knot 2] | [http://www-medlib.med.utah.edu/WebPath/PLACHTML/PLAC073.html WebPath - Pseudoknot of umbilical cord, gross] | [http://www-medlib.med.utah.edu/WebPath/PLACHTML/PLAC012.html WebPath - Torsion of umbilical cord, gross] | [http://www-medlib.med.utah.edu/WebPath/PLACHTML/PLAC011.html WebPath - Torsion of umbilical cord, with fetal demise, gross ]

===Placental Infections===
[[File:Malaria_plasmodium_falciparum.jpg‎|thumb|Malaria (plasmodium falciparum)]]
* Several infective agents may cross into the placenta from the maternal circulation, as well as enter the embry/fetal circulation. The variety of bacterial infections that can occur during pregnancy is as variable as the potential developmental effects, from virtually insignificant to a major developmental, abortive or fatal in outcome.
* Pregnant women have an increased susceptibility to malaria infection. Malarial infection of the placenta by sequestration of the infected red blood cells leading to low birth weight and other effects. There are four types of malaria caused by the protozoan parasite Plasmodium falciparum (main), Plasmodium vivax, Plasmodium ovale, Plasmodium malariae). This condition is common in regions where malaria is endemic with women carrying their first pregnancy (primigravida).

===Placental Pathology===
'''MH -''' content in this section is not examinable.
* Chronic Villitis - can occur following placental infection leading to maternal inflammation of the villous stroma, often with associated intervillositis. The inflammation can lead to disruption of blood flow and necrotic cell death.
* Massive Chronic Intervillositis (MCI) - maternal blood-filled space is filled with CD68-positive histiocytes and an increase in fibrin, occuring more commonly in the first trimester.
* Meconium Myonecrosis - prolonged meconium exposure leads to toxic death of myocytes of placental vessels (umbilical cord or chorionic plate).
* Neuroblastoma - a fetal malignancy that leads to an enlarged placenta, with tumor cells in the fetal circulation and rarely in the chorionic villi.
* Thrombophilias - (protein C or S deficiency, factor V Leiden, sickle cell disease, antiphospholipid antibody) can generate an increased fibrin/fibrinoid deposition in the maternal or intervillous space, this can trap and kill villi.

==Take the Quiz==
<quiz display=simple>

{The maternal endometrium response to trophoblast invasion is called the decidual reaction.
|type="()"}
+ true
- false
|| Yes, the endometrium becomes decisualised, deposits fibrinoid and also forms epithelial plaques.

{The human placenta is classified as :
|type="()"}
- Endotheliochorial
+ Haemochorial
- Epitheliochoria
- Mesoeliochorial
||Haemochorial - placenta where the chorion comes in direct contact with maternal blood (human)

{Stem villi - or terminal villi, are the region of main exchange, surrounded by maternal blood in intervillous spaces.
|type="()"}
- true
+ false
|| Stem villi - or anchoring villi, cytotrophoblast cells attached to maternal tissue.

{The 4 cellular layers separating maternal and fetal blood in sequence are:
|type="()"}
- spiral artery wall, Nichbaur layer, cytotrophoblast and Hofbaur layer
+ syncitiotrophoblast, cytotrophoblast, villi connective tissue and fetal capillary endothelium
- maternal lacuna, trophoblast layer, endothelial and fetal red blood cell
- fetal capillary endothelium, villi connective tissue, cytotrophoblast and syncitiotrophoblast
||Maternal and fetal blood normally do not mix and all exchange occurs across these cellular layers. Later in development the syncitiotrophoblast layer may not be continuous on the villi surface.

</quiz>

== References ==
===Textbooks===
* '''The Developing Human: Clinically Oriented Embryology''' (8th Edition) by Keith L. Moore and T.V.N Persaud
* '''Larsen’s Human Embryology''' by GC. Schoenwolf, SB. Bleyl, PR. Brauer and PH. Francis-West -

Additional Textbooks
* Before We Are Born (5th ed.) Moore and Persaud
* Essentials of Human Embryology
* Human Embryology Fitzgerald and Fitzgerald
* Human Embryology and Developmental Biology Carlson

===Online Textbooks===
* '''Developmental Biology''' by Gilbert, Scott F. Sunderland (MA): Sinauer Associates, Inc.; c2000 - [http://www.ncbi.nlm.nih.gov/books/bv.fcgi?&rid=dbio.figgrp.2627 Figure 11.30. Human embryo and placenta after 40 days of gestation] | [http://www.ncbi.nlm.nih.gov/books/bv.fcgi?&rid=dbio.figgrp.3736 Figure 15.11. Transfer of oxygen from the mother to the fetus in human embryos] | [http://www.ncbi.nlm.nih.gov/books/bv.fcgi?highlight=placenta&rid=dbio.section.2609#2626 Formation of extraembryonic membranes] | [http://www.ncbi.nlm.nih.gov/books/bv.fcgi?&rid=dbio.figgrp.3733 Figure 15.9. Circulatory system of the early avian embryo]

* '''Endocrinology: An Integrated Approach''' Nussey, S.S. and Whitehead, S.A. London:Taylor & Francis; c2001

===Search ===

* '''Bookshelf''' [http://www.ncbi.nlm.nih.gov/sites/entrez?db=Books&cmd=search&term=placenta placenta] | [http://www.ncbi.nlm.nih.gov/sites/entrez?db=Books&cmd=search&term=placental_villi_development placental villi development] |

* '''Pubmed''' [http://www.ncbi.nlm.nih.gov/sites/gquery?itool=toolbar&cmd=search&term=placenta_development placenta development] | [http://www.ncbi.nlm.nih.gov/sites/gquery?itool=toolbar&cmd=search&term=placenta placenta] | [http://www.ncbi.nlm.nih.gov/sites/gquery?itool=toolbar&cmd=search&term=placental_villi placental villi] |

===Reviews ===

* [http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=16085037&dopt=Abstract Vogel P.]    [http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Display&dopt=pubmed_pubmed&from_uid=16085037&tool=ExternalSearch [See Related Articles]] The current molecular phylogeny of Eutherian mammals challenges previous interpretations of placental evolution. Placenta. 2005 Sep-Oct;26(8-9):591-6.
* [http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=15837063&dopt=Abstract Cross JC.]    [http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Display&dopt=pubmed_pubmed&from_uid=15837063&tool=ExternalSearch [See Related Articles]] How to make a placenta: mechanisms of trophoblast cell differentiation in mice--a review. Placenta. 2005 Apr;26 Suppl A:S3-9.
* [http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=15963972&dopt=Abstract Simmons DG, Cross JC.]    [http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Display&dopt=pubmed_pubmed&from_uid=15963972&tool=ExternalSearch [See Related Articles]] Determinants of trophoblast lineage and cell subtype specification in the mouse placenta. Dev Biol. 2005 Aug 1;284(1):12-24.
* [http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=14619978&dopt=Abstract Rama S, Rao AJ.]    [http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Display&dopt=pubmed_pubmed&from_uid=14619978&tool=ExternalSearch [See Related Articles]] Regulation of growth and function of the human placenta. Mol Cell Biochem. 2003 Nov;253(1-2):263-8.
* [http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12914725&dopt=Abstract Evain-Brion D, Malassine A.]    [http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Display&dopt=pubmed_pubmed&from_uid=12914725&tool=ExternalSearch [See Related Articles]] Human placenta as an endocrine organ. Growth Horm IGF Res. 2003 Aug;13 Suppl A:S34-7.

== External Links ==

* [http://placentation.ucsd.edu/homefs.html Comparative Placentation]
* [http://courseweb.edteched.uottawa.ca/medicine-histology/English/Reproduction/Placenta/Default.htm University of Ottawa - Histology - Placenta]
* Virtual Microscopy Histology [http://vslide2.med.unsw.edu.au/fetal-membranes.html fetal-membranes] | [http://vslide2.med.unsw.edu.au/female-reproductive.html female reproductive]

== Placenta Terms ==
* '''after-birth''' - term used to describe the delivery of placenta and placental membranes following birth of the child.
* '''allantois''' - an endodermal diverticulum from the hindgut which extends from the superior end of the developing bladder into the adjacent placental cord.
* '''anastomose''' - term used to describe the connection between two tubes. Applied to describe the connection between peripheral blood vessels without an intervening capillary bed.
* '''angiogenesis''' development of new vessels from already existing vessels, this process is secondary to vasculogenesis which is the initial formation of first blood vessels by differentiation of pluripotent mesenchymal cells (extraembryonic mesoderm).
* '''angioblasts''' form clusters or blood islands on surface of yolk sac.
* '''capsularis'''
* '''chorionic sac''' fetal membrane that surrounds the developing embryo.
* '''cord knotting''' umbilical cord knotting occurs in 1%, prevents the passage of placental blood. pseudoknots also occur usually with no effect.
* '''cotyledons''' maternal side cobblestone appearance, originally placental septa formed grooves is covered with maternal decidua basalis.
* '''cytotrophoblast''' extraembryonic cells of trophoblastic shell surrounding embryo, contribute to villi and placental membranes.
* '''decidua basalis reaction '''occurs in maternal endometrium at site of, and following, blastocyst implantation. Seen as a deposition of glycogen and proliferation of blood vessels. (see also decidualization)
* '''decidualization''' process by which uterine stromal cells differentiate in response to both steroid hormones and embryonic signals into large epitheliod decidual cells. This process is essential for the progress of implantation and establishing fetal-maternal communication.
* '''endocrine''' function of placenta:
** Human chorionic gonadotrophin (hCG) like leutenizing hormone, supports corpus luteum
** Human chorionic somatommotropin (hCS) or placental lactogen, stimulate mammary development
** Human chorionic thyrotropin (hCT)
** Human chorionic corticotropin (hCACTH)
** progesterone and estrogens support maternal endometrium
** relaxin- role in parturition, softens ligaments
* '''fetal drug addiction''' occurs when drugs used maternally cross the placental barrier and can establish addiction in the unborn fetus.
* '''fetal erythroblastosis''' (Haemolytic Disease of the Newborn), an immune problem from fetus Rh+ /maternal Rh-, leakage from fetus causes anti-Rh antibodies, which is then dangerous for a 2nd child.
* '''frondosum-'''
* '''haemocytoblasts''' (hemangioblast) stem cells for embryonic blood cell formation, often appearing as a "cluster" or "island".
* '''Haemolytic Disease of the Newborn''' - see fetal erythroblastosis.
* '''hemotrophic nutrition''' - Term used to describe in late placental development the transfer of blood-borne nutrition from maternal to embryo/fetus compared to early [#histiotrophic_nutrition histiotrophic nutrition]. (More? Uterine glands provide histiotrophic nutrition for the human fetus during the first trimester of pregnancy. Burton GJ, Watson AL, Hempstock J, Skepper JN, Jauniaux E. J Clin Endocrinol Metab. 2002 Jun;87(6):2954-9. [http://www.ncbi.nlm.nih.gov/pubmed/12050279 PMID: 12050279] | [http://jcem.endojournals.org/cgi/content/full/87/6/2954 J Clin Endocrinol Metab.])
* '''histiotrophic nutrition''' - Term used to describe in early placental development the intital transfer of nutrition from maternal to embryo (histiotrophic nutrition) compared to later blood-borne nutrition ([#hemotrophic_nutrition hemotrophic nutrition]). Histotroph is the nutritional material accumulated in spaces between the maternal and fetal tissues, derived from the maternal endometrium and the uterine glands. This nutritional material is absorbed by phagocytosis initially by blastocyst trophectoderm and then by trophoblast of the placenta. in later placental development nutrition is by the exchange of blood-borne materials between the maternal and fetal circulations, hemotrophic nutrition. (More? Uterine glands provide histiotrophic nutrition for the human fetus during the first trimester of pregnancy. Burton GJ, Watson AL, Hempstock J, Skepper JN, Jauniaux E. J Clin Endocrinol Metab. 2002 Jun;87(6):2954-9. [http://www.ncbi.nlm.nih.gov/pubmed/12050279 PMID: 12050279] | [http://jcem.endojournals.org/cgi/content/full/87/6/2954 J Clin Endocrinol Metab.])
* '''Hofbauer cells''' - placental villi macrophages of mesenchymal origin with potentially additional functions (vasculogenesis/angiogenesis, villi remodeling, regulation of stromal water content) to their macrophage role.
* '''Human chorionic gonadotrophin-''' (hCG) like leutenizing hormone, supports corpus luteum
* '''Human chorionic somatommotropin '''- (hCS) or placental lactogen - hormone level increases in maternal blood through pregnancy, decreases maternal insulin sensitivity (raising maternal blood glucose levels and decreasing maternal glucose utilization) aiding fetal nutrition.
* '''Human chorionic thyrotropin-''' (hCT) placental derived hormone equivilant to thyroid
* '''Human chorionic corticotropin-''' (hCACTH) placental derived hormone equivilant to corticotropin (ACTH) from the pituitary.
* '''methyldopa''' - (alpha methyldopa) A central alpha agonist used to lower blood pressure. Used as an antihypertensive drug to lower blood pressure in pre-eclampsia, acting by either a direct or indirect central vasodilatory mechanism. A recent study suggests this drug may have a direct effect on placental and/or endothelial cell function in pre-eclampsia patients, altering angiogenic proteins. Drug commercial brandname (USA) "Aldomet", also available in combination with other drugs: methyldopa and chlorothiazide "Aldochlor", methyldopa and hydrochlorothiazide "Aldoril". (More? [http://embryology.med.unsw.edu.au/Notes/placenta2.htm#Pre-eclampsia Placenta Abnormalities - Pre-eclampsia] | [http://www.nlm.nih.gov/medlineplus/druginfo/meds/a682242.html Medline Plus - Methyldopa] | Effect of antihypertensive therapy with alpha methyldopa on levels of angiogenic factors in pregnancies with hypertensive disorders. Khalil A, Muttukrishna S, Harrington K, Jauniaux E. PLoS ONE. 2008 Jul 23;3(7):e2766. [http://www.ncbi.nlm.nih.gov/pubmed/18648513 PMID: 18648513])
* '''maternal antibodies-''' antibodies from the mother's immune system that are capable of crossing placental barrier. They can provide immune protection to the embryo, but may also participate in immune disease (fetal erythroblastosis).
* '''maternal sinusoids-''' placental spaces around chorionic villi that are filled with maternal blood. Closest maternal/fetal exchange site.
* '''Nitabuch's layer''' (fibrinoid layer) layer formed at maternal/fetal interface during placentation and is thought to act to prevent excessively deep conceptus implantation. Fibrin-type fibrinoid (maternal blood-clot product) and matrix-type fibrinoid (secreted by invasive extravillous trophoblast cells).
* '''placenta'''- (Gk. plakuos= flat cake) describes its typical mature discoid shape (20cm diameter and 3 cm thick at term,weighs 500-600 gm).
* '''placenta accreta-''' abnormal, adherence with absence of decidua basalis.
* '''placental arteries-''' paired, carry deoxygenated blood and waste from the embryo (dorsal aorta->internal iliacs->PA)
* '''placental blood'''- blood found within the placental vessels. Obviously part of the fetal blood, but can be collected at birth for theraputic use containing blood stem cells (see cord blood banks).
* '''placental blood vessels-''' form initially in the connecting stalk (then umbilical cord), anastomose in chorioni and extend maternally toward chorionic villi, extend embryonically to the sinus venosus and dorsal aorta.
* '''placental layers-''' 4 layers separate maternal and fetal blood: syncitiotrophoblast, cytotrophoblast, villi connective tissue, and fetal capillary endothelium.
* '''placenta percreta-''' abnormal, villi penetrate myometrium.
* '''placenta previa-''' placenta overlies internal os of uterus, abnormal bleeding, may require cesarian delivery.
* '''placental veins-''' paired initially then usually only one left at end of embryonic period, carry oxygenated blood to the embryo (sinus venosus)
* '''primary villi-''' develop week 2, consist of trophoblastic shell cells both syncitiotrophoblasts and cytotrophoblasts. Form finger-like extensions into the maternal endometrium.
* '''protein hormone-''' usually a protein distributed in the blood that binds to membrane receptors on target cells in different tissues. Do not easliy cross placental barrier.
* '''relaxin-''' hormone.
* '''secondary villi'''- develop week 3, extraembryonic mesoderm grows into villi, initially covers entire surface of chorionic sac.
* '''sinus venosus-''' cavity into which all major embryonic paired veins supply (vitelline, placental, cardinal)
* '''syncitiotrophoblast-''' extraembryonic cells of trophoblastic shell surrounding embryo, outside the cytotrophoblast layer, involved with implantation of the blastocyst by eroding extracellular matrix surrounding maternal endometrial cells at site of implantation, also contribute to villi. (dark staining, multinucleated)
* '''tertiary villi-''' develop week 4, mesenchyme within secondary villi differentiates into blood vessels and cells, forms arteriocapillary network, fuse with placental vessels developing in connecting stalk.
* '''trophoblast-'''
* '''umbilical cord-''' fetal attachment cord 1-2 cm diameter, 30-90cm long, covered with amniotic attached to chorionic plate, umbilical vessels (artery, vein) branch into chorionic vessels. Vessels anastomose within the placenta.
* '''vasculogenesis''' formation of first blood vessels by differentiation of pluripotent mesenchymal cells (extraembryonic mesoderm) followed by angiogenesis which is the development of new vessels from already existing vessels.
* '''villi-''' initially outgrowth of the trophoblastic shell which involve other tissues with development. Develop in sequence (primary, secondary, tertiary) with mature villi being stem por branched type.
* '''virus-''' small infectious agent able to cross placental barrier. Can infect embryo and cause developmental abnormalities. (e.g. cytomegalovirus, rubella, measles)
* '''vitelline- '''Blood vessels cover entire surface of yolk sac and connect to embryo through yolk stalk
** Arteries- arises from dorsal aorta and contribute to adult GIT arteries.
** Veins- empties into sinus venosus and contribute to the adult portal system.
* '''waste products''' products of cellular metabolism and cellular debris, e.g.- urea, uric acid, bilirubin
* '''Wharton's jelly''' placental cord (umbilical cord) gelatinous connective tissue composed of myofibroblast-like stromal cells, collagen fibers, and proteoglycans. Increases in volume (myxomatous, connective tissue embedded in mucus) at parturition to assist closure of placental blood vessels. Matrix cells from Wharton's jelly have recently been identified as a potential source of stem cells. This placental cord substance is named after Thomas Wharton (1614-1673) an English physician and anatomist who first described it.

{{Template:2009ANAT2341}}

[[Category:2009ANAT2341]] [[Category:Science-Undergraduate]] [[Category:Placenta]]

2010 Lecture 8

2010-08-18T04:12:47Z

Z3267024: /* Introduction */

== Introduction ==
<div style="background:#F5FFFA; border: 1px solid #CEF2E0; padding: 1em; margin: auto; width: 90%; float:left;"><div style="margin:0;background-color:#cef2e0;font-family:sans-serif;font-size:120%;font-weight:bold;border:1px solid #a3bfb1;text-align:left;color:#000;padding-left:0.4em;padding-top:0.2em;padding-bottom:0.2em;"> Lecturer : Dr Nalini Pather </div></div>

[[File:Placental membranes.jpg|350px|left|fetal membranes and placenta]]

This lecture is an introduction to the development and functions of the placenta.

[[File:Week2_001 icon.jpg|90px|link=Development_Animation_-_Implantation]]

The placenta (Greek, ''plakuos'' = flat cake) named on the basis of this organs appearance. The placenta a mateno-fetal organ which begins developing at implantation of the blastocyst and is delivered with the fetus at birth. Only recently have we begun to understand the many different functions this organ carries out in addition to its role in embryonic nutrition. This lecture follows on the concepts of cardiovascular development covered in the previous lecture.

The placenta and placental blood at birth has recently been seen as a new source for stem cells in bone marrow replacement therapy in many diseases. (More? [http://embryology.med.unsw.edu.au/Notes/stemcell4.htm Stem Cells - Cord Blood])

* '''Lectopia Lecture Audio'''

== Lecture Objectives ==
[[File:Uterine and placental vasculature.jpg|thumb|Uterine and placental vasculature]]
* Understanding of placental villi development
* Understanding of placental structure
* Understanding of placental functions
* Brief understanding of placental abnormalities

==Textbook References==
* '''Human Embryology''' Larson Ch7 p151-188 Heart, Ch8 p189-228 Vasculature
* The Developing Human: Clinically Oriented Embryology (6th ed.) Moore and Persaud Ch14: p304-349

'''Other textbooks'''
* Before we Are Born (5th ed.) Moore and Persaud Ch12; p241-254
* Essentials of Human Embryology Larson Ch7 p97-122 Heart, Ch8 p123-146 Vasculature
* Human Embryology Fitzgerald and Fitzgerald Ch13-17: p77-111

==UNSW Embryology Links==

* '''Placenta Slides''' [http://embryology.med.unsw.edu.au/Science/ANAT2341lecture08.htm Placenta Lecture 8 2008] | [http://embryology.med.unsw.edu.au/pdf/ANAT2341L8Placentas1.pdf Placenta Lecture 2008 - 1 slide/page ] | [http://embryology.med.unsw.edu.au/pdf/ANAT2341L8Placentas4.pdf Placenta Lecture 2008 Slides - 4 slides/page] | [http://embryology.med.unsw.edu.au/pdf/ANAT2341L8Placentas6.pdf Placenta Lecture 2008 Slides - 6 slides/page]
* '''Placenta Movies''' [http://embryology.med.unsw.edu.au/Movies/heart.htm Heart Movies] | [http://embryology.med.unsw.edu.au//Movies/larsen/looping.mov Heart Looping] | [http://embryology.med.unsw.edu.au//Movies/larsen/atrium.mov Atrial Septation] | [http://embryology.med.unsw.edu.au//Movies/larsen/avc.mov Realignment] | [http://embryology.med.unsw.edu.au//Movies/larsen/ventricl.mov Ventricular Septation] | [http://embryology.med.unsw.edu.au/Movies/heart.htm#HeartSeptation Heart Septation Models] | [http://embryology.med.unsw.edu.au/Movies/heart.htm#HistoricHeart Historic Heart Movie] |

* '''Placenta Notes''' [http://embryology.med.unsw.edu.au/Notes/placenta.htm Introduction] | [http://embryology.med.unsw.edu.au/Notes/placenta2.htm Abnormalities] | [http://embryology.med.unsw.edu.au/Notes/placenta3.htm Stage 13/14] | [http://embryology.med.unsw.edu.au/Notes/placenta4.htm Human (Stage22)] | [http://embryology.med.unsw.edu.au/Notes/placenta5.htm Histology] | [http://embryology.med.unsw.edu.au/Notes/placenta7.htm Villi Development] | [http://embryology.med.unsw.edu.au/Notes/placenta8.htm Maternal Decidua] | [http://embryology.med.unsw.edu.au/Notes/placenta6.htm Vascular Beds] | [http://embryology.med.unsw.edu.au/Notes/placenta11.htm Molecular] | [http://embryology.med.unsw.edu.au/Child/heart.htm Postnatal] | [http://embryology.med.unsw.edu.au/Notes/endocrine14.htm Endocrine Placenta]

* [http://embryology.med.unsw.edu.au/sysnote.htm System Notes] | [http://embryology.med.unsw.edu.au/week/weekbyweek.htm Development Timeline]
* [http://vslide2.med.unsw.edu.au/fetal-membranes.html Virtual Microscopy fetal-membranes]

== Nutrition ==
[[File:Gray0032.gif|thumb|Early implantation]]
* [[H#histiotrophic nutrition|Histiotrophic nutrition]] describes early placental development and the form of intital transfer of nutrition from maternal to embryo.
* [[H#hemotrophic nutrition|Hemotrophic nutrition]] describes the later blood-borne nutrition.

==Fetal Membranes==
<gallery>
File:Gray0024.gif
File:Gray0025.gif
File:Gray0026.gif
File:Gray0027.gif
</gallery>

== Placenta at Birth ==
[[File:Gray0038.gif|thumb|Fetus in utero, between fifth and sixth months]]
[[File:Early placental structure.jpg|thumb|Early placental structure]]
* '''Placenta '''(Greek, ''plakuos'' = flat cake)
* embryonic/maternal organ
* villous chorion/decidua basalis
* continuous with amniotic and chorionic sacks
===Dimensions===
* at birth - discoid up to 20cm diameter and 3 cm thick (term) and weighs 500-600 gm
* Shapes - accessory placenta, bidiscoid, diffuse, horseshoe
* maternal and embryonic surface, both delivered at parturition
** retention may cause uterine hemorrhage

===Maternal Surface===
* Cotyledons - form cobblestone appearance, originally placental septa formed grooves
* covered with maternal decidua basalis
===Fetal Surface===
* umbilical cord attachment - cord 1-2 cm diameter, 30-90cm long
* covered with amniotic membrane and attached to chorionic plate
* umbilical vessels branch into chorionic vessels which anastomose
[http://www.embryology.ch/anglais/fplacenta/villosite01.html Placenta:fetal and maternal surfaces]

==Placental Classification==
Classification of placenta is on the basis of histological (microscopic) structural organization and layers between fetal and maternal circulation, giving 3 main groups:
* '''Haemochorial''' - placenta where the chorion comes in direct contact with maternal blood (human)
* '''Endotheliochorial''' - maternal endometrial blood vessels are bare to their endothelium and these comes in contact with the chorion. (dogs, cats)
* '''Epitheliochorial''' - maternal epithelium of the uterus comes in contact with the chorion.considered as primitive (pigs, cows)

The presence of these three differing types of placenta have also been used to describe the pattern mammalian evolution. See also Placental Layers

==Placental Types==
* Discoid in humans, mice, insectivores, rabbits, rats, and monkeys.
* Zonary in dogs, cats, bears and seals.
* Cotyledenary in cows, deer, goat, and giraffe.
* Diffuse in horses, pigs, camels, lemurs, opossums, kangaroos, and whales

==Chorionic Villi==
<gallery>
File:Gray0036.gif|Primary chorionic villi
File:Gray0037.gif|Secondary chorionic villi
File:Placenta anchoring villi.jpg|Placenta anchoring villi
</gallery>
* '''primary villi''' - week 2, first stage of chorionic villi development, trophoblastic shell cells (syncitiotrophoblasts and cytotrophoblasts) form finger-like extensions into maternal decidua.

* '''secondary villi''' - week 3, second stage of chorionic villi development, extraembryonic mesoderm grows into villi, covers entire surface of chorionic sac.

* '''tertiary villi''' third stage of chorionic villi development, mesenchyme differentiates into blood vessels and cells, forms arteriocapillary network, fuse with placental vessels, developing in connecting stalk

* '''stem villi''' - or anchoring villi, cytotrophoblast cells attached to maternal tissue.

* '''branched villi''' - or terminal villi, grow from sides of stem villi, region of main exchange, surrounded by maternal blood in intervillous spaces.

===Chorionoic Villi Location===
[[File:Gray0034.gif|thumb]]
* originally cover entire chorionic surface and become restricted to decidua basalis region forming 2 regions
* Frondosum - "leafy" where villi are mainly located
* Capsularis - smooth chorion, where villi are absent or not abundant

===Chorionoic Villi Trimester Development===
'''Trimester 1 and 2'''
* In the first two trimesters immature intermediate villi, developmental steps towards the stem villi.
'''Trimester 3'''
* Mature intermediate villi develop during the last trimester, produce numerous terminal villi.
* Terminal villi are not active outgrowths caused by proliferation of the trophoblast, but rather passive protrusions induced by capillary coiling due to excessive longitudinal growth of the fetal capillaries within the mature intermediate villi.
* The arrangement of the capillary bed in the terminal villi can vary from simple U-like loops to a richly branched network due to capillary elongation and sprouting.

(Data from [http://www.ncbi.nlm.nih.gov/pubmed/11045879 PMID: 2327595])

==Placental Function==
* 4 layers separate maternal and fetal blood: syncitiotrophoblast, cytotrophoblast, villi connective tissue and fetal capillary endothelium
* 3 main functions: metabolism, transport and endocrine

===Placental Metabolism===

Synthesizes: glycogen, cholesterol, fatty acids
* provides nutrient and energy

===Placental Transport===
[[File:Placenta oxygen exchange levels.jpg|right|200px]]
gases and nutrition
* oxygen, carbon dioxide, carbon monoxide
* water, glucose, vitamins
* hormones, mainly steroid not protein
* electrolytes
* maternal antibodies
* waste products - urea, uric acid, bilirubin
* drugs and their metabolites (fetal drug addiction)
* infectious agents (cytomegalovirus, rubella, measles, microorganisms)

===Placental Endocrine===
* Human chorionic gonadotrophin (hCG) - like leutenizing hormone, supports corpus luteum
* Human chorionic somatommotropin (hCS) (or placental lactogen) - hormone level increases in maternal blood through pregnancy, decreases maternal insulin sensitivity (raising maternal blood glucose levels and decreasing maternal glucose utilization) aiding fetal nutrition ("anti-insulin" function)
* Human chorionic thyrotropin (hCT) - Peptide placental hormone, similar to anterior pituitary released thyroid stimulating hormone (TSH), which along with human chorionic gonadotrophin (hCG) is thought to act on maternal thyroid. There is little recent research published on this hormone, its level and activities.
* Human chorionic corticotropin (hCACTH) - placental hormone thought to have corticotropin (ACTH)-like activity, increasing maternal cortisol levels.
* Steroid Hormones
** progestins - progesterone, support of the endometrium and suppress uterine smooth muscle contractility.
** estrogens - estriol, stimulate growth of the myometrium and mammary gland development.
** both hormones support maternal endometrium
* Relaxin - Humans high levels early in pregnancy than at birth promotes angiogenesis probably plays a role in development of the uterus/ placenta than in the birth process

==Placental Blood vessels==
[[File:Gray0039.gif|thumb|Scheme of placental circulation]]
[[File:Placenta spiral artery conversion.jpg|thumb]]
* form initially in the connecting stalk (then umbilical cord) anastomose in chorioni
** extend maternally toward chorionic villi
** extend embryonically to the sinus venosus and dorsal aorta

Arteries - paired, carry deoxygenated blood (from dorsal aorta) and waste products to the placental villi

Veins - paired initially then only left at end of embryonic period, carry oxygenated blood to the embryo (sinus venosus) '''Parturition (Childbirth) Overview'''

== Fetal Placenta ==

Trophoblast cells are the major source of placental hormones.

'''Placental growth hormone''' (PGH) is mainly expressed in the syncytiotrophoblast cells (PGH differs from pituitary derived growth hormone by 13 amino acids). extravillous cytotrophoblast - arise from anchoring villi invade the uterine spiral arteries, generating fibrinoid material and endovascular trophoblastic cells. syncytiotrophoblast

'''Fetal Blood Vessels''' At least 2 phases of development during pregnancy driven by vascular endothelial growth factor (VEGF):

# Initially cytotrophoblasts are the cellular stimulus to vasculogenesis and angiogenesis.
# Later Hofbauer (lacental villi macrophages of mesenchymal origin) and stromal cells take over the stimulation of blood vessel development.

'''Placenta Human chorionic gonadotrophin''' (hCG) After implantation cells within the developing placenta (syncitiotrophoblasts) synthesize and secrete Human chorionic gonadotrophin (hCG) into the maternal bloodstream. The main function of serum hCG is to maintain the corpus luteum in the maternal ovary and therefore maintain the early pregnancy, that is block the menstrual cycle. Later the placenta itself supports the pregnancy.

== Maternal Placenta ==
[[File:Uterine and placental vasculature.jpg|thumb|Uterine and placental vasculature]]
[[File:Placenta spiral artery conversion.jpg|thumb|Placenta spiral artery conversion]]

'''Fibrinoid''' - said to exist as 2 forms of extracellular matrix:
# Fibrin-type fibrinoid is a maternal blood-clot product which replaces degenerative syncytiotrophoblast
# Matrix-type fibrinoid is secreted by invasive extravillous trophoblast cells.

Fibrinoid layer (Nitabuch's layer) is thought to act to prevent excessively deep implantation.

'''Decidualization''' - process of endometrial stromal cells (fibroblast-like) change in morphology (polygonal cells) and protein expression and secretion (specific decidual proteins: prolactin, insulin-like growth factor binding protein-1, tissue factor, interleukin-15, and VEGF).
# Estrogen and progesterone - receptive phase, luminal and glandular epithelial cells change in preparation for blastocyst adplantation.
# Human Chorionic gonadotropin - luminal epithelium endoreplication leading to epithelial plaque formation.
# Human Chorionic gonadotropin - trophoblast invasion and decidualization of human stromal fibroblasts.

'''Artery Dilatation''' - due to extravillous trophoblast cells invading uterine wall and maternal spiral arteries replacing both smooth muscle with fibrinoid material and part of vessel endothelium. There is also a proliferation of maternal blood vessels.

'''Other changes'''
* Endoreplication - rounds of nuclear DNA replication without intervening cell or nuclear division (mitosis).
* Cytokines - of maternal origin also act on placental development.
* Natural Killer (NK) cells - 30% of all the decidual cells towards the end of the first trimester of pregnancy. These lymphocytes are present in the maternal decidua in large numbers (70%, normal circulating blood lymphocytes 15%) close to the extravillous trophoblast cells. Have a cytolytic potential against virus-infected and tumor-transformed cells.

==Placental Abnormalities==
[[File:Placenta abnormalities.jpg|thumb|Placental abnormalities]]
[[File:Galletti1770_placenta previa.jpg|thumb|Historic model of placenta previa]]
[[File:Hydatidiform_mole.jpg|thumb|Hydatidiform mole pathology]]
* '''Placenta Accreta''' - abnormal adherence, with absence of decidua basalis. The incidence of placenta accreta also significantly increases in women with previous cesarean section compared to those without a prior surgical delivery.
* '''Placenta Increta''' - occurs when the placenta attaches deep into the uterine wall and penetrates into the uterine muscle, but does not penetrate the uterine serosa. Placenta increta accounts for approximately 15-17% of all cases.
* '''Placenta Percreta''' - placental villi penetrate myometrium and through to uterine serosa.
* '''Placenta Previa''' - In this placenatal abnormality, the placenta overlies internal os of uterus, essentially covering the birth canal. This condition occurs in approximately 1 in 200 to 250 pregnancies. In the third trimester and at term, abnormal bleeding can require cesarian delivery and can also lead to Abruptio Placenta. Ultrasound screening programs during 1st and early 2nd trimester pregnancies now include placental localization. Diagnosis can also be made by transvaginal ultrasound.
* '''Vasa Previa''' - (vasa praevia) placental abnormality where the fetal vessels lie within the membranes close too or crossing the inner cervical os (opening). This occurs normally in 1:2500-5000 pregnancies and leads to complications similar too those for Placenta Previa.Type II is defined as the condition where the fetal vessels are found crossing over the internal os connecting either a bilobed placenta or a succenturiate lobe with the main placental mass. Some recent evidence of successful in utero laser ablation of type II vasa previa at 22.5 weeks of gestation.
* '''Abruptio Placenta''' - a retroplacental blood clot formation, abnormal hemorrhage prior to delivery.
* '''Chronic Intervillositis''' - (massive chronicintervillositis, chronic histiocytic intervillositis) Rare placental abnormality and pathology defined by inflammatory placental lesions, mainly in the intervillous space (IVS), with a maternal infiltrate of mononuclear cells (monocytes, lymphocytes, histiocytes) and intervillous fibrinoid deposition.

* '''Hydatidiform mole''' - placental tumor with no embryo development. Several forms of hydatidiform mole: partial mole, complete mole and persistent gestational trophoblastic tumor. Many of these tumours arise from a haploid sperm fertilizing an egg without a female pronucleus (the alternative form, an embryo without sperm contribution, is called parthenogenesis). The tumour has a "grape-like" placental appearance without enclosed embryo formation. Following a first molar pregnancy, there is approximately a 1% risk of a second molar pregnancy.
'''Links:''' [http://embryology.med.unsw.edu.au/Notes/placenta2.htm Placental Abnormalities]

===Placental Cord Abnormalities===
[[File:Placental cord cross-section.jpg|thumb|Placental cord cross-section]]
There are few abnormalities associated with umbilical cord development, other that abnormally short or long cords, which in most cases do not cause difficulties. In some cases though, long cords can wrap around limbs or the fetus neck, which can then restrict blood flow or lead to tissue or nerve damage, and therefore effect develoment.

* '''Cord knotting''' - can also occur (1%) in most cases these knots have no effect, in some cases of severe knotting this can prevents the passage of placental blood.
* '''Cord torsion''' - Rare event where even without knot formation can also affect placental blood flow, even leading to fetal demise.

'''Links:''' [http://embryology.med.unsw.edu.au/Notes/placenta2.htm Placental Abnormalities] | [http://www-medlib.med.utah.edu/WebPath/PLACHTML/PLAC010.html WebPath - umbilical cord knot 1] | [http://www-medlib.med.utah.edu/WebPath/PLACHTML/PLAC028.html WebPath - umbilical cord knot 2] | [http://www-medlib.med.utah.edu/WebPath/PLACHTML/PLAC073.html WebPath - Pseudoknot of umbilical cord, gross] | [http://www-medlib.med.utah.edu/WebPath/PLACHTML/PLAC012.html WebPath - Torsion of umbilical cord, gross] | [http://www-medlib.med.utah.edu/WebPath/PLACHTML/PLAC011.html WebPath - Torsion of umbilical cord, with fetal demise, gross ]

===Placental Infections===
[[File:Malaria_plasmodium_falciparum.jpg‎|thumb|Malaria (plasmodium falciparum)]]
* Several infective agents may cross into the placenta from the maternal circulation, as well as enter the embry/fetal circulation. The variety of bacterial infections that can occur during pregnancy is as variable as the potential developmental effects, from virtually insignificant to a major developmental, abortive or fatal in outcome.
* Pregnant women have an increased susceptibility to malaria infection. Malarial infection of the placenta by sequestration of the infected red blood cells leading to low birth weight and other effects. There are four types of malaria caused by the protozoan parasite Plasmodium falciparum (main), Plasmodium vivax, Plasmodium ovale, Plasmodium malariae). This condition is common in regions where malaria is endemic with women carrying their first pregnancy (primigravida).

===Placental Pathology===
'''MH -''' content in this section is not examinable.
* Chronic Villitis - can occur following placental infection leading to maternal inflammation of the villous stroma, often with associated intervillositis. The inflammation can lead to disruption of blood flow and necrotic cell death.
* Massive Chronic Intervillositis (MCI) - maternal blood-filled space is filled with CD68-positive histiocytes and an increase in fibrin, occuring more commonly in the first trimester.
* Meconium Myonecrosis - prolonged meconium exposure leads to toxic death of myocytes of placental vessels (umbilical cord or chorionic plate).
* Neuroblastoma - a fetal malignancy that leads to an enlarged placenta, with tumor cells in the fetal circulation and rarely in the chorionic villi.
* Thrombophilias - (protein C or S deficiency, factor V Leiden, sickle cell disease, antiphospholipid antibody) can generate an increased fibrin/fibrinoid deposition in the maternal or intervillous space, this can trap and kill villi.

==Take the Quiz==
<quiz display=simple>

{The maternal endometrium response to trophoblast invasion is called the decidual reaction.
|type="()"}
+ true
- false
|| Yes, the endometrium becomes decisualised, deposits fibrinoid and also forms epithelial plaques.

{The human placenta is classified as :
|type="()"}
- Endotheliochorial
+ Haemochorial
- Epitheliochoria
- Mesoeliochorial
||Haemochorial - placenta where the chorion comes in direct contact with maternal blood (human)

{Stem villi - or terminal villi, are the region of main exchange, surrounded by maternal blood in intervillous spaces.
|type="()"}
- true
+ false
|| Stem villi - or anchoring villi, cytotrophoblast cells attached to maternal tissue.

{The 4 cellular layers separating maternal and fetal blood in sequence are:
|type="()"}
- spiral artery wall, Nichbaur layer, cytotrophoblast and Hofbaur layer
+ syncitiotrophoblast, cytotrophoblast, villi connective tissue and fetal capillary endothelium
- maternal lacuna, trophoblast layer, endothelial and fetal red blood cell
- fetal capillary endothelium, villi connective tissue, cytotrophoblast and syncitiotrophoblast
||Maternal and fetal blood normally do not mix and all exchange occurs across these cellular layers. Later in development the syncitiotrophoblast layer may not be continuous on the villi surface.

</quiz>

== References ==
===Textbooks===
* '''The Developing Human: Clinically Oriented Embryology''' (8th Edition) by Keith L. Moore and T.V.N Persaud
* '''Larsen’s Human Embryology''' by GC. Schoenwolf, SB. Bleyl, PR. Brauer and PH. Francis-West -

Additional Textbooks
* Before We Are Born (5th ed.) Moore and Persaud
* Essentials of Human Embryology
* Human Embryology Fitzgerald and Fitzgerald
* Human Embryology and Developmental Biology Carlson

===Online Textbooks===
* '''Developmental Biology''' by Gilbert, Scott F. Sunderland (MA): Sinauer Associates, Inc.; c2000 - [http://www.ncbi.nlm.nih.gov/books/bv.fcgi?&rid=dbio.figgrp.2627 Figure 11.30. Human embryo and placenta after 40 days of gestation] | [http://www.ncbi.nlm.nih.gov/books/bv.fcgi?&rid=dbio.figgrp.3736 Figure 15.11. Transfer of oxygen from the mother to the fetus in human embryos] | [http://www.ncbi.nlm.nih.gov/books/bv.fcgi?highlight=placenta&rid=dbio.section.2609#2626 Formation of extraembryonic membranes] | [http://www.ncbi.nlm.nih.gov/books/bv.fcgi?&rid=dbio.figgrp.3733 Figure 15.9. Circulatory system of the early avian embryo]

* '''Endocrinology: An Integrated Approach''' Nussey, S.S. and Whitehead, S.A. London:Taylor & Francis; c2001

===Search ===

* '''Bookshelf''' [http://www.ncbi.nlm.nih.gov/sites/entrez?db=Books&cmd=search&term=placenta placenta] | [http://www.ncbi.nlm.nih.gov/sites/entrez?db=Books&cmd=search&term=placental_villi_development placental villi development] |

* '''Pubmed''' [http://www.ncbi.nlm.nih.gov/sites/gquery?itool=toolbar&cmd=search&term=placenta_development placenta development] | [http://www.ncbi.nlm.nih.gov/sites/gquery?itool=toolbar&cmd=search&term=placenta placenta] | [http://www.ncbi.nlm.nih.gov/sites/gquery?itool=toolbar&cmd=search&term=placental_villi placental villi] |

===Reviews ===

* [http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=16085037&dopt=Abstract Vogel P.]    [http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Display&dopt=pubmed_pubmed&from_uid=16085037&tool=ExternalSearch [See Related Articles]] The current molecular phylogeny of Eutherian mammals challenges previous interpretations of placental evolution. Placenta. 2005 Sep-Oct;26(8-9):591-6.
* [http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=15837063&dopt=Abstract Cross JC.]    [http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Display&dopt=pubmed_pubmed&from_uid=15837063&tool=ExternalSearch [See Related Articles]] How to make a placenta: mechanisms of trophoblast cell differentiation in mice--a review. Placenta. 2005 Apr;26 Suppl A:S3-9.
* [http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=15963972&dopt=Abstract Simmons DG, Cross JC.]    [http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Display&dopt=pubmed_pubmed&from_uid=15963972&tool=ExternalSearch [See Related Articles]] Determinants of trophoblast lineage and cell subtype specification in the mouse placenta. Dev Biol. 2005 Aug 1;284(1):12-24.
* [http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=14619978&dopt=Abstract Rama S, Rao AJ.]    [http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Display&dopt=pubmed_pubmed&from_uid=14619978&tool=ExternalSearch [See Related Articles]] Regulation of growth and function of the human placenta. Mol Cell Biochem. 2003 Nov;253(1-2):263-8.
* [http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12914725&dopt=Abstract Evain-Brion D, Malassine A.]    [http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Display&dopt=pubmed_pubmed&from_uid=12914725&tool=ExternalSearch [See Related Articles]] Human placenta as an endocrine organ. Growth Horm IGF Res. 2003 Aug;13 Suppl A:S34-7.

== External Links ==

* [http://placentation.ucsd.edu/homefs.html Comparative Placentation]
* [http://courseweb.edteched.uottawa.ca/medicine-histology/English/Reproduction/Placenta/Default.htm University of Ottawa - Histology - Placenta]
* Virtual Microscopy Histology [http://vslide2.med.unsw.edu.au/fetal-membranes.html fetal-membranes] | [http://vslide2.med.unsw.edu.au/female-reproductive.html female reproductive]

== Placenta Terms ==
* '''after-birth''' - term used to describe the delivery of placenta and placental membranes following birth of the child.
* '''allantois''' - an endodermal diverticulum from the hindgut which extends from the superior end of the developing bladder into the adjacent placental cord.
* '''anastomose''' - term used to describe the connection between two tubes. Applied to describe the connection between peripheral blood vessels without an intervening capillary bed.
* '''angiogenesis''' development of new vessels from already existing vessels, this process is secondary to vasculogenesis which is the initial formation of first blood vessels by differentiation of pluripotent mesenchymal cells (extraembryonic mesoderm).
* '''angioblasts''' form clusters or blood islands on surface of yolk sac.
* '''capsularis'''
* '''chorionic sac''' fetal membrane that surrounds the developing embryo.
* '''cord knotting''' umbilical cord knotting occurs in 1%, prevents the passage of placental blood. pseudoknots also occur usually with no effect.
* '''cotyledons''' maternal side cobblestone appearance, originally placental septa formed grooves is covered with maternal decidua basalis.
* '''cytotrophoblast''' extraembryonic cells of trophoblastic shell surrounding embryo, contribute to villi and placental membranes.
* '''decidua basalis reaction '''occurs in maternal endometrium at site of, and following, blastocyst implantation. Seen as a deposition of glycogen and proliferation of blood vessels. (see also decidualization)
* '''decidualization''' process by which uterine stromal cells differentiate in response to both steroid hormones and embryonic signals into large epitheliod decidual cells. This process is essential for the progress of implantation and establishing fetal-maternal communication.
* '''endocrine''' function of placenta:
** Human chorionic gonadotrophin (hCG) like leutenizing hormone, supports corpus luteum
** Human chorionic somatommotropin (hCS) or placental lactogen, stimulate mammary development
** Human chorionic thyrotropin (hCT)
** Human chorionic corticotropin (hCACTH)
** progesterone and estrogens support maternal endometrium
** relaxin- role in parturition, softens ligaments
* '''fetal drug addiction''' occurs when drugs used maternally cross the placental barrier and can establish addiction in the unborn fetus.
* '''fetal erythroblastosis''' (Haemolytic Disease of the Newborn), an immune problem from fetus Rh+ /maternal Rh-, leakage from fetus causes anti-Rh antibodies, which is then dangerous for a 2nd child.
* '''frondosum-'''
* '''haemocytoblasts''' (hemangioblast) stem cells for embryonic blood cell formation, often appearing as a "cluster" or "island".
* '''Haemolytic Disease of the Newborn''' - see fetal erythroblastosis.
* '''hemotrophic nutrition''' - Term used to describe in late placental development the transfer of blood-borne nutrition from maternal to embryo/fetus compared to early [#histiotrophic_nutrition histiotrophic nutrition]. (More? Uterine glands provide histiotrophic nutrition for the human fetus during the first trimester of pregnancy. Burton GJ, Watson AL, Hempstock J, Skepper JN, Jauniaux E. J Clin Endocrinol Metab. 2002 Jun;87(6):2954-9. [http://www.ncbi.nlm.nih.gov/pubmed/12050279 PMID: 12050279] | [http://jcem.endojournals.org/cgi/content/full/87/6/2954 J Clin Endocrinol Metab.])
* '''histiotrophic nutrition''' - Term used to describe in early placental development the intital transfer of nutrition from maternal to embryo (histiotrophic nutrition) compared to later blood-borne nutrition ([#hemotrophic_nutrition hemotrophic nutrition]). Histotroph is the nutritional material accumulated in spaces between the maternal and fetal tissues, derived from the maternal endometrium and the uterine glands. This nutritional material is absorbed by phagocytosis initially by blastocyst trophectoderm and then by trophoblast of the placenta. in later placental development nutrition is by the exchange of blood-borne materials between the maternal and fetal circulations, hemotrophic nutrition. (More? Uterine glands provide histiotrophic nutrition for the human fetus during the first trimester of pregnancy. Burton GJ, Watson AL, Hempstock J, Skepper JN, Jauniaux E. J Clin Endocrinol Metab. 2002 Jun;87(6):2954-9. [http://www.ncbi.nlm.nih.gov/pubmed/12050279 PMID: 12050279] | [http://jcem.endojournals.org/cgi/content/full/87/6/2954 J Clin Endocrinol Metab.])
* '''Hofbauer cells''' - placental villi macrophages of mesenchymal origin with potentially additional functions (vasculogenesis/angiogenesis, villi remodeling, regulation of stromal water content) to their macrophage role.
* '''Human chorionic gonadotrophin-''' (hCG) like leutenizing hormone, supports corpus luteum
* '''Human chorionic somatommotropin '''- (hCS) or placental lactogen - hormone level increases in maternal blood through pregnancy, decreases maternal insulin sensitivity (raising maternal blood glucose levels and decreasing maternal glucose utilization) aiding fetal nutrition.
* '''Human chorionic thyrotropin-''' (hCT) placental derived hormone equivilant to thyroid
* '''Human chorionic corticotropin-''' (hCACTH) placental derived hormone equivilant to corticotropin (ACTH) from the pituitary.
* '''methyldopa''' - (alpha methyldopa) A central alpha agonist used to lower blood pressure. Used as an antihypertensive drug to lower blood pressure in pre-eclampsia, acting by either a direct or indirect central vasodilatory mechanism. A recent study suggests this drug may have a direct effect on placental and/or endothelial cell function in pre-eclampsia patients, altering angiogenic proteins. Drug commercial brandname (USA) "Aldomet", also available in combination with other drugs: methyldopa and chlorothiazide "Aldochlor", methyldopa and hydrochlorothiazide "Aldoril". (More? [http://embryology.med.unsw.edu.au/Notes/placenta2.htm#Pre-eclampsia Placenta Abnormalities - Pre-eclampsia] | [http://www.nlm.nih.gov/medlineplus/druginfo/meds/a682242.html Medline Plus - Methyldopa] | Effect of antihypertensive therapy with alpha methyldopa on levels of angiogenic factors in pregnancies with hypertensive disorders. Khalil A, Muttukrishna S, Harrington K, Jauniaux E. PLoS ONE. 2008 Jul 23;3(7):e2766. [http://www.ncbi.nlm.nih.gov/pubmed/18648513 PMID: 18648513])
* '''maternal antibodies-''' antibodies from the mother's immune system that are capable of crossing placental barrier. They can provide immune protection to the embryo, but may also participate in immune disease (fetal erythroblastosis).
* '''maternal sinusoids-''' placental spaces around chorionic villi that are filled with maternal blood. Closest maternal/fetal exchange site.
* '''Nitabuch's layer''' (fibrinoid layer) layer formed at maternal/fetal interface during placentation and is thought to act to prevent excessively deep conceptus implantation. Fibrin-type fibrinoid (maternal blood-clot product) and matrix-type fibrinoid (secreted by invasive extravillous trophoblast cells).
* '''placenta'''- (Gk. plakuos= flat cake) describes its typical mature discoid shape (20cm diameter and 3 cm thick at term,weighs 500-600 gm).
* '''placenta accreta-''' abnormal, adherence with absence of decidua basalis.
* '''placental arteries-''' paired, carry deoxygenated blood and waste from the embryo (dorsal aorta->internal iliacs->PA)
* '''placental blood'''- blood found within the placental vessels. Obviously part of the fetal blood, but can be collected at birth for theraputic use containing blood stem cells (see cord blood banks).
* '''placental blood vessels-''' form initially in the connecting stalk (then umbilical cord), anastomose in chorioni and extend maternally toward chorionic villi, extend embryonically to the sinus venosus and dorsal aorta.
* '''placental layers-''' 4 layers separate maternal and fetal blood: syncitiotrophoblast, cytotrophoblast, villi connective tissue, and fetal capillary endothelium.
* '''placenta percreta-''' abnormal, villi penetrate myometrium.
* '''placenta previa-''' placenta overlies internal os of uterus, abnormal bleeding, may require cesarian delivery.
* '''placental veins-''' paired initially then usually only one left at end of embryonic period, carry oxygenated blood to the embryo (sinus venosus)
* '''primary villi-''' develop week 2, consist of trophoblastic shell cells both syncitiotrophoblasts and cytotrophoblasts. Form finger-like extensions into the maternal endometrium.
* '''protein hormone-''' usually a protein distributed in the blood that binds to membrane receptors on target cells in different tissues. Do not easliy cross placental barrier.
* '''relaxin-''' hormone.
* '''secondary villi'''- develop week 3, extraembryonic mesoderm grows into villi, initially covers entire surface of chorionic sac.
* '''sinus venosus-''' cavity into which all major embryonic paired veins supply (vitelline, placental, cardinal)
* '''syncitiotrophoblast-''' extraembryonic cells of trophoblastic shell surrounding embryo, outside the cytotrophoblast layer, involved with implantation of the blastocyst by eroding extracellular matrix surrounding maternal endometrial cells at site of implantation, also contribute to villi. (dark staining, multinucleated)
* '''tertiary villi-''' develop week 4, mesenchyme within secondary villi differentiates into blood vessels and cells, forms arteriocapillary network, fuse with placental vessels developing in connecting stalk.
* '''trophoblast-'''
* '''umbilical cord-''' fetal attachment cord 1-2 cm diameter, 30-90cm long, covered with amniotic attached to chorionic plate, umbilical vessels (artery, vein) branch into chorionic vessels. Vessels anastomose within the placenta.
* '''vasculogenesis''' formation of first blood vessels by differentiation of pluripotent mesenchymal cells (extraembryonic mesoderm) followed by angiogenesis which is the development of new vessels from already existing vessels.
* '''villi-''' initially outgrowth of the trophoblastic shell which involve other tissues with development. Develop in sequence (primary, secondary, tertiary) with mature villi being stem por branched type.
* '''virus-''' small infectious agent able to cross placental barrier. Can infect embryo and cause developmental abnormalities. (e.g. cytomegalovirus, rubella, measles)
* '''vitelline- '''Blood vessels cover entire surface of yolk sac and connect to embryo through yolk stalk
** Arteries- arises from dorsal aorta and contribute to adult GIT arteries.
** Veins- empties into sinus venosus and contribute to the adult portal system.
* '''waste products''' products of cellular metabolism and cellular debris, e.g.- urea, uric acid, bilirubin
* '''Wharton's jelly''' placental cord (umbilical cord) gelatinous connective tissue composed of myofibroblast-like stromal cells, collagen fibers, and proteoglycans. Increases in volume (myxomatous, connective tissue embedded in mucus) at parturition to assist closure of placental blood vessels. Matrix cells from Wharton's jelly have recently been identified as a potential source of stem cells. This placental cord substance is named after Thomas Wharton (1614-1673) an English physician and anatomist who first described it.

{{Template:2009ANAT2341}}

[[Category:2009ANAT2341]] [[Category:Science-Undergraduate]] [[Category:Placenta]]

2010 Lab 4

2010-08-18T04:11:06Z

Z3267024: /* Introduction */

=Cardiovascular and Placenta=

== Introduction ==
[[Image:Embryonic Circulations.jpg|thumb|right|Three components of early circulation]]

The vascular system of the embryo is formed from blood islands that appear in the extraembryonic mesoderm of the yolk sac and the embryonic mesoderm (primarily splanchnic mesoderm). Both of these clusters fuse together and extend, forming a vast network.

The early circulation has 3 components: Vitelline, Embryonic, Placental Each of these has its own system of arteries and veins.

* '''Vitelline''' - (not shown) the vitelline arteries branch off the dorsal aortas and enter the yolk sac, covering its entire surface. The vitelline veins return red blood cells from the capillary beds to the sinus venosus, posterior to the heart. The vitelline vessels eventually contribute to the portal system of the liver in the adult.

* '''Embryonic''' - blood from the dorsal aorta enters intersegmental arteries, including the arteries of the pharyngeal arches. The blood returns to the heart via the anterior and posterior cardinal veins.

* '''Placental''' - the umbilical arteries receive blood from the aorta. This is carried to the chorionic villi, where exchange occurs with the mother. Waste products are disposed of, nutrients and oxygen are collected, and then the umbilical veins convey the blood to the sinus venosus.

'''Heart''' - The heart develops from cardiogenic mesoderm, a region of splanchnic mesoderm lying above the buccopharyngeal membrane. Development begins in week 3 with the formation of a pair of heart tubes. These fuse and form a single tube in week 4, as a result of the embryonic folding processes that occur. As the heart grows, septation events occur, transforming it into a 4-chambered pump. Initially, the ventricles develop above the atria; however simultaneous growth and bending of the tube bring the structures into correct position. In humans, the heart begins to beat on day 22-23.

==Objectives==

# Understand development of early embryo heart and vascular system.
# Understand the early placentation events and the development of placental blood vessels.

== Introduction ==
This laboratory will explore the development of the embryonic cardiovascular system, which includes the placental vascular system. We will look through cross-sections of the Carnegie stage 13 embryo and follow the flow of blood through the embryonic vasculature.

[[File:Stage13_bloodflow.jpg]]

== Stage 14 Embryo ==
'''Stage 14 3D CVS reconstruction''' [http://embryology.med.unsw.edu.au/Movies/CVS3dmodel.htm Small movie page] | [http://embryology.med.unsw.edu.au/Movies/CVS3dmodelonly.htm large movie page] | [[Media:CVS3d.mov|Stage 14 3D small movie]] | [[Media:Stage_14_CVS3d_large.mov|Stage 14 3D large movie]]

[[File:Stage14 planesm.gif|left]]
{| class="prettytable"
|-
| [http://embryology.med.unsw.edu.au/wwwpig/piga/a1l.htm A1]
| [http://embryology.med.unsw.edu.au/wwwpig/piga/a2l.htm A2]
| [http://embryology.med.unsw.edu.au/wwwpig/piga/a3l.htm A3]
| [http://embryology.med.unsw.edu.au/wwwpig/piga/a4l.htm A4]
| [http://embryology.med.unsw.edu.au/wwwpig/piga/a5l.htm A5]
| [http://embryology.med.unsw.edu.au/wwwpig/piga/a6l.htm A6]
| [http://embryology.med.unsw.edu.au/wwwpig/piga/a7l.htm A7]

|-
| [http://embryology.med.unsw.edu.au/wwwpig/pigb/b1l.htm B1]
| [http://embryology.med.unsw.edu.au/wwwpig/pigb/b2l.htm B2]
| [http://embryology.med.unsw.edu.au/wwwpig/pigb/b3l.htm B3]
| [http://embryology.med.unsw.edu.au/wwwpig/pigb/b4l.htm B4]
| [http://embryology.med.unsw.edu.au/wwwpig/pigb/b5l.htm B5]
| [http://embryology.med.unsw.edu.au/wwwpig/pigb/b6l.htm B6]
| [http://embryology.med.unsw.edu.au/wwwpig/pigb/b7l.htm B7]

|-
| [http://embryology.med.unsw.edu.au/wwwpig/pigc/c1l.htm C1]
| [http://embryology.med.unsw.edu.au/wwwpig/pigc/c2l.htm C2]
| [http://embryology.med.unsw.edu.au/wwwpig/pigc/c3l.htm C3]
| [http://embryology.med.unsw.edu.au/wwwpig/pigc/c4l.htm C4]
| [http://embryology.med.unsw.edu.au/wwwpig/pigc/c5l.htm C5]
| [http://embryology.med.unsw.edu.au/wwwpig/pigc/c6l.htm C6]
| [http://embryology.med.unsw.edu.au/wwwpig/pigc/c7l.htm C7]

|-
| [http://embryology.med.unsw.edu.au/wwwpig/pigd/d1l.htm D1]
| [http://embryology.med.unsw.edu.au/wwwpig/pigd/d2l.htm D2]
| [http://embryology.med.unsw.edu.au/wwwpig/pigd/d3l.htm D3]
| [http://embryology.med.unsw.edu.au/wwwpig/pigd/d4l.htm D4]
| [http://embryology.med.unsw.edu.au/wwwpig/pigd/d5l.htm D5]
| [http://embryology.med.unsw.edu.au/wwwpig/pigd/d6l.htm D6]
| [http://embryology.med.unsw.edu.au/wwwpig/pigd/d7l.htm D7]

|-
| [http://embryology.med.unsw.edu.au/wwwpig/pige/e1l.htm E1]
| [http://embryology.med.unsw.edu.au/wwwpig/pige/e2l.htm E2]
| [http://embryology.med.unsw.edu.au/wwwpig/pige/e3l.htm E3]
| [http://embryology.med.unsw.edu.au/wwwpig/pige/e4l.htm E4]
| [http://embryology.med.unsw.edu.au/wwwpig/pige/e5l.htm E5]
| [http://embryology.med.unsw.edu.au/wwwpig/pige/e6l.htm E6]
| [http://embryology.med.unsw.edu.au/wwwpig/pige/e7l.htm E7]

|-
| [http://embryology.med.unsw.edu.au/wwwpig/pigf/f1l.htm F1]
| [http://embryology.med.unsw.edu.au/wwwpig/pigf/f2l.htm F2]
| [http://embryology.med.unsw.edu.au/wwwpig/pigf/f3l.htm F3]
| [http://embryology.med.unsw.edu.au/wwwpig/pigf/f4l.htm F4]
| [http://embryology.med.unsw.edu.au/wwwpig/pigf/f5l.htm F5]
| [http://embryology.med.unsw.edu.au/wwwpig/pigf/f6l.htm F6]
| [http://embryology.med.unsw.edu.au/wwwpig/pigf/f7l.htm F7]

|-
| [http://embryology.med.unsw.edu.au/wwwpig/pigg/g1l.htm G1]
| [http://embryology.med.unsw.edu.au/wwwpig/pigg/g2l.htm G2]
| [http://embryology.med.unsw.edu.au/wwwpig/pigg/g3l.htm G3]
| [http://embryology.med.unsw.edu.au/wwwpig/pigg/g4l.htm G4]
| [http://embryology.med.unsw.edu.au/wwwpig/pigg/g5l.htm G5]
| [http://embryology.med.unsw.edu.au/wwwpig/pigg/g6l.htm G6]
| [http://embryology.med.unsw.edu.au/wwwpig/pigg/g7l.htm G7]

|}

Compare this mid-embryonic cardiovascular system with that existing at the end of embryonic development [http://embryology.med.unsw.edu.au/Movies/CVS3dmodelst22.htm Stage 22 3D CVS reconstruction]

== Group projects ==

The laboratory will also allow time for work on the group online project. What have your other group members and other groups done so far?

==UNSW Embryology Links==

* '''Cardiovascular Slides''' [http://embryology.med.unsw.edu.au/Science/ANAT2341lecture07.htm Cardiovasular Lecture 7 2008] | [http://embryology.med.unsw.edu.au/pdf/ANAT2341L07Hearts1.pdf Heart Lecture 2008 - 1 slide/page ] | [http://embryology.med.unsw.edu.au/pdf/ANAT2341L07Hearts4.pdf Heart Lecture 2008 Slides - 4 slides/page] | [http://embryology.med.unsw.edu.au/pdf/ANAT2341L07Hearts6.pdf Heart Lecture 2008 Slides - 6 slides/page]
* '''Cardiovascular Movies''' [http://embryology.med.unsw.edu.au/Movies/heart.htm Heart Movies] | [http://embryology.med.unsw.edu.au//Movies/larsen/looping.mov Heart Looping] | [http://embryology.med.unsw.edu.au//Movies/larsen/atrium.mov Atrial Septation] | [http://embryology.med.unsw.edu.au//Movies/larsen/avc.mov Realignment] | [http://embryology.med.unsw.edu.au//Movies/larsen/ventricl.mov Ventricular Septation] | [http://embryology.med.unsw.edu.au/Movies/heart.htm#HeartSeptation Heart Septation Models] | [http://embryology.med.unsw.edu.au/Movies/heart.htm#HistoricHeart Historic Heart Movie] |

* '''Cardiovascular Notes''' [http://embryology.med.unsw.edu.au/Notes/heart.htm Introduction] | [http://embryology.med.unsw.edu.au/Notes/heart2.htm Abnormalities] | [http://embryology.med.unsw.edu.au/Notes/heart3.htm Stage 13/14] | [http://embryology.med.unsw.edu.au/Notes/heart4.htm Stage 22] | [http://embryology.med.unsw.edu.au/Notes/heart5.htm Stage 22 Selected Highpower] | [http://embryology.med.unsw.edu.au/Notes/heart6.htm Heart] | [http://embryology.med.unsw.edu.au/Notes/heart8.htm Heart Rate] | [http://embryology.med.unsw.edu.au/Notes/heart20.htm Blood][http://embryology.med.unsw.edu.au/Notes/heart19.htm Blood Vessels] | [http://embryology.med.unsw.edu.au/Notes/heart11.htm Molecular] | [http://embryology.med.unsw.edu.au/Notes/heart31.htm Lymphatic] | [http://embryology.med.unsw.edu.au/Notes/hearttxt.htm Text only page] | [http://embryology.med.unsw.edu.au/Notes/heartlink.htm WWW Links] | [http://embryology.med.unsw.edu.au/Child/heart.htm Postnatal] | [http://embryology.med.unsw.edu.au/history/page2b.htm#Harvey History - Harvey]

* '''Placenta Slides''' [http://embryology.med.unsw.edu.au/Science/ANAT2341lecture08.htm Placenta Lecture 8 2008] | [http://embryology.med.unsw.edu.au/pdf/ANAT2341L8Placentas1.pdf Placenta Lecture 2008 - 1 slide/page ] | [http://embryology.med.unsw.edu.au/pdf/ANAT2341L8Placentas4.pdf Placenta Lecture 2008 Slides - 4 slides/page] | [http://embryology.med.unsw.edu.au/pdf/ANAT2341L8Placentas6.pdf Placenta Lecture 2008 Slides - 6 slides/page]
* '''Placenta Movies''' [http://embryology.med.unsw.edu.au/Movies/heart.htm Heart Movies] | [http://embryology.med.unsw.edu.au//Movies/larsen/looping.mov Heart Looping] | [http://embryology.med.unsw.edu.au//Movies/larsen/atrium.mov Atrial Septation] | [http://embryology.med.unsw.edu.au//Movies/larsen/avc.mov Realignment] | [http://embryology.med.unsw.edu.au//Movies/larsen/ventricl.mov Ventricular Septation] | [http://embryology.med.unsw.edu.au/Movies/heart.htm#HeartSeptation Heart Septation Models] | [http://embryology.med.unsw.edu.au/Movies/heart.htm#HistoricHeart Historic Heart Movie] |

* '''Placenta Notes''' [http://embryology.med.unsw.edu.au/Notes/placenta.htm Introduction] | [http://embryology.med.unsw.edu.au/Notes/placenta2.htm Abnormalities] | [http://embryology.med.unsw.edu.au/Notes/placenta3.htm Stage 13/14] | [http://embryology.med.unsw.edu.au/Notes/placenta4.htm Human (Stage22)] | [http://embryology.med.unsw.edu.au/Notes/placenta5.htm Histology] | [http://embryology.med.unsw.edu.au/Notes/placenta7.htm Villi Development] | [http://embryology.med.unsw.edu.au/Notes/placenta8.htm Maternal Decidua] | [http://embryology.med.unsw.edu.au/Notes/placenta6.htm Vascular Beds] | [http://embryology.med.unsw.edu.au/Notes/placenta11.htm Molecular] | [http://embryology.med.unsw.edu.au/Child/heart.htm Postnatal] | [http://embryology.med.unsw.edu.au/Notes/endocrine14.htm Endocrine Placenta]

* '''General Links''' [http://embryology.med.unsw.edu.au/sysnote.htm System Notes] | [http://embryology.med.unsw.edu.au/week/weekbyweek.htm Development Timeline]

==Internet links==

'''Embryo Images Unit:''' [http://www.med.unc.edu/embryo_images/ Embryo Images Online] Early Cell Populations (cardiogenic section) | [http://www.med.unc.edu/embryo_images/unit-cardev/cardev_htms/cardevtoc.htm Cardiovascular Development] | [http://www.med.unc.edu/embryo_images/unit-cardev/cardev_htms/cardev001.htm Week 3 Development] | [http://www.med.unc.edu/embryo_images/unit-cardev/cardev_htms/cardev007.htmhttp://www.med.unc.edu/embryo_images/unit-cardev/cardev_htms/cardev007.htm Week 4 Development] | [http://www.med.unc.edu/embryo_images/unit-cardev/cardev_htms/cardev018.htm Heart Chambers and Outflow Tract] | [http://www.med.unc.edu/embryo_images/unit-cardev/cardev_htms/cardev022.htm Atrioventricular Septation] | [http://www.med.unc.edu/embryo_images/unit-cardev/cardev_htms/cardev028.htm Outflow Tract Septation] | [http://www.med.unc.edu/embryo_images/unit-cardev/cardev_htms/cardev035.htm Ventricular Septation] | [http://www.med.unc.edu/embryo_images/unit-cardev/cardev_htms/cardev036.htm Atrial Septation] | [http://www.med.unc.edu/embryo_images/unit-cardev/cardev_htms/cardev040.htm Atrial Walls] [http://www.med.unc.edu/embryo_images/unit-cardev/cardev_htms/cardev041.htm Aortic Arch Vessels] | [http://www.med.unc.edu/embryo_images/unit-cardev/cardev_htms/cardev042.htm Changes at Birth]

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[[Category:2009ANAT2341]]
[[Category:Science-Undergraduate]]
[[Category:Heart]]
[[Category:Cardiovascular]]