Development of the Circulatory System Part II

Learning Objectives:
Compare and contrast the flow of blood through a fetal and adult heart.

Identify which parts of the heart are derived from the primary and secondary heart fields.
Describe how embryonic folding creates the primitive heart tube.

Explain how the heart's shape changes during cardiac looping.

Describe how the atrial septum and interventricular septum are formed.

Explain the function of the three fetal circulatory shunts.

Explain how blood flow in an infant changes at birth. What happens to the three shunts?

Intraembryonic circulatory arc: Flow of blood away from heart: Heart aortic sac aortic arches dorsal aorta A system of cardinal veins brings the blood back to the heart Cranial cardinal vein & caudal cardinal vein common cardinal vein heart

Development of the heart: After leaving the primitive streak, precardiac cells move anteriorly and form the primary heart field (cardiac crescent) which is made from cardiogenic mesoderm (splanchnic mesoderm) A second heart field is located medially to the cardiac crescent As the heart continues to develop, a cardiogenic plate forms from the cardiogenic mesoderm just rostral to the buccopharyngeal membrane

Cells of the primary heart field give rise to: Ventricles Left atrium Some of the right atrium Some of the outflow tract Cells of the secondary heart field give rise to: Most of the outflow tract Most of the right atrium

 The splanchnic and somatic mesoderm split The space between is called the pericardial coelom precursor to the pericardial cavity The splanchnic mesoderm of the precardiac region thickens to form the myocardial primordium The endocardial primordia forms as a tube between the myocardial primordium and the endoderm of the yolk sac/primitive gut

 Lateral/ventral folding events of the early embryo bring the primordia together where they fuse at the midline (ventral to the gut) to form the primitive heart tube Two separate lumen become the single lumen of the heart The primitive single tubular heart consists of: Endocardial lining Cardiac jelly Myocardium The tubular heart is located in the pericardial coelom Formation of the tubular heart has occurred by the end of the third week

Aortic sac

Vitelline veins

Review of adult circulation

Body

Right atrium

Right ventricle

Lungs

Left atrium

Left ventricle

Cardiac looping:

Around day 23, the primitive heart folds and loops to establish the future heart chambers in the correct spatial locations
The heart is the first asymmetrical structure to develop in the embryo The initially straight heart tube begins to take on an S shape The inflow tract (atrium) becomes positioned dorsal to the outflow tract (conotruncus) As the heart continues to grow, the atrium can be seen bulging out on either side of the heart

Video

Atrioventricular partitioning begins when endocardial cushions begin to form Endocardial cushions thickenings on the dorsal and ventral sides of the heart at the junction of the atrium and ventricle The cushions will eventually grow into the atrioventricular canal and meet, separating it into left and right channels The right atrioventricular canal will develop into the tricuspid valve The left atrioventricular canal will develop into the mitral (bicuspid) valve

1. Lateral endocardial cushion 2. Ventral endocardial cushion 3. Dorsal endocardial cushion 4. Left atrioventricular canal 5. Right atrioventricular canal

1. Left atrioventricular canal 2. Right atrioventricular canal

Partitioning of the atria begins at the same time as atrioventricular partitioning It begins with the downward growth of the interatrial septum primum, located between the atrial chambers The interatrial septum primum grows toward the atrioventricular canal and merges with the endocardial cushions A large opening called the foramen primum allows blood to pass from the right to left side When the septum primum meets the endocardial cushions, the foramen primum will be closed

 Perforations in the septum primum become the foramen secundum At weeks 5-6, a second atrial septum, the septum secundum descends to the right of the septum primum The septum secundum will cover and close the foramen secundum A oval-shaped passageway called the foramen ovale will be formed between the septum secundum and septum primum The foramen ovale allows blood to shunt right to left until birth, bypassing the lungs

The sinus venosus shifts completely to the right atrium Remember, the common cardinal vein, umbilical vein, and vitelline vein all empty into the sinus venosus

Partitioning of the ventricle begins with the formation of the interventricular septum The interventricular septum grows from the apex of the ventricular loop and eventually merges with the endocardial cushions The interventricular septum has two parts: Muscular septum Membranous septum The membranous septum is derived from neural crest cells and is a common defect site

In the tubular heart, the outflow tract is a single channel With the formation of the interventricular septum, the outflow tract separates into two channels: 1. Aortic outlet connects to the left ventricle. Becomes aorta 2. Pulmonary outlet connects to the right ventricle. Becomes pulmonary artery. The aorticopulmonary septum is a spiraling ridge of tissue that divides the outflow tract.

Semilunar valves (aortic and pulmonary valves) form where the outflow tract meets the ventricles

Adult circulation in the heart Body

Right atrium

Right ventricle

Lungs

Left atrium

Left ventricle

Dorsal aorta Cranial cardinal vein Umbilical veins Placenta Umbilical arteries Descending aorta Dorsal aorta Common cardinal vein Body Caudal cardinal vein

Aortic arches
Aortic sac Conotruncus

Vitelline veins Yolk sac Vitelline arteries

Ventricle Atrium Sinus venosus (Ductus venosus) Fetal circulation

Three shunts in fetal circulation are needed to supply highly oxygenated blood to the body and developing brain: 1. Foramen ovale Opening between right and left atria Shunts highly oxygenated blood from right atria to left atria Blood moves from LA to LV, aorta, body 2. Ductus arteriosus Temporary blood vessel connecting pulmonary artery and aorta Derived from left 6th aortic arch Allows blood leaving right ventricle to bypass lungs Fetal lungs are not fully developed and cannot handle the full amount of blood entering the pulmonary artery 3. Ductus venosus Connects umbilical vein to sinus venosus Allows oxygen-rich blood returning from placenta to bypass liver Liver is a dense capillary bed that would deoxygenate blood as it slowly passed through

Fetal circulation summary

Oxygenated blood from the placenta is carried by the umbilical vein past the liver via the ductus venosus. It empties into the sinus venosus, which in turn empties into the right atrium The right atrium would normally send the blood to the lungs, but instead the foramen ovale allows blood to be shunted directly to the left atrium

Blood then travels through the left atrium to the left ventricle and out to the body of the embryo
Enough blood passes into the pulmonary artery to supply the lungs with the oxygen they need Only 12% of the right ventricle output goes to the lungs, rest travels to ductus arteriosus

Circulation after birth

The embryo must prepare for the moment when oxygenating the blood must be done using the lungs instead of the placenta When the umbilical cord is cut, all blood flow via the umbilical vein stops The baby takes a few breaths, and the lungs expand enough to hold a larger amount of blood

More blood starts being directed to the lungs, and this combined with the lack of blood flow from the umbilical vein causes the blood pressure of the left atrium to increase with respect to the right atrium This increase in blood pressure causes the foramen ovale collapse on itself, and all blood from the right atrium will begin to enter the right ventricle
Ductus venosus begins closing when umbilical veins are occluded due to loss of blood flow. Fully closed by 1 week.

Ductus arteriosus closes quickly after birth. Wall of the vessel constricts in response to oxygen, prostaglandin levels.
For each shunt, functional closure is rapid. Anatomical closure takes longer.