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The Cardiovascular System (Part I) 黃敏銓

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德國敏斯特大學 細胞生物學/遺傳學 博士 解剖學暨細胞生物學研究所 助理教授 1 The Cardiovascular System

1. The first major system to function 2. The primordial and vascular system appear in the middle of the third week 3. The heart starts to function at the beginning of the fourth week

2 The cardiovascular system is derived mainly from:

• Splanchnic mesoderm

• Paraxial and lateral mesoderm

• Neural crest cells

3 Development of heart

4 Eraly development of heart

Heart primordium

Angioblastic cord

18 days Angioblastic cord

5 Development of veins

Three paired veins drain into the of a 4-week embryo

• Vitelline veins: poorly oxygenated blood from • Umbilical veins: oxygenated blood from the primordial : poorly oxygenated blood from the body of the embryo

6 Three paired veins Cardinal veins 26 days

Blue color

Vitelline vein

7 Three paired veins enter into the sinus venosus

Left Right

Dorsal view 24 days 8 Vitelline veins Hepatic vein and portal vein

Left Right

Hepatic vein: right vitelline vein

Liver

Portal vein: vitelline veins

9 Dorsal view (7 weeks) Duodenum Umbilical veins Umbilical vein & : left umbilical vein

Left Right

7th week

(Ligamentum venosum)

10 Dorsal view Anterior cardinal veins 1. Brachiocephalic veins 7 weeks Anastomosis between anterior cardinal veins

Left Right

8 weeks Left brachiocephalic vein Right brachiocephalic vein

11 Dorsal view

Dorsal view

Superior vena cava

Right Right common cardinal vein

12 Left Right Posterior cardinal veins: root of azygos v. and common iliac veins

6 weeks Adult

Azygos v.

Posterior cardinal vein (mesonephroi)

Common iliac v.

13 Right Left Subcardinal veins and supracardinal veins replace and supplement posterior cardinal veins

Supracardinal v.

Posterior cardinal v. Subcardinal v.

Right Left

6 weeks 7 weeks 14 Subcardinal veins

IVC (prerenal seg.) Stem of L. renal v.

R. suprarenal v. L. suprarenal v.

Subcardinal vein R. gonadal v. L. gonadal v.

6 weeks Adult 15 Right Left Supracardinal veins

Azygos v. Hemiazygos v.

IVC (postrenal seg.) degeneration

8 weeks Right Adult Left

16 Supracardinal vein Inferior vena cava (IVC)

IVC (hepatic segment): hepatic v. and sinusoids

IVC (prerenal segment): R. subcardinal v.

IVC (renal segment): Subcardinal-supracardinal anastomosis

IVC (postrenal segment): R. supracardinal v.

17 Right Adult Left Dorsal intersegmental arteries Dorsal

Pharyngeal arches

Aortic sac

4th-5th week (26 days)

18 Dorsal intersegmental arteries

•Neck: vertebral arteries •Thorax: intercostal arteries • Abdomen: – lumbar arteries – 5th pair: common iliac arteries •Sacrum: lateral sacral arteries • Caudal end of : median sacral artery.

19

• Celiac trunk: foregut

• Superior mesenteric artery: midgut

• Inferior mesenteric artery: hindgut

20 Umbilical arteries

• Proximal parts – Internal iliac arteries – Superior vesical arteries • Distal parts – Medial umbilical ligments

21 Further development of heart

22 Fusion of endocardial heart tubes

Ventral views

23 Fusion of endocardial heart tubes

Pericardial coelom 20-day

Dorsal mesocardium

Epicardium

Cardiac jelly 22-day Primordial myocardium 24 (from splanchnic mesoderm) Formation of heart wall and transverse pericardial sinus

Endocardium

Sinus venosus Myocardium

Epicardium

28 days 25 Transverse pericardial sinus

26 Relative position of human embryo during the 4th week

Head fold

Oropharyngeal membrane

foregut Tubular heart formation

Septum transversum

Pericardial cavity 27 U-shaped bulboventricular loop

Primordial

Sinus venosus

Bulbus cordis

Primordial ventricle

24 days 28 Lateral expansions of the sinus venosus

Left horn of sinus venosus

Right horn of sinus venosus

Dorsal view of the heart (about 26 days) 29 Circulation through primordial heart

6

Sinus venosus 1

2

3

5

4 30 End of 4th week: unidirectional flow 休息10分鐘

31 Partitioning of primordial heart

• begins around middle of the 4th week. •is completed by the end of the 5th week. • includes partitioning of: – – Primordial atrium – Primordial ventricle

32 Partitioning of Atrioventricular Canal

5th week

Fused endocardial canal

End of 4th week

Endocardial cushions (from cardiac Left AV canal jelly)

Transformed contribute to the 33 formation of valves and membranous septa of the heart. AV endocardial cushions

the primordia of the valves and membranous septa

Bone morphogenetic protein (BMP2)

34 Partitioning of primordial atrium

• begins at the end of the 4th week. • is divided into right and left atria by: –

35 Septum primum

Septum primum

Endocardial cushion

Septum secundum

Foramen secundum

Foramen primum

36 Septum primum

Septum primum

Foramum primum

Foramum primum

Foramum secundum

Foramum primum

Septum secundum

Foramum secundum

Septum primum 37 Septum secundum

Septum secundum (upper limb) Oval foramen

Valve of oval foramen (from septum primum)

Oval foramen

Valve (from septum primum)

38 Valve of oval foramen

Septum primum

Septum secundum

Oval foramen (open)

Valve of oval foramen

39 Oval fossa is a remnant of oval foramen

Before After birth

Septum secundum

Oval fossa Oval foramen Septum primum (valve of oval foramen)

40 Development of sinus venosus

Opening of sinus venosus into primordial atrium Left horn of sinus venosus Right horn of sinus venosus

Left Right

Dorsal view (4 th week) 41 Progressive enlargement of the right horn results from two left-to-right shunts of blood

Dorsal view (7 weeks)42 Left Right Doral view

Primordial atrium

26 days Right horn of sinus venosus

Left horn of sinus venosus

Sinus venarum of right atrium 8 weeks

Coronary sinus

43 Left Right Right sinuatrial valve → Left sinuatrial valve → • Crista terminalis fused with septum secundum → • Valve of IVC • Valve of coronary sinus

Crista terminalis

Valve of coronary sinus

Valve of inferior vena cava 44 Right Left Absorption of pulmonary vein into left atrium

5 weeks 6 weeks

Primordial pulmonary vein

Primordial left atrium

Smooth-walled part of left atrium

Left auricle 8 weeks 45 Right Left Myocardial sleeves

atrial fibrillation

46 Partitioning of primordial ventricle

Fused endocardial cushions

Interventricular foramen Expansion 5th week (muscular part)

47 Right Left Closure of the interventricular foramen

Right bulbar ridge Left bulbar IV foramen ridge

Fused endocardial cushions

Membranous part of IV septum

48 7 weeks Cavitation of the ventricular walls forms a sponge-work of muscular bundles – trabeculae carneae

5 weeks 6 weeks

20 weeks

Chordae tendinae 7 weeks Trabeculae carneae Papillary muscle 49 Right Left Partitioning of and Truncus Arteriosus

Truncus arteriosus Truncal ridge Bulbus cordis

Bulbar ridge 5 weeks

Aorta Pulmonary trunk

6 weeks

50 Spiral form of Aorticopulmonary Septum

51 Bulbus cordis incorporates into the walls of ventricles

Conus arteriosus (infundibulum)

Aortic vestibule

52 Development of cardiac valves

Swellings of subendothelial tissue Dorsal valve swelling

Bulbar ridges Ventral valve swelling

53 Hollowing and thinning of valve swellings

Valve swelling

54 Conducting system of heart

Sinuatrial node (5 th week)

Atrioventricular node

Atrioventricular bundle Branches of AV bundle Right Left 55