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PRESENTATION ON EMBRYOLOGY OF HUMAN HEART AND LUNGS SUBJECT : MEDICAL SURGICAL NURSING (Cardio-Thoracic Nursing). PRESENTED BY : HARMEET KAUR M.SC (N) II ND YEAR COLLEGE OF NURSING, AIMS, SRI MUKTSAR SAHIB.
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Heart and lung development

Aug 15, 2015

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Page 1: Heart and lung development

PRESENTATIONON

EMBRYOLOGY OF HUMAN HEART AND LUNGSSUBJECT: MEDICAL SURGICAL NURSING (Cardio-Thoracic Nursing).

PRESENTED BY: HARMEET KAUR

M.SC (N) IIND YEAR

COLLEGE OF NURSING, AIMS, SRI MUKTSAR SAHIB.

Page 2: Heart and lung development

EMBRYOLOGY OF HUMAN HEART

Heart development refers to development of the human heart.

This begins with the formation of two endocardial tubes which merge to form the tubular heart, also called the primitive heart tube, that loops and septates to form the adult, human heart.

The heart starts to beat spontaneously by 22nd day of development.

Page 3: Heart and lung development

The tubular heart quickly differentiates into the truncus arteriosus, bulbus cordis, primitive ventricle, primitive atrium, and the sinus venosus.

The heart tube elongates on the right side, looping and becoming the first visual sign of left-right asymmetry of the body. Septa form within the atria and ventricles to separate the left and right sides of the heart.

Page 4: Heart and lung development

PRIMITIVE DEVELOPMENT

The heart develop from embryonic mesoderm germ-layer cells that differentiate after gastrulation into:

mesothelium, endothelium, and myocardium.

Page 5: Heart and lung development

Endocardial tubesAt around 18 to 19

days after fertilisation, the heart begins to form.

starts to beat and pump blood at around day 21 or 22.

The heart begins to develop near the head of the embryo in the cardiogenic area that lies anterior to the buccopharyngeal membrane and neural tube.

Develop from splanchnopleuric mesenchyme

Page 6: Heart and lung development

Two strands or cords begin to form in the cardiogenic region

A lumen develops within them, at which point, they are referred to as endocardial tubes.

By day 19, an endocardial tube begins to develop and by the 22nd day (third week) they converged towards each other to merge together

From head to tail, these are the truncus arteriosus, bulbus cordis, primitive ventricle, primitive atrium, and the sinus venosus.

Page 7: Heart and lung development

Initially, all venous blood flows into the sinus venosus, and contractions propel the blood from tail to head, or from the sinus venosus to the truncus arteriosus.

The truncus arteriosus will divide to form the aorta and pulmonary artery; the bulbus cordis will develop into the right ventricle; the primitive ventricle will form the left ventricle; the primitive atrium will become the front parts of the left and right atria and their appendages, and the sinus venous will develop into the posterior part of the right atrium, the sinoatrial node and the coronary sinus.

Page 8: Heart and lung development
Page 9: Heart and lung development

Heart tube position

The central part of cardiogenic area is in front of the oropharyngeal membrane and the neural plate. The growth of the brain and the cephalic folds push the oropharyngeal membrane forward, while the heart and the pericardial cavity move first to the cervical region and then into the chest.

The curved portion of the horseshoe-shaped area expands to form the future ventricular infundibulum and the ventricular regions, as the heart tube continues to expand.

Page 10: Heart and lung development

Cardiac loopingThe heart tube continues stretching and by day 23,

in a process called morphogenesis, cardiac looping begins.

The cephalic portion curves in a frontal clockwise direction.

The atrial portion starts moving in a cephalically and then moves to the left from its original position.

This curved shape approaches the heart and finishes its growth on day 28.

The tube is divided into cardiac regions along its craniocaudal axis: the primitive ventricle, called primitive left ventricle, and the trabecular proximal arterial bulb, called the primitive right ventricle.

Page 11: Heart and lung development

Formation of heart chambersSinus venosus

In the middle of the fourth week, the sinus receives venous blood from the poles of right and left sinus.

Each pole receives blood from three major veins: the vitelline vein, the umbilical vein and the common cardinal vein.

The sinus opening moves clockwise.

Page 12: Heart and lung development

Left common cardinal vein disappears in the tenth week.

Only the oblique vein of the left atrium and the coronary sinus remains patent.

The right pole joins the right atrium to form the wall portion of the right atrium.

The right and left venous valves fuse and form a peak known as the septum spurium.

At the beginning, these valves are large but the left venous valve and the septum spurium fuse with the developing atrial septum. The upper right venous valve disappearing. The bottom evolves into: the inferior valve of the vena cava and the coronary sinus valve.

Page 13: Heart and lung development

Heart wall

The main walls of the heart are formed between day 27 and 37 of the development of the early embryo.

The growth consists of two tissue masses actively growing that approach one another until they merge and split light into two separate conduits.

Tissue masses called endocardial cushions develop into atrioventricular and conotroncal regions. In these places, the cushions will help in the formation of auricular septum, ventricular conduits, atrio-ventricular valves and aortic and pulmonary channels.

Page 14: Heart and lung development

Atria and Ventricle

At the end of the fourth week, a crest grows that leaves the cephalic part. This crest is the first part of the septum primum.

The opening between the bottom edge of the septum primum and endocardial cushions is the ostium primum (first opening).

Page 15: Heart and lung development
Page 16: Heart and lung development

Coalescence of these perforations will form the ostium secundum (second opening)

When the right of the atrium expands new fold appears, called the septum secundum.

A free opening will then appear, called the foramen ovale.

The remains of the upper septum primum, will become the valves of the foramen ovale.

The passage between the two atrial chambers consists of a long oblique slit through which blood flows from the right atrium to the left.

As with the developing left and right atrium, part of the initial atrioventricular canal becomes incorporated into the mitral and tricuspid valve simultaneously by 8th week.

Page 17: Heart and lung development

Initially, a single pulmonary vein develops in the form of a bulge in the back wall of the left atrium.

This vein will connect with the veins of the developing lung buds. As development proceeds the pulmonary vein and its branches are incorporated into the left atrium and they both form the smooth wall of the atrium.

At the end of the fourth week, two atrioventricular endocardial cushions appear.

Initially the atrioventricular canal gives access to the primitive left ventricle, and is separated from arterial bulb by the edge of the ventricular bulb.

Page 18: Heart and lung development

Because of this, blood can access both the left primitive ventricle and the right primitive ventricle. As the anterior and posterior pads project inwardly, they merge to form a right and left atrioventricular orifice.

When forming intra-atrial septa, atrio-ventricular valves will begin to grow.

An intra-muscular ventricular septum begins to grow from the common ventricle to the atrio-ventricular endocardial cushions.

Eventually the interventricular foramen disappears. This closure is achieved by further growth muscular interventricular septum.

Page 19: Heart and lung development

Development of the pacemaker and conduction system

The rhythmic electrical depolarization waves that trigger myocardial contraction is myogenic, which means that they begin in the heart muscle spontaneously and are then responsible for transmitting signals from cell to cell.

Primitive ventricle acts as initial pacemaker.But this pacemaker activity is actually made by a

group of cells that derive from the sinoatrial right venous sinus. These cells form an ovoid sinoatrial node (SAN), on the left venous valve.

After the development of the SAN, the superior endocardial cushions begin to form a pacemaker as known as the atrioventricular node.

Page 20: Heart and lung development

With the development of the SAN, a band of specialized conducting cells start to form creating the bundle of His that sends a branch to the right ventricle and one to the left ventricle.

The human embryonic heart begins beating approximately 21 days after conception.

Page 21: Heart and lung development

EMBRYOLOGY OF LUNGINTRODUCTION:Lung development refers to development of

the lungs. Lung develops from:o Endoderm - tubular ventral growth from foregut

pharynx.o Mesoderm - mesenchyme of lung buds.o Intraembryonic coelom - pleural cavities

elongated spaces connecting pericardial and peritoneal spaces.

The development of lungs starts after the 4th week of fertilization and continue to grow along with the heart.

Page 22: Heart and lung development
Page 23: Heart and lung development

Week 4 - laryngotracheal groove forms on floor foregut.

Week 5 - left and right lung buds push into the pericardioperitoneal canals (primordia of pleural cavity)

Page 24: Heart and lung development

Week 6 - descent of heart and lungs into thorax. Pleuroperitoneal foramen closes.

Week 7 - enlargement of liver stops descent of heart and lungs.

Page 25: Heart and lung development

Month 3-6 - lungs appear glandular, end month 6 alveolar cells type 2 appear and begin to secrete surfactant.

Month 7 - respiratory bronchioles proliferate and end in alveolar ducts and sacs.

Page 26: Heart and lung development

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