DEVELOPMENT OF ARTERIAL SYSTEM AORTIC ARCHES (page 135)

Anatomy of Aorta

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Abdominal aorta

Aortic Arches

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Left dorsal aorta Right dorsal aorta Aortic Sac Left 7th cervical inter-segmental a. Right 7th cervical inter-segmental a. 4th thoracic somite 4th lumbar somite Truncus arteriosus Pharynx Right limb Left limb

Maxillary a. Stapideal a. Ext. carotid a. Int. carotid a. C.C.A. Ductus caroticus (Disappeare) Rt. Subclavian a. The aortic arch Lt. subclavian a. Descending aorta Common iliac a. Degenerating 5th arch New branch of 6th arch Degenerating part of Rt dorsal aorta Degenerating dorsal part of Rt. 6th arch Ductus Arteriosus

Embryological Differences in the Course of Rt & Lt Recurrent laryngeal nerves (Page 139)

Course of Recurrent Laryngeal Nerves

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Rt. Subclavian a. The aortic arch Degenerating 5th arch New branch of 6th arch Rt recurrent laryngeal n. Lt. recurrent laryngeal n. Ductus arteriosus (persistent dorsal part of left 6th arch) Degenerating dorsal part of Rt 6th arch

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Arterial System Defects (Page 139)

Double Aortic Arch

Right sided aortic arch

Aortic Coarctation Post-ductal coarctation Pre-ductal coarctation

Interrupted aortic arch

Abnormal origin of Rt Subclavian artery

Abnormal origin of right subclavian artery

FETAL CIRCULATION • Oxygenated blood: Placenta left umbilical vein Lt branch of portal vein Ductus venosus------ Inferior vena cava Rt atrium Foramen ovale Lt atrium Left ventricle Aorta carotid & subclavian arteries H & N • Non-oxygenated blood: Venous blood from upper ½ of body Superior vena cava Rt atrium Rt ventricle pulmonary trunk left pulmonary artery ductus arteriosus Arch of aorta Descending aorta Umbilical arteries placenta.

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Changes that occur at birth A- Immediate changes: 1- Start of pulmonary circulation. 2- Functional closure of foramen ovale. 3- Functional closure of ductus arteriosus. B- Late fibrotic changes: 1- Left umbilical vein ligamentum teres. 2- Ductus venosus ligamentum venosum. 3- Ductus arteriosus ligamentum arteriosum. 4- Distal part of umbilical artery lateral umbilical ligament.

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Development of Diaphragm (Page 121)

DIAPHRAGM ➢It is developed from the following structures. 1- Septum transversum: It lies firstly infront the neck and forms central tendon. 2- Cervical myotomes (C3,4,5): Forms the muscular part around the central tendon and supplied by phrenic nerve. 3- Pleuro-peritoneal membrane: forms the postero-lateral parts of the diaphragm. 4- Meso-esophagus: forms the median posterior part. 5- Mesoderm of thoracic wall: forms the periphery of diaphragm. 6- Mesoderm around aorta: forms the crura.

Bucco-pharyngeal membrane Cloacal membrane Cardiogenic area Notochord Septum transversum Pericardium Pleura Pleuro- peritoneal membrane Peritoneum Intra-embryonic ceolom

Bucco-pharyngeal membrane heart Pericardium Septum transversum Pharynx

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CONGENITAL ANOMALIES • 1- Congenital Hernia of Bochdalek: due to failure of formation of pleuro-peritoneal membrane. • 2- Esophageal (Hiatus) Hernia: due to wide esophageal opening or short esophagus. • 3- Parasternal hernia (of Morgagni): wide gap between sternal and costal origin of diaphragm.

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