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Embryology · USMLE Step 1

USMLE Embryology: Cardiovascular System Development

Heart tube looping, cardiac septation steps, and the specific congenital heart defect tied to each disrupted step tested on USMLE Step 1.

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From what type of mesoderm does the primitive heart tube develop?
Splanchnic (lateral plate) mesoderm
Around what day of gestation does the primitive heart begin to beat?
Day 22
In normal development, which direction does the primitive heart tube loop?
To the right (rightward, D-looping)
What congenital defect results when the heart tube loops to the left instead of the right?
Dextrocardia
Listed from the venous to the arterial end, the primitive heart tube's five segments are the sinus venosus, primitive atrium, primitive ventricle, bulbus cordis, and ____.
truncus arteriosus
What right atrial structure develops from the sinus venosus?
The smooth-walled part (sinus venarum)
What right atrial structure develops from the primitive (embryonic) atrium?
The rough, trabeculated right auricle
What is the first septum to form within the primitive atrium?
The septum primum
What is the transient opening between the septum primum and the endocardial cushions, before it fuses, called?
The ostium primum (foramen primum)
As the ostium primum closes, what new opening forms from perforations in the septum primum?
The ostium secundum
What second atrial septum forms to the right of the septum primum?
The septum secundum
What is the opening in the septum secundum called?
The foramen ovale
An ostium primum atrial septal defect results from failure of which structures to fuse?
The septum primum and the endocardial cushions
An ostium primum ASD is classically associated with which condition?
Down syndrome, as part of an AV septal defect
The most common type of atrial septal defect results from excessive resorption of which structure?
The septum primum, causing an ostium secundum ASD

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