ventricular septal defect more about anatomy for first year medical students

1. Ventricular SeptumVentricular Septum
DefectsDefects
Nur Amalina bt Aminuddin Baki
082012100067

2. IntroductionIntroduction
Normal ventricle septum formation
Semilunar Valve Formation
VSD
Tetralogy of Fallot
Persistent truncus arteriosus
Transposition of Great Vessels
Valvular Stenosis

3. Normal Ventricle septumNormal Ventricle septum
formationformation
End of 4th
week, two primitive ventricles
begin to expand, accomplished by
continuous growth of myocardium
outside and cont.diverticulation and
trabecula formation on the inside
Medial wall merges  muscular
interventricular septum
Inferior endocardial cushion closes the
foreman  membranous part of
interventricular septum

4. Semilunar Valves(SLV)Semilunar Valves(SLV)
Partitioning of truncus almost complete,
primordia of SLV become visible as small
tubercles on main truncus swellings.
One of each pair for pulmonary and
aortic channel
Third tubercles appears opposite to the
fused truncus swellings
Tubercles hollow out forming SLV

6. Ventricle septum defects(VSD)Ventricle septum defects(VSD)
Involve membranous(more serious) or
muscular part of septum
VSD: Most common congenital cardiac
malformation 12/10,000 births

8. Tertralogy of FallotTertralogy of Fallot
Unequal division of conus , resulting from
anterior displacement of conotruncal
septumcardiovascular alteration
Narrow right ventricular outflow region
(pulmonary infundibular stenosis)
Large defect of interventricular septum
An overriding aorta
Hyperthropy of right ventricular wall
Not fatal, only 9.6/10,000 births

10. Persistent truncus arteriosusPersistent truncus arteriosus
Conotruncal ridges fail to fuse and
descend towards ventricles
0.8/10,000 births
Pulmonary artery arises some distance
above origin of undivided truncus
Accompanied by defective
interventricular septum
Overrides both ventricles and receive
blood from both side

12. Transposition of great vesselTransposition of great vessel
Conotruncal septum fail to follow
normal spiral course and run straight
down
Aorta originates from RV
Pulmonary artery originates from LV
4.8/10,000 births
Associated with membranous part
interventricular septum and open ductus
arterious

14. DIGEORGE SEQUENCEDIGEORGE SEQUENCE
Characterized by a pattern of
malformations that originates in abnormal
neural crest development
facial defects
thymic hypoplasia
 parathyroid dysfunction
cardiac abnormalities involving the outflow
tract

15. Valvular stenosisValvular stenosis
SLV fused ( 3-4/10,000 births)
Valvular Stenosis of Pulmonary Artery
pulmonary artery patent oval foramen  only outlet
for blood from right ventricle
Ductus arterious  only access route to pulmonary
circulation

17. Aortic Valvular Stenosis
Fusion of thickened valves left only a pinhole opening
Normal size of Aorta
• Aortic Valvular Atresia
 aorta, LV , LA underdeveloped
open ductus arteriosus

19. ConclusionConclusion
Tetralogy of Fallot unequal division of
conus
Persistent truncus
arteriosusconotruncal ridges failure to
fuse and descend
Transposition of Great
Vesselsconnotruncal septum fail to
follow spiral course
Valvular Stenosis fused SLV

20. ReferenceReference
Langman’s Medical Embryology, 10th
edition, TW Sandler