CVS Emryology

 Pharyngeal arches (6) form during the 4th & 5th weeks as neural crest cells migrate into
the
future head & neck region.
 Components of each arch:
 Arch artery (aortic arch artery).
 Cartilaginous rod that forms the skeleton of arch.
 Muscular component: primordium of the muscles in head & neck.
 Nerve that supplies the mucosa & muscles derived from each arch.
 Initially, the paired dorsal aortae run through the entire length of embryo.
 Later, the caudal portions of paired dorsal aortae fuse to form a single lower
thoracic/abdominal aorta.
 The remaining paired proximal dorsal aortae:
 The right regresses.
 The left becomes the primordial aorta.
 Branches of Dorsal Aorta:

Intersegmental Arteries
 ~ 30 branches of dorsal aorta
 Pass between & carry blood to the somites (cell masses) & their derivatives
 In the neck join to form the vertebral arteries.
 Most of the original connections of intersegmental arteries to dorsal aorta disappear.
 In the thorax persist as intercostal arteries.
 In the abdomen mostly become lumbar arteries.
o The 5th pair of lumbar intersegmental arteries remains as the common iliac arteries.
 In the sacral region form the lateral sacral arteries.
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Fate of Vitelline Artery
 Vitelline arteries supply the umbilical vesicle &, later, the primordial gut
 Only 3 vitelline arteries remain:
o Celiac arterial trunk to the foregut
o Superior mesenteric artery to the midgut
o Inferior mesenteric artery to the hindgut
Fate of Umbilical Artery

 The paired umbilical arteries pass through the connecting stalk
(primordial umbilical cord) & join the vessels in the chorion
(membrane enclosing the embryo).
 Umbilical arteries carry poorly oxygenated fetal blood to the placenta
o The proximal parts of these arteries become the internal iliac
arteries & superior vesical arteries
o The distal parts are obliterated after birth & become medial
umbilical ligaments.
 Pharyngeal arch is supplied by pharyngeal arch arteries.

 Pharyngeal arch arteries arising from the aortic sac & terminating in the dorsal aortae on the ipsilateral (same)
side.
 Six pairs of arch arteries usually develop; they are not present at the same time.
 Derivatives of First Pair of Pharyngeal Arch Arteries:
 Largely disappears but remnants of them form part of the maxillary arteries, which
supply ears, teeth & muscles of eyes & face.
 They may also contribute to the formation of external carotid arteries.
 Derivatives of Second Pair of Pharyngeal Arch Arteries: Dorsal parts of these arteries
persist & form the stems of small stapedial arteries, hyoid arteries.
 Stapedial artery: connects the embryonic precursors of internal carotid, maxillary &
middle meningeal arteries (provide connection between internal & external carotid
arteries to supply middle meningeal A). It regresses before birth (10th week)
 Hyoid artery: gives rise to the corticotympanic artery in adult.
2
 Derivatives of Third Pair of Pharyngeal Arch Arteries:
 Proximal parts: form common carotid arteries.
 Distal parts: join with the dorsal aortae to form internal carotid arteries.
 Derivatives of Fourth Pair of Pharyngeal Arch Arteries:

 Left fourth pharyngeal arch artery:
o Forms part of the arch of aorta
o Arch of aorta develops from:
1. Left 4th pharyngeal arch artery
2. aortic sac (proximal part)
3. left dorsal aorta (distal part)
 Right fourth pharyngeal arch artery:

o Becomes the proximal part of right subclavian artery.
o Right subclavian artery develops from:
1. Right 4th pharyngeal arch artery
2. Right dorsal aorta
3. Right seventh intersegmental artery.
o Left subclavian artery develops from left seventh intersegmental artery (not from
a pharyngeal arch artery)
 Fate of Fifth Pair of Pharyngeal Arch Arteries:

 Approximately 50% consists of rudimentary vessels that soon degenerate,
leaving no vascular derivatives.
 In other 50%, these arches do not develop.
 Derivatives of Sixth Pair of Pharyngeal Arch Arteries:

 Left sixth pharyngeal arch artery:
o Proximal part: persists as the proximal part of left pulmonary artery.
o Distal part: passes from the left pulmonary artery to the dorsal aorta & forms a
prenatal shunt, the ductus arteriosus
3
 Right sixth pharyngeal arch artery:
o Proximal part: persists as the proximal part of right pulmonary artery
o Distal part: degenerates
 Anomalous right subclavian artery (Retroesophageal):

 Right subclavian artery normally arises from the distal part of aortic arch &
passes posterior to the trachea & esophagus to supply the right upper limb
 Occurs when the right fourth pharyngeal arch artery & right dorsal aorta
disappear cranial to the seventh intersegmental artery.
o As a result right subclavian artery forms from the right seventh
intersegmental artery & distal part of right dorsal aorta.
o As development proceeds the origin of right subclavian artery will be
shifted cranially, until it comes to lie close to the origin of left subclavian
artery.
o Anomalous right subclavian artery is fairly common and always forms a
vascular ring
o It is rarely clinically significant because the ring is usually not tight enough
to constrict the esophagus & trachea very much.
o 10% of patients will have dysphagia lusoria> caused by aberrant Rt
subclavian A
 Double pharyngeal arch artery:

 Rare anomaly is characterized by a vascular ring around the trachea &
esophagus
 Results from failure of the distal part of right dorsal aorta to disappear.
 Right & left arches form.
 Usually, the right arch of aorta is the larger one & it passes posterior to
trachea & esophagus
 If the compression is significant causes wheezing respirations that are
aggravated by crying, feeding & flexion of the neck.
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 Right arch of aorta:
 Result from: the entire right dorsal aorta persists & the distal part of left
dorsal aorta involutes.
 Two main types:
1. Right arch of aorta without a retroesophageal component: ductus
arteriosus (ligamentum arteriosum) passes from the right pulmonary artery
to right arch of aorta.
2. Right arch of aorta with a retroesophageal component:
o Small left arch of aorta probably involuted
o Right arch of aorta posterior to esophagus.
o Ductus arteriosus attaches to the distal part of arch of aorta & forms a
ring that may constrict the esophagus & trachea
 Before birth:
 Lungs do not provide gas exchange
 Pulmonary vessels are vasoconstricted.
 The important vascular in transitional circulation are:

 Ductus venosus
 Oval foramen
 Ductus arteriosus
 Highly oxygenated, nutrient-rich blood returns under high pressure from the placenta
in umbilical vein.
 One-half of the blood bypasses the liver by passing directly into ductus venosus (fetal
vessel connecting the umbilical vein to IVC)
 The other half of blood in the umbilical vein flows into the sinusoids of liver & enters
IVC through hepatic veins.
 The liver receives well-oxygenated blood from the umbilical vein.
5
 From IVC, all of the blood enters the right atrium of heart
 Most blood is directed through the oval foramen into left atrium.
o There, it mixes with the relatively small amount of poorly oxygenated blood returning from
the lungs through pulmonary veins.
o From the left atrium, the blood then passes to the left ventricle & leaves through the ascending
aorta.
o The arteries to heart, neck, head & upper limbs receive well-oxygenated blood from the
ascending aorta.
o 10% of blood from the ascending aorta enters the descending aorta to supply the viscera &
inferior part of the body
o Most of the blood in descending aorta passes into the umbilical arteries & is returned to the
placenta for reoxygenation.
 The small amount of well-oxygenated blood from IVC in the right atrium mixes with poorly
oxygenated blood from SVC & coronary sinus & passes into the right ventricle.
o This blood, with medium oxygen content, leaves the heart through pulmonary trunk.
o 10% of this blood flow goes to the lungs; most blood passes through the ductus arteriosus into
the aorta to fetal body.
o It then returns to the placenta through the umbilical arteries.
 Important circulatory adjustments occur at birth:

 The circulation of fetal blood through the placenta ceases.
 The infant’s lungs expand & begin to function.
 As soon as the fetus is born, the oval foramen, ductus arteriosus, ductus venosus &
umbilical vessels are no longer needed.
 The sphincter in the ductus venosus constricts & all blood entering the liver passes
through the hepatic sinusoids
 This, combined with occlusion of placental circulation, causes an immediate
decrease in blood pressure in IVC & right atrium
 The pressure in left atrium is higher than in right atrium, because of increased
pulmonary blood flow.
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 The increased left atrial pressure closes the oval foramen by pressing the valve of foramen against the
septum secundum
 The output from right ventricle then flows entirely into the pulmonary circulation.
 Blood flow in the ductus arteriosus reverses passing from the aorta to pulmonary trunk, because
pulmonary vascular resistance is lower than systemic vascular resistance.
 Ductus arteriosus begins to constrict at birth, but for a few days there is often a small shunt of blood
from the aorta to pulmonary trunk in healthy, full-term neonates.
 In full-term neonates, oxygen is the most important factor in controlling closure of the ductus
arteriosus & it appears to be mediated by bradykinin (released from the lungs) & prostaglandins
that act on the smooth muscle in the wall of ductus arteriosus.
 The umbilical arteries constrict at birth, preventing loss of neonate’s blood.

 The umbilical cord is not tied for a minute; so, blood flow through the umbilical vein continues,
transferring fetal blood from placenta to neonate.
 The change from fetal to adult pattern of blood circulation is not a sudden occurrence.
 Umbilical Vein= Round Ligament of Liver (ligamentum teres)

 Ductus Venosus = Ligamentum Venosum
 Umbilical Arteries & Abdominal Ligaments:
 Most of the intra-abdominal parts of umbilical arteries become the medial umbilical ligaments
 Proximal parts of these vessels persist as the superior vesical arteries, which supply the urinary bladder.
 Oval Foramen = Oval Fossa

 Ductus Arteriosus = Ligamentum Arteriosum

CVS Emryology

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CVS Emryology

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 Pharyngeal arches (6) form during the 4th & 5th weeks as neural crest cells migrate into

 Branches of Dorsal Aorta:

 In the sacral region form the lateral sacral arteries.

Fate of Umbilical Artery

 Pharyngeal arch is supplied by pharyngeal arch arteries.

 Derivatives of Fourth Pair of Pharyngeal Arch Arteries:

 Right fourth pharyngeal arch artery:

 Fate of Fifth Pair of Pharyngeal Arch Arteries:

 Derivatives of Sixth Pair of Pharyngeal Arch Arteries:

 Anomalous right subclavian artery (Retroesophageal):

 Double pharyngeal arch artery:

 The important vascular in transitional circulation are:

 Important circulatory adjustments occur at birth:

 The umbilical arteries constrict at birth, preventing loss of neonate’s blood.

 Umbilical Vein= Round Ligament of Liver (ligamentum teres)

 Oval Foramen = Oval Fossa

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