Dr.B.B.

Gosai
Professor in Anatomy
Ojvensha e-learning resources

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Learning objectives:
 Formation of septum in common atrium.
 Formation of septum in atrioventricular canal.
 Formation of atrioventricular valves.
 Formation of septum in truncus arteriosus
and bulbus cordis.
 Formation of septum in Ventricles.
 Heart Defects: ASD, Patent foramen oval,
Tetralogy of Fallot,VSD etc.
Reference:
 Langman’s Medical Embryology by
T.W.Sadler

 Other Reference Book:

 Developing Human by Keith Moore
DEVELOPMENT OF HEART
AND ITS ANOMALIES
 Formation of Cardiac Septa
And Partitioning of the Primordial
heart
Partitioning of heart tube
 The early heart tube has a straight continuous lumen.
To fulfill the functional needs it is partitioned to make
arterial and venous circulations separate.
 The common opening between atrium and ventricle (atrio
ventricular canal) is partitioned into right and left atrio
ventricular openings.
 Atrium is partitioned into right and left atrium by inter
atrial septum .
 Ventricle is partitioned into right and left ventricle by
inter ventricular septum.

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Partitioning of atrioventricular canal

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Partitioning of atrio ventricular canal

 On dorsal and ventral walls of

atrio ventricular canal (AVC).
swellings of subendocardial
tissue develop. They are called
sub endocardial cushions
(SEC).
 They fuse in the middle.
 Fused SEC thus divide AV canal
into right and left atrio
ventricular canals or orifices
(RAVC) and (LAVC)

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Partitioning of atrio ventricular canal
 At margins of these orifices (RAVC and
LAVC) endocardium swells to form folds
which are hollowed out from ventricular
side to form valvular cusps.
 Three cusps are made in right atrio
ventricular orifice (Tricuspid valve)
and two in left atrio ventricular orifice
(Mitral valve).
 Cusps remain attached to myocardium
by muscular strands which later
differentiate into papillary muscles
and chordae tendineae

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DAY23 DAY 26 DAY 31 DAY 35

FORMATION OF SEPTUM IN ATRIOVENTRICULAR CANAL

FRONTAL SECTION THROUGH THE HEART OF A 35 DAY
EMBRYO
 Partitioning of atrium
(Development of Inter atrial septum)
 From roof of common atrium a thin
crescent shaped fold of endocardium
with a thin core of cardiac jelly grows
towards fused SEC (EC) called septum
primum (SP)
 The decreasing gap between growing
free margin of SP and fused SEC is called
foramen primum (FP)
 This foramen obliterates by fusion of SP
with fused SEC. However before that
upper part of SP degenerates to form
foramen secundum (FS)
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 Partitioning of atrium
(Development of Inter atrial septum)

 To right of SP, appears another

stout crescent shaped septum,
called septum secundum (SSE).
 It over lapses foramen secundum
and does not reach and fuse with
fused SEC.
 Oval aperture below its free margin
After birth SP and SS fuse
is called foramen ovale (FO) to form complete interatrial
 During IUL thus two atria are in septum. The lower edge of
free communication. SSE forms anulus ovalis
and oval depression below
that is called fossa ovalis

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ATRIAL SEPTA AT
VARIOUS STAGES
OF DEVELOPMENT
CORONAL SECTION THROUGH THE HEART TO SHOW THE
DEVELOPMENT OF SMOOTH WALLED PORTION OF ATRIA
 Clinical Correlation and Anomalies
 Heart defects
 Incidence: 1%..
 8% genetic factors. , Chromosomal
abnormalities , Trisomy 18, Down syndrome,
Digorge Syndrome.
 Mutationiheartspecifying gene : e.g.Nkx2-5 on 5q35
produces ASD
 2%environmental agents– rubella,
thalidomide, hypervitaminosis A,Alcohol,
Maternal diabetes, Hypertansion
 Multifactorial
Atrial Septal Defect (ASD)
 Incidence: 6.4/10,000 births,
 2:1 male:female
 Ostium secundum defect– large opening between
right and left atrium
 Cor triloculare biventriculare
 Prenatal closure of foramen ovale
 Persistant atrioventricular canal.--- improper
closure of Endocardial cushions– atrial and ventricular
component
 Osteium Primum Defect combined with a cleft in the anterior cleft of
tricuspid valve
COR TRICOLURAE BIVENTRICULARE
FAILURE OF DEVELOPMENT OF SEPTUM
SECUNDUM
 PERSISTENT COMMON
ATRIOVENTRICULAR CANAL
 Partitioning of ventricle
(Development of Inter ventricular septum)

 From ventral wall of common

ventricle a crescent shaped
septum grows dorsal wards.
 It lies obliquely and has 2 horns
 Cranial horn fuses with SEC.
Caudal horn fuses with bulber
ridge.
 Cardiac muscles grow in it. It is
the muscular part of inter
ventricular septum.

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 Partitioning of ventricle
(Development of Inter ventricular septum)

 The space bounded by

free margin of muscular
part of inter ventricular
septum and fused SEC is
the inter ventricular
foramen ( till end of 7th
week ).

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 Partitioning of ventricle
(Development of Inter ventricular septum)
 This foramen closes by
proliferation of bulbar ridges
(from bulbus cordis) and
subendocardial cushions
towards free margin of
muscular part of inter
ventricular septum.
 It is the membranous part
of inter ventricular septum.
The septum thereby divide
common ventricle into right
and left ventricles
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 Partitioning of ventricle
(Development of Inter ventricular septum)
 With establishment of right
and left ventricles proximal
portion of bulbus cordis
incorporates into right
ventricle as infundibulum
and into left ventricle as aortic
vestibule.
 Distal part of Bulbus cordis
and truncus arteriosus is
partitioned by aortico
pulmonary septum into aorta
and pulmonary trunk.
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Partitioning of bulbus cordis and truncus arteriosus
(Development of pulmonary trunk and aorta) 42
 Partitioning of bulbus cordis and truncus arteriosus
(Development of pulmonary trunk and aorta)

 The aortico pulmonary

septum is formed by
subendocardial thickenings…
induced by invasion of neural
crest cells.
 Two bulbar and two truncal
ridges ( right and left) project
from side walls of bulbus
cordis and truncus arteriosus
respectively

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Partitioning of bulbus cordis and truncus arteriosus
(Development of pulmonary trunk and aorta)

 They fuse with each other in

mid line to form aortico
pulmonary septum.
 It separates aorta from
pulmonary trunk.
 It twists 180o degrees
clockwise at its middle so
that aorta goes behind
pulmonary trunk
proximally

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 Partitioning of bulbus cordis and truncusarteriosus
(Development of pulmonary trunk and aorta)
 The aortico pulmonary septum
grows towards dividing ventricles.
 It unites with inter ventricular
septum.
 The aorta connects to left
ventricle and pulmonary trunk
to right ventricle.
 Three swellings appear at orifices of
each of aorta and pulmonary trunk.
These become excavated from their
upper side to form semi lunar
valves

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Left Atrium
 After division of common
atrium by inter atrial septum
into right and left atria the
original left atrium forms
trabeculated part of left
atrium
 The major smooth part of left
atrium arises by incorporation
of four pulmonary veins which
develop as lungs form

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 Clinical Correlation and Anomalies
 Heart defects
 Ventricular Septal Defect (VSD): most
common congenital anomaly. Defective
formation of interventricular septum.
 Incidence: 12/10000 births.
 Persistent Truncus arteriosus: due to failure of
fusion of conotruncal ridges.
 Transposition of great vessels: due to faulty
formation of conotruncal spiral septum.
 Valvular stenosis: Narrowing of the valves.
Pulmaonry stenosis, Mitral stenosis, aortic
stenosis.
Ventricular septal Defects

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Transposition of great vessels

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Tetralogy of Fallot
 Most frequently occuring
abnormality of the conotruncal
region. It is due to unequal division
of the conus. Displacement of the
conotruncal septum produces four
cardiovascular alterations:
 Narrow right ventricular outflow
region-Pulmonary stenosis
 Large defect of interventricular
septum
 Overriding aorta.
 Hypertrophy of the right ventricular
wall.
 Incidence: 9.6/10000 births.

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Dextrocardia Ectopic Cordis
….Thanks….

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