Embryology lecture 7

DEVELOPMENT OF CARDIOVASCULAR SYSTEM= BLOOD CELLS AND

VESSELS

Formation of the blood cells (hematopoiesis)

By the third week of gestation, the embryo size has grown to a size where
distribution of oxygen by diffusion to its increasing mass is unviable. This
necessitates the development of a cardiovascular system. At different
stages of embryonic development, there exist different sites where
embryonic blood cells are formed. The first embryonic blood cell formation
begins by the development of a blood island in the yolk sac. This island is
formed by cells called hemangioblasts which can give rise to endothelial
cells or hematopoietic cells. The embryonic hematopoietic stem cells
which are sometimes called hemacytoblasts are capable of giving rise to
all the cells of the embryonic blood.

Very early in development, the hematopoietic stem cells divide into two
separate lineages; the lymphoid stem cells and the myeloid stem cells.
Lymphoid stem cell lineage gives rise to T and B lymphocytes. Myeloid
stem cell lineage gives rise to erythrocytes, platelets and granulocytes.

The erythrocytes produced in the blood island enter the blood circulation
at around 22nd day of gestation. They are the main circulating erythrocytes
for the first six weeks. During this period, other sites of hematopoiesis are
undergoing preparation. From day 28, hematopoiesis begins in the
splanchnopleuric mesoderm and by the period of 5 th to 6th week,
hematopoietic centres are apparent in the liver. The liver eventual
replaces the yolk sac as the sole producer of the blood cells. The
erythrocytes produced by the liver are non nucleated and contains
different type of haemoglobin. The production of blood cells by the liver
declines by the 6th month and the responsibility is taken over by the bone
marrow. The shift of this function from the liver to the bone marrow is
controlled by the cortisol produced by the cortex of fetal adrenal glands. In
the absence of the cortisol, the function of blood cell formation remains
with the liver. Spleen and primitive kidneys may contribute to the
formation of small amounts of blood cells.

Formation of embryonic blood vessels

The blood island in the yolk sac contributes to the development of extra
embryonic vasculature of the embryo although much of the embryonic
vasculature has intra embryonic sources. Small vessels appear in many areas of
the embryo during the period of somite formation. The formation of the blood
vessels occurs in phases. The precursors of blood vessel are called angioblasts.

The first phase is the specification of a group of angioblasts as to whether an

artery or a vein will develop. These angioblasts are organised into a primary
capillary plexus through a process known as vasculogenesis. The capillary plexus
undergoes a process called angiogenesis. This process involves resorption of the
existing vessels and sprouting of new branches to cope with the expanding
vascular network. Angiogenesis process is retained in adult life
Angioblasts arise from most tissues of the mesodermal origin with some
contribution from allantois in the embryo. There are three main mechanism of
blood vessels formation in the embryo; the coalescence of angioblasts in situ as
for large vessels like aorta, the migration of angioblasts from other sites as for
the coronary artery, and vascular sprouting from existing larger vessels as for
the vessels of central nervous system.
After the formation of the vascular endothelial lining, the next step is to build up
the vascular wall. In the trunk and extremities, it is derived from the local
mesoderm associated with the endothelial lining while in the head and areas of
aortic arc system, mesenchymal of neurocrest origin contribute to the formation
of connective tissues and smooth muscles. Local factors influence the initiation
of vasculogenesis and the morphological pattern of a blood vessel.

Embryonic vasculator

ARTERIES
Aortic arches
The blood from the outflow tract of the early embryonic heart flows into an aortic
sac. Six pairs of aortic arches branch from the aortic sac and empty their blood
into a pair of dorsal aorta. Blood from the dorsal aorta is distributed to the
systemic circulation. The aortic arches undergo remodelling in order to adapt to
the morphological changes of the embryo. The first three aortic arches are
remodelled into the carotid artery system. The left fourth arch is retained as the
arch of the aorta while the right arch is integrated into the right subclavian
artery. The sixth arch which is also referred to as pulmonary arch undergoes
asymmetrical adaptation and regression. The distal part of the left arch becomes
ductus arteriosus while the distal part of the right arch regresses. The recurrent
laryngeal nerves are hooked around the corresponding left and right pulmonary
arches. As the heart descends from the cervical region to the thoracic cavity, it
pulls with it the left recurrent laryngeal nerve which is now associated with
ductus arteriosus. Due to the regression of the right pulmonary, the right
laryngeal nerve moves up and get trapped by the right subclavian artery. This
asymmetrical arrangement is reflected in adults where the right nerve curves
around right subclavian and the left nerve is hooked around the ligamentum
arteriosum, which is the adult remnant of ductus arteriosus.

Aortic arches

Branches of embryonic aorta

The paired embryonic dorsal aorta gives rise to three arterial branches; the
dorsal intersegmental, the ventral segmental, and the lateral segmental. These
branches undergoes some modifications before assuming their adult
configuration. The adult derivates of the dorsal intersegmental braches are;
subclavian arteries, intercostals arteries and iliac arteries. Derivates for the
lateral segmental are the renal, adrenal and the gonadol arteries. Ventral
segmental derivatives are the umbilical, and the mesenterics and the celiac
arteries.

Development of veins
The formation of veins is characterised by the formation of irregular capillaries
network, and the subsequent expansion of some of the capillary channels into
veins. The availability of multiple channels and a number of options contribute to
the increased incidence of anatomical variation in the adult venous system. In
the 5th week, 3 pairs of major veins can be distinguished; the vitelline carrying
blood from yolk sac to the sinus venosus, the umbilical carrying oxygenated
blood from chorionic villi to the embryo, and the cardinal veins draining the
body of the embryo.
Cardinal veins
The cardinal veins form the core of the intraembryonic venous circulation. These
veins appear and regresse at different times and locations. The initial cardinal
veins consist of a pair of anterior and posterior cardinal veins. The anterior drains
the head and the posterior drains the body. The two veins in each side join and
drain into the common cardinal vein which then empty into the sinus venosus of
the embryonic heart. Subsequent growth of the heart results in transformation of
the anterior cardinal veins into internal jugular veins and, the superior vena cava
which empties into the right atrium. The proximal part of left common cardinal
vein becomes the coronary sinus which drains into the right atrium.

Extraembryonic veins
These are the vitelline and the umbilical veins. Each begins as a pair of veins
that drains separately into the sinus venosus. Later, they become associated
with the developing liver. Meanwhile the hepatic portal vein which drains the gut
takes shape. Blood from hepatic portal vein enters the liver capillary bed and
leave through hepatic vein and drain into the sinus venosus. Later, ductus
venosus develop and shunts much of the blood from the umbilical vein through
the liver into the inferior vena cava. Ductus venosus enables oxygen rich blood
to bypass the liver capillaries
Pulmonary veins
Venous drainage channels from each lung converge and forms one common
pulmonary vein which drain into the left atrium of the heart. As the expansion of
the atrium progress, it incorporates with it the common pulmonary vein and this
extends to the second branch points of the original pulmonary veins. This results
in four independent pulmonary veins entering the left atrium.
CIRCULATORY CHANGES AT BIRTH
Before birth blood from placenta return to the fetus by the way of umbilical vein.
In the liver, much of this blood flows through ductus venosus into the inferior
vena cava. From here it enters the right atrium and most of it is channelled to
the left atrium through foramen ovale. The portion that enters the right ventricle
is channelled through ductus arteriosus into descending aorta. From the embryo,
blood is transported to the placenta through umbilical arteries.

Closure of the umbilical arteries a few minutes after birth. The distal
portion of the arteries gets obliterated and becomes medial umbilical
ligament. The proximal portion remains open as superior vesicular
arteries.

Closure of umbilical vein and ductus venosus. After obliteration, the

umbilical vein become ligamentum teres hepatis while ductus venosus
become ligamentum venosum.

Closure of ductus arteriosus. The obliterated duct becomes ligamentun

arteriosum .

Closure of foramen ovale. With the first breath, the septum primum is
pressed against septum secundum. During the first days of life, this
closure is reversible. Evidence of foramen ovale position in the adult is
represented by fossa ovalis

foetal circulation

neonatal circulation