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Respiratory System (CA) > 10. Developmental Aspects of Lung Disease > Flashcards

10. Developmental Aspects of Lung Disease Flashcards

1
Q

What is lung morphogenesis?

A

The origin and development of morphological structures

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2
Q

When is Embryonic lung morphogenesis?

A

3-8 weeks

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3
Q

When is Pseudo-glandular lung morphogenesis?

A

5-17 weeks

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4
Q

When is Canalicular lung morphogenesis?

A

16-26 weeks

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5
Q

When is Saccular lung morphogenesis?

A

24-38 weeks

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6
Q

When is Alveolar lung morphogenesis?

A

36 weeks - ~2-3years

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7
Q

What happens during Postnatal lung growth?

A

Alveolar septation continues
100-150 million at birth to 200-600 million at 8 years
Increased alveolar dimensions thereafter

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8
Q

When is the embryonic period?

A

0-8 weeks

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9
Q

When is the fatal period?

A

8-38 weeks

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10
Q

Which two types of morphogenesis are referred to as organogenesis?

A

Embryonic and Pseudoglandular

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11
Q

Which three types of morphogenesis are referred to as differentiation?

A

Canalicular, Saccular and Alveolar

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12
Q

What happens during Organogenesis?

A

Embryonic
- Formation of major airways

Pseudoglandular

  • Formation of bronchial tree and portions of respiratory parenchyma
  • Birth of the acinus
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13
Q

What happens during Differentiation?

A

Canalicular

  • Last generations of the lung periphery formed
  • Epithelial differentiation
  • Air-blood barrier formed

Saccular

  • Expansion of air spaces
  • Surfactant detectable in amnionic fluid

Alveolar
- Secondary septation

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14
Q

When does surfactant begin to appear?

A

~25 weeks

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15
Q

When does birth tend to occur?

A

38 weeks

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16
Q

What happens during the embryonic stage?

A

Appearance of lung buds and main pulmonary arteries, trachea and main bronchi

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17
Q

What happens during the pseudoglandular stage?

A

All conducting airways and accompanying blood vessels form, wall structure and epithelial cells differentiate

Bronchi: 8-13 generations
Bronchioli: 3-10 generations

18
Q

What happens during the canalicular stage?

A

Respiratory airways form, blood-gas barrier thins, surfactant appears

Respiratory bronchioli: 3-5 generations
Alveolar ducts: 2-3 generations

19
Q

What happens during the saccular-alveolar stage?

A

Saccules and then alveoli appear

100 million by birth

20
Q

What happens for two to four years after birth?

A

Alveoli multiply 300-600 million

Airways double in size

21
Q

Which two stages are form the acinus?

A

Canalicular and Saccular-alveolar stage

22
Q

What are the embryonic signs of congenital lung disease?

A

Tracheal, laryngeal stenosis
Pulmonary agenesis
Tracheo-oseophageal fistula

23
Q

What are the pseudoglandular signs of congenital lung disease?

A

Pulmonary sequestration
Cystadenomatoid malformation
Cyst formation

24
Q

Which tissues are involved in diaphragm development?

A

Membrana pleuro-peritonealis
Mesoesophagus
Septum transversum

25
Q

Which three tubular parts of the body are contained in the mesoesophagus?

A

Aorta
Esophagus
Vena cava

26
Q

At which point does the diaphragm close?

A

~18 weeks

27
Q

What are some features of a diaphragmatic hernia?

A

L>R
Pulmonary hypoplasia
Persistent pulmonary hypertension

28
Q

What are some diaphragmatic abnormalities?

A

Hernia

Eventration

29
Q

What happens to the cells in the lungs after birth?

A

Change from fluid secreting to fluid absorbing

Pulmonary vasodilation

30
Q

What occurs when a newborn has transient tachypnea?

A

Fluid is retained in the lungs and this can be seen as a wet lung upon xray

31
Q

What is surfactant and what does it do?

A

Detergent composed of phospholipids and lipophilic proteins

Stabilises alveoli and promotes gas exchange

32
Q

Where is surfactant produced?

A

Type 2 pneumocytes

- lamellar bodies

33
Q

What neonatal condition is associated with surfactant deficiency?

A

Hyaline Membrane Disease (RDS)

34
Q

How is RDS treated?

A 
Antenatal glucocorticoids
Surfactant replacement
O2
CPAP
Mechanical ventilation
35
Q

What is associated with Chronic neonatal lung disease (BDP, CLDP)?

A

Increased severity bronchiolitis
Asthma
Future COPD?

36
Q

What are the antenatal origins of adult lung disease (COPD)?

A

In utero nicotine exposure
Nutrition
Low birth weight/prematurity (antenatal steroids)
Micronutrients/vitamins

37
Q

What are the post-natal origins of adult lung disease (COPD)?

A 
Infection (barker hypothesis)
Growth
ETS (+/- a1 AT deficiency)
Environmental pollution
Micronutrients/vitamins
38
Q

At which age would respiratory symptoms appear in a person with a normal childhood grown and accelerated decline?

A

~65

39
Q

At which age would respiratory symptoms appear in a person with a normal childhood grown and early decline?

A

~75

40
Q

At which age would respiratory symptoms appear in a person with a failure to attain maximal growth and normal decline?

A

~65

41
Q

What trends occur in all FEV1/FVC ratios as a person ages?

A

Decrease

42
Q

What place does COPD take on the leading causes of death in the world?

A

3rd

Respiratory System (CA) (32 decks)

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