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CPR Exam 1 > 4. Respiratory Embryology > Flashcards

4. Respiratory Embryology Flashcards

1
Q

what does the resp system start as

A

laryngotracheal groove

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2
Q

What is the relative location of the laryngotracheal groove?

A

inferior to 4th pharyngeal arches and in the floor of the cuadal foregut/primordial pharynx

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3
Q

what gives rise to

pul epithelium

glands of larynx, trachea & bronchi

A

endoderm of laryngotracheal groove

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4
Q

what gives rist to the CT, cartilage & smooth m in resp system

A

splanchnic mesoderm (from lateral plate)

-surrounds the foregut

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5
Q

how does the globular respiratory bud form

A

anterior outgrowth from the laryngotracheal groove –> diverticulum –> continue to grow and becomes resp bud

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6
Q

what is the fxn of the tracheoesophageal folds

A

grow inward, fuse & form tracheoesophageal septum (end of week 5) and pinch off (seperate esophagus & laryngotracheal tube distal laryngotracheal opening)

still invested in splanchnic mesoderm

top part stays connected and then becomes two tubes

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7
Q

where does the laryngotracheal diverticulum branch off from

A

primordial pharynx

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8
Q

How is the foregut divided after trachoesphageal septum is formed?

A

ventral = laryngotracheal tube (primordium of larynx, trachea, bronchi, lungs)

dorsal = primordium of oropharynx, esophagus

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9
Q

what germ layer does the epithelial lining of the larynx derived from

A

endoderm of laryngotracheal tube

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10
Q

what germ layer does the cartilage of the larynx derived from

A

mesenchyme of 4th & 6th pairs of PAs

NCC

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11
Q

what converts the primordial glottis into a T-shaped laryngeal inlet

A

mesenchyme that produces paired arytenoid swellings

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12
Q

how do the vocal folds (cords) & vestibular folds form

A

laryngeal epithelium proliferate and occlude laryngeal lumen - close off inlet

recanalization at week 10 - recreate inlet

form laryngeal ventricles bounded by folds of mucous membrane

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13
Q

what does the epiglottis develop from

A

hypopharyngeal eminence

from mesenchyme of the 3-4th PAs

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14
Q

what do laryngeal Ms develop from

A

myoblasts of the 4th & 6th PAs

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15
Q

Which population of people are at a higher risk of choking and why?

A

Young children

Larynx is at a much higher location in children –> descends as you age (over the first 2 years)

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16
Q

why is the epiglottis initially so high up in neonates

A

epiglottis moves up toward and touches soft palate when ingesting food

  • helps w/ suckling reflex & makes neonates nose breathers
  • able to change from liquid to solid diet as child grows bc epiglottis descends
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17
Q

what is laryngeal atresia

A

rare birth defect from failure of recanalization of the larynx (very small inlet)

-obstruction of the upper fetal airway - or - congenital high airway obstruction syndrome

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18
Q

what are the effects of laryngeal atresia & how is it treated

A

airways dilated, lungs enlarged & filled with fluid

diaphragm flatten or inverted –> fetal ascites &/or hydrops

treat w/ endoscopic dilation of the laryngeal web

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19
Q

what germ layers form the tracheal epithelium & glands & pulmonary epithelium

A

endoderm

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20
Q

what does the laryngotracheal diverticulum differentiate into

A

trachea

2 primary bronchial buds

21
Q

what germ layer forms the tracheal cartilage (hyaline), CT and M

A

splanchnic mesenchyme

22
Q

what is tracheoesophageal fistula

A

abnormal connection btn trachea & esophagus bc failure of foregut endoderm to proliferate rapidly

most common congenital anomaly of lower resp tract - 1/3000-5000

23
Q

what is esophageal atresia

A

blind esophagus

associated with 85% of tracheoesophageal fistulas

24
Q

what are symptoms of trachoesophageal fistulas

A

cant swallow

freq drool saliva

immediate regurgitation

gastic/intestinal contents reflux thru fistual to trachea & lungs

may have polyhydramnios

25
Q

what is polyhydramnios

A

excess amniotic fluid

(fistula can impair this and fluid isn’t removed or resorbed)

USUALLY –> fetus inhales fluid to inflate and practice breating at mid to late gestation & also swallow fluid to help GI system ==> usually this is resorbed back to the placenta - in this case it isnt!

26
Q

when does the resp bud form

A

week 4

27
Q

what happens next after the resp bud

A

it grows ventrocaudally & bifurcates –> makes primary bronchial buds

-these then grow laterally into pericardioperitoneal canals

28
Q

when do the primary bronchial buds branch & what do they form

A

beginning of week 5

secondary bronchial buds –> tertiary bronchial buds

29
Q

what regulates the branching pattern of the lung endoderm

A

splanchnic mesoderm

30
Q

what are bronchopulmonary segments & when are they formed

A

segmental bronchi & mesenchyme

week 7

31
Q

what germ layer is the origin of the visceral pleura

A

splanchnic portion of the lateral plate mesoderm

32
Q

what is the germ layer origin of parietal pleura

A

somatic portion of the lateral plate mesoderm

33
Q

what are the 4 steps of lung maturation

A
  1. pseudoglandular (week 5-17)
  2. canalicular (week 16-25)
  3. terminal sac (week 24 to birth)
  4. alveolar (week 32- 8 yrs)
34
Q

what occurs in the pseudoglandular phase

A

week 5-17

histologically looks like exocrine gland

form all major elements of lung EXCEPT those involved in gas exchange

-born at this time - fetus cannot survive

35
Q

what happens in the canalicular phase

A

week 16-25

vascularization

resp bronchioles

primordial aleveolar & sacs present (primitive alevoli)

born now: +/- survive

36
Q

what happens in the terminal sac phase

A

week 24 to birth

form numerous alveoli

-thin epithelium w/ increased vascularization (type I & II pneumocytes & lymphatic capillaries)

gas exchange starts to occur

born now: survivable

37
Q

what happens in alveolar phase

A

week 32 to 8 years

alveolocapillary membrane

primitive alveoli

form more primitive alveoli

mature alveoli

(around 95% alveoli mature postnatally)

38
Q

why is splanchnic mesoderm critical as the bronchi develop

A

make :

  1. cartilaginous plates (bronchial)
  2. bronchial smooth M & CT
  3. pul CT & capillaries
39
Q

How are new alveoli added until 8 years of age?

A

a primitive alveoli may be split by a septa creating 2 alveoli. Mature alveoli CANNOT be split, only primitive

40
Q

What is the purpose of fetal breathing movements?

A

essential for normal lung development

used for fetal monitoring during development

Causes some aspiration of amniotic fluid

41
Q

How is amniotic fluid cleared from the lungs at birth?

A

pressure during vaginal delivery, suction, and absorbed by lymphatics, capillaries, arteries, and veins

42
Q

What is pulmonary agenesis?

A

Complete Absence of Lungs, Bronchi, and Vasculature. Respiratory bud fails to split into left and right bronchial buds

43
Q

What is pulmonary hypoplasia?

A

underdevelopment of the lungs due to uterine pressure on the the fetal thorax

Commonly caused by oligohydramnios, especially if it occurs <26 weeks

44
Q

What is oligohydramnios?

A

insufficient amniotic fluid production (<500mL)

Typically associated with renal agenesis or failure

45
Q

What is the oligohydramnios (Potters) sequence?

A

clubbed feet

hand position defects

pulm hypoplasia

breech position

cranial anomalies related to oligohydramnios

46
Q

What is respiratory distress syndrome?

A

absence of lung surfactant in premature infants due to a defect in type 2 alveolar cells

Previously called hyaline membrane disease due to glassy appearance

47
Q

What are the signs of respiratory distress syndrome?

A

tachypnea, nasal flaring, suprasternal, intercostal, or subcostal retractions, grunting, and cyanosis

48
Q

What are congenital lung cysts?

A

cysts filled with fluid or air

thought to be formed by the abnormal dilation of terminal bronchi

May cause wheezing, cyanosis, and difficulty breathing.

CPR Exam 1 (27 decks)

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