Developmental aspect of lung disease Flashcards
Whats the gestational age for embryonic, Pseudoglandular, canalicular, saccular and alveolar?
E: 3-8 weeks P: 5-17 weeks C: 16-26 weeks S: 24-38 weeks A: 36 weeks
Describe the morphogenesis in embryonic
Lungs originate from oespophagus
Respiratory diverticulum – trachea
In stage C, the lobes can sometimes be seen developing
Describe the morphogenesis in pseudoglandular
COnducting segments start to develop alongside the cilia and mucous
Describe the morphogenesis in canalicular
Early gas exchange begins to start
Development of small sacs that develop into alveoli
Surfactant organs began to develop too
Describe the morphogenesis in saccular
Precursors for alveoli
Development of type 1 and type 2
Describe the morphogenesis in alveolar
Once filled with air will change shape and geometry and continue to grow for the next 2-3 years
What is postnatal lung growth?
Alveolar septation continues
100-150 million at birth to 200-600 million at 3-8 years
Increased alveolar dimensions thereafter
MRI suggests new alveolar development up to late childhood
At which week can babies survive with ventilation?
Week 24
Name 3 common congenital upper abnormalities
Tracheal agenesis and stendosis
tracheomalacia
tracheo-oesophageal fistula
Name 3 common congenital lower abnormalities
Lung agenesis/pulmonary hypoplasia
bronchogenic cyst
CPAM
congenital diaphragmatic hernia
When does ultrasound happen for mum and baby?
At around 12 weeks during antenatal screening
Presenting features in newborn for lung disease
Newborn
Tachypnoea
Respiratory distress
Feeding issues
Presenting features in Childhood for lung disease
Stridor/wheeze
Recurrent pneumonia
Cough
Feeding issues
Presenting features in asymptomatic for lung disease
Incidental findings
What is tracheal agenesis?
Very rare an presents at birth with acute respiratory distress and inability to intubate
What is tracheal stenosis?
Very rare
Complete tracheal cartilage rings, may be generalized or segmental
Present at birth or within first year
Funnel shape near the end of the branching into two bronchi
What is tracheomalacia?
Dynamic abnormal collapse of tracheal walls
and leads to floppiness.
Can be caused by external compression
What is presentation of tracheomalacia?
Presentation: Barking cough Recurrent “croup” Breathless on exertion Stridor/wheeze
What is tracheo-oesphageal fistula?
Abnormal connection between trachea and oesphagus
Association with genetic conditions
What is presentation and treatment of tracheo-oesphageal fistula?
May be diagnosed antenatally or postnatally
Presentation: Choking Colour change Cough with feeding Unable to pass NG
Treatment with surgical repair
Complications include tracheomalacia, strictures, leak and reflux
What is congenital pulmonary airway malformation?
Abnormal non-functioning lung tissue
80% detected antenatally
Occur sporadically
May resolve spontaneously in utero
Conservative management if asymptomatic
Surgical intervention may be required
Possible risk of malignant change
When is diaphragm developed and closure occurs?
Around 7 weeks from multiple tissues
Closure by 18weeks
Describe congenital diaphragmatic hernia and its managment
Affects 1 in 2500 births
Different types, most common Bochdalek (90%)
Usually left side > right side
Most diagnosed antenatally
Some cases diagnosis late
Management surgical repair
Prognosis depends on degree of lung hypoplasia
What are the changes in lungs after birth?
Significant changes occur at birth after first breath
Lungs inflate and fluid in lungs is absorbed
