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Medicine 1 Respiratory > Developmental Aspects of Lung Disease > Flashcards

Developmental Aspects of Lung Disease Flashcards

1
Q

What is morphogenesis?

A

The origin and development of morphological characteristics

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2
Q

What is morphology?

A

Branch of biology dealing with the study of the form and structure of organisms

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3
Q

What are the stages of lung morphogenesis?

A

1) Embryonic (3-8 weeks)
2) Pseudo-glandular (5-17 weeks)
3) Canalicular (16-26 weeks)
4) Saccular (24-38 weeks)
5) Alveolar (36 weeks - 2/3 years)

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4
Q

When is the embryonic stage of lung morphogenesis?

A

3-8 weeks

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5
Q

When is the pseudo-glandular stage of lung morphogenesis?

A

5-17 weeks

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6
Q

When is the canalicular stage of lung morphogenesis?

A

16-26 weeks

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7
Q

When is the succular stage of lung morphogenesis?

A

24-38 weeks

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8
Q

When is the alveolar stage of lung morphogenesis?

A

36 weeks - 2/3 years

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9
Q

What stage of lung morphogenesis is this?

A

Embryonic

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10
Q

What stage of lung morphogenesis is this?

A

Pseudo-glandular

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11
Q

What happens to the alveoli after birth?

A

They continue to seperate

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12
Q

How many alveoli are there at birth compared to at 3-8 years?

A

100-150 million at birth

200-600 million at 3-8 years

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13
Q

What happens to alveolar dimensions as children age?

A

They increase

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14
Q

What happens during the embryonic and pseudo-glandular stages?

A

Formation of major airways

Formation of bronchial tree and portions of respiratory parenchyma

Birth of the acinus

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15
Q

What happens during the canalicular stage?

A

Last generation of the lung periphery formed

Epithelial differentiation

Air blood barrier formed

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16
Q

What happens during the saccular stage?

A

Expansion of air spaces

Surfactant detectable in amniotic fluid

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17
Q

What happens during the alveolar stage?

A

Secondary seperation

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18
Q

When are presenting problems found?

A

Foetal ultrasound (75%)

Childhood (15%)

Newborn (10%)

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19
Q

What presenting problems are detected in a newborn?

A

Trachypnoea (abnormally rapid breathing)

Respiratory distress

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20
Q

What is trachypnoea?

A

Abnormally rapid breathing

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21
Q

What is abnormally rapid breathing called?

A

Trachypnoea

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22
Q

What problems are often detected in childhood?

A

Wheeze/stridor

Recurrent pneumonia (same region of the lung)

Incidental finding

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23
Q

What is congenital?

A

A disease present from birth

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24
Q

What is a disease present from birth known as?

A

Congenital

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25
Q

What are some common congenital lung diseases?

A

Tracheo-bronchomalacia

Pulmonary adenomatoid malformation

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26
Q

What are symptoms of tracheo-bronchomalacia?

A

Barking cough

Early onset

Breathless on exertion

Stridor/wheeze

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27
Q

What is the management of tracheo-bronchomalacia?

A

Airway clearance physiotherapy

Antibiotics

Avoid asthma treatment

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28
Q

What is trachea-bronchomalacia?

A

Uncommon disease of the central airways resulting from softening or damage of the cartilaginous structures of the airway walls in the trachea and bronchi

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29
Q

What is pulmonary adenomatoid malformation?

A

Usually an entire lobe of lung is replaced with is replaced with a non-working cystic piece of abnormal lung tissue

30
Q

When does closure of the diaphragm occur?

A

About 18 weeks

31
Q

What contributes to the development of the diaphragm?

A

Variety of primitive tissues

32
Q

What are some possible diaphragm abnormalities?

A

Diaphragmatic hernia

Eventuation (protrusion of contents of the abdoment through a defect or weakness in the abdominal wall)

33
Q

What are some possible causes of a diaphragmatic hernia?

A

Pulmonary hypoplasia

Persistent pulmonary hypertension

34
Q

What is pulmonary hypoplasia?

A

Incomplete development of the lungs, resulting in a low number of bronchopulmonary segments or alveoli

35
Q

What is persistant pulmonary hypertension?

A

Babies circulation does not change over from feotal to newborn circulation, so blood is forced away from the lungs due to high pressure in the arteries

36
Q

What is eventuation?

A

Protrusion of contents of the abdoment through a defect or weakness in the abdominal wall

37
Q

What is protrusion of contents of the abdomen through a defect or weakness in the abdominal wall known as?

A

Eventuation

38
Q

What is a diaphragmatic hernia?

A

Abnormal opening in the diaphragm

39
Q

What is a functional change in the lungs at birth?

A

Change from fluid secretion to fluid absorption

40
Q

What could the change from fluid secretion to fluid absorption of the lungs at birth cause?

A

Transient tachypnea

41
Q

What is transient tachypea?

A

Retained foetal lung fluid

42
Q

What is transient tachypnea associated with?

A

Caesarean section delivery

43
Q

How long does it take for transient tachypnea to resolve?

A

24-48 hours

44
Q

What is surfactant?

A

Detergent made from phospholipids and lipophillic proteins

45
Q

What are the functions of surfactant?

A

Stabolises alveoli and promotes gas exchange

46
Q

What is surfactant secreted by?

A

Type II pneumocytes

47
Q

What do type II pneumocytes contain that allows them to secrete surfactant?

A

Lamellar bodies which are secretory organelles

48
Q

What are lamellar bodies?

A

Secretory organelles

49
Q

What is an example of a neotatal lung disease caused by surfactant deficiency?

A

Hyaline membrane disease (RDS)

50
Q

What is hyaline membrane disease?

A

The same as respiratory distress syndrome, caused by a deficiency of surfactant

51
Q

What is hyaline membrane disease also known as?

A

Respiratory distress syndrome

52
Q

What is the treatment of hyaline membrane disease?

A

Antenatal glucoricoids

Surfactant replacement

Supportive

53
Q

What is chronic neonatal lung disease?

A

General term for persistant respiratory problems in premature babies

54
Q

What is chronic neonatal lung disease also known as?

A

Bronchopulmonary dysplasia or CLD prematurity

55
Q

What are some of the possible causes of chronic neonatal lung disease?

A

Antenatal infection

Barotrauma/oxygen toxicity

Patent ductus arteriosus (PDA)

Genetic

56
Q

What is barotrauma?

A

Physical damage to bodies due to the pressure difference of gases inside and outside it

57
Q

What is patent ductus arteriosus (PDA)?

A

Ductus arteriosus fails to close after birth

58
Q

What does chronic neonatal lung disease increase the chances of?

A

Childhood respiratory morbidity

Future risk of COPD

59
Q

What is morbidity?

A

The condition of being diseased

60
Q

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

A

In utero nicotine exposure

Foetal infection

Maternal nutrition

Low birth weight/prematurity

Maternal macronutrients/vitamins

61
Q

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

A

Infection

Growth

ETS (environmental tobacco smoke)

Envrionmental pollution

Macronutrient/vitamins

62
Q

What is remodelling?

A

Alteration of structure following an external influence

63
Q

What are examples of remodelling due to pre-natal nicotine exposure?

A

Lung hypoplasia

Reduced alveolarisation

Reduced lung function

Increased susceptability to infection

Interference of inter-cellular signalling

64
Q

What is lung hypoplasia?

A

Incomplete development of the lungs, resulting in low numbers of bronchoplumonary segments or alveoli

65
Q

What are examples of remodelling due to asthma?

A

Chronic inflammation

Increased bronchial responsiveness

Increased mucuc secretions

Airway oedema

Airway narrowing

66
Q

What are examples of remodelling due to chronic neonatal lung disease (CNLD)?

A

Chronic inflammation

Interference of inter-cellular signalling

Treatment toxicity

67
Q

What is CNLD?

A

Chronic neonatal lung disease

68
Q

What is this curve called and what does it tell us?

A

Fletcher peto curve, which tells us the damage from smoking is irreversible, but the decline can be slowed by stopping

69
Q

What cause of death is COPD?

A

3rd leading cause of death in the world

70
Q

What leads to remodelling of the airway/lung parenchyma?

A

Antenatal programming

Environmental exposure

Gene interactions

71
Q

What does low lung function at birth increase the risk of in later life?

A

COPD

Medicine 1 Respiratory (20 decks)

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