developmental aspects of lung disease

Question 1

what arw the stages of lung morphogenesis

Answer 1

embryonic 3-8 weeks 
paeudoglandular 5-17
canalicukar 16-26
saccukar 24-38
alveolar 36 to 2/3 years

Question 2

what happens in the embryonic phase

Answer 2

lung bud starts to develop from foetal foregut
at 5 weeks two primary lung buds are visible which later become lobar buds of which 3 on right and 2 on left
derived from endoderm

Question 3

what happens in the pseudoglandular ohase

Answer 3

rapid branching of airways
eventually 16-25 prinaribe segmentive bronchi
cilia and mucous glands start to apprar

Question 4

what is the canalicukar phase

Answer 4

phase where lungs develop dostal architecture
terminal bronchioles, alveolar sace and capillary blood vessels form gas exhange units
thoe 1 and 2 pneumocytes form

Question 5

what happens in the saccular phase

Answer 5

albeolar sacs grow and become well formed
more surfactant productedb
interstitial tissue between sacs decrease
alveokar sace thin

Question 6

what happens in the alveolar stage

Answer 6

independently sustain breathing withour support

Question 7

what are common congenital abnormalities

Answer 7

UPPER
laryngomalacia and tracheomalacia
tracheo - oesophageal fistula

LOWER
COAM
congenital diaphragmatic hernia

Question 8

how do you find congenital abnormalities

Answer 8

antenatal scanning

• ultrasound
• MRI

newborn

• tachypnoea
• resp distress
• feeding issues

childhood

• stridor/ cough
• recurrent oneumonia
• wheeze
• feeing issues

Question 9

what is laryngomalacia

Answer 9

softening of the larynx
commonly seen in infants
present w strodor worse w feeing or when upset/excited
will imrove within first year
concern if it effects deeding, growth or causes wonorad

Question 10

what is tracheomalacia

Answer 10

floppiness of trachea 
associated w genetic conditions 
or external compression 
presbtw w a barking cough
recurrent croup
breathlessness on exertion 
stridor or wheeze

Question 11

who do u manage tracheomalacia

Answer 11

physio and antibiotics

batural history resolution w time

Question 12

what is tracheo - oespphageal fistula

Answer 12

abnormal connectuon between trachea and oesophagus
majorify have associated oesophageal atresja
associagion w genetic conditions

Question 13

how does a tracho oesophageal fistula oresent

Answer 13

choking
colour change
cough w feeding
unable to pass NG

treatment w surgical repair

Question 14

what are complications w tracheo oesophageal fistula

Answer 14

tracheomalacia
strictures
leak
reflux

Question 15

what is congenitak pulmonary airway malformation CPAM

Answer 15

abnormal non functioning lung tissue 
occur spontaneously 
may resokve spontaneoyslt in utero 
conservative management if asymptomatic 
may require surgical intervention
possible risk of malognant change

Question 16

what is a congenitak diaphragmatic hernia

Answer 16

diaphrahm sometimes doesnt close at 18 weeks or not properly
usually the left side
management is surficak repair

Question 17

what is transient tachypnoea

Answer 17

fluid in lungs does not move as effectively due to lings inflating from child passing theough birth canal and first breatb
improves in 1-2 days

Question 18

what is resp dostressbsyndrome

Answer 18

surfactant deficiency
treated w antenatel sterouds
surfactant replacement
appropriate cent and butritoon

Question 19

what is remodelling

Answer 19

aleteration of airway structure 
environmwntal exposure (smoking)
chrinic diseases id childhood ( asthma) 
infectjon 
leads to abnormalities due to interference of inter cellukar signallinf

Question 20

what does chrinic i flammation keas ro

Answer 20

increased bronchial responsiveness
incrrase mucus secretion
airway oedema
airway narrowing