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Year 1- Respiratory > Developmental Aspects of Lung Disease > Flashcards

Developmental Aspects of Lung Disease Flashcards

1
Q

How many stages are there in lung morphogenesis?

A

5

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2
Q

What is the first stage in lung morphogenesis and when does it take place?

A

Embryonic
3-8 weeks approx.

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3
Q

What is the second stage in lung morphogenesis and when does it take place?

A

Pseudoglandular
5-27 weeks approx.

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4
Q

What is the third stage in lung morphogenesis and when does it take place?

A

Canalicular
16-26 weeks approx.

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5
Q

What is the fourth stage in lung morphogenesis and when does it take place?

A

Saccular
24-38 weeks approx.

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6
Q

What is the fifth stage in lung morphogenesis and when does it take place?

A

Alveolar
36 weeks- 2/3 years approx.

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7
Q

What happens in the embryonic phase?

A

The lung bud (respiratory diverticulum) develops from the foetal foregut.

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8
Q

What should have happened by week 5 of the embryonic phase?

A

Two primary lung buds are visible.

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9
Q

What do the lung buds divide into?

A

Divide into lobar buds

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10
Q

How many lobar buds are on the right?

A

3

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11
Q

How many lobar buds on the left?

A

2

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12
Q

Where are the lung buds derived from?

A

Endoderm

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13
Q

Where are the blood vessels and connective tissues derived from?

A

Mesoderm

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14
Q

What happens in the Pseudoglandular stage?

A

Rapid branching of the airways.

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15
Q

Which types of specialised cell may appear in the airways during the pseudogladnular stage?

A

Cillia
Mucous glands

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16
Q

What happens in the canalicular phase?

A

Lungs develop their distal architecture- terminal bronchioles, alveolar sacs and capillary blood vessels

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17
Q

Which cells appears in the canalicular stage?

A

Type one and two pneumocytes

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18
Q

What do type 1 pneumocytes have?

A

Very thin membranes to allow gas exchange to take place

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19
Q

What do type 2 pneumocytes produce?

A

Surfacant

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20
Q

What is the limit of viability?

A

When it is possible for a foetus delivered prematurely to successfully survive with intensive care support.

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21
Q

What happens in the saccular phase?

A

Alveolar sacs grow in size and become well-formed.
The bronchioles continue to elongate, interstitial tissue between the sacs reduce and the alveolar walls be come thinner which will improve gas exchange.

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22
Q

What happens is the alveolar phase?

A

The lungs can independent sustain breathing without support.

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23
Q

What is meant by a congenital abnormality?

A

Airway abnormalities present a birth.

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24
Q

Is laryngomalacia an upper or lower resp. abnormality?

A

Upper

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25
Q

Is Congenital Diaphragmatic Hernia an upper or lower resp. abnormality?

A

Lower

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26
Q

Is CPAM (congenital pulmonary airway malformation) an upper or lower resp. abnormality?

A

Lower

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27
Q

Is tracheomalacia an upper or lower resp. abnormality?

A

Upper

28
Q

Is Tracheo-oesphageal fistula an upper or lower resp. abnormality?

A

Upper

29
Q

How can congenital abnormalities be discovered before birth?

A

Antenatal screening via MRI or ultrasound

30
Q

List some of the presenting congenital abnormality symptoms in new-borns.

A

Tachypnoea
Respiratory distress
Feeding issues

31
Q

List some of the presenting congenital abnormality symptoms in childhood.

A

Stridor/wheeze
Recurrent pneumonia
Cough
Feeding issues

32
Q

What happens in Laryngomalacia?

A

Dynamic abnormal collapse of larynx or voice box

33
Q

When is laryngomalacia commonly seen?

A

In infants about 6 weeks onwards

34
Q

What will children with laryngomalacia usually present with?

A

Stridor which gets worse when feeding or the child is excited/upset

35
Q

Discuss when it may be appropriate to give treatment to a child w laryngomalacia?

A

If it affects feeding, growth or causes pauses in breathing (apnoea’s)

36
Q

What is tracheomalacia?

A

Dynamic abnormal collapse of tracheal walls

37
Q

What is the clinical presentation for tracheomalacia?

A

Barking cough
Recurrent “croup”
Breathless on exertion
Stridor/wheeze

38
Q

What may the management of tracheomalacia include?

A

Physiotherapy and antibiotics if the child is unwell.

39
Q

What is a Tracheo-oesphageal fistula?

A

Abnormal connection between trachea and oesphagus

40
Q

What is tracheooesophageal fistula usually associated with?

A

Genetics

41
Q

What other association can those w tracheooesophageal fistula have?

A

Oesophageal atresia

42
Q

What is the presentation for those w tracheooesophageal fistula?

A

Choking
Colour change
Cough with feeding
Unable to pass NG

43
Q

What treatment is there for tracheooesophageal fistula?

A

Surgical repair

44
Q

What are some possible complications of tracheooesophageal fistula?

A

Tracheomalacia, strictures, leak and reflux

45
Q

What is Congenital Pulmonary Airway Malformation (CPAM)?

A

Abnormal non-functioning lung tissue

46
Q

What is a Congenital Diaphragmatic Hernia?

A

Diaphragm develops from multiple tissues around 7 weeks and closes by 18 weeks

47
Q

What side does Congenital Diaphragmatic Hernia usually affect?

A

Left

48
Q

What is the management for Congenital Diaphragmatic Hernia?

A

Surgical repair

49
Q

What changes happen after the first birth after birth?

A

Lungs inflate and fluid in lungs is absorbed

50
Q

What is Transient Tachypnoea of Newborn?

A

Fluid in lungs does not move effectively.

51
Q

What is Transient Tachypnoea of Newborn usually associated with?

A

Caesarean section

52
Q

What is Respiratory Distress Syndrome (RDS) due to?

A

Surfactant deficiency

53
Q

What is the treatment for RDS?

A

Antenatal steroids
Surfactant replacement
Appropriate ventilation and nutrition

54
Q

How can chronic lung disease be related to birth?

A

Associated with prematurity where ongoing oxygen requirement at term

55
Q

What is chronic lung disease associated with?

A

Increased childhood respiratory morbidity

56
Q

List some of the individual factors which may influence lung function at the age of 15.

A

Age
Gender
Height

57
Q

List some of the environmental/lifestyle factors which may influence lung function at the age of 15.

A

Air pollution
Smoking
Second hand smoking
BMI
Serum vitamin D conc.

58
Q

List some of the allergic diseases which may influence lung function at the age of 15.

A

Asthma
Rhinitis
Aero/food allergen sensitization

59
Q

List some of the earl life events which may influence lung function at the age of 15.

A

Parental atopy
Parental education
Maternal age at delivery
Maternal smoking during pregnancy
Second hand smoke
Season of birth
Weight at birth
Lung infections

60
Q

Define remodelling.

A

Alteration of airway structure following external influence

61
Q

Which external influences may cause remodelling?

A

Environmental exposures- smoking
Chronic diseases of childhood- chronic lung disease, asthma
Infection

62
Q

Why does remodelling lead to abnormalities of the airway?

A

Due to interference of inter-cellular signalling

63
Q

Describe some changes in the airway after remodelling.

A

Reduction of lumen with increased mucus plugging
Changes to cells, usually increasing mucus production
Increase in number of inflammatory cells

64
Q

In which diseases might remodelling be seen?

A

Asthma
Chronic lung disease of prematurity

65
Q

What things can the process of chronic inflammation lead to?

A

Increased bronchial responsiveness
Increase mucus secretion
Airway oedema
Airway narrowing

66
Q

List some factors which increase a child’s risks of having normal lung function in later life.

A

Genetics
Preterm birth
Early life exposures
LRTI
Childhood persistent asthma

Year 1- Respiratory (36 decks)

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