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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
Is Congenital Diaphragmatic Hernia an upper or lower resp. abnormality?
Lower
26
Is CPAM (congenital pulmonary airway malformation) an upper or lower resp. abnormality?
Lower
27
Is tracheomalacia an upper or lower resp. abnormality?
Upper
28
Is Tracheo-oesphageal fistula an upper or lower resp. abnormality?
Upper
29
How can congenital abnormalities be discovered before birth?
Antenatal screening via MRI or ultrasound
30
List some of the presenting congenital abnormality symptoms in new-borns.
Tachypnoea Respiratory distress Feeding issues
31
List some of the presenting congenital abnormality symptoms in childhood.
Stridor/wheeze Recurrent pneumonia Cough Feeding issues
32
What happens in Laryngomalacia?
Dynamic abnormal collapse of larynx or voice box
33
When is laryngomalacia commonly seen?
In infants about 6 weeks onwards
34
What will children with laryngomalacia usually present with?
Stridor which gets worse when feeding or the child is excited/upset
35
Discuss when it may be appropriate to give treatment to a child w laryngomalacia?
If it affects feeding, growth or causes pauses in breathing (apnoea's)
36
What is tracheomalacia?
Dynamic abnormal collapse of tracheal walls
37
What is the clinical presentation for tracheomalacia?
Barking cough Recurrent “croup” Breathless on exertion Stridor/wheeze
38
What may the management of tracheomalacia include?
Physiotherapy and antibiotics if the child is unwell.
39
What is a Tracheo-oesphageal fistula?
Abnormal connection between trachea and oesphagus
40
What is tracheooesophageal fistula usually associated with?
Genetics
41
What other association can those w tracheooesophageal fistula have?
Oesophageal atresia
42
What is the presentation for those w tracheooesophageal fistula?
Choking Colour change Cough with feeding Unable to pass NG
43
What treatment is there for tracheooesophageal fistula?
Surgical repair
44
What are some possible complications of tracheooesophageal fistula?
Tracheomalacia, strictures, leak and reflux
45
What is Congenital Pulmonary Airway Malformation (CPAM)?
Abnormal non-functioning lung tissue
46
What is a Congenital Diaphragmatic Hernia?
Diaphragm develops from multiple tissues around 7 weeks and closes by 18 weeks
47
What side does Congenital Diaphragmatic Hernia usually affect?
Left
48
What is the management for Congenital Diaphragmatic Hernia?
Surgical repair
49
What changes happen after the first birth after birth?
Lungs inflate and fluid in lungs is absorbed
50
What is Transient Tachypnoea of Newborn?
Fluid in lungs does not move effectively.
51
What is Transient Tachypnoea of Newborn usually associated with?
Caesarean section
52
What is Respiratory Distress Syndrome (RDS) due to?
Surfactant deficiency
53
What is the treatment for RDS?
Antenatal steroids Surfactant replacement Appropriate ventilation and nutrition
54
How can chronic lung disease be related to birth?
Associated with prematurity where ongoing oxygen requirement at term
55
What is chronic lung disease associated with?
Increased childhood respiratory morbidity
56
List some of the individual factors which may influence lung function at the age of 15.
Age Gender Height
57
List some of the environmental/lifestyle factors which may influence lung function at the age of 15.
Air pollution Smoking Second hand smoking BMI Serum vitamin D conc.
58
List some of the allergic diseases which may influence lung function at the age of 15.
Asthma Rhinitis Aero/food allergen sensitization
59
List some of the earl life events which may influence lung function at the age of 15.
Parental atopy Parental education Maternal age at delivery Maternal smoking during pregnancy Second hand smoke Season of birth Weight at birth Lung infections
60
Define remodelling.
Alteration of airway structure following external influence
61
Which external influences may cause remodelling?
Environmental exposures- smoking Chronic diseases of childhood- chronic lung disease, asthma Infection
62
Why does remodelling lead to abnormalities of the airway?
Due to interference of inter-cellular signalling
63
Describe some changes in the airway after remodelling.
Reduction of lumen with increased mucus plugging Changes to cells, usually increasing mucus production Increase in number of inflammatory cells
64
In which diseases might remodelling be seen?
Asthma Chronic lung disease of prematurity
65
What things can the process of chronic inflammation lead to?
Increased bronchial responsiveness Increase mucus secretion Airway oedema Airway narrowing
66
List some factors which increase a child's risks of having normal lung function in later life.
Genetics Preterm birth Early life exposures LRTI Childhood persistent asthma

Year 1- Respiratory (36 decks)

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