Developmental Aspects of Lung Disease Flashcards

1
Q

What are the stages of lung morphogenesis?

A

Embryonic - 3-8 weeks

Pseudo-glandular - 5-17

Canalicular - 16 - 26

Saccular - 24 - 38

Alveolar - 36 weeks - 2/3 years

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2
Q

What happens during the embryonic and pseudoglandular stages of lung development?

A

Formation of :

Major Airways, Bronchial tree and portions of respiratory parenchyma, acinus

Embryonic: appearance of lung buds and main pulmonary arteries

Pseudoglandular: All conducting airways and accompanying blood vessels form

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3
Q

What is meant by respiratory parenchyma?

A

lung tissue, including bronchioles, interstitium and alveoli

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4
Q

What happens during the canalicular stage of lung development?

A

Last generations of the lung periphery formed

Epithelial differentiation - acinai are replacing columnar epithelium with squamous epithelium

Air-blood barrier formed

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5
Q

What is significant about the canaliculi stage?

A

Life outside of the uterus is possible after the canalicular stage

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6
Q

What happens during the saccular stage?

A

Expansion of air spaces

Surfactant detectable in amnionic fluid

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7
Q

What happens during the alveolar stage?

A

Secondary septation

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8
Q

Which stages are organogenesis

Which are differentiation?

A

Organogenesis (embryonic and pseudoglandular)

Differentiation (cannalicular and saccular)

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9
Q

What are the common congenital abnormalities

A

Upper

  • Laryngomalacia and tracheomalacia
  • Tracheo-oesphageal fistula

Lower

  • CPAM
  • Congenital Diaphragmatic Hernia
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10
Q

How are congenital abnormalities detected during antenatal scanning

A

US

MRI

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11
Q

How are congenital abnormalities detected in a newborn

A
  • Tachypnoea
  • Respiratory distress
  • Feeding issues
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12
Q

How are congenital abnormalities detected in childhood

A
  • stridor/wheeze
  • recurrent pneumonia
  • chronic cough
  • feeding issues
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13
Q

Describe laryngomalacia

A
  • softening of larynx
  • infants > 6 w.
  • stridor, worse on feeding/upset/excited
  • improve within 1y
  • concern if failure to thrive/apnoeas
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14
Q

Describe tracheomalacia

A
  • healthy baby/genetic disease/external compression (tumour, vessel)
  • barking cough, recurrent croup
  • stridor wheeze
  • SOB on exertion
  • physio + Abx if unwell
  • natural resolution
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15
Q

Describe Trachea-oesophageal fistula

A
  • might have oesophageal atresia (abnormally closed passage)
  • antenatal or postnatal diagnosis
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16
Q

What are the symptoms of Trachea-oesophageal fistula

A
  • choking
  • colour change
  • cough w/feeding
  • unable to pass NG tube
  • can cause tracheomalacia, strictures, leak, reflux

Surgical repair

17
Q

Describe Congenital pulmonary airway malformation (CPAM)

A
  • abnormal non-functioning tissue
  • mostly antenatally
  • sporadic
  • resolve in utero
  • conservative management if asymptomatic
  • surgery
  • risk of cancer
18
Q

Describe Congenital diaphragmatic hernia

A
  • diaphragm develops 7-18 w.
  • hernia= improper closure of diaphragm
  • left side> right side
  • BUT right side WORSE
  • antenatal diagnosis
  • surgery
  • prognosis depends on lung hypoplasia
19
Q

How is the diaphragm formed?

A

Various sheets of primitive tissue move towards the centre of the diaphragm.

20
Q

What are the outcomes of diaphragmatic hernia?

A

Pulmonary hypoplasia

Persistant pulmonary hypertension

21
Q

What are the functional changes in the lung at birth?

A

Change from fluid secretion to fluid absorption

Pulmonary vasodilation

22
Q

What is Transient tachypnea of the Newborn?

A
  • C-section= fluid in lungs
  • Resolves in 1-2 d
23
Q

Describe respiratory distress syndrome

A
  • Surfactant deficiency
  • Antenatal steroids
  • Surfactant replacement
  • Ventilation
24
Q

Describe bronco-pulmonary dysplasia

A
  • Premature
  • Need O2 therapy
  • ↑ risk of resp disease