Developmental Aspects of Lung Disease Flashcards

1
Q

What are the 5 stages of lung morphogenesis?

A
  1. Embryonic
  2. Pseudo-glandular
  3. Canalicular
  4. Saccular
  5. Alveolar
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2
Q

What 2 stages fall into organogenesis?

A
  • Embryonic

- Pseudo-glandular

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3
Q

What 3 stages fall into differentiation?

A
  • Canalicular
  • Saccular
  • Alveolar
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4
Q

What post-natal lung growth is there?

A
  • Alveolar separation continues
  • Continuation in the increase of numbers of alveoli
  • Airways double in size
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5
Q

What occurs 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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6
Q

What occurs during the canalicular stage?

A
  • Last generations of the lung periphery formed
  • Epithelial differentiation
  • Air-blood barrier formed
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7
Q

What occurs during the saccular stage?

A
  • Expansion of air spaces

- Surfactant detectable in amniotic sac

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8
Q

What occurs during the alveolar stage?

A

Secondary septation

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9
Q

What can be seen at the embryonic stage?

A

Lung buds and main pulmonary arteries

Trachea and main bronchi

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10
Q

What can be seen at the pseudo-glandular stage?

A

All conducting airwys and accompanying vessels form, wall structure and epithelial cells differentiate

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11
Q

What can be seen at the canalicular stage?

A

Respiratory airways form, blood-gas barrier thins, surfactant appears.
Respiratory bronchiole
Alveolar ducts

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12
Q

What can be seen at the saccular-alveolar stages?

A

Saccules and then alveoli appear

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13
Q

What congenital lung diseases can occur at the embryonic stage?

A
  • Tracheal, laryngeal stenosis
  • Pulmonary agenesis
  • Tracheo-oesophageal fistula
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14
Q

What is a trachea-oesophageal fistula?

A

An abnormal connection between the oesophagus and trachea

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15
Q

What congenital lung diseases can occur at the pseudo-glandular stage?

A
  • Pulmonary sequestration
  • Cystadenomatoid malformation
  • Cyst formation
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16
Q

What are the forms of pulmonary sequestration?

A
  • Extralobular sequestration

- Innerlobular sequestration

17
Q

How does the diaphragm develop?

A
  • Develops from a variety of primitive tissues

- Closure by 18 weeks

18
Q

What is a diaphragmatic hernia?

A

Bowel has migrated up into the chest

19
Q

What is commonly found with diaphragmatic hernia?

A
  • Occurs more on the left side than the right
  • Pulmonary hypoplasia
  • Persistent pulmonary hypertension
20
Q

What is eventration of the diaphragm?

A

Abnormal elevation of one side of the diaphragm

21
Q

What functional changes take place at birth?

A
  • Change from fluid secretion to fluid absorption

- Pulmonary vasodilation

22
Q

What does transient tachypnea cause in newborns?

A

Wet lungs

23
Q

What does surfactant do?

A

Stabilises alveoli and promotes gas exchange

24
Q

What are other names of surfactant deficiency?

A
  • Hyaline membrane disease

- Infant Respiratory Distress Syndrome

25
Q

What is the treatment for IRDS?

A
  • Antenatal glucocorticoids
  • Surfactant replacement
  • Oxygen
  • CPAP
  • Mechanical ventilation
26
Q

If a child does not respond to IRDS treatment what can occur?

A
  • Chronic neonatal lung disease (BPD, CLDP)
  • Increased severity bronchiolitis
  • Asthma
  • Future COPD
27
Q

What are the antenatal origins of COPD?

A
  • In utero nicotine exposure
  • Nutrition
  • Low birth weight/ prematurity
  • Micronutrients/ vitamins
28
Q

What are the post-natal origins of COPD?

A
  • Infection (Barker hypothesis)
  • Growth
  • ETS
  • Environmental pollution
  • Micronutrients/ vitamins
29
Q

What rare the origins of COPD all influenced by?

A

Gene-environment interactions

30
Q

What does the Fletcher Peto Diagram show?

A

The effects of smoking on rate of decline in FEV