Developmental aspects of lung disease Flashcards

1
Q

What are the phases of lung morphogenesis?

A
Embryonic 3-8 weeks
Pseudoglandular 5-17 weeks
Canalicular 16-26 weeks
Saccular 24-38 weeks
Alveolar 38 weeks-2/3 years
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2
Q

What happens in the pseudoglandular phase of lung development (5-17 weeks)?

A

Start to get cartilage formation

Gas exchange not possible

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3
Q

What happens in the canalicular phase of lung development (16-26 weeks)?

A

Start to get squamous epithelium and blood vessels beside airways
Gas exchange just possible

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4
Q

What happens in the saccular phase of lung development (24-38 weeks)?

A

Acini increase

Surfactant production

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5
Q

What happens in the alveolar stage of lung development?

A

Acini bud off to form alveoli

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6
Q

How many alveoli are present at birth compared to 3-8 years?

A

100-150 million

200-600 million

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7
Q

What happens after alveoli stop developing in number?

A

Develop in size

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8
Q

What can problems in the embryonic period of lung development cause?

A

Tracheal/laryngeal stenosis
Pulmonary genesis
Tracheo-oesophageal fistula

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9
Q

What can problems in the pseudoglandular phase of development cause?

A

Pulmonary sequestration
Cystadenomatoid malformation (formation of multiple cysts)
Cyst formation

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10
Q

How does the diaphragm develop?

A

Forms in different parts then connects

Mainly muscular tissue but contains fibrous tissue

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11
Q

When does the diaphragm close?

A

About 18 weeks

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12
Q

What are some possible diaphragmatic abnormalities?

A

Diaphragmatic hernia

Eventration (protrusion)

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13
Q

What does a diaphragmatic hernia cause?

A

Pulmonary hypoplasia

Persistent pulmonary hypotension

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14
Q

What are the functional changes of the lungs at birth?

A

Fluid secretion–> fluid absorption

Pulmonary vasodilation

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15
Q

What does fluid i the lungs after birth cause?

A

Transient tachypnoea of the newborn

Normally resolves after 24-48 hours

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16
Q

What is surfactant?

A

Detergent like substance that decreases the work of breathing
Stabilises alveoli and presents them from collapsing
Promotes gas exchange

17
Q

What is surfactant produced by?

A

Type 2 pneumocytes

18
Q

When does surfactant production begin?

A

About 20 weeks gestation

19
Q

What is neonatal respiratory distress syndrome?

A

Surfactant deficiency causing difficulties breathing

20
Q

What is the treatment for neonatal respiratory distress syndrome?

A
Antenatal glucocorticoids
Surfactant replacement
Oxygen
CPAP
Mechanical ventilation
21
Q

What are the antenatal origins of adult lung disease?

A

In utero nicotine exposure
Nutrition
Low birth weight/prematurity
Micronutrients/vitamins

22
Q

What are the post natal origins of adult lung disease?

A

Infection
Growth
Environmental tobacco smoke or pollution
Micronutrients/vitamins