Developmental Aspects of Lung Disease Flashcards

1
Q

What is the first part of the respiratory system that develops?

A

The trachea

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2
Q

What happens during the embryonic stage of lung development?

A

The trachea branches off from the laryngo-tracheal groove and the mesoderm begins signalling to the surrounding cells

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3
Q

What happens during the pseudo-glandular stage of lung development?

A

The lobes of the lung, most of the major airways and primitive acinar structures have formed

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4
Q

What happens during the canalicular stage of lung development?

A

Smaller and smaller tubules are formed creating a thin air to blood barrier

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5
Q

What happens during the alveolar stage of lung development?

A

The alveoli are formed and the lungs have a large surface area

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6
Q

How does lung development progress after birth?

A

Alveolar septation continues and alveolar dimensions increase

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7
Q

What happens during the saccular stage of lung development?

A

The air spaces expand and surfactant is detectable in amniotic fluid

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8
Q

At what point are most features of abnormal lung development detected?

A

During a fetal ultrasound

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9
Q

What features of abnormal lung development can be seen in the newborn period?

A

Tachypnea and respiratory distress

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10
Q

What features of abnormal lung development are seen in childhood?

A

Stridor/wheeze, recurrent pneumonia or an accidental finding

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11
Q

What are the symptoms of tracheo-bronchomalacia?

A

Barking/seal-like cough, early-onset/recurrent croup, breathlessness on exertion and stridor/wheeze

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12
Q

What is the management of tracheo-bronchomalacia?

A

Airway clearance physiotherapy and antibiotics

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13
Q

What medication should not be given to a patient with tracheo-bronchomalacia?

A

Bronchodilators as these can cause further closure of the airway

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14
Q

What condition is associated with a surfactant deficiency in new-borns?

A

Infant respiratory distress syndrome

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15
Q

What are the causes of chronic neonatal lung disease?

A

Antenatal infection, barotrauma, oxygen toxicity, PDA and genetic factors

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16
Q

What is remodelling?

A

Alteration of structure following an external influence

17
Q

What are the effects of pre-natal nicotine exposure on the lungs?

A

Lung hypoplasia, reduced alveolarisation, reduced lung function, increased incidence of wheeze syndromes and increased susceptibility to infection

18
Q

What are the effects of chronic inflammation on the lungs?

A

Increased bronchial responsiveness, increased mucus secretion, airway oedema and airway narrowing

19
Q

What are the features of a diaphragmatic hernia

A
  • L>R
  • Pulmonary hyperplasia
  • Persistent pulmonary hypertension
20
Q

What are the functional changes in the lungs that happen at birth

A
  • Change from fluid secretion to fluid absorption

- Transient tachypnea of newborn is associated with C sections but resolves within 24-48hrs

21
Q

What are the treatment options for hyaline membrane disease (surfactant deficiency)

A
  • Antenatal glucocorticoids
  • Surfactant replacement
  • Supportive
22
Q

What are the causes of chronic neonatal lung disease

A
  • Antenatal infection
  • Barotrauma/oxygen toxicity
  • PDA
  • Genetic
23
Q

Name the antenatal causes of adult lung disease

A
  • In utero nicotine exposure
  • Fetal infection
  • Maternal nutrition
  • Low birth weight/prematurity
  • Maternal micronutrients/ vitamins
24
Q

Name the postnatal causes of adult lung disease

A
  • Infection
  • Growth
  • Environmental tobacco smoke
  • Environmental pollution
  • Micronutrients/vitamins
25
Q

How does remodelling happen in asthma?

A
  • Chronic inflammation
  • Increased bronchial responsiveness
  • Increase mucus secretion
  • Airway oedema
  • Airway narrowing