Developmental Lung Disease Flashcards

1
Q

What are the stages of lung morphogenesis?

A
  • Embryonic
  • Pseudo-Glandular
  • Canicular
  • Saccular
  • Alveolar
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2
Q

What forms in the embryonic stage?

A

A laryngo-tracheal groove on the oesophagus which eventullay seperates into the trachea.

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3
Q

What forms during the pseudo-glandular phase?

A

Bronchi form and seperate into the lobes that will eventually make up the lung.
Myofibroblasts and tubules form,
gas exchange isnt possible yet though.

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4
Q

What occurs in the canalicular phase?

A
  • Lot of cuboidal epithelium differentiates to squamous

- the blood vessel start to line the epithelium forming a blood-air barrier

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5
Q

What kind of lung development occurs postnatal?

A

Further alveolar septation (formation essentially).

100-150mill at birth to 200-600mill at 3-8 years.

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6
Q

At what stage of lung morphogenesis is surfactant produced?

A

IT becomes detectable in the saccular phase and is produced there and in the alveolar phase.

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7
Q

What kind of things can go wrong in embryonic phase?

A

Tracheal Stenosis - Constriction/narrowing of the trachea either short or long segment.
Tracheo-oesophageal fistula - joining of the 2 tubes.
Pulmonary Agenesis - The lung bud doesnt form.

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8
Q

What problems can occur in pseuoglandular phase?

A
  • Cysts can form
  • Pulmondary sequestration where part of the lung tissue is non-functioning and unconnected to the broncheal tree
  • Cystadenomatoid malformation?
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9
Q

At what point does the diaphragm close?

A

Around 18 weeks

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10
Q

.On which side is a diaphragmatic hernia most likely?

A

Left

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11
Q

.What can a hernia of the diaphragm cause?

A

Pulmonary hypoplasia - Essentially when thers an abnormally low number or size of bronchopulmonary segments.
Persistant pulmonary hypertension

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12
Q

.What is eventration?

A

When the diaphragm muscle doesnt form properly and becomes weak eventually forming an unusual bulge and not contracting on inspiration. It often protudes upwards into the thorax

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13
Q

.What functional changes occur in the lungs at birth?

A

From fluid secretion to absorption

Pulmonary vasodilation

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14
Q

.What embryonic tissues contribute to the diaphragm?

A

Lots, a variety really

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15
Q

.What embryonic tissue contributes to the airways?

A

The endoderm produces the epithelial cells of the trachea, pharynx and the alveolar cells.
This protudes into the mesoderm too

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16
Q

Whats the main cause of COPD?

A

Heavy smoking

17
Q

What kind of fatalities does COPD cause?

A

Its the 2rd biggest killer int he world

18
Q

How do we treat a surfactant deficiency?

A

If we know a child wil be early we can stimulate the surfactant system early with antenatal glucocorticoids.
We can also use surfactant replacement, oxygen, mechanical ventilation and CPAP postnatal

19
Q

What is BronchoPulmonary Dysplasia (BPD)?

A

(Also Known as Chronic Lung Disease of Prematurity CLDP, or Chronic Neonatal Lung Disease)
A very severe bronchiolitis leads to alveolar damage, inflammation and scarring.
Makes them more likely to suffer COPD, Asthma and early life viral lung infections.

20
Q

What kind of fatalities does COPD cause?

A

Its the 3rd biggest killer in the world.

21
Q

What happens if you have low lung funciton in early life?

A

You are more at risk of future COPD. Whether its due to early infection, premature birth or Asthma.

22
Q

What are the antenatal origins of adult lung disease (COPD)?

A
  • NIcotine exposure in utero
  • Prematurity/low birth weight
  • Nutrient/vitamin deficiency
23
Q

What is CPAP and why is it useful in treatment of a surfactant deficiency?

A

“Continuous Positive Airway Pressure”

All through the breathing cycle a positive presssure is appplied to the airways keeping them open and preventing alveolar collapse. Because its continuous the patient still has to initiate their own breaths.

24
Q

What 3 things influence remodelling of the aiway/lung parencyma during growth?

A
Antenatal programming
Enviromental exposures (e.g. nicotine)
Gene interactions
25
Q

What are some post-natal origins for adult lung disease COPD?

A
  • Infections in early life are correlated to later COPD
  • ETS (Enviromental tobacco smoke) exposure can lead to alpha1 AT deficiency which can cause emphysema/COPD
  • Enviromental pollution, for instance if you live by a road
  • Nutrient/vitamin deficiency