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Respiratory System > Embryology > Flashcards

Embryology Flashcards

1
Q

What are the 5 stages of respiratory system development?

A

1) Embryonic (wk 0-5)
- initial budding and branching

2) Pseudoglandular (wk 6-16)
- branching completes (till terminal bronchioles)

3) Canalicular (wk 17-24)
- Respiratory bronchioles
- formation & widening of canals

4) Saccular (wk 25-birth)
- terminal sacs and capillaries

5) Alveolar (8mths in utero-)
- alveoli development

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2
Q

What occurs during the embryonic stage of respiratory development (1st 5 weeks)?

A

1) Lung bud forms → tracheoesophageal septum/separation
2) Budding and branching of primary, secondary, tertiary bronchi

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3
Q

Where does the lung bud/respiratory diverticulum arise from?

A

outpouching of developing foregut

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4
Q

How do the trachea and oesophagus separate during fetal development?

A

Embryonic phase:
Tracheoesophageal folds emerge and fuse in the midline
→ Tracheoesophageal septum
→ separation

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5
Q

How are the bronchi formed during fetal development?

A

During 2nd half of embryonic phase:
1) Respiratory diverticulum bifurcates into left and right bronchial buds → primary bronchi

2) Primary bronchi bud and branch into secondary bronchi:
- 2 for left lung / 3 for right (supply each lobe)

3) Secondary bronchi bud and branch into tertiary bronchi (supply each bronchopulmonary segment)

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6
Q

What occurs during the pseudoglandular stage of respiratory development (wk 6-16)?

A

Tertiary bronchi bud and branch into bronchioles and terminal bronchioles within bronchopulmonary segments

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7
Q

When do bronchioles start to develop in a fetus?

A

6-16 weeks

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8
Q

What occurs during the canalicular stage of respiratory development (wk 17-24)?

A

1) Bronchioles bud and branch into respiratory bronchioles → alveolar ducts

2) Formation and widening of canals

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9
Q

When does canalisation of the respiratory mesenchyme occur in a fetus?

A

17-24 weeks

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10
Q

What occurs during the saccular stage of respiratory development (wk 25-birth)?

A

Alveolar ducts → alveolar sacs
(production of pneumocytes + surfactant)

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11
Q

When do fetuses start producing surfactant?

A

from 25wks (saccular stage)

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12
Q

What occurs during the alveolar stage of respiratory development (8mths in utero-childhood)?

A

1) Proliferation of alveoli
2) Maturation of alveoli
3) ↑Vascularisation (pulmonary capillaries)

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13
Q

During fetal life, the lungs are _______ as the alveoli are ________. Hence, pulmonary resistance is (high/low).

A

Lungs are filled with fluid, alveoli are collapsed.

  • pulmonary resistance is high
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14
Q

During fetal life, the fetus receives oxygen from __________. Thus, the heart has _____ to ________.

A

Fetus receives oxygenation form placenta

Heart has valves to bypass lungs

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15
Q

At birth, the baby takes a breath, causing the lungs to _____ and pulmonary resistance to (increase/decrease). Hence, the cardiac shunts (open/close).

A

Inflate with air
- pulmonary resistance decreases
- cardiac shunts close

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16
Q

What are the formative components of the diaphragm?

A

1) Somites (muscle progenitors)
2) Septum transversum
3) Pleuroperitoneal folds

17
Q

Where is the septum transversum located in a fetus and when does it develop?

A

22 days in:
- in region of developing cervical vertebrae
- caudal/posterior to the heart

18
Q

During fetal development, the developing diaphragm moves from (up/down) to its final position.

A

Down from cervical to thoracic region

19
Q

What is a fistula?

A

An abnormal connection between two body parts, such as an organ or blood vessel and another structure

20
Q

What is the pathogenesis of a tracheoesophageal fistula?

A

Failure of Tracheoesophageal folds to fuse in the midline

21
Q

What are 3 clinical features of a baby with a tracheoesophageal fistula?

A

1) Polyhydramnios (fetal failure to absorb amniotic fluid → accumulation in womb) esp in atresia
2) Failure to thrive
3) Aspiration/↑risk of lung infection

22
Q

How many types of tracheoesophageal fistulas are there?

A

5

A: atresia w/o fistula
B: atresia w proximal fistula
C: atresia w distal fistula
D: atresia w proximal & distal fistula
E: fistula w/o atresia

23
Q

Which form of tracheoesophageal fistula is most common?

A

Type C
(Atresia w distal fistula)

24
Q

How are tracheoesophageal fistula diagnoses confirmed?

A

1) Imaging (Xray)
- feeding tube unable to enter GIT
- GIT distended w air

2) Scope (endoscopy)

25
Q

How is a tracheoesophageal fistula treated?

A

Surgical repair/closure

26
Q

What is Newborn Respiratory Distress Syndrome (Hyaline Membrane Disease)?

A

Alveoli collapse due to insufficient surfactant production in immature lung of premature infants

27
Q

On average, how preterm do babies have to be to be at risk of Newborn Respiratory Distress Syndrome?

A

Before 35 weeks (sufficient surfactant levels)

↑risk the more preterm it is

28
Q

What are 2 clinical features of a baby with Newborn Respiratory Distress Syndrome?

A

1) Cyanosis
2) Respiratory distress (rapid & laboured breathing)
- Clinical sign: indrawing of ribcage ← use of accessory muscles

29
Q

How does Newborn Respiratory Distress Syndrome appear on a chest X ray?

A

Ground glass appearance/opacification
- ↑ patchiness
- ↓ lung vol.

30
Q

What are 3 ways babies with Newborn Respiratory Distress Syndrome are treated?

A

1) Antenatal corticosteroids
- accelerate lung development and surfactant production

2) Surfactant therapy
- artificial injected through airways

3) Continuous Positive Airway Pressure (CPAP)
- keep airways and alveoli open

31
Q

What is the pathogenesis of a Congenital Diaphragmatic Hernia?

A

Failure of normal closure of the pleuroperitoneal membrane during fetal development

32
Q

On which side do Congenital Diaphragmatic Hernia usually occur?

A

Left posterolateral diaphragm

33
Q

What are some structures that are affected in a Congenital Diaphragmatic Hernia?

A

1) Heart
2) Lungs
3) Intestines
4) Liver
5) Diaphragm

34
Q

What are 3 clinical features in a baby with a Congenital Diaphragmatic Hernia?

A

1) Scaphoid abdomen
(herniated of abdominal contents into chest)

2) Mediastinal shift
- Lung displacement → respiratory distress + pulmonary hypertension
- Cardiac displacement → change in location of apex beat

3) Absent breath sounds
(over area of herniation)

35
Q

How is a Congenital Diaphragmatic Hernia treated?

A

Surgical repair

36
Q
A

Respiratory System (10 decks)

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