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Cardiopulm Exam 1 > Formation Of The Respiratory System (EMB) > Flashcards

Formation Of The Respiratory System (EMB) Flashcards

1
Q

What pharyngeal arch is the respiratory system primarily derived?

A

6th arch

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2
Q

What embryonic layer is the respiratory system primarily derived from?

A

Endoderm

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3
Q

What structure gives rise to the larynx and trachea?

A

The laryngotracheal diverticulum

The inferior portion gives rise to the lung bud

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4
Q

When does the tracheoesophageal septum finish growing?

A

Week 5

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5
Q

From where does the larynx form?

A

The foregut endoderm and the 6th pharyngeal arch

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6
Q

When begins forming from the 6th pharyngeal arch?

A

Arytenoid swellings

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7
Q

What are Arytenoid swellings derived from and what do they eventually give rise to?

A

Neural crest cells (mesenchyme) covered with endoderm

Give rise to laryngeal cartilages

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8
Q

What is the significance of the hypobrancial/hypopharyngeal eminence?

A

It comes from the 3rd and 4th pharyngeal arches above the glottis and gives rise to the epiglottis

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9
Q

Why does recanalization need to occur?

A

Endoderm from the 6th pharyngeal arch proliferates so much that it fills the glottal space

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10
Q

What is recanalization/how does it occur?

A

It is the apoptosis of the endoderm in the glottal space during the 10th week, and allows the vocal and vestibular folds to develop

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11
Q

What is laryngeal atresia and when does it develop?

A

It develops during the 10th week and it is an obstruction of the upper fetal airway due to failure of of recanalization

Infants present with asphyxia at the time of birth (no breathing) and requires an emergency tracheotomy

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12
Q

What are laryngeal webs?

A

Another form of failure of recanalization but is incomplete atresia

There is still tissue between the vocal cords which blocks the glottis and can lead to respiratory distress and stridor

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13
Q

What is laryngomalacia?

A

The collapse of the supraglottic structures (i.e. epiglottis, arytenoid cartilage, vestibular folds) during inspiration

Unknown mechanism

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14
Q

What portion of the trachea are from endoderm?

A

The epithelium, glands, and pulmonary epithelium

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15
Q

What portion of the trachea is from splanchnic mesoderm?

A

The cartilage, connective tissue, and smooth muscle

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16
Q

What is a tracheoesophageal fistula?

A

It is an abnormal passage between the trachea and esophagus, and is almost always associated with esophageal atresia (blind end esophagus)

Due to failure of tracheoesophageal fold formation in week 5

17
Q

How do you diagnosis a TE fistula?

A

With an NG tube, and seeing that it coils after about 12 cm

18
Q

What are the different types of TE fistulas?

A

In 84% of cases, the esophagus has contents spill into the trachea

H-type happens in about 4% of the population and has a connection between the trachea and the esophagus (considered to be much harder to diagnose, but a much higher prevalence of respiratory infections)

19
Q

When does the lung bud form?

A

Week 4

20
Q

When do the primary bronchial buds form?

A

Week 5

21
Q

When do the secondary and tertiary bronchial buds form?

A

Week 6 and 7, respectively

22
Q

What do the secondary bronchial buds correspond to in lung anatomy?

A

They correspond to the lobes (2 on the left and 2 on the right)

23
Q

What do the tertiary bronchial buds correspond to in regard to lung anatomy?

A

They correspond to the lung segments (10 on the right, 9 on the left)

24
Q

By what week do we have our terminal bronchioles? What does this indicate?

A

10 weeks

Indicates that this is when our conduction system is complete

25
Q

What stage in lung development occurs between 15-17 weeks and what occurs during this stage?

A

Pseudoglandular: when terminal bronchioles are formed, connective tissue

NO ALVEOLI

If born: can’t survive

26
Q

What stage is between weeks 16-25 and what occurs during it?

A

Canalicular: vascularization, respiratory bronchioles (with primordial alveolar ducts) and terminal sacs (primitive alveoli)

If born: 50/50 survival, but the later the better

27
Q

What demographics tend to do better with premature birth?

A

African Americans and females

28
Q

What aspect of the lungs develops first?

A

Superior aspect

29
Q

During what time period does the Terminal Sac stage happen in development? What occurs during this stage?

A

24 weeks - birth

There’s gas exchange and Type I and II pneumocytes are developed (and surfactant produced), lymphatic capillaries are formed

If born: will survive

30
Q

During what time period in development does the alveolar stage occur? What happens during this stage?

A

32 weeks - 8 years

Develop the alveolocapillary membrane (both endoderm and mesoderm), more primitive alveoli along with mature alveoli

95% of mature alveoli form postnatally, up to 3 years

If born: will survive

31
Q

What are fetal breathing movements (FBMs)?

A

The fetus forcefully breathes in amniotic fluid in utero in order to facilitate proper lung development

32
Q

What factors are important for proper lung development?

A

Adequate thoracic space, sufficient amniotic fluid volume, and FBMs

Note: oligohydramnios (too little amniotic fluid) retards lung development

33
Q

How is amniotic fluid cleared from the lungs during birth?

A

Natural: when going through the vaginal canal, the pressure on the thorax pushes out the fluid

C-section: the fluid drains into the pulmonary capillaries, arteries, veins, and lymphatics, and is processed that way

34
Q

What is Hyaline Membrane Disease/Respiratory Distress Syndrome?

A

Pt presents with tachypnea, nasal flaring, suprasternal/intercostal/subcostal retractions, grunting, cyanosis, ground glass appearance on CXR

Due to a lack of surfactant which isn’t being produced by the type 2 pneumocytes (which could be due to the fact they haven’t differentiated yet)

35
Q

What is a congenital diaphragmatic hernia?

A

Pt presents with respiratory distress, cyanosis, lung hypoplasia (due to insufficient thoracic space), barrel chest, no breath sounds, scaphoid shaped abd, and displaced heart sounds

Occurs when intestines migrate into the thorax due to failure of the septum transversum to fold and fuse with the peritoneal folds during week 6
(Also called Foramen of Bochdalek)

36
Q

How do congenital lung cysts present?

A

Cysts are filled with fluid or air and have a honeycomb appearance on X-ray

Cardiopulm Exam 1 (4 decks)

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