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test 5 > Lecture 27 > Flashcards

Lecture 27 Flashcards

1
Q

What germ layers does the respiratory system derive from?

A

the endoderm and mesoderm

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2
Q

What is the order of lung development at week 4?

A

Laryngotracheal groove> Laryngotracheal diverticulum anterior to the foregut> distal end turns to Respiratory buds

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3
Q

What does splanich mesoderm surrounding the laryngotracheal diverticulum develop into?

A

cartilage, connective tissue, and muscles of the trachea

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4
Q

What does the tracheoesophageal septum divide the foregut into?

A

Ventral: laryngotracheal tube
Dorsal: Orophayrnx and esophagus

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5
Q

how many pharyngeal pouches are there and which one disintegrates? what do they form?

A

There are 6 and the 5th one disintegrates
1,2,3= tongue
hypopharyngeal= posterior part of tongue
4th and 6th= respiratory system

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6
Q

What germ layer does laryngeal epithelium come from?

A

endoderm of cranial part fo the laryngotracheal tube ( larynx+ trachea)

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7
Q

How are laryngeal cartilages derived from?

A

migration of neural crest cells into the mesenchymal of 4th and 6th pairs of pharyngeal arches

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8
Q

What do laryngeal muscles develop from?

A

mesenchymal myoblasts form the 4th and 6th pair of pharyngeal arches

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9
Q

Where do arytenoid swellings come from?

A

mesenchyme at cranial end of laryngotrachael tube

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10
Q

where are epiglottal swellings derived from?

A

from the caudal part of hypopharyngeal eminence ( from 3rd and 4th pharyngeal arches)

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11
Q

What forms the laryngeal ventricles?

A

formed by recanalization of the laryngeal lumen

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12
Q

How many lobes on each side of the lungs?

A

on the right there are 3 lobes on the left 2 lobes

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13
Q

The lung bud divides and forms what?

A

2 primary bronchial buds.

the secondary and tertiary buds grow laterally from the primary buds into the pericardioperitoneal canals.

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14
Q

Segmental bronchus with surrounding mesenchyme is called what?

A

bronchopulmonary segments

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15
Q

At what week do the respiratory bronchioles develop?

A

By week 24 ( 17 orders of branches are formed)

7 more generation of branches formed after birth to 8 years (24 branches)

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16
Q

Define Atresia

A

obstruction/ blockage/ abnormal closure of a passage, due to failure of recanalization of the lumen

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17
Q

Define stenosis

A

narrowing/ partial closure of a passage. Due to unequal partitioning of the foregut

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18
Q

Define fistula

A

abnormal communication/passage due to incomplete division of a tube. ( incomplete division of cranial part of foregut into respiratory system and esophagus)

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19
Q

Type I versus II and III atresia of trachea and esophagus

A

Type 1: superior part of trachea did not develop and inferior sticks to esophagus (m
Type2: no inferior or superior esophagus
Type 3: only bronchial buds are developed, lacks a trachea, nothing connects the buds.

LOOK AT PIC

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20
Q

Atresia with distal fistula

A

atresia means wrong communication:
this case is the stomach is connected to the trachea ( below so distal) and the esophagus is just closed/ blind, not connected to the stomach

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21
Q

Atresia with proximal fistula

A

the esophagus is bound to the trachea and the stomach tube is blind

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22
Q

Treacheoesophageal fistula

A

the stomach and the esophagus are linked by the same tube but they are both connected/communicated to the trachea

can be component of VACTERL= vertebral anomaly, anal atresia, cardiac defects, TEF, Esophageal atresia, Renal anomalies, and limb defects

can also be due to polyhydramnios= excessive quantity of amniotic fluid in fetal life.. the fluid is supposed to enter the stomach but instead goes to amniotic cavity.

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23
Q

Atresia with double fistula

A

the stomach and esophagus are not connected but each is connected to the trachea on their own

24
Q

Esophageal atresia

A

abnormal blockage/ development of the esophagus mainly due to failure of recanilization of lumen

nothing is connected. both tubes are blind just stop. failure of recanalization of the lumen

25
Q

What sex commonly has tracheoesophageal fistula?

A

males

26
Q

What caused tracheoesophageal fistula?

A

incomplete division of cranial forgut into respiratory system and esophagus

27
Q

what are signs and symptoms of tracheoesophageal atresia?

A

coughing and choking during feeding, pneumonia, polyhydramnios in fetal life

28
Q

At what week is the pseudoglandular stage?

A

5-17 week… major elements of lungs but no respiratory bronchioles

29
Q

at what week is the Canalicular period?

A

16-25 week, terminal bronchioles divides into 2 major respiratory bronchioles, which in turn divide into 3-6 alveolar ducts.
TYPE 2 alveolar cells that produce SURFECTANT appear.

30
Q

At what week does surfactant secretion occur?

A

week 20, increases a lot during the last 2 weeks of pregnancy important for survival at weeks 22-26 ( this is when produce is enough to survive in ICU)
week 26-28; can survive if born prematurely with adequate terminal sacks and surfactant.

31
Q

At what week Is the terminal sac period?

A

week 24 to birth; terminal sacs formed lined by squamous epithelium; capillaries establish close contact.

32
Q

At what week is the alveolar period?

A

week 32 to 8-10 years.
primitive alveoli with well developed epithelial-endothelial capillary contacts ( blood-air barrier after birth)
Mature alveoli are formed after birth as the lungs expand ( alveoli formation continues unto 8-10 years)

33
Q

What produces surfactant?

A

surfactant is a lipoprotein produced by type 2 alveolar cells

34
Q

what is the purpose of surfactant?

A

it reduces surface tension and facilitates expansion of terminal sacs

35
Q

What causes respiratory distress syndrome and hyaline membrane disease?

A

a surfactant deficiency/ rapid labored breathing 1-2% of babies mostly premature ones

36
Q

what occurs with prolonged intrauterine asphyxia?

A

irreversible changes in type II cells rendering them incapable of producing surfactant

37
Q

What medications can accelerate fetal lung movements and surfactant?

A

glucocorticoids during pregnancy, surfactant production ( corticosteroids, or exogenous surfactant)

38
Q

what are signs and symptoms of reduced surfactant?

A

under-inflated lungs, amorphous protein deposits in lungs and respiratory distress

39
Q

What occurs with a diaphragmatic hernia in an infant?

A

lung cannot develop normally because there is very little thoracic space, the intestines are there.

40
Q

What occurs to a still born’s lungs?

A

the still born lungs are firm and they sink in water as they have no air, only fluid.

in a normal baby, they have a little amniotic fluid in their lungs but it is taken up by capillaries and lymphatics

41
Q

what can oligohydroamnios lead to?

A

insufficient amount of amniotic fluid may lead to retarded development of lungs pulmonary hypoplasia

42
Q

What is the primordium of future body cavities?

A

intraembryonic coelom

43
Q

Where does the intraembryonic coelom develop?

A

lateral mesoderm

44
Q

What are the two layers that the lateral mesoderm is divided into?

A

somatopleure ( somatic)= parietal layer of serous pericardium, pleura, and peritoneum

Splanchopleure ( splanchnic)= visceral pericardium, pleura, peritoneum

45
Q

What does head folding of the embryo do?

A

brings the heart and pericardial cavity anterior to the foregut and the septum transversum forms

46
Q

what does the septum trasnversum partition separate ? ( head folding)

A

the pericardial and abdominal cavities and the heart is suspended by the dorsal mesocardium

47
Q

what does lateral folding of embryo do?

A

pericardial coeloms fuse forming the pericardial cavity. The pericardial cavity is lined by a visceral and parietal layer. the pericardial cavity is continuous with the pericardioperioneal canal.

48
Q

How is pleural cavity formation?

A

bronchial buds grow into pericardioperitoneal canal.
membranous ridges develop from lateral wall.
Cranial ridge: pleuropericardial fold
Caudal ridge: Pleuroperitoneal fold

49
Q

What separates the pleural cavity from pericardial cavity? and what fuses to form the fibrous pericardium?

A

Pleuropericardial membrane

50
Q

What is the septum transversum?

A

the primordium of central tendon of diaphragm

51
Q

what results in final closure of the pleuroperitoneal canal of diaphragm?

A

migration of myoblasts

52
Q

Anteromedial defect

A

diaphragmatic hernia
rare 2-5 %
defect between costal and sternal musculature

53
Q

Central defect

A

congenital hiatal hernia of esophagus

esophageal hiatus is abnormally large

54
Q

posterolateral defects

A
  • congenital diaphragmatic hernia.
  • defect of pleuroperitoneal membrane
  • abdominal contents herniate into thorax
  • more common on left side.

( foramen of bochdalek)

Abdomen is empty when lying flat because the contents herniate into the thorax, the lung is compressed and hyplastic ( high mortality rate) requires urgent surgery.

55
Q

Eventration of diaphragm

A

defective musculature on half of the diaphragm because of failure of the muscle tissue from body wall to extend into the pleuroperitoneal membrane. the affected side moves up with the contraction of diaphragm during respiration=== PARADOXICAL RESPIRATION.

PIC looks like the diaphragm is at the arm

test 5 (27 decks)

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