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(OMS1) CPR Exam 1 > Lecture 4: Respiratory Embryology > Flashcards

Lecture 4: Respiratory Embryology Flashcards

1
Q

When does the respiratory system start to develo

Describe the initial development of the respiratory system?:

A

Wk 4

Caudal to PA 4 > laryngotracheal groove grows forward from developing foregut > laryngotracheal diverticulum (lung bud) separates from foregut tube > mix with mesenchyme > respiratory bud > tracheobronchial tree

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2
Q

What does the endoderm of the laryngotracheal groove give rise to?

A

Pulmonary epithelium and glands of:

  • larynx
  • trachea
  • bronchi
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3
Q

What does the splanchnic mesoderm of the laryngotracheal groove give rise to?

A

CT, cartilage, and smooth muscles that surround foregut

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4
Q

What will the laryngotracheal groove evaginate into?

A

Laryngotracheal diverticulum –> respiratory bud

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5
Q

What is the function of the tracheoesophageal fold? When does this happen?

A

Endoderm > the folds fuse > tracheoesophageal septum that divides esophagus (dorsal) from trachea (ventral)

Week 5

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6
Q

How do the laryngeal cartilages form?

How does the larynx epithelium form?

A

4th and 6th PA mesenchyme > cartilage (mostly NCC derived) > form laryngela inlet

cranial endoderm of laryngotracheal tube > epithelium > proliferates as the growth inlet forms and airway is cleared at recanalization

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7
Q

How does the laryngeal inlet form and how does it make a bigger opening?

A

Cartilage grows into the T shaped laryngeal inlet > epithelium proliferates and blocks the lumen

Via recanalization at wk 10 > apoptosis of epithelium cells reopens the lumen > formation of laryngeal ventricles which lead to vocal and vestibular folds

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8
Q

How does the epiglottis form?

A

PA 3 and 4 mesenchyme > hypo-pharyngeal eminence > epiglottis

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9
Q

How does the trachea form?

How does the tracheal connective tissue, cartilage and muscle form?

A

Laryngotracheal diverticulum > endoderm > trachea, pulmonary epithelium and glands

Laryngeotracheal diverticulum > splanchnic mesenchyme > tracheal CT, cartilage and muscle

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10
Q

What is a tracheoesophageal fistula? What causes it?

A

Abnormal connection between trachea and esophagus due to foregut endoderm failing to proliferate rapidly

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11
Q

What is the most common form of a tracheoesophageal fistula?

A

Esophageal atresia: upper esophagus and does not connect with the lower esophagus and stomach

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12
Q

What are some symptoms of a tracheoesophageal fistula?

A 
Cannot swallow
Frequently drools saliva
Immediate regurgitation
Polyhydramnios (excess amniotic fluid)
Excess air in GI tract
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13
Q

Timeline of lung formation

A

Laryngeotracheal diverticulum > Respiratory bud > distal end bifurcation to form the primary bronchial buds (“tree”) at Wk 4 > Wk 5: secondary and tertiary bronchial buds form > Wk 7: bronchopulmonary segments (bronchi + mesenchyme)

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14
Q

Where do primary bronchial buds grow to?

A

Grows laterally to pericardioperitoneal canals

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15
Q

How is branching pattern of the lung endoderm initiated?

A

Splanchnic mesoderm via SHH and FGF 10

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16
Q

What composes a bronchopulmonary segment?

A

Segmental Bronchi and mesenchyme

17
Q

What are the four stages of lung maturation?

A

1) Pseudoglandular
2) Canalicular
3) Terminal Sac
4) Alveolar

18
Q

What happens in the pseudoglandular state of lung maturation?
When is this happening?

A

Major elements of lungs have formed except those involved with gas exchange

Week 5-17

19
Q

What happens in the canalicular state of lung maturation?

When is this happening?

A

Respiratory bronchioles develop and primordial alveolar structures are present, baby may or may not survive (need surfactant to survive)

Week 16 - 25

20
Q

What happens in the terminal state of lung maturation?

When is this happening?

A

Production of alveoli and pneumocytes (Type II - surfactant)
Gas exchange can occur, so survivable

Wk 24 - birth

21
Q

What happens in the alveolar state of lung maturation?

When is this happening?

A

Mature alveoli is formed from primitive alveoli

Wk 32 - 8 yo

22
Q

What structures form from the splanchnic mesoderm?

A

1) Cartilaginous plates
2) Bronchial smooth muscle and CT
3) Pulmonary CT and capillaries

23
Q

What are fetal breathing movements?

A

Erratic breathing can can cause aspiration of amniotic fluid, causing baby to swallow amniotic fluid to stimulate lung development

24
Q

How is amniotic fluid cleared at birth?

A

1) Pressure from vaginal birth or via suction tubes
2) Pulmonary capillaries, arteries, and veins
3) Lymphatics

25
Q

What is pulmonary agenesis? What causes this?

A

Complete absence of lung or a lobe due to failure of bud to split in 2

26
Q

What is oligohydramnios? What organ disease is this usually related to?

A

Insufficient amniotic fluid volume that can retard lung development

Kidney failure

27
Q

What causes pulmonary hypoplasia? What are the symptoms?

A

restricted fetal thorax > low pressure > decrease hydraulic pressure in lungs > Incomplete development of the lungs and oligohydramnios (insufficient)

28
Q

What is respiratory distress syndrome?

Symptoms?

A

Surfactant deficiency that can account for death in half of premature infants

Decreased lung inflation and alveolar membrane is hyaline like and has abnormal Type II pneumocytes

29
Q

What are congenital lung cysts?

A

Cyst formed from terminal bronchi dilations that can disrupt bronchial development and normal air flow

30
Q

Why do babies have higher risk of choking?

A

Neonates have higher larynx that descends within the 1st 2 years

31
Q

What is laryngeal atresia and what condition is this related to?

What are the symptoms of this condition and how is it treated?

A

recanalization does not occur > obstructed upper airway

CHAOS syndrome: dilated airways, enlarged and fluid filled lungs, inverted or flat diaphragm.
Treated with endoscopic dilation

32
Q

From what does pleura form? What parts form visceral and parietal pleura?

A

Lateral plate mesenchyme > splanchnic > visceral pleura

Lateral plate mesenchyme > somatic > parietal pleura

(OMS1) CPR Exam 1 (30 decks)

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