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Cardio Pulm > Lecture 5 - Respiratory Embryology > Flashcards

Lecture 5 - Respiratory Embryology Flashcards

1
Q

what does the endoderm of the laryngotracheal groove form

A

pulmonary epithelium, glands of larynx, trachea, and bronchi

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2
Q

what does the splanchnic mesoderm of the lateral plate form

A

CT, cartilage, smooth muscles; these surround the foregut

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3
Q

what does the laryngotracheal groove grow from

A

median outgrowth from the floor of the primitive pharynx

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4
Q

what does the laryngotracheal groove end up forming

A

laryngotracheal diverticulum aka lung bud

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5
Q

what does the lung bud or laryngotreacheal diverticulum form

A

respiratory bud

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6
Q

when does the respiratory bud birfurcate

A

days 26-28

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7
Q

what regulates the branching pattern of the lung endoderm

A

surrounding mesoderm

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8
Q

what do the primary bronchial buds form

A

early lungs and primary bronchi

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9
Q

when do the secondary bronchial buds form

A

beginning week 5

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10
Q

when do we see segmental bronchioles

A

week 7

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11
Q

what week do the bronchopulmonary segments form

A

24

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12
Q

about how many divisions have formed at the time of the bronchopulmonary segments

A

17 orders of branching

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13
Q

how many orders of branching airways happen after birth

A

7

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14
Q

what are the stages of maturation of the lungs

A
  1. pseudoglandular (5-17 wks)
  2. canalicular (16-25 wks)
  3. terminal sac (24 -birth)
  4. alveolar (32 weeks-8 years)
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15
Q

what are the characteristics of pseudglandular stage

A
  • looks like exocrine glands
  • all major elements have formed except those associated with gas exchange
  • fetus cannot survive
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16
Q

when is the stage at which survival from then on is possible

A

canalicular (16-25 wks)

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17
Q

what are the characteristics of the canalicular stage

A
  • overlap with pseudoglandular
  • vascularization
  • respiratory bronchioles
  • primitive alveoli present
  • survival possible
  • membrane is thicker than mature
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18
Q

what is a major cause of survival rate to increase in fetuses

A

increased with number of alveoli

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19
Q

what are the characteristics of the terminal sac

A
  • numerous alveoli
  • thin epithelium w/ increased vascularization
    • type 1 and 2 pneumocytes and lymphatic capillaries
  • gas exchange can occur
  • survivable
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20
Q

what are the characteristics of the alveolar stage

A
  • alveolocapillary membrane
  • primitive alveoli
  • form more primitive alveoli
  • mature alveoli
  • membrane is final thickness
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21
Q

how many of the mature alveoli develop postnatally

A

95%

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22
Q

when is alveolar development largely completed

A

3 yrs

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23
Q

until about what age are new alveoli added

A

8 yrs

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24
Q

during development of the brconchi what does the splanchnic mesoderm do

A

cartilaginous plates
bronchial SM and CT
pulmonary CT and capillaries

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25
Q

where does the visceral pleura come from

A

splanchnic mesenchyme

26
Q

what is the parietal pleura derived from

A

somatic mesoderm

27
Q

what is the space between the parietal and visceral pleura called

A

pleural cavity

28
Q

what forms the trachea and larnyx

A

proximal end of the laryngotracheal diverticulum

29
Q

what are the two components of the trachea and what are their origins

A 
splanchnic mesoderm
-cartilage
-CT
-SM
endoderm
-glands
-epithelium
30
Q

what is esophageal atresia

A

when the esophagus just ends and doesn’t connect to the stomach

31
Q

what is tracheoesophageal fistula

A

abnormal connection between the esophagus and the trachea

32
Q

what is a symptom of tracheoesophageal fistula

A

air in the GI on Xray

33
Q

what is one cause of tracheoesophageal fistula

A

polyhydramnios or excess amniotic fluid

-not as much is taken up by the body and it accumulates since placenta can’t get rid of it

34
Q

what are the characteristics of pulmonary agenesis

A

complete absence of a lung or a lobe and corresponding bronchi

35
Q

how can you describe fetal breathing movements

A

muscle memory of the respiratory muscles to allow proper breathing upon birth

36
Q

how is amniotic fluid cleared from the lungs

A

mouth and nose from vaginal pressure on chest on delivery; pulmonary capillaries arteries and veins; lymphatics

37
Q

what does oligohydramnios cause

A

too little fluid delays lung development and causes pulmonary hypolsasia
risk increases with oligohydromanios before 26 wks

38
Q

what is a primary cause of respiratory distress syndrome

A

surfactant deficiency from type 2 pneumocytes

39
Q

what are the symptoms of RDS

A

rapid, labored breathing shortly after birth

  • tachypnea
  • nasal flaring
  • retractions of skin in an effort to breath
  • grunting
  • cyanosis
40
Q

how is RDS treated

A

pure 02 to allow body to compensate

41
Q

what are congenital lung cysts

A

fluid or air filled

thought to be dilation of the terminal bronchi late in development

42
Q

during what week does the intraembryonic coelom develop

A

4

43
Q

what does the cranial/caudal portion of hte intraembryonic coelom develop into

A

cranial - future pericardial cavity

caudal - future pleural and peritoneal cavity

44
Q

what is a congenital diaphragmatic hernia

A

viscera bulge into pleural cavity, and stunt ipsilateral lung growth, left side typically impacted; can be corrected at birth

45
Q

after head folding the primitive pericardial cavity is located _________ to the septum transversum

A

cranially; heart now bulges into pericardial cavity

46
Q

What is a prenatal complication of tracheoesophageal ridge abnormalities

A

Polyhydramnios since the fetus can’t swallow

47
Q

The epithelial lining and glands of larynx are derived from __________

A

Endoderm

48
Q

When does the reopening of the larnyx occur to reopen this airway

A

10 weeks

49
Q

Laryngeal atresia is also known as

A

CHAOS or congenital high airway obstruction syndrome

50
Q

Laryngeal web is what

A

Partial occlusion of the airway

51
Q

At what week does the lung have the correct number of tertiary bronchi

A

10 on R and 8 on L starting at 7th week

52
Q

A 35 year-old woman delivers an infant at 40 weeks of gestation (based on the last time of menstruation). While in the neonatal care unit, the infant develops cyanosis and very rapid labored breathing and requires admission to the neonatal intensive care unit. Imaging studies of the thoracic cavity show congestion in the lungs but they appear to be of normal size and there is no apparent abnormality in the diaphragm. The woman reports no family history of lung disease and denies alcohol use, smoking, or taking medications during her pregnancy, and review of the mother’s medical records regarding prenatal care and ultrasound imaging is unremarkable.

  1. A biopsy of the infant’s lung tissue would most likely show:

A) an eosinophilic, hyaline “membrane” on the alveolar surfaces

B) complete absence of type II pneumocytes

C) significantly reduced branching of the
bronchiolar tree compared to other infants of the same age

D) bacterial infection and inflammation of the lung tissue (pneumonitis)

A

A, the symptoms are describing RDS, which is also known as hyaline membrane disease, the infant is also a recent delivery, labored breathing, cyanosis and no apparent abnormalities

53
Q

A 35 year-old woman delivers an infant at 40 weeks of gestation (based on the last time of menstruation). While in the neonatal care unit, the infant develops cyanosis and very rapid labored breathing and requires admission to the neonatal intensive care unit. Imaging studies of the thoracic cavity show congestion in the lungs but they appear to be of normal size and there is no apparent abnormality in the diaphragm. The woman reports no family history of lung disease and denies alcohol use, smoking, or taking medications during her pregnancy, and review of the mother’s medical records regarding prenatal care and ultrasound imaging is unremarkable.

  1. A possible cause of the infant’s condition is:

A) spontaneous mutation in the surfactant protein B gene
B) presence of a tracheoesophageal fistula
C) overproduction of mesoderm during gastrulation
D) congenital diaphragmatic hernia and lung hypoplasia.

A

A, RDS is caused by issues with surfactant production. It is either deficient or absent in these children

54
Q

The period of lung development in which no respiratory brochioles or alveoli have yet formed is known as

  1. Pseudoglandular
  2. Canalicular
  3. Terminal sac
  4. Alveolar period
A

1

55
Q

The period of lung development in which surfactant production begins (but is not necessarily sufficient to prevent airway collapse) is known as the:

  1. pseudoglandular period
  2. canalicular period
  3. terminal sac period
  4. alveolar period
A

2

56
Q

The skeletal muscle of the diaphragm is derived primarily from

A
  1. Myoblasts from thoracic somites
  2. Myoblasts from cervical somites
  3. Vagal neural crest cells
  4. Cervical neural crest cells
  5. Thoracic neural crest cells
57
Q

The smooth muscle in the wall of the respiratory tract is derived from

  1. Foregut endoderm
  2. Splanchnic mesoderm
  3. Somatic mesoderm
  4. Intermediate mesoderm
  5. Neural crest
A

2

58
Q

Congenital diaphragmatic hernias

  1. Arise due to a failure of the pleuropericardial folds to completely separate the pleural and pericardial cavities
  2. Tend to occur more frequently on the right side of affected individuals
  3. Can cause lung hypoplasia
  4. Are due to a failure of neural crest cells to migrate and/or differentiate properly
  5. All of the above
A

3, happens more on the left side and causes pressure on the developing lung which doesn’t allow it to grow to full size

59
Q

What stage of lung development have the alveoli not formed and survival is not possible

A

Pseudoglandular

60
Q

Premature infants born at this stage have a good prognosis although they will require respiratory support and treatment with exogenous surfactant

A

Terminal sac

61
Q

Stage in lung development in which there is the most surfactant production

A

alveolar

Cardio Pulm (22 decks)

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