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Week 42 > Lung Developement > Flashcards

Lung Developement Flashcards

1
Q

Describe the pulmonary vasculature in adults

A

PVR=low resistance

needed for gas exchange

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2
Q

Bronchi

A

Proximal Large airways with cartilage

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3
Q

Bronchioles

A

Distal, smaller airways

NO CARTILAGE

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4
Q

Acini

A
  • all respiratory structures below terminal bronchioles
    • respiratory bronchioles
    • alveolar ducts
    • alveoli
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5
Q

Epithelial of lungs is derived from?

A

Foregut Endoderm

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6
Q

The connective tissue, smooth muscle, blood vessels of the lungs is derived from what layer in utero?

A

Splanchic Mesoderm

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7
Q

Developement of the lungs in utero is dependent on?

A

interaction between splanchic mesoderm and pulmonary endoderm

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8
Q

Describe the affinity of O2 of fetal hemoglobin relative to dadult hemoglobin

A
  • Fetal hemoglobin has a higher affinity for oxygen than adult Hemoglobin
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9
Q

Stages of Lung Developement:

A

2 fundamental phases: time is variable

  • Organogenesis: Week 4-16
    • establish air-conducting system/organ
    • Embryonic: Week 4-5
    • Pseudoglandular: Week 5-17
  • Differentation: Week 16+
    • develop the respiratory surface area for breathing and cell differentiation for specific fxns.
    • alveoli have not developed before canalicular
      • Canalicular: 16-25
      • Saccular: 24-40
      • Alveolar: week 36-8 years after conception
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10
Q

Lung Developement: Embryonic Stage

A
  • Week 4-5
  • Features:
    • 2 Lung buds:
      • outpouching from the foregut endoderm into surrounding splanchic mesenchyme
  • Vascular:
    • pulmonary circulation present by 5 weeks
    • extra pulmonary artery then lobular arteries form
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11
Q

Differentiation of lung tissue during pseudoglandular stage:

A
  • Takes place in a centrifugal direction (proximal out)
    • epithelium of central conducting airways differentiate into ciliated cells and goblet cells
    • After week 10: develop
      • chest wall
      • smooth muscle cells
      • bronchial glands
    • Peripheral sections-cuboidal epithelium for branching to continue
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12
Q

What blood vessels form during pseudo-glandular stage?

A
  • Pre-acinar arteries and veins form by vasculogenesis
  • use airway as template
  • formed by week 17
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13
Q

Pseudoglandular Stage: Lung features

A
  • Features:
    • conducting airways develop
      • Terminal bronchioles are formed
        • goblet cells
        • cilia cells
      • extensive airway branching
    • After week 10 central conducting airways develop:
      • cartilage
      • smooth muscle
      • bronchial glands
    • periphery-cuboidal epitheliulm to allow further development of bronchial tree
    • Differentation of lung tissue takes place in centrifugal direction
      • proximal to distal
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14
Q

is a child born before the 16-17th week viable?

A
  • all elements of the lung are developed except those involved in gas exchange (pseudoglandular stage)
  • fetuses will not survive because there is no surfactant or alveoli for gas exchange
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15
Q

Lung Developement: Canalicular stage

A
  • Features: week 17-27
  • Formation of the acinus
    • form respiratory bronchioles and alveolar duts
      • some alveoli form
    • Type II pneuomocytes differentiate into Type I Pneuomocytes
      • Type II begins producing surfactant @ week 26
  • Bronchi and Bronchiole lumens become larger
  • interstitial tissue between each airspace thins
  • Vascular:
    • proliferation of capillaries
      • intra-acinar arteries and veins form by angiogenesis
  • Respiration is possible at end of staage
    • weigh 1,000g
    • week 26-29 before enough surfactant is produced
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16
Q

Lung Developement: Saccular Stage

A
  • Features: 28-36 weeks
  • Blood-air barrier formed
    • ​fusion of epithelial and endothelium basement membranes
  • Alveoli continue to develop
    • septation increases surface area
  • type I and II pneumocytes develop and differentiate
  • Vascular:
    • alveolar duct arteries form
17
Q

What is the paradoxical respiration

A
  • thorax and abdomen move in opposite directions during respiration:
    • thorax contract
    • abdomen extend
18
Q

Lung developement: Alveolar stage

A
  • Week 36-8 y.o.
  • Formation of squamous epithelium to prepare for gas exchange
  • alveoli continue to develop until 8 years old
  • Vascular:
    • ​alveolar arteries continue to form
19
Q

Lungs at birth:

A
  • Fluid is cleared through mouth and nose, pulmonary capillaries, pulmonary arteries, veins, and lymphatics
  • After birth, mainly increase the number of respiratory bronchioles and alveoli
    • not the size of alveoli
      *
20
Q

Tracheo-esophageal Fistula (TEF)

A
  • Failure of the tracheoesophageal septum to form
  • incidence: 1:3000 births
  • Risk factors:
    • genetic
    • enviromental
    • immunology
  • 50% of infants with a esophageal atresia (EA) or TEF have another birth defect, especially cardiac abnormalities
21
Q

Lung pathologies in neonates:

A
  • TEF
  • Pulmonary hypoplasia
  • BPD
  • Meconium aspiration
22
Q

Bronchoplmonary Dysplasia (BPD)

A
  • Chronic lung disease in infants who received respiratory support with mechanical ventilation and prolonged oxygenation.
  • primary risk factor:
    • premature birth
  • other risk factors:
    • male sex
    • smoking
    • drug use
    • malnutrition
23
Q

Meconium Aspiration Syndrome

A
  • serious condition
  • newborn breathes a mixture of meconium (First feces) and amniotic fluid into lungs during delivary
24
Q

At what stage do you stop developing alveoli?

A

8 y.o.

25
Q

How many lobes are in the right vs left lung?

A

Right lung: 3 Lobes

Left lung: 2 lobes

26
Q

What has developed by the end of the pseudoglandular stage?

A
  • Development of chest wall, mediastinum, diaphgram, pleural splaces descend during this stage
  • by the end of this stage, all elements of the lungs are developed except those involved in gas exchange
27
Q

Pulmonary Hypoplasia:

A
  • aka congenital diaphragmatic hernia
  • Occurs during pseudoglandular stage
    • failure of the chest well/diaphgram to develop causes a herniation
    • 1 in 2,500 newborns
    • leads to morbidity and mortality
    • caused by exposure to enviromental toxicants during week 3-4

Week 42 (10 decks)

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