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CP Exam 1 > Respiratory Embryo > Flashcards

Respiratory Embryo Flashcards

1
Q

What tissue does our respiratory sysetm come from?

A

Foregut endoderm from the 6th arch arch of our primitive pharynx.

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2
Q

What tissue do lungs come from?

A

Foregut endoderm

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3
Q

What is on the inside of the 6th arch of our pharynx?

A

Laryngotracheal groove, which is the precursor for our larynx and trachea.

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4
Q

What is on the outside of of the 6th large of our primitive pharynx?

A

Laryngotracheal diverticulum (aka respiratory diverticulum or lung bud)

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5
Q

What are is the inferior portion of the laryngotracheal diverticulum called?

A

Respiratory bud.

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6
Q

Describe the formation of our ESOPHAGUS and LARYNGOTRACHEAL TUBE.

WHEN DOES THIS OCCUR?

A
  1. At week 4, laryngotracheal diverticulum grows out of the foregut endoderm.
  2. At the same time, the rest of our foregut endoderm is forming.
  3. Tracheoesophageal folds form.
  4. Folds migrate to the midline, fuse and form the tracheoesophageal septum. The septum then effectively creates our esophagus and our laryngotreacheal tube.

Thus, we separate esphogus from the trachea and larynx, so that food will not go down wrong way.

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7
Q

What is the shape of the tracheoesophageal folds and septum?

A

They are very longitudinal structures. This can be a problem, clincally.

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8
Q

Larynx comes from what tissue?

A

Foregut endoderm of the laryngotracheal groove in the ventral wall of the 6th arch of the primitive pharynx.

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9
Q

What kind of tissue is bilateral arytenoid swellings?

A

Endodermal covering mesenchyme (cartilage) that is derived from NEURAL CREST.

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10
Q

How do we form our larynx?

A
  1. Bilateral arytenoid swellings converge into a T shaped opening, forming the glottis- opening of our vocal cords
  2. Hypobranchial eminence (hypopharyngeal eminence) is in our 3rd and 4th arch. The one in our 4th arch forms our epiglottis.
  3. As the swellngs proliferate and move, the endoderm is proliferating, completely filling up the glottis.
  4. Endoderm in the glottis will under apoptosis called recanilization. This should be complete by week 10.

This forms our laryngeal vesicles, vocal and vestibular folds (both of which are mucuous membranes)

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11
Q

What is laryngeal atresia?

A

Results from failure of recanilization at week 10.

This obstructs the upper fetal airway, causing the child to have asphyxia at birth (can’t breathe).

This can be detected on ultrasound.

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12
Q

What are laryngeal webs?

A

-Incomprete atresia due to failure of recanilization at week 10.

Laryngeal webs block the glottis (vocal folds).

Children with laryngeal webs will have [respiratory distress], have an [unusual cry] and [stridor].

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13
Q

What is laryngomalacia?

A

Laryngomalacia is the most common congenital anomaly of the larynx.

  • Supraglottic structures collapse during inspiration.
  • We do not know how this occurs.
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14
Q

What tissue is our trachea and lungs derived from?

A
  1. Endoderm
  2. Splanchnic mesenchyme (mesoderm)
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15
Q

What does the endoderm create?

A
  1. Epithelium and glands of the trachea
  2. Epithelium of the lungs
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16
Q

What does the splanchnic mesenchyme (mesoderm) create?

A
  1. Rings of cartilage around the trachea.
  2. CT
  3. Smooth muscle
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17
Q

What is a tracheoesophageal (TE) fistula?

Underlying problem and week?

A

TE fistula usually result in two problems:

  1. Esophageal atresia- a blind-end esophagus
  2. TE fistula- abnormal connection between the trachea and esophagus

Problem: tracheal esphogus at week 5.

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18
Q

What are the symptoms of TE fistula?

A

Child will cough, sputter during feeding,

Alot of secretions from mouth.

Cyanotic.

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19
Q

How can we diagnose a TE fistula?

A

Usually, a a NG tube will reach the stomach in 17 cm.

If it stops at 12 cm, we can diagnose as a TE fistula

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20
Q

What is the most common type of TE fistula?

A

Fistula is where the inferior part of the esophagus connects to the trachea.

84%

NG tube will only reach 12 cm.

21
Q

What is the second most common type of fistula?

A

H-type

4%.

Can be diagnosed up to 4-5 years old.

Respiratory infections are common.

22
Q

When does the lung bud form?

A

week 4

23
Q

The lung bud divides into what?

A

2 primary bronchial buds, which will form your

L and R Main bronchi at week 5

24
Q

Primary bronchi divide into what?

A

Secondary bronchi (lobar bronchi).

R lung has 3: superior, middle and inferior

L lung has 2: superior and inferior.

Formed at week 6

25
Q

Secondary bronchi (lobar bronchi) divide into what?

A

Tertiary bronchi buds with form your tertiary bronchi (segmental bronchi) at week 7.

Right lung has 10

Left lung has 9.

26
Q

When do we have our bronchopulmonary segment formed?

A

By 24 weeks, we have 17 orders of branching which end in our terminal bronchioles.

Thus, we have made our conducting system and CANNOT exchange gas yet because we have not made our respiratory zone.

27
Q

By 24 weeks, can gas exchange occur?

A

No. Because we have only formed our conducting zone.

Not our respiratory zone.

thus, gas exchange cannot occur.

28
Q

How do the buds grow?

A

They grow into our splanchnic mesoderm.

As they are growing, they grow into the pericardialperitoneal canal.

29
Q

What are the stages of lung development?

A
  1. Pseudoglandular stage (weeks 5-17)
  2. Canalicular stage (weeks 16- 25)
  3. Terminal sac stage (24 weeks to birth)
  4. Alveolar stage (32 weeks- 8 years).
30
Q

Why is there an overlap of weeks during lung stage development?

A

Because the development of lungs is going to affected by gender, race and region.

F will develop lungs first

African americans will develop lungs first.

Superior region of lungs will develop first.

31
Q

What occurs during the pseudoglandular stage?

A

Weeks 5-17.

  1. Terminal bronchioles are formed, which are surrounded by CT from splanchnic mesoderm.
  2. Capillaries are not surrounding terminal sacs

If an infant is born during this time, they cannot survive because gas exchange cannot occur.

32
Q

What occurs at the canalicular stage?

A

Weeks 16-25.

  1. Respiratory bronchioles are formed and they divide into our primordial alveolar ducts.
  2. Terminal sacs (primitive alveoli) are formed.
  3. Vascularization occurs.

Depending on when born, survival is possible (more likely 22+ weeks)

33
Q

What occurs at the terminal sac stage?

A

24 weeks - birth.

  1. Gas exchange occurs because there is differentiation of
    - Squamous epithelium into type 1 pneumocytes, flatten out and close for vascularization
    - Secretory epithelial cells into type II pneumocytes, which create surfactant
  2. Lymphatic capillaries form.

Infant will surive if born

34
Q

What occurs at the alveolar stage?

A

32 weeks- 8 years old.

  1. Alveolarcapillary membrane (from endoderm and mesoderm is formed)
  2. Primitive alveoli form, which form more primitive alveoli)
  3. This will create mature aveolar.
35
Q

95% of our MATURE ALVEOLI form when?

A

After birth. Around 3 years.

36
Q

Why does the alveolar stage last until year 8?

A

Because lungs are not done developing until 8 years. This is why pediatricians ask about smoking in homes.

37
Q

What stage does do terminal bronchioles supply specific regions of the lungs (birth of the acinus)?

A

Pseudoglandular (weeks 5-17)

38
Q

What stage does epithelial differentiation and air-blood barrier form?

A

Terminal sac stage (weeks

39
Q

As a fetus develops, they will undergo what?

A

Fetal breathing movements (FBMs)

40
Q

What is FBM?

A

Fetus is breathing in the amnoitic fluid with enough force to cause aspiration of the amnoitic fluid, thus, priming our lungs.

41
Q

What are the THREE things that are essential for normal lung development?

A
  1. FBM
  2. Adequate amount of thoracic space for growth
  3. Adequate amount of amnoitic fluid volume
42
Q

At birth, we must clear our intra-alveolar fluid. How does this occur during vaginal delivery and a C-section?

A

Vaginal delivery- pressure on the fetal thorax will expel the fluid from the mouth and noise.

C-section-fluid goes into the pulmonary capillaries, arteries, veins and lymphatics.

43
Q

What is oligohydramnois?

A

Too little amnoitic fluid, causing the lungs to not fully develop and may result in pulmonary hypoplasia.

44
Q

When does the risk of pulmonary hypoplasia increase?

A

Increases significantly with oligohydramnois before 26 weeks.

45
Q

Causes of respiratory distress?

A

TE fistula

lack of surfactant

Laryngeal web

Oligohydramnois

46
Q

signs and syptoms of resp distress

A

tachypnea

nasal flaring

suprasterna, intercosta or subcostal retractions

grunting

cyanosis

47
Q

what to do if a bb has respiratory distress

A

X ray

48
Q

Respiratory distress syndrome

AKA

Caused by?

Stage?

A

Also called Hyaline membrane disease

  • Caused by lack of surfactant
  • Terminal sac stage
  • Low lung volume. lungs have a reticulogranular ground glass appearance
49
Q
A

CP Exam 1 (29 decks)

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