Respiratory Embryo Flashcards

1
Q

What is the first step into creating the future respiratory system ?

A

the development of the laryngotracheal groove in the caudal foregut , inferior to the 4th PAs

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2
Q

Where does the tracheobronchial tree develop?

A

caudal to the 4th pharyngeal pouches

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3
Q

What is the sequence of events in forming the respiratory system?

A

laryngotracheal groove -> laryngotracheal diverticulum -> laryngotracheal tube

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4
Q

What does laryngotracheal groove endoderm give rise to?

A
  • pulmonary epithelium

- glands of larynx, trachea, and bronchi

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5
Q

What does the laryngotracheal groove splanchnic mesoderm give rise to?

A
  • CT
  • cartilage
  • SM
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6
Q

What two dermal layers compromise the laryngotracheal tube?

A
  • foregut endoderm

- splanchnic mesoderm

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7
Q

Describe the steps in formation of laryngotracheal tube

A

1 - laryngotracheal groove develops in caudal foregut, inferior to 4th PA
2 - groove evaginates to form the laryngotracheal diverticulum
3 - diverticulum elongates and is invested w/ splanchnic mesoderm
4 - distal end of diverticulum = respiratory bud (origin of respiratory. tree)
5 - tracheoesophageal folds fuse and form the tracheoesophageal septum all while above is happening

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8
Q

When do the tracheoesophageal fold become the septum?

A

end week 5

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9
Q

What layer are the tracheoesophageal folds derived from?

A

endoderm

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10
Q

What to the tracheoesophageal folds divide the cranial foregut into?

A
ventral = laryngotracheal tube
dorsal = prim. oropharynx and esophagus
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11
Q

what does the laryngotracheal tube give rise to?

A
  • prim. larynx, trachea, brochi, lungs
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12
Q

Where the the larynx being to develop?

A

@ cranial end of LTT

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13
Q

Name the steps in larynx development

A

1) mesenchyme swelling appear at cranial end of LTT (arytenoids)
2) arytenoids convert primordial glottis into a T shaped laryngeal inlet
3) inlet closes via epithelium proliferation
4) inlet recanalizes
5) inlet creates a laryngeal vestibule and epiglottis appears

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14
Q

When does recanalization of the larynx happen?

A

by end of week 10

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15
Q

What does the laryngeal vestibule contain?

A

-> contains mucous membrane folds which create vocal and vestibular folds

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16
Q

How is the epiglottis formed?

A

Via the hypo pharyngeal eminence

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17
Q

Where are laryngeal m. derived from ?

A

myoblasts of 4th and 6th PA

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18
Q

Where is the epiglottis derived from?

A

mesenchyme of 3rd and 4th PA

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19
Q

What are the 3 layers that make up the larynx?

A
  • epidermis
  • cartilage
  • muscles
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20
Q

Where is laryngeal epidermis derived from ?

A

foregut endoderm (from LTT)

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21
Q

Where is cartilage of larynx derived from?

A

NCC of 4th and 6th PA

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22
Q

What does the laryngotracheal diverticulum give rise to?

A

trachea and primary bronchial buds

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23
Q

What dermal layer gives rise to tracheal epithelium and glands?

A

foregut endoderm

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24
Q

What dermal layer gives rise to the tracheal cartilage, CT, & SM?

A

splanchnic mesenchyme

25
Q

Describe the steps of lung development from the LTT

A

1) distal end of laryngotracheal diverticulum enlarges to form the respiratory bud (wk 4)
2) bud grown ventrocaudally and bifurcates
3) during 5th week 1ry bronchi -> 2ndry bronchi -> 3ry bronchi
4) bronchopulmonary segments appear by wk 7

26
Q

What regulates the branching pattern of the developing lungs?

A

splanchnic mesenchyme

27
Q

When do you start to see 1,2,3ry bronchi

A

5th week

28
Q

When do bronchopulmonary segments form?

A

7th week

29
Q

What is a tracheoespohageal fistula?

A

abnormal connx b/w trachea and esophagus
(lower respiratory tract)

-assoc. w/ esophageal atreasia

30
Q

What causes a tracheoesophageal fistula?

A

result of failure of foregut endoderm to proliferate rapidly enough in relation to developing embryo

31
Q

Presenting symptoms of a tracheoesophageal fistula?

A
  • cannot swallow
  • drool
  • immediate regurgitation
  • polyhydramnios (amniotic fluid cannot enter stomach to be recycled via placenta)
32
Q

what are the stages of lung maturation?

A

pseudo glandular -> canalicular -> terminal sac -> alveolar

33
Q

What characterizes the pseudo glandular stage?

A

5-17 weeks

  • looks like exocrine gland
  • all major structures except gas exchange ones
  • NOT SURVIVABLE
34
Q

What characterizes the canalicular stage?

A
16-25 weeks
-vascularization
-respiratory bronchioles
-1ry alveolar and sacs present (primitive alveoli)
MAY OR MAY NOT SURVIVE
35
Q

What characterizes the terminal sac stage?

A
24 weeks -birth 
-numerous alveoli
-thin epic, high vascularization
-Type 1 & 2 pnumeocytes ; lymph capillaries 
GAS EXCHANGE CAN OCCUR

SURVIVABLE

36
Q

What is a major determinant of fetal survivability in lung maturation stage?

A

-development of capillaries

more capillary development = high survivability

37
Q

What characterizes the alveolar stage?

A

32 weeks - 8 years

  • alveolocapillary membrane
  • primitive alveoli form more primitive alveoli
  • mature alveoli
38
Q

Alveolar development is largely completed by what year of life?

A

3

39
Q

What does splanchnic mesoderm create in the developing bronchial/resp bud?

A

1) cartilaginous plates (bronchial)
2) bronchial SM & CT
3) pulmonary CT and capillaries

40
Q

What are fetal breathing movements?

A

intermittent patterns that conditions respiratory m -> essential for lung development

causes: inspiration of amniotic fluid
* early predictor if fetal outcome in preterm delivery

41
Q

What is laryngeal atresia?

A

RARE

-obstruction of upper fetal airway (CHAOS)

42
Q

What causes laryngeal atresia?

A

failure of recanalization of laryngeal inlet

43
Q

What are symptoms of laryngeal atresia?

A

lungs enlarged ; dilated airways -> filled with fluid

diaphragm flattened or inverted ; fetal ascites or hydros

44
Q

What is pulmonary agenesis?

A

complete absence of a lung to lobe and accompanying bronchi

45
Q

What causes pulmonary agenesis?

A

respiratory bud fails to split into R/L bronchial buds

46
Q

What is Oligohydramnios?

A

insufficient amniotic fluid production (<500 ml)

severe = retards lung development

47
Q

what is oligohydramnios assoc. with?

A

renal agenesis/failure in fetus

48
Q

Pulmonary hypoplasia is a result of?

A

restriction on fetal thorax due to uterine pressure

  • dec. hydronic pressure on lungs
  • affects stretch receptors and lung growth

exacerbated by oligohydroamnios < 26 wks

49
Q

What is oligohydramnios (potter’s) sequence?

A

atypical physical appearance if baby due to oligohydramnios when in utero

  • clubbed feet ; pulmonary hypoplasia ; cranial anomalies ; limb hypoplasia
50
Q

What is respiratory distress syndrome?

A

rapid, labored breathing developed shortly after birth

major cause: surfactant deficiency
-50-70% of premie deaths

51
Q

What are the mechanisms behind respiratory distress syndrome?

A

lungs under inflated ; alveoli filled with fluid that resembles glassy membrane

-irrev. changes in type 2 cells making them incapable of producing surfactant

52
Q

What are symptoms of RDS?

A
  • tachypnea, nasal flaring
  • suprasternal, intercostal, subcostal retractions
  • grunting
  • cyanosis
53
Q

What are congenital lung cysts?

A

cause : formed by dilation of terminal bronchioles

  • filled with fluid/air
  • disturbance of bronchial deep. during late fetal life
54
Q

Symptoms of congenital lung cysts?

A

wheezing
cyanosis
difficulty breathing

55
Q

What is developed by week 4 ?

A

respiratory diverticulum -> resp. bud

56
Q

What is developed by week 5?

A

tracheoespohageal folds -> septum

1ry bronchi -> 2ndry ->3ry

57
Q

When are terminal bronchioles developed?

A

week 16

58
Q

What is developed by week 28?

A

respiratory bronchioles, 1st terminal sacs

59
Q

What is developed by week 36?

A

terminal sacs -> mature alveoli