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USMLE > Respiratory Embryology > Flashcards

Respiratory Embryology Flashcards

1
Q

What does the upper respiratory tract consist of?

A

Larynx + trachea

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2
Q

What does the lower respiratory tract consist of?

A

Bronchi + lungs

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3
Q

What develops first, the URT or the LRT?

A

Upper respiratory tract

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4
Q

What are the stages of lung development?

A
  1. Pseudoglandular
  2. Canalicular
  3. Saccular
  4. Alveolar
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5
Q

From what does the larynx, the trachea and the lung buds develop from?

A

An outpouching of the esophagus

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6
Q

At what stage in-utero does the primordial respiratory system arise?

A

3rd-4th week

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7
Q

And from WHERE does the primordial respiratory system arise?

A

The laryngotracheal grove on the ventral foregut

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8
Q

What partitions the outpouching of the esophagus, that becomes the laryngotracheal tube, from the esophagus?

A

The tracheoesophageal septum

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9
Q

What are the functions of the larynx?

A
  1. Airway protection
  2. Aid in respiration
  3. Vocalization
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10
Q

What marks the first division between the respiratory and the digestive systems?

A

Larynx

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11
Q

To what is the larynx attached superiorly?

A

Hyoid bone

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12
Q

To what bone is the larynx attached?

A

Hyoid bone

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13
Q

From what are the laryngeal cartilage and musculature derived?

A

4th + 6th pharyngeal arch mesenchyme

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14
Q

How many pharyngeal arches do humans have?

A

6

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15
Q

From what are the pharyngeal arches derived?

A

Neural crest tissues

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16
Q

What does the 1st pharyngeal arch form? (Mainly M’s)

A

Muscles - Mastication muscles; anterior belly of digastric; Mylohyoid; tensor tympani; tensor veli palatini

Skeletal - Maxilla; Mandible; Malleus; incus; Meckel cartilage

Nerves - V2 and V3

Arteries - Maxillary artery; external carotid artery

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17
Q

What does the 2nd pharyngeal arch form? (Sort-of Solely S’s)

A

Muscles - muscles of facial expression; Stapedius; Stylohyoid; buccinator; platysma; posterior belly of digastric

Skeletal - Stapes; Styloid process; Reichert cartilage; lesser horn + upper part of body of hyoid

Nerves - VII

Arteries - Stapedial artery

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18
Q

What does the 3rd pharyngeal arch form?

A

Muscles - stylopharyngeus

Skeletal - thymus; greater horn and lower part of body of hyoid

Nerves - IX

Arteries - common carotid; internal carotid artery

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19
Q

What does the 4th pharyngeal arch form?

A

Muscles - cricothyroid; intrinsic muscles of the soft palate

Skeletal - thyroid and epiglottic cartilage

Nerves - X, superior laryngeal nerve

Arteries - R subclavian + aortic arch

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20
Q

At what point are the false and true vocal cords formed?

A

Week 10, when the epithelial tissue occluding the primitive laryngeal orifice breaks down and the surrounding epithelial folds differentiate into them

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21
Q

What does the 6th pharyngeal arch form?

A

Muscles - intrinsic muscles of the larynx, except cricothyroid

Skeletal - cricoid; arytenoid; corniculate cartilages

Nerves - X, recurrent laryngeal nerve

Arteries - pulmonary arteries; ductus arteriosus

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22
Q

From what are the cartilage, smooth muscle and connective tissue of the trachea derived from?

A

Splanchnic mesoderm

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23
Q

Which bronchi is more lateral, L or R?

A

L bronchi

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24
Q

Which bronchi is more central, L or R?

A

R bronchi

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25
Q

How many divisions does the R bronchi give rise to?

A

3

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26
Q

How many divisions does the L bronchi give rise to?

A

2

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27
Q

At what point do the lung buds (which also give rise to the bronchi and bronchioles) form?

A

End of week 4

28
Q

In what time frame is the pseudoglandular period?

A

Weeks 5-16

29
Q

In what time frame is the canalicular period?

A

Weeks 16-26

30
Q

What occurs during the canalicular period?

A

The airways increase in diameter
Vasculature develops
Primitive end respiratory units of bronchioles, alveolar ducts and terminal sacs are formed

31
Q

In what time frame is the saccular period?

A

Weeks 26 - Birth

32
Q

What occurs during the saccular period?

A

Terminal sacs develop

33
Q

What are the type I cells of the respiratory system?

A

Form the gas exchange surface

34
Q

What are type II cells of the respiratory system?

A

Synthesis of surfactant

35
Q

In what time frame is the alveolar period?

A

Prenatal - childhood

36
Q

From what are the pleural cavities derived?

A

Intraembryonic coelom (body cavity)

37
Q

What are the 2 layers of pleura?

A

Visceral + parietal

38
Q

From what is the visceral pleura formed from?

A

Splanchnic mesoderm

39
Q

From what is the parietal pleura formed from?

A

Somatic mesoderm

40
Q

What is the innervation of the diaphragm?

A

C3; C4; C5

41
Q

What is the pneumonic for the innervation of the diaphragm?

A

C3, 4 and 5 keep the diaphragm alive

42
Q

What 4 embryonic structures fuse to make the diaphragm?

A 
S = septum transversum
P = pleuroperitoneal folds
B = body wall
D = dorsal mesentery of the esophagus
43
Q

What is the pneumonic for the 4 embryonic structures that fuse to make the diaphragm?

A

Several Parts Build a Diaphragm

44
Q

By what week in-utero is the diaphragm formed?

45
Q

What does the septum transverse, that makes up the diaphragm, form in an adult?

A

Central tendon

46
Q

What does the body wall, that makes up the diaphragm, from in an adult?

A

Peripheral, muscular part of the diaphragm

47
Q

At what stage doing the type II pneumocytes begin producing surfactant?

A

Weeks 25-28

48
Q

What is the surfactant?

A

A reduction in surface tension that facilitates alveolar opening

49
Q

How may RDS be treated?

A
  1. Antenatal maternal steroids

2. Surfactant replacement

50
Q

What problems may congenital cysts of the respiratory system cause?

A
  1. Chronic infection, secondary to poor drainage
51
Q

What problems may congenital cysts of the respiratory system cause?

A

Chronic infection, secondary to poor drainage

52
Q

What is pulmonary aplasia?

A

Failure of the lungs to develop

53
Q

What is purpose of surfactant?

A

A reduction in surface tension that facilitates alveolar opening

54
Q

What is the most common cause of pulmonary hypoplasia?

A

Congenital diaphragmatic hernia (CDH)

55
Q

What are the different forms of pulmonary hypoplasia?

A

Primary

Secondary - e.g. caused by oligohydramnios or CDH

56
Q

What is the cause of CDH?

A

Failure of the 4 embryonic structures that make up the diaphragm to fuse

57
Q

How may CDH present?

A
  1. RDS
  2. Loops of bowel in the thoracic cavity on XR
  3. Bowel sounds on auscultation
58
Q

What is laryngomalacia?

A

Congenital weakness of the cartilages of the larynx

59
Q

How may laryngomalacia present?

A

The collapse of the larynx on inspiration results in a ‘wet’ inspiratory stridor. Common + usually resolves spontaneously

60
Q

What is the treatment of laryngeal atresia?

A

Tracheostomy - a neonate will asphyxiate without it

61
Q

How may a tracheoesophageal fistula (TEF) present?

A

Coughing during feeding

62
Q

What secondary problems may a TEF cause?

A

Aspiration pneumonitis - chemical irritation of the airways by the gastric contents
Aspiration pneumonia - infection of the lungs by aspiration of gastric contents

63
Q

TEF and EA may be part of a larger pattern of congenital abnormalities including what else?

A 
VACTERL
V
A
C
T
E
R
L
64
Q

What are the different anomalies of the tracheoesophageal septum?

A 
Esophaeal atresia (EA)
TEF
65
Q

What is the most common abnormality of the tracheoesophageal septum?

A

Proximal EA + distal TEF

66
Q

TEF and EA may be part of a larger pattern of congenital abnormalities including what else?

A 
VACTERL
V - vertebral defects
A - anal atresia
C - cardiac defects
T - TEF
E - EA
R - renal agenesis/obstruction
L - limb hypoplasia

USMLE (14 decks)

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