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CardioPulmRenal > Respiratory Embryology > Flashcards

Respiratory Embryology Flashcards

1
Q

What is the first structure in the formation of the respiratory system?

A

laryngotracheal groove

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2
Q

Where does the laryngotracheal groove form?

A

in the anterior portion of the foregut and primordial pharynx

-inferior to the 4th pharyngeal arches

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3
Q

What does the laryngotracheal groove morph into as it expands?

A

laryngotracheal diverticulum

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4
Q

In the respiratory system, what does the endoderm become?

A
  • pulmonary epithelium

- glands of the larynx, trachea, and bronchi

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5
Q

In the respiratory system, what does the splanchnic mesoderm become?

A
  • connective tissue
  • cartilage
  • smooth muscle
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6
Q

What is the structure that grows inward to separate the esophagus from the trachea?

A

tracheoesophageal fold

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7
Q

What does the tracheoesophageal fold become?

A

tracheoesophageal septum

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8
Q

What are the inner and outer linings of the esophagus and the trachea?

A

-endoderm surrounded by splanchnic mesoderm

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9
Q

What are the growths around the laryngeal groove that aid in transforming it into the laryngeal inlet?

A

arytenoid swellings

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10
Q

True or False: the laryngeal epithelium proliferates at such a rate that it occludes the laryngeal inlet at a point in time during development

A

True

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11
Q

What is the embryological process that re-opens the laryngeal inlet and when does it occur?

A

recanalization at 10 wks

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12
Q

Is the larynx of a neonate higher or lower than that of an adult?

A

higher

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13
Q

What is the embryological origin of the epiglottis?

A

hypopharyngeal eminence

-from mesenchyme of the 3rd and 4th pharyngeal arches

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14
Q

From what structures do the laryngeal muscles develop?

A

4th and 6th pharyngeal arches

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15
Q

True or False: in an infant, the epiglottis is in contact with the soft palate

A

True; it assists in the suckling reflex while nursing

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16
Q

What are two consequences of the larynx still descending over the course of a child’s first two years?

A

children are nosebreathers

children are at a higher risk of choking

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17
Q

What are the endodermal components of the trachea?

A
  • trachea epithelium
  • trachea glands
  • pulmonary epithelium
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18
Q

What are the mesodermal components of the trachea?

A
  • tracheal cartilages (hyaline)
  • connective tissue
  • smooth muscle
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19
Q

What is the role of the tracheoesophageal septum?

A

separation of respiratory and digestive system structures

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20
Q

During what week does the respiratory bud form and bifurcate into the primary bronchial buds?

A

week 4

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21
Q

During what week do the primary bronchial buds branch into the secondary bronchial buds?

A

week 5

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22
Q

During what week do the secondary bronchial buds branch into the tertiary bronchial buds?

A

week 7

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23
Q

During what week does the tracheoesophageal septum form?

A

week 5

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24
Q

What are the four stages of lung development?

A

1) pseudoglandular
2) canalicular
3) terminal sac
4) alveolar

25
Q

What weeks comprise the pseudoglandular stage?

A

weeks 5-17

26
Q

What are the characteristics during the pseudoglandular stage?

A
  • histologically. the lung tissue looks like an exocrine gland
  • all major elements have formed, except those involved with gas exchange
27
Q

Can a fetus survive if born during the pseudoglandular stage of lung development?

A

No

28
Q

What weeks comprise the canalicular stage?

A

weeks 16-25

29
Q

What are the characteristics during the canalicular stage?

A
  • vascularization
  • formation of respiratory bronchioles
  • formation of primordial alveolar sacs
30
Q

Which parts of the lungs develops in advance of the other?

A

cranial segments advance in development before the caudal segments

31
Q

Can a fetus survive if born during the canalicular stage of lung development?

A

some can

some can’t

32
Q

What weeks comprise the terminal sac stage of lung development?

A

week 24 to birth

33
Q

What are the characteristics of the terminal sac stage?

A
  • numerous alveoli are forming
  • thin epithelium w/ vascularization
  • Type I and Type II pneumocytes
  • gas exchange can occur
34
Q

Can a fetus survive if born during the terminal sac stage of lung development?

A

Yes, but it depends on the production of surfactant and capillary development.

35
Q

What weeks comprise the alveolar stage of lung development?

A

32 weeks to 8 yrs of age

36
Q

What are the characteristics of the alveolar stage of lung development?

A
  • primitive alveoli still forming
  • mature alveoli exist
  • new alveoli are formed
  • largely completed by age 3 yrs
37
Q

Can a fetus survive if born during the alveolar stage of lung development?

A

Yes

38
Q

What cells produce surfactant?

A

Type II pneumocytes

39
Q

What is the role of surfactant?

A

decrease surface tension of the lungs so that they can expand during breathing

40
Q

Where is surfactant found in the body?

A

in the pleural cavity

41
Q

Pathology: Laryngeal Atresia

A
  • CHAOS (congenital high airway obstruction syndrome)
  • dilated airways
  • enlarged lungs filled w/ fluid
  • diaphragm flattened or inverted
42
Q

What is the embryological cause of laryngeal atresia?

A

failure of recanalization of larynx

43
Q

What is the treatment for laryngeal atresia?

A

endoscopic dilation of the laryngeal web

44
Q

Pathology: Tracheoesophageal Fistula

A
  • abnormal connetion b/w esophagus and trachea

- most common congenital anomaly of the lower respiratory tract (1/4,000 live births)

45
Q

Symptoms of a tracheoesophageal fistula

A
  • cannot swallow
  • frequently drool

-immediate regurgitation upon eating or gastric/intestinal contents may reflux into trachea/lungs

46
Q

What is the most common form of a tracheoesophageal fistula?

A

-85% associated with an esophageal atresia

47
Q

What is the embryologic cause of a tracheoesophageal fistula?

A

-failure of foregut endoderm to proliferate rapidly enough in relation to the rest of the embryo

48
Q

What condition of pregnancy may accompany the presence of a tracheoesophageal fistula in a fetus?

A

polyhydramnios

  • excess amniotic fluid bc it can’t enter fetal stomach
  • fluid can’t be transferred via placenta for disposal
49
Q

Pathology: Pulmonary Agenesis

1/15,000

A
  • unilateral loss of a lung or a lobe of a lung and its accompanying bronchi
  • respiratory bud fails to split into R/L bronchial buds
50
Q

Pathology: Oligohydramnios

14/10,000

A
  • insufficient amniotic fluid, <500 mL

- can retard lung development if chronic/severe

51
Q

What fetal condition is often associated w/ oligohydramnios?

A
  • renal agenesis

- renal failure

52
Q

What fetal lung condition is associated with oligohydramnios?

A
  • pulmonary hypoplasia

- d/t restriction of fetal thorax as a result of uterine pressure

53
Q

When during pregnancy does oligohydramnios carry the greatest risk of pulmonary hypoplasia?

A

-prior to 26 weeks

54
Q

What are some fetal characteristics caused by oligohydramnios?

A
  • breech presentation

- positioning defects of hands and feet

55
Q

Pathology: Respiratory Distress Syndrome

A
  • rapid, labored breathing shortly after birth
  • approx. 2% of infants
  • 50-70% of deaths in premature infants
  • surfactant deficiency
  • underinflated lungs
56
Q

Symptoms of Respiratory Distress Syndrome

A
  • tachypnea or nasal flaring
  • suprasternal, intercostal, or subcostal retractions
  • grunting and cyanosis
57
Q

What are characteristics of Respiratory Distress Syndrome?

A
  • alveoli contain fluid that resembles a glassy membrane

- irreversible changes in Type II pneumocytes that make them incapable of producing surfactant

58
Q

Pathology: Congenital Lung Cysts

A
  • filled with fluid or air

- thought to be formed by abnormal dilation of certain segments of bronchi

59
Q

Symptoms of Congenital Lung Cysts

A
  • wheezing
  • coughing
  • difficulty breathing

CardioPulmRenal (18 decks)

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