Respiritory Development Flashcards

1
Q

Explain the role that local mesenchyme tissue plays in lung development

A

Regional specificity of the mesenchyme determines the differentiation of the developing respiratory tube.

In the developing mammal, the respiratory epithelium responds to local signals from mesenchyme 
    tissue in two distinct fashions. 
	
	In the region of the neck, it grows straight, forming the trachea. 
	Surrounded by tracheal mesenchyme = straight bronchi
	
	After entering the thorax, it branches, forming the two bronchi and then the lungs. 
	Retained lung mesenchyme = branching of bronchus
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2
Q

Describe the formation of the trachea and lung buds from the embryonic endoderm

A

The function of the embryonic endoderm is to

Construct the linings of two tubes within the body. 

	The first tube, extending throughout the length of the body, is the digestive tube. Buds from 
             this tube form the liver, gallbladder, and pancreas. 

	The second tube, the respiratory tube, forms as an outgrowth of the digestive tube, and it 
            eventually bifurcates into two lungs.
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3
Q

Describe how the formation of lung buds occur

A

A) formation of laryngotracheal groove.
- This buds into two main bronchi.

B) Further budding may be unequal
- e.g. 3x on right (3 right lobes) 2x on left (2 left lobes).

They develop by branching morphogenesis

C) Final septation distinguishes pharynx from larynx and thus trachea from oesophagus

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4
Q

Outline how the lower respiritory structure form

A

Subsequent divisions generate bronchi, then bronchioles and finally the alveoli

Majority divisions occur in utero (17 of 24)

Further postnatal maturation (7 more divisions)

At birth LUNGS are IMMATURE but functional

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5
Q

Describe the various stages of lung development

A

Embryonic
Formation of major airways and budding of bronchial branches
Pseudoglandular
Formation of the bronchial trees & portions of the respiritory parenchyma
Acinus is formed
Canalicular
Last generations of lung periphery formed
Epithelial differentiation
Air blood barrier formed
Saccular
Expansion of air spaces
Surfactant is detectible in amniotic fluid
Alveolar
Secondary septations - maturation of the alveolar during the end of fetal development and a
period of time after birth

In all species, lung development continues postnatally (in litter-bearing species this maybe a really long time)

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6
Q

Describe how the timing of the lung development stages varies between different domestic animal species

A

Stage Man (weeks) Sheep (days) Rat (days)
Embryonic 3-6 (7-15%) 17-40 (11-27%) ?-13 (-61%)
Pseudoglandular 6-16 (15-40%) 40-80 (27-55%) 13-18 (61-85%)
Canalicular 16-26 (40-65%) 80-120 (55-82%) 18-20 (85-95%)
Saccular 26-40 (65-100%) 120-145 (82-100%) 20-21 (95-100%)
Alveolar 32- 2yr (80-270%) 120-0.5y (82-125%) 21- 42 (100-200%)

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7
Q

Define polytocous

A

litter bearing

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8
Q

Define monotocous

A

produce single offspring

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9
Q

Define altricial

A

dependent at birth on each other and the mother

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10
Q

Define precocial

A

Increased independence and is able to walk within hours of birth

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11
Q

List the 4 factors which influence lung development

A

Intra-thoracic space
Intra-uterine space
Fetal breathing movements
Lung liquid production

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12
Q

Explain how intra-thoracic space can modulate lung development

A

Size of space for lungs to develop in

Impaired by conditions like congenital diaphragmatic hernia.

This is a relatively common condition, affecting around 1:4000 births – here the diaphragm fails to close in the fetus and the abdominal contents enter into the thoracic cavity, compressing the lungs and impairing lung growth.

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13
Q

Explain how intra-uterine space can modulate lung development

A

Size of uterus, amount of amniotic fluid

Fetal lungs need adequate intra-uterine space

Impaired by oligohydramnios which is a lack of amniotic fluid.

A reduction in amniotic fluid volume can lead to uterine compression and changes in fetal posture – and this is quite a common cause of pulmonary hypoplasia.

Too much fluid in the within the fetal lung is known as polyhydramnios

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14
Q

Explain how fetal breathing movements can modulate lung development

A

Frequency, intensity

The normal, unstressed fetus practices breathing before birth and regular activation of the respiratory muscles is essential for the normal development of the fetal lungs.

During practice breathing, there is relatively little change in lung volume, as it only causes slight movement to the water.

However, the importance of fetal breathing movements can be demonstrated experimentally as abolishing them by denervation of the diaphragm leads to hypoplasia of the lungs (lung hypoplasia)

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15
Q

Explain how lung liquid production can modulate lung development

A

How much produced…

Lungs need an adequate secretion of fluid to help maintain the appropriate balance of volume and pressure during development.

Lungs secrete liquid into lung cavity which helps to inflate them. This helps lungs grow.

If prevent secretion, lungs or lobes do not develop e.g. right lobes on figure (contrast with left lobe)

Lung liquid is produced from around mid-gestation – it is a secretory product of the pulmonary epithelium and is either swallowed or enters into the amniotic fluid. The secretions are thought to be induced locally (each lung)

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16
Q

What is the clinical relevance of lung development?

A

If any of these are affected the it can lead to underdeveloped lungs which will require neonatal support. If it is mild then it can manifest as exercise intolerance

17
Q

What are glucocorticoids and describe their importance?

A

Class of corticosteroid which plays an important role in reducing the working of breathing, helping lung inflation and prevent collapse, stimulate production of luid for the lungs and prepare lungs for new gaseous environment prior to birth

18
Q

Explain how glucocorticoids reduce the work of breathing in utero

A

Increase elastin content
Enhance lung compliance and reduce the work of ventilation

Thinning of alveolar wall and interstitial tissue
Reduce the distance for gaseous diffusion

Differentiation of Type II pneumocytes
Allow the lung to inflate easily but not to collapse during expiration.

19
Q

Explain how glucocorticoids increase surfactant production in utero

A

Increase in surfactant production
Enhance lung compliance and reduce the work of ventilation

Increase in enzymes responsible for phospholipid synthesis
Allow the lung to inflate easily but not to collapse during expiration.

20
Q

Explain how glucocorticoid stimulate production of lung liquids

A

Increase in pulmonary β-adrenoceptors
Indirectly stimulate lung liquid absorption and surfactant secretion.

Increase in expression of epithelial Na+ channels and Na+/K+ ATPase
Act directly by promoting expression of Na+ channels and Na+/K+ ATP pumps in the pulmonary epithelium.

21
Q

Explain how glucocorticoids prepare the lungs for a new gaseous environment

A

Increase in antioxidant enzymes
Protect the lungs against damage by O2 free radicals.

22
Q

Describe the components and function of surfactant

A

Enables alveolar cells to touch one another without sticking

90% phospholipid 10% protein

Made by type two pneumocytes in the lung

23
Q

Outline the benefit of surfactant

A

Fluid-filled lungs have very low compliance (cannot open), as water has high surface tension

Air-filled lungs are very compliant due to surfactant reducing surface tension

No surfactant = respiratory distress syndrome