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Developmental/Neonatal Physiology > Session 5: Development of Respiratory system > Flashcards

Session 5: Development of Respiratory system Flashcards

1
Q

Outgrowth from the caudal end of the primitive pharynx (laryngotracheal groove)

A

Primitive respiratory system

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2
Q

What does the laryngotracheal groove give rise to?

A

Epithelium and glands of larynx, trachea, bronchi and pulmonary epithelium

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3
Q

By the end of the 4th week the laryngotracheal groove evaginates to form what?

A

Laryngotrachial diverticulum

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4
Q

Primitive Pharynx&raquo_space;»»»»

A

Laryngotracheal Groove

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5
Q

Laryngotracheal Groove&raquo_space;»»»»

A

Laryngotracheal Diverticulum

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6
Q

Laryngotracheal Diverticulum&raquo_space;»»»»

A

Lung bud and Tracheoesophageal Folds

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7
Q

Tracheoesophageal Folds&raquo_space;»»»»

A

Tracheoesophageal Septum

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8
Q

Tracheoesophagal Septum&raquo_space;»»»»

A

Laryngotracheal Tube (larynx, trachea, bronchi, lungs) & Primitive oropharynx and esophagus

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9
Q

Where does the epithelial lining of the larynx develop from?

A

The cranial end of the laryngotracheal tube

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10
Q

Where does the cartilage of the larynx derive?

A

4th and 6th pharangeal arches

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11
Q

When does the larynx reopen?

A

10th week

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12
Q

When the larynx reopens the folds of mucus membrane develop what?

A

Vocal cords

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13
Q

What forms from the 3rd and 4th pair of pharyngeal arches?

A

Epiglottis

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14
Q

What happens if there is an incomplete reopening of the larynx?

A

Laryngeal web

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15
Q

Where do the laryngeal muscles derive from?

A

Myoblasts from the 4th and 6th pharyngeal arches

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16
Q

What nerve supplies the laryngeal muscles?

A

Vagus

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17
Q

What differentiates into the trachea?

A

Endoderm part of laryngotracheal tube

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18
Q

The mesoderm surrounding the laryngotracheal tube creates what?

A

Cartilage, connective tissue and muscles of the trachea

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19
Q

What causes TEF?

A

Incomplete separation of trachea and esophagus

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20
Q

What is the most common TEF?

A

Superior part of esophagus terminates in blind pouch and it’s inferior part is joined to the trachea via fistula

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21
Q

What is the first symptom of TEF?

A

Rapid abdominal distention from air in the stomach and intestines.

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22
Q

What is an H type TEF?

A

Fistula in the middle portion of the esophagus and trachea. Gastric contents can get into the trachea.

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23
Q

What do the lung buds divide into?

A

Bronchial buds (primitive pleural cavity) and Bronchi

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24
Q

When does the connection of the bronchial buds with trachea to form primitive main stem bronchus occur?

A

5th Week

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25
Q

Which TEF occurs more in male than female?

A

Esophageal atresia with proximal and distal TEF

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26
Q

Which bronchus is longer and straighter?

A

Right

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27
Q

In the 5th week, main bronchus subdivides into 2 more bronchial buds: primitive secondary bronchi what do they yield?

A

Right: Superior segment of secondary bronchus yields the upper lobe of lung. The inferior yields the middle lobe of right lung and the lower lobe of the lung.
Left: Upper and lower lobes of left lung.

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28
Q

When do the tertiary bronchi develop?

A

7th Week

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29
Q

What is the 1st stage of lung development?

A

Pseudoglandular period

30
Q

What is the 2nd stage of lung development?

A

Canalicular period

31
Q

What is the 3rd stage of lung development?

A

Terminal sac periord

32
Q

What is the 4th stage of lung development?

A

Alveolar period

33
Q

When is the pseudoglandular period and what is formed?

A

5-17 weeks, All major parts of lung form except alveoli.

34
Q

When is the canalicular period and what is formed?

A

16-25 weeks, Terminal bronchioles divide to form smaller bronchioles and 3-6 alveolar ducts

35
Q

When is the terminal sac period and what occurs?

A

24 weeks to birth, Many more terminal sacs and epithelial lining sac becomes thin and capillaries bulge into them

36
Q

What percent of the alveolar surface is covered by type I cells?

A

95%

37
Q

What is the function of type I cells?

A

Gas exchange, with tight junctions to prevent leakage of fluid into air space

38
Q

When is the alveolar period and what occurs?

A

Late fetal to 8 years old, Adequate production of surfactant lungs transformed from secretory into gas exchange units, pulmonary and systemic circulation is established

39
Q

When do mature alveoli form?

A

after birth, 95%

40
Q

What happens in the 3rd year?

A

Enlargement of the lungs due to increased number of immature alveoli

41
Q

What happens by year 8?

A

Increase in number of alveoli and size

42
Q

What is RDS?

A

Deficiency of surfactant production. Lungs have glassy hyaline membrane covering alveoli

43
Q

When can lung structures support life?

A

26-28 weeks

44
Q

What is VQ matching?

A

Epithelium of alveoli thinned enough to allow for gas exchange to occur

45
Q

What are type II pneumocytes?

A

5% of alveolar surface, cuboidal cells, more organelles

46
Q

What is a characteristic of type II pneumocytes and what do they do?

A

Osmophillic lamellated bodies, produce surfactant

47
Q

When does alveolar stability occur?

A

Between 33-36 weeks

48
Q

What is surfactant made of?

A

It is a lipoprotein, 90% lipid and 10% protein

49
Q

What is the primary lipid in surfactant?

A

Lecithin or phosphatidylcholine

50
Q

What is lecithin made of?

A

dipalmitoyl phosphatidylcholine or DPPC which is 80% of surfactant

51
Q

When they check a mother’s amniotic fluid what are they looking for?

A

Phosphotidylglycerol which is unique to lung cells

52
Q

Where is surfactant produced?

A

In the smooth and rough endoplasmic reticulum of type II cells and alternately in the mitochondria

53
Q

Where is surfactant transported to and stored and excreted?

A

Transported to Golgi apparatus and stored in lamellar bodies. Excreted by exocytosis.

54
Q

What does surfactant do?

A

Migrates to surface of liquid layer and breaks surface tension at air/liquid interface of alveoli (lipids face outside and air stays inside)

55
Q

What do the proteins in surfactant do?

A

Improves function of phosphatidyl-choline

56
Q

What does Surfactant Protein A do?

A

Helps in the spreading of surfactant, antioxidant, and antimicrobial

57
Q

What does Surfactant Protein B and C do?

A

Purely functional, Maintains the integrity of the cell wall

58
Q

How does glucocorticoids affect surfactant production?

A

Accelerates fetal lung development, increases availability of glucose, and increases surfactant production

59
Q

How do thyroid hormones affect surfactant production?

A

Increase rate of phospholipid synthesis and give thyrotropin releasing hormone

60
Q

How does insulin affect surfactant production?

A

Inhibits production of surfactant, inhibits glycogen breakdown, and results in decreased lung maturation

61
Q

What is the L/S ratio and what does it mean?

A

Lecithin/Sphingomyelin ratio, shows presence of surfactant phospholipids in amniotic fluid

62
Q

When do lecithin levels begin to increase?

A

At 34 weeks

63
Q

What L/S ratio indicates mature lungs?

A

2:1

64
Q

Where are chemoreceptors located and what do they do?

A

Carotid and aortic bodies, when PaO2 falls below acceptable range it stimulates efferent nerves in the respiratory center of the brain and increase ventilation

65
Q

What must happen to chemoreceptors after birth?

A

Must be reset to increased PaO2

66
Q

When is the peripheral chemoreceptor activity similar to adult?

A

2 weeks of age for term and 4 weeks for preterm

67
Q

What is the problem with newborn chemoreceptors?

A

Limited response to CO2

68
Q

What are chest wall reflexes?

A

Spinal reflex arcs in intercostal muscle that stretch with respiration, activated with each respiration

69
Q

What are lung reflexes?

A

Sense lung inflation and deflation, inflation inhibits inspiration and prolongs expiration time (Hering-Breuer relflex)

70
Q

What is an irritant reflex and when is it present?

A

Cough, 35 weeks

71
Q

What does the respiratory center do?

A

Interprets information from the chemoreceptors to establish respiratory pattern

72
Q

What are the the areas of the respiratory center and their functions?

A

Apneustic: cuts off expiration
Pneumotaxic: switches inspiration to expiration
Medullary: Rhythm of respiration

Developmental/Neonatal Physiology (4 decks)

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