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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
Which TEF occurs more in male than female?
Esophageal atresia with proximal and distal TEF
26
Which bronchus is longer and straighter?
Right
27
In the 5th week, main bronchus subdivides into 2 more bronchial buds: primitive secondary bronchi what do they yield?
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.
28
When do the tertiary bronchi develop?
7th Week
29
What is the 1st stage of lung development?
Pseudoglandular period
30
What is the 2nd stage of lung development?
Canalicular period
31
What is the 3rd stage of lung development?
Terminal sac periord
32
What is the 4th stage of lung development?
Alveolar period
33
When is the pseudoglandular period and what is formed?
5-17 weeks, All major parts of lung form except alveoli.
34
When is the canalicular period and what is formed?
16-25 weeks, Terminal bronchioles divide to form smaller bronchioles and 3-6 alveolar ducts
35
When is the terminal sac period and what occurs?
24 weeks to birth, Many more terminal sacs and epithelial lining sac becomes thin and capillaries bulge into them
36
What percent of the alveolar surface is covered by type I cells?
95%
37
What is the function of type I cells?
Gas exchange, with tight junctions to prevent leakage of fluid into air space
38
When is the alveolar period and what occurs?
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
When do mature alveoli form?
after birth, 95%
40
What happens in the 3rd year?
Enlargement of the lungs due to increased number of immature alveoli
41
What happens by year 8?
Increase in number of alveoli and size
42
What is RDS?
Deficiency of surfactant production. Lungs have glassy hyaline membrane covering alveoli
43
When can lung structures support life?
26-28 weeks
44
What is VQ matching?
Epithelium of alveoli thinned enough to allow for gas exchange to occur
45
What are type II pneumocytes?
5% of alveolar surface, cuboidal cells, more organelles
46
What is a characteristic of type II pneumocytes and what do they do?
Osmophillic lamellated bodies, produce surfactant
47
When does alveolar stability occur?
Between 33-36 weeks
48
What is surfactant made of?
It is a lipoprotein, 90% lipid and 10% protein
49
What is the primary lipid in surfactant?
Lecithin or phosphatidylcholine
50
What is lecithin made of?
dipalmitoyl phosphatidylcholine or DPPC which is 80% of surfactant
51
When they check a mother's amniotic fluid what are they looking for?
Phosphotidylglycerol which is unique to lung cells
52
Where is surfactant produced?
In the smooth and rough endoplasmic reticulum of type II cells and alternately in the mitochondria
53
Where is surfactant transported to and stored and excreted?
Transported to Golgi apparatus and stored in lamellar bodies. Excreted by exocytosis.
54
What does surfactant do?
Migrates to surface of liquid layer and breaks surface tension at air/liquid interface of alveoli (lipids face outside and air stays inside)
55
What do the proteins in surfactant do?
Improves function of phosphatidyl-choline
56
What does Surfactant Protein A do?
Helps in the spreading of surfactant, antioxidant, and antimicrobial
57
What does Surfactant Protein B and C do?
Purely functional, Maintains the integrity of the cell wall
58
How does glucocorticoids affect surfactant production?
Accelerates fetal lung development, increases availability of glucose, and increases surfactant production
59
How do thyroid hormones affect surfactant production?
Increase rate of phospholipid synthesis and give thyrotropin releasing hormone
60
How does insulin affect surfactant production?
Inhibits production of surfactant, inhibits glycogen breakdown, and results in decreased lung maturation
61
What is the L/S ratio and what does it mean?
Lecithin/Sphingomyelin ratio, shows presence of surfactant phospholipids in amniotic fluid
62
When do lecithin levels begin to increase?
At 34 weeks
63
What L/S ratio indicates mature lungs?
2:1
64
Where are chemoreceptors located and what do they do?
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
What must happen to chemoreceptors after birth?
Must be reset to increased PaO2
66
When is the peripheral chemoreceptor activity similar to adult?
2 weeks of age for term and 4 weeks for preterm
67
What is the problem with newborn chemoreceptors?
Limited response to CO2
68
What are chest wall reflexes?
Spinal reflex arcs in intercostal muscle that stretch with respiration, activated with each respiration
69
What are lung reflexes?
Sense lung inflation and deflation, inflation inhibits inspiration and prolongs expiration time (Hering-Breuer relflex)
70
What is an irritant reflex and when is it present?
Cough, 35 weeks
71
What does the respiratory center do?
Interprets information from the chemoreceptors to establish respiratory pattern
72
What are the the areas of the respiratory center and their functions?
Apneustic: cuts off expiration Pneumotaxic: switches inspiration to expiration Medullary: Rhythm of respiration

Developmental/Neonatal Physiology (4 decks)

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