LEC 18: Respiratory System - 08.28.14 Flashcards

1
Q

Upper vs. Lower Respiratory Tract

A
  • Upper
    • nasal cavities, etc.
  • Lower
    • larynx
    • trachea
    • bronchi
    • lungs
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2
Q

When do the lower respiratory organs begin to form

A

~4 weeks

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3
Q

Respiratory primordium

A
  • respiratory primordium indicated by median outgrowth from caudal end of ventral wall of primordial pharynx
  • elongates to form laryngotracheal tube
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4
Q

Laryngotracheal groove

A
  • median outgrowth in anterior wall of endodermally-derived foregut
  • by end of 4th week the laryngotracheal groove invaginates to form pouch-like respiratory diverticulum (lung bud)
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5
Q

Formation of lung bud

A
  • by end of 4th week the laryngotracheal groove invaginates to form pouch-like respiratory diverticulum (lung bud)
  • as diverticulum elongates, it is invested with splanchnic mesenchyme and its distal end enlarges to form tracheal bud
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6
Q

Relationship between respiratory diverticulum and primordial pharynx

A
  • respiratory diverticulum separates from primordial pharynx, but maintains communication with it through the primordial laryngeal inlet
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7
Q

composition of laryngeal tube

A

endoderm = epithelium and glands of larynx, trachea, bronchi, and pulmonary epithelium

splanchnic mesoderm = connective tissue, cartilage, smooth muscle

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8
Q

functions of larynx

A
  • swallowing
  • respiration
  • voice production

upper border = epiglottis

lower border = cricoid cartilage

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9
Q

Formation of larynx

A
  • forms at cranial end of LT tube
  • epithelial lining develops from endoderm of LT tube
  • laryngeal cartilages develop from mesenchyme that is derived from neural crest cells
    • mesenchyme at cranial end of LT tube proliferates rapidly, forms paired arytenoid swellings
  • swellings grow toward tongue, forming T-shaped laryngeal inlet
  • Proliferation of epithelium temporarily occludes laryngeal lumen (recanalizes by week 10)
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10
Q

recanalization of larynx

A
  • T-shaped glottis bounded by lateral arytenoid swellings and cranial epiglottis
  • temporarily occludes laryngeal lumen
  • recanlized at week 10
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11
Q

vocal cords

A

vocal cords form from laryngeal ventricles (recesses)

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12
Q

epiglottis

A
  • covers larynx
  • develops from caudal hypobranchial eminence
  • muscles form from myoblasts in 4th-6th arches
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13
Q

laryngeal web

A
  • incomplete recanalization of larynx in week 10
  • partial obstruction of airway in newborn
  • not necessarily fatal, may be fixed
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14
Q

development of trachea (respiratory diverticulum)

A
  • straight portion of respiratory diverticulum is the primordium of the trachea
  • bronchial buds develop into bronchial tree
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15
Q

What controls the extent of branching within the respiratory tract

A
  • mesoderm surrounding endoderm controls the extent of branching within the respiratory tract
  • endoderm = epithelium and glands of trachea and pulmonary epithelium
  • mesoderm = tracheal cartilage, connective tissue and muscles
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16
Q

laryngeal-tracheal diverticulum

A
  • by end of week 4, LT groove envaginates to form laryngeal-tracheal diverticulum
  • respiratory diverticulum soon separates from the primordial pharynx, however it maintains communication with it through the primordial laryngeal inlet
17
Q

Laryngeal inlet

A
  • maintains connection between laryngeotracheal diverticulum and primordial pharynx
18
Q

tracheo-esophageal septum

A
  • longitudinal folds develop in laryngeal-tracheal diverticulum
  • folds fuse to form tracheo-esophageal septum
  • divides laryngealtracheal tube from oro-pharynx and esophagus
19
Q

T-E fistula (tracheoesophageal fistula)

A
  • abnormal communication between trachea and esophagus
  • most common anomaly of lower respiratory tract
  • incomplete fusion of TE folds
  • 85% associated with esophageal atresia (poor esophagus development)
20
Q

bronchi and lungs

A
  • trachea divides into L/R bronchi
  • each bronchus divides again and again, narrowing
  • smallest airways end in aveoli (thin air sacs, look like balloons)
  • tiny blood vessels surround the 300 million aveoli in lungs
  • oxygen picked up from blood vessels
  • CO2 dumped (breathed out)
21
Q

primary bronchus vs. secondary bronchi

A
  • 5th week, connection of each bronchial bud with the trachea enlarges to form primordium of main bronchus
  • R is slightly larger than L bronchus and oriented more vertically (why you get stuff stuck in right side)
22
Q

Describe the differences between R/L bronchi

A

RIGHT

  • 3 secondary bronchi
  • larger, shorter, more vertical

LEFT

  • 2 secondary bronchi
  • 2 lobes
23
Q

segmental bronchi

A
  • form at 7 weeks
  • bronchopulmonary segment = bronchus + mesenchyme
  • by 24 weeks, 17 orders of branches
24
Q

Maturation of the lungs (in 4 stages)

A
  1. pseudoglandular phase (5-17 weeks)
  2. canalicular period (16-25 weeks)
  3. terminal sac period (24 weeks until birth)
  4. alveolar period (birth-8 years)
25
Q

pseudoglandular phase

A
  • 5-17 weeks
  • incompatible with life
  • formation and growth of duct systems
  • bronchopulmonary segments not well developed
26
Q

canalicular phase

A
  • 16-25 weeks
  • late canalicular phase may be compatible with life (respiration possible, especially towards end)
  • highly vascular
  • alveolar sacs not truly differentiated
27
Q

terminal sac phase

A
  • 24 weeks until birth
  • capillaries bulge into alveoli
  • epithelium very thin
  • contact between epithelial and endothelial cells permits gas exchange
  • proliferation of capillary network
  • Type 1 alveolar cells line terminal saccules
  • Type 2 alveolar cells secrete surfactant
    • forms monomolecular film over internal walls of terminal saccules
    • lowers surface tension
    • reaches adequate level in late fetal period
28
Q

alveolar phase

A
  • birth to 8 years
  • terminal sacs have very thin epithelial lining
  • alveolocapillary membrane allows gas exchange
  • terminal saccules = future air ducts
29
Q

surfactant

A
  • Type 2 alveolar cells secrete surfactant
    • forms monomolecular film over internal walls of terminal saccules
    • lowers surface tension
    • reaches adequate level in late fetal period
30
Q

Type 1 vs. Type 2 alvelolar cells

A

Type 1 alveolar cells = line terminal saccules

Type 2 alveolar cells = secrete surfactant

31
Q

Lungs prior to 26-28 weeks

A
  • respiratory distress
  • inadequate surfactant
  • insufficient alveolar surface area
  • inadequate pulmonary vasculature
32
Q

requirements for autonomous gas exchange

A
  • surfactant
  • transformation of lungs to gas exchanging organ
  • establishment of parallel pulmonary and systemic circulations
  • 95% of alveoli develop post-natally
33
Q

preparation for respiration

A
  • fetal breathing movements
    • condition respiratory muscles
    • stimulate lung development
  • at birth, lungs filled with fluid
  • birth
    • replacement of intra-alveolar fluid with air
34
Q

normal lung development in-utero depends on…

A
  • adequate thoracic space for lung growth
  • fetal breathing movements
  • amniotic fluid volume
35
Q

respiratory distress syndrome

A
  • 2% of live newborns
  • lack of surfactant production
    • lungs are under inflated
  • prenatal steroids
    • produce exogenous (outside) surfactant