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CPR > Body Cavities and Respiratory Embryo > Flashcards

Body Cavities and Respiratory Embryo Flashcards

1
Q

What produces the lateral folds?

A

rapid growth of SC and somites

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2
Q

How does head folding occur?

A
  1. embryo elongates cranially and caudally week 4
  2. neural folds project dorsally and overgrow oropharyngeal mem
  3. endoderm is incorporated as foregut
  4. Septum transversum, primordial heart, pericardial coelom and oropharyngeal form
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3
Q

What three things happen after head folding?

A
  1. Pericardial cavity is ventral
  2. Pericardioperitoneal canals run dorsally on sides of foregut
  3. Intraembryonic and extraembryonic coeloms are in communication
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4
Q

What is Gastroschisis?

A
  • protrustion of viscera usually is to right of umbilical cord rather than midline
  • Bowel is not covered and floating in amniotic fluid
  • Results from failure of lateral body folds to fuse at week four
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5
Q

What is congenital epigastric hernia?

A
  • Midline bulge of abdominal wall located between the xiphoid process and umbilicus
  • The bowel is covered by skin and subcutaneous tissues
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6
Q

What is the significance of intraembryonic coelom with body wall formation?

A
  • Divides the lateral mesoderm into somatic layers of mesoderm and splanchnic layer of lateral mesoderm
    • Somatic (parietal) continuous with extraembryonic mesoderm covering amnion
    • Splanchnic (visceral) layer of lat mesoderm is continuous with extraembryonic mesoderm covering umbilical vesicle
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7
Q

What three divisions does the intraembryonic coelom consist of?

A
  • Pericardial cavity
  • Pericardioperitoneal canals (2)
  • Peritoneal cavity
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8
Q

What is the more superior fold that divides the pericardial caivity from pleural cavity?

A

Pleuropericardial folds

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9
Q

What fold separates the pleural cavities from peritoneal cavity?

A

Pleuroperitoneal folds

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10
Q

How do pleuropericardial membranes form?

A
  • Pleuropericardial folds form as outgrowths of lateral body wall and grow ventrally
  • They enlarge as the pleuropericardial membranes and project across upper limit of pericardioperitoneal canals
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11
Q

What causes the pleural cavity to expand and what results from this expansion?

A
  • Bronchial bud outgrowths (lungs) are growing ventrally and shapes the cavity
  • It splits mesenchyme into an outer layer and inner layer
    • Thoracic wall (outer)
    • Fibrous pericardium (inner layer of mesenchyme, but outer layer of the pericardial sac)
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12
Q

How do pleuroperitoneal membranes form?

A
  • Pleuroperitoneal folds form as outgrowths of lateral body wall and project into the pericardioperitoneal canals forming the pleuroperitoneal membranes
  • Myoblasts contribute to pleuroperitoneal membranes to complete closure
    • right closes before left
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13
Q

When do the pleuroperitoneal membranes fuse with dorsal mesentery of esophagus and septum transversum?

A

6th week

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14
Q

What are the four components of the diaphragm?

A
  • Septum transversum:
    • Expands and fuses with dorsal mesentery of esophagus and pleuroperitoneal membranes
    • central tendon
  • Pleuroperitoneal mem:
    • fuses wit hdorsal mesentery of esophagus and septum transversum
    • Primordial diaphragm
  • Dorsal mesentery:
    • Median portion of diaphragm
  • Myoblasts:
    • grows into dorsal mesentery
    • Crura of diaphragm
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15
Q

What do myoblasts form that is part of the adult diaphragm?

A

Crura

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16
Q

What forms from the septum transversum?

A

Central tendon of the diaphragm

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17
Q
A
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18
Q

How does the diaphragm get innervation?

A
  • Myoblasts will pull C3,4,5 ventral rami with them as they pass through the pleuropericardial membranes
  • Eventually phrenic will lie on the fibrous pericardium
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19
Q

What is a congenital diaphragmatic hernia?

A
  • Lack of myoblasts populating pleuroperitoneal membranes and results in weakness and herniation of abdominal viscera into pleural cavity
  • Lung maturation can be delayed and polyhydramnios may also be present
  • Left side is usually impacted
  • Can be corrected at brith
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20
Q

How does the respiratory system start and where is this structure located?

A
  • As a median outgrowth called the laryngotracheal groove
  • Which is located in the floor of the foregut/primordial pharynx
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21
Q

What does the laryngotracheal groove evaginate into?

A

Laryngotracheal diverticulum, the primordium of the traccheobronchial tree

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22
Q

What does the endoderm of the laryngotracheal groove form?

A
  • Pulmonary epithelium and glands of larynx trachea and bronchi
23
Q

What does the splanchinic mesoderm of the respiratory system form?

A
  • CT
  • Cartilage
  • Smooth mm
24
Q

How does the laryngotracheal diverticulum and splanchnic mesoderm relate?

A

The diverticulum elongates and becomes invested with the splanchnic mesoderm. The distal end elarges to form respiratory bud

25
Q

When do tracheoesophageal folds develop?

A

Fuse to form the trachoesophageal septum at end of week 5

26
Q

Where does the cartilage of the larynx come from?

A

Mesenchyme of the fourth and sixth pharyngeal arches

(NCC derivative)

27
Q

when do vestibular and vocal folds form?

A
  • Forms during recanalization around week 10
28
Q

What is laryngeal atresia, what causes it, what happens to lungs and dipahrgam and what is the treatment?

A
  • Rare, results from failure of recanalizstion of larynx
  • Obstruction of the upper fetal airway or Congeniatal high ariway obstruction syndrom (CHAOS)
  • Airways become dilated and lungs enlarged and filled with fluid
  • Diaphragm is flattened or inverted and fetal ascites or hydrops is present
  • Treatment is by endoscopic dilation of laryngeal web
29
Q

Where does the epiglottis develop from?

A
  • Hypopharyngeal eminence produced from the mesenchyme of 3 &4 PA
30
Q

What PA’s do laryngeal muscles develop from?

A

Myoblasts of 4th and 6th arch

31
Q

Describe position of larynx an epiglottis in neonates?

A
  • High position in the neck of the neonate
  • Epiglottis is in contact with the soft palate and separates respiratory and digestive tracts
32
Q

What does the endoderm contribute to the trachea?

A
  • Differentiates into the tracheal epithelium and glands
33
Q

What does the splanchnic mesoderm contribute to the trachea?

A
  • CT
  • Muscle
  • tracheal cartilages
34
Q

What is a tracheoesophageal fistula and what is associated with it?

A
  • Most common anomaly of lower respiratory tract
  • Abnormal conection btw trachea and esophagus
  • Failure of th eforegut endodemr to proliferate quick enough in relation to the rest of the body
  • 85% of cases associated with esophageal atresia (blind esophagus)
35
Q

How do patients with tracheoesophageal fistula present?

A
  • Can’t swallow
  • Frequently drool
  • Immediate regurgitation after feeding
  • Gastric and intestinal contents may reflux through fistula into trachea and lungs
  • Can develop polyhydramnios as fluid can’t enter stomach/intestines for absorption
36
Q

In week 4, the laryngotracheal diverticulum enlarges to form ____.

A

In week 4, the laryngotracheal diverticulum enlarges to form respiratory bud

37
Q

How does the respiratory bud grow, what induces this, and what does it form?

A
  • Ventrocaudally and bifurcates forming the primary bronchial buds
  • Requires FGF and inductive interactions btw endoderm and splanchinc mesoderm
38
Q

Describe the order of bronchi.

A
  • Main bronchi
  • Secondary bronchi
  • Lobar
  • Segmental
  • Intrasegmental branches
39
Q

What are bronchopulmonary segments?

A
  • Form during week 7
  • Made of segmental bronchi and mesenchyme
40
Q

Describe psuedoglandular lung maturation.

A
  • Weeks 5-17
  • All major elements formed except those involved with gas exchange
  • Fetus cannot live
41
Q

What happens in the canalicular lung maturation stage?

A
  • Overlaps with the psuedoglandular
  • Vascularization
  • Respiratory bronchioles present
  • Primordial alveolar and sacs present
  • may or may not survive
  • weeks 16-25
42
Q

What is the terminal sac maturation stage?

A
  • Numerous alveoli form
  • Thin epithelium with increased vascularization such as:
    • Type 1 pneumocytes
    • Type 2 pneumocytes (surfactant!)
    • Lymphatic capillaries
  • Gas exchange can occur
  • Survivable with appropriate care
  • 24 wks to birth
43
Q

What is the alveolar stage of maturation?

A
  • 32 wks-8 yrs
  • Alveolocapillary membrane
  • Primitive alveoli form more primitive alveoli
  • Mature alveoli

Primitive alveoli are key to adding more alveoli, once they turn mature they can’t add more

44
Q

When do 95% of mature alveoli develop?

A

Postnatally

45
Q

What is lung growth dependent on?

A
  • Increase in number of respiratory bronchioles and primordial alveoli
46
Q

How long are new alveoli added?

A

Until 8 years of age as the CT septa divide immature/promordial alveoli

47
Q

What is the significance of fetal breathing movemnts?

A
  • Essential for normal lung maturation exercising the respiratory muscles
  • Forceful enough to cause aspiration of amniotic fluid and helps stimulate lung dev
  • At birth aeration of lungs reuires rapid replacecment of intralveolar fluid with air
48
Q

How is the intra-alveolar fluid cleared?

A
  • Released from mouth and nose by pressure on thorax duirng vaginal delivery
  • Pulmonary capillaries rteries and veins
  • Lymphatics
49
Q

What is unilateral agenesis?

A
  • Compelte absence of a lung or lobe accompanying bronchi
  • Respiratory bud fails to split into L and R
50
Q

What is pulmonary hypoplasia?

A
  • Results from restriction of fetal thorax due to uterine pressure
  • Decreased hydrostatic pressure on the lungs affects stretch receptors and lung growth
  • It occurs wit hsevere and chronic oligohydramnios
  • Risk increases significantly with oligohydramnions at less than 26 weeks
51
Q

what is RDS?

A
  • Rapid labored breathing developing after birth
  • Surfactant deficiency is major cause as lungs are underinflated
  • Accounts for 5-7-% of deaths in premature infants
  • Alveoli contain glassy membrane fluid and it is an irreversible change in type 2 alveolar cells
52
Q

Signs and Symptoms of RDS?

A
  • Tachypnea
  • Nasal flaring
  • Suprasternal intercostal or subcostal retractions
  • Grunting and cyanosis
  • Opacification on x ray
53
Q

How does head folding movements reshape the intraembryonic coelom?

A
  • Pericardial cavity is relocated ventrally anterior to foregut
  • Pericardial cavity opens into pericardioperitoneal canals located dorsal to foregut
  • Caudal periotneal cavity is positoned where IE and EE coelomes are continuous

CPR (18 decks)

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