Lecture 4: Respiratory Embryology Flashcards

(32 cards)

1
Q

When does the respiratory system start to develo

Describe the initial development of the respiratory system?:

A

Wk 4

Caudal to PA 4 > laryngotracheal groove grows forward from developing foregut > laryngotracheal diverticulum (lung bud) separates from foregut tube > mix with mesenchyme > respiratory bud > tracheobronchial tree

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2
Q

What does the endoderm of the laryngotracheal groove give rise to?

A

Pulmonary epithelium and glands of:

  • larynx
  • trachea
  • bronchi
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3
Q

What does the splanchnic mesoderm of the laryngotracheal groove give rise to?

A

CT, cartilage, and smooth muscles that surround foregut

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4
Q

What will the laryngotracheal groove evaginate into?

A

Laryngotracheal diverticulum –> respiratory bud

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5
Q

What is the function of the tracheoesophageal fold? When does this happen?

A

Endoderm > the folds fuse > tracheoesophageal septum that divides esophagus (dorsal) from trachea (ventral)

Week 5

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6
Q

How do the laryngeal cartilages form?

How does the larynx epithelium form?

A

4th and 6th PA mesenchyme > cartilage (mostly NCC derived) > form laryngela inlet

cranial endoderm of laryngotracheal tube > epithelium > proliferates as the growth inlet forms and airway is cleared at recanalization

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7
Q

How does the laryngeal inlet form and how does it make a bigger opening?

A

Cartilage grows into the T shaped laryngeal inlet > epithelium proliferates and blocks the lumen

Via recanalization at wk 10 > apoptosis of epithelium cells reopens the lumen > formation of laryngeal ventricles which lead to vocal and vestibular folds

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8
Q

How does the epiglottis form?

A

PA 3 and 4 mesenchyme > hypo-pharyngeal eminence > epiglottis

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9
Q

How does the trachea form?

How does the tracheal connective tissue, cartilage and muscle form?

A

Laryngotracheal diverticulum > endoderm > trachea, pulmonary epithelium and glands

Laryngeotracheal diverticulum > splanchnic mesenchyme > tracheal CT, cartilage and muscle

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10
Q

What is a tracheoesophageal fistula? What causes it?

A

Abnormal connection between trachea and esophagus due to foregut endoderm failing to proliferate rapidly

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11
Q

What is the most common form of a tracheoesophageal fistula?

A

Esophageal atresia: upper esophagus and does not connect with the lower esophagus and stomach

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12
Q

What are some symptoms of a tracheoesophageal fistula?

A
Cannot swallow
Frequently drools saliva
Immediate regurgitation
Polyhydramnios (excess amniotic fluid)
Excess air in GI tract
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13
Q

Timeline of lung formation

A

Laryngeotracheal diverticulum > Respiratory bud > distal end bifurcation to form the primary bronchial buds (“tree”) at Wk 4 > Wk 5: secondary and tertiary bronchial buds form > Wk 7: bronchopulmonary segments (bronchi + mesenchyme)

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14
Q

Where do primary bronchial buds grow to?

A

Grows laterally to pericardioperitoneal canals

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15
Q

How is branching pattern of the lung endoderm initiated?

A

Splanchnic mesoderm via SHH and FGF 10

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16
Q

What composes a bronchopulmonary segment?

A

Segmental Bronchi and mesenchyme

17
Q

What are the four stages of lung maturation?

A

1) Pseudoglandular
2) Canalicular
3) Terminal Sac
4) Alveolar

18
Q

What happens in the pseudoglandular state of lung maturation?
When is this happening?

A

Major elements of lungs have formed except those involved with gas exchange

Week 5-17

19
Q

What happens in the canalicular state of lung maturation?

When is this happening?

A

Respiratory bronchioles develop and primordial alveolar structures are present, baby may or may not survive (need surfactant to survive)

Week 16 - 25

20
Q

What happens in the terminal state of lung maturation?

When is this happening?

A

Production of alveoli and pneumocytes (Type II - surfactant)
Gas exchange can occur, so survivable

Wk 24 - birth

21
Q

What happens in the alveolar state of lung maturation?

When is this happening?

A

Mature alveoli is formed from primitive alveoli

Wk 32 - 8 yo

22
Q

What structures form from the splanchnic mesoderm?

A

1) Cartilaginous plates
2) Bronchial smooth muscle and CT
3) Pulmonary CT and capillaries

23
Q

What are fetal breathing movements?

A

Erratic breathing can can cause aspiration of amniotic fluid, causing baby to swallow amniotic fluid to stimulate lung development

24
Q

How is amniotic fluid cleared at birth?

A

1) Pressure from vaginal birth or via suction tubes
2) Pulmonary capillaries, arteries, and veins
3) Lymphatics

25
What is pulmonary agenesis? What causes this?
Complete absence of lung or a lobe due to failure of bud to split in 2
26
What is oligohydramnios? What organ disease is this usually related to?
Insufficient amniotic fluid volume that can retard lung development Kidney failure
27
What causes pulmonary hypoplasia? What are the symptoms?
restricted fetal thorax > low pressure > decrease hydraulic pressure in lungs > Incomplete development of the lungs and oligohydramnios (insufficient)
28
What is respiratory distress syndrome? Symptoms?
Surfactant deficiency that can account for death in half of premature infants Decreased lung inflation and alveolar membrane is hyaline like and has abnormal Type II pneumocytes
29
What are congenital lung cysts?
Cyst formed from terminal bronchi dilations that can disrupt bronchial development and normal air flow
30
Why do babies have higher risk of choking?
Neonates have higher larynx that descends within the 1st 2 years
31
What is laryngeal atresia and what condition is this related to? What are the symptoms of this condition and how is it treated?
recanalization does not occur > obstructed upper airway CHAOS syndrome: dilated airways, enlarged and fluid filled lungs, inverted or flat diaphragm. Treated with endoscopic dilation
32
From what does pleura form? What parts form visceral and parietal pleura?
Lateral plate mesenchyme > splanchnic > visceral pleura Lateral plate mesenchyme > somatic > parietal pleura