Oct10 M3-Embryonic congenital anomalies

Question 1

thing in common between resp system and foregut and why

Answer 1

share common origin (primitive pharynx or esophagus gives tracheal bud)

Question 2

most common atresia and fistula of foregut (2) and type name

Answer 2

esophageal atresia (type A): 8%
tracheo-esophageal fistula (bottom esoph) and atresia (of esoph) (type C): 85%

Question 3

Type B fistula or atresia def

Answer 3

tracheo-esophageal fistula at upper esoph and atresia of esoph

Question 4

Type D fistula or atresia def

Answer 4

tracheo-esophageal fistulas at upper and lower esophagus + esophageal atresia

Question 5

Type E fistula or atresia def

Answer 5

tracheo-esophageal fistula

Question 6

symptoms of esophageal atresia and tracheo-esophageal fistula (4)

Answer 6

excessive salivation, respiratory distress, choking on feeds, MATERNAL POLYHYDRAMNIOS

Question 7

diagnosis of esophageal atresia and tracheo-esophageal fistula

Answer 7

NG tube through esophagus and look at CXR

Question 8

bronchopulmonary foregut cyst def

Answer 8

cyst remnant of budding process found on mediastinum

Question 9

bronchopulmonary foregut cyst composition

Answer 9

GI and respiratory components (GI muscle pattern) and ciliated columnar cell of resp)

Question 10

bronchopulmonary foregut cyst problems outcomes (3)

Answer 10

• asymptomatic
• aero-digestive tract symptoms
• prone to infection

Question 11

lung dev at week 4

Answer 11

buds

Question 12

lung dev at week 5

Answer 12

secondary bronchi form

Question 13

lung dev at 8 weeks

Answer 13

segmental bronchi form

Question 14

lung dev at 24 weeks

Answer 14

17 orders of branches have formed

Question 15

17 orders of branching in the lung: normal prenatally?

Answer 15

yes. 7 additional orders develop after birth

Question 16

Type A atresia stomach size

Answer 16

smaller stomach bc don’t swallow amniotic fluid

Question 17

Type A atresia on CXR

Answer 17

Tip of NG tube is high in thorax below neck

Question 18

Type C atresia on CXR

Answer 18

air in stomach and bowel bc of fistula. tip of NG tube high in thorax below neck

Question 19

Bronchopulmonary foregut cyst on CXR

Answer 19

shifting of the right of upper thorax organs

Question 20

4 periods of lung dev and time

Answer 20

pseudoglandular (6-16 wks)
canalicular (16-26 wks)
terminal saccular (26-23 wks)
alveolar (32 wks-8 yrs)

Question 21

at what phase lung can do gas exchange and in what structure

Answer 21

canalicular phase (at week 26) at terminal saccules (primordial alveoli)

Question 22

terminal saccular period: what happens

Answer 22

Type 1 cells become thin
Type 2 cells increase and secrete surfactant
Capillaries bulge in developing alveoli

Question 23

what phase surfactant formed

Answer 23

terminal saccular phase

Question 24

surfactant deficiency of foetus is when

Answer 24

prenatally until last 4-6 weeks of pregnancy

Question 25

surfactant gross def

Answer 25

complex mixture of phospholipids

Question 26

surfactant composition and relevance clinically

Answer 26

Lecithin and Sphingomyelin. If L:S ratio less than 2, fetal surfactant deficiency

Question 27

how can treat surfactant deficiency before birth (antenataly)

Answer 27

steroid therapy (promotes type 2 pneumocyte development and lung maturation)

Question 28

consequences of untreated surfactant deficiency (what we try to minimize with the steroid therapy) (2)

Answer 28

Risk of respiratory distress syndrome (RDS) | Risk of hyaline membrane disease (HMD)

Question 29

how can treat surfactant deficiency after birth (antenataly)

Answer 29

surfactant delivery by tracheal route

Question 30

surfactant delivery by tracheal route can help treat what other thing

Answer 30

lung hypoplasia in case of diaphragmatic hernia

Question 31

3 factors required for normal lung dev

Answer 31

- thoracic space for lung growth - fetal breathing movements - adequate amniotic fluid volume

Question 32

Potters syndrome def

Answer 32

congenital kidney agenesis: lack of amniotic fluid. lung hypoplasia

Question 33

congenital lobar emphysema: what it is

Answer 33

hyperinflation (of affected lobe) and severe air trapping

Question 34

congenital lobar emphysema: cause

Answer 34

failure of bronchial mesenchyme. dysplastic bronchial cartilage collapses during expiration

Question 35

congenital cystic adenomatoid malformation (CCAM) def

Answer 35

segment of lung arrested in dev at pseudoglandular period and is cystic and glandular (adenomatoid)

Question 36

symptoms of CCAM frequency and cause

Answer 36

usually asymptomatic. | symptom causes: large non functional mass or delayed infections

Question 37

pulmonary sequestration def

Answer 37

non functional mass of normal lung tissue (intra or extra lobal) with systemic vascular supply and not communicating with tracheobronchial tree

Question 38

2 examples of pleural cavity pathologies

Answer 38

empyema (pleura infection | pneumothorax

Question 39

fetal circulation main points

Answer 39

right to left heart shunt through foramen ovale. high pulmonary pressure. placenta provides supply with umbilicus

Question 40

neonatal circulation main points

Answer 40

oxygen is trigger for drop in pulmonary vascular resistance. foramen ovale closes.

Question 41

4 structures contributing to the diaphragm (development

Answer 41

- septum transversum - pleuroperitoneal membrane - mesentery of the esophagus - muscular ingrowth from body wall

Question 42

congenital diaphramatic hernia: 2 ways it leads to resp failure

Answer 42

- hernia-hypoplasia of lung-poor gas exchange | - hyperplastic and hypersensitive pulm vasculature-pulm hypertension-rightleft shunt

Question 43

eventration of diaphragm def

Answer 43

paralysis to do deficient innervation

Question 44

eventration of diaphragm 2 types

Answer 44

congenital acquired

Question 45

congenital diaphragm eventration def

Answer 45

defective dev or innervation of diaphragm

Question 46

acquired diaphragm eventration causes (3)

Answer 46

- injury to phrenic nerve - traction injury at birth - iatrogenic surgical injury

Question 47

diaphragm eventration symptoms

Answer 47

(can be asymptomatic) - respiratory distress - abdominal paradox

Question 48

persistent fetal circulation what and cause

Answer 48

persistent fetal circulation after birth bc hypertension in pulm vasculature