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USMLE > Respiratory Embryology > Flashcards

Respiratory Embryology Flashcards

(66 cards)

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1
Q

What does the upper respiratory tract consist of?

A

Larynx + trachea

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2
Q

What does the lower respiratory tract consist of?

A

Bronchi + lungs

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3
Q

What develops first, the URT or the LRT?

A

Upper respiratory tract

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4
Q

What are the stages of lung development?

A
  1. Pseudoglandular
  2. Canalicular
  3. Saccular
  4. Alveolar
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5
Q

From what does the larynx, the trachea and the lung buds develop from?

A

An outpouching of the esophagus

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6
Q

At what stage in-utero does the primordial respiratory system arise?

A

3rd-4th week

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7
Q

And from WHERE does the primordial respiratory system arise?

A

The laryngotracheal grove on the ventral foregut

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8
Q

What partitions the outpouching of the esophagus, that becomes the laryngotracheal tube, from the esophagus?

A

The tracheoesophageal septum

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9
Q

What are the functions of the larynx?

A
  1. Airway protection
  2. Aid in respiration
  3. Vocalization
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10
Q

What marks the first division between the respiratory and the digestive systems?

A

Larynx

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11
Q

To what is the larynx attached superiorly?

A

Hyoid bone

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12
Q

To what bone is the larynx attached?

A

Hyoid bone

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13
Q

From what are the laryngeal cartilage and musculature derived?

A

4th + 6th pharyngeal arch mesenchyme

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14
Q

How many pharyngeal arches do humans have?

A

6

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15
Q

From what are the pharyngeal arches derived?

A

Neural crest tissues

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16
Q

What does the 1st pharyngeal arch form? (Mainly M’s)

A

Muscles - Mastication muscles; anterior belly of digastric; Mylohyoid; tensor tympani; tensor veli palatini

Skeletal - Maxilla; Mandible; Malleus; incus; Meckel cartilage

Nerves - V2 and V3

Arteries - Maxillary artery; external carotid artery

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17
Q

What does the 2nd pharyngeal arch form? (Sort-of Solely S’s)

A

Muscles - muscles of facial expression; Stapedius; Stylohyoid; buccinator; platysma; posterior belly of digastric

Skeletal - Stapes; Styloid process; Reichert cartilage; lesser horn + upper part of body of hyoid

Nerves - VII

Arteries - Stapedial artery

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18
Q

What does the 3rd pharyngeal arch form?

A

Muscles - stylopharyngeus

Skeletal - thymus; greater horn and lower part of body of hyoid

Nerves - IX

Arteries - common carotid; internal carotid artery

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19
Q

What does the 4th pharyngeal arch form?

A

Muscles - cricothyroid; intrinsic muscles of the soft palate

Skeletal - thyroid and epiglottic cartilage

Nerves - X, superior laryngeal nerve

Arteries - R subclavian + aortic arch

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20
Q

At what point are the false and true vocal cords formed?

A

Week 10, when the epithelial tissue occluding the primitive laryngeal orifice breaks down and the surrounding epithelial folds differentiate into them

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21
Q

What does the 6th pharyngeal arch form?

A

Muscles - intrinsic muscles of the larynx, except cricothyroid

Skeletal - cricoid; arytenoid; corniculate cartilages

Nerves - X, recurrent laryngeal nerve

Arteries - pulmonary arteries; ductus arteriosus

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22
Q

From what are the cartilage, smooth muscle and connective tissue of the trachea derived from?

A

Splanchnic mesoderm

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23
Q

Which bronchi is more lateral, L or R?

A

L bronchi

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24
Q

Which bronchi is more central, L or R?

A

R bronchi

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25
How many divisions does the R bronchi give rise to?
3
26
How many divisions does the L bronchi give rise to?
2
27
At what point do the lung buds (which also give rise to the bronchi and bronchioles) form?
End of week 4
28
In what time frame is the pseudoglandular period?
Weeks 5-16
29
In what time frame is the canalicular period?
Weeks 16-26
30
What occurs during the canalicular period?
The airways increase in diameter Vasculature develops Primitive end respiratory units of bronchioles, alveolar ducts and terminal sacs are formed
31
In what time frame is the saccular period?
Weeks 26 - Birth
32
What occurs during the saccular period?
Terminal sacs develop
33
What are the type I cells of the respiratory system?
Form the gas exchange surface
34
What are type II cells of the respiratory system?
Synthesis of surfactant
35
In what time frame is the alveolar period?
Prenatal - childhood
36
From what are the pleural cavities derived?
Intraembryonic coelom (body cavity)
37
What are the 2 layers of pleura?
Visceral + parietal
38
From what is the visceral pleura formed from?
Splanchnic mesoderm
39
From what is the parietal pleura formed from?
Somatic mesoderm
40
What is the innervation of the diaphragm?
C3; C4; C5
41
What is the pneumonic for the innervation of the diaphragm?
C3, 4 and 5 keep the diaphragm alive
42
What 4 embryonic structures fuse to make the diaphragm?
``` S = septum transversum P = pleuroperitoneal folds B = body wall D = dorsal mesentery of the esophagus ```
43
What is the pneumonic for the 4 embryonic structures that fuse to make the diaphragm?
Several Parts Build a Diaphragm
44
By what week in-utero is the diaphragm formed?
Week 7
45
What does the septum transverse, that makes up the diaphragm, form in an adult?
Central tendon
46
What does the body wall, that makes up the diaphragm, from in an adult?
Peripheral, muscular part of the diaphragm
47
At what stage doing the type II pneumocytes begin producing surfactant?
Weeks 25-28
48
What is the surfactant?
A reduction in surface tension that facilitates alveolar opening
49
How may RDS be treated?
1. Antenatal maternal steroids | 2. Surfactant replacement
50
What problems may congenital cysts of the respiratory system cause?
1. Chronic infection, secondary to poor drainage
51
What problems may congenital cysts of the respiratory system cause?
Chronic infection, secondary to poor drainage
52
What is pulmonary aplasia?
Failure of the lungs to develop
53
What is purpose of surfactant?
A reduction in surface tension that facilitates alveolar opening
54
What is the most common cause of pulmonary hypoplasia?
Congenital diaphragmatic hernia (CDH)
55
What are the different forms of pulmonary hypoplasia?
Primary | Secondary - e.g. caused by oligohydramnios or CDH
56
What is the cause of CDH?
Failure of the 4 embryonic structures that make up the diaphragm to fuse
57
How may CDH present?
1. RDS 2. Loops of bowel in the thoracic cavity on XR 3. Bowel sounds on auscultation
58
What is laryngomalacia?
Congenital weakness of the cartilages of the larynx
59
How may laryngomalacia present?
The collapse of the larynx on inspiration results in a 'wet' inspiratory stridor. Common + usually resolves spontaneously
60
What is the treatment of laryngeal atresia?
Tracheostomy - a neonate will asphyxiate without it
61
How may a tracheoesophageal fistula (TEF) present?
Coughing during feeding
62
What secondary problems may a TEF cause?
Aspiration pneumonitis - chemical irritation of the airways by the gastric contents Aspiration pneumonia - infection of the lungs by aspiration of gastric contents
63
TEF and EA may be part of a larger pattern of congenital abnormalities including what else?
``` VACTERL V A C T E R L ```
64
What are the different anomalies of the tracheoesophageal septum?
``` Esophaeal atresia (EA) TEF ```
65
What is the most common abnormality of the tracheoesophageal septum?
Proximal EA + distal TEF
66
TEF and EA may be part of a larger pattern of congenital abnormalities including what else?
``` VACTERL V - vertebral defects A - anal atresia C - cardiac defects T - TEF E - EA R - renal agenesis/obstruction L - limb hypoplasia ```

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