Developmental aspects of lung disease Flashcards Preview

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Flashcards in Developmental aspects of lung disease Deck (34)
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1
Q

what are the 5 stages in lung morphogenesis?

A
  1. embryonic
  2. pseudo-glandular
  3. canalicular
  4. saccular
  5. alveolar
2
Q

when is extra-uterine life possible?

A

at late canalicular/early saccular stage

3
Q

what happens in the embryonic stage of lung morphogenesis?

A

a single tube-the oesophagus branches off to form the trachea. Cells of the trachea are cuboidal and far from the blood vessels so gas exchange cannot take place

4
Q

what happens in the pseudoglandular stage of lung morphogenesis?

A

lungs tissue resembles endocrine tissue, branching of bronchi and bronchioles takes place to form conductive airways. acinus formed

5
Q

what is the canalicular stage of lung morphogenesis?

A

last generations of the lung periphery formed, epithelium differentiates into squamous epithelium and air-blood barrier is formed.

6
Q

what is the saccular stage of lung development?

A

air spaces expand and surfactant is detectable in the amnionic fluid

7
Q

what is the alveolar stage of lung morphogenesis?

A

secondary septation of alveoli which begins in utero but continues ater birth.

8
Q

what is airway stenosis and in what stage of lung development is it likely to originate from?

A

narrowing of the airways, originates in the earlier stages of lung morphogenesis

9
Q

what is airway malacia and in what stage of lung development is it likely to originate from?

A

trachea and bronchi are floppy, originates in earlier stages of lung morphogenesis

10
Q

what is pulmonary agenesis/hypoplasia and in what stage of lung development is it likely to originate from?

A

incomplete development of the lungs, resulting in an abnormally low number or size of bronchopulmonary segments or alveoli, originates in earlier stages of lung morphogenesis

11
Q

what is a tracheo-oesophageal fistula and in what stage of lung development is it likely to originate from?

A

abnormal connection between primitive gut and airway. originates in earlier stages of lung morphogenesis

12
Q

what are bronchial cysts and in what stage of lung development is it likely to originate from?

A

congenital malformations of the bronchial tree, likely to occur in late stages of lung morphogenesis.

13
Q

what is lobar emphysema and in what stage of lung development is it likely to originate from?

A

air can be drawn into the lungs but not expelled out. likely to occur in late stages of lung morphogenesis

14
Q

what is cystadenomatoid malformation and in what stage of lung development is it likely to originate from?

A

varying number and sizes of cysts in one lobe of lung. occurs in later lung morphogenesis

15
Q

what is sequestration and in what stage of lung development is it likely to originate from?

A

aberrant formation of segmental lung tissue that has no connection with the bronchial tree or pulmonary arteries occurs in later stages lung morphogenesis

16
Q

when are there presenting features of developmental lung diseases?

A
  • in fetal ultrasound
  • in newborn
  • in childhood or adulthood
17
Q

what are the presenting features of developmental lung diseases in the newborn?

A
tchypnea
respiratory distress (chest wall retraction)
18
Q

what are the presenting features of developmental diseases in childhood and in adulthood?

A

stridor/wheeze
recurrent pneumonia
incidental finding

19
Q

what are the symptoms of tracheo-bronchomalacia?

A
  • barking/seal-like cough
  • early onset/ recurrent croup
  • breathlessness of exertion
  • stridor/wheeze
20
Q

what is the management of tracheo-bronchomalacia?

A
  • airway clearance physiotherapy
  • antibiotics
  • NOT asthma treatment
21
Q

what is a possible risk of Pulmonary adenomatoid malformation?

A

it may become malignant

22
Q

how does the diaphragm develop?

A

membranes develop towards the centre of the embryo until the fuse in the centre

23
Q

what may happen if the diaphragm doesn’t develop correctly?

A

diaphragmatic hernia

24
Q

what cn a diaphragmatic hernia result in?

A

pulmonary hypertension and pulmonary hypoplasia

25
Q

what is transient tachypnea of the newborn (wet lung)?

A

amnionic fluid remains in the lung after birth, resolves in 24-48hrs

26
Q

what is a surfactant deficiency called?

A

hyaline membrane disease (respiratoty distress syndrome)

27
Q

what causes hyaline membrane disease?

A

a build up of a membrane of dead cells and proteins in the alveoli caused by a deficiency of surfactant.

28
Q

what is the treatment fro hyaline membrane disease?

A
  • Antenatal glucocorticoids
  • Surfactant replacement
  • Supportive

until endogenous surfactant production by day 5

29
Q

what are the antenatal causes of adult lung disease (COPD)?

A
  • in utero nicotine exposure
  • fetal infection
  • maternal nutrition
  • low birth weight/prematurity (antenatal steroids)
  • maternal micronutrients/vitamins
30
Q

what are the post-natal causes of adult lung disease?

A
  • infection (Barker hypothesis)
  • growth
  • ETS (exposure to tobacco smoke) (+/- alpha 1 AT deficiency)
  • environmental pollution
  • micronutrients/vitamins
31
Q

what is the chronic neonatal lung disease?

A

chronic inflammation in the lungs causes damage and scarring which reduces compliance.

32
Q

what are some of the causes of chronic neonatal lung disease?

A
  • antenatal infection
  • barotrauma/ oxygen toxicity
  • patent ductus arteriosus
  • ventilation
  • genetic
33
Q

what does pre-natal nicotine exposure do to lungs?

A

-Lung hypoplasia
-Reduced alveolarisation
-Reduced lung function (small airways)
causing Increased incidence wheeze syndromes
-Increased susceptibility to infection

34
Q

what does remodelling in asthma cause?

A
  • Increased bronchial responsiveness
  • Increase mucus secretion
  • Airway oedema
  • Airway narrowing