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Neonatal/Pediatrics
Chapter 1 Fetal Lung Development
| Question | Answer |
|---|---|
| Fetal Lung development is not considered complete until what happens to the alveoli? | The alveoli must have an adequate surface area for gas exchange. |
| The pulmonary vascular system must have sufficient capacity to transport _____ through the _____ for CO2 and O2 exchange. | blood lungs |
| Alveoli need to be structurally and functionally stable and sufficiently _____ and _____ to endure the cyclical stretching. | elastic resilient |
| At what week does the BRONCHIAL TREE develop? | week 16 |
| After birth, the alveoli develop in increasing numbers until the age of _____. | 8 |
| _____ arteries and veins develop after the _____ has been established. | pre-acinar airway |
| _____ vessels develop AFTER the alveoli are generated. | intra-acinar |
| Full-term infants have an estimated ____ million alveoli and have the potential to add another _____ million alveoli. | 50 million 250 million |
| How many phases of lung development are there? | 5 phases |
| List the 5 phases of lung development. | embyonic pseudoglandular canalicular saccular alveolar |
| When is the embryonic phase? | 3-6 weeks post conceptional age |
| What developments happen in the embryonic phase? | trachea major bronchi pleura |
| Lungs begin to emerge as a bud from the _____, _____ days after conception. | pharynx 26 |
| At about week 5 the left and right _____ _____ start to develop. | pulmonary veins |
| Respiratory epithelium develops from the _____ _____. | foregot bud |
| The diaphragm develops during the _____ phase and is complete by approximately week _____ of gestation. | emryonic 7 |
| The pseudoglandular phase lasts from weeks _____ to _____ of gestation. | 5 16 |
| What appears during the pseudoglandular phase of lung development? | acini lymphatics appear in the hilar region cilia appear on the tracheal epithelium goblet cells, submucosal glands, airway cartilage airways, arteries, veins (same as an adult) |
| The _____ phase lasts from weeks 17 to 26 weeks. | canalicular |
| The vascular bed grows during what phase? | canalicular phase |
| Capillaries develop at _____ weeks of gestation and by _____ weeks have increased in number. | 20 22 |
| What appears during the canalicular phase? | capillaries surfactant appears pulmonary acinar units |
| Extra uterine viability is at how many weeks? | 22 to 24 |
| At the end of the canalicular phase what is available? | gas exchange |
| The _____ phase lasts from weeks 26 to 35/36. | saccular |
| Terminal structures are referred to as saccules during what phase? | saccular |
| Saccules are smooth-walled _____ structures. | cylindrical |
| During what phase is there an increased potential for gas exchange? | saccular |
| The alveolar stage is from about _____ weeks to _____ months post gestation. | 36 18 |
| During what phase is alveolar maturation and proliferation. | alveolar |
| Postnatal lung growth extends through _____ and _____. | infancy childhood |
| More than _____ million, about 80% of the total number of alveoli form after birth. | 300 |
| Most of the postnatal formation of alveoli occurs over the first _____ years of life. | 2 |
| What factors can affect lung development during the embryonic phase? | development of the initial structures of the pulmonary tree laryngeal anomalies tracheal anomalies esophageal anomalies |
| What factors can affect lung development during the pseudoglandular phase? | pulmonary hypoplasia can develop |
| What factors can affect lung development during the canalicular phase? | severe respiratory distress due to underdeveloped airways and insufficient and immature surfactant production by alveolar type II |
| What can cause diminished lung growth? | thoracic volume reduction oligohydramnios diminished respiration hormonal and metabolic disorders |
| An incomplete development of the lungs characterized by an abnormally low number or size of bronchopulmonary segments or alveoli. | pulmonary hypoplasia |
| A reduced quantity of amniotic fluid present for an extended period of time. | oligohydramnios |
| An abnormal opening in the prenatal diaphragm that allows some of the abdominal organs to move in to the chest and exert pressure on the developing lungs. | diaphragmatic hernia |
| Abnormal fluid accumulation in the fetus often resulting in hydrothorax and ascites. | hydrops fetalis |
| Lack of stretch of the developing lungs parenchyma. | diminished respiration |
| Dysmorphic lungs with a decreased number of terminal bronchioles, dilated alveolar ducts and saccules, and enlarged airspaces. | leprechaunism |
| What are 2 hormonal and metabolic disorders that can cause diminished lung growth? | leprechaunism diabetes |
| What does lung growth retardation affect and not affect? | size but not maturation |
| The timing of an adverse event influences what? | Fetal Lung development |
| Failure of the lungs to develop in utero is known as ________. | pulmonary hypoplasia |
| What pathology can only be diagnosed upon autopsy? | pulmonary hypoplasia |
| In what phase can hypoplasia occur? | pseudoglandular phase |
| The incidence of pulmonary hypoloplasia diagnosed at autopsy is between _____ and _____. | 10% - 25% |
| Diaphragmatic hernia, lung compression, chest wall abnormalities, oligohydramnios, and hormonal imbalances are all associated with _____. | pulmonary hypoplasia |
| The best-studied condition associated with hypoplasia is _____ _____. | diaphragmatic hernia |
| The incidence of diaphragmatic hernia is about ________. | 1:4000 |
| What causes incomplete branching of the conducting airways, terminal airways, or both? | compression of the lung at 16 weeks |
| Pulmonary hypoplasia occurs in conditions with oligohydramnios because of leakage of _____ _____. | amniotic fluid |
| Epithelial lining undergoes cellular division and differentiation into the highly specialized type I and type II _____. | pneumocytes |
| Which type pneumocytes are flat cells serving as a thin, gas-permeable membrane for the diffusion of gases as a barrier against water and solute leakage? | type I |
| Because of their size, shape, and large cellular surface, type I pneumocytes account for more than ____% of the alveolar surface. | 97 |
| Which type pneumocyte has a smaller surface area and is the principal cell involved in surfactant production, storage, secretion, and reuse. | type II pneumocyte |
| Which type of pneumocyte is responsible for the production of surfactant? | type II pneumocyte |
| What is the role of surfactant? | to prevent alveolar collapse |
| Fetal lungs are secretory organs that make breathing-like movements but serve no respiratory function before birth. They secrete about ____ to ____ mL of liquid per day. | 250 300 |
| Fetal airways are not collapsed but filled with fluid from the _____ phase until delivery and the initiation of ventilation. | canalicular |
| What prevents alveolar collapse in utero? | Fetal Lung liquid |
| Fetal Lung liquid is swallowed or expelled into the _____ _____. | amniotic fluid |
| True or False. Fetal lung liquid is essential for normal lung development. | True |
| The clearance of _____ _____ _____ is essential for normal neonatal respiratory adaptation. | Fetal lung fluid |
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Respiratory22
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