5 Development Anatomy of the Respiratory Organedit Pagi23mei

8/15/2019 5 Development Anatomy of the Respiratory Organedit Pagi23mei

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Development anatomy ofthe respiratory organ


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Organ respiratoria• Upper respiratory

organs• Nose• Nasal cavity• nasopharynx

• Lower respiratoryorgans

• Larynx• Trachea• Bronchi• lung


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Embrio mge!"

• #g pertama$ Tahapanembrioblast$

%ygot &hasilfertilisasi &blastomer &morula '()

sel*! 3 hari!blasto ista &implantasi )hari


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Lapisan embriologi$

• " lapisan 'bilaminer*ca ram embrional$minggu e "!epiblast +anhipoblast

• 3 lapisan embriologi'gastrulasi*$ mg e 3embrional 'hari e(,*

• Ecto+erm 'epiblast*•

#eso+erm 'epiblast*• En+o+erm'hypoblast*


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EndodermUsus enteron

primitif

Usus depanPre entero

anterior

Usus tengahMesentero

Usus belakangMet enteron

caudal

Mulut, esophagus, gaster, duodenum

(partim)

Duodenum, jejenumIleum, colon ascenolon trans! (part)

olon trans (part)olon desc, colon"igmoid, rectum

"aluran pernafasan#rachea, pulmo#h$mus, th$roid

%ati, pancreas&esica urinaria,

urethra


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somite


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Development of face$nose• Nasal placo+es an+

me+ial an+ lateral nasalprocesses

• Nasal cofactorplaco+e$two ecto+ermalelevation on each si+eof me+ian plane offrontonasal process &an+ surface +epression/

an+ the e+ges becomenasal process/ thelateral more prominent/forms alae of nose

• #e+ial process merge eachother/ as result growing ofmaxillar eminence 'maxillarprocess*/ become mi++lepart of upper lip/ upper 2aw/primary palate

• emains of maxillarprocess become chee

• #an+ibular process$ lowerlip an+ lower 2aw

• 4ormation eyes$ from lensplaco+e54ormation externalear/ from ecto+ermal cleftfrom series meso+ermalthic ening 'pinna*


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Development ofnasal cavity

• 4ormation of nasal pit/after primitive palateforme+ by fusion lateralan+ me+ial nasalprocesses/ create+partition between nasalpits an+ stomato+eum

• 4ormation of nasalsacs/nasal pits +eepen an+enlarge +orsally/ cau+allyform nasal sacs

• 6osterior part of nasalsacs/ separate+ bybuconasal membrane/ an+soon +isappears/ formingposterior nares

• 4ormation of nasalseptum/ the nasal sacs/separate+ each other by

the with intervening partof frontonasal process• 7econ+ary palate/

separates nasal cavitiesfrom mouth cavity

• 4ormation structures oflateral wall$lateral nasalprocess/ nasal conchae/olfactory epithelium'ecto+ermal thic ening*

• 6aranasal sinus$xaxillaryan+ sphenoi+ forme+ en+of fetal life/ other forme+after birth


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:nomaly of nasal cavity

• :tresia of nasal cavity• :nomaly of nasal septum/ +e;ecte+

of nasal septum an+ absence ofseptum

•


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6rimor+ia lower respiratoryorgans

• espiratory+iverticulum 'lungbu+*$ en+o+ermalstructures fromforegut/ formsepithelial lining

• 7planchnicmeso+erm5surroun+ing

lungbu+$ formscartilagenous part/muscular/ connectivetissue component

• 4ourth an+ sixpharyngeal arches/forms cartilage 'thyroi+/cricoi+/ arytenoi+/

corniculata/ cuneiform*an+ muscle of larynx'intrinsic muscle*/cricothyroi+/ contrictorof pharynx muscles $innervasi n vagus'superior laryngeal 9recurrent laryneal*


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• LARYNX=


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Embriologi rongga tubuh


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Diaphragma +an rongga +a+a• 7eptum transversum & se at meso+erm $ rongga +a+a &

tang ai antong uning telur• Ti+a memisah an sempurna rongga +a+a 9 ronggaperut

• Lubang$ saluran peri ar+ioperitoneal +i iri anan usus+epan

• :+a tunas pulmo/ tumbuh cepat +i +alam saluranperi ar+ioperitoneal/ lipatan pleuroperi ar+ial & rigimenon2ol & ruang +a+a primitif/ pulmo meluas/ ronggameso+erma +in+ing tubuh & +ibelah " omponen$+in+ing+a+a +e8nitif +an membrana pleuroperi ar+ial

• ?antung turun/ sinus venosus/ membrana tertari eluar &rongga +a+a5 rongga peri ar+ium tetap 9 +ua ronggapleura tetap


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Embriologi +iaphragma• 7eptum transversum

'bag ten+inosa*• #ioblast +in+ing

tubuh lateral 9ventral 'bag>#uscular*

• 7elaputpleuroperitoneal'se at yang +itempatimioblas*

• #esenteriumesophagus 'crura*


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Deri!at' lapisan embrional

di thora

endoderm mesoderm ectooderm

Esophagus (fore gut), antung,

pembuluh darah Medulla spinalis*

basalis (!entral) +alaris (dorsalis

Pulmo (fore gut)

#h$mus saccus phar$ngealis

Mesoderma somatik

"omite* skelotome(tulang)- otot

(dermomiotome)

Mesoderma splanknik

"el crista neuralis


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Phases of lung development

• Embryonic phase• 6seu+oglan+ular phase

•


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• (4oregut":nlage of thethyroi+

3:nlage of thelungs07tomach

• 5 :nlage of the

+orsal pancreas)#i+gut,Ain+gu


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• at the en+ of theembryonic perio+ the8rst segments appear in

the 8ve 'three right an+two left* lobes of thelungs>

• ith their +isten+e+en+s the lungs resemblean exocrine glan+>

•:t this time thepulmonar" vessels have forme+themselves>

• The pulmonarycirculation system'smaller circulationsystem* is forme+ out ofthe $th phar"ngeal

arch arter" >

• These +evelopsomewhat +i erentlythan the other 0 aorticarches in that 8rst avessel ple%us formsaroun+ the lung anlage/originating from theaortic sac>

• The true )th aortic archis only then forme+after vessels ! also fromthe +orsal aorta ! growinto this plexus an+thus a connectionbetween the truncuspulmonalis anddorsal aorta hasarisen>


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6seu+oglan+ularphase

• :t this stage the lungsresemble the +evelopmentof a tu&ulo'acinous gland >

• :ccor+ing to the classicalview/ the entire air'conducting &ronchial tree up to the terminal&ronchioli are set +own inthis phase '() generations*>

• ecent morphometricstu+ies '3* have shown thatwith the en+ of thepseu+oglan+ular phase ".generations are partiallypresent in the lungs/ whichmeans that at this point intime the respirator" ducts have alrea+y been forme+>

The primor+ial system ofpassages/ the air!con+uctingbronchial tree/ is initiallycoate+ by cu&icepithelium

• These are the precursor cellsof the ciliated epithelium an+ of the secretor" cells >n humans/ the 8rst ciliate+epithelial cells can be foun+in the (3th wee of

pregnancy ',*>n the respiratory part the8rst typically lung!speci8ccells/ connecte+ to theterminal bronchioli/ appear$the t"pe (( pneumoc"tes 'alveolar cells* '3*>

The +eveloping broncho!pulmonary epithelium beginsto pro+uce amniotic )uid /which is also foun+ in thelungs up to the time of birth>


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the pseu+oglan+ular phase

• n the pseu+oglan+ularphase the lungs resemblea glan+> :t the en+ of thisphase the precursors ofthe pneumocytes can be+iscerne+ in therespiratory sections ascubic epithelium>


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• The canaliculi compose theproper respirator" part ofthe lungs/ the pulmonar"parench"ma > :ll of the airspaces that +erive from aterminal &ronchiolus form an acinus >

• Each one comprisesrespirator" &ronchioli an+ the alveolar ducts an+ later the alveolarsacculi >

• The chief characteristic ofthis canalicular phase is thealteration of theepithelium and the

surroundingmesench"ma >• :long the acinus/ which

+evelops from the terminalbronchiolus/ an invasionof capillaries into themesenchyma occurs>

• The capillaries surroun+ theacini an+ thus form thefoun+ation for the laterexchange of gases>

• The lumen of the tu&ules becomes wi+er an+ a partof the epithelial cells get tobe ;atter> 4rom the cu&ict"pe (( pneumoc"tes +evelop the )attenedt"pe ( pneumoc"tes >


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canalicularphase

• The 8rst breathing movementcan be registere+ alrea+y at theen+ of the embryonic perio+>

• They are controlle+ by abreathing center in the brainstem>

• Nevertheless/ these breathingmovements are para+oxical inthat when the +iaphragmcontracts/ the thorax movesinwar+ly an+ vice versa> '"*

• The surfactant 'abbreviation forsur face act ive a ge nt * consistsof gl"cerophospholipids /speci c proteins / neutral fats an+ cholesterol > t covers thealveolar surface an+ reducesthe surface tension so that/following birth/ the alveoli +o notcollapse +uring the expiration>

• :t the en+ of this canalicularphase which is the beginningof the saccular phase 'ca>"- wee s* ! a large part of theamniotic )uid is pro+uce+by the lung epithelium >

• 4rom this time on/ thematurit" of the lungs canbe measure+ clinicall" base+on the activity of the t"pe ((

pneumoc"tes / which beginto pro+uce the surfactant > The ratio of lecithin tosphingom"elin in theamniotic ;ui+/ whichincreases with fetal age is+etermine+>

• n this stage +evelopmental+amage alrea+y a ects thegas!exchange componentsan+ result in structuralalterations of the laterpulmonary parenchyma>


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• The capillariesmultiply aroun+ theacini> They push closeto the surface an+

form a common basalmembrane with thatof the epithelium

• (> Type pneumocyte

"Type pneumocyte3


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• n the alveolar phasethe alveoli form fromthe terminal en+ingsof the alveolar sacculian+ with time increasetheir +iameter>

• (:lveolar +uct"6rimary septum3:lveolar sac

0Type pneumocyte-Type pneumocyte)


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• n the alveolar phaseafter birth more an+more alveoli form fromthe terminal en+ingsof the alveolar sacculi

an+ with time increasein +iameter> They are+elimite+ bysecon+ary septa>

• (:lveolar +uct"7econ+ary septum3:lveoli0Type pneumocyte-Type pneumocyte)


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• 4or the branching out ofever new lung bu+s aninteraction between therespiratory en+o+ermal

epithelium an+ thesurroun+ing pulmonarymesenchyma is primarilyresponsible> #ainly theepidermal gro#th factor 'EK4* an+ the extracellularform of the transforminggrowth factors 'TK4!b*appear to be important forlung +evelopment>n a++ition/ one 8n+sspeci8c extracellularmatrix components li ecollagen of types an+ /as well as proteogl"can an+ the &ronectin ands"ndecangl"coproteins >> '

• These molecules are foun+aroun+ the passages an+ inthe for s of the bronchialtree> They are responsiblefor the stabili%ation of thealrea+y forme+ structures !

these are not present in theregions of the newlyforme+ branches>2pimorphine / a furtherprotein/ appears topromote the formation ofepithelial passages> fepimorphine is bloc e+ byantibo+ies/ the epitheliumthat lies above it can notform itself into tubes an+remains unorgani%e+


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anomaly• Laryngeal atresia• 4istula tracheo!

esophageal

• Tracheal stenosis/atresia• :genesis trachea• :genesis of lung• Ayaline membrane

+iseaseIrespiratory+istress syn+rome


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• Tracheoesophageal8stula: 8stula is a tube>

The esophagus is a

tube that goes tothe stomach an+the trachea is atube that goes tothe lungs>

• Normally these twotubes +o not connectbut when a baby hasa tracheoesophageal

8stula/ there is atube connecting thetwo> This can causeproblems withfee+ing an+ evenbreathing innewborns an+ nee+sto be correcte+>


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• 7uccessive stages in the +evelopment of the tracheoesophagealseptum +uring embryologic +evelopment> 6A7 The laryngotracheal+iverticulum forms as a ventral outpouching from the cau+al partof the primitive pharynx> 6/7 Longitu+inal tracheoesophageal fol+sbegin to fuse towar+ the mi+line to eventually form thetracheoesophageal septum> 6C7 The tracheoesophageal septumhas completely forme+> 687 f the tracheoesophageal septum+eviates posteriorly/ esophageal atresia with a tracheoesophageal8stula +evelops>


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GI Motility online '#ay "..)* +oi$(.>(.31Igimo)

igure 10 #ain types of tracheoesophageal 8stulae


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• The main varieties of tracheoesophageal 8stula> 6ossible

+irections of the ;ow of the contents are in+icate+ by arrows>Esophageal atresia/ as illustrate+ in A / is associate+ withtracheoesophageal 8stula in more than 1-P of cases> B/4istula between the trachea an+ esophagus> n C/ air cannotenter the +istal esophagus an+ stomach> :ir can enter the+istal esophagus an+ stomach in D/ an+ the esophageal an+gastric contents may enter the trachea an+ lungs>


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5 Development Anatomy of the Respiratory Organedit Pagi23mei