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Embryology of the Lungs By: Alessandro Cau, Howell Liu, Gregory Jen Overview of Presentation 1. Gastrulation and the Early Embryo 2. The Development of the Lungs 3. The Development of the Pulmonary Vasculature 4. The Embryonic Origins of the Diaphragm 5. Formation of the Chest Wall Case Study: Brandon • Weighed just 4 lbs 9oz • Frothy, white bubbles in the mouth. • Coughing or choking when feeding • Vomits frequently • Very round, full abdomen • History of hydramnios Image from https://thriving.childrenshospital.org/one-patients-story-our-babys-esophagealatresia-and-tracheoesophageal-fistula/ Gastrulation: Development of the Three Primary Germ Layers • Epiblast is lined by ectoderm • Cells along primitive streak ingress to form endoderm, then mesoderm • This results in a trilaminar structure System Differentiation Begins: Formation of Notochord and Somites There are 5 phases of lung development. 1. Embryonic phase (3 weeks-7 weeks) 2. Pseudoglandular phase (5 weeks-18 weeks) 3. Canalicular phase (16 weeks-26 weeks) 4. Saccular phase (24 weeks until 36 weeks) 5. Alveolar phase (36 weeks until 8 years after birth) Image from http://embryology4genius.weebly.com/maturation-of-the-lungs.html Body wall lateral folding encloses foregut endoderm to form the intra-embryonic coelom (Weeks 3 to 4) Image from https://www.pinterest.com/pin/282319470368880617/ Appearance of the sulcus laryngotrachealis and lung buds mark the beginning of the embryonic phase. (Weeks 3 to 7) Image from https://pedclerk.bsd.uchicago.edu/page/tracheoesophageal-fistula Differentiation of the lung buds form the bronchi and pulmonary lobes during the embryonic phase. (Weeks 3 to 7) Image from http://slideplayer.com/slide/5258408/ As the lung buds differentiate, they punch into the intraembryonic coelom. (Weeks 4 to 8) Image from http://discovery.lifemapsc.com/library/review-of-medical-embryology Appearance of cartilage, smooth muscle and tall ciliated columnar cells are hallmarks of the pseudoglandular phase. (Weeks 5 to18) Image from http://slideplayer.com/slide/5258408/ Progression into the canalicular phase is indicated by the formation of canaliculi. (Weeks 16 to 26) Image from http://slideplayer.com/slide/5258408/ Growth of the bronchial tree and the appearance of sacculi, precursors to alveoli, define the saccular phase. (Weeks 24 to 36) Image from http://slideplayer.com/slide/5258408/ Alveolarization and the formation of secondary septa mark the alveolar phase and continues after birth. (Week 36 to 8 years) Image from http://slideplayer.com/slide/5258408/ Image from http://embryology4genius.weebly.com/maturation-of-the-lungs.html Case Study: Brandon • Weighed just 4 lbs 9oz • Frothy, white bubbles in the mouth. • Coughing or choking when feeding • Vomits frequently • Very round, full abdomen • History of hydramnios Image from https://thriving.childrenshospital.org/one-patients-story-our-babys-esophagealatresia-and-tracheoesophageal-fistula/ Improper separation of the trachea and esophagus leads to tracheo-oesophageal fistula (TOF). Image from http://flylib.com/books/en/3.98.1.127/1/ Image from https://tefnormalanatomy.wordpress.com/ Pulmonary vasculature develops concurrently with the lungs. • The pulmonary arteries and veins develop separately from the capillaries • The capillaries form from the splanchnopleuric mesoderm The diaphragm is formed from four different structures. 1. Septum Transversum 2. Paraxial Mesoderm 3. Esophageal Mesenchyme 4. Pleuroperitoneal Membrane Embryology Image from https://embryology.med.unsw.edu.au/ embryology/index.php/File:Diaphragm_components.jpg Different structures of the chest wall have different embryonic origins. Vertebrae: • Paraxial mesoderm forms somites • Forms sclerotome migrate and divide to wrap around the notochord Image from http://www.innerbody.com/anatomy/ skeletal/cervical-vertebrae-lateral Muscle: • Sclerotome leaves cells known as dermamyotomes dorsal and intercostal muscles Image from http://www.eastwestmassageboston.com/interco stal-ribcage-muscle-tension.html The ribs and sternum ossify between 5-6 weeks of age. Ribs • Condensations of mesenchyme near vertebrae extend and lay down cartilage • Bone forms through endochondral ossification Sternum • Longitudinal mesenchymal condensation lay down cartilage, and endochondral ossification occurs Image from http://diseasespictures.com/sternum-pain/ Summary • The development of the lungs consists of the embryonic, pseudoglandular, canalicular, saccular and alveolar phases. • Each stage is characterized by a few key events. ie. the embryonic stage is defined by the formation of the lung buds. • The pulmonary vasculature develops concurrently with the lungs, but the critical stages are the embryonic and pseudoglandular phases. • The diaphragm forms from four different embryonic structures. References • Ryan, S. (2008). Embryology and Anatomy of the Neonatal Chest (pp. 1–10). http://doi.org/10.1007/978-3-540-33749-2_1. • Warburton et al. (201). Lung Organogenesis. Curr Top Dev Biol 90: 73158. DOI: 10.1016/S0070-2153(10)90003-3.