Development of Respiratory System

Development of the Respiratory System
Dr KhaleeL
Associate Professor of Anatomy
Dr KHALEEL 1
RESPIRATORY PRIMORDIUM
• laryngotracheal groove--→ pouchlike laryngotracheal diverticulum-
-→As this diverticulum elongates, it is invested with splanchnic
mesenchyme and its distal end enlarges to form a globular
respiratory bud.
• Tracheoesophageal folds --→tracheoesophageal septum --

→laryngotracheal tube (primordium of lower respiratory tract),
and a dorsal part (primordium of oropharynx and esophagus).
Dr KHALEEL 2
Dr KHALEEL 3
The cartilaginous, muscular, and connectlve tissue components of the trachea and
lungs are derived from splanchnlc mesoderm surrounding the foregut
Dr KHALEEL 4
DEVELOPMENT OF THE LARYNX
• The cartilages of the larynx
• The mesenchyme at the cranial end of the laryngotracheal tube

proliferates rapidly, producing paired arytenoid swellings ----
→ converting the slitlike aperture-the primordial glottis-into a
T-shaped laryngeal inlet.
• The laryngeal epithelium proliferates rapidly, resulting in

temporary occlusion of the laryngeal lumen.
• Recanalization of the larynx normally occurs by the 10th week.

– **failure of recanalization atresia (blockage) or stenosis
(narrowing)
Dr KHALEEL 5
Figure: Successive stages in the development of the larynx. A, At 4 weeks. B, At 5 weeks.
C, At 6 weeks. D, At 10 weeks.
Dr KHALEEL 6
• The laryngeal ventricles form during this recanalization process.
These recesses are bounded by folds of mucous membrane that
become the vocal folds (cords) and vestibular folds.
• Growth of the larynx and epiglottis is rapid during the first 3

years after birth. By this time, the epiglottis has reached its
adult form.
Dr KHALEEL 7
DEVELOPMENT OF THE TRACHEA
• The cartilage, connective tissue, and muscles of the trachea are

derived from the splanchnic mesenchyme surrounding the
laryngotracheal tube
Dr KHALEEL 8
Tracheoesophageal Fistula (TEF)
• Incomplete fusion of the tracheoesophageal folds results in a

defective tracheoesophageal septum and a TEF between the
trachea and esophagus. Often associated with esophageal atresia
• pneumonitis and Polyhydramnios
Dr KHALEEL 9
Tracheal Stenosis and Atresia
• uncommon anomalies that are usually associated with one of the
varieties of TEF.
• probably result from unequal partitioning of the foregut
Tracheal Diverticulum
• This extremely rare anomaly consists of a blind, bronchus-like
projection from the trachea.
• The outgrowth may terminate in normal-appearing lung tissue,

forming a tracheal lobe of the lung.
Dr KHALEEL 10
DEVELOPMENT OF THE BRONCHI AND LUNGS
• The respiratory bud (lung bud) --→-the primary bronchial

buds.--→grow laterally into the pericardioperitoneal canals.
• Secondary and tertiary bronchial buds soon develop. Together

with the surrounding splanchnic mesenchyme, the bronchial buds
differentiate into the bronchi and their ramifications in the
lungs.
Dr KHALEEL 11
Dr KHALEEL 12
Maturation of the Lungs
• Maturation of the lungs is divided into four stages:

pseudoglandular, canalicular, terminal sac, and alveolar.
1. Pseudoglandular Stage (6 to 16 Weeks)

• By 16 weeks, all major elements of the lung have formed, except
those involved with gas exchange.
Dr KHALEEL 13
Dr KHALEEL 14
Canalicular Stage (16 to 26 Weeks)
• the lumina of the bronchi and terminal bronchioles become larger,
and the lung tissue becomes highly vascular.
• By 24 weeks, each terminal bronchiole has given rise to two or

more respiratory bronchioles, each of which then divides into
three to six passages- primordial alveolar ducts.
• Respiration is possible at the end of the canalicular stage
• Although a fetus born toward the end of this period may survive
if given intensive care, it often dies because its respiratory and
other systems are still relatively immature.
Dr KHALEEL 15
Terminal Sac Stage (26 Weeks to Birth)
• During this period, many more terminal sacs or saccules develop, and
their epithelium becomes very thin (type I & II pneumocytes).
Capillaries begin to bulge into these sacs (developing alveoli) and also
capillary network rapidly proliferates .
• The intimate contact between epithelial and endothelial cells establishes

the blood-air barrier, which permits adequate gas exchange for survival
of the fetus if it is born prematurely.
Dr KHALEEL 16
Alveolar Stage (32 Weeks to 8 Years)
• Sacs analogous to alveoli are present at 32 weeks.
• The epithelial lining of the terminal sacs attenuates to a thin

squamous epithelial layer.
• At the beginning of the alveolar stage, each respiratory

bronchiole terminates in a cluster of thin-walled alveolar sacs,
separated from one another by loose connective tissue. These
saccules represent future alveolar ducts.
• Characteristic mature alveoli do not form until after birth;

approximately 95% of mature alveoli develop postnatally.
• Alveolar development is largely completed by 3 years of age, but

new alveoli may be added until approximately 8 years of age.
Dr KHALEEL 17
Dr KHALEEL 18
…cont’d
• The transition from dependence on the placenta for gas

exchange to autonomous gas exchange requires the following
adaptive changes in the lungs:
– Production of surfactant in the alveolar sacs

– Transformation of the lungs from secretory into gas
exchanging organs
– Establishment of parallel pulmonary and systemic circulations
Dr KHALEEL 19
…cont’d
• At birth, the lungs are approximately half-filled with fluid

derived from the amniotic cavity, lungs, and tracheal glands.
• The fluid in the lungs is cleared at birth by three routes:

– Through the mouth and nose by pressure on the fetal thorax
during vaginal delivery
– Into the pulmonary arteries, veins, and capillaries
– Into the lymphatics
• Three factors are important for normal lung development:

– adequate thoracic space for lung growth
– Fetal breathing movements (FBMs), and
– an adequate amniotic fluid volume.
Dr KHALEEL 20
Respiratory Distress Syndrome
• This disease (RDS) affects approximately 2% of live newborn
infants; those born prematurely are most susceptible.
• These infants develop rapid, labored breathing shortly after

birth. RDS is also known as hyaline membrane disease (HMD). An
estimated 30% of all neonatal disease results from HMD or its
complications.
• Surfactant deficiency is a major cause of RDS or HMD.
• The lungs are underinflated, and the alveoli contain a fluid with a
high protein content that resembles a glassy or hyaline
membrane. This membrane is believed to be derived from a
combination of substances in the circulation and from the injured
pulmonary epithelium.
Dr KHALEEL 21
Agenesis of Lungs
• Absence of the lungs results from failure of the respiratory bud
to develop.
• Unilateral pulmonary agenesis is compatible with life.
• The heart and other mediastinal structures are shifted to the

affected side, and the existing lung is hyperexpanded.
Dr KHALEEL 22
THANK U
Dr KHALEEL 23

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Development of the Respiratory System

• Tracheoesophageal folds --→tracheoesophageal septum --

• The cartilages of the larynx

• The mesenchyme at the cranial end of the laryngotracheal tube

• The laryngeal epithelium proliferates rapidly, resulting in

• Recanalization of the larynx normally occurs by the 10th week.

• Growth of the larynx and epiglottis is rapid during the first 3

• The cartilage, connective tissue, and muscles of the trachea are

• Incomplete fusion of the tracheoesophageal folds results in a

• probably result from unequal partitioning of the foregut

• The outgrowth may terminate in normal-appearing lung tissue,

• The respiratory bud (lung bud) --→-the primary bronchial

• Secondary and tertiary bronchial buds soon develop. Together

• Maturation of the lungs is divided into four stages:

1. Pseudoglandular Stage (6 to 16 Weeks)

• By 24 weeks, each terminal bronchiole has given rise to two or

• Respiration is possible at the end of the canalicular stage

• The intimate contact between epithelial and endothelial cells establishes

• The epithelial lining of the terminal sacs attenuates to a thin

• At the beginning of the alveolar stage, each respiratory

• Characteristic mature alveoli do not form until after birth;

• Alveolar development is largely completed by 3 years of age, but

• The transition from dependence on the placenta for gas

– Production of surfactant in the alveolar sacs

• At birth, the lungs are approximately half-filled with fluid

• The fluid in the lungs is cleared at birth by three routes:

• Three factors are important for normal lung development:

• These infants develop rapid, labored breathing shortly after

• Surfactant deficiency is a major cause of RDS or HMD.

• Unilateral pulmonary agenesis is compatible with life.

• The heart and other mediastinal structures are shifted to the

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