Development of Respiratory

System
Dr. Saeed Vohra
&
Dr. Sanaa Alshaarawy
 OBJECTIVES

At the end of the lecture the students should be able to:

 Identify the development of the laryngeotracheal

(respiratory) diverticulum.
 Identify the development of the larynx.

 Identify the development of the trachea.

 Identify the development of the bronchi & lungs.

 Describe the periods of the maturation of the lung.

 Identify the most congenital anomaly.

 Respiratory System
 Upper respiratory tract:
 Nose

 Nasal cavity & paranasal

sinuses
 Pharynx

 Lower respiratory tract:

 Larynx

 Trachea

 Bronchi

 Lungs
Development of the Lower Respiratory Tract
 Begins to form during the
4th week of development
 Begins as a median
outgrowth
(laryngotracheal groove)
from the caudal part of
the ventral wall of the
primitive pharynx
 The groove envaginates
and forms the
laryngotracheal
(respiratory) diverticulum
 A longitudinal tracheo-
esophageal septum
develops and divides
the diverticulum into a:
 Dorsal portion:

primordium of the
oropharynx and
esophagus
 Ventral portion:

primordium of
larynx, trachea,
bronchi and lungs
 The proximal part of
the respiratory
diverticulum remains
tubular and forms
larynx & trachea.
 The distal end of the
diverticulum dilates to
form lung bud, which
divides to give rise to
2 lung buds (primary
bronchial buds)
 The endoderm lining the laryngotracheal
diverticulum gives rise to the:
 Epithelium & Glands of the respiratory tract

 The surrounding splanchnic mesoderm

gives rise to the:
 Connective tissue, Cartilage & Smooth

muscles of the respiratory tract

 Development of the Larynx
 The opening of the
laryngotracheal diverticulum
into the primitive foregut
becomes the laryngeal
orifice.
 The epithelium & glands are
derived from endoderm.
 Laryngeal muscles & the
cartilages of the larynx
except Epiglottis, develop
from the mesoderm of 4th &
6th pairs of pharyngeal
arches.
 Epiglottis
 It develops from the
caudal part of the
hypopharyngeal
eminence, a swelling
formed by the
proliferation of
mesoderm in the
floor of the pharynx.
Growth of the larynx and epiglottis is rapid during
the first three years after birth. By this time the
epiglottis has reached its adult form.
Recanalization of larynx
 The laryngeal
epithelium proliferates
rapidly resulting in
temporary occlusion
of the laryngeal lumen
 Recanalization of
larynx normally occurs
by the 10th week.
 Laryngeal ventricles,
vocal folds and
vestibular folds are
formed during
recanalization.
 Development of the Trachea
 The endodermal lining
of the laryngotracheal
tube distal to the larynx
differentiates into the
epithelium and glands
of the trachea and
pulmonary epithelium
 The cartilages,
connective tissue, and
muscles of the trachea
are derived from the
mesoderm.
 Development of the Bronchi & Lungs
 The 2 primary
bronchial buds grow
laterally into the
pericardio-peritoneal
canals (part of the
intraembryonic
celome), the
primordia of pleural
cavities
 Bronchial buds divide
and re-divide to give
the bronchial tree.
 The right main
bronchus is slightly
larger than the left
one and is oriented
more vertically
 The embryonic
relationship persists
in the adult.
 The main bronchi
subdivide into
secondary and
tertiary (segmental)
bronchi which give
rise to further
branches.
 The segmental bronchi,
10 in right lung and 8 or
9 in the left lung begin to
form by the 7th week
 The surrounding
mesenchyme also divides.
 Each segmental bronchus
with its surrounding
mass of mesenchyme is
the primordium of a
bronchopulmonary
segment.
As the lungs develop
they acquire a layer of
visceral pleura from
splanchnic
mesenchyme.
The thoracic body wall
becomes lined by a
layer of parietal pleura
derived from the
somatic mesoderm.
 Maturation of the Lungs
 Maturation of lung is divided into 4 periods:
 Pseudoglandular (5 - 17 weeks)

 Canalicular (16 - 25 weeks)

 Terminal sac (24 weeks - birth)
 Alveolar (late fetal period - childhood)

 These periods overlap each other because the cranial

segments of the lungs mature faster than the caudal ones.
 Pseudoglandular Period (5-17 weeks)
 Developing lungs somewhat
resembles an exocrine gland
during this period.
 By 17 weeks all major
elements of the lung have
formed except those involved
with gas exchange (alveoli).
 Respiration is NOT possible.
 Fetuses born during this
period are unable to survive.
 Canalicular Period (16-25 weeks)

 Lung tissue becomes highly

vascular.
 Lumina of bronchi and terminal
bronchioles become larger.
 By 24 weeks each terminal
bronchiole has given rise to two or
more respiratory bronchioles.  Respiration is possible at
 The respiratory bronchioles divide the end of this period.
into 3 to 6 tubular passages called  Fetus born at the end of
alveolar ducts. this period may survive if
 Some thin-walled terminal sacs given intensive care (but
(primordial alveoli) develop at the usually die because of the
end of respiratory bronchioles. immaturity of respiratory
as well as other systems)
 Terminal Sac Period (24 weeks - birth)
 Many more terminal sacs develop.
 Their epithelium becomes very
thin.
 Capillaries begin to bulge into
developing alveoli.
 The epithelial cells of the alveoli
and the endothelial cells of the
capillaries come in intimate
contact and establish the blood-air
barrier.
 Adequate gas exchange can occur
which allows the prematurely born
fetus to survive
By 24 weeks, the terminal sacs are lined by:
Squamous type I pneumocytes and
Rounded secretory, type II pneumocytes, that
secrete a mixture of phospholipids called surfactant.

 Surfactant production begins by 20 weeks and

increases during the terminal stages of pregnancy.
 Sufficient terminal sacs, pulmonary vasculature
& surfactant are present to permit survival of a
prematurely born infants
 Fetuses born prematurely at 24-26 weeks may suffer
from respiratory distress due to surfactant
deficiency but may survive if given intensive care.
 Alveolar Period (32 weeks – 8 years)
 At the beginning of the alveolar
period, each respiratory
bronchiole terminates in a cluster
of thin-walled terminal saccules,
separated from one another by
loose connective tissue.
 These terminal saccules represent
future alveolar sacs.
 The epithelial lining of the
terminal sacs attenuates to an
extremely thin squamous
epithelial layer.
 Characteristic mature alveoli  Most increase in the size
do not form until after birth. of the lungs results from
95% of alveoli develop an increase in the number
postnatally. of respiratory bronchioles
and primordial alveoli.
 About 50 million alveoli, one rather than from an
sixth of the adult number are increase in the size of the
present in the lungs of a full- alveoli.
term newborn infant.

 From 3-8 year or so, the number of immature alveoli

continues to increase, forming additional primordial
alveoli.
 By about the eighth year, the adult complement of 300
million alveoli is present.
Breathing Movements Lungs at birth
 Occur before birth,  The lungs are half filled with fluid
are not continuous derived from the amniotic fluid and from
and increase as the the lungs & tracheal glands.
time of delivery
 This fluid in the lungs is cleared at birth:
by:
approaches.
 Pressure on the fetal thorax during
 Help in conditioning
delivery.
the respiratory  Absorption into the pulmonary
muscles. capillaries and lymphatics.
 Stimulate lung
development and are Lungs of a Newborn
essential for normal  Fresh healthy lung always contains
lung development. some air (lungs float in water).
Diseased lung may contain some fluid
and may not float (may sink).
Lungs of a stillborn infant are
firm, contain fluid and may sink in
 Developmental anomalies
Factors important for  Laryngeal atresia.
normal lung development  Tracheoesophageal
 Adequate thoracic space
fistula.
for lung growth.
 Tracheal stenosis &
 Fetal breathing
movements. atresia.
 Adequate amniotic fluid  Congenital lung cysts.
volume.  Agenesis of lungs.
 Lung hypoplasia.
 Accessory lungs.
 Tracheoesophageal Fistula
 An abnormal passage between
the trachea and esophagus.
 Results from incomplete
division of the cranial part of
the foregut into respiratory and
esophageal parts.
 Occurs once in 3000 to 4500 live
births.
 Most affected infants are males.
 In more than 85% of cases, the
fistula is associated with
esophageal atresia (esophagus
ends in a blind-ended pouch
rather than connecting normally
to the stomach).
Thank You