Thoracic viscera overwiew.

Pleuopulmonary
cavities.Lungdeveloptment

January 29th ,2016

DEVELOPTMENT
CEPHALOCAUDALFOLD

Carlson
LATERALFOLD

Larsen
LATERALFOLD

Larsen
 The Lungbuds form during the 4th week

Iniatially,appear asthe
4th week
respiratory diverticulum
which is aventraloutgrowth
of the ventralforegut

Larsen

Endoderm epithelium of the internal respiratory system

Mesoderm cartilage,connective tissue and smooth muscle of the respiratory system

Splitting of foregut into esophagus and trachea
 Tracheaesophageal fistulas

Larsen

Incompleteseparation and/or atresiaof trachea or esophagus

Likely due to adefect of mesoderm.Usually associated with other anormalities of
mesoderm development (cardiovascularmalformations,VATER,VACTERL)

VATER:Vertebralanomalies,Analatresia,Tracheaesophageal fistula,Esophagus atresia,Renalatresia

VACTERL: VATER+Cardiac defects &Limbs defects
Tracheaesophageal fistula

1/3000births
Prenatal:polyhydramnios
Postnatal:Regurgitation after feeding

MoorePersaud
 Coelum:thoracic and abdominalcavities

Larsen

Parietalmesoderm lines embryonic bodycavity

Visceralmesoderm coversForegut endoderm is surrounded byvisceralmesoderm

Gut tube is suspendedfrom bodywall bydorsalmesentery

Development of the septum transversum and diaphragm

Larsen
 Development of the septum transversum and diaphragm

It grows from front to back

Atweek 4it is atC1level caudally

Atweek 8it is atT7level (front)and T12(back)

Innervation C3C5(phrenic nerves)

week 4
week 6

week 7 week 8
Carlson
*Extension of the septum transversum partially dividesthe thoracic and abdominalcavities
 Development of the diaphragm

Larsen

Diaphragm:
Septum transversum
Pleuroperitoneal membranes
Muscles from dorsolateralbodywall
Esophagus mesentery
Congenital diaphagmatic hernias
Congenital diaphagmatic hernias

1/2000births
Usually on the left side (8090%)
 Growth of lungs into the bodycavity

Foregut endoderm is surrounded byvisceralmesoderm

Aslungs grow they expand into the bodycavity

Growth of lungs into the bodycavity.Pleuralcavities

Carlson, 1998
 Pericardioperitoneal canals pleuralcavities

Basmajian,1971

Pericardioperitoneal canals Visceralpleura parietalpleura

Trachea

Splacnic
mesodem

somatic
mesodem

Pleuralcavity MoorePersaud,1999
 Innitial patterning of the lungs

Thrachea is divided into two primary bronchi

Left primary bronchus is divided into two

secondary bronchi (corresponding to the two
lobes of the left lung)

5week Right primary bronchus is divided into three

secondary bronchi (correspondingtothethree
lobesoftherightlung)

Eight terciary (segmental)brochi areformed in

the left lung and teninthe right lung

Carlson,1998

7week
*Branching regulation:members of the fibroblast growth factor(FGF)
 Stages of maturation of the lungs

Psudoglandular stage (616week)Canalicular stage (1626week)

Terminalsac (26weekbirth)Alveolarstage (32weekpostnatal)

RESPIRATORYSYSTEMANATOMY
Lungs

Fritsch y Khnel, 2003

 Lobes and fissures

Upper lobe

Horizontalfissure
Upper lobe

Middle lobe

Oblique fissure Oblique fissure

Inferior
lobe
Inferior
lobe
Lungs

Rohen ycols.,2003
Thrachea and main bronchi

Netter, 1999
Rohen y col., 2003
 Bronchopulmonary
Segmentos pulmonares Segments
pulmn derecho
Superiorlobe
Iapical
IIposterior
IIIanterior

Middle lobe
IVlateral
Vmedial

Inferiorlobe
VIsuperior
VIIMedialbasal
VIIIAnteriorbasal
IXLateralbasal
XPosteriorbasal
 Bronchopulmonary
Segmentos Segments
pulmonares pulmn izquierdo
Superiorlobe
Iapical
IIposterior(I&II apicoposterior)
IIIanterior
IVSuperiorlingular
VInferiorlingular

Inferiorlobe
VISuperior
VIIMedialbasal
VIIIAnteriorbasal
IXlateralbasal
XPosteriorbasal
Mediastinal surface:impressions
Pleuralcavities
Endothoracic Fascia
 Parietalpleura

cervical
pleura

mediastinal
pleura

costalpleura

diaphagmatic
pleura
Peripheral reflections andpleuralrecesses
Parietalcavity:
Midclavicular line:rib VII
Midaxillary line:rib X
Vertebralcolumn:TXII
Lungs:
Midclavicular line:ribVi
Midaxillary line:ribVIII
Vertebralcolumn:TX
Peripheral reflections and pleural recesses

Netter, 1999
 cervical
pleura

Mediastinal pleura

Parietal pleura

Visceralpleura

Pleural
Reflection
(hilum)
 Costalrecesses

Costomediastinal recesses

Costodiaphragmatic recesses

Costomediastinal anteriorrecesses

Costomediastinal posteriorrecesses
Pulmnary root

Pulmonary ligament
Root andhilum
 Right Lung
Pulmonary artery

Bronchus

Pulmonary veins
Left lung

Pulmonary artery

Bronchus

Pulmonary veins