Respiratory System

Development
ANA208 (Sytemic Embryology)

M.K. Rayyan
Human Anatomy Department,
Faculty of Basic Medical Sciences,
Federal University Dutse, Jigawa State.

8/12/23 February, 2022 1

 Learning Objectives
• At the end of the lecture, the student
should 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.
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 Respiratory System
 Upper respiratory
tract:
Nose
Nasal cavity &
paranasal sinuses
Pharynx
 Lower respiratory
tract:
Larynx
Trachea
Bronchi
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Lungs 3
Lower Respiratory Tract Development
• The lower respiratory system
develops from a median
diverticulum of the foregut.
• When the embryo is
approximately 4 weeks old, the
respiratory diverticulum (lung
bud) appears as an outgrowth from
the ventral wall of the foregut

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 Development of the Lower
Respiratory Tract...
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
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 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)

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 Development of the Lower
Respiratory Tract...

 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

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 Development of the Larynx
 The opening of the
laryngotracheal diverticulum
into the primitive foregut
becomes the laryngeal
orifice.
 The internal lining of the
larynx (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.
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 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 3years
after birth. By this
time the epiglottis has
reached its adult form.
9
8/12/23
 Epiglottis...
• As a result of rapid proliferation
of this mesenchyme, the
laryngeal orifice changes in
appearance from a sagittal slit to
a T-shaped opening

• Subsequently, when mesenchyme

of the two arches transforms
into the thyroid, cricoid, and
arytenoid cartilages, the
characteristic adult shape of the
laryngeal orifice can be
recognized
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 Recanalization of larynx
• At about the time that the
cartilages are formed, the
laryngeal epithelium also
proliferates rapidly resulting in a
temporary occlusion of the lumen.

• Subsequently, vacuolization and

recanalization produce a pair of
lateral recesses, the laryngeal
ventricles10th week.

• These recesses are bounded by

folds of tissue that differentiate
into the false and true vocal cords.
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 Recanalization of larynx...
• Laryngeal ventricles, vocal folds and vestibular
folds are formed during recanalization.

• Since musculature of the larynx is derived from

mesenchyme of the 4th & 6th pharyngeal arches,
all laryngeal muscles are innervated by branches
of the 10th cranial nerve, the vagus nerve

• The superior laryngeal nerve innervates

derivatives of the 4th pharyngeal arch, and the
recurrent laryngeal nerve innervates derivatives
of the sixth pharyngeal arch
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 Laryngeal Atresia
• Laryngeal atresia (congenital high airway
obstruction syndrome,CHAOS) is a rare
anomaly and cause obstruction of the upper
fetal airway.
• Distal to the atresia or
stenosis the lung are enlarged
and capable of producing
echoes (echogenic)

• Also the diaphragm is

flattened or inverted and fetal
ascites and hydrops
( accumulation of serous fluid)
is present

•8/12/23
Prenatal ultra-sonograpghy 13
permits diagnosis.
 Laryngeal Web
• Partial occuulution
via a membraneous
web over the vocal
cord

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 Development of the Trachea
• During its separation
from the foregut, the
lung bud forms the
trachea and two lateral
outpocketings, the
bronchial buds

• At the beginning of the

fifth week, each of
these buds enlarges to
form right and left main
bronchi
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 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.

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 Tracheoesaphageal fistula (TEF)
• Abnormalities in partitioning of
the esophagus and trachea by
the tracheoesaphageal septum
result in esophageal atresia
with or without
tracheoesaphageal fistulas

• These defects occur in

approximately in 1/3000 births,
and 90% result in the upper
portion of the esophagus ending
in a blind pouch and the lower
segment forming a fistula with
the trachea

• Predominantly affect male

infants
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 Tracheoesaphageal fistula...
• Isolated esophageal
atresia and H-type TEF
without esophageal
Atresia each account
for 4% of these
defects.

• Other variations each

account for
approximately 1% of
these defects.
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 Tracheoesaphageal fistula...
• TEF is the most common
anomaly in the lower
respiratory tract

• Infants with common type

TEF and esophageal
atesia cough and choke
because of excessive
amounts of saliva in the
mouth

• When the infant try to

swallow milk it rapidly
fills the esophageal pouch
and is regurgitated
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 Tracheal atresia and
stenosis
• Are uncommon anomalies and
usually associated with one of the
verities of TEF

• In some case a web tissue may

obstructs the airflow (incomplete
tracheal atresia)

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Lungs and Bronchial tree
development
 Development of the Bronchi & Lungs
 The 2 primary bronchial
buds grow laterally into
the pericardio-peritoneal
canals, the primordia of
pleural cavities

 Bronchial buds divide and

redivide to give the
bronchial tree.

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 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.
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 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.
8/12/23 24
Development of the Bronchi & Lungs...

• With subsequent
growth in caudal and
lateral directions, the
lung buds expand into
the body cavity

• The spaces for the

lungs, the
pericardioperitoneal
canals, are narrow.

• They lie on each side

of the foregut
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 Development of the Bronchi &
Lungs...
• Ultimately the
pleuroperitoneal and
pleuropericardial folds
separate the
pericardioperitoneal
canals from the peritoneal
and pericardial cavities

• and the remaining spaces

form the primitive pleural
cavities

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Development of the Bronchi & Lungs...

• The mesoderm, which

covers the outside of the
lung, develops into the
visceral pleura from the
splanchnic mesenchyme

• The somatic mesoderm

layer, covering the body
wall from the inside,
becomes the parietal
pleura

• The space between the

parietal and visceral
pleura is the pleural
cavity
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 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.

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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.
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 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.

8/12/23 30
 Canalicular Period (16-25 weeks)...
 The respiratory bronchioles divide into 3 to 6 tubular
passages called alveolar ducts.

 Some thin-walled terminal sacs (primordial alveoli)

develope at the end of respiratory bronchioles.

 Respiration is possible at the end of this period.

 Fetus born at the end of this period may survive if

given intensive care (but usually die because of the
immaturity of respiratory as well as other systems

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 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
8/12/23 32
 Terminal Sac Period...

 By 24 weeks, the terminal sacs are lined by:

 Squamous type I pneumocytes and
 Rounded secretory, type II pneumocytes, that
secrete 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.
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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.
8/12/23 34
Alveolar Period (32 weeks – 8 years)
 From 3-8 year or so, the number of immature alveoli
continues to increase. Unlike mature alveoli, immature
alveoli have the potential for forming additional primordial
alveoli.

 By about the eighth year, the adult complement of 300

million alveoli is present.
 Characteristic mature alveoli do not form
until after birth. 95% of alveoli develop
postnatally.

 About 50 million alveoli, one sixth of the

adult number are present in the lungs of a
full-term newborn infant.
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 Breathing Movements
 Occur before birth, are
not continuous and
increase as the time of
delivery approaches.
 Help in conditioning the
respiratory muscles.
 Stimulate lung
development and
respiratory muscles and
these are essential for
normal lung development.
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 Lungs at birth
 The lungs are half filled
with fluid derived from the
amniotic fluid and from the
lungs & tracheal glands.

 This fluid in the lungs is

cleared at birth: by:
 Pressure on the fetal
thorax during delivery.
 Absorption into the
pulmonary capillaries and
lymphatics.

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 Lungs of a Newborn
 Fresh healthy lung always contains 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 water.

8/12/23 38
 Maturation of the Lungs
• Fetal breathing movements begin before birth
and cause aspiration of amniotic fluid

 When respiration begins at birth, most of the

lung fluid is rapidly resorbed by the blood and
lymph capillaries, and a small amount is probably
expelled via the trachea and bronchi during
delivery.

• When the fluid is resorbed from alveolar sacs,

surfactant remains deposited as a thin
phospholipid coat on alveolar cell membranes.

8/12/23 39
 Maturation of the Lungs...
• With air entering alveoli during the first
breath, the surfactant coat prevents
development of an air-water (blood)
interface with high surface tension

• Without the fatty

surfactant layer, the
alveoli would collapse
during expiration.

8/12/23 40
 Maturation of the Lungs...
• Respiratory movements after birth bring air into the
lungs, which expand and fill the pleural cavity.

• Although the alveoli increase somewhat in size, growth

of the lungs after birth is due primarily to an increase
in the number of respiratory bronchioles and alveoli.

• It is estimated that only one-sixth of the adult

number of alveoli are present at birth

• The remaining alveoli are formed during the first 10

years of postnatal life through the continuous
formation of new primitive alveoli.

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 Factors important for
normal lung development

 Adequate thoracic space

for lung growth.

 Fetal breathing movements.

 Adequate amniotic fluid

volume.

8/12/23 42
 Respiratory Distress Syndrome (RDS)
• Surfactant is particularly
important for survival of the
premature infant

• When surfactant is insufficient,

the air-water (blood) surface
membrane tension becomes high,
bringing great risk that alveoli
will collapse during expiration.

• As a result, respiratory distress

syndrome (RDS) develops

8/12/23 43
Respiratory Distress Syndrome...
• In these cases the partially collapsed alveoli
contain a fluid with a high protein content,
many hyaline membranes, and lamellar bodies,
probably derived from the surfactant layer

• Recent development of artificial surfactant and

treatment of premature babies with
glucocorticoids to stimulate surfactant
production have reduced the mortality
associated with RDS

• Thyroxine is the most important stimulator for

surfactants production
8/12/23 44
 Ectopic Lung Lobes
• ectopic lung lobes may
arising from the trachea
or esophagus

• It is believed that these

lobes are formed from
additional respiratory buds
of the foregut that
develop independently of
the main respiratory
system.
8/12/23 45
 Congenital Cysts of the Lung
• which are formed by dilation
of terminal or larger bronchi

• These cysts may be small

and multiple, giving the lung
a honeycomb appearance on
radiograph

• Or they may be restricted

to one or more larger ones

• Cystic structures of the lung

usually drain poorly and
frequently cause chronic
infections
8/12/23 46
 Oligohydroamnios and lungs
• When oligohydroamnios (reduced amniotic
fluid) is severe lung development is retarded

• Severe pulmonary hypoplasia results

8/12/23 47
 Lung Hernia

• Part of a lung may herniate:

– through the inlet of the
thorax,
– through a defect in the
thoracic wall
– into the mediastinum, or
– into the opposite pleural
cavity.

8/12/23 48
 Lung Hypoplasia
• In infants with congenital
diaphragmatic hernia (CDH) the lung
is unable to develop normally

• Because it is compressed by the

abnormally positioned abdominal
viscera

• It is characterized by reduced lung

volume

• Most infants with CDH die of

pulmonary insufficiency as their
lungs are too hypoplastic to support
life

8/12/23 49
 Displaced Bronchi

• These may arise from the trachea above its

bifurcation or even from the oesophagus.
• They may supply:
– (a) a normal segment of one of the lungs
– (b) an accessory lobe
– (c) they may be blind

8/12/23 50
 Displaced Bronchi...
• Although many abnormalities of the lung and
bronchial tree have been found (e.g., blind-ending
trachea with absence of lungs and agenesis of one
lung) most of these gross abnormalities are rare

• Abnormal divisions of the bronchial tree are more

common; some result in supernumerary lobules.

• These variations of the bronchial tree have little

functional significance, but they may cause
unexpected difficulties during bronchoscopies.

8/12/23 51
 Summary

8/12/23 52