‫‪Respiratory System‬‬

‫‪Chapter 17‬‬ ‫علم األنسجة ‪2‬‬

‫برنامج الطب البشري‬

‫كلية الطب وعلوم الصحة‬
‫جامعة بولتكنيك فلسطين‬

‫‪27.09.2022‬‬
‫د‪ .‬سالمة الوحش‬

‫‪1‬‬
Respiratory System

• Functionally, the respiratory system is divided

into two major components:
– The air-conducting components
– The respiratory/ gas-exchange components

2
1. Air conducting portion (anatomy)
Consists of the:
– Nasal cavities
– Nasopharynx
– Larynx
– Trachea
– Extrapulmonary bronchi
– Intrapulmonary bronchi and bronchioles
– Terminal bronchioles

3
2. Respiratory components (anatomy)
Lower respiratory tract
Consist of:
- Respiratory bronchioles
- Alveolar ducts are where respiratory bronchioles
branch
- Alveolar sacs are clusters of alveoli
- Alveoli:
* Specialized sac-like structures that make up the greater part
of the lung and are the main sites for the exchange of O2 and
CO2 between inspired air and blood

4
1. Air conducting portion (physiology)
Functions:
- Conduit for air to and from
the lungs
- Conditioning of the air 
Filters, moistens, and
warms air before it enters
the lungs

5
Respiratory epithelium
• Consists of five cell types:
3 columnar cell type with blunt microvilli
Brush cells are chemosensory receptors

1- 3- (brush)
Most common cells
2- 5-
(small granule cell)
4-

are mitotically active stem and progenitor cells 5 are part of diffuse neuroendocrine system
that give rise to the other epithelial cell types (DNES)

6
Nasal cavity
• It consists of the external vestibule and the internal
nasal fossae
1- Vestibule:
• * Lined by skin which has short coarse hairs
(vibrissae) which trap large particles
* This keratinized epithelium undergoes transition into typical
respiratory epithelium (pseudostratified columnar which lines
the nasal cavities) before entering the nasal fossae

• The thin mucus layer produced by seromucous glands and goblet cells serves
to trap particulate and gaseous air impurities that are then removed
• The secretions also contain immunoglobulin A (IgA) from plasma cells in the
lamina propria
8
 Blockage of sinuses/ swelling of the mucosa

Hypersensitivity- pollen to inflammation

https://www.youtube.com/watch?v=e3gsndH9q1s
 Nasal cavity
2- Nasal fossae:
* Olfactory mucosa lines
the roof of nasal cavity
* Ciliated Turbinates
pseudostratified Increase surface area

epithelium lines the rest

proper
of nasal cavity

Based on
function
differences, the
nasal cavity
proper is divided
into:

10
 NC: nasal cavity,
Nasal cavity
NS: nasal septum,

PS: paranasal sinuses,

T: turbinate system of
bones (conchae)
*****

11
Turbinate system
(Space)

12
Nasal mucosa
Consists of ciliated pseudostratified colomnar
Epithelium (E) with numerous goblet cells supported
by a lamina propria containing serous (S) and
mucous (M) Glands with a rich plexus of thin-walled
venules (V)

Functions of nasal mucosa:

- Filtering of particulate matter : mucous from goblet -

cells and mucous glands + wave like beating of celia

- Adjusting the temperature of inspired air : by heat

exchange between the air and blood in venules

- Humidifying of inspired air : by watery secretions of

serous glands

These functions are enhanced by large surface area

13
provided by the turbinate system of bones.
Olfactory region
• Tissues on the superior concha and the nasal septum
form the olfactory region of the nasal cavity
• It is made up of the olfactory epithelium and the
underlying lamina propria
• The olfactory epithelium consists of a three basic cell
types:
1- bipolar olfactory receptor neurons;
2- sustentacular cells (a type of supporting cell);
3-basal cells (the stem cells) that continuously give rise to
new olfactory receptor neurons and sustentacular cells
Olfactory receptors
 Olfactory Epithelium
Supporting cells: have broad apexes and narow
bases with microvilli on their surface.

Basal cells: small spherical or cone-shaped at the

base of the epithelium.

Olfactory cells: bipolar neurons with 6-20 long

and nonmotile celia on their apexes.

Function of olfactory epithelium

????

OLFACTION = SMELL
17
Basal cells divide to either supporting cells or especial olfactory receptor cells
The lamina propria
• It contains connective tissue containing
fibroblasts, blood vessels, Bowman's glands
(unknown function) and bundles of fine axons
from the olfactory neurons
• Cilia in the epithelium of the olfactory region
arise from olfactory cells; the cilia do not move
• The cell membrane covering the surface of the cilia
contains olfactory receptors which respond to odour-
producing substances, odorants, dissolved in the
serous ‫ سائل‬covering the epithelium
• The axons of the olfactory cells collect into bundles in
the lamina propria
• The olfactory cells and their processes receive
mechanical and metabolic support from supporting
cells (sustentacular cells) (affected by Covid-19 virus)
• Basal cells can divide and differentiate into
either olfactory or supporting cells
• The supporting cells contain lipofuscin
granules, which give a yellow-brown colour to
the surface of the olfactory region
 Pharynx
• The pharynx connects the nasal cavity with the larynx
• The nasopharynx is lined with respiratory epithelium
The oropharynx and laryngopharynx are lined with a
stratified squamous epithelium which also covers the
surfaces of the oral cavity and the oesophagus
• Lamina propria that contains a thick layer of
longitudinally oriented elastic fibers and mucous
glands seen
• Lymphocytes frequently accumulate beneath the
epithelium of the pharynx
Pharynx
• The next layer is the muscularis externa is composed of
irregularly arranged skeletal muscle, the longitudinal
and constrictor muscles of the pharynx
• Mucous glands might be seen in this muscular layer,
they are extensions of those present in the lamina
propria
• The outer layer is a fibrous layer
• https://www.youtube.com/watch?v=PhrPfq9YwqQ
0
 Non-smokers

Smokers Seromucus gland help in trapping

contaminants and increasing
moisture of air that breath in the
surface is lined with respiratory
epithelium
 Larynx
• The larynx and false vocal fold is lined by
pseudostratified columnar epithelium with cilia
and goblet cells (respiratory epithelium)
• The true vocal folds are lined by stratified
squamous epithelium and contain the muscle
(striated) and ligaments
• The larynx is supported by a set of complexly
shaped cartilages
Lamina Propria;
• contains mixed glands (mostly mucus) with excretory
ducts from glands, open on surface of the epithelium

• Lymphatic nodules can be seen on the ventricular side

• Underneath the mucosa, cartilages can be seen

‫مهم الخراج الصوت‬
• epithelium of the human upper respiratory
mucosa acts as the first physical barrier that
protects against inhaled substances and
pathogens
• The epithelium is a highly regulated and
impermeable barrier exclusively formed by
tight junctions
Trachea
• The trachea is lined by respiratory epithelium
• The respiratory epithelium contains basal cells, ciliated
cells and goblet cells, endocrine cells (or small granule
cells, function not clear), surfactant producing cells
(Clara cells), and serous cells
• Epithelium and underlying lamina propria are called the
mucosa
The lamina propria
• Consists of loose connective tissue with many elastic
fibres, which condense at the deep border of the
lamina propria to form an elastic membrane

• This elastic membrane forms the border between the

mucosa and the connective tissue below it, which is
called the submucosa
The submucosa
• Contains muco-serous glands (submucosal glands),
they supplement the secretions of cells in the
epithelium
• The submucosa ends with the perichondrium of the
tracheal cartilages
Tracheal cartilages

• The trachea is stabilised by 16-20 C-shaped cartilages

(hyaline cartilage, horseshoe shape)
• The free dorsal ends of the cartilages are connected by
bands of smooth muscle (trachealis muscle) and
longitudinal collagenous and elastic connective tissue
fibres (annular ligaments)
Tracheal cartilages
• These, link the individual cartilages and allow both the
lengthening and shortening of the trachea for example
during swallowing or movements of the neck
• They are inseparable from (close to) the fibres of the
perichondrium
• The tracheal cartilages may ossify with age Tunica
adventitia is an outer layer of fibrous tissue surrounds
the cartilages
 Oesophagus

Hyaline

Connective tissue and elastic tissue separate the trachea from oesophagus
Submucosal gland: both serous and mucus gland, they keep the surface of the
epithelium moist and maintain mucus raft to trap debris which is carried to be
swallowed (GI) or coughing out of the body
Bronchi
• Conductive structures of a size down to ~1 mm are
termed bronchi
• Smaller ones are called bronchioles. Aside from their
different sizes, bronchi are characterized by the
presence of glands and supporting cartilage
• The histological structure of the epithelium and the
underlying connective tissue of the bronchi corresponds
largely to that of the trachea and the main bronchi
• In addition, bronchi are surrounded by a layer of
smooth muscle, which is located within the lamina
propria
The submucosa of the bronchi
• Contains muco-serous glands (submucosal glands)
• The Hyaline cartilage supporting the bronchi is typically
found in several small pieces
• The cartilage is surrounded by adventitia
Bronchi
• The primary bronchi have cartilage and
a mucous membrane that are similar to those
found in the trachea
• Hyaline cartilage forms an incomplete ring in the
bronchi that gives them the characteristic "D"-
shaped appearance in the larger bronchi, and as
small “plates and islands” in smaller-sized
bronchi
• As the branching continues throughout the
bronchial tree, the amount of hyaline cartilage in
the walls decrease until it reaches the bronchioles,
which have a cartilage-free wall
• The amount of smooth muscle increases as the
amount of cartilage decreases, and smooth muscle
is also present continuously around the bronchi
• In addition, the mucous membrane will undergo a
transition from ciliated pseudostratified columnar
epithelium to simple cuboidal epithelium to simple
squamous epithelium
Trache
a
Bronchioles
• Bronchioles are the terminal segments of the
conductive portion
• At the transition from bronchi to bronchioles the
epithelium changes to a ciliated columnar
epithelium, but most of the cell types found in the
epithelium of other parts of the conductive portion
are still present
Bronchioles …
• As bronchioles get smaller, Goblet cells start to
decrease in number and replaced by Clara cells
which are cuboidal shaped cells and have no
cilia, found in the small airways bronchioles;
• Clara cells may secrete glycosaminoglycans to
protect the bronchiole lining; as well, they act as a
stem cells
• Glands and cartilage are absent.
• The layer of smooth muscle is relatively thicker
than in the bronchi
Bronch
us
• Horseshoe shape of the cartilage become disappeared, but the smooth muscle becomes
more dominant
• As move from the trachea into the lung, the branches increase, and the lumen of the
bronchi getting smaller and smaller, but it’s still hardly supported by cartilages that act
against collapsing during breathing processes.
• As move further into the lung, the walls of bronchioles are supported by smooth muscles
(no longer have cartilages)
• Control of smooth muscle contraction by innervation and chemicals (e.g., asthma:
contraction of smooth muscle causes closing the airways)
Respiratory portion
• Bronchioles divide into respiratory bronchioles, which are the
first structures that belong to the respiratory portion of the
respiratory system ‫أول منطقة يبدأ بها تبادل الهواء مع االوعية‬
• Small outpouchings of the walls of the respiratory
bronchioles form alveoli, the site of gas exchange
• The number of alveoli increases as the respiratory bronchioles
continue to divide
• They terminate in alveolar ducts
Histological structure of Alveoli
• The wall of the alveoli is formed by a thin sheet (~2µm) of
tissue separating two neighbouring alveoli. This sheet is
formed by epithelial cells and intervening connective tissue
• Collagenous (few and fine), reticular and elastic fibres are
present
• Between the connective tissue fibres there is a dense,
anastomosing network of pulmonary capillaries.
Alveoli …
• The wall of the capillaries are in direct contact
with the epithelial lining of the alveoli

• The basal laminae of the epithelial lining of the

alveoli- and that of the endothelium may actually
fuse neighbouring alveoli may be connected to
each other by small alveolar pores.
The epithelium of the alveoli is formed by
1- Alveolar type I cells (small alveolar cells or type I
pneumocytes) are extremely flattened (the cell may be
as thin as 0.05 µm) and form the bulk (95%) of the
surface of the alveolar walls.
2- Alveolar type II cells (large alveolar cells or type II
pneumocytes) are irregularly (sometimes cuboidal)
shaped. They form small bulges on the alveolar walls
• Type II alveolar cells contain are large number of
granules called cytosomes, which consist of
precursors to pulmonary surfactant (the mixture
of phospholipids which keep surface tension in
the alveoli low). There are just about as many
type II cells as type I cells
• Cilia are absent from the alveolar epithelium and
cannot help to remove particulate matter which
continuously enters the alveoli with the inspired
air
3- Alveolar macrophages take care of this
job
They migrate freely over the alveolar epithelium
and ingest particulate matter
Towards the end of their life span, they migrate
either towards the bronchioles, where they
enter the mucus on the epithelium to be finally
discharged into the pharynx, or they enter the
connective tissue septa of the lung
• Move from bronchioles into alveolar duct and alveoli, the cells
lining the respiratory trach changes from typical respiratory cells
(ciliated pseudostratified epithelium (to warm, moist, and clean
the air), into cuboidal without cilia, into finally simple squamous
epithelium (gas exchange))

• Sometime the respiratory epithelial cells are changed

(transformed) into stratified squamous cells (dysplasia) (more
resistant to contaminated air pass on them)

• Smoking cause the cells to loose the cilia and mucus production,
so the smokers have cough to compensate losing of cilia and
mucus, if the smokers become non-smokers, the cells heal and
become ciliated …
 ‫مهم في طرد‬
‫الهواء اثناء الزفير‬
‫ويعود لوضعه‬
‫الطبيعي‪..‬‬
‫‪Recoil‬‬
‫‪ ،‬والناس التي‬
‫عندها نقص في‬
‫الخيوط هذه تعاني‬
• Clara cells secrete surface activation agents, stops the surfaces from collapsing/ sticking
together, and reduce the surface tension between the surfaces
• These cells moisten the surfaces
• We do not want the airways to stick together and therefore prevent the air passing
down their
 Electron microscope
1. interstitium: Area of connective tissue where fluid on the surface of the alveoli can
accumulate and return back from the lung via lymphatic system
7-8 μm in diameter
Macrophage/ dust cell
 Type II

Surfactant reduces the surface tension in the alveoli sacs, during expiration
The pleurae
• The pleura is a serous membrane that lines the thoracic wall and forms the
surface of the lung. It has two layers, visceral and parietal
• The visceral pleura forms the surface of the lung and extends even into the
fissures between the lobes
• At the hilum, it turns back on itself and forms the parietal pleura, which adheres
to the mediastinum, inner surface of the rib cage, and superior surface of the
diaphragm
• An extension of the parietal pleura, the pulmonary ligament, connects it to the
diaphragm
• The space between the parietal and visceral pleurae is called the pleural cavity
• The pleural cavity does not contain the lung; rather, it wraps around the lung,
much like the pericardium wrapping around the heart
• The pleural cavity contains nothing but a thin film of lubricating pleural fluid; the
cavity is only a potential space, meaning there is normally no room between the
membranes
• However, under pathological conditions such as chest wounds, the space can fill
with air or liquid
The pleurae and pleural fluid have three functions:
1. Reduction of friction. Pleural fluid acts as a lubricant that enables the
lungs to expand and contract with minimal friction. Infection of the pleurae
can produce a condition called pleurisy, in which the pleurae roughen and
rub together, making each breath a painful experience.
2. Creation of a pressure gradient. The pleurae play a role, explained
later, in the creation of a pressure gradient that expands the lungs when
one inhales.
3. Compartmentalization. The pleurae, mediastinum, and pericardium
compartmentalize the thoracic organs and prevent infections of one organ
from spreading easily to neighboring organs.