THE RESPIRATORY SYSTEM

Introduction
• The term respiration includes the following distinct
processes:
1. Pulmonary ventilation (breathing)
– mechanical process, moves air into and out of lungs (expiration
+ inspiration)
2. Gas exchange (oxygen loading and carbon dioxide
unloading) between :
– air and blood in lungs which is called external respiration and
– blood and tissue cells in systemic capillaries which is called
internal respiration
3. Oxygen utilization by tissues known as cellular
respiration.
– is the corner stone of all energy producing chemical reactions
in the body
 Introduction
• In addition to gas exchange, the respiratory system
also has the following functions:
– Regulation of blood PH
– Contains receptors for the sense of smell
– Filtration of inspired air
– Production of sound
– Excretion of some water and gets rid of heat in exhaled
air
Components of the Respiratory System
1. Nose
2. Pharynx (throat)
3. Larynx (voice box)
4. Trachea (wind pipe)
5. Bronchi, and
6. Lungs
 Basic anatomy of the respiratory system
• Structurally the respiratory system consist of two parts:
1. Upper respiratory system:- consists of nose, pharynx and
associated structures
2. Lower respiratory system:– consists of larynx, trachea,
bronchi, and lungs
• Functionally the respiratory system consists of two
portions:
1. Conducting portion :- mouth/nose pharynx, larynx, trachea,
bronchus, bronchioles (up to the terminal bronchioles)
- are transporting (conducting) gases to and from the alveoli.
- filter, warm, and moisten inspired air
Structural divisions of the respiratory system
Functional divisions of the respiratory system
2. Respiratory portion:-
respiratory bronchioles,
alveolar ducts,
alveolar sacs, and
alveoli (functional unit of
respiratory system)
- consists of tissues within
the lungs
- is the main site of gas
exchange between air and
blood.
 The conducting passages
• Air is conducted through the oral and nasal cavities
to the pharynx and then through the larynx to the
trachea and bronchial tree.
• These structures deliver warmed and humidified air
to the respiratory division in the lungs.
• The passageways are lined with various types of
epithelia to prepare the air properly for utilization.
• The majority of conducting passages are held
permanently open by muscle on a bony or
cartilaginous framework.
 1. Nose
• Nose is divided into two portions.
1. External part:- is covered by skin and is supported by bones and
cartilages
2. Internal part (nasal cavity):- is the cavity for passage of air.
– nasal septum-divides the nasal cavity into two lateral halves
– nasal septum made up of
• The perpendicular plate of ethmoid bone,
• the vomer,
• the septal cartilage
• Each half is referred to as a nasal fossa.
• Each nasal fossa opens anteriorly through the nostril (or external
nares), and communicates posteriorly with the nasopharynx by
internal nares
 Nasal Cavity
Functions of nasal cavity:
I. Sensation of smell (olfactory
nerves)
II. To provide airway for
respiration
III. To filter, warm and moisten
the inspired air
IV. To cleanse itself of foreign
matter that it extracts from
the air
V. Resonance of voice
 Nasal Cavity
- is surrounded by rings of air filled cavities called
paranasal sinuses which open into nasal cavity. Those
are:
1. Frontal
2. Sphenoidal
3. Ethmoidal, and
4. Maxillary sinuses
- the nasolacrimal duct also opens into the nasal cavity
to transport a tear from lacrimal sac into nasal cavity
Paranasal Sinuses
 Lining of the Nasal Cavity
• The surface of the nasal cavity is lined by two
types of epithelium:
1. Nasal epithelium
– Mucous secreting goblet cells
– Pseudo stratified ciliated columnar cells
2. Olfactory epithelium
– lines suppero-posterior part of the nasal cavity
– sensory endings from olfactory nerve (sensation of
smell)
 2. Pharynx
• is a funnel shaped
passageway:
starts at the internal
nares, and extends to
the level of the cricoid
cartilage .
lies posterior to the
nasal and oral cavities
superior to the larynx
and
anterior to the cervical
vertebrae.
 Functions of Pharynx
- is a passageway for
air and food
- Provides
resonating chamber
for speech sounds
- houses the tonsils –
which have
immunological
reaction against
foreign invaders.
 Portions of Pharynx
• Pharynx is divided in to three anatomical
regions:
A. Nasopharynx
B. Oropharynx
C. Laryngopharynx

A. Nasopharynx

B. Oropharynx

C. Laryngopharynx
A. Nasopharynx
• Nasopharynx lies posterior to the nasal cavity
• Nasopharynx has five openings into its wall.
• two internal nares
• two openings to the auditory tubes(eustachian tubes)
• opening into the oropharynx
• Through the internal nares, it receives air from the
nasal cavity and packages of dust-laden mucus.
• Its posterior wall contains pharyngeal tonsils.
• Exchanges small amount of air with the middle ear
through the Eustachian tubes to equalize air
pressure between the two chambers.
Nasopharynx
B. Oropharynx
• lies posterior to the oral cavity and extends from
the soft palate to the level of hyoid bone
• has opening - the fauces - the opening to the oral
cavity .
• Has both respiratory and digestive functions; (a
common passageway for air, food and drink).
• Has two pairs of tonsils:
1. Palatine tonsils
2. Lingual tonsils
• Has roof, floor, posterior and anterior walls.
 C. Laryngopharynx
• begins at the level
of the hyoid bone
• opens in to the
esophagus
posteriorly and
larynx anteriorly
• is both respiratory
and digestive
passageway.
 3. Larynx (voice box)
• is a short passageway that connects the
laryngeopharynx and the trachea.
• lies in the midline of the neck anterior to the 4th - 6th
cervical vertebrae
• Its wall is composed of nine pieces of cartilages
 Three single

→ cricoid cartilage
 Three paired → arytenoid cartilages

→ corniculate cartilage
• The larynx is connected to the structures of the throat by
extrinsic muscles, whereas the cartilages are connected
to each other by intrinsic muscles.
Laryngeal cartilages

23
 The epiglottis
• is a cartilaginous flap behind the root of the tongue
which helps to close the glottis (laryngeal opening)
during swallowing.
• Two pairs of strong connective tissue bands are
stretched across the upper opening of the larynx from
the thyroid cartilage anteriorly to the arythenoid
cartilages posteriorly.
– These are the true vocal cords and the false vocal
cords.
– The false vocal cords are not involved in sound
production.
• Intrinsic muscles alter the length, position, and tension
of the vocal cords upon contraction.
24
 Structures of Voice Production
• Mucous membrane of the larynx forms two pairs of folds;
1. superior pair called false vocal folds (ventricular folds)
– false vocal cords - support the true vocal cords and do not
produce sound
2. Inferior pair called the true vocal cords
– true vocal cords- produce sound because they have vocalis
muscle
• Note: The space between the true vocal cords is known
as rima glottidis.
Structures of Voice Production
 Due to the influence of androgens;
• the vocal cords are usually thicker and longer in
males than females, therefore they vibrate more
slowly
• the men’s voice generally has a lower range of pitch
than women’s
• Sound originates from vibration of the vocal cords,
but other structures (pharynx, nose & mouth) are
necessary for converting the sound in to
recognizable speech.
• Muscles of the face, tongue, and lips help to
pronounce (articulate) words.
 4. Trachea ( Wind pipe )
- is a tubular passageway for air
- located anterior to the esophagus.
- extends from the larynx (cricoid cartilage) to the superior
border of the 5th thoracic vertebra (T5)
• Layers of Trachea from inner to outer;
1. mucosa, 3. hyaline cartilage,
2. submucosa, 4. adventitia,
• Mucosa is lined by pseudostratified ciliated columnar
epithelium.
• Macroscopically it is composed of 16-20 incomplete rings of
hyaline cartilage that resemble the letter “c” arranged one
above the other.
 Trachea
• The free space of the
cartilage rings looks
posteriorly and faces
the esophagus and is
completed by
membranous part
(connective tissue
and trachialis
muscle).
• This gives a space for
expansion of the
esophagus during
swallowing.
 5. Bronchi
• At the lower border of the 4th thoracic vertebra, the
trachea bifurcates into right and left primary
(principal) bronchi; which enter the respective lungs.
• The right primary bronchus is more vertical, shorter,
and wider than the left.
• As a result, when ever there is aspiration of foreign
body, it is more likely to enter the right primary
bronchus than the left.
• The primary bronchi contain incomplete rings of
cartilages and are lined by pseudostratified ciliated
columnar epithelium.
 Bronchi
• The primary bronchi divide into secondary (lobar)
bronchi
• The right lung has three lobes, so it has three lobar
bronchi; whereas the left lung has two lobes and
receives two lobar bronchi.
• The secondary bronchi continue to branch, forming
tertiary (segmental) bronchi, that supply the segments
of the lungs, and then divide into bronchioles.
• Bronchioles in turn divide repeatedly forming terminal
bronchioles.
 Bronchi
• As the branching becomes extensive in the bronchial tree,
many structural changes occur.
1.The epithelial lining changes from pseudostratified
ciliated columnar ciliated simple columnar
ciliated simple cuboidal non-ciliated simple cuboidal
epithelium
2. Incomplete rings of cartilages are gradually replaced by
plate of cartilages; and then finally the plates of cartilages
disappear in the distal bronchioles.
3. As the amount of cartilage decreases the amount of
smooth muscles increase
 6. Lungs
• are two cone–shaped, spongy organs of respiration attached to the
heart and trachea by their roots
• The lungs extend from the diaphragm to just slightly above the
clavicles.
– The lower part of the lungs is the base.
– The narrow superior part is called the apex.
• are covered by double layered serous membrane called pleura
 the superficial layer lines the wall of the thoracic cavity and is called
parietal pleura, and
 the deep layer is called visceral pleura, that covers the lungs.
– The space between the parietal and visceral layers; is called
pleural cavity.
• filled with a serous fluid from the membranes
– decreases friction between the membranes
Pleura
 Lungs
• The space between the parietal and visceral layers; is called
pleural cavity.
– filled with a serous fluid from the membranes
• decreases friction between the membranes
• The lungs extend from the diaphragm to just slightly above the
clavicles.
• The lower part of the lungs is the base.
• The narrow superior part is called the apex.
• The area where bronchi, pulmonary arteries and veins,
lymphatic and nerve plexuses enter and leave the lungs is called
the hilus, and the bundle of structures is called the root of the
lungs.
• On the anterior border of the left lung there is an interruption
called the cardiac notch in which the heart lies.
Lungs
 Lungs
As a result the left lung is smaller than the right lung.
The right lung is shorter than the left lung as the right
dome of the diaphragm is at higher level than the left
due to the presence of the liver in the right upper
quadrant.
Fissures, Lobes and Lobules
• The lungs are divided into lobes by fissures.
• Both lungs have an oblique fissure.
• The right lung has also a horizontal fissure.
• The left lung has two lobes (U&L)
• The right lung has three lobes (upper, middle and
lower)
Lungs
 Lungs
• Each lobe gets its own lobar (secondary) bronchus,
thus the right primary bronchus gives three lobar
bronchi, while the left primary bronchus gives two
lobar bronchi.
• Lobar bronchi give rise to tertiary (segmental)
bronchi.
• There are ten segmental bronchi on both lungs.
• Each segment of the lungs contains many small
compartments called lobules, which are separated by
connective tissue, and contains lymphatic vessels,
blood vessels, and bronchioles.
Bronchopulmonary segment of the lung
• refers to a partition of
lung tissue supplied by
segmental (tertiary)
bronchus & a segmental
branch of pulmonary
artery.
• is anatomical &
functional unit of the
lung which is important
clinically for surgeons to
remove the diseased
segment of lung
 Trachea
↓
Right primary bronchus Left primary bronchus
↓ ↓
3 Lobar bronchi 2 Lobar bronchi
↓ ↓
10 segmental bronchi 10 segmental bronchi
Bronchioles
↓
Terminal Bronchioles
↓
Respiratory Bronchioles
↓
Alveolar ducts
↓
Alveolar sac
↓
Alveolus
 Differences between the two lungs
• ??
 Alveoli
• are cup-shaped out pouchings lined by simple
squamous epithelium and supported by thin elastic
basement membrane.
• are about 300 million air filled units
• Alveolar sac: consists two or more alveoli that share
a common opening
• The wall of the alveoli contains two types of epithelial
cells.
1. Type I alveolar cells
- are the predominant cells
- simple squamous epithelial cells
- form the lining of the alveolar wall
Alveoli
 Alveoli
2. Type II alveolar cells (septal cells)
– are fewer in number and are found between type I cells
– are cuboidal epithelial cells which contain microvilli
– secrete alveolar fluid; which keeps the surfaces between
the cells and air moist
– also secrete surfactant - decreases the surface tension of
alveolar fluid, which decreases the tendency of alveolar
collapse.
• In the wall of the alveoli, there are alveolar macrophages
(dust cells), that remove fine dust particles.
• Exchange of O2 and CO2 between the air spaces in the lungs
and the blood takes place by diffusion across the
respiratory membrane
The respiratory membrane consist of:
1. epithelium of the alveolar wall
2. basement membrane of the alveolar wall
3. capillary basement membrane
4. endothelial cells of the capillary.
Muscles of inspiration include
– Diaphragm
– external intercostals muscles
During inspiration:
– the diaphragm contracts
– the lungs enlarge
– intra
intra--alveolar pressure decreases
– ribs elevate
– abdominal pressure is increased
– abdominal volume is decreased
– thoracic volume is increased and the opposite is true for
expiration.
– All this events happen due to the activities of muscles
 Clinical correlations
Asthma
- an allergic condition that involves the respiratory system
causing spasm of smooth muscles result in constriction of
air passage
Bronchitis or tracheobronchitis;
- inflammation of the bronchi or tracheobroncheal tree &
may results in narrowing/ blocking of the air way passage
 Emphysema
– disease that cause breakdown of alveolar septa
resulting in decrease surface area for gas exchange
 Sinusitis
– inflammation of paranasal sinuses
 Clinical correlations
Laryngitis
- inflammation of the larynx, most often caused by a
respiratory infection or irritants such as cigarette smoke.
 Inflammation of the vocal cords causes hoarseness of
voice by interfering with contraction of the folds or by
causing swelling of the folds → decrease vibration.
Cancer of the larynx:
- is found almost exclusively in individual who smoke.