THE RESPIRATORY

SYSTEM
 FUNCTIONS OF RESPIRATORY SYSTEM

• Provides an extensive area for gas exchange between air & circulating blood

• Moving air to & from the exchange surfaces of the lungs

• Protects respiratory surfaces from dehydration, temperature changes & other

environmental variations

• Defend respiratory system & other tissues from invasion by pathogenic micro-
organisms

• Produce sounds involved in speaking, singing or non-verbal communication

• Assists in regulation of blood volume, blood pressure & the control of body fluid
pH
 ORGANIZATION OF RESPIRATORY SYSTEM
Upper respiratory system
• Nose

• Nasal cavity

• Paranasal sinuses
Filters, warms & humidifies air

• Pharynx

Lower respiratory system

• Larynx

• Trachea

• Bronchi

• Lungs
 RESPIRATORY TRACT

Consists of airways that carry air to & from exchange surfaces of lungs

Conducting portion : Extends from

entrance to nasal cavity to smallest
bronchioles of lungs

Respiratory portion : Includes

respiratory bronchioles & air sacs
(alveoli)

By the time air reaches lung alveoli, most foreign particles &
pathogens have been removed due to filtering, warming &
humidification of air- due to properties of respiratory epithelium
 RESPIRATORY EPITHELIUM
• Consists of pseudostratified, ciliated,
columnar epithelium with goblet cells.

• Lines entire respiratory tract except for

finest conducting portions & alveoli

• Goblet cells & mucus glands beneath

epithelium produce a sticky mucus
that bathes exposed surfaces

• In nasal cavity, cilia sweep any debris

trapped in mucus or micro-organisms
toward pharynx where it will be
swallowed & exposed to enzymes &
acids of stomach
UPPER RESPIRATORY
SYSTEM
 NOSE & NASAL CAVITY
• Nose is primary passageway for air
entering respiratory system
• Air enters paired external nares that open
into nasal cavity
• Vestibule : portion of nasal cavity
contained within flexible tissues of
external nose
• Vestibule contains coarse hair that trap
foreign particles
• Nasal septum : divides cavity into right &
left halves
• Bony portion of nasal septum is formed
by perpendicular plate of ethmoid &
vomer
• Anterior portion of septum is formed by
hyaline cartilage
 NOSE & NASAL CAVITY

Maxillary, nasal, frontal, ethmoid & sphenoid bones form lateral &
superior walls of nasal cavity
 NASAL CAVITY… Lateral wall
• Projecting from lateral wall are:

• Superior, middle & inferior conchae

• Air flows between adjacent

conchae through superior, middle
or inferior meatuses (narrow
grooves)

• Incoming air bounces off conchal

surfaces creating turbulence which
causes small air borne particles to
come into contact with mucus that
lines cavity

• In addition to promoting filtration,

turbulence allows extra time for
humidifying & warming incoming
air
 NASAL CAVITY… Floor
• Formed by hard palate (maxillary & palatine bones)
• Soft palate extends posterior to hard palate marking boundary line between superior
nasopharynx & rest of pharynx
• Nasal cavity opens into nasopharynx at internal nares
 THE PHARYNX
• Nose, mouth, throat connect each other by a common passageway called pharynx
• Pharynx is shared by digestive & respiratory systems
• Extends between internal nares & entrance to larynx & esophagus
• Has three regions : nasopharynx, oropharynx, laryngopharynx
 NASOPHARYNX

• Superior part of pharynx

• Connected to posterior portion of

nasal cavity via internal nares

• Separated from oral cavity by soft

palate

• Lined by respiratory epithelium

• Pharyngeal (adenoid) tonsil is located

on posterior wall

• Lateral walls contain openings of

auditory tubes
 OROPHARYNX
• Extends between soft palate & base of
tongue at level of hyoid bone

• Posterior portion of oral cavity &

posterior & inferior portions of
nasopharynx communicates directly with
oropharynx

• At boundary between naso & oropharynx

epithelium changes from respiratory
epithelium to stratified squamous
epithelium

• Soft palate supports uvula & two pairs of

pharyngeal arches

• Anterior palatoglossal arch

Palatine tonsil
• Posterior palatoglossal arch lies in between
 LARYNGOPHARYNX
• Includes that portion of pharynx lying between hyoid bone & entrance to esophagus
• Most inferior portion of pharynx
• Lined by stratified squamous epithelium
 THE LARYNX
• Inspired air leaves pharynx by passing through a narrow opening – glottis
• Larynx surrounds & protects glottis
• Larynx begins at C4 & ends at C7 vertebral levels
• Larynx essentially is a cylinder whose cartilaginous walls are stabilized by ligaments & muscle
 CARTILAGES OF LARYNX

UNPAIRED

• Thyroid
• Cricoid
• Epiglottis
 CARTILAGES OF LARYNX
THYROID CARTILAGE

• Largest laryngeal cartilage

• Forms most of anterior & lateral

walls of larynx

• Commonly called Adams Apple

(laryngeal prominence)

• Inferior surface articulates with

cricoid

• Superior surface has ligamentous

attachments to epiglottis & other
smaller laryngeal cartilages
 CARTILAGES OF LARYNX
CRICOID CARTILAGE
• Ring shaped

• Posterior portion greatly

expanded providing support
in absence of thyroid
cartilage

• Cricoid & thyroid cartilages

protect glottis & entrance to
trachea & their broad
surfaces provide sites for
laryngeal muscles &
ligaments

• Superior surface of cricoid

articulates with arytenoid
cartilages
 CARTILAGES OF LARYNX
• Leaf shaped EPIGLOTTIS
• Projects above glottis
• Has attachments to thyroid cartilage &
hyoid bone
• During swallowing, larynx is elevated,
epiglottis fold back over glottis, preventing
entry of liquid or solid food into respiratory
passageways
 CARTILAGES OF LARYNX

PAIRED
Arytenoid Corniculate Cuneiform
 CARTILAGES OF LARYNX
PAIRED
Arytenoid cartilages (ladle shaped) : articulate with superior border of enlarged portion of
cricoid cartilage
Corniculate cartilages (horn shaped): articulate with arytenoid cartilages. Corniculate & arytenoid
cartilages are involved in opening & closing the glottis & production of sound
Cuneiform cartilages (wedge shaped): Lies within aryepiglottic fold that extends between lateral
aspects of each arytenoid cartilage & epiglottis
 LARYNGEAL LIGAMENTS
• Intrinsic ligaments bind all 9
cartilages together to form
larynx
• Extrinsic ligaments attach
thyroid cartilage to hyoid bone &
cricoid cartilage to trachea
• Ventricular & vocal ligaments
extends between thyroid
cartilage & arytenoids
• Ventricular & vocal ligaments
covered by folds of laryngeal
epithelium that project into
glottis
• Ventricular ligaments lie within
superior pair of folds –
ventricular folds (inelastic & help
prevent foreign objects from
entering glottis & provide
protection for more delicate
vocal folds
 THE TRACHEA
• Trachea is a tough, flexible tube with diameter of
2.5cm & length of 11cm
• Begins anterior to C6 vertebra in a ligamentous
attachment to cricoid cartilage
• Ends in mediastinum at level of T5 vertebra
• Branches to form right & left primary bronchi
• Lining of trachea consists of respiratory
epithelium overlying a layer of looser connective
tissue (lamina propria)
• Trachea contains tracheal cartilages
• Each tracheal cartilage is bound to neighboring
cartilages by elastic annular ligaments
• Tracheal cartilages stiffen tracheal walls & protect
airway
• Also prevent its collapse or overexpansion as
pressures change in respiratory system
 THE TRACHEA
• Each tracheal cartilage is C shaped

• Closed portion of C protects anterior &

lateral surfaces of trachea

• Open portion of C faces posteriorly toward

oesophagus

• Because cartilages do not continue

around trachea, posterior tracheal wall can
easily distort during swallowing permitting
passage of large masses of food

• Trachealis : An inelastic ligament & band

of smooth muscle connecting ends of
each tracheal cartilage
 PRIMARY BRONCHI
• Right & left primary bronchi
• Carina marks line of separation between 2
bronchi
• Has cartilaginous C shaped supporting rings
• Right primary bronchus – larger diameter than
left & descends towards lung in steeper angle
• Hilum of lung : Access for entry of pulmonary
vessels, nerves, bronchi
THE PLEURA
 THORACIC CAVITY
• Cavity of thorax contains right & left pleural cavities completely invaginated & occupied by
lungs
• Right & left pleural cavities separated by thick median partition called mediastinum
• Heart lies in mediastinum
 INTRODUCTION
• Pleura is a serous membrane lined by mesothelium
• Two pleural sacs – one on either side of mediastinum
• Pleural sac invaginated from medial side by lung so it has outer layer
(parietal pleura) & inner layer (visceral pleura)
• Two layers continuous with each other around hilum of lung & enclose
between them a potential space (pleural cavity)
 PULMONARY PLEURA
• Covers surfaces & fissures of lung except at hilum & along attachment of
pulmonary ligament where it is continuous with parietal pleura
• Firmly adherent to lung & cannot be removed from it
 PARIETAL PLEURA
Lines pulmonary cavities & thus adheres to thoracic wall, mediastinum &
diaphragm. Has 4 parts:
Extends into neck
about 2 inches
Pleural cupula/
above 1st costal
cartilage & one dome of pleura
inch above medial
1/3 clavicle; covers
apex of lung Lines corresponding surface
of mediastinum; reflected
Lines thoracic wall over root of lung & becomes
(ribs, intercostal continuous with pulmonary
spaces)
pleura around hilum

Lines superior
surface of
diaphragm
 PULMONARY LIGAMENT
DEFINTION : Parietal pleura surrounding root of lung extending downward beyond
root as a fold

• Function: Provides

space into which

pulmonary veins can

expand during

increased venous

return; lung root also

descends into it with

descent of diaphragm
 PULMONARY VENTILATION

REFERS TO PHYSICAL MOVEMENT OF AIR INTO & OUT

OF BRONCHIAL TREE
RESPIRATORY MUSCLES
Contraction of diaphragm – increases volume of thoracic cavity – draws
air into lungs

Inspiration: elevate ribs Expiration: depress ribs

External & internal inercostal Transversus thoracis

SCM; pectoralis minor; scalenes Abdominal obliques

Serratus anterior Rectus abdominis

 THE LUNGS
• Lungs : pair of respiratory organs situated in thoracic cavity
• Each lung invaginates corresponding pleural cavity
• Right & left lungs separated by mediastinum
• Right & left lungs situated in right &
left pleural cavities
• Each lung is a blunt cone with apex
pointing superiorly
• Base of lung rests on diaphragm
 FISSURES & LOBES OF LUNG … RIGHT LUNG
• 3 lobes – viz. : superior, inferior, middle lobes
• Superior lobe separated from middle lobe by horizontal fissure
• Middle lobe is separated from inferior lobe by oblique fissure
• Horizontal fissure runs at level of 4th costal cartilage; meets oblique fissure in
midaxillary line
 FISSURES & LOBES OF LUNG … LEFT LUNG
• 2 lobes viz. : superior & inferior
• Separated by oblique fissure
• Tongue shaped projection of left lung below cardiac notch is called LINGULA ;
corresponds to middle lobe of right lung
 DIFFERENCES BETWEEN RIGHT & LEFT LUNGS

RIGHT LUNG LEFT LUNG

• Has 2 fissures, 3 lobes 1. 1 fissure, 2 lobes

• Anterior border straight 2. Anterior border interrupted by cardiac notch
• Larger, heavier (700g) 3. Smaller, lighter (600g)
• Shorter, broader 4. Longer, narrower
 STRUCTURES RELATED TO MEDIASTINAL
SURFACE OF RIGHT LUNG

• Right atrium & auricle

• A small part of right

ventricle

• Superior vena cava

• Lower part of right

brachiocephalic vein

• Azygos vein

• Oesophagus

• Inferior vena cava

• Trachea

• Right vagus nerve

• Right phrenic nerve

 STRUCTURES RELATED TO MEDIASTINAL
SURFACE OF LEFT LUNG

• Left ventricle, auricle,

infundibulum & adjoining part
of right ventricle
• Pulmonary trunk
• Arch of aorta
• Descending thoracic aorta
• Left subclavian artery
• Thoracic duct
• Oesophagus
• Left brachiocephalic vein
• Left vagus nerve
• Left phrenic nerve
• Left recurrent laryngeal nerve
 THE BRONCHI
RIGHT
LEFT
SUPERIOR LOBAR
SUPERIOR LOBAR
MIDDLE LOBAR 1º BRONCHI
INFERIOR LOBAR
INFERIOR LOBAR

2º BRONCHI (LOBAR BRONCHI)

3º BRONCHI (SEGMENTAL BRONCHI)

SUPPLIES AIR TO SINGLE

BRONCHOPULMONARY SEGMENT

10 RIGHT 8/9 LEFT

DIFFERENCES BETWEEN RIGHT & LEFT BRONCHI
RIGHT BRONCHUS LEFT BRONCHUS

• Shorter Longer
• Wider Narrower
• Runs more vertically Wider angle
 CLINICAL IMPACT

FOREIGN BODY IN RIGHT MAIN BRONCHUS

TERTIARY BRONCHI
 WHAT IS A BRONCHOPULMONARY SEGMENT?
• Largest subdivision of a lobe
• Separated from adjacent segments by septa
• Supplied by segmental bronchus & tertiary branch of pulmonary artery
• Drained by intersegmental parts of pulmonary veins
• Surgically resectable
BRONCHOPULMONARY SEGMENTS
 BRONCHOPULMONARY SEGMENTS

Each lobe of lungs can be divided into smaller units – bronchopulmonary

segment; Have names that correspond to tertiary bronchi
BRONCHOPULMONARY SEGMENTS
BRONCHOGRAM
BRONCHIOLES
3º BRONCHI

TERMINAL BRONCHIOLES

RESPIRATORY BRONCHIOLES

THINNEST, MOST DELICATE

BRANCHES OF BRONCHIAL
TREE ; DELIVER AIR TO THE
EXCHANGE SURFACES OF LUNG

ALVEOLI
 ALEVOLAR DUCTS &
ALVEOLI

Respiratory bronchioles connected to

alveoli along regions called alveolar
ducts
Passageways end at alveolar sacs
Each lung has 150 million alveoli –
gives lung spongy appearance
 ALEVOLUS & RESPIRATORY MEMBRANE

Type 1 cells : squamous epithelial cells

Type II cells : septal or surfactant cells

Secrete surfactant which

coats inner surface of each
alveolus

• Reduces surface tension in

fluid coating alveolar surface
• Without surfactant alveoli
would collapse
 ARTERIAL SUPPLY OF LUNGS

• Bronchial arteries arise from systemic circulation & supply lung & its
associated tissues with nutrients
• Left bronchial artery arises from descending thoracic aorta; right
bronchial artery arises from 3rd posterior intercostal artery
 VENOUS DRAINAGE OF LUNGS

• Bronchial veins drain lung tissues

• Right bronchial vein drains into azygos vein; left bronchial vein drains into
accessory hemiazygos vein or left superior intercostal vein
SUPERFICIAL LYMPHATICS OF LUNG
SUPERFICIAL (SUBPLEURAL) LYMPHATIC PLEXUS
(drains lung tissue & visceral pleura)

BRONCHOPULMONARY (HILAR) LYMPH NODES

 DEEP LYMPHATICS OF LUNG
DEEP LYMPHATIC PLEXUS
(drains structures forming root of lung)

PULMONARY LYMPH NODES

(root of lung)

BRONCHOPULMONARY LYMPH NODES

TRACHEOBRONCHIAL LYMPH NODES

(around bifurcation of trachea & main bronchi)

BRONCHOMEDIASTINAL TRUNKS

R: RIGHT LYMPHATIC DUCT L: THORACIC DUCT

TERMINATE AT JUNCTION OF SUBCLAVIAN & INTERNAL JUGULAR VEINS

LYMPH NODE SWELLING
CLINICAL IMPLICATIONS
SMOKER’S LUNG
 TUBERCULOSIS (TB)
• Contagious bacterial disease that primarily involves lungs
• TB may develop after inhaling infected droplets sprayed into air from a cough or
sneeze of someone infected with Mycobacterium tuberculosis