Lecture 4

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THE RESPIRATORY SYSTEM

• The complex of organs and tissue which are


necessary to exchange blood carbon dioxide
(CO2) with air oxygen (O2) is called the
respiratory system. It consists of
• structures, which function as ducts, and which
together are called the conductive portion of
the respiratory system
• structures which form the respiratory portion of
the respiratory system, in which the exchange of
CO2 and O2 is occurring

Nasal Cavity
• The surface of the lateral parts of the nasal
cavity is thrown into folds by bony projections
called conchae. These folds increase the
surface area of the nasal cavity and create
turbulence in the stream of passing air, both of
which facilitate the conditioning (warming,
cooling and filtration) of the air. Mucous and
serous glands in the connective tissue
underlying the epithelium, the lamina propria,
supplement the secretion of the goblet cells.
Veins in the lamina propria

Nasal Cavity Nasal Cavity


• The Nasal cavity is divided into three structurally • Tissues on the superior concha and the nasal septum form
and functionally different parts. the olfactory region. Cilia at that region do not move,
• The vestibules (the first ~1.5 cm of the conductive because they lack dynein arms which are necessary for cilial
portion following the nostrils) are lined with a motility. The cell membrane covering the surface of the cilia
keratinised stratified squamous epithelium. contains olfactory receptors which respond to odour-
Hairs, which filter large particulate matter out of the producing substances, odorants, dissolved in the serous
airstream, and sebaceous glands are also present. covering the epithelium. The axons of the olfactory cells
collect into bundles in the lamina propria.

At the transition from the vestibule to the • The olfactory cells and their processes receive mechanical
respiratory region of the nasal cavity the epithelium and metabolic support from supporting cells (or
becomes first stratified squamous and sustentacular cells). Basal cells can divide and differentiate
into either olfactory or supporting cells.
then pseudostratified columnar and ciliated. The supporting cells and the secretion of the serous glands
Mucus producing goblet cells are present in the contain lipofuscin granules, which give a yellow-brown colour to
epithelium. the surface of the olfactory region.
Nasal Cavity, Olfactory Region, rat - Alcian blue &
The olfactory epithelium van Gieson
• Formed by Olfactory Cells, Sustentacular Cells
and basal cells. Basal cells can be identified by their
location. Sustentacular cells are preferentially
located in the superficial cell.
• Cilia are not visible and goblet cells are absent
from the olfactory epithelium. Cilia do not move,
because they Lack Dynein Arms which are
necessary for cilial motility. The cell membrane
covering the surface of the cilia contains olfactory
receptors which Lightly stained rounded areas in
the lamina propria represent bundles of Olfactory
Axons in the lamina propria. Small mucous glands,
Olfactory Glands Or Bowman's Glands,

Respiratory region of the nasal cavity - H&E, van


Gieson Pharynx
• The pharynx connects the nasal cavity with the
larynx.
• The pharynx is either lined with respiratory
epithelium (nasopharynx) or with a stratified
squamous epithelium (oropharynx), which
also covers the surfaces of the oral cavity and
the oesophagus. Lymphocytes frequently
accumulate beneath the epithelium of the
pharynx.
• Accumulations of lymphoid tissues surrounding
the openings of the digestive and respiratory
passages form the Tonsils.

Pseudostratified Columnar Epithelium Pseudostratified columnar epithelium


• Composed of one Layer of Cells
• All cells of this type of epithelium are in contact with the
basement membrane, but not all of them reach the
surface of the epithelium.
• Nuclei of the epithelial cells are typically located in the
widest part of the cell. Consequently, the nuclei of cells
which do or do not reach the surface of the epithelium
are often located at different heights within the
epithelium and give the epithelium a stratified
appearance.
• The epithelium will look stratified but it is not - hence its
name "pseudostratified".
• Pseudostratified columnar epithelia are found in the
Respiratory System
Larynx
• The vocal folds of the larynx control airflow and
allow the production of sound. The vocal folds
are lined by stratified squamous epithelium
and contain the muscle (striated, skeletal) and
ligaments needed to control the tension of the
vocal folds. The larynx is supported by a set of
U/C shaped cartilages.
• Epithelium covering vocal cords is stratified
squamous type.
• The number of goblet cells is variable and
depends on physical or chemical irritation of
the epithelium which increase goblet cell
number. Prolonged intense irritation of the
epithelium may lead to its transformation to a
stratified squamous epithelium (squamous
metaplasia).

Transition of cartilage
• Trachea C-ring cartilages
• Main Bronchi Complete Ring
• Secondary Bronchi Complete Ring
• Tertiary Bronchi Platelet
• Terminal Bronchi No cartilage

Cartilage Platelets

Tissue from Trachea slides 2-3


Tertiary Bronchiole
Trachea
1. Lumen of the trachea
2. Epithelium of the Trachea
3. Submucosa
4. Sero-mucous Gland
5. Hyaline Cartilage
6. Adventitia
7

Transition of Epithelium
• Trachea Ciliated pseudostratified
3
• Main Bronchi Ciliated pseudostratified
2
1 5
• Secondary Bron. Ciliated pseudostratified
• Tertiary Bronchi Ciliated pseudostratified

8 4
Terminal Bronchi Ciliated & non-ciliated
6 • Respiratory Alveolar 1 & 2

Organ? 40X

Alveolar Cells
Alveolar Duct
• 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.
• 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 large number of granules
called cytosomes (or multilamellar bodies), which
consist of Precursors To Pulmonary Surfactant (the
mixture of phospholipids which keep surface tension
in the alveoli low) . There are less type II cells than
type I cells. But since Type I are smaller in size we
see more type I in one focus of the section.
fusion of basement membrane lungs and kidneys Clinical Application
• Newborn respiratory distress
syndrome (NRDS) happens
when a baby's lungs are
not fully developed and
cannot provide enough
oxygen, causing breathing
difficulties. It usually affects
premature babies. It's also
known as infant respiratory
distress syndrome

Cystic Fibrosis Cystic Fibrosis


– Autosomal recessive Genetic disorder • Pathophysiology
Mutation in CFTR (cystic fibrosis – Mutation in the CFTR gene
transmembrane conductance regulator) gene
– The protein created by this gene is anchored
– Product of this gene makes chloride ion to the outer membrane of cells in the sweat
channel glands, lungs, pancreas, and other affected
• Inherited disease of secretory glands organs
(which make mucous and sweat) – The protein spans this membrane and acts as
A Channel Connecting The Inner Part Of
The Cell (Cytoplasm) To The Surrounding
Fluid
Cystic Fibrosis Cystic Fibrosis
• Pathophysiology • Mucus Becomes Thick And Sticky
– This channel is primarily responsible for
Controlling The Movement Of Chloride • Mucus Builds Up In Lungs And Blocks
From Inside To Outside Of The Cell; Airways
however, in the sweat ducts it facilitates the
movement of chloride from the sweat into the
• Buildup Of Mucus Good Culture & Makes
cytoplasm
It Easy For Bacteria To Grow
– When the CFTR protein does not work,
Chloride Is Trapped Inside The Cells In The
Airway And Outside In The Skin • This Leads To Repeated, Serious Lung
Infections. Over Time, These Infections
Can Severely Damage Lungs

Cystic Fibrosis (GIT)


Healthy and CF Lung
• The thick, sticky mucus also can Block
Tubes, or ducts in pancreas
• As a result, the digestive enzymes that
pancreas makes can't reach small intestine
• Intestines can't fully absorb fats and proteins
• This can cause vitamin deficiency and
malnutrition
• It also can cause bulky stools, intestinal gas,
a swollen belly from severe constipation, and
pain or discomfort

Cystic Fibrosis (SKIN) CF and the Lungs


• Also causes sweat to become very salty • The lungs when affected by CF have very
thick mucous.
• As a result body loses large amounts of • Unlike other parts of the body that it is
salt during sweating unknown why the missing CFTR gene
effects the lungs so greatly.
• This can upset the balance of minerals in • The mucous that builds up is able to hold
blood bacteria so large amounts of bacteria
begin to grow in the lungs.
Definitions
• Emphysema - abnormal permanent enlargement
of the airspace distal to the terminal bronchioles,
accompanied by destruction of their walls and without
obvious fibrosis.
• Chronic Bronchitis - presence of chronic
productive cough for 3 months in each of 2 successive
years…
• COPD - disease state characterized by airflow
limitation that is not fully reversible.

DEFINITION CHRONIC BRONCHITIS


• COPD is characterised by airflow obstruction.
air flow obstruction is usually progressive • Continuous inflammation of the cells lining the
• It is not fully reversible bronchi
• does not change markedly over several months • Mucous hypersecretion
. The disease is pre-dominantly caused by smoking. • Destruction of the cilia, impairing mucous clearance
OCCUPATIONAL EXPOSURE TO RESPIRATORY leading to increased risk of infection
POLLUTANTS:
Chemicals, dust, atmospheric pollutants, inherited tendency Diagnosed by the production of sputum and cough on
most days for three months in two consecutive years

EMPHYSEMA
• Destructive of the alveoli and terminal bronchioles
• Loss of elasticity of smaller airways
• Loss of patency of bronchioles

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