The Respiratory System

The Respiratory System

 This consists of the lungs and the air passages that lead to and form the lungs.
 The air passages branch as they enter the lungs to finally form alveoli.

 This system has 3 functions:

1. Air conduction;
2. Air filtration;
3. Gas exchange (respiration).

 Also air passing through the larynx gives rise to speech and air passing over the olfactory mucosa leads to
our sense of smell.
 Air passages consist of a conducting portion and a respiratory portion.
 The conducting portion is the air passages that lead to the sites of respiration so gas exchange can
occur.

 The passages external to the lungs are:

1. Nasal cavities;
2. Nasopharynx and oropharynx;
3. Larynx;
4. Trachea;
5. Paired primary bronchi.

 Bronchi within the lungs branch extensively to form bronchioles, which are the terminal part of
the conducting system.
 The respiratory portion is the part of the tract where gaseous exchange takes place and includes:
1. Respiratory bronchioles;
2. Alveolar ducts;
3. Alveolar sacs;
4. Alveoli.
 Capillaries within the lungs come into intimate contact with the alveoli and are the structural basis of gas
exchange in the lung parenchyma.
 Conditioning of the air before it reaches the respiratory portion occurs and consists
of warming, moistening, and removal of particulate material.
 Mucous and serous secretions are very important in the conditioning process and also stops
dehydration of the underlying epithelium.
 Mucous is produced from goblet cells and mucus-secreting glands.
 Cilia push mucous into the pharynx.
 Vibrissae are small hairs that trap particulate material.

Nasal cavities
 The nasal cavities have 3 regions:
1. Vestibule;
2. Respiratory segment;
3. Olfactory segment.
 The paranasal sinuses are filled with respiratory epithelium.

The Vestibule of the Nasal Cavity

 The vestibule communicates anteriorly with the environment and is lined by stratified squamous
epithelium and contains vibrissae.
 Sebaceous glands are present and also assist in the entrapment of particulate matter.
 Posteriorly, the epithelium changes to ciliated pseudostratified columnar epithelium of the respiratory
portion.

The Respiratory Portion of the Nasal Cavity

  The respiratory portion has its lamina propria attached to the underlying bone.
 The medial wall is the nasal septum.
 The lateral wall contains conchae.
 The conchae increase the surface area and cause turbulence in the airflow to allow more efficient
conditioning of air and also the removal of particulate matter via turbulent precipitation.
 The epithelium consists of 5 types:
1. Ciliated cells;
2. Goblet cells;
3. Brush cells (have short blunt microvilli);
4. Small granule cells (contain secretory granules);
5. Basal cells (stem cells).
 The lamina propria of the respiratory segment has a rich vascular network.
 This allows inhaled air to be warmed, and also contains mucus glands, many with serous demilunes.
 It is directly contiguous with the periosteum of the underlying bone.
 The laminae propria also contains blood and lymphatic vessels, unmyelinated olfactory
nerves, myelinated nerves and the olfactory glands (Bowman's glands).

The Olfactory Portion of the Nasal Cavity

 The olfactory segment is lined by the olfactory mucosa.
 It is also pseudo-stratified but contains very different cells:
1. Olfactory cells, bipolar neurons;
2. Supporting or sustentacular cells (columnar cells providing mechanical and metabolic support of olfactory
cells, and microvilli);
3. Basal cells;
4. Brush cells (have short blunt microvilli and are columnar, they appear to be involved in the transduction of
general sensory stimulation of the mucosa to CNV).
 Olfactory cells are bipolar neurons that possess an apical projection called the olfactory
vesicle bearing cilia.
 The olfactory glands are tubuloalveolar serous glands, which deliver secretions via ducts to the
surface.
 The serous secretions remove odours so that new scents can be smelt.

Pharynx
 This part connects the nasal and oral cavities to the larynx and the oesophagus.
 It provides a resonating chamber for speech.
 This is divided into nasopharynx, oropharynx and laryngopharynx.

Larynx
 This is the passageway of air between the oropharynx and the trachea.
 It serves as the organ of speech.
 The vocal folds are 2 folds of mucosa that project into the lumen of the larynx in an anteroposterior
direction.
 In each are the vocal ligament and the vocalis muscle.
 Intrinsic skeletal muscles join cartilage plates and generate tension in the vocal
folds and open and close the glottis.
 This is important for pitch.
 Extrinsic laryngeal muscles move larynx during swallowing.
 Above the vocal folds is the laryngeal ventricle, an elongated recess.
 Above this are the false vocal cords, or the vestibular folds.
 These are important for resonance.
 The larynx lined by ciliated, pseudostratified columnar epithelium, but the luminal surface of the vocal
fold is lined by stratified squamous epithelia.

Trachea
 This extends from larynx to the middle of the thorax and divides into two primary bronchi.
 The wall of the trachea has 4 layers:
1. Mucosa (ciliated, pseudostratified epithelium and elastic fibre-rich lamina propria);
 2. Submucosa (denser connective tissue);
3. Cartilaginous layer (C-shaped cartilages);
4. Adventitia (binds trachea to other structures).
 The trachealis muscle bridges the gap in the cartilage.

Mucosa of the Tracheal Wall

 The epithelium is similar to respiratory epithelium in other parts of the conducting system.
1. Ciliated cells (remove small inhaled particles from the lungs);
2. Mucous cells (lack cilia and look like goblet cells);
3. Brush cells (columnar cells that bear microvilli, and the basal surface is in synaptic contact with an afferent
nerve ending so is a receptor cell);
4. Small granule cell;
5. Basal cell (serve as a reserve population by maintaining individual cell replacement in the epithelium).
 A thick basement membrane is characteristic of tracheal epithelium.
 The lamina propria appears as typical loose connective tissue.
 It is very cellular and contains many lymphocytes, which infiltrate the epithelium.
 Furthermore, there are also plasma cells, mast cells, eosinophils and fibroblasts.
 The lymphatic tissue in diffuse and nodular forms.

Submucosa of the Tracheal Wall

 There is an elastic membrane that marks the boundary between the lamina propria and
the submucosa.
 The submucosa is loose connective tissue.
 Diffuse lymphatic tissue and nodular lymphatics are found.
 The submucosa also has mucous-secreting acini with serous demilunes.
 These have ducts that extend to the epithelium (simple cuboidal).
 This layer ends when the connective tissue blends with the perichondrium of the cartilage.

Adventitia of the Tracheal Wall

 The adventitia lies peripheral to the tracheal rings and the trachealis muscle.
 It contains large blood vessels and nerves supplying the tracheal wall and also the lymphatics draining
it.

Bronchi
 The trachea divides into the primary bronchi (extrapulmonary, left and right).
 The right is wider and shorter than the left.
 The primary bronchi enter the lung and become intrapulmonary and branch to give lobar bronchi.
 The left lung has 2 lobes and the right lung has 3 lobes.
 Each lobe receives a lobar bronchus.
 The left lung is further divided into 8 bronchopulmonary segments and the right into 10.
 Each segment gets a segmental bronchus.
 Bronchi have the same structure as the trachea but where they becomes intrapulmonary, the cartilage
rings become cartilage plates of irregular shape.
 These cartilage plates are arranged to give the circular shape of the bronchi.
 As branching occurs plates become smaller and less.
 Smooth muscle appears upon entering the lung and increases as cartilage decreases.
 As there is smooth muscle in the wall of the bronchus, it can be considered to have 5 layers:
1. Mucosa;
2. Muscularis;
3. Submucosa;
4. Cartilage layer;
5. Adventitia.
 At 1 mm diameter, the cartilage plates disappear and it becomes a bronchiole.

Bronchioles
  The bronchopulmonary segments are further subdivided into pulmonary lobules; each supplied by
a bronchiole.
 Lobules are composed of pulmonary acini.
 Each pulmonary acinus is made up of a terminal bronchiole, and the respiratory
bronchioles and alveoli it aerates.
 The respiratory bronchiolar unit consists of a single respiratory bronchiole and alveoli.
 The epithelium changes from ciliated, pseudostratified columnar to simple cuboidal as the size
decreases.
 The number of glands decreases.
 Clara cells increase as the ciliated cells decrease in number.
 These cells produce a lipoprotein (a surfactant) that prevents luminal adhesion should airway fold on
itself.
 There are small amounts of connective tissue.
 Outpocketings of the respiratory bronchiole are the alveoli.
 It is here that the gas exchange occurs.

Alveoli
 Each alveolus is confluent with a respiratory bronchiole by means of an alveolar duct (elongated
airways with almost no walls only alveoli) and an alveolar sac (spaces surrounded the alveolus).
 Alveoli are separated from one another by a thin connective tissue layer (alveolar septum) with many
capillaries.
 Alveolar epithelium is composed of:
1. Type I pneumocytes (squamous, 95 % of surface area);
2. Type II pneumocytes (secretory, cuboidal cells, 5% of surface area, they bulge into the lumen and are filled
with granules called lamellar bodies which contain a surfactant that is secreted onto the surface of the
alveoli to reduce surface tension);
3. The occasional brush cell.
 Components of the alveolar septum:
1. Alveolar epithelial cells;
2. Basal laminae of alveolar epithelium;
3. Basal laminae of the capillary endothelium;
4. Endothelial cells;
5. Fibroblasts, macrophages, collagen fibres and elastic fibres.
 The air-blood barrier is the cells and cell products across which gases may diffuse between the alveolar
compartment and the capillary compartment.
 The thin portion is for most of the gas exchange and the thick portion is a site in which tissue fluid can
accumulate, which is drained by lymphatics of the terminal bronchiole.
 Alveolar macrophages remove inhaled particulate matter from the air spaces and red blood cells from the
septum.
 Collateral air circulation through alveolar pores allows air to pass between alveoli.

Blood Supply
 The pulmonary circulation supplies the capillaries of the alveolar septum and is derived from
the pulmonary artery.
 The bronchial circulation, via bronchial arteries, branches from the aorta and supplies the whole lung.
 The 2 circulations anastomose at the level of the junction between the conducting and respiratory
passages.

Lymphatic Vessels
 One set of lymphatic vessels drains the parenchyma of the lung and follows the air passages.
 The second set drains the surface of the lung and travels in the connective tissue of the visceral
pleura.

Nerves
 There are parasympathetic and sympathetic divisions of the ANS.
 These mediate reflexes that moderate the dimensions of the air passages and blood
vessels by contraction of smooth muscle.