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LECTURE 12

RESPIRATORY SYSTEM Ali Hussein

The function of the REPIRATORY SYSTEM is the transfer of oxygen in the air to the
blood and the transfer of carbon dioxide in the opposite direction. The respiratory system can PASSAGE OF
AIR

be anatomically split into the upper respiratory tract and the lower respiratory tract, connected LARYNX

by the pharynx. ↓
TRACHEA
The UPPER RESPIRATORY TRACT, compromising of the nasal cavity, paranasal ↓
PRIMARY
sinuses and the nasopharynx, is involved in the filtration, moistening and warming of inhaled BRONCHI

air, as well as the sensation of smell. The LOWER RESPIRATORY TRACT involves the SECONDARY
BRONCHI
passage of air as detailed in the column. ↓
TERTIARY
The passage of air from the upper respiratory tract to the lower respiratory is BRONCHI

constantly lined by RESPIRATORY EPITHELIUM, 30% of which consists of tall, BRONCHIOLES

pseudostratified columnar ciliated epithelial cells. These epithelial cells consist of 7-10um ALVEOLAR
DUCTS
motile structures known as CILIA, which have a core of 9+2 microtubules ↓
ALVEOLAR SACS
growing out of the basal body. These cilia coordinate the propelling of mucus
towards the pharynx. GOBLET CELLS, also 30% of the respiratory
epithelium, are involved in secreting this mucus, which traps dust.
NEUROENDOCRINE CELLS secrete various substances, such as serotonin
and calcitonin, and BASAL CELLS, which are the stem cells of the
respiratory epithelium, are also present.
Along the respiratory tract, there is a pattern of a reduction in height of
respiratory epithelium and a gradual reduction in quantities of goblet cells:
The TRACHEA is a tube that carries the passage of air from the upper respiratory
tract down to the lungs. The many C-shaped rings of cartilage (C) along its length
prevent collapse during inspiration. TRACHEALIS MUSCLE (M,T,L), a form of
smooth muscle, is found around the lumen to allow stimulated reduction of the tracheas
diameter and increase of intrathoracic pressure. The respiratory epithelium is very tall,
resting on a lamina propria rich in elastin, and highly packed with cells and blood
vessels. The submucosa contains mucoserous glands, which secrete mucus and serum.
The PRIMARY BRONCHI and SECONDARY BRONCHI have a less tall
respiratory epithelium, fewer goblet cells (G), and there are plates of cartilage (C) rather
than C-shaped rings. There is still smooth muscle (SM), but it is now a layer separating
the lamina propria (LP) and the submucosa.
The TERTIARY BRONCHI have tall columnar respiratory epithelium, but the
pseudostratification has lessened, and there are even fewer goblet and mucoserous
glands (G). The places of cartilage have lost regularity (C), but there is a complete layer
of smooth muscle exists (M), whose contraction is stimulated by the parasympathetic
nervous system.
The BRONCHIOLES are airways less than a millimetre in diameter, lacking any
cartilage or submucosal glands. Only discrete bundles of smooth muscle exist around
the respiratory epithelium (M). The respiratory epithelium is even shorter as the cells
are no longer ciliated-columnar, but ciliated-cuboidal. Goblet cells also decrease in
quantity. TERMINAL BRONCHIOLES (T) are bronchioles that secrete components
required by cells to produce lubricating surfactant. These secretions occur not from
Goblet cells, but from CLARA CELLS, which also secrete Cl-. The small terminal
bronchioles terminate into RESPIRATORY BRONCHIOLES (R), which further terminate in
ALVEOLAR DUCTS. These are made up entirely of alveoli, and supported by smooth cells, collagen
and elastin. Due to the absence of cilia and mucus, inhaled particulate matter is removed by alveolar
macrophages, which crawl back up the respiratory tract, past the pharynx
and later travel to the lymph nodes.
Alveolar Ducts (AD) terminate into ALVEOLAR SACS, which are the
sites of gas exchange. There are two main cell types in alveolar sacs; Type I
PNEUMOCYTES, which are extremely flattened squamous epithelial cells,
and TYPE II PNEUMOCYTES, which are the cells that secrete surfactant.
These Type II Pneumoctyes contains lamellar bodies that, once released by
exocytosis, combine with the secreted surfactant proteins to form a tubular
lattice that overcomes surface tension and allows the alveolar walls to separate. The Type II
Pneumoctyes are more numerous than Type I Pneumoctyes, but cover less than 10% of the alveolar
surface.
The alveolar sacs have adapted well for the immense demand for gas exchange, as the endothelial
cells of the extensive capillary plexus surrounding the alveoli share the same basal lamina as the type I
pnuemocytes, reducing the distance for diffusion to less than 0.5μm. The walls of the alveoli are
supported by bundles of elastin that condense around the opening of the sacs. A 3d network is formed
between the elastin and some collagen to support the lung parenchyma, something very important for
passive recoil. The destruction of elastin is characterised by the destruction of the alveolar walls in
Emphysema.
The PHYSIOLOGICAL DEAD SPACE is the sum of the conducting airways that do not contribute
to gas exchange, known as the ANATOMICAL DEAD SPACE, and the volume of alveoli with a poor
blood supply. The typical value for anatomical dead space is 150ml/min.
The pulmonary arteries split along the adjacent bronchi, carrying deoxygenated blood to the lungs.
These arteries are relatively thin walled and their tunica media contain many lamellae of elastin, whose
level decreases at the level of bronchioles, meaning the arteries become more muscular. Bronchial
arteries carry oxygenated blood to the bronchiolar walls, although a small proportion of that blood drains
back to the right side of the heart via the azygous and hemi-azygous veins.

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